関節リウマチ及び変形性関節症に対するハイドロコーチゾン関注及び温泉療法の治療経験

1. We classified 89 cases of rheumatoid arthritis and arthrosis deformans according to Prof. T. Kodama's criteria as follows: 33 cases of (222) polyarthritis systemica (37%), 15 cases of (221) polyarthritis non systemica (16.8%) 22 cases of (111) monoarthrosis non systemica (24%), and others. 2. We analysed their symptoms following the criteria recommended by the New York Rheumatism Association and Prof. T. Kodama. In many cases of (222), their local and general symptoms were found to belong to Class III or IV, and in many cases of (111) and (221), to Class I or II. This shows that (222), here treated, was severer than (111) and (221) in both local and general conditions. The hepatic disorder and anemia were found to occur in patients with (222). 3. We treated these 89 cases chiefly by spa therapy and intraarticular injection of hydrocortisune, and evaluated the results by the criteria recommended by N. Y. R. A. and Prot. T. Kodama. Each of these treatments was more effective on (111), (121), and (221) than on (222). In all cases, the combined treatment with the said two measures was more efficacious than the separate treatment with each of the two. 4. The effects of the intraarticular hydrocortisone injections, 686 in total and mostly into knee joints, were examined. The most efficacious of these were obtained when the injection was made into fingers, toes or hip joints. In our experiences, the post-injection flare ups and the adverse effects of the treatments were observed in 2.8% of the cases treated, but they lasted only for a few days. 5. Of five cases of (222), where the combined treatment of hydrocortisone intraarticular injection and spa therapy was given for 5-14 months, detailed descriptions are given. By this treatment the physical abilities in joints of patients were improved remarkably and their general conditions were ameliorated gradually without any adverse effects.

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