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#hdMenu .trigger a { display: block; text-indent: -9999px; width: 40px; height: 40px; background: url(/image/pc/ico_ar.png) no-repeat 0 10px;} #hdMenu .trigger a:hover { background-position: 0 -40px;} #searchArea { position: relative; margin-left: 238px; margin-bottom: 16px;} #searchArea form { position: absolute; top: 0; right: 0;} #searchArea input, #searchArea select, .customSelect { float: left; display: inline; width: 120px; height: 40px; margin-top: 10px; border: 1px solid #1a1a1a; cursor: pointer; border-radius: 3px; -o-border-radius: 3px; -webkit-border-radius: 3px; -moz-border-radius: 3px; -ms-border-radius: 3px; -webkit-appearance: none; box-sizing: border-box;} #searchArea input#search_input { width: 482px; padding-right: 10px; padding-left: 10px; cursor: auto; box-sizing: border-box; margin-right: 10px;} #searchArea .selectwrap { position: relative; float: left; display: block; width: 120px;} #searchArea select { left: 0;} .customSelect { padding: 6px 10px; background: 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#sponsor { float: left; display: inline;} #sponsor li { float: left; display: inline; height: 30px; margin-right: 20px;} #sponsor li:last-of-type { margin-right: 0;} #sponsor a.spoa img { width: 98px; height: 30px;} #sponsor a.spov img { width: 115px; height: 22px;} #ftWrap .menu { float: right; display: inline;} #ftWrap .menu li:first-child {margin-left: 0;} #ftWrap .menu li { float: left; display: inline; margin-left: 20px;} #ftWrap .menu li a { color: #fff; font-weight: bold;} #copyright { clear: both; padding-top: 30px; color: #808080;} #copyright a.spoy { display: none;} /* media ============================================================ */ @media only screen and (-webkit-min-device-pixel-ratio: 2) and (min-width: 641px) { ul.links a, #hdMenu .trigger a, .customSelect { background-image: url(/image/pc/ico_ar@2x.png); -webkit-background-size: 50px 300px; -moz-background-size: 50px 300px; background-size: 50px 300px;} #hdBtn a { background-image: url(/image/pc/bt_app@2x.gif); -webkit-background-size: 136px 39px; -moz-background-size: 136px 39px; background-size: 136px 39px;} } /* pagination ============================================================ */ #pagination { display: flex; justify-content: center; align-items: center; margin: 40px 70px;} #pagination .button { display: flex; justify-content: center; align-items: center; width: 80px; height: 40px; border: none; border-radius: 4px; background-color: #f2f2f2; margin: 0 5px; cursor: pointer;} #pagination .button:hover { background-color: #e3e3e3;} #pagination .chevron { fill: #333;} #pagination .numbered-page { font-size: 16px; font-weight: bold; margin: 0 10px; color: #333;} #pagination .previous { padding-left: 10px;} #pagination .next { padding-right: 10px;} /* TOP 情報 ============================================================ */ #topInfo { text-align: center; margin-top: 70px; } /* モーダル ============================================================ */ .kotobankModal { display: none; position: fixed; z-index: 1; left: 0; top: 0; width: 100%; height: 100%; overflow: auto; background-color: rgba(0,0,0,0.4); } .kotobankModal .modal-content { background-color: #fefefe; margin: 15% auto; padding: 35px 35px 35px 35px; border: 1px solid #888; width: 75%; position: relative; } .kotobankModal .modal-button { display: flex; justify-content: center; align-items: center; color: #000; width: 90%; height: 50px; padding: 10px; text-align: center; margin: 10px auto; border: 1px solid #888; border-radius: 4px; text-decoration: none; } .kotobankModal .modal-button:hover { background-color: #eee; } .kotobankModal .modal-arrow { display: inline-block; width: 20px; height: 20px; border: 1px solid #000; border-radius: 50%; text-align: center; line-height: 18px; margin-left: 10px; } .kotobankModal .modal-close { position: absolute; top: 10px; right: 10px; font-size: 20px; cursor: pointer; } /* 課金誘導情報 ============================================================ */ #payment_info a { text-decoration: none; } #payment_info div.info { display: inline-block; margin: 20px 0px 10px 0px; padding: 7px 12px 8px 12px; border-radius: 12px; border: 1px solid; border-color: #DAE2ED; color: #0073E6; background-color: #EBF5FF; font-size: 90%; font-weight: bold; width: 740px } #payment_info div.info:hover { background-color: #D6E9FF; } body.payment .plan-container { display: flex; flex-wrap: wrap; justify-content: space-between; max-width: 1400px; margin: 0 auto; } body.payment .plan { flex: 1 1 calc(50% - 20px); margin: 10px; min-width: 300px; } body.payment .plan-box { padding: 10px; border: 1px solid #666; margin-bottom: 14px; } body.payment .plan-description { font-size: 85%; } @media (max-width: 768px) { body.payment .plan { flex: 1 1 100%; } } /* 下部検索窓モバイル ============================================================ */ @media only screen and (max-width: 1020px) { .winpc #contentArea { width: 100%;} .winpc #hdWrap #searchArea { margin-left: 238px;} .winpc #hdWrap #searchArea form { width: 100%;} 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url(/image/sp/ico_ar.png) no-repeat 0 -180px;} .winsp #pagination { margin: 0px 0px;} .winsp .bodyWrap { padding: 0;} .winsp #hdMenu { top: 20px; left: 0;} .winsp #hdMenu .trigger a { width: 100px; height: 90px; background: url(/image/sp/ico_ar.png) no-repeat 20px 20px;} .winsp #hdMenu .trigger a:hover { background-position: 20px -54px;} .winsp #searchArea { margin-top: 36px; margin-left: 0;} .winsp #searchArea form { position: relative;} .winsp #searchArea .selectwrap, .winsp #searchArea select, .winsp .customSelect { display: none;} .winsp #searchArea input { float: none; display: block; width: 160px; height: 80px; margin-top: 0; border: 0; border-radius: 0; -o-border-radius: 0; -webkit-border-radius: 0; -moz-border-radius: 0; -ms-border-radius: 0; -webkit-appearance: none;} .winsp #searchArea input#search_input { width: 100%; margin-right: 0; padding-right: 180px; padding-left: 20px; border-top: 1px solid #1a1a1a; border-right: 0; border-bottom: 1px solid #1a1a1a; border-left: 0;} .winsp #searchArea input.searchbtn { z-index: 30; position: absolute; top: 0; right: 0; width: 160px; height: 80px; margin-left: 0;} .winsp #searchAreaWordBottom .selectwrap { display: none;} .winsp #hdWrap #searchArea form, .winsp #hdWrap #search_input { width: 100%; box-sizing: border-box;} .winsp #hdMenuCont .box { padding: 28px 0 26px; font-size: 73.3%;} .winsp #hdMenuCont .todayWordDesc { display: -webkit-box; -webkit-box-orient: vertical; -webkit-line-clamp: 3; overflow: hidden;} .winsp #hdNav .links li a { padding: 0 0 0 12px; background-position: 0 -185px; line-height: 2; font-weight: bold;} .winsp #ftWrap .bodyWrap {} .winsp #sponsor { position: relative; float: none; display: block;} .winsp #sponsor li {} .winsp #sponsor a, .winsp #copyright a.spoy { display: block; } .winsp #sponsor a.spoa img { width: 142px; height: 44px;} .winsp #sponsor li.spoy { display: none;} .winsp #sponsor a.spov img { width: 160px; height: 36px;} .winsp #ftWrap .menu { position: relative; float: none; display: block; padding-top: 36px;} .winsp #ftWrap .menu li {} .winsp #copyright { line-height: 1.4;} .winsp #copyright a.spoy { position: relative; float: left; width: 58px; height: 36px; margin: 0 5px 3px 0; background-position: 0 -100px;} #topInfo { margin-top: 10px; font-size: 73.3%; } } @media only screen and (max-width: 500px) { body.winsp, .winsp input, .winsp select { font-size: 18px;} .winsp input, .winsp select { font-size: 18px;} .winsp #contentArea .title { padding-left: 10px; padding-right: 10px;} .winsp ul.links a { padding-left: 12px; background: url(/image/sp/ico_ar.png) no-repeat 0 -90px; -webkit-background-size: 50px 200px; -moz-background-size: 50px 200px; background-size: 50px 200px;} .winsp #pagination { margin: 0px 0px;} .winsp #hdMenu { top: 10px;} .winsp #hdMenu .trigger a { width: 50px; height: 45px; background: url(/image/sp/ico_ar.png) no-repeat 10px 10px; -webkit-background-size: 50px 200px; -moz-background-size: 50px 200px; background-size: 50px 200px;} .winsp #hdMenu .trigger a:hover { background-position: 10px -27px;} .winsp #searchArea { margin: 18px 0;} .winsp #searchArea input { width: 80px; height: 40px;} .winsp #searchArea input#search_input { padding-right: 90px; padding-left: 10px;} .winsp #searchArea input.searchbtn { width: 80px; height: 40px;} .winsp #searchAreaWordBottom { margin: 0;} .winsp #searchAreaWordBottom .search_inputwrap { width: calc(100% - 80px); vertical-align: top;} .winsp #searchAreaWordBottom input { width: 80px; height: 40px; border-radius: 0; box-sizing: border-box;} .winsp #searchAreaWordBottom input#search_input { padding-right: 10px; padding-left: 10px; margin: 0; width: 100%;} .winsp #searchAreaWordBottom input.searchbtn { width: 80px; height: 40px; margin: 0; border: 0;} .winsp #searchAreaWordBottom .selectwrap { display: none;} .winsp #hdMenuCont { left: -210px; width: 199px; padding-left: 10px;} .winsp #hdMenuCont .box { padding: 14px 0 13px;} .winsp #hdNav .links li a { padding: 0 0 0 10px; background-position: 0 -92px;} .winsp #ftWrap .bodyWrap { padding: 0 10px;} .winsp #ftWrap .inner { padding: 20px 0 18px;} .winsp #sponsor {} .winsp #sponsor li { margin-right: 10px;} .winsp #sponsor a, .winsp #copyright a.spoy { -webkit-background-size: 100px 150px; -moz-background-size: 100px 150px; background-size: 100px 150px;} .winsp #sponsor a.spoa img { width: 71px; height: 22px;} .winsp #sponsor a.spov img { width: 80px; height: 18px;} .winsp #ftWrap .menu { padding-top: 20px;} .winsp #ftWrap .menu li:first-child { margin-left: 0;} .winsp #ftWrap .menu li { margin-left: 10px; padding-bottom: 0;} .winsp #copyright { padding-top: 20px;} .winsp #copyright a.spoy { width: 29px; height: 18px; margin-top: 0; background-position: 0 -50px;} } /* clear ============================================================ */ .cf, #hdWrap, #searchArea, #ftWrap .menu, #sponsor { zoom: 1;} .cf:after, #hdWrap:after, #searchArea:after, #ftWrap .menu:after, #sponsor:after { content: "."; display: block; height: 0; clear: both; visibility: hidden;} </style> <style>@charset "utf-8"; /* module ============================================================ */ .ad.bn.w300 { max-width: 300px; width: 100%;} .ad.bn.w336 { max-width: 336px; width: 100%;} .ad.bn.w468 { max-width: 468px; width: 100%;} .ad.bn.w728 { max-width: 728px; width: 100%;} .ad.bn img { max-width: 100%; height: auto; width/***/: auto;} /* base layout ============================================================ */ #hdWrap { position: relative; padding-top: 40px;} #hdWrap #toplogo a, #hdY a { display: block; text-indent: -9999px;} #hdWrap #toplogo { float: left; display: inline; margin-top: 10px;} #hdWrap #toplogo a { width: 198px; height: 40px; margin-right: 40px; background: url(/image/pc/logo.gif) no-repeat 0 0;} #hdY { position: absolute; top: 15px; right: 0;} #hdY a { width: 336px; height: 17px; background: url(/image/pc/txt_hd.png) no-repeat 0 0;} #topicPath { clear: both; padding: 0 0 10px;} #topicPath li { float: left; display: inline; padding-right: 5px; font-size: 86.7%;} #mainTitle { position: relative; padding: 8px 0 30px; border-top: 1px solid #e6e6e6;} #mainTitle h1 { font-family: "Times New Roman", Times, 'ヒラギノ明朝 ProN', 'Hiragino Mincho ProN', 'YuMincho', 'Yu Mincho', 'メイリオ', Meiryo, 'ＭＳＰゴシック', serif;} #mainTitle h1 { font-weight: bold; font-size: 240%;} #mainTitle h1 span { margin-left: 10px; font-size: 18px; font-weight: normal;} /* payment */ #payment { text-align: right; height:48px; font-size:17px; padding-right:5px; } /* main ============================================================ */ /* mainArea */ #mainArea { border-top: 1px solid #e6e6e6;} #mainArea .ad { margin: 34px 0px 0px;} #mainArea .ad.bn { padding-bottom: 3px;} #retailkeyword { padding: 5px 0 36px;} #retailkeyword h2 { font-size: 140%; margin-bottom: 10px;} /* subArea */ #subArea { position: relative; padding-bottom: 36px;} #subArea .ad { padding-bottom: 10px;} /* mainFt */ #mainFt { clear: both; position: relative; padding-bottom: 28px;} #mainFt .ad { text-align: center; margin: 0 auto; padding-bottom: 12px;} /* submenu */ #sub_menu_body { font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} #sub_menu_body { position:fixed; display:none; z-index:2; width:70%; margin:0; padding:10px 20px; border:2px solid #aaa; background:#fff;} #sub_menu_body ul { overflow: auto; } .sub_menu_first { font-size: 125%; } .modal-overlay { z-index:1; display:none; position:fixed; top:0; left:0; width:100%; height:120%; background-color:rgba(0,0,0,0.75); } .header_menu { width: 100%;} .header_menu a { margin-left: 24px; margin-right: 16px; font-size:80%; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .H4 { display: block; font-size: 115%;} .H5 { display:inline; padding: 0px 6px;} .H6 { display:none; padding: 0px 4px; font-size:80%;} #hdSearch { display: none;} #searchForm { display: none;} /* pageWord ============================================================ */ .dictype { padding-bottom: 45px;} .dictype h2 { padding-bottom: 28px; font-size: 140%;} .dictype h2 a { color: #000; text-decoration: none;} .dictype h2 span { font-weight: normal;} .dictype h3 { margin-bottom: 10px;} .dictype h4 { margin-top: 24px;} .dictype .ex section { font-family: "Times New Roman", Times, 'ヒラギノ明朝 ProN', 'Hiragino Mincho ProN', 'YuMincho', 'Yu Mincho', 'メイリオ', Meiryo, 'ＭＳＰゴシック', serif; margin-bottom: 30px;} .dictype .ex section b { font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section h3 { margin-top: 24px; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section h4 { margin-top: 24px; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section h5 { margin-top: 24px; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section h6 { margin-top: 12px; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section .year { margin-right: 12px; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section .month {} .dictype .ex section p.talent_doc b {margin-right: 12px;} .dictype .ex section dt { font-weight:bold; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif; margin-right: 12px;} .dictype .ex section dt { display: inline; padding: 0px; 6px;} .dictype .ex section dd { display: inline;} .dictype .ex section dl.talent dt.dt24 {display:block;} .dictype .ex section .description_linklist { margin-top: 6px;} .dictype .ex section .description_linklist a { font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section .media { padding: 6px 0px; width: 100%;} .dictype .ex section .media figure { margin:4px; float:left;} .dictype .ex section .media figure img { height:150px;} .dictype .ex section .media figure p { text-align:center; font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section.kome { margin-top: 24px;} .dictype .ex section .description_comment { margin-top: 8px; font-size: 90%;} .dictype table { width: 100%; margin-top: 30px;} .dictype table caption { padding-bottom: 3px; font-weight: bold;} .dictype table thead td, .dictype table thead th { padding: 5px 0; border-top: 1px solid #1a1a1a; font-weight: bold; vertical-align: top;} .dictype table tbody td, .dictype table tbody th { padding: 5px 0; border-top: 1px solid #e6e6e6; vertical-align: top;} .dictype table tbody .last td, .dictype table tbody .last th { padding: 5px 0 0;} .dictype table tr > th { border-right: 10px solid #fff;} .dictype table tbody th { white-space: nowrap;} .dictype table tbody td { width: 90%;} .dictype .source { margin-top: 31px; color: #808080; font-size: 73.3%; line-height: 1.5;} .dictype .source small:first-child { display: inline;} .dictype .source small { display: block;} .dictype#sekai_refs .note { margin-bottom: 15px;} #spWordHeaderAd > div:first-of-type { margin-bottom: 15px; } /* lightbox captions */ .lbdata_caption { } .lbdata_desc { } .lbdata_copyright { margin-left: 8px; font-size: 80%; } /* 辞書個別 */ div[data-orgtag="meaning"] { margin: 4px 0px 4px 0px; } div[data-orgtag="example"] { margin: 4px 0px 4px 0px; } div[data-orgtag="subheadword"] { margin: 20px 0px 4px 0px; } /* pageEjjeWord ============================================================ */ .wordtop p { padding-top: 16px; padding-bottom: 14px; font-size: 86.7%;} .dictype { padding-bottom: 45px;} .dictype h2 { padding-bottom: 28px; font-size: 140%;} .dictype h2 span { font-weight: normal;} .dictype h3 { margin-bottom: 24px;} .dictype h4 { margin-top: 24px;} .dictype .ex section { font-family: "Times New Roman", Times, 'ヒラギノ明朝 ProN', 'Hiragino Mincho ProN', 'YuMincho', 'Yu Mincho', 'メイリオ', Meiryo, 'ＭＳＰゴシック', serif;} .dictype .ex section b { font-family: Helvetica, 'Hiragino Kaku Gothic Pro', 'ヒラギノ角ゴ Pro W3', 'メイリオ', Meiryo, 'ＭＳＰゴシック', HirakakuProN-W3, sans-serif;} .dictype .ex section.kome { margin-top: 24px;} .dictype table { width: 100%; margin-top: 30px; table-layout:fixed;} .dictype table caption { padding-bottom: 3px; font-weight: bold;} .dictype table thead td, .dictype table thead th { padding: 5px 0; border-top: 1px solid #1a1a1a; font-weight: bold; vertical-align: top;} .dictype table tbody td, .dictype table tbody th { padding: 5px 0; border-top: 1px solid #e6e6e6; vertical-align: top;} .dictype table tbody .last td, .dictype table tbody .last th { padding: 5px 0 0;} .dictype table tr > th { border-right: 10px solid #fff;} .dictype table tbody th { white-space: nowrap;} .dictype table tbody td { width: 90%;} .dictype .source { margin-top: 31px; color: #808080; font-size: 73.3%; line-height: 1.5;} .dictype .source small:first-child { display: inline;} .dictype .source small { display: block;} .word_foreign { margin-top: 24px } /* pageGuide ============================================================ */ .pageGuide .title { text-indent: -9999px; height: 60px; padding-top: 0; background: url(/image/pc/title_about.gif) no-repeat 0 20px;} .pageGuide .lead { padding-bottom: 1.7em;} .pageGuide .lead p, .sec01 p, .sec01 ol, .sec03 p, .secend p { margin-top: 1.6em;} .sec01 { padding-bottom: 1.6em;} .sec01 p.morebtn { margin-top: 5px;} .sec02 h3.ttl { margin-bottom: 0;} .sec03 { padding-top: 26px;} .secend { padding: 55px 0 30px;} .pageGuide img { max-width: 100%; width: 100%;} /* pageDic ============================================================ */ .pageDic .title { text-indent: -9999px; height: 60px; padding-top: 0; background: url(/image/pc/title_dic.gif) no-repeat 0 20px;} .pageDic .lead { margin-top: 1.6em; padding-bottom: 3.5em;} .diccategory { padding-bottom: .5em;} .diccategory h2.ttl { padding: 15px 0 28px; border-top: 1px solid #e6e6e6; font-size: 140%;} .diccategory h3 { padding-bottom: 1.6em;} .diccategory dl { margin: 1em 0 3.4em;} .diccategory dl dt, .diccategory dl dd { float: left; display: inline;} .diccategory dl dd { padding-right: 14px;} /* pageDicdetail ============================================================ */ .pageDicdetail .lead { margin-top: -1em; padding-bottom: 0.3em;} .pageDicdetail .lead p.source { margin-top: 20px; font-size: 85%; color:#808080;} .pageDicdetail h2.ttl { margin: 25px 0 4px;} .pageDicdetail #mainArea .grid02 { margin-top: 15px;} .pageDicdetail #mainArea .grid02 li { display:inline-block; vertical-align: top; width: 46.875%; margin-left: 6.25%; padding: 8px 0; border-top: 1px solid #e6e6e6; line-height: 1.3;} .pageDicdetail #mainArea .grid02 li:nth-child(odd) { margin-left: 0;} /* pageAbc ============================================================ */ .pageAbc .title { text-indent: -9999px; height: 60px; padding-top: 0; background: url(/image/pc/title_abc.gif) no-repeat 0 20px;} .pageAbc #mainArea .grid05 { margin-top: 28px; padding-bottom: 28px;} .pageAbc #mainArea .grid05 li { text-align: center; float: left; display: inline; width: 17.5%; margin-left: 3.125%; padding: 20px 0; border-top: 1px solid #e6e6e6; font-weight: bold; line-height: 1.4;} .pageAbc #mainArea .grid05 li.first { clear: left; margin-left: 0;} /* pageAbcdetail ============================================================ */ .pageAbcdetail .lead { margin-top: -1em; padding-bottom: 0.3em;} .pageAbcdetail h2.ttl { margin: 25px 0 4px;} .pageAbcdetail #mainArea .grid02 { margin-top: 15px;} .pageAbcdetail #mainArea .grid02 li { display:inline-block; vertical-align: top; width: 46.875%; margin-left: 6.25%; padding: 8px 0; border-top: 1px solid #e6e6e6; line-height: 1.3;} .pageAbcdetail #mainArea .grid02 li:nth-child(odd) { margin-left: 0;} /* pageInfo ============================================================ */ .pageInfo .title { text-indent: -9999px; height: 60px; padding-top: 0; background: url(/image/pc/title_info.gif) no-repeat 0 20px;} /* pageRanking ============================================================ */ .pageRanking #mainTitle { padding: 8px 0 32px;} .pageRanking .title { text-indent: -9999px; height: 35px; padding-top: 0; background: url(/image/pc/title_rank.gif) no-repeat 0 12px;} .pageRanking #mainArea { border-top: 0;} .pageRanking #mainArea dt, .pageRanking #mainArea li { position: relative; border-top: 1px solid #e6e6e6;} .pageRanking #mainArea dt { padding: 19px 0 0 60px; font-size: 140%; font-weight: bold;} .pageRanking #mainArea dd { padding: 11px 0 16px 60px;} .pageRanking #mainArea .ranksecond li { padding: 17px 0 17px 60px; font-size: 140%;} .pageRanking #mainArea .num { position: absolute; top: 20px; left: 0; display: block; text-indent: -9999px; width: 45px; height: 24px;} .pageRanking #mainArea .ranksecond li .num { top: 17px;} .pageRanking #mainArea dt .num01 { background: url(/image/pc/txt_rank01.gif) no-repeat 0 0;} .pageRanking #mainArea dt .num02 { background: url(/image/pc/txt_rank02.gif) no-repeat 0 0;} .pageRanking #mainArea dt .num03 { background: url(/image/pc/txt_rank03.gif) no-repeat 0 0;} .pageRanking #mainArea li .num04 { background: url(/image/pc/txt_rank04.gif) no-repeat 0 0;} .pageRanking #mainArea li .num05 { background: url(/image/pc/txt_rank05.gif) no-repeat 0 0;} .pageRanking #mainArea li .num06 { background: url(/image/pc/txt_rank06.gif) no-repeat 0 0;} .pageRanking #mainArea li .num07 { background: url(/image/pc/txt_rank07.gif) no-repeat 0 0;} .pageRanking #mainArea li .num08 { background: url(/image/pc/txt_rank08.gif) no-repeat 0 0;} .pageRanking #mainArea li .num09 { background: url(/image/pc/txt_rank09.gif) no-repeat 0 0;} .pageRanking #mainArea li .num10 { background: url(/image/pc/txt_rank10.gif) no-repeat 0 0;} .pageRanking #mainArea .below { width: 46.875%; margin-top: 38px; padding-bottom: 30px;} .pageRanking #mainArea .below li { clear: both; padding-top: 7px;} .pageRanking #mainArea .below span { float: left; display: block; width: 3em; padding-bottom: 8px;} /* media ============================================================ */ @media only screen and (-webkit-min-device-pixel-ratio: 2) and (min-width: 641px) { #hdWrap #toplogo a { background-image: url(/image/pc/logo@2x.gif); -webkit-background-size: 198px 40px; -moz-background-size: 198px 40px; background-size: 198px 40px;} #hdY a { background-image: url(/image/pc/txt_hd@2x.gif); -webkit-background-size: 336px 17px; -moz-background-size: 336px 17px; background-size: 336px 17px;} .pageGuide .title { background-image: url(/image/pc/title_about@2x.gif); -webkit-background-size: 249px 28px; -moz-background-size: 249px 28px; background-size: 249px 28px;} .pageDic .title { background-image: url(/image/pc/title_dic@2x.gif); -webkit-background-size: 111px 28px; -moz-background-size: 111px 28px; background-size: 111px 28px;} .pageAbc .title { background-image: url(/image/pc/title_abc@2x.gif); -webkit-background-size: 55px 27px; -moz-background-size: 55px 27px; background-size: 55px 27px;} .pageInfo .title { background-image: url(/image/pc/title_info@2x.gif); -webkit-background-size: 306px 28px; -moz-background-size: 306px 28px; background-size: 306px 28px;} .pageRanking .title { background-image: url(/image/pc/title_rank@2x.gif); -webkit-background-size: 251px 28px; -moz-background-size: 251px 28px; background-size: 251px 28px;} .pageRanking #mainArea dt .num01 { background-image: url(/image/pc/txt_rank01@2x.gif); -webkit-background-size: 30px 24px; -moz-background-size: 30px 24px; background-size: 30px 24px;} .pageRanking #mainArea dt .num02 { background-image: url(/image/pc/txt_rank02@2x.gif); -webkit-background-size: 35px 24px; -moz-background-size: 35px 24px; background-size: 35px 24px;} .pageRanking #mainArea dt .num03 { background-image: url(/image/pc/txt_rank03@2x.gif); -webkit-background-size: 35px 24px; -moz-background-size: 35px 24px; background-size: 35px 24px;} .pageRanking #mainArea li .num04 { background-image: url(/image/pc/txt_rank04@2x.gif); -webkit-background-size: 34px 24px; -moz-background-size: 34px 24px; background-size: 34px 24px;} .pageRanking #mainArea li .num05 { background-image: url(/image/pc/txt_rank05@2x.gif); -webkit-background-size: 33px 24px; -moz-background-size: 33px 24px; background-size: 33px 24px;} .pageRanking #mainArea li .num06 { background-image: url(/image/pc/txt_rank06@2x.gif); -webkit-background-size: 33px 24px; -moz-background-size: 33px 24px; background-size: 33px 24px;} .pageRanking #mainArea li .num07 { background-image: url(/image/pc/txt_rank07@2x.gif); -webkit-background-size: 33px 24px; -moz-background-size: 33px 24px; background-size: 33px 24px;} .pageRanking #mainArea li .num08 { background-image: url(/image/pc/txt_rank08@2x.gif); -webkit-background-size: 33px 24px; -moz-background-size: 33px 24px; background-size: 33px 24px;} .pageRanking #mainArea li .num09 { background-image: url(/image/pc/txt_rank09@2x.gif); -webkit-background-size: 33px 24px; -moz-background-size: 33px 24px; background-size: 33px 24px;} .pageRanking #mainArea li .num10 { background-image: url(/image/pc/txt_rank10@2x.gif); -webkit-background-size: 43px 24px; -moz-background-size: 43px 24px; background-size: 43px 24px;} } @media only screen and (max-width: 800px) { .pageDicdetail #mainArea .grid02 li { width: 100%; margin-left: 0;} .pageAbcdetail #mainArea .grid02 li { width: 100%; margin-left: 0;} .pageRanking #mainArea .below { float: none; display: block; width: auto;} } @media only screen and (max-width: 700px) { .pageInfo .title { -webkit-background-size: 100% auto; -moz-background-size: 100% auto; background-size: 100% auto;} } @media only screen and (max-width: 660px) { .ad.bn.w300, .ad.bn.w336, .ad.bn.w468, .ad.bn.w728 { max-width: 100%; width: 100%;} .winsp #hdWrap { padding-top: 28px;} .winsp #hdWrap #toplogo { float: none; display: block} .winsp #hdWrap #toplogo a { width: 318px; height: 64px; background: url(/image/sp/logo.gif) no-repeat 0 0;} .winsp #hdY, .winsp #topicPath { display: none;} .winsp #mainTitle { margin-top: 0; padding: 24px 20px 30px; border-top: 0;} .winsp #mainTitle h1 { padding-bottom: 24px; line-height: 1.2;} .winsp #mainTitle h1 { font-size: 170%;} .winsp #mainTitle h1 span { margin-left: 0; display: block; font-size: 22px;} .winsp #mainArea { border:none; margin-top: 26px; padding-top: 10px;} .winsp #mainArea .ad.bn img { width: 100%;} .winsp #mainArea .ad.sub { margin: 0 0 50px;} .winsp #retailkeyword { padding: 0 20px 50px;} .winsp #subArea { display: none;} .winsp #mainFt { width: 92%; padding: 0px 10px 0px 10px;} .winsp .wordtop { padding: 0 20px;} .winsp .dictype { padding-bottom: 50px;} .winsp .dictype .ex { padding: 50px 20px 0;} .winsp .dictype h2 { vertical-align: middle; padding: 12px 10px; font-size: 16px; background-color: #000; color: #fff;} .winsp .dictype h2 a { color: #fff;} .winsp .dictype h3 { margin-bottom: 50px;} .winsp .dictype h4 { margin-top: 50px;} .winsp .dictype table tbody th { white-space: normal;} .winsp .dictype table tbody td { width: 70%;} .winsp .dictype .source { margin-top: 50px; padding: 0 20px;} .winsp.pageGuide .lead, .winsp.pageGuide .sec01, .winsp.pageGuide .sec02, .winsp.pageGuide .sec03, .winsp.pageGuide .secend, .winsp.pageDic .lead, .winsp.pageDic .diccategory, .winsp.pageDicdetail .lead, .winsp.pageDicdetail .list, .winsp.pageRanking #mainArea dl, .winsp.pageRanking #mainArea ul, .winsp.pageInfo .info { margin: 0 20px;} .winsp.pageGuide #mainArea, .winsp.pageDic #mainArea, 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display: inline; } article.kabuki .ex dl dd:after { content: '\A'; white-space: pre; } /* ================== 六訂版家庭医学大全科 ================== */ article.kateiigaku div.detailItems { margin-top: 20px; margin-bottom: 10px; } /* ================== 六訂版家庭医学大全科 ================== */ article.ebmchiryo p.peferences { margin-top: 30px; font-size: 70%; } /* ================== 四訂版病院で受ける検査がわかる本 ================== */ article.byoinkensa img { max-width: 100%; height: auto; } /* ================== 化学辞典第2版 ================== */ article.kagakujiten2 span.smallcapital { font-variant: small-caps; } article.kagakujiten2 img { margin: 10px; max-width: 100% } body.amp article.kagakujiten2 section span.image-container { display: block; margin: 10px 0; } /* ================== 病院でもらった薬がわかる薬の手引き電子改訂版 ================== */ article.kusurinotebiki span.title { font-size: 100%; font-weight: bold; } article.kusurinotebiki em { font-weight: bold; } /* ================== 伊和中辞典 ================== */ article.ij02 img[src*="gaiji"] { height: 30px; } /* ================== 和伊忠辞典 ================== */ article.ji02 img[src*="gaiji"] { height: 30px; } /* ================== 平凡社字通 ================== */ article.jitsu img.gaiji { margin-bottom: 4px; } article.jitsu h3 span.main_title { font-size: 30px } @media screen and (min-width: 500px){ article.jitsu h3 { margin-top: 24px; } } /* ================== 大学事典 ================== */ article.daigaku p { margin-top: 12px; margin-bottom: 12px; } article.daigaku img.gaiji { height: 18px; } /* ================== プログレッシブ和英中辞典(第4版) ================== */ article.pje04 img.gaiji { max-width: 18px; } article.pje04 img.image { max-width: 100%; } article.pje04 p.headword { font-size: 28px; } article.pje04 p.headword { font-weight: bold; } article.pje04 p.meaning { margin: 0 0 0 0; } article.pje04 p.example { margin: 0px 20px 0px 20px; padding: 6px 0px 6px 20px; line-height: 1.7; background-color: #ececec; } article.pje04 p.example i { font-style: normal; } article.pje04 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googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951350949-0'); }); </script> </div> </center> </div> </div> <div id="word_head" class=""> <div id="mainTitle"> <h1 class="grid02 grid1 left">パーキンソン病<span>（読み）パーキンソンビョウ</span></h1> </div> </div> </header> <div class="grid022leftwrap"> <div id="mainArea" class="grid02 grid2 left"> <article itemscope itemtype="https://schema.org/Article" id="E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89" class="dictype cf daijisen"> <h2><a href="/dictionary/daijisen/2534/">デジタル大辞泉</a><span> 「パーキンソン病」の意味・読み・例文・類語 </span></h2> <div class="page_link_marker" id="w-597858"></div> <div class="ex cf"> <h3>パーキンソン‐びょう〔‐ビヤウ〕【パーキンソン病】</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-0').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-0' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-0'); }); </script> </div></div> <section class="description"> 脳底部にある<a href="/word/%E7%B7%9A%E6%9D%A1%E4%BD%93-550242#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">線条体</a>などが変性し、<a href="/word/%E3%81%A9%E3%83%BC%E3%81%B1%E3%81%BF%E3%82%93-3161765#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">ドーパミン</a>が不足するために起こる疾患。手指の震え、筋肉のこわばりなどから始まり、徐々に進行して高度の運動障害がみられるようになる。中年以降に多い。英国の医師<a href="/word/%E3%81%B1%E3%83%BC%E3%81%8D%E3%82%93%E3%81%9D%E3%82%93-3184608#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">パーキンソン</a>（J.Parkinson）が1817年に報告。<a href="/word/%E6%8C%87%E5%AE%9A%E9%9B%A3%E7%97%85-1710963#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">指定難病</a>の一つ。<ruby><rb>振顫麻痺</rb><rt>しんせんまひ</rt></ruby>。<br>[補説]平成24年（2012）、家族性パーキンソン病患者の皮膚細胞から<a href="/word/ips%E7%B4%B0%E8%83%9E-3140304#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">iPS細胞</a>が作製され、患者に由来する<a href="/word/%E7%A5%9E%E7%B5%8C%E7%B4%B0%E8%83%9E-81597#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">神経細胞</a>では<a href="/word/%E9%85%B8%E5%8C%96%E3%81%99%E3%81%A8%E3%82%8C%E3%81%99-688825" data-type="al">酸化ストレス</a>が増強され、<a href="/word/%E3%81%BF%E3%81%A8%E3%81%93%E3%82%93%E3%81%A9%E3%82%8A%E3%81%82-3172243#E3.83.87.E3.82.B8.E3.82.BF.E3.83.AB.E5.A4.A7.E8.BE.9E.E6.B3.89">ミトコンドリア</a>に機能異常が生じていることが確認された。 </section> </div> <p class="source">出典　<small><a href="http://www.daijisen.jp/" target="_blank"><cite>小学館</cite></a></small><small>デジタル大辞泉について　<a href='/dictionary/daijisen/'>情報</a> | <a href='/hanrei/daijisen/01'>凡例</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E5.85.B1.E5.90.8C.E9.80.9A.E4.BF.A1.E3.83.8B.E3.83.A5.E3.83.BC.E3.82.B9.E7.94.A8.E8.AA.9E.E8.A7.A3.E8.AA.AC" class="dictype cf kyodonews"> <h2><a href="/dictionary/kyodonews/">共同通信ニュース用語解説</a><span> 「パーキンソン病」の解説 </span></h2> <div class="page_link_marker" id="w-3450075"></div> <div class="ex cf"> <h3>パーキンソン病</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-1').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-1' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-1'); }); </script> </div></div> <section class="description"> <p> 脳の情報伝達を担うドーパミンを出す神経細胞が減り、震えや運動機能低下などのほか、意欲の低下、幻覚が起きることもある。<a href="/word/%E5%8E%9A%E7%94%9F%E5%8A%B4%E5%83%8D%E7%9C%81-176327" data-type="al">厚生労働省</a>の指定難病。主に50歳以上で発症し、高齢になるほど多くなる。40歳以下での発症は若年性パーキンソン病と呼ばれる。ドーパミンを補う<a href="/word/%E8%96%AC%E7%89%A9%E7%99%82%E6%B3%95-187083" data-type="al">薬物療法</a>は、病気が進行すると効きにくくなるとされる。外科手術で、脳に電極を埋め込み、刺激を送る治療もあるが、根本的な治療法は見つかっていない。</p><p>更新日:<time itemprop="dateModified" datetime="2019-05-21">2019年5月21日</time></p> </section> </div> <p class="source">出典　<small>共同通信社共同通信ニュース用語解説</small><small>共同通信ニュース用語解説について　<a href='/dictionary/kyodonews/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E7.B2.BE.E9.81.B8.E7.89.88.20.E6.97.A5.E6.9C.AC.E5.9B.BD.E8.AA.9E.E5.A4.A7.E8.BE.9E.E5.85.B8" class="dictype cf nikkokuseisen"> <h2><a href="/dictionary/nikkokuseisen/3181/">精選版日本国語大辞典</a><span> 「パーキンソン病」の意味・読み・例文・類語 </span></h2> <div class="page_link_marker" id="w-2083273"></div> <div class="ex cf"> <h3>パーキンソン‐びょう<small>‥ビャウ</small>【パーキンソン病】</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-2').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-2' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-2'); }); </script> </div></div> <section class="description"> <ol><li><b>〘名詞〙</b> ( パーキンソンはParkinson ) 錐体外路系脳疾患の一つ。イギリスの病理学者Ｊ=パーキンソンが一八一七年に初めて記載した。筋硬直と振顫、運動緩徐を主徴とし、中年以後に多い。原因不明の<a href="/word/%E5%A4%89%E6%80%A7%E7%96%BE%E6%82%A3-682570" data-type="al">変性疾患</a>。特定疾患の一つ。</li></ol> </section> </div> <p class="source">出典　<small>精選版日本国語大辞典</small><small>精選版日本国語大辞典について　<a href='/dictionary/nikkokuseisen/'>情報</a> | <a href='/hanrei/nikkokuseisen/01/'>凡例</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="BM.20.E6.AD.A3.E3.81.97.E3.81.84.E6.B2.BB.E7.99.82.E3.81.8C.E3.82.8F.E3.81.8B.E3.82.8B.E6.9C.AC" class="dictype cf ebmchiryo"> <h2><a href="/dictionary/ebmchiryo/2/">EBM 正しい治療がわかる本</a><span> 「パーキンソン病」の解説 </span></h2> <div class="page_link_marker" id="w-2199435"></div> <div class="ex cf"> <h3>パーキンソン病</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-3').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-3' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-3'); }); </script> </div></div> <section class="description"> <b>どんな病気でしょうか?</b><br /> <br /> <b>●おもな症状と経過</b><br /> 　手足のふるえ、筋肉のこわばり、動作が鈍くなり表情が乏しくなる寡動(かどう)、姿勢反射障害（一定以上に姿勢が傾くと元に戻すことができなくなる）の四つをおもな症状とする脳の病気です。<br /> 　パーキンソン病は進行性の病気で、歩行障害から長い期間を経て、ついには<a href="/word/%E5%AF%9D%E3%81%9F%E3%81%8D%E3%82%8A-2119720" data-type="al">寝たきり</a>になります。便秘や異常な発汗(はっかん)、<a href="/word/%E8%B5%B7%E7%AB%8B%E6%80%A7%E4%BD%8E%E8%A1%80%E5%9C%A7-1302719" data-type="al">起立性低血圧</a>(きりつせいていけつあつ)などの<a href="/word/%E8%87%AA%E5%BE%8B%E7%A5%9E%E7%B5%8C%E9%9A%9C%E5%AE%B3-2120622" data-type="al">自律神経障害</a>の症状がみられることもあります。<br /> 　筋肉がこわばる、動作がゆっくりで鈍くなるといった症状から始まるといわれていますが、一般的には手足のふるえで気がつくことがほとんどです。こわばりやふるえは、最初体の片側におこり、病気が進行するにしたがって両側に現れるようになります。<br /> 　また、パーキンソン病のふるえは安静にしているときのほうが強くなり、なにかしようとするときには止まるという特徴があります。<br /> 　立った姿勢も特徴的で、やや前かがみでひじと膝が少し曲がった格好になります。<br /> 　病状が進んでくると、歩幅が小刻みになったり、歩き始めようとすると、最初の一歩がなかなか踏みだせないすくみ足などもみられるようになったりします。簡単にバランスを崩しやすくなるので、転倒する危険が増し、とくに歩いているときには前のめりの姿勢から元に戻せなくなるため、小走り状態でなにかにつかまるか、転倒するまで止まれなくなってしまう突進状態となり非常に危険です。<br /> 　このような症状がでてくるまでには長い時間がかかります。転倒やけがなどには十分注意を必要としますが、できるだけこれまでの日常生活を続けるように努め、最終的に寝たきりにならないようにすることが肝心です。<br /> <br /> <b>●病気の原因や症状がおこってくるしくみ</b><br /> 　くわしい原因はわかっていませんが、パーキンソン病が発生するしくみについては、中脳(ちゅうのう)（大脳の下に位置し、脊髄(<a href="/word/%E3%81%9B%E3%81%8D%E3%81%9A%E3%81%84-2838670" data-type="al">せきずい</a>)につながる脳幹部(のうかんぶ)の一番上）にある黒質線条体(こくしつせんじょうたい)という部分の神経細胞が変性し、<a href="/word/%E7%A5%9E%E7%B5%8C%E4%BC%9D%E9%81%94%E7%89%A9%E8%B3%AA-165987" data-type="al">神経伝達物質</a>であるドパミンをつくる働きが損なわれるためであることはわかっています。しかし、なぜ黒質線条体の変性がおこるかについては不明です。<br /> 　パーキンソン病の進行はゆるやかですが、その重症度は次の5段階に分類されています。<br /> 　Ⅰ．症状が一側性で障害はごく軽度<br /> 　Ⅱ．症状は両側性であるが、歩行の障害はない<br /> 　Ⅲ．方向転換が不安定、突進現象、歩行障害がある<br /> 　Ⅳ．歩行は介助なしでどうにか可能であるが、ほかの日常動作は部分介助<br /> 　Ⅴ．日常動作に全面介護が必要、車いす、ベッドに寝たきり<br /> 　となっています<br /> 　現在では、<a href="/word/%E3%82%81%E3%81%8B%E3%81%AB%E3%81%9A%E3%82%80-3219591" data-type="al">メカニズム</a>の違うさまざまな治療薬が登場し、外科的な治療の研究も進んできています。専門医による治療が必要な病気ですので、疑われる症状に気づいたらできるだけ早く受診し、正確な診断を受けるべきでしょう。<br /> <br /> <b>●病気の特徴</b><br /> 　わが国では厚生労働省の指定難病に選定されています。人口10万人あたり100～150人程度の有病率ですが、50歳代から次第に増加し、60歳以上では10万人あたり1000人と、急速に増えています。<br /> <br /> <br /> <b>よく行われている治療とケアをEBMでチェック</b><br /> <br /> ［治療とケア］<a href="/word/%E3%81%B1%E3%83%BC%E3%81%8D%E3%82%93%E3%81%9D%E3%82%93%E7%97%85%E6%B2%BB%E7%99%82%E8%96%AC-3190392" data-type="al">パーキンソン病治療薬</a>によって、薬物療法を行う<br />［評価］☆☆☆☆☆<br /> ［評価のポイント］　パーキンソン病に対する薬物療法の効果は非常に信頼性の高い<a href="/word/%E8%87%A8%E5%BA%8A%E7%A0%94%E7%A9%B6-1721994" data-type="al">臨床研究</a>によって確認されています。<br /> 　パーキンソン病の治療薬には、変性がおきている黒質線条体の部分に働きかけるしくみの違いによって、さまざまな薬があります。まず、黒質線条体の①ドパミンを補う薬（<a href="/word/l%E3%81%A9%E3%83%BC%E3%81%B1-3178650" data-type="al">L-ドーパ</a>）、②ドパミン受容体を直接刺激する薬、③ドパミンを分解する酵素（モノアミンオキシダーゼB）を阻害する薬（<a href="/word/mao%E9%98%BB%E5%AE%B3%E8%96%AC-135593" data-type="al">MAO阻害薬</a>）、④ドパミンの働きが低下すると、相対的に機能が亢進(こうしん)するコリン作動ニューロンの働きを抑制する薬（<a href="/word/%E6%8A%97%E3%81%93%E3%82%8A%E3%82%93%E8%96%AC-1313604" data-type="al">抗コリン薬</a>）、⑤ドパミン放出を促進する薬、⑥ドパミン系とともに低下している<a href="/word/%E3%81%AE%E3%82%8B%E3%81%88%E3%81%B4%E3%81%AD%E3%81%B5%E3%82%8A%E3%82%93-3191443" data-type="al">ノルエピネフリン</a>系を活性化する薬、などです。年齢や症状、病気の進行度に応じてこれらの薬を使い分けて治療します。ドパミンを直接補う薬の効果は劇的ですが、長期間使うことによって、薬の効いている時間が短くなったり、1日のうちで症状が突然悪化したり改善したりするなどの副作用がでてくることが知られています。<a href="/word/%E6%97%A5%E6%9C%AC%E7%A5%9E%E7%B5%8C%E5%AD%A6%E4%BC%9A-1386123" data-type="al">日本神経学会</a>の<a href="/word/%E3%81%8C%E3%81%84%E3%81%A9%E3%82%89%E3%81%84%E3%82%93-3148434" data-type="al">ガイドライン</a>では、それらの副作用は若い人で多く認められるため、ドパミン受容体刺激薬から治療を開始することが勧められています。(1)(2)<br /> <br /> ［治療とケア］外科的手術を検討する（高周波温熱度凝固術(こうしゅうはおんねつどぎょうこじゅつ)、<a href="/word/%E8%84%B3%E6%B7%B1%E9%83%A8%E5%88%BA%E6%BF%80%E7%99%82%E6%B3%95-596341" data-type="al">脳深部刺激療法</a>(のうしんぶしげきりょうほう)）<br />［評価］☆☆☆☆<br /> ［評価のポイント］　十分な<a href="/word/%E8%96%AC%E7%89%A9%E6%B2%BB%E7%99%82-1429096" data-type="al">薬物治療</a>によっても症状が抑えられない場合や、副作用のため治療薬の服用が困難になった場合には外科的な手術を行うかどうかを検討します。<a href="/word/%E6%89%8B%E8%A1%93%E7%99%82%E6%B3%95-163123" data-type="al">手術療法</a>としては高周波温熱凝固（破壊術）、あるいは電極埋め込み（脳深部刺激療法）の2種類があります。手術を行う場所は視床VL核・Vim核、淡蒼球内節(たんそうきゅうないせつ)、<a href="/word/%E8%A6%96%E5%BA%8A%E4%B8%8B%E6%A0%B8-519430" data-type="al">視床下核</a>(ししょうかかく)の3カ所のうちいずれかであり、症状によって決められます。これらの手術効果は信頼性の高い臨床研究により確認されています。(2)～(4)<br /> <br /> ［治療とケア］連続経頭蓋磁気刺激療法(れんぞくけいとうがいじきしげきりょうほう)を行う<br />［評価］☆☆☆<br /> ［評価のポイント］　高頻度刺激と低頻度刺激に分けられ、一次運動野への高頻度刺激で運動機能の改善が示唆されています。しかし、短期間での効果のみで、長期間での効果や安全性については不明です。(2)(5)<br /> <br /> <br /> <b>よく使われている薬をEBMでチェック</b><br /> <br /> <b>ドパミン受容体刺激薬(1)(2)(6)(7)</b><br /> ［薬用途］麦角系<br /> ［薬名］ペルマックス（ペルゴリドメシル酸塩）(8)<br />［評価］☆☆☆☆☆<br /> ［薬名］パーロデル（ブロモクリプチンメシル酸塩）(9)(10)<br />［評価］☆☆☆☆☆<br /> ［評価のポイント］　ペルゴリドメシル酸塩は非常に信頼性の高い臨床研究によって効果が確認されています。<br /> 　ブロモクリプチンメシル酸塩を早期に単独で用いることに対しては、効果があるという臨床研究と効果がないという臨床研究があり、評価が定まっていません。しかし、L-ドーパ含有製剤との併用の効果や、L-ドーパ治療によって現れる運動についての副作用を軽減することは非常に信頼性の高い臨床研究によって確認されています。<br /> <br /> ［薬用途］非麦角系<br /> ［薬名］ミラペックスLA（プラミペキソール塩酸塩水和物）(11)<br />［評価］☆☆☆☆☆<br /> ［薬名］レキップ錠（ロピニロール塩酸塩）(12)<br />［評価］☆☆☆☆☆<br /> ［評価のポイント］　いずれも非常に信頼性の高い臨床研究によって効果が確認されています。ただし、日中の仮眠や突発的睡眠を引きおこすおそれがあるため、自動車の運転や機械の操作、高所作業など、危険を伴う作業を行う人には推奨されていません。(2)<br /> <br /> <b>L-ドーパ含有製剤(1)(2)</b><br /> ［薬名］ドパストン／ドパゾール（レボドパ）<br />［評価］☆☆☆☆☆<br /> ［薬名］メネシット／ネオドパストン（レボドパ：カルビドパ＝10：1配合剤）<br />［評価］☆☆☆☆☆<br /> ［薬名］マドパー／イーシー・ドパール／ネオドパゾール（レボドパ：ベンセラジド塩酸塩＝4：1配合剤）<br />［評価］☆☆☆☆<br /> ［薬名］スタレボ（レボドパ：カルビドパ：エンタカポン＝10：1：10配合剤）<br />［評価］☆☆☆☆<br /> ［評価のポイント］　L-ドーパ含有製剤は非常に信頼性の高い臨床研究によって効果が確認されています。ただし、長期間使用すると、さまざまな副作用がでてくるため、その場合は、ドパミン受容体刺激薬を併用することが勧められています。<br /> <br /> <b>補助的に用いる薬</b><br /> ［薬用途］抗コリン薬<br /> ［薬名］アーテン（<a href="/word/%E3%81%A8%E3%82%8A%E3%81%B8%E3%81%8D%E3%81%97%E3%81%B5%E3%81%88%E3%81%AB%E3%81%98%E3%82%8B%E5%A1%A9%E9%85%B8%E5%A1%A9-2126761" data-type="al">トリヘキシフェニジル塩酸塩</a>）(1)(2)<br />［評価］☆☆☆<br /> ［評価のポイント］　トリヘキシフェニジル塩酸塩は臨床研究によって効果が確認されています。早期のごく軽い症状の場合は単独で用いられることもあります。<br /> <br /> ［薬用途］ドパミン遊離促進薬<br /> ［薬名］シンメトレル（アマンタジン塩酸塩）(1)(2)(13)<br />［評価］☆☆☆☆☆<br /> ［評価のポイント］　アマンタジン塩酸塩は非常に信頼性の高い臨床研究によって効果が確認されています。<br /> <br /> ［薬用途］MAO阻害薬<br /> ［薬名］エフピー（セレギリン塩酸塩）(1)(2)(14)<br />［評価］☆☆☆☆☆<br /> ［評価のポイント］　セレギリン塩酸塩は非常に信頼性の高い臨床研究によって早期治療効果が確認されています。ほかの薬に比べて副作用が少ないといわれています。<br /> <br /> ［薬用途］ノルエピネフリンを補う薬<br /> ［薬名］ドプス（ドロキシドパ）(1)(2)<br />［評価］☆☆<br /> ［評価のポイント］　L-ドーパ使用中のすくみ足、姿勢反射障害、構音障害などの治療に有効であるとの信頼性の高い臨床研究がありますが、有効率は必ずしも高くありません。起立性低血圧について有効性が報告されていますが今後の検証が必要です。<br /> ［薬用途］<a href="/word/%E3%81%8B%E3%81%A6%E3%81%93%E3%83%BC%E3%82%8B-3147466" data-type="al">カテコール</a>-O-メチル基転移酵素（COMT）阻害薬<br /> ［薬名］コムタン（エンタカポン）(1)(2)<br />［評価］☆☆☆<br /> ［評価のポイント］　L-ドーパを代謝する末梢のCOMT（カテコール-O-メチル基転移酵素）という酵素を選択的に阻害して、レボドパの血中半減期を延長し、レボドパの脳内移行が高まり、作用持続時間を長くするお薬です。L-ドーパが効いている時間が短くなったりする（ウェアリングオフ）場合に、効果時間を延長することが示されています。<br /> <br /> <br /> <b>総合的に見て現在もっとも確かな治療法</b><br /> まずは、正確な診断を<br /> 　パーキンソン病には、筋肉のこわばり、緩慢な動作や無表情、ふるえ、歩行障害といった非常に特徴的な症状が認められます。<br /> 　一般的にはふるえで気づくことが多いとされますが、これらの症状が現れたら、できるだけ早く専門医を受診し、正確な診断を受けるようにします。わが国では厚生労働省の難病に指定されています。<br /> 　ゆるやかですが、確実に進行していく病気なので、なるべく進行を遅らせ、通常の日常生活をでき得る限り長い期間送れるようにすることが治療の目的となります。<br /> <br /> 損なわれたドパミン産生機能をさまざまな薬で補う<br /> 　パーキンソン病は中脳にある黒質線条体がなんらかの原因で変性し、神経伝達物質であるドパミンをつくる機能が損なわれるためにおこると考えられています。そこで、直接ドパミンを補う薬やドパミン放出を促進する薬を用いると、ほとんどの患者さんで、少なくとも当初は症状が劇的に改善します。<br /> 　しかし、問題は、これらの薬を長期間使用し続けると、薬の効いている時間が短くなったり、突然、症状が1日のうちで悪化したり軽快したりと変動するなど、さまざまな副作用のみ前面にでてくるようになることです。<br /> 　そのような副作用の問題を解決するために、最初は、直接ドパミンを補う薬を用いず、副作用の出現が少ないドパミン受容体を直接刺激する薬やドパミンを分解する酵素（モノアミンオキシダーゼB）を阻害する薬を利用する場合があります。しかし、ドパミン受容体を直接刺激する薬も高齢者などでは精神症状をきたすなどの副作用や、そのなかの麦角系では<a href="/word/%E5%BF%83%E8%87%93%E5%BC%81%E8%86%9C%E7%97%87-82150" data-type="al">心臓弁膜症</a>などの心疾患、非麦角系では突発的睡眠をおこす可能性があり、患者の年齢、認知機能、社会的活動性（運転など）を考慮して薬剤を選択することが重要です。<br /> 　また、パーキンソン病の運動症状だけでなく、非運動症状である倦怠感(けんたいかん)、うつ病、認知障害、起立性低血圧、便秘、不眠などにも注意してコントロールすることで患者さんのQOL（生活の質）が改善するといわれています。<br /> <br /> 歩行や運動の障害にあわせて衣食住の工夫を<br /> 　病状が進行するにつれて、歩行などの運動が困難になります。<br /> 　薬物の服用の有無にかかわらず、なるべく日常生活に支障をきたさないような工夫や周囲の協力が必要になります。<br /> 　たとえば、脱ぎ着がしやすく動作の邪魔にならないような靴や衣服や使いやすい食器を選びます。<br /> 　また、いす、手すり、床に注意を払い、とくに転倒を予防することが大変重要になります。<p class="peferences"><small><cite>(1)Connolly BS, Lang AE.Pharmacological treatment of Parkinson <a href="/word/disease-1229483" data-type="al">disease</a>: a review. JAMA. 2014 Apr 23-30;311(16):1670-1683.</cite><br /> <cite>(2)日本神経学会. パーキンソン病治療ガイドライン2011／2011追補版. 医学書院. https://www.neurology-jp.org/guidelinem/parkinson.html　／　https://www.neurology-jp.org/guidelinem/parkinson_tuiho.html</cite><br /> <cite>(3)Lyons MK. Deep brain stimulation: current and future clinical applications. Mayo Clin Proc. 2011 Jul;86(7):662-672.</cite><br /> <cite>(4)Okun MS. Deep-barin stimultaion for <a href="/word/parkinsonsdisease-1249184" data-type="al">Parkinson's disease</a>. N Engl J MEd. 2012; 367 (16): 1529-1538.</cite><br /> <cite>(5)Chou YH, Hickey PT, Sundman M, Song AW, Chen NK. Effects of repetitive transcranial magnetic stimulation on motor symptoms in Parkinson disease: a systematic review and meta-analysis. JAMA Neurol. 2015 Apr;72(4):432-440.</cite><br /> <cite>(6)<a href="/word/stowe-1241080" data-type="al">Stowe</a> RL, Ives NJ, Clarke C, van Hilten J, Ferreira J, Hawker RJ, Shah L, Wheatley K, Gray R. Dopamine agonist therapy in early Parkinson's disease. Cochrane Database Syst Rev. 2008 Apr 16;(2):CD006564.</cite><br /> <cite>(7)Stowe R, Ives N, Clarke CE, Deane K; van Hilten, Wheatley K, Gray R, Handley K, Furmston A. Evaluation of the efficacy and safety of adjuvant treatment to levodopa therapy in Parkinson s disease patients with motor complications. Cochrane Database Syst Rev. 2010 Jul 7;(7):CD007166.</cite><br /> <cite>(8)Corvol JC, Anzouan-Kacou JB, Fauveau E, Bonnet AM, Lebrun-Vignes B, Girault C, Agid Y, Lechat P, Isnard R, Lacomblez L. Heart valve regurgitation, pergolide use, and parkinson disease: an observational study and meta-analysis. Arch Neurol. 2007 Dec;64(12):1721-1726.</cite><br /> <cite>(9)van Hilten JJ, Ramaker CC, Stowe R, Ives NJ. Bromocriptine/levodopa combined versus levodopa alone for early Parkinson's disease. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD003634.</cite><br /> <cite>(10)van Hilten JJ, Ramaker CC, Stowe R, Ives NJ. Bromocriptine versus levodopa in early Parkinson's disease. Cochrane Database Syst Rev. 2007 Oct 17;(4):CD002258.</cite><br /> <cite>(11)Poewe W, Rascol O, Barone P, Hauser RA, Mizuno Y, Haaksma M, Salin L, Juhel N, Schapira AH. Pramipexole ER Studies Group.Extended-release pramipexole in early Parkinson disease: a 33-week randomized controlled trial. Neurology. 2011 Aug 23;77(8):759-766.</cite><br /> <cite>(12)Kulisevsky J, Pagonabarraga J. Tolerability and safety of ropinirole versus other dopamine agonists and levodopa in the treatment of Parkinson's disease: meta-analysis of randomized controlled trials. Drug Saf. 2010 Feb 1;33(2):147-161.</cite><br /> <cite>(13)Hubsher G, Haider M, Okun MS. Amantadine: the journey from fighting flu to treating Parkinson disease. Neurology. 2012 Apr 3;78(14):1096-1099.</cite><br /> <cite>(14)Caslake R, Macleod A, Ives N, Stowe R, Counsell C. Monoamine oxidase B inhibitors versus other dopaminergic agents in early Parkinson's disease. Cochrane Database Syst Rev. 2009 Oct 7;(4):CD006661.</cite><br /> </small></p> </section> </div> <p class="source">出典　<small>法研「EBM 正しい治療がわかる本」</small><small>EBM 正しい治療がわかる本について　<a href='/dictionary/ebmchiryo/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91" class="dictype cf kateiigaku"> <h2><a href="/dictionary/kateiigaku/15/">六訂版家庭医学大全科</a><span> 「パーキンソン病」の解説 </span></h2> <div class="page_link_marker" id="w-2197322"></div> <div class="ex cf"> <h3>パーキンソン病<br />パーキンソンびょう<br />Parkinson's disease<br />(脳・神経・筋の病気)</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-4').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-4' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-4'); }); </script> </div></div> <section class="description"> <p><h4 class="header_menu" id="どんな病気か_080439000">どんな病気か</h4></p><p>　50歳以降に発症することが多く、いくつかの特徴的な症状がみられます。手足が震える、筋肉がこわばる、動作が遅くなる、歩きづらくなるなどで、徐々に症状が進行し、10数年後には寝たきりになる患者さんもいます。有病率は、人口10万人に対し100人程度です。</p><p><h4 class="header_menu" id="原因は何か_080439000">原因は何か</h4></p><p>　原因は現在も不明です。脳の病理学的変化では、中脳の<ruby><rb>黒質</rb><rp>(</rp><rt>こくしつ</rt><rp>)</rp></ruby>ドーパミン性神経細胞の変性が確認されています。ドーパミン性神経細胞の変性により、神経伝達物質であるドーパミンの産生が減少し、前述した特徴的な症状が現れます。</p><p><h4 class="header_menu" id="症状の現れ方_080439000">症状の現れ方</h4></p><p>　初発症状は、片方の手の震え（安静時<ruby><rb>振戦</rb><rp>(</rp><rt>しんせん</rt><rp>)</rp></ruby>）や歩きづらさ（歩行障害）が多く、前かがみで小きざみに歩くようになります（<a href="#" class="ref_img" id="080439000_26.jpg" data-dic="kateiigaku">図23</a>）。筋のこわばり（歯車様<ruby><rb>固縮</rb><rp>(</rp><rt>こしゅく</rt><rp>)</rp></ruby>）や手足の震え（振戦）は当初は片側だけですが、進行するにしたがって反対側にも現れます。</p><p>　1歩めが出にくくなり（すくみ足）、歩幅も小さくなります（小きざみ歩行）。全体に動作が遅くなり（動作<ruby><rb>緩慢</rb><rp>(</rp><rt>かんまん</rt><rp>)</rp></ruby>）、方向転換や寝返りが苦手になります。歩いているうちに足が体に追いつかなくなり（突進現象）、姿勢の反射も障害されている（姿勢反射障害）ために前のめりの姿勢を立て直せずに転倒することもあります。</p><p>　そのほか、表情が乏しく（仮面様<ruby><rb>顔貌</rb><rp>(</rp><rt>がんぼう</rt><rp>)</rp></ruby>）、おでこや頬が脂っぽくなります。自律神経系では、<a href="/word/%E6%8E%92%E4%BE%BF%E9%9A%9C%E5%AE%B3-2120479#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">便秘</a>や立ちくらみ（<ruby><rb>起立性低血圧</rb><rp>(</rp><rt>きりつせいていけつあつ</rt><rp>)</rp></ruby>）が現れます。精神症状として、うつ状態もみられることがありますが、一般には知能は正常に保たれます。</p><p><h4 class="header_menu" id="検査と診断_080439000">検査と診断</h4></p><p>　左右差のある<a href="/word/%E5%AE%89%E9%9D%99%E6%99%82%E6%8C%AF%E6%88%A6-1266546" data-type="al">安静時振戦</a>を示し、筋のこわばりやすくみ足、小きざみ歩行、動作の緩慢などがある場合、抗パーキンソン病薬の効果が認められれば、まずパーキンソン病と考えられます。類似した症状を示す疾患には、脳血管性<a href="/word/%E3%81%B1%E3%83%BC%E3%81%8D%E3%82%93%E3%81%9D%E3%82%93%E7%97%87%E5%80%99%E7%BE%A4-3165143#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">パーキンソニズム</a>、薬物性<a href="/word/%E3%81%B1%E3%83%BC%E3%81%8D%E3%82%93%E3%81%9D%E3%82%93%E7%97%87%E5%80%99%E7%BE%A4-3165143#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">パーキンソニズム</a>、<ruby><rb>多系統萎縮症</rb><rp>(</rp><rt>たけいとういしゅくしょう</rt><rp>)</rp></ruby>といわれる変性疾患などがあり、これらを除外することが必要になります。</p><p>　そのためには、頭部MRIなどで多発性<ruby><rb><a href="/word/%E8%84%B3%E6%A2%97%E5%A1%9E-178146#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">脳梗塞</a></rb><rp>(</rp><rt>のうこうそく</rt><rp>)</rp></ruby>などの<a href="/word/%E8%84%B3%E5%8D%92%E4%B8%AD-111955#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">脳血管障害</a>がなく、明らかな<ruby><rb>脳萎縮</rb><rp>(</rp><rt>のういしゅく</rt><rp>)</rp></ruby>がないことを確認します。また、薬剤性の場合、服薬を中止することで症状が改善するため、<a href="/word/%E3%81%B1%E3%83%BC%E3%81%8D%E3%82%93%E3%81%9D%E3%82%93%E7%97%87%E5%80%99%E7%BE%A4-3165143#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">パーキンソニズム</a>を呈する可能性のある薬剤をのんでいないか確認することも大切です。このような変性疾患に関しては、初期の段階ではパーキンソン病との区別が困難な場合があり、神経内科のある専門機関を受診して相談するのがよいでしょう。</p><p><h4 class="header_menu" id="治療の方法_080439000">治療の方法</h4></p><p>　治療の基本は、抗パーキンソン病薬の内服治療です。中心になるのはドーパミンの前駆物質レボドパ（Lドーパ）で、脳内で減少したドーパミンを補充します。しかし、長期使用によって効果が減弱したり、血中濃度の変化に応じた症状変動（ウェアリング・オフ現象）、自分の意志とは無関係に口元が動いたり体がくねる<a href="/word/%E4%B8%8D%E9%9A%8F%E6%84%8F%E9%81%8B%E5%8B%95-124760#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">不随意(ふずいい)運動</a>（ジスキネジア）が現れることがあります。また、吐き気、不整脈などの合併症も認められることがあります。</p><p>　近年では、レボドパの内服量を減らし、補助薬を併用することが推奨されています。補助薬には、ドーパミンを受け取りやすくするドーパミン受容体刺激薬（ビ・シフロール、レキップなど）、ドーパミン放出を促進するアマンタジン（シンメトレル）、ドーパミン分解阻害薬のセレギリン（エフピー）などがあります。これらの併用で副作用を少なくし、効果を持続させることが可能になります。</p><p>　内服治療でコントロールが困難な症例では、定位脳手術や深部脳刺激法などの外科的治療法が検討されます。</p><p><h4 class="header_menu" id="病気に気づいたらどうする_080439000">病気に気づいたらどうする</h4></p><p>　手の震えには、いくつかの種類があります。パーキンソン病に特徴的な安静時振戦、手を伸ばした時などにみられる姿勢時振戦、頭や手の震えが緊張で強くなる<a href="/word/%E6%9C%AC%E6%85%8B%E6%80%A7%E6%8C%AF%E6%88%A6-632310" data-type="al">本態性振戦</a>、<ruby><rb><a href="/word/%E7%94%B2%E7%8A%B6%E8%85%BA%E6%A9%9F%E8%83%BD%E4%BA%A2%E9%80%B2%E7%97%87-62314#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">甲状腺機能亢進症</a></rb><rp>(</rp><rt>こうじょうせんきのうこうしんしょう</rt><rp>)</rp></ruby>に伴う振戦などがあれば、神経内科のある専門の医療機関を受診することが必要です。</p><p>　日常生活では、転倒による骨折や便秘などの予防が大切です。また、病状が進行して長期<ruby><rb>臥床</rb><rp>(</rp><rt>がしょう</rt><rp>)</rp></ruby>した場合も、<ruby><rb>仙骨部</rb><rp>(</rp><rt>せんこつぶ</rt><rp>)</rp></ruby>などの<a href="/word/%E5%BA%8A%E3%81%9A%E3%82%8C-855767#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">床ずれ</a>（<ruby><rb>褥瘡</rb><rp>(</rp><rt>じょくそう</rt><rp>)</rp></ruby>）や<a href="/word/%E8%82%BA%E7%82%8E-112691#E5.85.AD.E8.A8.82.E7.89.88.20.E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E5.A4.A7.E5.85.A8.E7.A7.91">肺炎</a>（<ruby><rb>誤嚥性</rb><rp>(</rp><rt>ごえんせい</rt><rp>)</rp></ruby>肺炎）が生じる可能性があるため、その予防が重要となります。</p><p>波木井　靖人, 黒岩　義之</p> <div class="media"> <figure> <a href="/image/dictionary/kateiigaku/media/080439000_26.jpg" data-lightbox="media-2197322" data-title="<span class='lbdata_caption'>図23　パーキンソン病の特徴的姿勢</span><br>"> <p class="image"><img src="/image/dictionary/kateiigaku/media/t_080439000_26.jpg"></p> <p class="caption">図23　パーキンソン病の特徴的姿勢</p></a> </figure> </div><br clear="all"> </section> </div> <p class="source">出典　<small>法研「六訂版家庭医学大全科」</small><small>六訂版家庭医学大全科について　<a href='/dictionary/kateiigaku/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E5.AE.B6.E5.BA.AD.E5.8C.BB.E5.AD.A6.E9.A4.A8" class="dictype cf igakukatei"> <h2><a href="/dictionary/igakukatei/14/">家庭医学館</a><span> 「パーキンソン病」の解説 </span></h2> <div class="page_link_marker" id="w-792911"></div> <div class="ex cf"> <h3>ぱーきんそんびょうとくはつせいぱーきんそにずむ【パーキンソン病（特発性パーキンソニズム） Parkinson Disease】</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-5').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-5' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-5'); }); </script> </div></div> <section class="description"> <strong>◎中年以降の人に多くおこる</strong><br /> <strong>[どんな病気か]</strong><br /> 　パーキンソン病は、イギリスの医師、ジェームス・パーキンソンが、1817年に発表した病気です。<br /> ①手足が震（ふる）える（振戦（しんせん））<br /> ②からだの筋肉がかたくなる（固縮（こしゅく））<br /> ③からだの動きが減って、ひとつの動作に時間がかかる（無動（むどう））<br /> 　以上3つの症状をまとめて、1つの病気であると報告したのです。これをパーキンソン病の三徴候といいますが、これに<br /> ④ちょっと押されただけで、前方や後方へ転倒する（姿勢保持障害）<br /> という症状を加え、四徴候とする専門家もいます。<br /> 　パーキンソン病は、50歳代からの発病がいちばん多く、ついで、60歳代、40歳代ですから、中年以降の人の病気ということができます。<br /> 　日本での発病は、人口10万人に対し50人ほどで、神経内科が担当する病気のなかでは比較的多い病気です。<br /> 　発病に男女差はありません。<br /> <strong>[症状]</strong><br /> 　前述の四徴候の内容を詳しく説明します。<br /> <strong>●振戦（震（ふる）え）</strong><br /> 　震えは、規則正しい、小刻みな動きです。1秒間に5～6回震えます。手の震えによって気づかれることが多く、紙幣を数えたり、指先で物を丸めたりするのに似た手指の異常運動がおこります。<br /> 　このような震えは、動いているときよりもむしろ、いすに腰掛けて膝（ひざ）に手を置き、じっとしているときにおこりやすいものです（静止時振戦（せいしじしんせん））。<br /> <strong>●固縮</strong><br /> 　固縮は、筋肉の緊張度が高まったもので、手を例にとると、握手をして、手首を軸にして回転させると、ちょうど、歯車を回したときのようにがくがくと抵抗を感じます。<br /> 　くびの筋肉がかたくなると、寝ているときに枕（まくら）をそっと抜いても、くびが宙に浮いたままになっています。<br /> <strong>●無動</strong><br /> 　顔の表情を変えずにじっとしています。たとえば、診察を受けに病院に行き名前を呼ばれても、なかなかいすから離れることができなかったり、歩くにしても、前かがみの姿勢で、狭い歩幅でゆっくりと歩きます。<br /> <strong>●姿勢保持障害</strong><br /> 　この障害の有無を調べるためには、立った状態で、胸をちょっと押してみます。ふつうであれば、のけぞるのと同時に、反射的に足も後ろに下げるので転びません。しかし、パーキンソン病の場合は、足を後ろに下げる動作が追いつかず、足が元の位置のままなので、後ろに転倒します。<br /> 　このため、この検査を行なうときは、必ず誰かが後ろで支えるようにします。<br /> <strong>[原因]</strong><br /> 　脳の根元のところ（脳幹部（のうかんぶ））に、色が黒いので黒質（こくしつ）と名づけられた、神経細胞がたくさん集まっている部位があります。<br /> 　黒質は、長い腕を伸ばして、大脳（だいのう）の線条体（せんじょうたい）と呼ばれる神経細胞のかたまりに情報を送ります。情報を伝えるのは、黒質でつくられるドパミンという物質です（ドパミン伝達系）。<br /> 　線条体は、運動（動作）がスムーズに行なえるように調節している部位です。ここでは、ドパミンとアセチルコリンという2種類の物質のはたらきがうまくバランスをとり、運動が滑らかに行なわれるようにしています。<br /> 　ちょうど、シーソーの両端にドパミンとアセチルコリンが乗って、バランスをとって、シーソーの平行状態を保っているようなものです。<br /> 　黒質に損傷が生じ、つくられるドパミンの量が減ると、相対的にアセチルコリンの量が増えたのと同じことになり、バランスが崩れます。<br /> 　その結果、動作をスムーズに行なえなくなり、先に述べた症状が出現してくるのです。黒質が損傷を受ける原因は、まだ解明されていません。<br /> <strong>◎薬は、必ず正しく服用する</strong><br /> <strong>[治療]</strong><br /> 　薬剤による治療が中心となります。治療に用いられる薬剤（パーキンソン病治療薬）には、つぎのようなものがあります。<br /> ①不足しているドパミンを補充する薬（レボドパ剤など）<br /> ②ドパミン伝達系の後（こう）シナプス受容体（じゅようたい）を刺激して反応しやすくする薬（塩酸タリペキソールやメシル酸ペルゴリドなど）<br /> ③不足しているドパミンの放出を促進させる薬（アマンタジン）<br /> ④アセチルコリンのはたらきを抑え、バランスをとる薬（抗コリン薬など）<br /> 　どれか1種類の薬を処方する医師もいれば、2、3種類の薬を処方する医師もいますが、これは、それぞれの経験や考えに基づいてのことです。<br /> 　これらの薬はよく効きますが、ほかの病気、とくに緑内障（りょくないしょう）を悪化させる恐れがあって使用できないことがあります。ですから、受診するときには、これまでにかかったことのある病気を、医師に報告する必要があります。<br /> <strong>●副作用</strong><br /> 　パーキンソン病の治療に用いられる薬の副作用には、脳の症状（幻覚、妄想（もうそう）、不安、興奮など）、消化器系の症状（吐（は）き気（け）、嘔吐（おうと）、胃部不快感、下痢（げり）、食欲不振など）、自律神経系の症状（口が乾く、便秘＜パーキンソン病自体、便秘をおこしやすい＞、動悸（どうき）など）、皮膚の症状（発疹（ほっしん））があります。<br /> 　誰にでも必ず副作用が現われるとはかぎりませんが、おかしいと思ったら、主治医に相談しましょう。<br /> <strong>[日常生活の注意]</strong><br /> 　きょうは調子がよいから服用をやめるとか、半分にする、あるいは、きょうは調子が悪いから2倍飲むという飲み方はよくありません。<br /> 　とくに長期間服用してきた人が急に服用をやめると、発熱、意識障害などの重い症状が現われることがあります。これを悪性症候群（あくせいしょうこうぐん）といい、適切な治療を受けないと、生命にかかわることがあります。<br /> 　同じ悩みをもった人々と交流し、お互いにはげまし合うことも療養の支えになります。<br /> 　ただし、病気の暗い面だけを話し合うような情報交換の場にしないように注意すべきでしょう。 </section> </div> <p class="source">出典　<small><a href="http://www.shogakukan.co.jp/" target="_blank" rel="nofollow"><cite>小学館</cite></a></small><small>家庭医学館について　<a href='/dictionary/igakukatei/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2" class="dictype cf mypedia"> <h2><a href="/dictionary/mypedia/662/">百科事典マイペディア</a><span> 「パーキンソン病」の意味・わかりやすい解説 </span></h2> <div class="page_link_marker" id="w-860366"></div> <div class="ex cf"> <h3>パーキンソン病【パーキンソンびょう】</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-6').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-6' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-6'); }); </script> </div></div> <section class="description"> 振顫麻痺(しんせんまひ)ともいい，<a href="/word/%E9%9B%A3%E7%97%85-108937#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">難病</a>に指定。1817年英国の医師J.パーキンソン〔1755-1824〕が初めて記載。ドーパミンの著しい減少によって脳の変性をきたす疾患で，筋硬直，全身の動作減少，手指の<a href="/word/%E6%8C%AF%E9%A1%AB-844200#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">振顫</a>，姿勢保持困難が主な症状で，独特の顔つきなどを呈する。治療にはL−ドーパやドーパミンの放出を促すアマンタジンなどの服用や抗コリン薬などの薬物療法を行う。パーキンソニスムス（症候群）はパーキンソン病と似た症状を示す疾患で，流行性脳炎，梅毒，一酸化炭素や重金属による中毒などで錐体外路系が冒された場合に起こる。<br />→関連項目<a href="/word/%E3%81%82%E3%82%8A-2003968#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">アリ</a>｜<a href="/word/es%E7%B4%B0%E8%83%9E-3192071#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">ES細胞</a>｜<a href="/word/%E7%95%B0%E7%A8%AE%E9%96%93%E8%87%93%E5%99%A8%E7%A7%BB%E6%A4%8D-817550#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">異種間臓器移植</a>｜<a href="/word/%E5%B7%A8%E5%A4%A7%E7%B5%90%E8%85%B8%E7%97%87-53415#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">巨大結腸症</a>｜<a href="/word/%E9%8C%90%E4%BD%93%E5%A4%96%E8%B7%AF%E9%9A%9C%E5%AE%B3-844752#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">錐体外路障害</a>｜<a href="/word/%E3%81%A9%E3%83%BC%E3%81%B1%E3%81%BF%E3%82%93-3161765#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">ドーパミン</a>｜<a href="/word/%E8%84%B3%E7%A3%81%E5%9B%B3-162966#E7.99.BE.E7.A7.91.E4.BA.8B.E5.85.B8.E3.83.9E.E3.82.A4.E3.83.9A.E3.83.87.E3.82.A3.E3.82.A2">脳磁図</a> </section> </div> <p class="source">出典　<small>株式会社平凡社</small><small>百科事典マイペディアについて　<a href='/dictionary/mypedia/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E7.9F.A5.E6.81.B5.E8.94.B5" class="dictype cf chiezo"> <h2><a href="/dictionary/chiezo/90/">知恵蔵</a><span> 「パーキンソン病」の解説 </span></h2> <div class="page_link_marker" id="w-186992"></div> <div class="ex cf"> <h3>パーキンソン病</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-7').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-7' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-7'); }); </script> </div></div> <section class="description"> 1817年にパーキンソンが報告した病気。中脳の黒質という部位にあるメラニン細胞の変性・萎縮と大脳基底核の病変により起こる。高年齢者に多く、ふるえや、筋肉がこわばったりするなどの症状が現れる。表情は仮面のようになり、次いで身体が前傾し、歩幅が小刻みになる特徴的な歩行障害もある。副交感神経遮断剤やL‐ドーパがよく効く。 <p class="description_comment">(今西二郎京都府立医科大学大学院教授／ 2007年)</p> </section> </div> <p class="source">出典　<small>(株)朝日新聞出版発行「知恵蔵」</small><small>知恵蔵について　<a href='/dictionary/chiezo/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E6.A0.84.E9.A4.8A.E3.83.BB.E7.94.9F.E5.8C.96.E5.AD.A6.E8.BE.9E.E5.85.B8" class="dictype cf eiyo"> <h2><a href="/dictionary/eiyo/143/">栄養・生化学辞典</a><span> 「パーキンソン病」の解説 </span></h2> <div class="page_link_marker" id="w-770751"></div> <div class="ex cf"> <h3>パーキンソン病</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-8').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-8' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-8'); }); </script> </div></div> <section class="description"> 　ドーパミン欠乏を原因とする神経の症候で，筋肉のふるえ，運動の硬直前傾姿勢などの特徴的な症状を示す． </section> </div> <p class="source">出典　<small><a href="http://www.asakura.co.jp/books/isbn/978-4-254-43075-2/" target="_blank" rel="nofollow"><cite>朝倉書店</cite></a></small><small>栄養・生化学辞典について　<a href='/dictionary/eiyo/'>情報</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="E6.97.A5.E6.9C.AC.E5.A4.A7.E7.99.BE.E7.A7.91.E5.85.A8.E6.9B.B8.28.E3.83.8B.E3.83.83.E3.83.9D.E3.83.8B.E3.82.AB.29" class="dictype cf nipponica"> <h2><a href="/dictionary/nipponica/1190/">日本大百科全書(ニッポニカ)</a><span> 「パーキンソン病」の意味・わかりやすい解説 </span></h2> <div class="page_link_marker" id="w-1581117"></div> <div class="ex cf"> <h3>パーキンソン病<br />ぱーきんそんびょう</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-9').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-9' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-9'); }); </script> </div></div> <section class="description"> <p>→<a href="/word/%E3%81%B1%E3%83%BC%E3%81%8D%E3%82%93%E3%81%9D%E3%82%93%E7%97%87%E5%80%99%E7%BE%A4-3165143#E6.97.A5.E6.9C.AC.E5.A4.A7.E7.99.BE.E7.A7.91.E5.85.A8.E6.9B.B8.28.E3.83.8B.E3.83.83.E3.83.9D.E3.83.8B.E3.82.AB.29">パーキンソン症候群</a></p> </section> </div> <p class="source">出典　<small><cite>小学館　日本大百科全書(ニッポニカ)</cite></small><small>日本大百科全書(ニッポニカ)について　<a href='/dictionary/nipponica/'>情報</a> | <a href='/hanrei/nipponica/01'>凡例</a></small> </p> </article> <article itemscope itemtype="https://schema.org/Article" id="sekai_refs" class="dictype"> <h2>世界大百科事典（旧版）<span>内の</span>パーキンソン病<span>の言及</span></h2> <div class="ex cf"> <h3>【パーキンソン症候群】より</h3> <div class="pc-word-ad"><script> window.googletag = window.googletag || {cmd: []}; googletag.cmd.push(function() { googletag.defineSlot('/3125536/132493749', [336, 280], 'div-gpt-ad-1664951416799-10').addService(googletag.pubads()); googletag.pubads().enableLazyLoad({ fetchMarginPercent: 50, }); googletag.pubads().collapseEmptyDivs(); googletag.enableServices(); }); </script>  <div id='div-gpt-ad-1664951416799-10' class='pc-word-ad-desc' style='min-width: 336px; min-height: 280px;'> <script> googletag.cmd.push(function() { googletag.display('div-gpt-ad-1664951416799-10'); }); </script> </div></div> <section class="description"> <p>…原因不明の疾患であるパーキンソン病や，その他いくつかの神経疾患でみられるパーキンソン病類似の症候群をいう。パーキンソニズムparkinsonismともいわれる。…</p> </section> </div> <p class="note"> ※「パーキンソン病」について言及している用語解説の一部を掲載しています。 </p> <p class="source">出典｜<small>株式会社平凡社「世界大百科事典（旧版）」</small> </p> </article> <div 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パーキンソン病(パーキンソンビョウ)とは？ 意味や使い方 - コトバンク

パーキンソン病(パーキンソンビョウ)とは？意味や使い方 - コトバンク