《みんなの家庭の医学》原因不明の「長引く息切れ」の悩み！気管支喘息でなく軟骨の炎症「再発性多発軟骨炎」が原因だった！
※たけしのみんなの家庭の医学 2013年9月24日放送分より
貴方の長引く不調を解消！
病の本当の原因を探る、
セカンドオピニオンスペシャルの第9弾。
セカンドオピニオンとは主治医とは異なる別の医師に、
診断や治療についての意見を求める事。
主治医からの紹介状が必要で自費診療が原則だが、
その結果、思わぬ原因や解決法が発見出来る可能性がある。
謎の「長引く息切れ」に関する悩み
名医が呼吸音で息切れの真犯人（原因）を明らかに！
心肺機能は歳を重ねるにつれ、
誰でも低下するもの。
更に喫煙や運動不足などの生活習慣でも、
心肺機能は大きく低下してしまう。
そんな息切れ・呼吸に関するお悩みに答える名医は、
京都府・京都市の洛和会音羽病院に勤務する、
呼吸器の名医・長坂行雄先生である。
長坂行雄先生は20年異常にわたって、
呼吸音の分析を続ける息遣いのスペシャリストである。
呼吸器の病は肺や気管支、扁桃腺の異常など、
多岐に渡りその数はなんと40種類以上と言われている。
長坂行雄先生はそれぞれの病を、
微妙な呼吸音の違いを聴診器だけで聴き分けるという。
実際の症例
長引く息切れの原因
→実は軟骨の炎症による気管の狭窄
長坂行雄先生が体験した実際の症例を紹介。
西田佑子さん（50歳・仮名）の場合。
症状は以下の通り。
症状①：ちょっとした運動で息切れ。
症状②：歩いだだけで息苦しい息切れ。
症状③：息をする度に肺（喉）から奇妙な呼吸音。
症状④：家の中を移動しただけで息切れ。
最初の診断（ファーストオピニオン）は、
「気管支喘息」であった。
気管支喘息とは何らかの影響により、
アレルギー反応が起こり、
気管支の一部が収縮してしまう病。
その結果、空気の通り道が狭くなり、
息苦しさや咳などに襲われる。
気管支喘息最大の特徴は、
狭くなった気管支を空気が通る時に、
「ヒューヒュー」という音が鳴る事である。
喘息の症状を抑える為に、
吸入タイプのステロイド剤を処方され、
一時的に症状は改善されたが、
すぐに薬は効かなくなった。
長坂行雄先生の、
二回目の診断（セカンドオピニオン）が始まる。
長坂行雄先生の注目したポイントは以下の通り。
①喘息は横になると苦しいが横になった方が楽になる。
②左右の肺の音（呼吸音）が同じ。
③首からも「ヒュー」という奇妙な音が聞こえる。
④鼻筋に5ミリ程のくぼみ。
長坂行雄先生は西野さんに耳鼻科を受診するよう勧め、
その結果「再発性多発軟骨炎」である事が判明。
再発性多発軟骨炎とは何らかの原因で、
全身の軟骨が破壊されてしまう病。
詳しい原因や治療法が確立されていない病である。
そもそも我々の体には無数の軟骨が存在し、
鼻・耳など柔らかい骨が代表的だが、
実は呼吸を司る気管にも気管軟骨というものがある。
再発性多発軟骨炎を発症すると、
軟骨が炎症を起こし、気管自体が狭くなってしまう。
長坂行雄先生は肺の音に左右差がない事に、
最大の違和感を覚えていた。
気管支喘息の場合、
気管そのものえなく、
気管支の一部が細くなり、
細くなっている部分から音が鳴る。
そしてこの気管支が、
左右対称に細くなる事はないのである。
つまり音の左右差が生まれる。
一方で再発性多発軟骨炎の場合、
気管支ではなく、気管そのものが細くなる。
つまり体の中心にある気管から音が鳴る為、
聞こえる音に左右差がない。
そして鼻は軟骨で作られている為、
鼻のくぼみから再発性多発軟骨炎を確信。
実際に耳鼻科を受診すると、
鼻の軟骨組織から炎症が見つかったという。
《もうちょっと調べてみた&所感》
私も結構、気管が弱く、
風邪を引いた時なんかはもれなく、
肺から「ヒューヒュー」と嫌な音が流れます。
あの不快さは感じた人でないと分からないと思いますし、
とんでもなく息苦しさを感じますよね。
私の場合は、
横になると特に辛くなる典型的な喘息の特徴が見られた為、
おそらく気管支炎だとは思うのですが、
自覚症状として横になった方が楽になるという方は、
それは気管支にまつわる病気でない可能性があります。
原因不明の長引く息切れでお悩みの方は、
今回、セカンドオピニオンを提供して下さった、
「洛和会音羽病院」に勤務する、
呼吸器の名医・長坂行雄先生の、
診察を受けてみた方が良いかもしれません。
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タグ：たけしのみんなの家庭の医学, 医師, 病気, 病院, 症状
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