medicina58巻3号

2021年03月発行

特集 いまさら聞けない！ 肝胆膵疾患—みなさんのギモンに答えます 肝硬変の診断と合併症に対する治療

筋痙攣（こむらがえり）や痒みの治療

著者： 澤田保彦¹ 赤羽たけみ¹ 吉治仁志¹

所属機関： ¹奈良県立医科大学消化器内科学講座

ページ範囲：P.470 - P.473

Question 1
肝硬変症例の筋痙攣（こむらがえり）の治療はどうすればよいですか？

参考文献

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2）Iwasa M, et al：Relationship of muscle cramps to quality of life and sleep disturbance in patients with chronic liver diseases；A nationwide study. Liver Int 38：2309-2316, 2018

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4）Sawada Y, et al：The effects of diuretic use and the presence of ascites on muscle cramps in patients with cirrhosis；A nationwide study. J Gastroenterol 55：868-876, 2020

5）Mehta SS, Fallon MB：Muscle cramps in cirrhosis；A moving target. Clin Gastroenterol Hepatol 13：1544-1546, 2015

6）Vidot H, et al：Systematic review；The treatment of muscle cramps in patients with cirrhosis. Aliment Pharmacol Ther 40：221-232, 2014

7）Lee FY, et al：A randomized controlled trial of quinidine in the treatment of cirrhotic patients with muscle cramps. J Hepatol 12：236-240, 1991

8）Vidot H, et al：Randomised clinical trial；Oral taurine supplementation versus placebo reduces muscle cramps in patients with chronic liver disease. Aliment Pharmacol Ther 48：704-712, 2018

9）Hiraoka A, et al：Clinical features of liver cirrhosis patients with muscle cramping；A multicenter study. Eur J Gastroenterol Hepatol 31：1557-1562, 2019

10）Nakanishi H, et al：L-carnitine reduces muscle cramps in patients with cirrhosis. Clin Gastroenterol Hepatol 13：1540-1543, 2015

11）熊田　卓，他：TJ-68ツムラ芍薬甘草湯の筋痙攣（肝硬変に伴うもの）に対するプラセボ対照二重盲検群間比較試験．臨床医薬15：499-523, 1999

12）Hidaka H, et al：The efficacy of nocturnal administration of branched-chain amino acid granules to improve quality of life in patients with cirrhosis. J Gastroenterol 48：269-276, 2013

13）Oeda S, et al：Prevalence of pruritus in patients with chronic liver disease；A multicenter study. Hepatol Res 48：E252-E262, 2018

14）Kumada H, et al：Efficacy of nalfurafine hydrochloride in patients with chronic liver disease with refractory pruritus；A randomized, double-blind trial. Hepatol Res 47：972-982, 2017