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薬が効くヘルニアと効かないヘルニア

薬局

ヘルニアというと腰痛や薬の服用による痛みの緩和などをイメージされる方が多いかもしれません。しかし、ヘルニアの中では薬の服用が効果的ではないものもあります。薬の服用が効果的なヘルニアとそうでないヘルニアはどのように違うのでしょうか。

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すべてのヘルニアに薬が効くわけじゃない?

医師

ヘルニアというと腰の痛み・痛み止めの薬を服用するといったイメージをお持ちの方が多いかもしれません。腰痛を生じさせるヘルニアは頚椎ヘルニアといい、このタイプのヘルニアの場合には痛み止めが確かに有効です。

しかし、すべてのヘルニアに対して薬の服用が有効なわけではありません。そもそもヘルニアとは、体の内部の臓器等が本来あるべき場所からほかの場所に移動してしまっている状態を指します。頚椎ヘルニアの場合には椎間板という骨のクッションが本来の場所から飛び出てしまい、神経を圧迫して痛みを生じます。そのため、痛み止めの薬が有効です。

しかし、腸などが飛び出してしまっている鼠径ヘルニア(いわゆる脱腸)や脳が頭蓋骨の隙間から飛び出してしまっている脳ヘルニアなどの場合には薬での治療は有効とは言えません。特に、脳ヘルニアの場合には緊急で手術をしなければ命に関わります。

このようにヘルニアすべてに薬の処方が効果的というわけではありません。このことを前提に以下では薬が有効な種類のヘルニアについて、よく処方される薬の種類についてまとめていきます。

痛みを緩和させる・椎間板ヘルニアの治療薬

薬が有効なヘルニアの種類としては椎間板ヘルニアがあります。椎間板ヘルニアの場合、椎間板によって神経が圧迫されて、ひどい痛みが襲いますので痛みを抑えるために薬を処方することがよく行われます。

椎間板ヘルニアによる痛みに対して有効な薬としては、例えば、ミオナールが処方されます。ミオナールはヘルニアによる痛みを和らげるとともに血行を促進する働きがあり、しかも、効果が穏やかであるということから非常によく処方される薬の一つと言えます。

また、腰痛ないしは腰痛による炎症を抑える効果があるロルカムという薬も処方されます。ロルカムは直接に椎間板ヘルニアを治すものではありません。しかし、痛みを抑えるために処方されることがある薬です。

その他、椎間板ヘルニアに使用される薬としては、ボルタレンサポ・モーラス(湿布)メトカルバモール・カリソプロドール・シクロベンザプリン・ジアゼパムなどといった薬があります。

椎間板ヘルニアに対しては、痛みの程度、副作用の危険性などを考慮した上で医師がもっとも適切と考える薬が処方されることとなります。

主として逆流性食道炎解消のために薬を処方・食道裂孔ヘルニア

食道裂孔ヘルニアは横隔膜を超えて胃の一部が飛び出してしまっている状態です。胃が横隔膜を超えてしまうというととてつもなくひどい症状にも思えますが、実は、食道裂孔ヘルニアそれ自体ではあまり健康への害はありません。

食道裂孔ヘルニアが問題となるのは、例えば、胃酸が逆流する逆流性食道炎を併発してしまったような場合です。このような場合には食道裂孔ヘルニアそれ自体よりも逆流性食道炎を解消するための薬が処方されます。

例えば胃酸の分泌を抑えるプロトンポンプ阻害薬、H2ブロッカーなどが処方されます。
食道裂孔ヘルニアそれ自体ではなく逆流性食道炎を解消するために薬が処方されますので、胃酸をいかにしてコントロールするかが重要なポイントとなると言えます。

薬では治療できない・鼠径ヘルニア

一方で薬の処方では治療することができないヘルニアの一種として鼠径ヘルニアがあります。鼠径ヘルニアは、腸や腹膜の一部が飛び出してしまう状態です。内太ももの部分に飛び出した突起ができます。

鼠径ヘルニアの場合、薬による治療は基本的に不可能です。鼠径ヘルニアはお腹の筋膜が弱まってしまうことが大きな原因であり、薬によってお腹の筋膜が弱くなってしまった状態を解消することは困難であるためです。

鼠径ヘルニアの場合、手術による治療やヘルニアバンドと呼ばれる帯を装着することで対処・解消を図ることになります。

鼠径ヘルニアは放置しておくと飛び出た腸が腐ってしまうこともありますのでしっかりと病院で治療を受けることが必要です。

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ALINCO(アルインコ) (2012-04-05)
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まとめ:薬によるヘルニア治療は主として頚椎ヘルニア

以上、本文で述べましたヘルニアと薬の処方についてポイントをまとめますと以下のようになります。

  • ヘルニアの場合、薬が効果的なヘルニアとそうではないヘルニアとがあります。薬が効果的なヘルニアは主として頚椎ヘルニア、薬が効果的ではないヘルニアは主として脳ヘルニア・鼠径ヘルニアなどとなります
  • 頚椎ヘルニアの場合、炎症や痛みを抑えるためにミオナールやロルカムなどの薬が処方されます
  • 食道裂孔ヘルニアの場合、逆流性食道炎を抑えるために胃酸の分泌を抑えるプロトンポンプ阻害薬、H2ブロッカーなどの薬が処方されます

ヘルニアの中で薬の処方が効果的なヘルニアは主として頚椎ヘルニアであるということができます。その他の種類のヘルニアの場合には手術なども視野に入れて診察・治療を受ける必要があると言えます。

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