{"id":571,"date":"2026-04-24T09:07:28","date_gmt":"2026-04-24T00:07:28","guid":{"rendered":"https:\/\/spell.umin.jp\/thespellblog\/?p=571"},"modified":"2026-04-24T09:07:28","modified_gmt":"2026-04-24T00:07:28","slug":"american-headache-society%ef%bc%88ahs%ef%bc%89%e3%81%ae%e6%9c%80%e6%96%b0%e3%81%ae%e8%a8%ba%e7%99%82%e3%82%ac%e3%82%a4%e3%83%89%e3%83%a9%e3%82%a4%e3%83%b3%e3%81%ab%e3%81%82%e3%82%8b%e5%a4%a7%e5%be%8c","status":"publish","type":"post","link":"https:\/\/spell.umin.jp\/thespellblog\/?p=571","title":{"rendered":"American Headache Society\uff08AHS\uff09\u306e\u6700\u65b0\u306e\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u3042\u308b\u5927\u5f8c\u982d\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\u306e\u30ec\u30d9\u30ebA\u63a8\u5968\u306f\u59a5\u5f53\u304b"},"content":{"rendered":"
\"\"<\/div>\n

\u7247\u982d\u75db\u6551\u6025\u6cbb\u7642\u306b\u5bfe\u3057\u3066\u5927\u5f8c\u982d\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\u304c\u30ec\u30d9\u30ebA\u3067\u63a8\u5968\u3055\u308c\u3066\u3044\u308b\u3053\u3068\u304c\u5c11\u3057\u524d\u306b\u8a71\u984c\u306b\u306a\u3063\u3066\u3044\u308b\u304c\uff0c\u305d\u306e\u63a8\u5968\u3092\u51fa\u3057\u305f2025\u5e74\u306eAmerican Headache Society\uff08AHS\uff09\u306e\u6700\u65b0\u306e\u7247\u982d\u75db\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3<\/a>\u3092\u659c\u3081\u8aad\u307f\u3057\u3066\u307f\u305f\uff0e<\/p>\n\n\n\n

2025\u5e74\u306eAHS\u306e\u7247\u982d\u75db\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306b\u793a\u3055\u308c\u3066\u3044\u308b\u63a8\u5968<\/h1>\n\n\n\n

\u63a8\u5968<\/h2>\n\n\n\n
\u3010\u30ec\u30d9\u30ebA\uff1a\u5fc5\u305a\u63d0\u4f9b\u3059\u308b\u3011<\/td>\u3010\u30ec\u30d9\u30ebB\uff1a\u63d0\u4f9b\u3059\u3079\u304d\u3011<\/td>\u3010\u30ec\u30d9\u30ebC\uff1a\u63d0\u4f9b\u3059\u308b\u53ef\u80fd\u6027\u304c\u3042\u308b\u3011<\/td>\u3010\u30ec\u30d9\u30ebC\uff1a\u63d0\u4f9b\u3057\u306a\u3044\u5834\u5408\u304c\u3042\u308b\u3011<\/td>\u3010\u30ec\u30d9\u30ebB\uff1a\u63d0\u4f9b\u3059\u3079\u304d\u3067\u306a\u3044\u3011<\/td>\u3010\u30ec\u30d9\u30ebA\uff1a\u63d0\u4f9b\u3057\u3066\u306f\u306a\u3089\u306a\u3044\u3011<\/td><\/tr>
\u30d7\u30ed\u30af\u30ed\u30eb\u30da\u30e9\u30b8\u30f3\u9759\u8108\u5185\u6295\u4e0e
\u5927\u5f8c\u982d\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\uff08GONB\uff09<\/td>		\u30c7\u30af\u30b9\u30b1\u30c8\u30d7\u30ed\u30d5\u30a7\u30f3\u9759\u6ce8
\u30b1\u30c8\u30ed\u30e9\u30af\u9759\u8108\u6ce8\u5c04
\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u9759\u6ce8
\u30b9\u30de\u30c8\u30ea\u30d7\u30bf\u30f3SC
\u773c\u7aa9\u4e0a\u795e\u7d4c\u30d6\u30ed\u30c3\u30af<\/td>		\u30a2\u30bb\u30c1\u30eb\u30b5\u30ea\u30c1\u30eb\u9178IV
\u30af\u30ed\u30eb\u30d7\u30ed\u30de\u30b8\u30f3\u9759\u8108\u6ce8\u5c04
\u30c7\u30ad\u30b5\u30e1\u30bf\u30be\u30f3\u9759\u8108\u5185\u6295\u4e0e
\u30b8\u30af\u30ed\u30d5\u30a7\u30ca\u30af\u7b4b\u6ce8
\u30b8\u30d4\u30ed\u30f3IV
\u30c9\u30ed\u30da\u30ea\u30c9\u30fc\u30eb\u7b4b\u6ce8
\u30cf\u30ed\u30da\u30ea\u30c9\u30fc\u30eb\u9759\u8108\u6ce8\u5c04
\u30d0\u30eb\u30d7\u30ed\u9178\u9759\u8108\u6ce8\u5c04<\/td>		\u30b8\u30d5\u30a7\u30f3\u30d2\u30c9\u30e9\u30df\u30f3\u9759\u8108\u5185\u6295\u4e0e
\u30e2\u30eb\u30d2\u30cd\u9759\u8108\u6ce8\u5c04
\u30aa\u30af\u30c8\u30ec\u30aa\u30c1\u30c9\u76ae\u4e0b\u6ce8\u5c04\uff0f\u9759\u8108\u6ce8\u5c04
\u30d1\u30e9\u30bb\u30bf\u30e2\u30fc\u30eb\u9759\u8108\u6ce8\u5c04<\/td>		\u306a\u3057<\/td>\u30d2\u30c9\u30ed\u30e2\u30eb\u30db\u30f3IV<\/td><\/tr><\/tbody><\/table><\/figure>\n\n\n\n

\u78ba\u304b\u306b\uff0c\u5927\u5f8c\u982d\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\uff08GONB\uff09\u306f\u30ec\u30d9\u30ebA\uff08\u5fc5\u305a\u63d0\u4f9b\u3059\u308b\uff1alevel A \u2013 must offer\uff09\u306b\u30e9\u30f3\u30af\u3055\u308c\u3066\u3044\u308b\uff0e\u3053\u308c\u3092\u898b\u3066\u6700\u521d\uff0c\u30d7\u30ed\u30af\u30ed\u30eb\u30da\u30e9\u30b8\u30f3\u306f\u56fd\u5185\u3067\u306f\u4f7f\u7528\u3067\u304d\u306a\u3044\u306e\u3067\uff0c\u6025\u6027\u7247\u982d\u75db\u767a\u4f5c\u306b\u306f\uff0c\u7b2c\u4e00\u9078\u629e\u3068\u3057\u3066GONB\u3092\u884c\u308f\u306a\u3051\u308c\u3070\u306a\u3089\u306a\u3044\u306e\u304b\u3068\u601d\u3063\u305f\uff0e\u300c\u30ec\u30d9\u30ebA\uff1a\u5fc5\u305a\u63d0\u4f9b\u3059\u308b\u300d\u3068\u66f8\u3044\u3066\u3042\u308b\u304b\u3089\u3060\uff0e<\/strong><\/p>\n\n\n\n

\u72ec\u7279\u306a\u63a8\u5968\u306e\u8868\u8a18<\/h2>\n\n\n\n

\u554f\u984c\u306f\u3053\u306e\u3042\u307e\u308a\u805e\u304d\u6163\u308c\u306a\u3044\u63a8\u5968\u306e\u8868\u8a18\u306e\u4ed5\u65b9\u3067\u3042\u308b\uff0e\u65b9\u6cd5\u306b\u3042\u308b\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u8cea\u306e\u8a55\u4fa1\u3068\u63a8\u5968\u306e\u6c7a\u3081\u65b9\u306e\u90e8\u5206\u3092\u307e\u3068\u3081\u308b\uff0e<\/p>\n\n\n\n

\n

\u30b7\u30b9\u30c6\u30de\u30c6\u30a3\u30c3\u30af\u30ec\u30d3\u30e5\u30fc\u306b\u3088\u3063\u3066\u5f97\u3089\u308c\u305f\u5404\u7814\u7a76\u306f\uff0c\u30d0\u30a4\u30a2\u30b9\u306e\u30ea\u30b9\u30af\u304c\u8a55\u4fa1\u3055\u308c\u305f\uff0e\u7814\u7a76\u306fRoB\u57fa\u6e96\uff08\u4f8b\uff1a\u30e9\u30f3\u30c0\u30e0\u5316\u306e\u65b9\u6cd5\u3001\u76f2\u691c\u5316\u3001\u5272\u308a\u4ed8\u3051\u306e\u96a0\u853d\u3001\u7d50\u679c\u30c7\u30fc\u30bf\u306e\u5b8c\u5168\u6027\u3001\u304a\u3088\u3073intention-to-treat\u5206\u6790\u3078\u306e\u6e96\u62e0\uff09\u306b\u57fa\u3065\u3044\u3066\u30af\u30e9\u30b9I\u304b\u3089\u30af\u30e9\u30b9IV\u306b\u5206\u985e\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n

\u30af\u30e9\u30b9\u2160\u306fLow risk of bias\uff0c\u30af\u30e9\u30b9\u2161\u306fModerate\uff0c\u30af\u30e9\u30b9\u2162\u306fModerately high\uff0c\u30af\u30e9\u30b9\u2163\u306fVery high risk of bias\u3068\u3057\u3066\u63a8\u5968\u4e8b\u9805\u306e\u4f5c\u6210\u304b\u3089\u9664\u5916\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n

\u305d\u3057\u3066\uff0c\u78ba\u5b9f\u6027\u306e\u30ec\u30d9\u30eb\u304c\u4ee5\u4e0b\u306e\u3088\u3046\u306b\u5b9a\u7fa9\u3055\u308c\u3066\u3044\u308b\uff0e
\u8907\u6570\u306e\u30af\u30e9\u30b9\u2160\u7814\u7a76\uff1a\u300cAre highly likely to be in\/effective\u2026\u300d
\u8907\u6570\u306e\u30af\u30e9\u30b9\u2161\u7814\u7a76\u307e\u305f\u306f1\u3064\u306e\u30af\u30e9\u30b9\u2160\u7814\u7a76\uff1a\u300cAre likely in\/effective\u2026\u300d
\u8907\u6570\u306e\u30af\u30e9\u30b9\u2162\u7814\u7a76\u307e\u305f\u306f1\u3064\u306e\u30af\u30e9\u30b9\u2161\u7814\u7a76\uff1a\u300cAre possibly in\/effective\u2026 \u300d
\u8907\u6570\u306e\u30af\u30e9\u30b9\u2163\u7814\u7a76\u307e\u305f\u306f1\u3064\u306e\u30af\u30e9\u30b9\u2162\u7814\u7a76\uff1a\u300cThere is insufficient evidence to support or refute the effectiveness of\u2026\u300d<\/p>\n\n\n\n

\u305d\u306e\u3046\u3048\u3067\uff0c\u63a8\u5968\u306e\u5f37\u3055\u3092\uff0c\u30a8\u30d3\u30c7\u30f3\u30b9\u306e\u30af\u30e9\u30b9\u3068\u8cea\uff0c\u5229\u76ca\u306e\u4e00\u8cab\u6027\u3068\u5927\u304d\u3055\uff0c\u304a\u3088\u3073\u6709\u5bb3\u6027\u306e\u53ef\u80fd\u6027\u3092\u7d71\u5408\u3057\u3066\u6b21\u306e\u3088\u3046\u306b\u5206\u985e\u3057\u305f\uff0e
\u30ec\u30d9\u30ebA = \u63d0\u4f9b\u5fc5\u9808\u307e\u305f\u306f\u63d0\u4f9b\u4e0d\u53ef\uff08level A \u2013 must offer\uff09
\u30ec\u30d9\u30ebB = \u63d0\u4f9b\u3059\u3079\u304d\u304b\u3001\u63d0\u4f9b\u3059\u3079\u304d\u3067\u306a\u3044\u304b\uff08level B \u2013 should offer\uff09
\u30ec\u30d9\u30ebC = \u63d0\u4f9b\u3059\u308b\u5834\u5408\u3068\u63d0\u4f9b\u3057\u306a\u3044\u5834\u5408\u304c\u3042\u308a\u307e\u3059\uff08level C \u2013 may offer\uff09
\u30ec\u30d9\u30ebU = \u63a8\u5968\u306a\u3057\uff08no recommendation\uff09<\/p>\n\n\n\n

\u8cbb\u7528\uff0c\u5b9f\u73fe\u53ef\u80fd\u6027\u306b\u95a2\u3059\u308b\u61f8\u5ff5\uff0c\u6f5c\u5728\u7684\u306a\u30ea\u30b9\u30af\uff0c\u304a\u3088\u3073\u526f\u4f5c\u7528\u306f\u691c\u8a0e\u3055\u308c\u3066\u3044\u308b\u3088\u3046\u3060\u304c\uff0c\u60a3\u8005\u306e\u4fa1\u5024\u89b3\u306e\u3070\u3089\u3064\u304d\u306b\u3064\u3044\u3066\u306f\u691c\u8a0e\u3055\u308c\u306a\u3044\u3088\u3046\u3060\u3063\u305f\uff0e<\/p>\n<\/blockquote>\n\n\n\n

\u3053\u306e\u65b9\u6cd5\u306f\uff0c\u3044\u308f\u3086\u308bMinds2007\u65b9\u5f0f\u3068\u8a00\u308f\u308c\u308b\u65e7\u5f0f\u306e\uff0c\u3057\u304b\u3082\u72ec\u81ea\u306e\u3082\u306e\u3067\u3042\u308b\uff0e
\u3053\u308c\u3060\u3068\uff0c\u7814\u7a76\u3092\u9078\u308a\u597d\u307f\u3057\u3066\uff0c\u52b9\u679c\u304c\u3042\u3063\u305f\u7814\u7a76\u3092\u90fd\u5408\u3088\u304f\u53d6\u308a\u4e0a\u3052\u3066\u63a8\u5968\u3092\u4f5c\u6210\u3057\u3066\u3057\u307e\u3046\u3053\u3068\u304c\u5bb9\u6613\u306b\u3067\u304d\u3066\u3057\u307e\u3046\uff0e<\/strong><\/p>\n\n\n\n

\u305d\u3057\u3066\uff0c\u63a8\u5968\u306e\u6839\u62e0\u3092\u898b\u3066\u307f\u308b\uff0e<\/p>\n\n\n\n

\n

Question 2: Are nerve blocks, including sphenopalatine ganglion blocks, effective for the treatment of adults with migraine who present to an ED?\uff08\u8cea\u554f2\uff1a\u8776\u5f62\u9aa8\u53e3\u84cb\u795e\u7d4c\u7bc0\u30d6\u30ed\u30c3\u30af\u3092\u542b\u3080\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\u306f\u3001\u6551\u6025\u5916\u6765\u3092\u53d7\u8a3a\u3057\u305f\u7247\u982d\u75db\u306e\u6210\u4eba\u60a3\u8005\u306e\u6cbb\u7642\u306b\u52b9\u679c\u7684\u3067\u3059\u304b\uff1f\uff09<\/p>\n<\/blockquote>\n\n\n\n


\u5927\u5f8c\u982d\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\uff08GONB\uff09\u3067\u306f\uff0c3\u3064\u306e\u30af\u30e9\u30b9\u2160\u7814\u7a76\u30681\u3064\u306e\u30af\u30e9\u30b9\u2161\u7814\u7a76\u3067\u8a55\u4fa1\u3055\u308c\u305f\uff0e<\/p>\n\n\n\n

1\u3064\u76ee\u306eFriedman\u3089\u306b\u3088\u308b2018\u5e74\u306e\u30af\u30e9\u30b9\u2160\u7814\u7a76\u3067\u306f\uff0c\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u306b\u62b5\u6297\u6027\u3092\u793a\u3059\u60a3\u8005\u306b\u304a\u3044\u3066\uff0c0.5%\u30d6\u30d4\u30d0\u30ab\u30a4\u30f3\u3092\u7528\u3044\u305f\u4e21\u50743mL\u306eGONB\u3092\u53d7\u3051\u305f\u53c2\u52a0\u8005\u306e31%\uff084\/13\uff09\u304c30\u5206\u5f8c\u306b\u982d\u75db\u6d88\u5931\u3092\u9054\u6210\u3057\u305f\u306e\u306b\u5bfe\u3057\uff0c\u507d\u624b\u8853\uff080.5mL\u306e0.5%\u30d6\u30d4\u30d0\u30ab\u30a4\u30f3\uff0c\u6d45\u3044\u6df1\u3055\uff09\u3092\u53d7\u3051\u305f\u53c2\u52a0\u8005\u3067\u306f0%\uff080\/15\uff09\u3067\u3042\u3063\u305f\uff0895%\u4fe1\u983c\u533a\u95936\uff5e56\uff0cp = 0.035\uff09\uff0e
\u52b9\u679c\u306f\u793a\u3055\u308c\u305f\u304c\uff0c\u75c7\u4f8b\u6570\u304c\u308f\u305a\u304b28\u4f8b\u3057\u304b\u306a\u304f\uff0c\u3057\u304b\u3082\uff0c\u9759\u8108\u5185\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u306b\u3088\u308b\u6a19\u6e96\u6cbb\u7642\u306b\u3082\u304b\u304b\u308f\u3089\u305a\u4e2d\u7b49\u5ea6\u307e\u305f\u306f\u91cd\u5ea6\u306e\u982d\u75db\u304c\u6301\u7d9a\u3057\u3066\u3044\u308b\u3068\u5831\u544a\u3057\u305f\u6551\u6025\u5916\u6765\uff08ED\uff09\u60a3\u8005\u304c\u5bfe\u8c61\u3068\u306a\u3063\u3066\u3044\u308b\u3053\u3068\u306b\u6ce8\u76ee\u3057\u305f\u3044\uff0e<\/p>\n\n\n\n

2\u3064\u76ee\u306eFriedman \u3089\u306b\u3088\u308b2020\u5e74\u306e\u30af\u30e9\u30b9\u2160\u7814\u7a76\u306fGONB\u304c\u9759\u8108\u5185\u6295\u4e0e\u306e\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u3068\u540c\u7b49\u306e\u7247\u982d\u75db\u6cbb\u7642\u52b9\u679c\u3092\u6301\u3064\u304b\u3069\u3046\u304b\u3092\u8a55\u4fa1\u3057\u305f\u7814\u7a76\u3067\uff0c0.5% \u30d6\u30d4\u30d0\u30ab\u30a4\u30f3\u3092\u4f7f\u7528\u3057\u305f\u4e21\u5074 3 mL GONB\u306f\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9 10 mg IV \u3068\u75bc\u75db\u91cd\u75c7\u5ea6\u306e\u5e73\u5747\u6539\u5584\u306b\u9055\u3044\u304c\u898b\u3089\u308c\u306a\u304b\u3063\u305f\uff0e
\u30b5\u30d6\u30b0\u30eb\u30fc\u30d7\u89e3\u6790\u3067\u306f\uff0cGONB \u306e\u7d4c\u9a13\u8c4a\u5bcc\u306a\u6ce8\u5c04\u8005 (15\/51) \u306e\u5e73\u5747\u6539\u5584\u306f 6.9 (SD 2.6)\u3001\u7d4c\u9a13\u306e\u306a\u3044\u6ce8\u5c04\u8005 (36\/51) \u306e\u5e73\u5747\u6539\u5584\u306f 4.1 (SD 2.9) \u3067 (\u5dee 2.8\u300195% CI 1.1\u20134.5)\uff0c\u7d4c\u9a13\u306b\u3088\u3063\u3066\u52b9\u679c\u304c\u7570\u306a\u308b\u3053\u3068\u304c\u793a\u3055\u308c\u305f\u3068\u3044\u3046\u70b9\u304c\u5927\u4e8b\uff0e<\/p>\n\n\n\n

3\u3064\u76ee\u306eHokenek\u3089\u306b\u3088\u308b2021\u5e74\u306e\u30af\u30e9\u30b9\u2160\u7814\u7a76\u3067\u306f\uff0c1%\u30ea\u30c9\u30ab\u30a4\u30f3GONB\u3092\u8a55\u4fa1\u3057\uff0c120\u5206\u5f8c\u306eVAS\u306e\u5e73\u5747\u5909\u5316\u306f\uff0cGONB 0.75 mL\u3067-54.1\uff0895% CI -58.5\uff5e-49.7\uff09\uff0c\u773c\u7aa9\u4e0a\u795e\u7d4c\u30d6\u30ed\u30c3\u30af\uff08SONB\uff090.25 mL\u3067-42\uff08-46.5\uff5e-37.4\uff09\uff0c\u4f75\u7528\u3067-59.3\uff08-63.0\uff5e-55.7\uff09\uff0c\u751f\u7406\u98df\u5869\u6c34\u3092\u7528\u3044\u305f\u507d\u51e6\u7f6e\u3067-9.9\uff08-14.5\uff5e-5.3\uff09\u3060\u3063\u305f\uff0e\u3057\u304b\u3057\uff0c\u3053\u306e\u7814\u7a76\u3082\u75c7\u4f8b\u6570\u306f128\u4f8b\u3057\u304b\u306a\u304f\uff0c\u4ed6\u306e\u85ac\u7269\u7642\u6cd5\u3068\u306e\u6bd4\u8f03\u304c\u306a\u304b\u3063\u305f\uff0e<\/p>\n\n\n\n

4\u3064\u76ee\u306eKorucu\u3089\u306b\u3088\u308b2018\u5e74\u306e\u30af\u30e9\u30b9\u2161\u8a66\u9a13\uff08n = 60\uff09\u3067\u306f\uff0c45\u5206\u6642\u70b9\u3067\u306e\u75bc\u75db\u30b9\u30b3\u30a2\u306e\u5e73\u5747\u5909\u5316\u3092\u8a55\u4fa1\u3057\u305f\u3068\u3053\u308d\uff0c\u30c7\u30af\u30b9\u30b1\u30c8\u30d7\u30ed\u30d5\u30a7\u30f3\u30fb\u30c8\u30ed\u30e1\u30bf\u30e2\u30fc\u30eb50mg\u9759\u8108\u5185\u6295\u4e0e\u3068\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c910mg\u9759\u8108\u5185\u6295\u4e0e\u306e\u4f75\u7528\uff087\uff0cIQR 5\uff5e8\uff09\u306f\uff0c0.5%\u30d6\u30d4\u30d0\u30ab\u30a4\u30f31mL\uff0b\u751f\u7406\u98df\u5869\u6c341mL\u306eGONB\uff087\uff0cIQR 6\uff5e9\uff0cp = 0.39\uff09\u3068\u6709\u610f\u5dee\u306f\u306a\u304b\u3063\u305f\u304c\uff0c\u3069\u3061\u3089\u3082\u507d\u624b\u8853\uff085\uff0cIQR 2.25\uff5e7\uff0cGON\u3067\u306fp = 0.016\uff0c IV\u6cbb\u7642\u3067\u306fp = 0.03\uff09 \u3088\u308a\u512a\u308c\u3066\u3044\u305f\uff0e<\/p>\n\n\n\n

\u8003\u5bdf<\/h2>\n\n\n\n

GONB\u306f\u507d\u6cbb\u7642\u3068\u6bd4\u8f03\u3057\u3066\u52b9\u679c\u304c\u3042\u308b\u3053\u3068\u306f\u9593\u9055\u3044\u306a\u3055\u305d\u3046\u3060\u304c\uff0c\u4ed6\u306e\u5185\u670d\u30fb\u9759\u6ce8\u306e\u85ac\u7269\u7642\u6cd5\u3088\u308a\u3082\u512a\u308c\u308b\u304b\u3069\u3046\u304b\u306f\u5fae\u5999\u3067\uff0c\u3053\u306e\u30ec\u30d3\u30e5\u30fc\u306e\u7d50\u679c\u304b\u3089\u306f\u7d50\u8ad6\u304c\u51fa\u305b\u306a\u3044\u304c\uff0c\u3069\u3061\u3089\u304b\u3068\u3044\u3046\u3068\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u3068\u306f\u540c\u7b49\u3067\u3042\u308b\u53ef\u80fd\u6027\u306e\u307b\u3046\u304c\u9ad8\u3044\uff0eGRADE approach\u3092\u7528\u3044\u3066\u3044\u306a\u3044\u304c\uff0c\u3042\u3048\u3066Grading\u3059\u308b\u3068\uff0cInconsistency\u3068Impricision\u306e2\u3064\u3067grade down\u3067\uff0cLow\uff5eVery low\u306b\u306a\u308b\u306e\u3067\u306f\u306a\u3044\u304b\uff08Impricision\u30672\u6bb5\u968egrade down\u3082\u3042\u308a\u5f97\u308b\uff09\uff0e
\u305d\u3057\u3066\uff0c\u30e1\u30bf\u30a2\u30ca\u30ea\u30b7\u30b9\u3055\u308c\u3066\u3044\u306a\u3044\u306e\u3067\u306a\u3093\u3068\u3082\u8a00\u3048\u306a\u3044\u304c\uff0c\u30ec\u30d9\u30ebB\u306e\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u9759\u6ce8\u3068\u5dee\u3092\u3064\u3051\u308b\u3060\u3051\u306e\u6839\u62e0\u306f\u306a\u3044\u3088\u3046\u306b\u601d\u3063\u305f\uff0e\u307e\u3057\u3066\u3084\uff0cNSAIDs\u3084\u30c8\u30ea\u30d7\u30bf\u30f3\u3068\u306e\u6bd4\u8f03\u3057\u305f\u7814\u7a76\u306f\u5b58\u5728\u3057\u306a\u3044\u306e\u3067\u3069\u3061\u3089\u304c\u512a\u308c\u3066\u3044\u308b\u304b\u306f\u4e0d\u660e\u3060\uff0e\u7279\u306b\u9650\u5b9a\u7684\u306a\u75c7\u4f8b\u6570\u306b\u3088\u308b\u7d50\u679c\u3067\u3042\u308b\u3053\u3068\u3092\u8003\u3048\u308b\u3068\uff0cGONB\u306f\uff0c\u4e2d\u7b49\u75c7\u4ee5\u4e0a\u306e\u7247\u982d\u75db\u767a\u4f5c\u3067\uff0c\u4ed6\u306e\u85ac\u7269\u7642\u6cd5\u304c\u52b9\u304b\u306a\u304b\u3063\u305f\u5834\u5408\u306e2\u756a\u624b\u306e\u6cbb\u7642\u3068\u3059\u308b\u3079\u304d\u3067\u306f\u306a\u3044\u304b\uff0e\u3082\u3061\u308d\u3093\uff0c\u624b\u6280\u306b\u8c4a\u5bcc\u306a\u7d4c\u9a13\u304c\u3042\u308c\u3070\u7b2c1\u9078\u629e\u3067\u3082\u826f\u3044\u306e\u304b\u3082\u3057\u308c\u306a\u3044\u304c\uff0c\u3042\u304f\u307e\u3067\u6551\u6025\u5916\u6765\u3092\u53d7\u8a3a\u3057\u305f\u60a3\u8005\u3067\u306e\u8a71\u306b\u306a\u308b\uff0e\u306a\u305c\u306a\u308c\u3070\uff0c\u5f15\u7528\u3055\u308c\u3066\u3044\u308b\u7814\u7a76\u304c\uff0c\u3059\u3079\u3066\u6551\u6025\u5916\u6765\u3092\u53d7\u8a3a\u3057\u305f\u6025\u6027\u7247\u982d\u75db\u306e\u60a3\u8005\u304c\u5bfe\u8c61\u306b\u306a\u3063\u3066\u3044\u308b\u304b\u3089\u3067\u3042\u308b\uff0e\u901a\u5e38\u306e\u5916\u6765\u306b\u982d\u75db\u3067\u53d7\u8a3a\u3057\u305f\u60a3\u8005\u306b\u884c\u3046\u3082\u306e\u3067\u306f\u306a\u3044\uff0e
\u3069\u3046\u3082\uff0c\u3010\u30ec\u30d9\u30ebA\uff1a\u5fc5\u305a\u63d0\u4f9b\u3059\u308b\uff08level A \u2013 must offer\uff09\u3011\u3068\u3044\u3046\u306e\u304c\u5f15\u3063\u304b\u304b\u308b\uff0e\u672c\u6765\uff0c\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\u300c\u5fc5\u305a\u884c\u3046\u300d\u3068\u3044\u3046\u63a8\u5968\u3092\u3064\u3051\u306a\u3044\u3057\uff0c\u3064\u3051\u308b\u3079\u304d\u3067\u306f\u306a\u3044\uff0e\u300c\u5fc5\u305a\u884c\u3046\u300d\u3068\u3055\u308c\u3066\u3057\u307e\u3046\u3068\u4ed6\u306e\u30aa\u30d7\u30b7\u30e7\u30f3\u304c\u9078\u3079\u306a\u304f\u306a\u308b\u3057\uff0c\u6cd5\u7684\u62d8\u675f\u529b\u3059\u3089\u751f\u3058\u3066\u3057\u307e\u3046\u3060\u308d\u3046\uff0e<\/strong>
\u63a8\u5968\u304c\u72ec\u308a\u6b69\u304d\u3057\u305d\u3046\u3067\u6016\u3044\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u3060\u3068\u601d\u3063\u305f\uff0e<\/p>\n\n\n\n

\u73fe\u6642\u70b9\u3067\u306f\uff0c\u6025\u6027\u7247\u982d\u75db\u767a\u4f5c\u306b\u306f\u4ee5\u4e0b\u306e\u3088\u3046\u306a\u5bfe\u5fdc\u304c\u59a5\u5f53\u3067\u306f\u306a\u3044\u304b\uff0e<\/p>\n\n\n\n

\n

\u8efd\u75c7\uff1a\u30a2\u30bb\u30c8\u30a2\u30df\u30ce\u30d5\u30a7\u30f3\uff0cNSAIDs\uff0c\u52b9\u304b\u306a\u3051\u308c\u3070\u30c8\u30ea\u30d7\u30bf\u30f3\u306e\u4f75\u7528
\u4e2d\u7b49\u75c7\uff5e\u91cd\u75c7\uff1a\u6700\u521d\u304b\u3089\u30c8\u30ea\u30d7\u30bf\u30f3\u7d4c\u53e3\uff0c\u98f2\u3081\u306a\u3051\u308c\u3070\u76ae\u4e0b\u6ce8
\u5614\u6c17\u30fb\u5614\u5410\u304c\u3072\u3069\u3044\u306a\u3089\u3070\u30e1\u30c8\u30af\u30ed\u30d7\u30e9\u30df\u30c9\u9759\u6ce8\u4f75\u7528
\u6551\u6025\u5916\u6765\uff1a\u4e2d\u7b49\u75c7\uff5e\u91cd\u75c7\u306e\u6cbb\u7642\u306b\u52a0\u3048\u3066\uff0c\u30c7\u30ad\u30b5\u30e1\u30bf\u30be\u30f34mg\uff0cGONB
CGRP\u62ee\u6297\u85ac\u304c\u5fc5\u8981\u306a\u72b6\u614b\u306a\u3089\u3070\u8133\u795e\u7d4c\u5185\u79d1\u533b\u306b\u76f8\u8ac7<\/p>\n<\/blockquote>\n\n\n\n

\u305f\u3060\uff0cGONB\u306e\u624b\u6280\u306f\u6bd4\u8f03\u7684\u7c21\u4fbf\u306a\u51e6\u7f6e\u3068\u8a00\u3048\u305d\u3046\u306a\u306e\u3067\uff0c\u30aa\u30d7\u30b7\u30e7\u30f3\u306e1\u3064\u3068\u3057\u3066\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u533b\u3067\u3082\u7372\u5f97\u3057\u3066\u304a\u304f\u3079\u304d\u3060\u3068\u601d\u3063\u305f\uff0e<\/p>\n\n\n\n

\u7d50\u8ad6<\/h2>\n\n\n\n

AHS\u306e\u65b0\u3057\u3044\u6025\u6027\u7247\u982d\u75db\u767a\u4f5c\u306e\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u306f\uff0c\u63a8\u5968\u3092\u9d5c\u5451\u307f\u306b\u3067\u304d\u306a\u3044\uff0e<\/p>\n\n\n\n

\u3010\u5229\u76ca\u76f8\u53cd\uff08COI\uff09\u306e\u958b\u793a\u3011
\u5b66\u8853\u7684COI\uff1a\u5e02\u4e2d\u75c5\u9662\u533b\u5e2b\uff0c\u7dcf\u5408\u8a3a\u7642\u533b \uff0cEBMer\uff0fEBM educator\uff0e\u65e5\u672c\u30d7\u30e9\u30a4\u30de\u30ea\u30fb\u30b1\u30a2\u9023\u5408\u5b66\u4f1a\u7406\u4e8b\uff0c\u65e5\u672c\u533b\u5b66\u6559\u80b2\u5b66\u4f1a\u7406\u4e8b\uff0e\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u4f5c\u6210\u65b9\u6cd5\u5c02\u9580\u5bb6\uff0c\u65e5\u672c\u795e\u7d4c\u5b66\u4f1a\u300c\u982d\u75db\u306e\u8a3a\u7642\u30ac\u30a4\u30c9\u30e9\u30a4\u30f3\u300d\u5916\u90e8\u59d4\u54e1
\u7d4c\u6e08\u7684COI\uff1a\u982d\u75db\u6cbb\u7642\u85ac\u3092\u542b\u3081\u308b\u88fd\u85ac\u4f01\u696d\u304b\u3089\u306e\u91d1\u92ad\u7b49\u306e\u6388\u53d7\u306f\u306a\u3044<\/p>\n\n\n\n

\"\"
\uff08\u571f\u5c45\u4ef2\u30d0\u30b9\u505c\uff0c\u611b\u5a9b\u770c\u5b87\u548c\u5cf6\u5e02<\/a>\uff0c2026\/3\/22\u64ae\u5f71\uff09<\/figcaption><\/figure>\n","protected":false},"excerpt":{"rendered":"

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