{"id":2504,"date":"2023-12-06T17:20:06","date_gmt":"2023-12-06T08:20:06","guid":{"rendered":"https:\/\/www.hcfm.jp\/journal\/?p=2504"},"modified":"2023-12-06T17:20:06","modified_gmt":"2023-12-06T08:20:06","slug":"%e8%96%ac%e7%89%a9%e3%81%ae%e4%bd%bf%e7%94%a8%e9%81%8e%e5%a4%9a%e3%81%ab%e3%82%88%e3%82%8b%e9%a0%ad%e7%97%9bmoh-medication-overuse-headache%e3%81%ab%e5%af%be%e3%81%99%e3%82%8b-3-%e3%81%a4%e3%81%ae","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=2504","title":{"rendered":"\u85ac\u7269\u306e\u4f7f\u7528\u904e\u591a\u306b\u3088\u308b\u982d\u75db(MOH, Medication Overuse Headache)\u306b\u5bfe\u3059\u308b 3 \u3064\u306e\u6cbb\u7642\u6226\u7565 : \u7121\u4f5c\u70ba\u5316\u81e8\u5e8a\u8a66\u9a13"},"content":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d
\nCarlsen LN, Munksgaard SB, Nielsen M, et al. Comparison of 3 Treatment Strategies for Medication
\nOveruse Headache: A Randomized Clinical Trial. JAMA Neurol. 2020;77(9):1069\u20131078.<\/p>\n

\uff0d\u8981\u7d04\uff0d
\nIntroduction\uff1a<\/strong>\u4e16\u754c\u3067\u306f\u30016,000 \u4e07\u4eba\u4ee5\u4e0a\u306e\u4eba\u3005\u304c MOH \u306b\u7f79\u60a3\u3057\u3066\u3044\u308b\u3002(\u62c5\u5f53\u8005\u6ce8\uff1a\u4e00\u822c\u4eba\u53e3 \u306e\u7d04\uff11\u2212
\n \uff12%\u3068\u8a00 \u308f \u308c\u3066\u3044\u308b\u3002 )\u500b\u4eba\u306b\u3068\u3063\u3066\u5927\u304d\u306a\u8ca0\u62c5\u3068\u306a\u308a\u3001\u793e\u4f1a\u7d4c\u6e08\u7684\u306a\u554f\u984c\u3092\u5f15\u304d\u8d77\u3053\u3059\u3002
\n\u4e16\u754c\u75be\u75c5\u8ca0\u62c5\u8abf\u67fb\u3067\u3001\u969c \u5bb3\u306b\u3088\u308b\u751f\u547d\u55aa\u5931\u5e74\u6570\u306e\u4e0a\u4f4d 20 \u75be\u60a3\u306b\u8907\u6570\u56de\u53d6\u308a\u4e0a\u3052\u3089\u308c\u3066\u3044\u308b\u3002\u982d\u75db\u306e\u983b\u5ea6\u304c\u5897\u52a0\u3057\u3001\u77ed\u671f\u9593\u306e\u85ac\u7269\u4e71\u7528\u304c \u9032\u307f\u3001\u6cbb\u7642\u304c\u56f0\u96e3\u306a\u6162\u6027\u982d\u75db\u3092\u5f15\u304d\u8d77\u3053\u3059\u3053\u3068\u304c\u7279\u5fb4\u3067\u3059\u3002
\n(\u62c5\u5f53\u8005\u6ce8\uff1a\u75c5\u614b\u751f\u7406\u306f\u4e0d\u660e\u3002\u907a\u4f1d\u7d20\u56e0 \u3084 5-HT 1B\/1D \u53d7\u5bb9\u4f53\u306e\u611f\u53d7\u6027\u304b\u3002
\n\u7247\u982d\u75db\u60a3\u8005\u304c MOH \u306b\u9032\u5c55\u3059\u308b\u3053\u3068\u304c\u591a\u304f\u3001\u7fa4\u767a\u982d\u75db\u60a3\u8005\u3084 \u6bce\u65e5\u306e\u3088\u3046\u306b\u6d88\u708e\u93ae\u75db\u5264\u3092\u670d\u7528\u3059\u308b RA \u60a3\u8005\u3067\u306f MOH \u306f\u591a\u304f\u306a\u3044\u3002)
\n\u85ac\u306e\u4f7f\u3044\u3059\u304e\u306f\u3001\u65e2\u5b58\u306e\u982d\u75db\u306e\u6cbb\u7642\u304c\u4e0d\u5341\u5206\u3067\u3042\u308b\u3053\u3068\u306e\u7d50\u679c\u3067 \u3042\u308b\u304b\u3082\u3057\u308c\u307e\u305b\u3093\u3002\u8907\u6570\u306e\u6cbb\u7642\u6226\u7565\u304c\u8003\u3048\u3089\u308c\u3066\u3044\u307e\u3059\u304c\u3001\u8b70\u8ad6\u306e\u4f59\u5730\u304c\u3042\u308a\u307e\u3059\u3002<\/p>\n

\u76ee\u7684\uff1aMOH \u306e 3 \u3064\u306e\u6cbb\u7642\u6226\u7565\u3092\u6bd4\u8f03\u3059\u308b<\/strong>
\n\u30001. \u59cb\u3081\u304b\u3089\u4f11\u85ac\u3068\u4e88\u9632\u3092\u884c\u3046\u300c\u4f11\u85ac\uff0b\u4e88\u9632\u6226\u7565\u300d
\n\u30002. \u4f11\u85ac\u306f\u305b\u305a\u4e88\u9632\u3060\u3051\u306e \u300c\u4e88\u9632\u6226\u7565\u300d
\n\u30003. \u4f11\u85ac\u306e 2 \u30f6\u6708\u5f8c\u306b\u3001\u4e88\u9632\u6cbb\u7642\u3092\u4efb\u610f\u306b\u884c\u3046 \u300c\u4f11\u85ac\u6226\u7565\u300d
\n\u3000(\u30c7\u30f3\u30de\u30fc\u30af\u306e GL \u3067\u3001\u4f11\u85ac\u306f\uff12\u30f6 \u6708\u9593\u306e \u93ae\u75db\u5264\u306e\u5b8c\u5168\u4f11\u6b62\u3068\u5b9a\u7fa9\u3064\u3051\u3089\u308c\u3066\u3044\u308b\u3002)<\/p>\n

Method\uff1a<\/strong>
\n \u5bfe\u8c61\uff1a<\/strong>
\n\u30c7\u30f3\u30de\u30fc\u30af\u982d\u75db\u30bb\u30f3\u30bf\u30fc(DHC)\u306e 3 \u6b21\u533b\u7642\u306b\u7d39\u4ecb\u3055\u308c\u305f\u56fd\u969b\u982d\u75db\u5206\u985e\u7b2c 3 \u7248(\u30d9\u30fc\u30bf\u7248)\u306b\u3088\u308b MOH \u306e\u8a3a\u65ad\u3092\u53d7 \u3051\u305f\u60a3\u8005\u3002\u982d\u75db\u306e\u65e5\u6570\u3068\u85ac\u306e\u4f7f\u7528\u306f\u3001\u8a73\u7d30\u306a\u75c5\u6b74\u3068\u5c11\u306a\u304f\u3068\u3082 1 \u30f6\u6708\u5206\u306e\u30c7\u30fc\u30bf\u304c\u3042\u308b\u982d\u75db\u30ab\u30ec\u30f3\u30c0\u30fc\u304b\u3089\u78ba\u8a8d\u3057\u305f\u3002
\n \u7d44\u5165\uff1a<\/strong>
\n\u982d\u75db\u30ab\u30ec\u30f3\u30c0\u30fc\u3092\u8a18\u5165\u3067\u304d\u308b\u3053\u3068\u300118 \u6b73\u4ee5\u4e0a\u3067\u3042\u308b\u3053\u3068\u3001ICHD-3\u03b2\u306e\u57fa\u6e96\u306b\u5f93\u3063\u3066\u3001\u65e2\u5b58\u306e\u7dca\u5f35\u578b\u982d\u75db\u304a\u3088\u3073\u7247\u982d\u75db(\u30a8\u30d4\u30bd\u30fc\u30c9\u578b\u304a\u3088\u3073\u6162\u6027\u578b\u3092\u542b\u3080)\u306b\u8d77\u56e0\u3059\u308b MOH \u3067\u3042\u308b\u3053\u3068\u3001
\n\u85ac\u306e\u904e\u5270\u4f7f\u7528\u306e\u30bf\u30a4\u30d7(\u30aa\u30d4\u30aa\u30a4\u30c9\u3084\u30d0\u30eb\u30d3\u30c4\u30fc\u30eb\u9178\u3092\u6bce\u65e5\u307e\u305f\u306f\u307b\u307c\u6bce\u65e5\u4f7f\u7528\u3057\u306a\u3044)\u3001\u500b\u4eba\u306e\u8cc7\u6e90\u3001\u30e2\u30c1\u30d9\u30fc\u30b7\u30e7\u30f3\u306b\u57fa\u3065\u3044\u3066\u5916\u6765\u6cbb\u7642\u306b\u9069\u683c\u3067\u3042\u308b\u3068\u307f\u306a\u3055\u308c\u305f\u3002
\n \u9664\u5916\uff1a<\/strong>
\n\u91cd\u5ea6\u306e\u8eab\u4f53\u75be\u60a3(\u4f8b\uff1a\u91cd\u5ea6\u306e\u75bc\u75db\u306e\u4f75\u5b58\u3001\u30b3\u30f3\u30c8\u30ed\u30fc\u30eb\u4e0d\u80fd\u306a\u7cd6\u5c3f\u75c5\u3001\u91cd\u7be4\u306a\u5fc3\u81d3\u75c5\u3001\u764c)\u3001\u7cbe\u795e\u75be\u60a3 (\u6297\u3046\u3064\u85ac\u306e\u6295\u4e0e\u3001\u7cbe\u795e\u79d1\u533b\u306b\u3088\u308b\u7d99\u7d9a\u7684\u6cbb\u7642\u3001\u7cbe\u795e\u79d1\u30af\u30ea\u30cb\u30c3\u30af\u3067\u306e\u6cbb\u7642)\u3001
\n\u30a2\u30eb\u30b3\u30fc\u30eb\u30fb\u85ac\u7269\u4e2d\u6bd2\u304c\u3042\u308b\u5834\u5408\u3001\u598a \u5a20\u30fb\u6388\u4e73\u4e2d\u300112 \u30f6\u6708\u4ee5\u5185\u306b\u598a\u5a20\u4e88\u5b9a\u306e\u5834\u5408\u3001\u75c5\u6b74\u306b\u3064\u3044\u3066\u60c5\u5831\u3092\u63d0\u4f9b\u3067\u304d\u306a\u3044\u5834\u5408(\u8a00\u8a9e\u306e\u58c1\u3092\u542b\u3080)\u3001\u4ed6\u306e\u982d\u75db \u4e88\u9632\u6cbb\u7642\u3092\u884c\u3063\u3066\u3044\u308b\u5834\u5408<\/p>\n

\u7814\u7a76\u30c7\u30b6\u30a4\u30f3<\/strong>
\n\u30d7\u30ed\u30c8\u30b3\u30eb\u306f\u3001Sup. 1 \u306b\u8a18\u8f09\u3002\u524d\u5411\u304d\u7e26\u65ad\u7684\u30aa\u30fc\u30d7\u30f3\u30e9\u30d9\u30eb\u7121\u4f5c\u70ba\u5316\u81e8\u5e8a\u8a66\u9a13(RCT)\u3067\u3001\u60a3\u8005\u306f 1\uff1a1\uff1a1 \u3067\u3001\u4f11 \u85ac\uff0b\u4e88\u9632\u7fa4\u3001\u4e88\u9632\u7fa4\u3001\u4f11\u85ac\u7fa4\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u305f\u3002
\n3 \u3064\u306e\u6226\u7565\u306f\u3059\u3079\u3066\u5916\u6765\u6cbb\u7642\u3067\u3042\u3063\u305f\u3002\u60a3\u8005\u306f\u3001\u30d9\u30fc\u30b9 \u30e9\u30a4\u30f3\u3068 2 \u30ab\u6708\u30016 \u30ab\u6708\u306b\u9762\u4f1a\u3057\u3001\u6cbb\u7642\u958b\u59cb\u5f8c 1 \u30ab\u6708\u3068 4 \u30ab\u6708\u306b\u96fb\u8a71\u3067\u30d5\u30a9\u30ed\u30fc\u30a2\u30c3\u30d7\u3055\u308c\u305f\u3002
\n\u4f11\u85ac\u30a2\u30d7\u30ed\u30fc\u30c1<\/strong>
\n\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u304a\u3088\u3073\u4f11\u85ac\u7fa4\u306f\u3001\u8a13\u7df4\u3092\u53d7\u3051\u305f\u770b\u8b77\u5e2b\u304b\u3089\u4f11\u85ac\u3068 MOH \u306b\u95a2\u3059\u308b\u500b\u5225\u30a2\u30c9\u30d0\u30a4\u30b9\u3092\u53d7\u3051\u3001\u305d\u306e\u5f8c\u30012 \u30f6\u6708\u9593\u93ae\u75db\u5264\u3092\u5b8c\u5168\u306b\u4e2d\u6b62\u3057\u305f(Sup.2 \u306e\u8868 1)\u3002
\n\u4e88\u9632\u7fa4\u306f\u3001\u30d7\u30ed\u30b8\u30a7\u30af\u30c8\u306e\u8aac\u660e\u306b\u95a2\u9023\u3057\u3066\u4f11\u85ac\u306b\u3064\u3044\u3066\u7c21\u5358\u306a\u8aac\u660e\u3092\u53d7\u3051\u305f\u3060\u3051\u3067\u3001\u77ed\u671f\u9593\u306e\u85ac\u7269\u4f7f\u7528\u306e\u5236\u9650\u306f\u6c42\u3081\u3089\u308c\u306a\u304b\u3063\u305f(Sup.2 \u306e\u8868 1)\u3002
\n\u4f11\u85ac\u4e2d\u306f\u30ec\u30b9\u30ad\u30e5\u30fc\u85ac(\u30ec\u30dc\u30e1\u30d7\u30ed \u30de\u30b8\u30f3(\u30d2\u30eb\u30ca\u30df\u30f3\u00ae)\u307e\u305f\u306f\u5869\u9178\u30d7\u30ed\u30e1\u30bf\u30b8\u30f3(\u30d2\u30d9\u30eb\u30ca\u00ae)\u3001\u6700\u5927\u7528\u91cf 75 mg\/\u65e5)\u3068\u5236\u5410\u85ac(\u5869\u9178\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u307e\u305f\u306f\u30c9\u30f3\u30da\u30ea\u30c9\u30f3\u9320\u3001\u63a8\u5968\u7528\u91cf 10 mg)\u304c\u5168\u4f8b\u306b\u63d0\u4f9b\u3055\u308c\u305f\u3002
\n\u4f11\u85ac\u5f8c\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u6295\u4e0e\u7fa4\u53ca\u3073\u4f11\u85ac\u7fa4\u3067\u306f\u3001\u6708 9 \u65e5(\u5358\u7d14\u93ae\u75db\u5264\u306e\u307f\u3067\u306f\u6708 14 \u65e5)\u306e\u7bc4\u56f2\u3067\u77ed\u671f\u9593\u306e\u6295\u85ac\u304c\u53ef\u80fd\u3068\u306a\u308a\u3001\u4f11\u85ac\u7fa4\u306b\u306f\u4e88\u9632\u6295\u4e0e\u304c\u884c\u308f\u308c\u305f\u3002
\n \u4e88\u9632\u7684\u30a2\u30d7\u30ed\u30fc\u30c1<\/strong>
\n \u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u304a\u3088\u3073\u4e88\u9632\u7fa4\u306b\u306f\u3001\u30c7\u30f3\u30de\u30fc\u30af\u306e\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u5f93\u3063\u3066\u9078\u629e\u3055\u308c\u305f\u7279\u5b9a\u306e\u4e88\u9632\u6cbb\u7642\u306b\u95a2\u3059\u308b\u60c5\u5831\u304c\u63d0\u4f9b\u3055\u308c\u305f(Sup.2 \u306e\u8868 1)\u3002
\nCGRP \u95a2\u9023\u6297\u4f53\u306f\u3001\u672c\u8a66\u9a13\u306e\u6642\u70b9\u3067\u306f\u5165\u624b\u3067\u304d\u306a\u304b\u3063\u305f\u3002
\n\u30a8\u30f3\u30c9\u30dd\u30a4\u30f3\u30c8<\/strong>
\n\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee\u306f\u30013 \u3064\u306e\u6cbb\u7642\u6226\u7565\u306b\u304a\u3051\u308b\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304b\u3089 6 \u30f6\u6708\u5f8c\u307e\u3067\u306e 1 \u30f6 \u6708\u3042\u305f\u308a\u306e\u982d\u75db\u65e5\u6570\u306e\u5909\u5316 \u3002
\n\u526f\u6b21\u7684\u8a55\u4fa1\u9805\u76ee\u306f\u30013 \u3064\u306e\u6cbb\u7642\u6cd5\u306b\u3064\u3044\u3066\u4ee5\u4e0b\u306e\u9805\u76ee\u3092\u6bd4\u8f03\u3057\u305f\u3002(1)\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304b\u3089 1\u30012\u30014 \u30f5\u6708\u5f8c\u307e\u3067\u306e 1\u30f5\u6708\u3042\u305f\u308a\u306e\u982d\u75db\u65e5\u6570\u306e\u5909\u5316(2)\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304b\u3089 1\u30012\u30014\u30016 \u30f5\u6708\u5f8c\u307e\u3067\u306e1\u30f5\u6708\u3042\u305f\u308a\u306e\u7247\u982d\u75db\u65e5\u6570\u306e\u5909\u5316(3)\u30d9\u30fc\u30b9\u30e9 \u30a4\u30f3\u304b\u3089 1\u30012\u30014\u30016 \u30f5\u6708\u5f8c\u307e\u3067\u306e 1 \u30f5\u6708\u3042\u305f\u308a\u306e\u77ed\u671f\u85ac\u5264\u4f7f\u7528\u65e5\u6570\u306e\u5909\u5316(4)0 \u304b\u3089 90 \u307e\u3067\u306e 1 \u30f5\u6708\u3042\u305f\u308a\u306e\u7dcf\u982d \u75db\u5f37\u5ea6\u5f97\u70b9\u306e\u5909\u5316 (5)2 \u30f6\u6708\u5f8c\u304a\u3088\u3073 6 \u30f6\u6708\u5f8c\u306b 1 \u30f6\u6708\u3042\u305f\u308a\u306e\u982d\u75db\u65e5\u6570\u304c 50\uff05\u4ee5\u4e0a\u6e1b\u5c11\u3057\u305f\u60a3\u8005\u6570 (6)2 \u30f6\u6708\u5f8c\u304a\u3088\u3073 6 \u30f6\u6708\u5f8c\u306b\u30a8\u30d4\u30bd\u30fc\u30c9\u6027\u982d\u75db\u306b\u623b\u3063\u305f\u60a3\u8005\u6570 (7)2 \u30f6\u6708\u5f8c\u304a\u3088\u3073 6 \u30f6\u6708\u5f8c\u306b\u85ac\u306e\u4f7f\u3044\u3059\u304e\u3067\u30016 \u30f6\u6708\u5f8c\u306bMOH \u306e\u6cbb\u7652\u304c\u78ba\u8a8d\u3055\u308c\u305f\u60a3\u8005\u6570<\/p>\n

Results\uff1a <\/strong>
\n\u5bfe\u8c61\u8005<\/strong>
\n2016 \u5e74 10 \u6708 25 \u65e5\u304b\u3089 2018 \u5e74 11 \u6708 19 \u65e5\u307e\u3067\u306e MOH \u60a3\u8005\u306f 483 \u4eba\u3067\u3042\u3063\u305f\u3002
\n\u3053\u308c\u3089\u306e\u60a3\u8005\u306e\u3046\u3061\u3001195 \u4eba \u304c\u5305\u62ec\u57fa\u6e96\u3092\u6e80\u305f\u3057\u300175 \u4eba\u304c\u53c2\u52a0\u3092\u62d2\u5426\u3057\u3001120 \u4eba\u304c\u9023\u7d9a\u3057\u3066\u8a66\u9a13\u306b\u7d44\u307f\u5165\u308c\u3089\u308c\u305f(\u56f3 1)\u3002
\n40 \u540d\u306e\u60a3\u8005\u304c\u5404 \u6cbb\u7642\u6cd5\u306b\u7121\u4f5c\u70ba\u306b\u5272\u308a\u4ed8\u3051\u3089\u308c\u3001102 \u540d\u304c 6 \u30f6\u6708\u9593\u306e\u8ffd\u8de1\u8abf\u67fb\u3092\u5b8c\u4e86\u3057\u305f(\u5e73\u5747\uff3bSD\uff3d\u5e74\u9f62\uff1a43.9\uff3b11.8\uff3d \u6b73\u3001
\n\u5973\u6027 81 \u540d\uff3b79.4\uff3d\u3001\u7537\u6027 21 \u540d\uff3b20.6\uff3d)\u3001\u5408\u8a08 15\uff05\u306e\u8131\u843d\u7387(\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\uff1a40 \u540d\u4e2d 9 \u540d\uff3b22.5\uff3d\u3001\u4e88\u9632\u7fa4\uff1a40 \u540d\u4e2d 5 \u540d\uff3b12.5\uff3d\u3001\u4f11\u85ac\u7fa4\uff1a40 \u540d\u4e2d 4 \u540d\uff3b10.0\uff3d)\u306b\u76f8\u5f53\u3057\u305f\u3002\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u306e\u7279\u5fb4 \u306f 3 \u7fa4\u9593\u3067\u540c\u69d8\u3067\u3042\u3063\u305f(\u8868 1)\u3002
\n\"\"<\/a>
\n\"\"<\/a>
\n\"\"<\/a><\/p>\n

\u6708\u5225\u982d\u75db\u65e5\u6570\u306e\u5909\u5316(\u4e3b\u8981\u8a55\u4fa1\u9805\u76ee) <\/strong>
\n1 \u30f6\u6708\u306e\u982d\u75db\u65e5\u6570\u306f\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u6295\u4e0e\u7fa4\u3067 12.3 \u65e5(95\uff05CI\u30019.3-15.3)\u3001\u4e88\u9632\u6295\u4e0e\u7fa4\u3067 9.9 \u65e5(95\uff05CI\u30017.2-
\n12.6)\u3001\u4f11\u85ac\u7fa4\u3067 8.5 \u65e5(95\uff05CI\u30015.6-11.5)\u6e1b\u5c11\u3057\u307e\u3057\u305f\u30026 \u30f5\u6708\u5f8c(P = 0.20)\u3001\u3042\u308b\u3044\u306f\u305d\u306e\u4ed6\u306e\u6642\u70b9\u3067\u3082\u30013 \u7fa4 \u9593\u306b\u5dee\u306f\u306a\u304b\u3063\u305f(\u56f3 2A)\u3002
\n\u6708\u9593\u7247\u982d\u75db\u65e5\u6570\u3001\u77ed\u671f\u9593\u306e\u85ac\u7269\u4f7f\u7528\u65e5\u6570\u3001\u982d\u75db\u306e\u75db\u307f\u306e\u5f37\u3055\u306e\u5909\u5316(\u526f\u6b21\u8a55\u4fa1\u9805\u76ee)<\/strong>
\n\u56f3 2B\u301cD \u306f\u3001\u30d9\u30fc\u30b9\u30e9\u30a4\u30f3\u304b\u3089 1\u30012\u30014\u30016 \u30f5\u6708\u5f8c\u307e\u3067\u306e\u7247\u982d\u75db\u306e\u3042\u308b\u65e5\u6570\u3001\u77ed\u671f\u9593\u85ac\u3092\u4f7f\u7528\u3057\u305f\u65e5\u6570\u3001\u982d\u75db\u306e\u75db \u307f\u306e\u5f37\u3055\u306e\u5e73\u5747\u6e1b\u5c11\u91cf\u3092\u793a\u3059\u30021 \u304b\u6708\u3042\u305f\u308a\u306e\u7247\u982d\u75db\u65e5\u6570\u306f\uff0c\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067 5.0 \u65e5(95\uff05CI\uff0c1.4-8.6)\uff0c\u4e88 \u9632\u7fa4\u3067 4.1 \u65e5(95\uff05CI\uff0c1.1-7.1)\uff0c\u4f11\u85ac\u7fa4\u3067 3.3 \u65e5(95\uff05CI, 0.9-5.7 )\u77ed\u7e2e\u3057\u305f(p = 0.74)\u3002<\/p>\n

1\u30f5\u6708\u5f8c\u30011\u30f5\u6708\u3042\u305f\u308a\u306e\u77ed\u671f\u85ac\u7269\u4f7f\u7528\u65e5\u6570\u306f\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067 21.9 \u65e5(95\uff05CI\u300119.5-24.3)\u3001\u4e88\u9632\u7fa4\u3067 8.6\u65e5(95\uff05CI\u30016.6-10.6)\u3001\u4f11\u85ac\u7fa4\u3067 22.0 \u65e5(95\uff05CI\u300119.6-24.4)\u6e1b\u5c11\u3057\u3066\u3044\u305f\u3002
\n\u75db\u307f\u306e\u5f37\u3055\u306e\u30b9\u30b3\u30a2\u306f\uff0c\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067 28.1(95\uff05 CI\uff0c21.1-35.1)\uff0c \u4e88\u9632\u7fa4\u3067 23.7(95\uff05 CI\uff0c17.1- 30.2)\uff0c \u4f11\u85ac\u7fa4\u3067 20.8(95\uff05 CI\uff0c12.2-29.4) \u306b\u6e1b\u5c11\u3057\u305f(P = 0.42)\uff0e<\/p>\n

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

\u6cbb\u7642\u52b9\u679c\u3001\u30a8\u30d4\u30bd\u30fc\u30c9\u6027\u982d\u75db\u306e\u5bdb\u89e3\u3001\u304a\u3088\u3073 MOH \u306e\u6cbb\u7652<\/strong>
\n\u8868 3 \u306b\u793a\u3059\u30026 \u30f5\u6708\u5f8c\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067\u306f 31 \u4eba\u4e2d 23 \u4eba(74.2%)\u304c\u30a8\u30d4\u30bd\u30fc\u30c9\u6027\u982d\u75db\u306b\u623b\u3063\u305f\u306e\u306b\u5bfe\u3057\u3001\u4e88\u9632\u7fa4 \u3067\u306f 35 \u4eba\u4e2d 21 \u4eba(60.0%)\u3001\u4f11\u85ac\u7fa4\u3067\u306f 36 \u4eba\u4e2d 15 \u4eba(41.7%)\u3060\u3063\u305f(P = 0.03)\u3002\u30a8\u30d4\u30bd\u30fc\u30c9\u6027\u982d\u75db\u3078\u306e\u56de\u5e30\u306e RR \u306f 1.8(95\uff05CI, 1.1-2.8; P = .03)\u3067\u3042\u308a\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067\u306f\u4f11\u85ac\u7fa4\u3068\u6bd4\u8f03\u3057\u3066\u3001\u30a8\u30d4\u30bd\u30fc\u30c9\u6027\u982d\u75db\u306b\u56de\u5e30\u3059\u308b \u78ba\u7387\u304c 80\uff05\u9ad8\u3044\u3053\u3068\u306b\u76f8\u5f53\u3057\u305f\u3002
\n6 \u30f5\u6708\u5f8c\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067\u306f 31 \u4eba\u4e2d 30 \u4eba(96.8%)\u304c MOH \u3092\u6cbb\u7652\u3057\u305f\u306e\u306b\u5bfe\u3057\u3001\u4e88\u9632\u7fa4\u3067\u306f 35 \u4eba\u4e2d 26 \u4eba (74.3%)\u3001\u4f11\u85ac\u7fa4\u3067\u306f 36 \u4eba\u4e2d 32 \u4eba(88.9%)\u3067\u3057\u305f(P = 0.03)\u3002\u3053\u308c\u306f\u3001\u4f11\u85ac\uff0b\u4e88\u9632\u7fa4\u3067\u306f\u4e88\u9632\u7fa4\u306b\u6bd4\u3079\u3066 MOH \u304c\u6cbb\u7652\u3059\u308b\u78ba\u7387\u304c 30\uff05(RR\u30011.3\uff1b95\uff05CI\u30011.1-1.6)\u9ad8\u3044\u3053\u3068\u306b\u76f8\u5f53\u3059\u308b(P = 0.03)\u3002<\/p>\n

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

Discussion\uff1a <\/strong>
\n\u4f55\u5341\u5e74\u3082\u306e\u9593\u3001MOH \u60a3\u8005\u306b\u5bfe\u3059\u308b\u6700\u9069\u306a\u6cbb\u7642\u65b9\u91dd\u304c\u8b70\u8ad6\u3055\u308c\u3066\u304d\u305f\u3002\u3044\u304f\u3064\u304b\u306e\u7814\u7a76\u3067\u4f11\u85ac\u6cbb\u7642\u306e\u52b9\u679c\u304c\u63a8\u5b9a\u3055\u308c\u3001MOH \u306b\u5bfe\u3059\u308b\u4f11\u85ac\u3068\u4e88\u9632\u6cbb\u7642\u306e\u7d44\u307f\u5408\u308f\u305b\u304c\u591a\u56fd\u7c4d\u591a\u65bd\u8a2d\u5171\u540c\u7814\u7a76(COMOESTAS)\u3067\u691c\u8a3c\u3055\u308c\u307e\u3057\u305f\u3002
\n\u672c\u7814\u7a76\u306f\u3001\u8b70\u8ad6\u3055\u308c\u3066\u3044\u308b 3 \u3064\u306e\u6cbb\u7642\u6226\u7565\u3092\u76f4\u63a5\u6bd4\u8f03\u3057\u3001MOH \u60a3\u8005\u3092\u3069\u306e\u3088\u3046\u306b\u6cbb\u7642\u3059\u3079\u304d\u304b\u3068\u3044\u3046\u81e8\u5e8a\u7684\u306a \u554f\u984c\u306b\u53d6\u308a\u7d44\u3093\u3060\u3001\u6211\u3005\u306e\u77e5\u308b\u9650\u308a\u521d\u306e\u8a66\u307f\u3067\u3042\u308b\u3002\u983b\u56de\u982d\u75db\u306b\u3088\u308b MOH \u306e\u65e2\u5f80\u306e\u3042\u308b\u60a3\u8005\u3055\u3093\u306b\u306f\u3001\u65b0\u305f\u306a\u6162 \u6027\u982d\u75db\u306e\u767a\u75c7\u3084 MOH \u306e\u518d\u767a\u3092\u9632\u3050\u305f\u3081\u306b\u6709\u52b9\u306a\u85ac\u7269\u7642\u6cd5\u304c\u5fc5\u8981\u3067\u3059\u3002
\n\u9577\u6240\u3068\u77ed\u6240<\/strong>
\n\u4f11\u85ac\u6cbb\u7642\u306f\u76f2\u691c\u5316\u304c\u4e0d\u53ef\u80fd\u3067\u3042\u308a\u3001\u672c\u7814\u7a76\u306e\u30c7\u30b6\u30a4\u30f3\u306f\u3001\u3053\u306e\u81e8\u5e8a\u7684\u554f\u984c\u3092\u89e3\u6c7a\u3059\u308b\u305f\u3081\u306b\u6700\u3082\u5b9f\u73fe\u53ef\u80fd\u3067\u5b9f\u7528 \u7684\u306a\u3082\u306e\u3067\u3042\u3063\u305f\u3002\u672c\u7814\u7a76\u306e\u5927\u304d\u306a\u5f37\u307f\u306f\u3001\u81e8\u5e8a\u7684\u59a5\u5f53\u6027\u304c\u9ad8\u3044\u3053\u3068\u3067\u3042\u308b\u3002\u3053\u306e\u7d50\u679c\u306f\u3001\u307b\u3068\u3093\u3069\u306e MOH \u60a3\u8005\u306b \u5bb9\u6613\u306b\u9069\u7528\u3067\u304d\u30013 \u3064\u306e\u6cbb\u7642\u6226\u7565\u306f\u3059\u3079\u3066\u5916\u6765\u30d7\u30ed\u30b0\u30e9\u30e0\u3067\u3042\u308a\u3001\u30d7\u30e9\u30a4\u30de\u30ea\u30fc\u30b1\u30a2\u3084\u30bb\u30ab\u30f3\u30c0\u30ea\u30fc\u30b1\u30a2\u3067\u3082\u5b9f\u884c\u53ef\u80fd\u3067\u3042 \u308b\u3068\u8003\u3048\u3089\u308c\u308b\u3002\u7814\u7a76\u5bfe\u8c61\u8005\u306e 75\uff05\u4ee5\u4e0a\u304c\u3001\u5358\u7d14\u306a\u93ae\u75db\u5264\u3068\u3044\u3046 1 \u7a2e\u985e\u306e\u85ac\u306e\u904e\u5270\u4f7f\u7528\u3067\u3042\u3063\u305f\u3002
\nMOH \u306b\u306f\u3069\u306e\u6cbb\u7642\u304c\u6700\u3082\u52b9\u679c\u7684\u304b\uff1f<\/strong>
\n\u60a3\u8005 120 \u4eba\u3092\u5bfe\u8c61\u3068\u3057\u305f\u3053\u306e\u7121\u4f5c\u70ba\u5316\u81e8\u5e8a\u8a66\u9a13\u3067\u306f\u3001\u4f11\u85ac\u3068\u4e88\u9632\u85ac\u306b\u3088\u308b\u6cbb\u7642\u304c\u6700\u3082\u52b9\u679c\u7684\u3067\u30011 \u30f6\u6708\u3042\u305f\u308a\u306e \u982d\u75db\u65e5\u6570\u304c\u5e73\u5747 12.3 \u65e5\u6e1b\u5c11\u3057\u307e\u3057\u305f\u3002\u85ac\u7269\u4e71\u7528\u982d\u75db\u306e\u6cbb\u7642\u306b\u306f\u3001\u4f11\u85ac\u958b\u59cb\u6642\u304b\u3089\u4f11\u85ac\u3068\u4e88\u9632\u85ac\u3092\u4f7f\u7528\u3059\u308b\u3053\u3068 \u304c\u63a8\u5968\u3055\u308c\u307e\u3059\u3002<\/p>\n

\u3010\u958b\u50ac\u65e5\u30112023\u5e743\u67081\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

\uff0d\u6587\u732e\u540d\uff0d Carlsen LN, Munksgaard SB, Nielsen M, et al. Comparison of 3 Treatment Strategies for Medication Overuse … \u7d9a\u304d\u3092\u8aad\u3080 \u85ac\u7269\u306e\u4f7f\u7528\u904e\u591a\u306b\u3088\u308b\u982d\u75db(MOH, Medication Overuse Headache)\u306b\u5bfe\u3059\u308b 3 \u3064\u306e\u6cbb\u7642\u6226\u7565 : \u7121\u4f5c\u70ba\u5316\u81e8\u5e8a\u8a66\u9a13<\/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":[23,17],"tags":[],"class_list":["post-2504","post","type-post","status-publish","format-standard","hentry","category-23","category-17"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2504","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=2504"}],"version-history":[{"count":4,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2504\/revisions"}],"predecessor-version":[{"id":2513,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/2504\/revisions\/2513"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=2504"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=2504"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=2504"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}