Clinical Search for Undiagnosed Mesenteric Phlebosclerosis at Outpatient Departments Specializing in Herbal (Kampo) Medicine
Clinical Search for Undiagnosed Mesenteric Phlebosclerosis at Outpatient Departments Specializing in Herbal (Kampo) Medicine
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DOI：
10.2169/internalmedicine.55.5642
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发表时间：
2016-01-01
影响因子：
1.2
通讯作者：
Taniuchi, Norihide
中科院分区：
文献类型：
--
作者：
Nagata, Yutaka;Watanabe, Tetsuo;Taniuchi, Norihide
目的肠系膜静脉硬化（Mesenteric phlebosclerosis， MP）是一种以肠系膜静脉钙化为特征的疾病，可引起慢性肠系膜缺血。最近，长期摄入栀子果（日语“三狮狮”）作为可能的原因引起了人们的关注。通常，只有晚期、严重的MP病例才会被报道。然而，我们怀疑这种疾病可能存在一些潜伏病例。我们进行这项研究是为了确定我们门诊中草药（汉布）的预诊断病例，特别注意最初的变化，如结肠镜检查显示的结肠的任何轻微颜色变化。方法对于长期服用栀子类中草药的患者，建议进行结肠镜检查和计算机断层扫描。2013年12月至2014年11月，经患者同意后进行临床检查。结果103例长期服用栀子果的患者中，29例同意接受MP检查。14例患者行结肠镜检查。4例患者在组织学检查中因结肠膜纤维化沉积而确诊为MP。21例患者行腹部CT筛查。2例患者在CT上观察到特征性肠系膜静脉钙化。4例MP患者均服用含栀子的汉布方，疗程均在6.8年以上。其他患者没有发生MP，尽管长期食用栀子果。结论发现了潜伏和未确诊的MP病例。所有的诊断都是在仔细注意结肠镜检查和CT扫描的任何细微变化的情况下做出的。
Objective Mesenteric phlebosclerosis (MP) is a disease characterized by calcification of the mesenteric vein, which causes chronic mesenteric ischemia. Recently, the long-term intake of gardenia fruit ('Sanshishi' in Japanese) has been attracting attention as a possible cause. Usually, only advanced, severe MP cases get reported. However, we suspected that some latent cases of this disease may exist.We performed this study in order to determine the prediagnostic cases at our outpatient departments of herbal (Kampo) medicine, with particular attention paid to the initial changes, such as any slight color change of the colon, as shown in colonoscopy.Methods We recommend colonoscopy and computed tomography (CT) scans for patients with a long-term history of taking herbal medicines containing gardenia fruit. Clinical examinations were performed upon receiving patients' consent from December 2013 to November 2014.Results Of the 103 patients who took gardenia fruit long-term, 29 agreed to be checked for MP. 14 patients underwent colonoscopy. Four patients were confirmed to have MP due to the presence of fibrotic deposition of the colonic membrane on histological inspection. Twenty-one patients underwent abdominal CT screening. Characteristic calcification of the mesenteric vein was observed on CT scans in 2 patients. All 4 MP patients took Kampo formulas containing gardenia fruit for more than 6.8 years. The other patients did not develop MP, despite long-term gardenia fruit intake.Conclusion We detected the latent and undiagnosed MP cases. All diagnoses were made while paying careful attention to any slight changes in colonoscopy and CT scans.