{"id":961,"date":"2015-12-15T15:01:40","date_gmt":"2015-12-15T06:01:40","guid":{"rendered":"http:\/\/www.hcfm.jp\/journal\/?p=961"},"modified":"2015-12-15T15:01:40","modified_gmt":"2015-12-15T06:01:40","slug":"%e3%80%90ebm%e3%81%ae%e5%ad%a6%e3%81%b3%e3%80%91%e8%aa%8d%e7%9f%a5%e7%97%87%e6%82%a3%e8%80%85%e3%81%ae%e6%b2%bb%e7%99%82","status":"publish","type":"post","link":"https:\/\/www.hcfm.jp\/journal\/?p=961","title":{"rendered":"\u3010EBM\u306e\u5b66\u3073\u3011\u8a8d\u77e5\u75c7\u60a3\u8005\u306e\u6cbb\u7642"},"content":{"rendered":"

STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO<\/strong>
\n\u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011
\n2015\u5e7412\u67089\u65e5
\n\u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011
\n\u3042\u308b\u65e5\u306e\u65bd\u8a2d\u56de\u8a3a\u306e\u4e00\u5834\u9762\u3002
\n79\u6b73\u5973\u6027\u3000\u4eca\u5e749\u6708\u304b\u3089\u7279\u990a\u5165\u6240\u4e2d\u3000\u9244\u6b20\u4e4f\u6027\u8ca7\u8840\u3084\u983b\u5c3f\u3067\u3082\u3068\u3082\u3068\u5f53\u9662\u3078\u901a\u9662\u3055\u308c\u3066\u3044\u305f\u3002\u30a2\u30eb\u30c4\u30cf\u30a4\u30de\u30fc\u578b\u8a8d\u77e5\u75c7\u306b\u3064\u3044\u3066\u306f3\u5e74\u524d\u306b\u4ed6\u75c5\u9662\u3067\u8a3a\u65ad\u30fb\u30d5\u30a9\u30ed\u30fc\u3055\u308c\u3066\u3044\u308b\u3002\u5f53\u9662\u3067\u306eHDS-R\u306f8\u70b9\uff082\u5e74\u524d\uff09\u3002\u4eca\u5e747\u6708\u304b\u3089\u30ea\u30d0\u30b9\u30bf\u30c3\u30c1\u30d1\u30c3\u30c1\uff08\u30ea\u30d0\u30b9\u30c1\u30b0\u30df\u30f3\uff09\u5c0e\u5165\u3055\u308c\u3066\u304a\u308a9\u6708\u9803\u304b\u3089\u80cc\u4e2d\u306e\u8cbc\u4ed8\u90e8\u4f4d\u306b\u76ae\u819a\u708e\u51fa\u73fe\u3002\u4ed6\u75c5\u9662\u306e\u51e6\u65b9\u533b\u306b\u76f8\u8ac7\u3059\u308b\u3068\u8db3\u5e95\u306b\u8cbc\u308b\u3088\u3046\u6307\u793a\u3055\u308c\u305f\u3068\u306e\u3053\u3068\u3067\u5909\u66f4\u3057\u305f\u3068\u3053\u308d\u5927\u304d\u306a\u6c34\u75b1\u3092\u5f62\u6210\u300210\u6708\u3088\u308a\u30ec\u30df\u30cb\u30fc\u30eb\uff08\u30ac\u30e9\u30f3\u30bf\u30df\u30f3\uff094mg2T2\u00d7\u5185\u670d\u306b\u5909\u66f4\u3055\u308c\u305f\u3002\u65bd\u8a2d\u770b\u8b77\u5e2b\u300c\u30ec\u30df\u30cb\u30fc\u30eb\u306b\u5909\u66f4\u5f8c\u306f\u4ee5\u524d\u3088\u308a\u7720\u308a\u304c\u3061\u3067\u3059\u30fb\u30fb\u3082\u3068\u3082\u3068\u8a8d\u77e5\u75c7\u306e\u5468\u8fba\u75c7\u72b6\u306f\u5f37\u304f\u306a\u304f\u304a\u3068\u306a\u3057\u3044\u65b9\u3067\u3059\u30fb\u30fb\u300d
\n\u73fe\u5728\u306eADL\u306f\u4e00\u90e8\u4ecb\u52a9\u3067\u8eca\u6905\u5b50\u30ec\u30d9\u30eb\u3002
\n\u3053\u306e\u65b9\u304c\u8a8d\u77e5\u75c7\u6cbb\u7642\u85ac\u3092\u98f2\u307f\u7d9a\u3051\u308b\u5fc5\u8981\u306f\u3042\u308b\u306e\u304b\uff1f<\/p>\n

P\uff1b\u91cd\u5ea6\u30a2\u30eb\u30c4\u30cf\u30a4\u30de\u30fc\u578b\u8a8d\u77e5\u75c7\u3067\u8a8d\u77e5\u75c7\u6cbb\u7642\u85ac\u3092\u5185\u670d\u3057\u3066\u3044\u308b\u9ad8\u9f62\u5973\u6027
\nI(E)\uff1b\u5185\u670d\u3092\u7d99\u7d9a\u3057\u3066\u3044\u308b\u5834\u5408
\nC\uff1b\u5185\u670d\u3092\u4e2d\u65ad\u3059\u308b\u5834\u5408
\nO\uff1b\u4e88\u5f8c\u3092\u6539\u5584\u3059\u308b\u304b\uff1f<\/p>\n

STEP2\u3000\u691c\u7d22\u3057\u3066\u898b\u3064\u3051\u305f\u6587\u732e\u306e\u540d\u524d<\/strong>
\n\u3010\u898b\u3064\u3051\u305f\u8ad6\u6587\u3011
\n\u25c6Up to date\u306eCholinesterase inhibitors in the treatment of dementia\u306b\u306fDuration of therapy\u306e\u9805\u76ee\u304c\u3042\u308a\u3001ChEI\u306e\u4e2d\u65ad\u306b\u3088\u308a\u3057\u3070\u3057\u3070\u60aa\u5316\u3059\u308b\u3053\u3068\u304c\u3042\u308b\u3068\u306e\u8a18\u8f09\u3002\u95a2\u9023\u3059\u308b\u8ad6\u6587\u306f\u3044\u305a\u308c\u3082RCT\u3067\u306f\u306a\u304f\u6a2a\u65ad\u7814\u7a76\u3060\u3063\u305f\u3002
\n\u6a2a\u65ad\u7814\u7a76\uff1ahttp:\/\/www.uptodate.com\/contents\/cholinesterase-inhibitors-in-the-treatment-of-dementia\/abstract\/67?utdPopup=true<\/a><\/span>
\n \u3000\u3000\u3000\u3000\u3000\u3000http:\/\/www.uptodate.com\/contents\/cholinesterase-inhibitors-in-the-treatment-of-dementia\/abstract\/68?utdPopup=true<\/a><\/span><\/p>\n

Galantamine\u306e\u9805\u306b\u306f36\u30f6\u6708\u306f\u52b9\u679c\u6301\u7d9a\u3059\u308b\u3068\u3042\u308a\u3001\u305d\u306e\u6839\u62e0\u3068\u306a\u3063\u3066\u3044\u308b\u8ad6\u6587\u3092\u8aad\u3093\u3067\u307f\u305f\u3002
\nThe Cognitive Benefits of Galantamine Are Sustained for at Least 36 Months<\/strong>
\n\u3000http:\/\/www.uptodate.com\/contents\/cholinesterase-inhibitors-in-the-treatment-of-dementia\/abstract\/33?utdPopup=true<\/a><\/span>
\n\u2192Pubmed\u3067http:\/\/archneur.jamanetwork.com\/article.aspx?articleid=785390<\/a><\/span>
\n\u8efd\u75c7\uff5e\u4e2d\u7b49\u5ea6\u8a8d\u77e5\u75c7\u60a3\u8005\u3092\u5bfe\u8c61\u3068\u3057\u3066\u304a\u308a\u3001\u60a3\u8005\u306ePICO\u306b\u306f\u5408\u308f\u306a\u3044\u2026<\/p>\n

\u25c6Dynamed \u306eAlzheimer dementia\u3067\u306e\u85ac\u7269\u6cbb\u7642\u306e\u9805\u76ee\u306b\u306fcontinuing donepezil may slow cognitive decline compared to discontinuing donepezil\u3068\u3042\u308b\u3002\u3053\u306e\u6839\u62e0\u3068\u306a\u3063\u305fRCT\u304c\u3053\u3061\u3089
\n\u2192Donepezil and memantine for moderate-to-severe Alzheimer’s disease.<\/strong>
\n http:\/\/www.nejm.org\/doi\/full\/10.1056\/NEJMoa1106668<\/a><\/span><\/p>\n

\u25c6\u8a8d\u77e5\u75c7\u75be\u60a3\u6cbb\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f32010\u3067\u306f\u305d\u306e\u6642\u70b9\u3067\u306f\u30ea\u30d0\u30b9\u30c1\u30b0\u30df\u30f3\u30fb\u30ac\u30e9\u30f3\u30bf\u30df\u30f3\u306f\u672c\u90a6\u672a\u767a\u58f2\u3060\u3063\u305f\u304c\u3001\u91cd\u5ea6AD\u60a3\u8005\u3078\u306e\u30c9\u30cd\u30da\u30b8\u30eb24\u9031\u9593\u6cbb\u7642\u306e\u6709\u52b9\u6027\u306b\u3064\u3044\u3066\u306eRCT\u304c\u7d39\u4ecb\u3055\u308c\u3066\u3044\u308b\u3002
\n\u3000http:\/\/www.neurology-jp.org\/guidelinem\/nintisyo.html<\/a><\/span><\/p>\n

STEP3\uff1b\u8ad6\u6587\u306e\u8a55\u4fa1
\nSTEP3-1.\u8ad6\u6587\u306ePECO\u306f\u60a3\u8005\u306ePECO\u3068\u5408\u81f4\u3059\u308b\u304b\uff1f<\/strong>
\nP\uff1b\u5730\u57df\u306b\u4f4f\u307f\u30013\u30f6\u6708\u4ee5\u4e0a\u30c9\u30cd\u30da\u30b8\u30eb\u3092\u5185\u670d\u3057\u3066\u304a\u308a\u305d\u306e\u3046\u3061\u5c11\u306a\u304f\u3068\u3082\u6700\u8fd16\u9031\u9593\u306f10mg\u5185\u670d\u3057\u3066\u3044\u308b\u3001\u4e2d\u7b49\u5ea6\uff5e\u91cd\u5ea6\uff08SMMSE5-13\u70b9\uff09\u306e
\n\u30a2\u30eb\u30c4\u30cf\u30a4\u30de\u30fc\u578b\u8a8d\u77e5\u75c7\uff08\u7591\u3044\uff09\u60a3\u8005
\nI(E)\uff1b\u30c9\u30cd\u30da\u30b8\u30eb\u3092\u7d9a\u3051\u308b\/\u30e1\u30de\u30f3\u30c1\u30f3\u3092\u4f7f\u7528\u3059\u308b\/\u30c9\u30cd\u30da\u30b8\u30eb\u3068\u30e1\u30de\u30f3\u30c1\u30f3\u3092\u4f75\u7528\u3059\u308b\u306e\u306f\uff08\u30c9\u30cd\u30da\u30b8\u30eb\u30fb\u30e1\u30de\u30f3\u30c1\u30f3\u306e\u5358\u72ec\u307e\u305f\u306f\u4f75\u7528\u6cbb\u7642\u306f\uff09
\nC\uff1b\u30c9\u30cd\u30da\u30b8\u30eb\u3092\u3084\u3081\u308b\/\u30e1\u30de\u30f3\u30c1\u30f3\u3092\u4f7f\u7528\u3057\u306a\u3044\/\u30c9\u30cd\u30da\u30b8\u30eb\u3068\u30e1\u30de\u30f3\u30c1\u30f3\u3092\u4f75\u7528\u3057\u306a\u3044\u306e\u306b\u6bd4\u3079\u3066\uff08\u30d7\u30e9\u30bb\u30dc\u306b\u6bd4\u3079\u3066\uff09
\nO\uff1b52\u9031\u5f8c\u306eSMMSE\u30b9\u30b3\u30a2\u3084BADLS\u30b9\u30b3\u30a2\u306e\u5024\u306f\u826f\u304f\u306a\u308b\u304b
\n\u2192\u60a3\u8005\u306ePECO\u3068\u3000(\u5408\u81f4\u3059\u308b\u3000\u30fb\u3000\u591a\u5c11\u7570\u306a\u308b\u304cOK<\/strong><\/span>\u3000\u30fb\u3000\u5927\u304d\u304f\u7570\u306a\u308b\u305f\u3081\u4e0d\u9069\u5207)<\/p>\n

STEP3-2\u3000\u8ad6\u6587\u306e\u7814\u7a76\u30c7\u30b6\u30a4\u30f3\u306e\u8a55\u4fa1\uff1b\u5185\u7684\u59a5\u5f53\u6027\u306e\u8a55\u4fa1<\/strong>
\n\u2460\u7814\u7a76\u65b9\u6cd5\u304cRCT\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f\u96a0\u853d\u5316\u3068\u76f2\u691c\u5316\u306f\u3055\u308c\u3066\u3044\u308b\u304b\uff1f
\n\u2192\u30e9\u30f3\u30c0\u30e0\u5272\u308a\u4ed8\u3051\u304c\u3000\uff08\u3000\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09
\n\u2192\u96a0\u853d\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09
\n\u2192\u76f2\u691c\u5316\u304c\u3000\u3000\u3000\u3000\u3000\u3000\uff08\u3000\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\u3000\uff09
\n\u5b9f\u969b\u306eTable\u3067\u4ecb\u5165\u7fa4\u3068\u5bfe\u7167\u7fa4\u306f\u540c\u3058\u3088\u3046\u306a\u96c6\u56e3\u306b\u306a\u3063\u3066\u3044\u308b\u304b\uff1f
\n\u2192\uff08\u3000\u306a\u3063\u3066\u3044\u308b<\/strong><\/span>\u3000\u30fb\u3000\u306a\u3063\u3066\u3044\u306a\u3044\uff09
\n\u3069\u3046\u7570\u306a\u308b\u304b\uff1f\u3000\u4ecb\u5165\u7fa4\u306e\u65b9\u304c\u3001\u5973\u6027\u306e\u5272\u5408\u304c\u9ad8\u3044
\n\u2461 \u89e3\u6790\u65b9\u6cd5\u306fITT(intention to treat)\u304b\uff1f
\n\u2192ITT\u304c\u3000\uff08\u3055\u308c\u3066\u3044\u308b<\/strong><\/span>\u3000\u3000\u30fb\u3000\u3000\u3055\u308c\u3066\u3044\u306a\u3044\uff09<\/p>\n

STEP3-3\u3000\u8ad6\u6587\u3067\u898b\u3044\u3060\u3055\u308c\u305f\u7d50\u679c\u306e\u8a55\u4fa1<\/strong>
\nOutcome\u306b\u3064\u3044\u3066\u3001\u4ee5\u4e0b\u306e\u5024\u3092\u78ba\u8a8d\u3059\u308b
\n\u3010\u2460 \u6cbb\u7642\u52b9\u679c\u306e\u6709\u7121\uff1b P\u5024\u3092\u78ba\u8a8d\u3059\u308b\u3011
\n\u3000\u30fb\u30c9\u30cd\u30da\u30b8\u30eb\u7d99\u7d9a\u7fa4\u3067\u306f\u30c9\u30cd\u30da\u30b8\u30eb\u4e2d\u6b62\u7fa4\u3068\u6bd4\u8f03\u3057\u3066SMMSE\u30b9\u30b3\u30a2\u304c\u5e73\u5747\u30671.9\u30dd\u30a4\u30f3\u30c8\u9ad8\u304b\u3063\u305f(95%\u4fe1\u983c\u533a\u95931.3-2.5\u3001P<0.001)\u3002
\n\u3000\u3000BADLS\u30b9\u30b3\u30a2\u306f\u5e73\u5747\u30673.0\u30dd\u30a4\u30f3\u30c8\u4f4e\u304b\u3063\u305f(95%\u4fe1\u983c\u533a\u95931.8-4.3\u3001P<0.001)\u3002
\n\u3000\u30fb\u30e1\u30de\u30f3\u30c1\u30f3\u6295\u4e0e\u7fa4\u3067\u306f\u30e1\u30de\u30f3\u30c1\u30f3\u975e\u6295\u4e0e\u7fa4\u3068\u6bd4\u8f03\u3057\u3066SMMSE\u30b9\u30b3\u30a2\u304c\u5e73\u5747\u30671.2\u30dd\u30a4\u30f3\u30c8\u9ad8\u304b\u3063\u305f(95%\u4fe1\u983c\u533a\u95930.6-1.8\u3001P<0.001)\u3002
\n\u3000\u3000BADLS\u30b9\u30b3\u30a2\u306f\u5e73\u5747\u30671.5\u30dd\u30a4\u30f3\u30c8\u4f4e\u304b\u3063\u305f(95%\u4fe1\u983c\u533a\u95930.3-2.8\u3001P = 0.02)
\n\u3000\u30fb\u30c9\u30cd\u30da\u30b8\u30eb\u3068\u30e1\u30de\u30f3\u30c1\u30f3\u306e\u6709\u52b9\u6027\u306b\u306f\u4e92\u3044\u306b\u6709\u610f\u306a\u5dee\u304c\u307f\u3089\u308c\u306a\u304b\u3063\u305f\u3002(SMMSE\uff1ap=0.14\u3001BADLS\uff1ap=0.09)
\n\u3000\u30fb\u30c9\u30cd\u30da\u30b8\u30eb\u3068\u30e1\u30de\u30f3\u30c1\u30f3\u4f75\u7528\u3067\u306f\u30c9\u30cd\u30da\u30b8\u30eb\u5358\u72ec\u3092\u4e0a\u56de\u308b\u52b9\u679c\u306f\u898b\u3089\u308c\u306a\u304b\u3063\u305f\u3002(SMMSE\uff1ap=0.07\u3001BADLS\uff1ap=0.57)<\/p>\n

\u3010\u2461\u6cbb\u7642\u52b9\u679c\u306e\u5927\u304d\u3055\uff1b\u6bd4\u306e\u6307\u6a19\u3068\u5dee\u306e\u6307\u6a19\u3092\u78ba\u8a8d\u3059\u308b\u3011
\n\u3000\u9023\u7d9a\u5909\u6570\u3067\u3042\u308b\u75c7\u72b6\u30b9\u30b3\u30a2\u304c\u6307\u6a19\u3068\u306a\u3063\u3066\u304a\u308a\u7387\u304c\u6c42\u3081\u3089\u308c\u306a\u3044\u3002
\n\u3000\u5206\u6790\u306b\u3042\u305f\u3063\u3066\u3001SMMSE\u306f1.4\u30dd\u30a4\u30f3\u30c8\u3001BADLS\u306f3.5\u30dd\u30a4\u30f3\u30c8\u306e\u5dee\u3092\u3082\u3063\u3066\u81e8\u5e8a\u7684\u306b\u610f\u7fa9\u306e\u3042\u308b\u30b9\u30b3\u30a2\u3068\u3057\u3066\u3044\u308b\u3002
\n\u3010\u2462\u6cbb\u7642\u52b9\u679c\u306e\u3086\u3089\u304e\uff1b\u4fe1\u983c\u533a\u9593\u3092\u78ba\u8a8d\u3059\u308b\u3011
\n\u3000P\u5024\u3068\u540c\u69d8\u306e\u9805\u76ee\u3067\u6709\u610f\u5dee\u3042\u308a\u3002<\/p>\n

STEP4\u3000\u60a3\u8005\u3078\u306e\u9069\u7528<\/strong>
\n\u3010\u2460\u8ad6\u6587\u306e\u60a3\u8005\u3068\u3001\u76ee\u306e\u524d\u306e\u60a3\u8005\u304c\u3001\u7d50\u679c\u304c\u9069\u7528\u3067\u304d\u306a\u3044\u307b\u3069\u7570\u306a\u3063\u3066\u3044\u306a\u3044\u304b\uff1f\u3011
\n\u3000\u4f7f\u7528\u3057\u3066\u3044\u308b\u85ac\u5264\u306f\u540c\u3058ChEI\u3060\u304c\u305d\u3082\u305d\u3082\u30c9\u30cd\u30da\u30b8\u30eb\u3068\u30ac\u30e9\u30f3\u30bf\u30df\u30f3\u3001\u30ea\u30d0\u30b9\u30c1\u30b0\u30df\u30f3\u3067\u7a2e\u985e\u306f\u7570\u306a\u308b\u3002
\n\u3000\u307e\u305f\u65bd\u8a2d\u5165\u6240\u4e2d\u306e\u60a3\u8005\u3067\u3042\u308b\u70b9\u3082\u7570\u306a\u308b\u3002
\n\u3010\u2461\u6cbb\u7642\u305d\u306e\u3082\u306e\u306f\u5fe0\u5b9f\u306b\u5b9f\u884c\u53ef\u80fd\u304b\uff1f\u3011
\n\u3000\u5185\u670d\u305d\u306e\u3082\u306e\u306f\u65bd\u8a2d\u4ecb\u8b77\u8005\u304c\u624b\u52a9\u3051\u3057\u3066\u304f\u308c\u3001\u62d2\u98df\u3084\u62d2\u85ac\u306e\u75c7\u72b6\u306f\u307f\u3089\u308c\u306a\u3044\u305f\u3081\u3001\u30c9\u30cd\u30da\u30b8\u30eb10mg\u5185\u670d\u7d99\u7d9a\u3068\u3044\u3046\u6cbb\u7642\u306f\u6709\u5bb3\u4e8b\u8c61\u304c\u306a\u3051\u308c\u3070\u5b9f\u884c\u53ef\u80fd\u3068\u8003\u3048\u3089\u308c\u308b\u3002
\n\u3010\u2462\u91cd\u8981\u306a\u30a2\u30a6\u30c8\u30ab\u30e0\u306f\u30b3\u30b9\u30c8\u3084\u5bb3\u3092\u542b\u3081\u3066\u5168\u3066\u8a55\u4fa1\u3055\u308c\u305f\u304b\uff1f\u3011
\n\u3000\u30c9\u30cd\u30da\u30b8\u30eb10mg\u306f\u5f8c\u767a\u54c1\u3067\u30821\u65e5300\u70b9\u4ee5\u4e0a\u3002\u30ac\u30e9\u30f3\u30bf\u30df\u30f316mg\u3060\u3068400\u70b9\u3002\u30b3\u30b9\u30c8\u306f\u304b\u304b\u308b\u3002
\n\u3000\u305d\u3082\u305d\u3082\u30ac\u30e9\u30f3\u30bf\u30df\u30f3\u3068\u30ea\u30d0\u30b9\u30c1\u30b0\u30df\u30f3\u306f\u8efd\u5ea6\uff5e\u4e2d\u7b49\u75c7\u306e\u8a8d\u77e5\u75c7\u306b\u5bfe\u3057\u3066\u4fdd\u967a\u9069\u5fdc\u3068\u306a\u3063\u3066\u304a\u308a\u91cd\u75c7\u306b\u3064\u3044\u3066\u4fdd\u967a\u9069\u5fdc\u304c\u3042\u308b\u306e\u306f\u30c9\u30cd\u30da\u30b8\u30eb\u3068\u30e1\u30de\u30f3\u30c1\u30f3\u3002
\n\u3000\u5185\u670d\u524d\u306b\u6bd4\u3079\u3066\u50be\u7720\u306e\u526f\u4f5c\u7528\u304c\u524d\u9762\u306b\u51fa\u308b\u5834\u5408\u306f\u8ee2\u5012\u306e\u30ea\u30b9\u30af\u3082\u3042\u308a\u3001\u5185\u670d\u7d99\u7d9a\u306f\u671b\u307e\u3057\u304f\u306a\u3044\u3002
\n\u3010\u2463\u60a3\u8005\u306e\u8003\u3048\u30fb\u55dc\u597d\u306f\u3069\u3046\u306a\u306e\u304b\uff1f\u3011
\n\u3000\u73fe\u6642\u70b9\u3067\u672c\u4eba\u306f\u65bd\u8a2d\u3067\u306e\u751f\u6d3b\u306b\u6e80\u8db3\u3057\u3066\u304a\u308a\u3001\u4ecb\u8b77\u8005\u3082\u8a8d\u77e5\u75c7\u306b\u3088\u308b\u75c7\u72b6\u3067\u56f0\u96e3\u3092\u611f\u3058\u3066\u3044\u306a\u3044\u3002\u91cd\u75c7\u306e\u8a8d\u77e5\u75c7\u60a3\u8005\u3068\u8003\u3048\u308b\u3068\u8a8d\u77e5\u75c7\u6cbb\u7642\u85ac\u3092\u5185\u670d\u7d99\u7d9a\u3059\u308b\u3053\u3068\u3067\u50c5\u304b\u306eMMSE\u3084BADLS\u306e\u5024\u306e\u6539\u5584\u304c\u305d\u306e\u5f8c\u306e\u751f\u6d3b\u3092\u5927\u304d\u304f\u5909\u3048\u308b\u3068\u306f\u8003\u3048\u306b\u304f\u3044\u3002<\/p>\n

 <\/p>\n

\u3010\u958b\u50ac\u65e5\u3011
\n2015\u5e7412\u67089\u65e5\uff08\u6c34\uff09<\/p>\n","protected":false},"excerpt":{"rendered":"

STEP1\u3000\u81e8\u5e8a\u60a3\u8005\u306b\u5373\u3057\u305fPI(E)CO \u3010\u8a55\u4fa1\u3092\u884c\u3063\u305f\u65e5\u4ed8\u3011 2015\u5e7412\u67089\u65e5 \u3010\u81e8\u5e8a\u72b6\u6cc1\u306e\u30b5\u30de\u30ea\u30fc\u3011 \u3042\u308b\u65e5\u306e\u65bd\u8a2d\u56de\u8a3a\u306e\u4e00\u5834\u9762\u3002 79\u6b73\u5973\u6027\u3000\u4eca\u5e749\u6708\u304b\u3089\u7279\u990a\u5165\u6240\u4e2d\u3000\u9244\u6b20\u4e4f\u6027\u8ca7\u8840\u3084\u983b\u5c3f\u3067\u3082\u3068\u3082\u3068\u5f53\u9662\u3078\u901a\u9662\u3055\u308c\u3066 … \u7d9a\u304d\u3092\u8aad\u3080 \u3010EBM\u306e\u5b66\u3073\u3011\u8a8d\u77e5\u75c7\u60a3\u8005\u306e\u6cbb\u7642<\/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":[11],"tags":[],"class_list":["post-961","post","type-post","status-publish","format-standard","hentry","category-11"],"_links":{"self":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/961","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=961"}],"version-history":[{"count":6,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/961\/revisions"}],"predecessor-version":[{"id":967,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=\/wp\/v2\/posts\/961\/revisions\/967"}],"wp:attachment":[{"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=961"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=961"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.hcfm.jp\/journal\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=961"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}