2016-12-23 08:01:02 Risk measure. com.
http://diamond.jp/articles/-/112137?page=2
The reason that "grandmother's legend" is most more than medicine for cold
Risk measure. com.
December 21, 2016
This season air dries, and it's easy to get active in a virus when. When air dries, Tsutomu who defends a mucous membrane of the throat and a nose falls and becomes easy to be infected with a virus. Is everyone careful of physical condition management?
The season chill in the morning and evening makes a winter arrival feel when. Nakazawa who felt "the throat did a mussel moth,..." from a morning (a 45 year old male, pseudonym and omission of titles from names) decided to leave with operation from the afternoon as the a subordinate and leave early because a body also left the heat languidly when lunch was taken at a company. (Of an article of No. "risk measure. com" magazine 2015 year November 25 carrying, saikei,)
"Did you catch a cold,..." while I was having a clinic around here in the going home way, was being a reception and was waiting order of the medical examination by a waiting room, I took notice of one book put right in front of the suddenness. It seems to be the book a doctor wrote.
It's written on a cover with "myths which concerns a cold", and I'm beginning to take in my hand and turn over a page slowly. "By the way what is myths?" when Nakazawa checked it by smart phone, it was said to be "myth, fiction, ill-founded social common belief and plural form of myth". The following thing was written on the book.
"Please prescribe an antibiotic."
I take such order from a patient, but unfortunately, the antibiotic is invalid for cold.
An antibiotic is the medicine at which so-called germs (bacteria) are beat. A cold, bacteria (germs), because it's the sickness which happens by a virus, the antibiotic is just ineffective.
As well as not working, bad. There are germs with which I coexist originally (It's called indigenous bacteria.) in the human interior of the body, and important work is being done. An antibiotic, this, all indigenous bacteria is also beat, so physical condition is destroyed too much as a side effect.
Bacteria by which an antibiotic won't work in the future by using an antibiotic easily incompletely (resistant bacteria) is produced. An antibiotic isn't prescribed to a cold.
"Even if I take an over-the-counter cold medicine, it doesn't become good, and I want... to take out medicine which often works."
I want you to take out medicine really effective against a cold at a hospital, have not you said? (A※ picture is an image.)
Unfortunately... understood well doesn't exist in such medicine for the feeling. You'll expect something special of the medicine for which a doctor prescribes us, but unfortunately there are no changes in the effect.
The meaning of the "total" of the over-the-counter overall medicine for cold means that more than one medicine to the symptom of the cold is included in medicine for antifebrile, medicine for a painkiller, medicine for a cough medicine, the medicine which often takes out and has phlegm and medicine to allergy, but the difference with the medicine prescribed at a hospital will be about the fact that I have medicine to the symptom separately.
If I try to take medicine in all symptoms of a cold, I have to take 5 for once-medicine for 6 kinds, and it's difficult realistically and I can't recommend you. When I say more, I don't get over my cold by medicine. It's a just different story to take medicine and suppress the symptom and to get over the cold. A cold is something to cure by oneself.
"I think you'll examine at a hospital so as not to come to have a severe cold, and,..."
"I think it's better to take medicine rather early so that heat isn't generated, and,..."
"Can I have the medicine which prevents a cold,..."
Early detection and an early treatment are an important thing in all sickness. But the medicine which makes sure that I won't deteriorate and the medicine which prevents a cold don't exist in start of catching a cold.
When there is a treatment method of the purpose which isn't aggravated, that's nutritiousness (meal) and daily physical condition management including sleep (sleep) etc.. In other words, if I feel "Physical condition is strange. May it be a cold?", I go home early, and it's said that they rest a body.
Since it itself takes for an adverse effect and a body to go to a hospital to a cold, it may be harmful. I'll return and rest a body early!
"Because... tomorrow when SUKKIRI recovered won't be also rested to work if I give an intravenous drip injection at a hospital at a cold before, isn't there an intravenous drip which works with SUPA (injection)?"
Do you even say "intravenous drip belief", after someone once probably visited a hospital at a cold and received an intravenous drip and an injection somewhere, a story of the personal experience as "... which came to feel good simple..." has been impressed with intensely as the successful experience to which I say "When I administer an intravenous drip injection at a cold, I recover by blow!" all too soon. Even if you say "He who becomes fine by blow asks!", such dangerous medicine doesn't exist.
The next page >> What kind of time is it that a doctor does intravenous drip treatment?
Then, we, what kind of time is it that a doctor does intravenous drip treatment?
It's very physiological for man and efficient to eat from the mouth and drink, so it's a principle to say "When the mouth can be used, use the mouth." Can nourishment and water be taken by an intravenous drip? Unfortunately this is an insignificant one.
Man is taking nourishment and water from the mouth by having a meal (This is called oral absorption.) When you can't take orally, I need an intravenous drip, but it's only the situation that that was also limited.
Even if a meal can't be taken at all, I'm fine with a human body surprisingly (There is an example of fasting and a fast.) But when water can't be taken, a human body will be dehydration, and I fall in the dangerous state. A doctor asks a patient us certainly. "Is a meal had?" "Is the water drinkable?"
When water can be even taken even if it can't be taken, the meal is OK, but if water can't also be taken, this needs intravenous drip treatment.
"Because I won't rest to work tomorrow, can I have medicine for antifebrile,..."
Heat isn't to fall= to get over sickness. Because they're serious illness and a slight fever because I have a high fever, it isn't also right to say a slight illness.
An example is given. Though a sports player is injured, the impressive tale by which what ones are ancient times (?) is... which injected with a painkiller, participated in a game and rescued a pinch of a team?
Even if I take medicine and lower heat similarly, and it becomes temporary easily, I'm not over original sickness as "cold". When I take medicine, and forces oneself even though it became easy, a cold will be aggravated, and is the prolonged cause. A sleep period certain degree of is needed to get over the cold. Please give up and be absent from work.
The next page >> A cold gets by its physical strength and is the sickness cured by oneself.
After all do I have to lower heat?
It's a reaction of a normal body to catch a cold and run a fever. When thinking "I'm fighting against a virus of a cold in the body by raising the body temperature.", it would be easy to understand. The cold becomes difficult to get over by lowering heat by force, and it's prolonged. Unless daily life is hindered remarkably, (example: A meal can't also be taken by a cause of the heat exhausted by a high fever, the... etc. which can't sleep) it isn't necessary to lower heat by force.
In the long run for, grandmother's legend
"If I catch a cold, return early, eat something good and sleep early,..." experience called what isn't there?
A cold is an infection by a virus and even if they'll be left alone, is the sickness cured naturally (I say self limited disease.) and the sickness which gets by the physical strength and cures by itself.
When supposing that this is to fight against a virus of a cold, the energy is needed to fight. So you have to take a meal tightly.
Physical strength is necessary for the purpose against which I fight, so preservation (Physical strength is consumed by other ones.) rests a body tightly, and does physical strength.
I thought so, of an old grandmother as "eat something good and sleep early,...", it's told, yes, even if it'll be the horn age, it's right, said, it'll be. "If specific medicine for a cold is made, it's Nobel prize MON!" it's called, but what will this grandmother's legend be Nobel prize thing?
Even though it was read as... to here, it was called by a nurse "I'm sorry to have kept you waiting. To Mr. Nakazawa and a consulting room, please." He lowers his head deep and Nakazawa who stood up makes a "oh, excuse me. It's special, but... sees how things are at home just as it is up to now,..." clinic later and has arrived at way home.
(Corporation guidance medicine. com managing director)
2016-12-23 08:01:02 Risk measure. com.p
カゼには薬より「おばあちゃんの言い伝え」が一番な理由
空気が乾燥して、ウイルスが活発化しやすいこの季節。空気が乾燥すれば喉や鼻の粘膜を防御する力が落ち、ウイルスに感染しやすくなる。みなさんは、体調管理に気を付けているか？朝晩の冷え込みが冬の到来を感じさせる季節。朝から「ノドがイガイガするなぁ…」と感じていた中澤（45才男性、仮名、敬称略）は、会社で昼食を摂る頃には身体がだるく熱も出てきたため、午後からのオペレーションを部下に任せて早退することにした。（「リスク対策.com」誌2015年11月25日号掲載の記事を再掲したものです）
「カゼひいたかな…」、帰宅途中に近くのクリニックを受診し、受付をして待合室で診察の順番を待っている間、ふと目の前に置かれていた一冊の本に目がとまった。どうやらお医者さんが書いた本らしい。
表紙には「カゼにまつわるmyths」と書かれており、おもむろに手にとってページをめくり始める。「ところでmythsってなんだっけ？」中澤がスマートフォンで調べると「神話、作り話、根拠の薄い社会的通念、mythの複数形」とのことであった。その本には以下のようなことが書かれていた。
「抗生物質を処方してください」
患者から、こんな注文を受けることがありますが、残念ながら、カゼに抗生物質は無効です。
抗生物質はいわゆるバイキン（細菌のこと）をやっつける薬です。カゼは細菌（バイキン）ではなくウイルスによっておこる病気ですから抗生物質は全く効果がありません。
効かないばかりか悪いこともあります。人間の体内にはもともと共存しているバイキン（常在菌と呼びます）がいて、大切な働きをしています。抗生物質はこれら常在菌も全てやっつけてしまうので、副作用として余計に体調を崩したりします。
また、中途半端に安易に抗生物質を使うことによって将来的に抗生物質の効かない細菌（耐性菌）を作り出してしまいます。カゼには抗生物質は処方しません。
「市販の風邪薬を飲んでもよくならなくて…よく効く薬を出して欲しい」
病院で風邪によく効く薬を出して欲しいって、言ったことありませんか？ （※画像はイメージです）
そのお気持ちはよく分かります…が、残念ながらそんな薬は存在しないのです。我々医師が処方する薬に特別な何かを期待されるのでしょうが、残念ながら効果に変わりはありません。
市販の総合感冒薬の「総合」の意味は、熱冷ましの薬、痛み止めの薬、咳止めの薬、痰を出しやすくする薬、アレルギーに対する薬などカゼの症状に対する複数の薬が含まれるという意味ですが、病院で処方する薬との違いは症状に対する薬が別々にあるということぐらいでしょう。
もし、カゼの諸症状すべてに薬を飲もうとしたら1回に5～6種類もの薬を飲まなければならず現実的に難しいですし、お勧めできません。もっと言うとカゼは薬では治りません。薬を飲んで症状を抑えることと、カゼが治ることとはまったく別のお話です。カゼは自分で治すものです。
「カゼがひどくならないように病院で診てもらおうと思って…」
「熱が出ないように早めに薬を飲んだほうがいいと思って…」
「カゼを予防する薬ください…」
早期発見、早期治療はすべての病気において大切なことです。しかし、カゼの引き始めに悪化しないようにする薬やカゼを予防する薬は存在しません。
悪化しないための治療方法があるとすれば、それは栄養（食事）や休養（睡眠）などを含めた日々の体調管理です。つまり、「体調がおかしい。カゼかも？」と感じたら、早く家に帰って身体を休めるということです。
病院に行くこと自体がカゼに対して逆効果、身体にとっては有害（体調の悪化？）かもしれません。早く帰って身体を休めましょう！
「以前カゼの時に病院で点滴したらスッキリ治った…明日も仕事で休めないからスパッと効く点滴（注射）ないですか？」
「点滴信仰」とでもいいますか、おそらくいつかどこかで誰かがカゼの時に病院を受診し点滴や注射を受けた後に「気分がよくなった…スッキリした…」という経験談がいつの間にか「カゼのときには点滴をすると一発で治る！」という成功体験として強烈に印象付けられてしまったのでしょう。「一発で元気になるやつ頼むよ！」と言われましても、そんなアブナイ薬は存在しません。
じゃあ、我々医師が点滴治療を行うのはどんな時か？
口から食べたり飲んだりすることは人間にとって極めて生理的かつ効率的ですので「口が使える時は口を使え」というのが原則です。点滴で栄養や水分が摂れるか？これは残念ながら微々たるものです。
人間は食事をすることで栄養や水分を口から摂取しています（これを経口摂取と言います）。経口摂取ができない場合は点滴が必要になることもありますが、それも限られた状況のみです。
食事はまったく摂れなくても人間の身体は意外に平気です（ファスティングや断食の例がありますね）。しかし、水分が摂れないと人間の身体は脱水になり危険な状態に陥ります。我々医師は患者に必ず聞きます。「食事は食べられますか？」「お水は飲めますか？」。
食事は摂れなくても水分さえ摂れればオッケーですが、水分も摂れないとなればこれは点滴治療が必要です。
「明日仕事で休めないから熱冷ましの薬をください…」
熱が下がること＝病気が治ることではありません。熱が高いから重症、微熱だから軽症というのも正しくありません。
例を挙げます。スポーツ選手が怪我をしているにもかかわらず、痛み止めの注射を打って試合に出てチームのピンチを救った…なんていうのは大昔の美談（？）です。
それと同じで薬を飲んで熱を下げて一時的に楽になっても本来の「カゼ」という病気は治ってはいません。薬を飲んで楽になったからといって無理をすると悪化したり、カゼが長引いたりする原因となります。カゼが治るためにはある程度の休養期間が必要です。どうか諦めて仕事を休んでください。
そもそも、熱は下げないといけないのか？
カゼをひいて熱が出るということは正常な身体の反応です。「体温を上げることで身体の中でカゼのウイルスと闘っている」と考えればわかりやすいでしょう。無理に熱を下げることでカゼが治りにくくなったり、長引いたりします。著しく日常生活に支障を来さない限り（例：高熱でぐったりしてしまう、熱のせいで食事も摂れない、眠れない…など）無理に熱を下げる必要はありません。
結局はおばあちゃんの言い伝え
「カゼひいたら、早く帰って美味しいもの食べて早く寝なさい…」なんて言われた経験はありませんか？
カゼはウイルスによる感染症であり、放っておいても自然に治る病気（self limited diseaseと言います）、自分の体力で乗り越えて自分で治す病気なのです。
これをカゼのウイルスと闘うことだと仮定すれば、闘うためにはエネルギーが必要です。だからしっかりと食事を摂る必要があるのです。
また、闘うためには体力が必要です、だからしっかりと身体を休めて体力を温存（他のことで体力を消耗しないように）するのです。
やっぱり「美味しいものを食べて早く寝なさい…」という昔のおばあちゃんの言い伝えはいつの時代になっても正しいということになります。「カゼの特効薬ができたらノーベル賞モンだ！」なんて言われますが、このおばあちゃんの言い伝えこそがノーベル賞ものでしょう。
…と、ここまで読んだところで「お待たせしました。中澤さん、診察室へどうぞ」と看護師に呼ばれた。立ち上がった中澤は深々と頭を下げ「あっ、すみません。せっかくですけど…今日のところはこのまま自宅で様子をみます…」クリニックをあとにして帰路に着いた。
（株式会社指導医.com代表取締役)
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