神経系疾患におけるビタミンB12a大量療法の臨床的応用

CLINICAL APPLICATION OF A NEW VITAMIN B12 DERIVATE (HYDROXOCOBALAMIN) WITH MASSIVE DOSES ON NERVOUS SYSTEM DISEASES

I．緒言

　ビタミンB₁₂（Cyanocobalamin）の内科的臨床応用はすでに1948年SmithおよびRickesの同時的発見以来，乳酸菌増殖因子として発青促進作用を有することか知られ，小児の発育障害ならびに悪性貧血の造血障害に使用され，画期的な効果をおさめたことは今さら贅言を要するまでもなく，周知のごとくである。しかし成長促進因子，造血促進因子として利用されてきたビタミンB₁₂が，同時に悪性貧血の神経症状をも改善させるということが切掛となつて，神経疾患におよぼすビタミンB₁₂の作用が新たな分野となつて開拓されるにいたつた。ことにKaczkaが1949年ビタミンB₁₂と生理作用を同一にするB₁₂の同族体B_12a（Hydroxocobalamin）を合成し，本剤がCyanocobalaminよりも持効性があることを証明（Glass, Heinrich）してからは，本剤の大量療法が悪性貧血および神経疾患に応用されるようになつた。私どもも神経系疾患に新ビタミンB_12aを大量投与したのでその成績を報告する。

This paper represents the effect of a new vitamin B₁₂ derivate (hydroxocobalamin) with massive doses suffering from nervous system diseases including the cerebrovascular diseases, neuritis, neuralgia, and subacute combined degeneration. All cases were given on hydroxocobalamin 500γ, ATP 20mg subcutaneou-sly and vitamin B₁ (alinamin) 50mg intravenously. Several cases with acute onset associated with leuko-cytosis and high fever were given on steroid hormone simultaneously. The results were obtained as fol-lows:

1) In the group with cerebrovascular diseases, psychoneurological symptoms such as anxiety, sen-sory disturbance were improved in 7-10 days after injection.

2) Neuritis involving N. Trigeminus, N. Facial, N. Radial, N. Ulnar, N. Sciatics were improved within 4-10 days after injection, which was sup-posed to be earlier than that of steroid hormone alone.

3) In a case of pernicious anemia with subacute combined degeneration shows rapid improvement.

4) In a case with acute myelitis, the paralysis of legs were remarkably improved, however ataxia was unchanged.

5) Neuritis due to trauma was ineffective until the trauma was get rid of it.

With the results mentioned above, it is believed, the injection with hydroxocobalamin, ATP and alina-min in addition to steroid hormone preparations are a new trial for the treatment of nervous system diseases.