{"id":2373,"date":"2023-08-02T13:31:00","date_gmt":"2023-08-02T04:31:00","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2373"},"modified":"2023-08-02T13:31:00","modified_gmt":"2023-08-02T04:31:00","slug":"%e6%88%90%e4%ba%ba%e3%81%ae%e4%b8%8d%e7%9c%a0%e7%97%87%e6%b2%bb%e7%99%82%e8%96%ac%e3%81%ae%e3%83%8d%e3%83%83%e3%83%88%e3%83%af%e3%83%bc%e3%82%af%e3%83%a1%e3%82%bf%e3%82%a2%e3%83%8a%e3%83%aa%e3%82%b7","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2373","title":{"rendered":"\u6210\u4eba\u306e\u4e0d\u7720\u75c7\u6cbb\u7642\u85ac\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\uff08NMA\uff09"},"content":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002<\/p>\n

-\u6587\u732e\u540d-
\nDe Crescenzo F, D’Al\u00f2 GL, Ostinelli EG, et al. Comparative effects of pharmacological interventions for the acute and long-term management of insomnia disorder in adults: a systematic review and network meta-analysis. Lancet. 2022 Jul 16;400(10347):170-184.<\/p>\n

-\u8981\u7d04-
\nIntroduction\uff1a\u4e0d\u7720\u75c7\u306f\u4e00\u822c\u4eba\u53e3\u306b\u975e\u5e38\u306b\u3088\u304f\u307f\u3089\u308c\u308b\u75be\u60a3\u3067\u3001\u6162\u6027\u7684\u306a\u7d4c\u904e\u3092\u305f\u3069\u308a\u3001\u60a3\u8005\u304a\u3088\u3073\u533b\u7642\u5236\u5ea6\u306b\u5927\u304d\u306a\u8ca0\u62c5\u3092\u304b\u3051\u3066\u3044\u308b\u3002 \u975e\u85ac\u7406\u5b66\u7684\u4ecb\u5165\u3068\u85ac\u7406\u5b66\u7684\u4ecb\u5165\u306e\u4e21\u65b9\u304c\u5229\u7528\u3067\u304d\u308b\u304c\u3001\u85ac\u7269\u306f\u304b\u306a\u308a\u306e\u6709\u5bb3\u4e8b\u8c61\uff08\u3059\u306a\u308f\u3061\u3001\u8ee2\u5012\uff3b\u7279\u306b\u9ad8\u9f62\u8005\uff3d\uff09\u3068\u95a2\u9023\u3057\u3066\u3044\u308b\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u3001\u5229\u7528\u3057\u3084\u3059\u3044\u305f\u3081\u3057\u3070\u3057\u3070\u51e6\u65b9\u3055\u308c\u308b\u3002\u85ac\u7406\u5b66\u7684\u6cbb\u7642\u306f\u3001\u307b\u3068\u3093\u3069\u304c\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u3067\u8abf\u67fb\u3055\u308c\u3066\u3044\u308b\u305f\u3081\u3001\u305d\u306e\u6bd4\u8f03\u52b9\u679c\u306b\u3064\u3044\u3066\u306f\u307b\u3068\u3093\u3069\u60c5\u5831\u304c\u3042\u308a\u307e\u305b\u3093\u3002\u79d1\u5b66\u6587\u732e\u306e\u4e2d\u3067\u3001\u6211\u3005\u306f5\u3064\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u5206\u6790\u3092\u898b\u3064\u3051\u305f\u304c\u3001\u3053\u308c\u3089\u306f\u975e\u5e38\u306b\u7279\u5b9a\u306e\u96c6\u56e3\uff08\u4f8b\u3048\u3070\u3001\u9ad8\u9f62\u8005\u307e\u305f\u306f\u81ea\u5df1\u514d\u75ab\u75be\u60a3\u3068\u8a3a\u65ad\u3055\u308c\u305f\u4eba\uff09\u306b\u306e\u307f\u7126\u70b9\u3092\u5f53\u3066\u3066\u3044\u308b\u304b\u3001\u91cd\u8981\u306a\u65b9\u6cd5\u8ad6\u306e\u5236\u9650\uff08\u4f8b\u3048\u3070\u3001\u30d7\u30e9\u30bb\u30dc\u5bfe\u7167\u8a66\u9a13\u306e\u307f\u307e\u305f\u306f\u85ac\u7406\u7642\u6cd5\u306e\u5c0f\u3055\u306a\u30b5\u30d6\u30bb\u30c3\u30c8\u3092\u542b\u3080\uff09\u304c\u3042\u3063\u305f\u3002\u3053\u306e\u30ae\u30e3\u30c3\u30d7\u3092\u57cb\u3081\u308b\u305f\u3081\u306b\u3001\u6211\u3005\u306f\u3001\u6025\u6027\u304a\u3088\u3073\u9577\u671f\u6cbb\u7642\u306e\u4e0d\u7720\u75c7\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u8a8d\u53ef\u304a\u3088\u3073\u975e\u8a8d\u53ef\u85ac\u3092\u542b\u3080\u4f53\u7cfb\u7684\u30ec\u30d3\u30e5\u30fc\u3068\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u5206\u6790\u3092\u884c\u3063\u305f\u3002<\/p>\n

Method\uff1a\u3053\u306e\u7cfb\u7d71\u7684\u30ec\u30d3\u30e5\u30fc\u304a\u3088\u3073\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u5206\u6790\u3067\u306f\uff0c\u30c7\u30fc\u30bf\u30d9\u30fc\u30b9\u958b\u8a2d\u304b\u30892021\u5e7411\u670825\u65e5\u307e\u3067\u306bCochrane Central Register of Controlled Trials\uff0cMEDLINE\uff0cPubMed\uff0cEmbase\uff0cPsycINFO\uff0cWHO International Clinical Trials Registry Platform\uff0cClinicalTrials.gov \u304a\u3088\u3073\u898f\u5236\u6a5f\u95a2\u306e\u30a6\u30a7\u30d6\u30b5\u30a4\u30c8\u3092\u691c\u7d22\u3057\uff0c\u516c\u958b\u304a\u3088\u3073\u672a\u767a\u8868\u306e\u30e9\u30f3\u30c0\u30e0\u5316\u5bfe\u7167\u8a66\u9a13\u306b\u3064\u3044\u3066\u660e\u3089\u304b\u306b\u3057\u305f\u3002\u7279\u5b9a\u306e\u8a3a\u65ad\u57fa\u6e96\u3067\u8a3a\u65ad\u3055\u308c\u305f\u6210\u4eba\uff0818\u6b73\u4ee5\u4e0a\uff09\u306e\u4e0d\u7720\u75c7\u969c\u5bb3\u306b\u5bfe\u3059\u308b\u6cbb\u7642\u3068\u3057\u3066\u3001\u85ac\u7269\u7642\u6cd5\u307e\u305f\u306f\u30d7\u30e9\u30bb\u30dc\u3092\u5358\u5264\u3067\u6bd4\u8f03\u3057\u305f\u7814\u7a76\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3002NMA\u3067\u306f\u30af\u30e9\u30b9\u30bf\u30fc\u7121\u4f5c\u70ba\u5316\u8a66\u9a13\u307e\u305f\u306f\u30af\u30ed\u30b9\u30aa\u30fc\u30d0\u30fc\u8a66\u9a13\u3001\u304a\u3088\u3073\u4e8c\u6b21\u6027\u4e0d\u7720\u75c7\uff08\u7cbe\u795e\u75be\u60a3\u307e\u305f\u306f\u8eab\u4f53\u7684\u306a\u4f75\u5b58\u75be\u60a3\u306b\u3088\u308b\u4e0d\u7720\u75c7\u3001\u85ac\u7269\u307e\u305f\u306f\u30a2\u30eb\u30b3\u30fc\u30eb\u306a\u3069\u306e\u7269\u8cea\u306b\u3088\u308b\u4e0d\u7720\u75c7\uff09\u60a3\u8005\u304c\u542b\u307e\u308c\u308b\u8a66\u9a13\u306f\u9664\u5916\u3057\u305f\u3002\u4fe1\u983c\u6027\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u89e3\u6790\uff08CINeMA\uff09\u30d5\u30ec\u30fc\u30e0\u30ef\u30fc\u30af\u3092\u7528\u3044\u3066\u3001\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u78ba\u5b9f\u6027\u3092\u8a55\u4fa1\u3057\u305f\u3002\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u3001\u6025\u6027\u671f\u6cbb\u7642\u3068\u9577\u671f\u6cbb\u7642\u306e\u4e21\u65b9\u3067\u3001\u6709\u52b9\u6027\uff08\u3059\u306a\u308f\u3061\u3001\u4efb\u610f\u306e\u81ea\u5df1\u8a55\u4fa1\u5c3a\u5ea6\u3067\u6e2c\u5b9a\u3057\u305f\u7761\u7720\u306e\u8cea\uff09\u3001\u4f55\u3089\u304b\u306e\u7406\u7531\u304a\u3088\u3073\u7279\u306b\u526f\u4f5c\u7528\u306b\u3088\u308b\u6cbb\u7642\u4e2d\u6b62\u3001\u5b89\u5168\u6027\uff08\u3059\u306a\u308f\u3061\u3001\u5c11\u306a\u304f\u3068\u30821\u3064\u306e\u6709\u5bb3\u4e8b\u8c61\u3092\u793a\u3057\u305f\u60a3\u8005\u6570\uff09\u3067\u3042\u3063\u305f\u3002\u6a19\u6e96\u5316\u5e73\u5747\u5dee\uff08SMD\uff09\u304a\u3088\u3073\u30aa\u30c3\u30ba\u6bd4\uff08OR\uff09\u306f\u3001\u30e9\u30f3\u30c0\u30e0\u52b9\u679c\u306b\u3088\u308b\u30da\u30a2\u30ef\u30a4\u30ba\u30e1\u30bf\u89e3\u6790\u304a\u3088\u3073\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u89e3\u6790\u3092\u7528\u3044\u3066\u63a8\u5b9a\u3057\u305f\u3002\u672c\u7814\u7a76\u306fOpen Science Framework, https:\/\/doi.org\/10.17605\/OSF.IO\/PU4QJ \u306b\u767b\u9332\u3055\u308c\u3066\u3044\u308b\u3002\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30fb\u30ec\u30d3\u30e5\u30fc\u306b\u306f170\u8a66\u9a13\uff0836\u4ecb\u5165\u30014\u4e077,950\u4f8b\uff09\u3001\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30fb\u30e1\u30bf\u89e3\u6790\u306b\u306f\u7121\u4f5c\u70ba\u5316\u4e8c\u91cd\u76f2\u691c\u6bd4\u8f03\u8a66\u9a13154\u8a66\u9a13\uff0830\u4ecb\u5165\u30014\u4e074,089\u4f8b\uff09\u304c\u7d44\u307f\u8fbc\u307e\u308c\u305f\u3002<\/p>\n

Results\uff1a
\n\u30fb\u6025\u6027\u6cbb\u7642\u306b\u304a\u3044\u3066\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\uff08\u77ed\u6642\u9593\u4f5c\u7528\u578b\u3001\u4e2d\u9593\u4f5c\u7528\u578b\u3001\u9577\u6642\u9593\u4f5c\u7528\u578b\uff09\u3001\u30c9\u30ad\u30b7\u30e9\u30df\u30f3\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u3001\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u3001\u30be\u30eb\u30d4\u30c7\u30e0\u3001\u30be\u30d4\u30af\u30ed\u30f3\u306f\u3001\u30d7\u30e9\u30bb\u30dc\u3088\u308a\u6709\u52b9\u3067\u3042\u308a\u3001SMD\uff08\u6a19\u6e96\u504f\u5dee\uff08SD\uff09\u306e\u5358\u4f4d\u3068\u3057\u3066\u4ecb\u5165\u52b9\u679c\u3092\u8868\u3059\uff09\u306f0.36\u304b\u30890.83\u306e\u7bc4\u56f2\u3060\u3063\u305f\uff08\u8a3c\u62e0\u306e\u78ba\u5b9f\u6027\u306f\u4e2d\u7a0b\u5ea6\u304b\u3089\u9ad8\u5ea6\u3067\u3042\u308b\uff09\u3002
\n\u30fb\u9577\u671f\u6cbb\u7642\u3067\u306f\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u304a\u3088\u3073\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u306f\u30d7\u30e9\u30bb\u30dc\u3088\u308a\u3082\u6709\u52b9\u3067\u3042\u3063\u305f\uff08\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u3002SMD 0.63 [95% CI 0.36-0.90\uff1b\u975e\u5e38\u306b\u4f4e\u3044]\u3001\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8 0.41 [0.04-0.78\uff1b \u975e\u5e38\u306b\u4f4e\u3044]\uff09\u3002
\n\u30fb\u76f4\u63a5\u6bd4\u8f03\u3067\u306f\u3001\u6295\u4e0e4\u9031\u9593\u5f8c\u3001\u77ed\u6642\u9593\u4f5c\u7528\u578b\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u306f\u30c0\u30ea\u30c9\u30ec\u30ad\u30b5\u30f3\u30c8\u3001\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u3001\u30b6\u30ec\u30d7\u30ed\u30f3\u3088\u308a\u52b9\u679c\u304c\u9ad8\u304f\uff08SMDs 0.47-0.64\uff3b\u9ad8\u301c\u4e2d\uff3d\uff09\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u3068\u30be\u30eb\u30d4\u30c7\u30e0\u306f\u30b6\u30ec\u30d7\u30ed\u30f3\u3088\u308a\u52b9\u679c\u304c\u9ad8\u304f\uff08\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3: 0.33\uff3b0.08-0.58\uff1b \u4e2d\uff3d\u3001\u30be\u30eb\u30d4\u30c7\u30e0\uff1a 0.27 \uff3b0.08-0.45\uff1b \u4e2d\uff3d\u3001\u56f33\uff09\u3001\u77ed\u6642\u9593\u4f5c\u7528\u578b\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u306f\u3001\u30b6\u30ec\u30d7\u30ec\u30af\u30b5\u30f3\u30c8\u306b\u6bd4\u3079\u6709\u52b9\u3067\u3057\u305f\uff08SMDs 0.42\uff3b1.42\uff3d\uff09\u3002
\n\u30fb\u6025\u6027\u671f\u6cbb\u7642\u306b\u304a\u3044\u3066\u3001\u4e2d\u6642\u9593\u4f5c\u7528\u578b\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\u3001\u9577\u6642\u9593\u4f5c\u7528\u578b\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u306f\u3001\u30e9\u30e1\u30eb\u30c6\u30aa\u30f3\u3088\u308a\u3082\u4f55\u3089\u304b\u306e\u539f\u56e0\u306b\u3088\u308b\u4e2d\u6b62\u304c\u5c11\u306a\u304b\u3063\u305f(\u56f33)\u3002 (\u4e2d\u4f5c\u7528\u578b\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\u3002OR 0.72\uff3b95\uff05CI\uff1a0.52-0.99\uff1b\u4e2d\u7a0b\u5ea6\uff3d\uff1b\u9577\u6642\u9593\u4f5c\u7528\u578b\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u30020.70\uff3b0.51-0.95\uff1b\u4e2d\u7b49\u5ea6\uff3d\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\uff1a0.71\uff3b0.52-0.98\uff1b\u4e2d\u7b49\u5ea6\uff3d)
\n\u30fb\u9577\u671f\u6295\u4e0e\u3067\u306f\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u3068\u30be\u30eb\u30d4\u30c7\u30e0\u306f\u30e9\u30e1\u30eb\u30c6\u30aa\u30f3\u3088\u308a\u3082\u6295\u4e0e\u4e2d\u6b62\u304c\u5c11\u306a\u304b\u3063\u305f\uff08\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\uff1aOR0.43\uff3b95\uff05CI\uff3d\u3001\u30be\u30eb\u30d4\u30c7\u30e0\uff1aOR0.98\uff3b95\uff05CI\uff3d\uff09\u3002OR 0.43\uff3b95\uff05CI0.20-0.93\uff1b\u975e\u5e38\u306b\u4f4e\u3044\uff3d\u3001\u30be\u30eb\u30d4\u30c7\u30e0\uff1a0.43\uff3b0.19.0.95\uff1b\u975e\u5e38\u306b\u4f4e\u3044\uff3d\u3001\u56f33)\u3002
\n\u30fb\u30be\u30d4\u30af\u30ed\u30f3\u3068\u30be\u30eb\u30d4\u30c7\u30e0\u306f\u3001\u6cbb\u76424\u9031\u9593\u5f8c\u306b\u30d7\u30e9\u30bb\u30dc\u3088\u308a\u3082\u6709\u5bb3\u4e8b\u8c61\u306b\u3088\u308b\u8131\u843d\u304c\u591a\u304b\u3063\u305f\uff08\u30be\u30d4\u30af\u30ed\u30f3\uff1a2.00\uff3b1.28-3.13\u3001\u975e\u5e38\u306b\u4f4e\u3044\uff3d\u3001\u30be\u30eb\u30d4\u30c7\u30e0\uff1a1.79\uff3b1.25-2.50\u3001\u4e2d\u7b49\u5ea6\uff3d\uff09\u3002
\n\u30fb\u30be\u30d4\u30af\u30ed\u30f3\u3067\u306f\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u3001\u30c0\u30ea\u30c9\u30ec\u30ad\u30b5\u30f3\u30c8\u3001\u30b9\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u306b\u6bd4\u3079\u3066\u6709\u5bb3\u4e8b\u8c61\u306b\u3088\u308b\u8131\u843d\u304c\u591a\u304b\u3063\u305f\uff08\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f31.82\uff3b1.01-3.33\uff3d\u3001\u4f4e\uff09\uff08\u30c0\u30ea\u30c9\u30ec\u30ad\u30b5\u30f3\u30c83.45\uff3b1.41-8.33\u3001\u4f4e\uff09\uff08\u30b9\u30dc\u30ec\u30ad\u30b5\u30f3\u30c83.13\uff3b1.47-6.67\u3001\u4f4e\uff3d\uff09\u3001\u56f34\uff09\u3002
\n\u30fb\u8a66\u9a13\u7d42\u4e86\u6642\u306b\u526f\u4f5c\u7528\u3092\u5831\u544a\u3057\u305f\u60a3\u8005\u6570\u3067\u306f\u3001\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u3001\u30be\u30eb\u30d4\u30c7\u30e0\u3001\u30be\u30d4\u30af\u30ed\u30f3\u304c\u3001\u30d7\u30e9\u30bb\u30dc\u3001\u30c9\u30af\u30bb\u30d4\u30f3\u3001\u30bb\u30eb\u30c8\u30ec\u30ad\u30b5\u30fc\u30c8\u3001\u30b6\u30ec\u30d7\u30ed\u30f3\u3088\u308a\u526f\u4f5c\u7528\u306e\u5831\u544a\u304c\u591a\u304f\uff08 OR \u7bc4\u56f2 1.27-2.78 [high to very low] \uff09\u3001\u30be\u30d4\u30af\u30ed\u30f3\u3082\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u3001\u30e1\u30e9\u30c8\u30cb\u30f3\u3001\u30e9\u30e1\u30eb\u30c6\u30aa\u30f3\u3001\u30b9\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u3088\u308a\u591a\u304f\u306a\u308a\u307e\u3057\u305f \uff08\u56f34\uff09<\/p>\n

Discussion\uff1a
\n\u30fb\u6025\u6027\u671f\u304a\u3088\u3073\u9577\u671f\u6cbb\u7642\u306b\u304a\u3051\u308b\u3059\u3079\u3066\u306e\u7d50\u679c\u3092\u8003\u616e\u3059\u308b\u3068\u3001\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u3068\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u306f\u6709\u52b9\u6027\uff08\u81e8\u5e8a\u7684\u306b\u95a2\u9023\u3059\u308b\u4e3b\u8981\u30a2\u30a6\u30c8\u30ab\u30e0\u3067\u3042\u308b\u7761\u7720\u306e\u8cea\uff09\u3001\u53d7\u5bb9\u6027\uff08\u4f55\u3089\u304b\u306e\u539f\u56e0\u306b\u3088\u308b\u4e2d\u6b62\uff09\u3001\u304a\u3088\u3073\u5fcd\u5bb9\u6027\uff08\u4f55\u3089\u304b\u306e\u6709\u5bb3\u4e8b\u8c61\u306b\u3088\u308b\u4e2d\u6b62\uff09\u306e\u70b9\u3067\u6700\u9ad8\u306e\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u3092\u6709\u3057\u3066\u3044\u305f\u3002\u3057\u304b\u3057\u3001\u30a8\u30b9\u30be\u30d4\u30af\u30ed\u30f3\u306f\u304b\u306a\u308a\u306e\u6709\u5bb3\u4e8b\u8c61\u3092\u5f15\u304d\u8d77\u3053\u3059\u6050\u308c\u304c\u3042\u308a\u3001\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u306b\u95a2\u3059\u308b\u5b89\u5168\u6027\uff08\u5c11\u306a\u304f\u3068\u30821\u3064\u306e\u6709\u5bb3\u4e8b\u8c61\uff09\u30c7\u30fc\u30bf\u306f\u7d50\u8ad6\u306b\u81f3\u3063\u3066\u3044\u306a\u3044\u3002\u30d9\u30f3\u30be\u30b8\u30a2\u30bc\u30d4\u30f3\u7cfb\u85ac\u5264\uff08\u77ed\u6642\u9593\u4f5c\u7528\u578b\u3001\u4e2d\u9593\u4f5c\u7528\u578b\u3001\u9577\u6642\u9593\u4f5c\u7528\u578b\uff09\u306f\u6025\u6027\u671f\u306e\u6cbb\u7642\u306b\u306f\u975e\u5e38\u306b\u6709\u52b9\u3067\u3042\u308b\u304c\u3001\u5fcd\u5bb9\u6027\u3068\u5b89\u5168\u6027\u306e\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u306f\u597d\u307e\u3057\u304f\u306a\u3044\u3002\u6700\u3082\u91cd\u8981\u306a\u3053\u3068\u306f\u3001\u9577\u671f\u9593\u306e\u8a66\u9a13\u30c7\u30fc\u30bf\u304c\u306a\u3044\u305f\u3081\u3001\u3053\u308c\u3089\u306e\u85ac\u5264\u306e\u81e8\u5e8a\u52b9\u679c\u3092\u9069\u5207\u306b\u8a55\u4fa1\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u3044\u3053\u3068\u3067\u3042\u3063\u305f\u3002
\n\u30fb\u6211\u3005\u306e\u5206\u6790\u3067\u306f\u3001\u30ec\u30f3\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u306f\u77ed\u671f\u3001\u9577\u671f\u3068\u3082\u306b\u7761\u7720\u3092\u6539\u5584\u3059\u308b\u6700\u3082\u6709\u52b9\u306a\u30aa\u30ec\u30ad\u30b7\u30f3\u62ee\u6297\u85ac\u3067\u3042\u308a\u3001\u30bb\u30eb\u30c8\u30ec\u30ad\u30b5\u30f3\u30c8\u3068\u30b9\u30dc\u30ec\u30ad\u30b5\u30f3\u30c8\u306f\u3088\u308a\u826f\u3044\u5fcd\u5bb9\u6027\u30d7\u30ed\u30d5\u30a1\u30a4\u30eb\u3092\u6709\u3057\u3066\u3044\u305f\u3002
\n[\u9650\u754c]
\n\u30fbCINeMA\u306b\u3088\u308b\u3068\u3001\u7279\u306b\u9577\u671f\u306e\u30bf\u30a4\u30e0\u30dd\u30a4\u30f3\u30c8\u3067\u306f\u3001\u591a\u304f\u306e\u6bd4\u8f03\u3092\u8cea\u304c\u4f4e\u3044\u304b\u975e\u5e38\u306b\u4f4e\u3044\u3068\u8a55\u4fa1\u3057\u3001\u591a\u304f\u306e\u8a66\u9a13\u304c\u7121\u4f5c\u70ba\u5316\u3068\u5272\u4ed8\u96a0\u853d\u306b\u95a2\u3059\u308b\u5341\u5206\u306a\u60c5\u5831\u3092\u5831\u544a\u3057\u3066\u3044\u306a\u3044\u305f\u3081\u3001\u3053\u308c\u3089\u306e\u7d50\u679c\u306e\u89e3\u91c8\u306b\u306f\u9650\u754c\u304c\u3042\u308b\u3002
\n\u30fb\u8eab\u4f53\u7684\u4f75\u5b58\u75be\u60a3\u304a\u3088\u3073\u6cbb\u7642\u62b5\u6297\u6027\u4e0d\u7720\u75c7\u306e\u60a3\u8005\u3092\u9664\u5916\u3057\u305f\u305f\u3081\u3001\u3053\u308c\u3089\u306e\u81e8\u5e8a\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u3078\u306e\u7d50\u679c\u306e\u9069\u7528\u6027\u304c\u5236\u9650\u3055\u308c\u308b\u304b\u3082\u3057\u308c\u306a\u3044\u3002
\n\u30fb\u6211\u3005\u306f\u5e73\u5747\u7684\u306a\u6cbb\u7642\u52b9\u679c\u306e\u307f\u3092\u5206\u6790\u3057\u3001\u500b\u3005\u306e\u60a3\u8005\u30ec\u30d9\u30eb\u3067\u306e\u6cbb\u7642\u53cd\u5fdc\u306e\u6f5c\u5728\u7684\u306b\u91cd\u8981\u306a\u81e8\u5e8a\u7684\u304a\u3088\u3073\u4eba\u53e3\u7d71\u8a08\u5b66\u7684\u4fee\u98fe\u56e0\u5b50\uff08\u4f8b\u3048\u3070\u3001\u6027\u5225\u3001\u75c7\u72b6\u306e\u91cd\u75c7\u5ea6\u3001\u304a\u3088\u3073\u7f79\u75c5\u671f\u9593\uff09\u3092\u8abf\u67fb\u3059\u308b\u3053\u3068\u304c\u3067\u304d\u306a\u304b\u3063\u305f\u3002\u307e\u305f\u3001\u6b63\u5f0f\u306a\u8cbb\u7528\u5bfe\u52b9\u679c\u5206\u6790\u306f\u884c\u308f\u305a\u3001\u7279\u5b9a\u306e\u6709\u5bb3\u4e8b\u8c61\u306b\u95a2\u3059\u308b\u30c7\u30fc\u30bf\u306f\u500b\u3005\u306e\u7814\u7a76\u9593\u3067\u4e00\u8cab\u3057\u3066\u5831\u544a\u3055\u308c\u3066\u3044\u307e\u305b\u3093\u3067\u3057\u305f\u3002\u3053\u306e\u3053\u3068\u306f\u3001\u60a3\u8005\u3084\u81e8\u5e8a\u533b\u304c\u6cbb\u7642\u306e\u6709\u52b9\u6027\u3084\u53d7\u5bb9\u6027\u3060\u3051\u3067\u306a\u304f\u3001\u526f\u4f5c\u7528\u306e\u767a\u751f\u7387\u3084\u91cd\u7be4\u5ea6\u3082\u8003\u616e\u3057\u3066\u81ea\u3089\u5224\u65ad\u3059\u308b\u305f\u3081\u3001\u91cd\u8981\u306a\u5236\u7d04\u3068\u306a\u308a\u307e\u3059\u3002<\/p>\n

\"\"<\/a><\/p>\n

\"\"<\/a><\/p>\n

\u3010\u958b\u50ac\u65e5\u30112022\u5e749\u67087\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\u203b\u3053\u306e\u6642\u671f\u306eUpToDate\u306b\u3042\u308b\u201dWhat\u2019s new in family medicine\u201d\u306eTopic\u3067\u53c2\u8003\u306b\u3055\u308c\u3066\u3044\u308b\u6587\u732e\u3067\u3059\u3002 -\u6587\u732e\u540d- De Crescenzo F, D’Al\u00f2 GL, Ost … \u7d9a\u304d\u3092\u8aad\u3080 \u6210\u4eba\u306e\u4e0d\u7720\u75c7\u6cbb\u7642\u85ac\u306e\u30cd\u30c3\u30c8\u30ef\u30fc\u30af\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\uff08NMA\uff09<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[33,15],"tags":[],"class_list":["post-2373","post","type-post","status-publish","format-standard","hentry","category-whats-new","category-15"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2373","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=2373"}],"version-history":[{"count":1,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2373\/revisions"}],"predecessor-version":[{"id":2376,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2373\/revisions\/2376"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2373"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2373"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2373"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}