胃粘膜血流に及ぼす温泉水の効果 －長期連日飲泉の効果－

内視鏡（オリンパス製XQ－10胃ファイバースコープ）と臓器反射スペクトル法を応用して，2週間連日の飲泉が胃粘膜血流におよぼす効果を検討した。健常者3名および胃疾患患者9名（治癒期にある胃潰瘍の患者6名と慢性胃炎の患者3名）を対象とした。当院飲泉場の温泉水による2週間連日の飲泉を行ない，2週間の飲泉の前後において，胃の3箇所（胃幽門部小弯，前庭部小弯，胃角部小弯）で胃粘膜血流を測定した。その結果，胃前庭部小弯では胃粘膜血流の有意の増加を認めた。しかし胃全体としては有意差を検出出来なかった。個々の症例について検討すると、飲泉後で胃の3箇所すべてにおいて血流が増加したケースが頻度多く認められ，飲泉の有効性が示唆された。従来から認められてきた慢性胃腸疾患に対する飲泉の効果には，胃粘膜血流の改善による要因も加わっている可能性が考えられる。

Effect of long-term oral intake of thermal water on gastric mucosal blood flow was evaluated, using an endoscopic organ reflex spectrophotometry together along with an Olympus XQ-10 forward viewing gastro-fiberscope． Three healthy volunteers and nine patients with gastric diseases in remission (six with healed gastric ulcer and three with chronic gastritis) were put on a 2-week treatment with daily oral intake of Misasa thermal water (38 to 42 ℃, 200mℓ, two times a day between meals). Gastric mucosal blood flow was measured just before and after the treatment period at three spots of the stomach (lesser curvature of the pylorus, antrum and angle) : Life style and drugs were unchanged during the period. Following results were obtained : (1) Pre-and post-treatment gastric mucosal blood flow (IHb) was 95.0±18.0, and 98.2±15.3 at the pylorus, respectively ; 104.8±16.9 and 110.8±12.8 at the antrum, respectively ; 116.1±20.4 and 118.7±18.5 at the angle, respectively. (2) However, Evaluation of each individual case showed that the post-treatment values were　higher than the pretreatment ones in 75 % of patients at the pylorus and in 67 % of patients at the antrum and angle, respectively. (3) Student's paired t-test showed that the post-treatment increase in blood flow was statistically significant (p<0.05) only at the antrum． These results suggest that an improvement in gastric mucosal blood flow, along with an improvement in gastric secretion and motility, is also contributory to the favorable therapeutic results of spa-drink in chronic gastric diseases. Further studies are in progress to reveal (1) the clinical significance of the improvement in gastric mucosial blood flow, such asacceleration of healing and maintenance of remission, and (2) the characteristics of patients who are likely to show favorable response to the treatment．