総 説㩷
がん薬物療法におけるレジメン管理の意義と標準レジメンの開発㩷
㩷
ട⮮ਭ㩷
ᤘᄢቇ㩷⮎ቇㇱ㩷ක⮎ຠᖱႎቇᢎቶ㩷
㩷
ⷐ ᣦ㩷
᛫߇ࠎߦࠃࠆක≮ߩᄙߊߪ㧘᛫߇ࠎߩⶄ㔀ߥᛩਈᣇᴺߦ࿃ߒߡࠆ㧚᛫߇ࠎߦࠃ ࠆක≮ࠍᧂὼߦ㒐ߋߦߪ㧘᛫߇ࠎ㧘ャᶧ㧘૬↪⮎ߥߤࠍᤨ♽⊛ߦ⸥タߒߚࠫࡔࡦߦ ࠃࠆಣᣇ⋙ᩏߣߘߩ▤ℂ߇㊀ⷐߢࠆ㧚㩷
ࠫࡔࡦࠍ⊓㍳ߔࠆ㓙ߪ㧘චಽߥࠫࡔࡦክᩏࠍታᣉߒߥߌࠇ߫ߥࠄߥ㧚ߘߩߚ㧘ᣉ⸳ౝ
ߦࠫࡔࡦክᩏᆔຬળࠍ⸳⟎ߔࠆᔅⷐ߇ࠆ㧚ߎࠇࠍᜂᒰߔࠆߩߪ߇ࠎ⮎‛≮ᴺߦ♖ㅢߒߚ⮎
Ꮷ߇ㆡછߢࠅ㧘⮎Ꮷ߇ߘߩ⢻ജࠍචಽߦ⊒ើߢ߈ࠆߪߕߢࠆ㧚㩷
ක≮ోࠍ⏕ߒ㧘ㆡᱜߥ߇ࠎ⮎‛≮ᴺࠍታᣉߔࠆߚߩᣇ╷ߣߒߡ㧘ࠫࡔࡦ▤ℂߪ㕖Ᏹߦ
↪ߢࠅ㧘ലᨐ⊛ߥࠪࠬ࠹ࡓߢࠆ㧚ߒ߆ߒ㧘ߘߩࠃ߁ߥ↪ߥࠪࠬ࠹ࡓ߽ㆡಾߦ▤ℂߐࠇ㧘 ᡷༀߐࠇ⛯ߌߥߌࠇ߫㧘චಽߦᵴ↪ߔࠆߎߣߪߢ߈ߥ㧚ߘߒߡ㧘ࠫࡔࡦߩᮡḰൻ߽ታᣉߔࠆ ᔅⷐ߇ࠆ㧚㩷
ࠫࡔࡦࠍᮡḰൻߔࠆߚߩ⮎ቇ⊛⥃ᐥ⎇ⓥߩ㪈ߟߣߒߡ㧘ࠊࠇࠊࠇߪᣣᧄੱߦ߅ߌࠆࠣ࠾
࠻ࡠࡦᵈᶧߩㆡಾߥᛩਈ㊂ࠍᬌ⸛ߒߚ㧚᛫߇ࠎߩᛩਈߦࠃࠅ⺃⊒ߐࠇࠆᶖൻེ∝⁁㧔ᖡᔃ ߅ࠃ߮ཌྷฯ㧕ߦኻߔࠆࠣ࠾࠻ࡠࡦᵈᶧ㧔㪈㫄㪾㧕ߩ㕖ഠᕈߩᬌ⸽ࠍࠣ࠾࠻ࡠࡦᵈᶧ㧔㪊㫄㪾㧕 ߣߩήὑൻᲧセ⹜㛎ߦࠃࠅᬌ⸛ߒߚ㧚ߘߩ⚿ᨐ㧘ཌྷฯᕈ⽎ߦ߅ߌࠆࠣ࠾࠻ࡠࡦᵈᶧ㪈㫄㪾 ߩ㪊㫄㪾ߦኻߔࠆ㕖ഠᕈߪᬌ⸽ߐࠇߥ߆ߞߚ߇㧘㪘㪪㪚㪦㧘㪜㪪㪤㪦㧘㪥㪚㪚㪥ߦ߅ߌࠆࠟࠗ࠼ࠗࡦ㧘ࠣ
࠾࠻ࡠࡦ㪈㫄㪾߹ߚߪ㪈㪇Ǵ㪾㪆㫂㪾ߩ੍㒐⊛ᛩਈߩផᅑ㧘ක≮⾌ᛥߦ߅ߌࠆ⚻ᷣ⊛ലᨐ㧘ᬌജ ਇ⿷߽㐓ߺ㧘ฯࠬࠢߩ㜞᛫߇ࠎᛩਈᤨߩࠣ࠾࠻ࡠࡦ㪈㫄㪾 ߩ੍㒐⊛ᛩਈߪ㧘චಽߦ߇ ࠎ⮎‛≮ᴺߦ߅ߌࠆࠝࡊ࡚ࠪࡦߩ৻ߟߣߥࠅ߁ࠆߎߣ߇್ߒߚ㧚㩷
㩷
㪢㪼㫐㩷㪮㫆㫉㪻㫊㧦ࠫࡔࡦ㧘߇ࠎ⮎‛≮ᴺ㧘ක≮ో㧘ᡰᜬ≮ᴺ㧘ࠣ࠾࠻ࡠࡦ㩷 㩷
㩷
ߪߓߦ
߇ࠎߦࠃߞߡᱫߔࠆᣣᧄੱߪ㧘ᐕ㑆⚂㪊㪇ਁੱ㧘
✚ᱫߩ⚂㪊ഀࠍභ㧘㪈㪐㪏㪈ᐕ߆ࠄᱫ࿃ߩ࠻࠶ࡊࠍභ
ߡࠆ㧚ᐔᚑ㪈㪉ᐕߦߪᱫᢙ㪉㪐㪌㪃㪋㪏㪋ੱ㧘✚ᱫߩ 㪊㪇㪅㪎㧑ߣߥߞߡࠆ㧚㪉㪇㪉㪇ᐕߦߪ߇ࠎߦࠃࠆᱫ⠪
ᢙߪ㧘㪋㪌ਁ㨪㪌㪇ਁੱߦ㆐ߔࠆߣផ⸘ߐࠇߡࠆ㪈㧕㧚
࿖᳃ߩ㪉ੱߦ㪈ੱߪ߇ࠎߦ⟕ᖚߒ㧘ߘߩ߁ߜ㪊ੱߦ㪈ੱ
ߪ߇ࠎߢߊߥࠆᤨઍߢࠆ㧚㩷
ߘߩࠃ߁ߥ⁁ᴫߩਛߢ㧘߇ࠎᴦ≮ࠍขࠅᏎߊ㗴 ߪጊⓍߒߡࠆ㧚㗴ὐߣߒߡ㧘ᄌൻߩỗߒ߇ࠎ
⮎‛≮ᴺ㧘߇ࠎ⮎‛≮ᴺߩ࿖ౝᄖᩰᏅ㧘߇ࠎ⮎‛≮
ᴺߩᣉ⸳㑆ᩰᏅߣᣉ⸳ౝᩰᏅ㧘Ქᕈߩᒝ᛫߇ࠎ
ߩㆡᔕᄖ↪ߩ㗴㧘ᄙ᭽ߥᡰᜬ≮ᴺߩሽ㧘ᄖ᧪
ൻቇ≮ᴺߩჇടߦࠃࠆਇ⛔৻ߥࠫࡔࡦߩ᳚Ử㧘㍲
⛱ߔࠆ߇ࠎᴦ≮ᖱႎߥߤ߇ߍࠄࠇࠆ㧚㩷
৻ᣇ㧘᛫߇ࠎߦࠃࠆක≮ߪ㊀◊ߥ⚿ᨐߣߥ ࠆߎߣ߇ᄙߊ㧘ߘߩ㒐ᱛߪ߇ࠎ⮎‛≮ᴺߩో⏕
ߦ߅ߡᦨ㊀ⷐ⺖㗴ߣ⸒߃ࠆ㪉㧕㧚㪈㪐㪐㪋ᐕ㧘☨࿖ߦ߅
ߡ᛫߇ࠎߩㆊᛩਈߦࠃࠆක≮߇⊒↢ߒߚ㧚 ߘߩߪޟ࠳࠽ࡂࡃઙޠ㪊㧕ߣߒߡᐢߊ⍮
ࠄࠇ㧘ࠊ߇࿖ߦ߽ᄢ߈ߥⴣ᠄ࠍ߽ߚࠄߒߚ㧚☨࿖࠳
࠽ࡈࠔࡃ߇ࠎ⎇ⓥᚲ㧔ࡏࠬ࠻ࡦ㧕ߢ⥃ᐥ⹜㛎 ਛߩㅴⴕᕈ߇ࠎᖚ⠪㪉ੱߦࠕ࡞ࠠ࡞ൻߢࠆࠪ
ࠢࡠࡎࡈࠔࡒ࠼㪋㪾㪆㫄㪉㪆㪋ᣣ㑆㧘ߟ߹ࠅ㪈ᣣ㪈㪾㪆㫄㪉ࠍᛩਈ ߔࠆߣߎࠈ㧘㪋㪾㪆㫄㪉㪋ᣣ㑆ߩ㪋㊂ࠍᛩਈߒߚߚ㧘 㪈ੱߪ↪ߦࠃࠅ㪊ㅳ㑆ᓟߦᱫߒߚ㧚߽߁㪈ੱߪਇ นㅒᕈߩᔃਇోࠍ૬⊒ߒߚ㧚㪉ᐕ⋡ߩࡈࠚࡠ㧔කᏧ㧕 ߇ಣᣇߒ㧘ߩකᏧ߇⏕ߒߚ㧚⮎Ꮷ߽᳇߇ߟ߆ ߕ㧘ᦨᓟߦ⋴⼔Ꮷ߇ࠝ࠳ㅢࠅὐṢࠍߟߥߛ㧚
∛ߦߪࡊࡠ࠻ࠦ࡞߇ߥߊ㧘ᬌᩏ࠺࠲ߪ⇣Ᏹ୯ ࠍ␜ߒߡߚ߇㧘⥃ᐥ⹜㛎↪ߦሽߐࠇߡߚߛߌ ߢ㧘ࠞ࡞࠹ߦߪ⸥タߐࠇߡߥ߆ߞߚ㧚㩷
ࠊ߇࿖ߦ߅ߡ߽㧘ห᭽ߩ᛫߇ࠎߦࠃࠆක≮
߇ᢙᄙߊ⊒↢ߒߡࠆ㧔㪈㧕㧚ߎࠇࠄߩක≮
ߩᄙߊߪ㧘᛫߇ࠎߩⶄ㔀ߥᛩਈᣇᴺߦ࿃ߒߡ
ࠆ㧚᛫߇ࠎߦࠃࠆක≮ࠍᧂὼߦ㒐ߋߦߪ㧘᛫
߇ࠎ㧘ャᶧ㧘૬↪⮎ߥߤࠍᤨ♽⊛ߦ⸥タߒߚ
ࠫࡔࡦߩℂ⸃ߣߘߩㆡᱜߥ▤ℂ߇㊀ⷐߢࠆ㪋㧕㧚 ᧄⓂߢߪ㧘ㆡᱜߥࠫࡔࡦ▤ℂߩⷐὐߣࠫࡔࡦߩ
ᮡḰൻߦะߌߚ⮎Ꮷߩขࠅ⚵ߺߦߟߡㅀߴࠆ㧚㩷
㧝㧚ࠫࡔࡦߩ⇛㩷
㪈㧕᛫߇ࠎߣᡰᜬ≮ᴺ⮎ߩ㐿⊒㩷
᛫߇ࠎߪ㧘㪈㪐㪍㪇ᐕઍߩ࠽ࠗ࠻ࡠࠫࠚࡦࡑࠬ
࠲࠼ߩ⺃ዉߢࠆࠕ࡞ࠠ࡞ൻ߆ࠄߪߓ߹ࠅ㧘 ࠕࡦࠬࠨࠢࡦ♽㧘⊕㊄♽㧘࠲ࠠࠨࡦ♽᛫߇ࠎ
㧘ߘߒߡಽሶᮡ⊛⮎߇㐿⊒ߐࠇߚ㧚૬ߖߡ㧘߇ ࠎ⮎‛≮ᴺ߽ᄙ૬↪≮ᴺ㧘ᄢ㊂ൻቇ≮ᴺ㧘ⴚ೨
ⴚᓟഥൻቇ≮ᴺ㧘✢ൻቇ≮ᴺ߳ߣ⊒ዷߒߡ
ࠆ㪌㧕㧚㩷
ߘߒߡ㧘᛫߇ࠎ߿ᴦ≮ᴺߩ㐿⊒ߣߦᲥᕈߩ ᒝ᛫߇ࠎߩ↪ࠍシᷫࠆߪ੍㒐ߔࠆߚ
㧘ᡰᜬ≮ᴺ߇㐿⊒ߐࠇߚ㧚ౕ⊛ߦߪ㧘᛫߇ࠎ
ߩᛩਈߦࠃߞߡ⊒ߔࠆ㛽㜑ᛥߦኻߔࠆ㧳 㪄㪚㪪㪝㧔㪾㫉㪸㫅㫌㫃㫆㪺㫐㫋㪼㩷 㪺㫆㫃㫆㫅㫐㪄㫊㫋㫀㫄㫌㫃㪸㫋㫀㫅㪾㩷 㪽㪸㪺㫋㫆㫉㧧㗰☸
ࠦࡠ࠾ೝỗ࿃ሶ㧕ߩ੍㒐߅ࠃ߮ᴦ≮ᛩਈ
㪍㧕㧘ᧃ᪳ⴊᐙ⚦⢩⒖ᬀ߿ࡒ࠾⒖ᬀ㪎㧕㧘⊒ᾲᕈᅢਛ
ᷫዋ∝߳ߩ᛫↢‛⾰ߩ⸘↹⊛੍㒐߅ࠃ߮ᴦ≮ᛩਈ
㪏㧕㧘ᖡᔃ߿ཌྷฯߦኻߔࠆࡔ࠻ࠢࡠࡊࡒ࠼ߩᄢ㊂ ᛩਈ߆ࠄᆎ߹ߞߚ㪌㪄㪟㪫㪊ฃኈᜟ᛫㧘⣢⊹⾰
ࠬ࠹ࡠࠗ࠼ߣߩ૬↪≮ᴺ㪐㧕㧘⣢㓚ኂ੍㒐ߩߚ
ߩャᶧ≮ᴺߥߤ߇㐿⊒ߐࠇߚ㧚㩷
ߎߩࠃ߁ߦ㧘ൻቇ≮ᴺߣᡰᜬ≮ᴺߩ૬↪ߦࠃࠅ㧘 ߇ࠎᖚ⠪ߪೋߡᔃ߆ߟోߦ߇ࠎ⮎‛≮ᴺࠍ ฃߌࠄࠇࠆ㧚߇ࠎᴦ≮ߢߪ᛫߇ࠎߦᵈ⋡ߐࠇ߇ ߜߛ߇㧘ㆡಾߥᡰᜬ≮ᴺ߇૬↪ߐࠇߥߌࠇ߫㧘߇ ࠎ⮎‛≮ᴺࠍታᣉߔࠆߎߣߪߢ߈ߥ㧚㩷
㩷
㧝 ᛫߇ࠎߦࠃࠆਥߥ࿖ౝක≮㧔ႎ⸥ᛮ☴㧕
ޣౝ⮎ޤ㩷
ᐔᚑ㪈㪋ᐕ㪊㩷 㪬㪝㪫㧙㧱ᛩਈਛߦ㧘૬↪ᔊ⮎ߢࠆ㪫㪪㧙㪈ࠞࡊ࡞ࠍ㪐ᣣ㑆ᛩਈ㧚㊀◊ߥᗧ⼂㓚ኂࠍ⊒∝㧚㩷 ᐔᚑ㪈㪍ᐕ㪋㩷 㪫㪪㧙㪈ࠞࡊ࡞ᛩਈਛߦ㧘૬↪ᔊ⮎ߢࠆࡈ࡞࠷ࡠࡦࠞࡊ࡞ࠍ㪊ᣣ㑆ᛩਈ㧚㪈㪈ᣣᓟߦᱫ㧚㩷 ޣᵈ⮎ޤ㩷
ᐔᚑ㪈㪈ᐕ㪈㪉㩷 ࠪࠬࡊ࠴ࡦᵈᶧ㪈㪉㪇㫄㪾ࠍ㪈ᣣᛩਈᓟ㪊ㅳ㑆એߩભ⮎ߩߣߎࠈ㧘㪊ᣣㅪ⛯ᛩਈ㧚㪈㪈ᣣᓟᄙ⤳ེਇోߣ ᢌⴊ∝ߢᱫ㧚㩷
ᐔᚑ㪈㪉ᐕ㪍㩷 ࡆࡦࡉࠬ࠴ࡦᵈᶧ㪌㫄㪾ࠍ㧘㪌㪇㫄㪾ߣᵈ▐ߦ⺋ォ⸥㧚ᄙ⤳ེਇోߢᱫ㧚㩷 ᐔᚑ㪈㪉ᐕ㪈㪇㩷 ࡆࡦࠢࠬ࠴ࡦᵈᶧㅳ㪈࿁ᛩਈߩߣߎࠈ⚂㪈ㅳ㑆ㅪ⛯ᛩਈ㧚ᄙ⤳ེਇోߢᱫ㧚㩷
ᐔᚑ㪈㪋ᐕ㪋㩷 ࡄࠢ࠲ࠠ࡞ᵈᶧ㧔࠲ࠠ࠰࡞㫤ᵈᶧ㧕㪏㪏㪅㪏㫄㪾ᛩਈߩߣߎࠈ㧘࠼࠲ࠠ࡞ᵈᶧ㧔࠲ࠠ࠰࠹
࡞㫤ᵈᶧ㧕㪏㪏㪅㪏㫄㪾ࠍᛩਈ㧚ᄙ⤳ེਇోߢᱫ㧚㩷
ᐔᚑ㪈㪌ᐕ㪐㩷 ࠪࠢࡠࡎࠬࡈࠔࡒ࠼ᵈᶧ㪉㪅㪐㨓ࠍ㪉ᣣ㑆ᛩਈߩߣߎࠈ㪉㊂ߩ㪌㪅㪏㨓ࠍ㪉ᣣ㑆ᛩਈ㧚㪌ᣣᓟ㧘ᔃਇోߢᱫ㧚 ᐔᚑ㪈㪌ᐕ㪐㩷 ࡄࠢ࠲ࠠ࡞ᵈᶧ㧔࠲ࠠ࠰࡞㫤ᵈᶧ㧕㪉㪏㪇㫄㪾ࠍᛩਈߩߣߎࠈ㧘࠼࠲ࠠ࡞ᵈᶧ㧔࠲ࠠ࠰࠹
࡞㫤ᵈᶧ㧕㪉㪏㪇㫄㪾ࠍᛩਈ㧚ᄙ⤳ེਇోߢᱫ㧚㩷 㩷
㪉㧕߇ࠎ⮎‛≮ᴺ㩷
᛫߇ࠎߪ৻⥸⮎ߦᲧセߒ㧘↪㊂̆↪ᦛ✢ߦ ߅ߡ↪ߣ↪߇ㄭធࠆߪ㊀ߥࠆߎߣߦ ࠃࠅ㧘ࠊߕ߆ߥᛩਈ㊂ߩ㆑ߦࠃߞߡ߽㊀◊ߥ
↪ࠍ⊒ߔࠆߎߣ߇⍮ࠄࠇߡࠆ㪈㪇㧕㧚ߘߒߡ㧘
㪞㫆㫃㪻㫀㪼ߣ㪚㫆㫃㪻㫄㪸㫅߇ឭ໒ߒߡࠆࠃ߁ߦ㧘߇ࠎ⚦
⢩ߪᤨ㑆ߩ⚻ㆊߣߣ߽ߦ⥄ὼߦ⮎⠴ᕈࠍ₪ᓧߒ Ⴧᱺߔࠆ㧚߇ࠎ⚦⢩㊂ߩዋߥᣧᦼߦᄙ૬↪≮
ᴺࠍታᣉߔߴ߈ߢࠅ㧘᛫߇ࠎߦࠃࠆ᛫⣲≌ല ᨐߪනᤨ㑆ᒰߚࠅߩᛩਈ㊂㧔㪻㫆㫊㪼㩷 㫀㫅㫋㪼㫅㫊㫀㫋㫐㧕ߦ ଐሽߒߡࠆ㪈㪈㧕㧚㩷
ห৻ߩ᛫߇ࠎߢߞߡ߽߇ࠎ⣲ߦࠃࠅ↪ᴺ߅ ࠃ߮↪㊂߇ᄢ߈ߊ⇣ߥߞߡߚࠅ㧘㪈ࠢ࡞ߦ㪈࿁
ߒ߆ᛩਈߒߥ႐วߢ߽ᛩਈ㐿ᆎ߇㪈ᣣ⋡߿㪏ᣣ⋡
ߢߞߚࠅߔࠆ㧚߹ߚ㧘᛫߇ࠎߪᴦ≮ലᨐߩะ
ߣ↪ߩシᷫߥߒ࿁ㆱࠍ⋡⊛ߦ૬↪ߐࠇࠆ ߎߣ߇ᄙ㧚ߒ߆ߒ㧘ᛩਈ㗅ߦࠃߞߡߪᴦ≮ലᨐ
߿Ქᕈߩ⊒ߦᄢ߈ߥ⋧㆑߇↢ߓࠆߎߣ߽⍮ࠄࠇ ߡࠆ㪈㪉㧕㧚ߐࠄߦ㧘↪ߩ⊒ࠍ੍㒐ࠆߪ シᷫߔࠆߚฯ߿ᶧߥߤߩᡰᜬ≮ᴺ⮎߇ᄙ ߊ૬↪ߐࠇⶄ㔀ൻߒߡࠆ㧚ߒߚ߇ߞߡ㧘㪈ੱߩ߇ ࠎᖚ⠪ߦᛩਈߔࠆක⮎ຠ߇⤘ᄢߥᢙߦ߱ߎߣ߽
ࠆ㧚㩷
㪊㧕ࠫࡔࡦߣࡊࡠ࠻ࠦ࡞㩷
߇ࠎ⮎‛≮ᴺߦ߅ߌࠆࠫࡔࡦ㧔㫉㪼㪾㫀㫄㪼㫅㧕ߣߪ㧘
᛫߇ࠎ㧘ャᶧ㧘ᡰᜬ≮ᴺ⮎㧔ฯߥߤ㧕ࠍ⚵
ߺวࠊߖߚᤨ♽⊛ߥᴦ≮⸘↹ࠍ⸒߁㪈㪊㧕㧚ࠫࡔ ࡦ ߩ ⒓ ߦ ߟ ߡ ߪ 㧘 ☨ ࿖ ࿖ ┙ ߇ ࠎ ⎇ ⓥ ᚲ 㧔㪥㪸㫋㫀㫆㫅㪸㫃㩷 㪚㪸㫅㪺㪼㫉㩷 㪠㫅㫊㫋㫀㫋㫌㫋㪼㧧㪥㪚㪠㧕ߩࡎࡓࡍࠫ
ߩ↪⺆ߩቯ⟵ߦ⸥ߐࠇߡࠆ㧚ߟ߹ࠅ㧘ࠫࡔ ࡦߣߪ㧘ޟ㧔᛫߇ࠎ㧘ᡰᜬ≮ᴺ⮎ߩ㧕ᛩਈ㊂㧘ᛩ ਈ ࠬ ࠤ ࠫ ࡘ ࡞ 㧘 ᴦ ≮ ᦼ 㑆 ࠍ ␜ ߒ ߚ ᴦ ≮ ⸘ ↹ 㧔㫉㪼㪾㫀㫄㪼㫅㪑㪘㩷㫋㫉㪼㪸㫋㫄㪼㫅㫋㩷㫇㫃㪸㫅㩷㫋㪿㪸㫋㩷㫊㫇㪼㪺㫀㪽㫀㪼㫊㩷㫋㪿㪼㩷㪻㫆㫊㪸㪾㪼㪃㩷
㫋㪿㪼㩷㫊㪺㪿㪼㪻㫌㫃㪼㪃㩷㪸㫅㪻㩷㫋㪿㪼㩷㪻㫌㫉㪸㫋㫀㫆㫅㩷㫆㪽㩷㫋㫉㪼㪸㫋㫄㪼㫅㫋㪅㧕ޠߣ⸃
㉼ߔࠆߩ߇৻⥸⊛ߢࠆ㧚ߣߎࠈ߇㧘ࠫࡔࡦߪ ࡊࡠ࠻ࠦ࡞㧔㫇㫉㫆㫋㫆㪺㫆㫃㧕ߣ߁⒓ߢ㧘ߒ߫ߒ߫
ᷙหߒߡࠊࠇߡࠆ㧚㩷
ࡊࡠ࠻ࠦ࡞ߪࠫࡔࡦߣห᭽ߦ㪥㪚㪠ߢ↪⺆߇ ⷙቯߐࠇߡ߅ࠅ㧘ޟ∝ㆬቯၮḰ㧘ᴦ≮⸘↹㧘࠺
࠲㓸㧘Ქᕈႎ๔㧘ലᨐ⹏ଔ㧘ⷙⷐઙ㧘หᗧᢥ ᦠߘߒߡ⛔⸘⸃ᨆߦᔅⷐߥᚻ㗅ߥߤ߇⸥ߐࠇߚ
⸘↹ᦠ㧔㫇㫉㫆㫋㫆㪺㫆㫃㪑㩷㪘㫅㩷㪸㪺㫋㫀㫆㫅㩷㫇㫃㪸㫅㩷㪽㫆㫉㩷㪸㩷㪺㫃㫀㫅㫀㪺㪸㫃㩷㫋㫉㫀㪸㫃㪅㩷 㪫㪿㪼㩷㫇㫃㪸㫅㩷㫊㫋㪸㫋㪼㫊㩷㫎㪿㪸㫋㩷㫋㪿㪼㩷㫊㫋㫌㪻㫐㩷㫎㫀㫃㫃㩷㪻㫆㪃㩷㪿㫆㫎㪃㩷㪸㫅㪻㩷㫎㪿㫐㪅㩷 㪠㫋㩷 㪼㫏㫇㫃㪸㫀㫅㫊㩷 㪿㫆㫎㩷 㫄㪸㫅㫐㩷 㫇㪼㫆㫇㫃㪼㩷 㫎㫀㫃㫃㩷 㪹㪼㩷 㫀㫅㩷 㫀㫋㪃㩷 㫎㪿㫆㩷 㫀㫊㩷 㪼㫃㫀㪾㫀㪹㫃㪼㩷 㫋㫆㩷 㫇㪸㫉㫋㫀㪺㫀㫇㪸㫋㪼㪃㩷 㫎㪿㪸㫋㩷 㫊㫋㫌㪻㫐㩷 㪸㪾㪼㫅㫋㫊㩷 㫆㫉㩷 㫆㫋㪿㪼㫉㩷 㫀㫅㫋㪼㫉㫍㪼㫅㫋㫀㫆㫅㫊㩷㫋㪿㪼㫐㩷㫎㫀㫃㫃㩷㪹㪼㩷㪾㫀㫍㪼㫅㪃㩷㫎㪿㪸㫋㩷㫋㪼㫊㫋㫊㩷㫋㪿㪼㫐㩷㫎㫀㫃㫃㩷 㫉㪼㪺㪼㫀㫍㪼㩷 㪸㫅㪻㩷 㪿㫆㫎㩷 㫆㪽㫋㪼㫅㪃㩷 㪸㫅㪻㩷 㫎㪿㪸㫋㩷 㫀㫅㪽㫆㫉㫄㪸㫋㫀㫆㫅㩷 㫎㫀㫃㫃㩷 㪹㪼㩷 㪾㪸㫋㪿㪼㫉㪼㪻㪅㧕ޠߣߐࠇ㧘ㅢᏱ㧘⥃ᐥ⹜㛎ߢ↪ߐࠇࠆ ߩߢࠫࡔࡦߣᷙหߒߥࠃ߁ᵈᗧߔࠆᔅⷐ߇
ࠆ㪈㪋㧕㧚㩷
㪋㧕ࠫࡔࡦߩ㩷
߇ࠎ⮎‛≮ᴺߦ߅ߌࠆࠫࡔࡦߪ㧘೨ㅀߒߚࠃ ߁ߦ᛫߇ࠎ㧘ャᶧ㧘ᡰᜬ≮ᴺ⮎㧔ฯߥߤ㧕 ࠍ⚵ߺวࠊߖߚᤨ♽⊛ߥᴦ≮⸘↹ߩߎߣߢࠆ ߆ࠄ㧘ߘࠇࠄ߇ߔߴߡ৻ర▤ℂߐࠇߡߥߌࠇ߫
ߥࠄߥ㧚ಾ㒰ਇ⢻ォ⒖ౣ⊒ᄢ⣺߇ࠎߦኻߔࠆ ൻቇ≮ᴺߢࠆ㫄㪝㪦㪣㪝㪦㪯㪍ࠫࡔࡦࠍߦ㧘ᛩਈ 㑆㓒㧘ભ⮎ᦼ㑆㧘ࠗࡦ࠲ࡃ࡞ߥߤߦߟߡㅀߴ ࠆ㧚࿑㪈ߪ㫄㪝㪦㪣㪝㪦㪯㪍ߩᴦ≮ࠬࠤࠫࡘ࡞ߢ
ࠆ㪈㪌㧕㧚㩷
᛫߇ࠎߪㅪᣣᛩਈߐࠇࠆߎߣߪዋߥߊ㧘᛫߇ ࠎߩ↪ߦࠃࠆᖚ⠪߳ߩ⽶ᜂࠍ⠨ᘦߒߡ㧘ㅢ Ᏹ㧘ᛩਈ㑆㓒㧘ભ⮎ᦼ㑆ߘߒߡࠗࡦ࠲ࡃ࡞㧔ࠨ
ࠗࠢ࡞ࠆߪࠦࠬ㧕߇⸳ቯߐࠇߡࠆ㧚ᛩਈ 㑆㓒ߪ㧘න⁛ࠆߪ૬↪ߐࠇࠆⶄᢙߩ᛫߇ࠎ
ࠍ㪈࿁ߦᛩਈߔࠆᣣᢙࠍ␜ߒ㧘㫄㪝㪦㪣㪝㪦㪯㪍≮ᴺߩ ႐วߪࠝࠠࠨࡊ࠴ࡦ㧔㪣㪄㪦㪟㪧㧕ߣࡈ࡞ࠝࡠ࠙
ࠪ࡞㧔㪌㪄㪝㪬㧕ࠍᛩਈߔࠆ㪉ᣣ㑆㧘ભ⮎ᦼ㑆ߪ㪈
࿁ߩᛩਈ㑆㓒ᓟߩ㪉࿁⋡ߩᛩਈ߹ߢߩᣣᢙࠍᜰߒ㧘 㪈㪉ᣣ㑆ߣߥࠆ㧚ࠗࡦ࠲ࡃ࡞ߪᛩਈ㑆㓒ߣભ⮎ᦼ 㑆ࠍว▚ߒߚᣣᢙߢࠆ߆ࠄ㪉ㅳ㑆ߣߥࠆ㧚ࠗࡦ
࠲ࡃ࡞ߪ㧘ޟࠨࠗࠢ࡞ޠࠆߪޟࠦࠬޠߣ߽
⸒ࠊࠇࠆߩߢᵈᗧ߇ᔅⷐߢࠆ㧚㩷
࿑㪈ߦ⊓㍳ߐࠇߡࠆ㫄㪝㪦㪣㪝㪦㪯㪍ߩᴦ≮ࠬࠤࠫ
ࡘ࡞ߦᡰᜬ≮ᴺ⮎߿ャᶧ㧘ᚻᛛ㧘ᛩਈ࡞࠻㧘 ᛩਈㅦᐲ╬ࠍㅊടߒߡ㧘ೋߡ㫄㪝㪦㪣㪝㪦㪯㪍ࠫࡔ ࡦߣߥࠆ㧔࿑㪉㧕㪈㪌㧕㧚ห৻ߩᛩਈࠬࠤࠫࡘ࡞ߢ߽
ᣉ⸳㑆ߢࠫࡔࡦߩౝኈߪᄢ߈ߊᄌࠊࠆ㧚ᣉ⸳ߦ ࠃߞߡߪࠣ࡞ࠦࡦ㉄ࠞ࡞ࠪ࠙ࡓ᳓‛ᵈᶧ㧔ࠞ
࡞࠴ࠦ࡞㫤ᵈᶧ㧕߿⎫㉄ࡑࠣࡀࠪ࠙ࡓࡉ࠼
࠙♧㈩วᵈᶧ㧔ࡑࠣࡀ࠱࡞㫤ᵈᶧ㧕ߩㅊട㧘
ࡏࡎ࠽࠻㧔㷔㪄㪣㪭㧕ᵈᶧ㧔ࠕࠗ࠰ࡏࡦ㫤㩷
㩷
㫄㪝㪦㪣㪝㪦㪯㪍≮ᴺ㧔ᄢ⣺߇ࠎ㧕㩷
ࠝࠠࠨࡊ࠴ࡦ㫭㫭㫭㫭㫭㫭㫭㫭㫭 㪏㪌㫄㪾㪆㫄㪉ὐṢ㕒ᵈ㧔㪻㪸㫐㪈㧕㩷
㪌㪄㪝㪬 㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭 㪋㪇㪇㫄㪾㪆㫄㪉ࡢࡦ࡚ࠪ࠶࠻㕒ᵈ㧔㪻㪸㫐㪈㧕㩷 㪌㪄㪝㪬 㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭㫭 㪉㪃㪋㪇㪇㩷㫄㪾㪆㫄㪉ᜬ⛯ὐṢ㧔㪻㪸㫐㪈㪉㧕㩷 㪉ㅳ㑆Ფ㩷
㩷
⮎ຠฬ㩷 ᚻ ᛛ㩷 㪻㪸㫐㪈㩷 㪻㪸㫐㪉㩷 ભ⮎㧔㪈㪉ᣣ㧕㩷 㪻㪸㫐㪈㩷
ࠝࠠࠨࡊ࠴ࡦ㩷 ὐṢ㕒ᵈ㩷 ٤㩷 㩷 㩷 ٤㩷
㪌㪄㪝㪬㩷 ࡢࡦ࡚ࠪ࠶࠻㕒ᵈ㩷 ٤㩷 㩷 㩷 ٤㩷
㪌㪄㪝㪬㩷 ᜬ⛯ὐṢ㧔㪋㪍㪿㫉㧕㩷 ٤㩷 㩷 㩷
㩷 㩷 㩷
㪻㪸㫐㪈߆ࠄߩࠗࡦ࠲ࡃ࡞㪉ㅳ㑆㩷
ᛩਈ㑆㓒㩷 ભ⮎ᦼ㑆㩷 㩷
㩷 㩷 㩷 㩷
㩷 㩷 ࠗࡦ࠲ࡃ࡞㧔ࠨࠗࠢ࡞ࠆߪࠦࠬ㧕㩷 㩷
㩷
࿑㧝 㫄㪝㪦㪣㪝㪦㪯㪍ᴦ≮ࠬࠤࠫࡘ࡞㧕
㪩㫇㩷 ⮎ຠฬ㨯ⷙᩰ㩷 ᛩਈ㊂㩷 ᚻ ᛛ㩷 ᛩਈ࡞࠻㩷 ὐṢᤨ㑆㨯ㅦᐲ㩷 㪻㪸㫐㩿㪈㪀㩷
ࠣ࠾࠻ࡠࡦᵈᶧ㩷
㩿㪊㫄㪾㪆㪊㫄㪣㪀㩷 㪊㫄㪾㩷
࠺ࠠࠨࡔ࠲࠱ࡦᵈᶧ㩷
㩿㪏㫄㪾㪆㪉㫄㪣㪀㩷 㪏㫄㪾㩷
㪈㩷
ᵈ↪↢ℂ㘩Ⴎᶧ㩷
㩿㪌㪇㫄㪣㪀㩷 㪌㪇㫄㪣㩷
ਛᔃ㕒⣂ᵈ ਛᔃ㕒⣂࡞࠻ࡔࠗࡦ㪈 㪈㪌ಽߢ㩷 㪐㧦㪇㪇
ࡏࡎ࠽࠻ᵈᶧ㩷
㩿㪉㪌㪈㪇㪇㫄㪾㪀㩷 㪉㪇㪇㫄㪾㪆㫄㪉㩷
㪉㩷
ᵈ↪↢ℂ㘩Ⴎᶧ㩿㪌㪇㪇㫄㪣㪀㩷 㪌㪇㪇㫄㪣㩷
ਛᔃ㕒⣂ᵈ ਛᔃ㕒⣂࡞࠻ࡔࠗࡦ㪈 㪈㪉㪇ಽߢ㩷 㪐㧦㪈㪌
ࠝࠠࠨࡊ࠴ࡦᵈᶧ㩷
㩿㪈㪇㪇㫄㪾㪀㩷 㪏㪌㫄㪾㪆㫄㪉㩷
㪊㩷 ᵈ↪㪌㩼ࡉ࠼࠙♧ᶧ㩷
㩿㪉㪌㪇㫄㪣㪀㩷 㪉㪌㪇㫄㪣㩷
ਛᔃ㕒⣂ᵈ ਛᔃ㕒⣂▤㪈㩷 㪈㪉㪇ಽߢ㩷 㪐㧦㪈㪌
㪋㩷 㪌㪄㪝㪬ᵈᶧ㩿㪉㪌㪇㫄㪾㪆㪌㫄㪣㪀㩷 㪋㪇㪇㫄㪾㪆㫄㪉㩷 ࡢࡦ࡚ࠪ࠶࠻㕒ᵈ ਛᔃ㕒⣂࡞࠻ࡔࠗࡦ㪈 㩷 㪈㪈㧦㪈㪌 㪌㪄㪝㪬ᵈᶧ㩿㪉㪌㪇㫄㪾㪆㪌㫄㪣㪀㩷 㪉㪃㪋㪇㪇㫄㪾㪆㫄㪉㩷
㪌㩷 ᵈ↪↢ℂ㘩Ⴎᶧ㩷
㩿㪌㪇㪈㪇㪇㫄㪣㪀㩷 㪈㪌㪇㫄㪣㩷 ਛᔃ㕒⣂ᵈ ਛᔃ㕒⣂࡞࠻ࡔࠗࡦ㪈 㪌㫄㪣㪆㪿㩷
ࠗࡦࡅࡘࠩ㪣㪭㪌㩷 㪈㪈㧦㪈㪌
࿑㧞 㫄㪝㪦㪣㪝㪦㪯㪍ࠫࡔࡦ㧕 㩷
ᵈᶧ㧕ߩṁ⸃ᶧߣᜬ⛯ᛩਈ㪌㪄㪝㪬 ᵈᶧߩᏗ㉼
ᶧߩ㆑㧘㪈࿁ᛩਈߩ㪌㪄㪝㪬 ᵈᶧߩᛩਈᤨ㑆㧔㪈 ಽߣ㪈㪌ಽ㧕ߥߤᄙ⢇ߦࠊߚࠆ㧚ߎߩࠃ߁ߦ㧘ห৻
ߩ᛫߇ࠎߩᴦ≮ࠬࠤࠫࡘ࡞ߢ߽ࠫࡔࡦߩ
ᚑߢߪ㧘ᣉ⸳ߩ⁛⥄ᕈ߇㗼⪺ߦࠇࠆ㧚․ߦᡰᜬ
≮ᴺߢߪ⪺ߒߊ㧘⮎Ꮷߪᡰᜬ≮ᴺߦ߅ߌࠆኾ㐷 ᕈࠍ㜞ࠆߎߣߦࠃߞߡ㧘Ⓧᭂ⊛ߦ࠴ࡓක≮ߦ
ෳ↹ߒ㧘߇ࠎᖚ⠪ߩᴦ≮ߦ⽸₂ߔࠆߎߣ߇ߢ߈ࠆ ߣ⠨߃ࠆ㧚㩷
㩷
㧞㧚ࠫࡔࡦ▤ℂ㩷
ࠫࡔࡦ▤ℂߩ⋡⊛ߪ㧘ක≮ోߩ⏕㧘߇ࠎ⮎
‛≮ᴺߩㆡᱜൻ㧘ᖚ⠪ߩ㪨㫌㪸㫃㫀㫋㫐㩷㫆㪽㩷㪣㫀㪽㪼㩿㪨㪦㪣㪀ߩะ㧘 ㆡᱜߥක≮⾗Ḯ㧔ක⮎ຠ߅ࠃ߮ක≮↪ᶖ⠻ຠ㧕ߩ
↪߇ߍࠄࠇࠆ㧚㩷 㩷
㪈㧕ක≮ోߩ⏕㩷
Ქᕈߩᒝ᛫߇ࠎᴦ≮ࠍⴕ߁߇ࠎ⮎‛≮ᴺߢ ߪ㧘ᖚ⠪ߩක≮ోߩ⏕߇ᦨఝవߐࠇࠆ㧚․ߦ ᄖ᧪ൻቇ≮ᴺ߇Ⴧടߔࠆਛߢ㧘⸻≮⑼ࠆߪ
ࠫࡔࡦߏߣߦฯ╬ߩᡰᜬ≮ᴺ⮎ߩᛩਈᣇᴺ߇
⇣ߥࠆߣ㧘ᵈߩᷙว⺞ࡒࠬ߿ᄖ᧪ㅢ㒮ᴦ≮
ࡦ࠲╬ߢߩ㕒⣂ౝᛩਈᤨ㑆ߩ⺋ࠅࠍߎߒ㧘 ක≮ࡒࠬߩෂ㒾ᕈࠍ㜞ࠆ㧚㩷
߹ߚ㧘㔚ሶࠞ࡞࠹߿ࠝ࠳ࡦࠣࠪࠬ࠹ࡓࠍ
↪ߒߚࠫࡔࡦ▤ℂࠪࠬ࠹ࡓ߿ශߐࠇߚࠬࠤ
ࠫࡘ࡞▤ℂࠍ↪ߒߚࠫࡔࡦ▤ℂࠍⴕߞߚ ߣߒߡ߽㧘ࠫࡔࡦࠍᣉ⸳ౝߢ೨ߦ৻ర⊓㍳߅
ࠃ߮ክᩏߒ㧘ಣᣇ೨ߦࠫࡔࡦࠍ⸻≮ㇱ㐷߆ࠄ⮎
ㇱ㐷ߣ⋴⼔ㇱ㐷ߦ⍮ߔࠆߎߣߦࠃߞߡ㧘᛫߇ ࠎߩห৻ᖚ⠪߳ߩ㊀ⶄᛩਈߩ࿁ㆱ㧘᛫߇ࠎߩ ᛩਈ㊂㧘ᛩਈᦼ㑆㧘ભ⮎ᦼ㑆㧘⚥Ⓧ㊂ߩ⏕㧘ャ ᶧ↪ࡐࡦࡊߩㆡᱜ↪߇ೋߡน⢻ߣߥࠆ㧚㩷
ࠫࡔࡦࠍ⊓㍳ߔࠆ㓙ߪ㧘෩ᩰߥࠫࡔࡦክᩏ ࠍⴕࠊߥߌࠇ߫ߥࠄߥ㧚ߘߩߚᣉ⸳ౝߦࠫ
ࡔࡦክᩏᆔຬળࠍ⸳⟎ߔࠆᔅⷐ߇ࠆ㧚ߎࠇࠍᜂ ᒰߔࠆߩߪ㧘߇ࠎ⮎‛≮ᴺߦ♖ㅢߒߚ⮎Ꮷ߇ㆡ છߢࠅ㧘⮎Ꮷ߇ߘߩ⢻ജࠍචಽߦ⊒ើߢ߈ࠆ ߪߕߢࠆ㧚㩷
㩷
㪉㧕߇ࠎ⮎‛≮ᴺߩㆡᱜൻ㩷
᛫߇ࠎࠍㆡಾߦᛩਈߔࠆߚߦߪ㧘ᣉ⸳ౝߩ
ో⸻≮⑼ߩ᛫߇ࠎߩᛩਈᣇᴺࠍㆡᱜߦ⛔৻ߔࠆ ᔅⷐ߇ࠆ㧚ߐࠄߦ㧘⇣ߥࠆ⸻≮⑼ߢ߽ࠫࡔࡦ ߩౝኈ߇⛔৻ߐࠇߡࠆߎߣ߽㊀ⷐߢࠆ㧚߹ߚ㧘
᛫߇ࠎߪㆡᔕᄖ↪ߐࠇࠆߎߣ߇ᄙߩߢ㧘ක
⮎ຠߩㆡᔕᄖ↪ߩኻᔕߦߟߡ߽ᣉ⸳ౝߢ⏕
ߦߒߡ߅ߊᔅⷐ߇ࠆ㧚㩷
߇ࠎ⮎‛≮ᴺߩㆡᱜൻߦߪࠫࡔࡦ▤ℂߪᔅ㗇 ߢࠆ߇㧘ߔߴߡࠍ✂⟜ߔࠆߎߣߪߢ߈ߥ㧚߇ ࠎ⮎‛≮ᴺߩㆡᱜൻߦߪࠫࡔࡦክᩏߩ߶߆ߦ㧘 ක⮎ຠߩㆡᔕᄖ↪ߦ㑐ߔࠆክᩏ㧘⥃ᐥ⎇ⓥߩߚ
ߩ୶ℂክᩏߘߒߡකᏧਥዉࠍᴦ㛎ࠍታᣉߔ ࠆߚߩฃ⸤⎇ⓥክᩏ߇㊀ⷐߢࠆ㧔࿑㪊㧕㧚ߎࠇ ࠄ㪋ᧄߩᩇߦࠃࠅ߇ࠎ⮎‛≮ᴺߩㆡᱜൻ߇ߥߐࠇ㧘 ߇ࠎᖚ⠪ߦᔃߢోߥ᛫߇ࠎߩᛩਈ߇ߢ߈ࠆ ߣ⠨߃ࠆ㧚㩷
㩷
ࠫࡔࡦ ክᩏ
୶ℂክᩏ ω 㧔⥃ᐥ⎇ⓥ㧕
ฃ⸤⎇ⓥ
ክᩏ ω 㧔ᴦ㛎㧕
ᔃ߆ߟోߥ᛫߇ࠎᛩਈ
ㆡᔕᄖ
↪
ክᩏ
᛫߇ࠎߩㆡᱜ↪
࿑㧟 ᛫߇ࠎߩో▤ℂ
㩷
㪊㧕ᖚ⠪ߩ㪨㪦㪣ߩะ㩷
ࠫࡔࡦ߇ᮡḰൻߐࠇࠆߎߣߦࠃࠅ㧘⮎ㇱ㐷 ߥࠄ߮ߦ⋴⼔ㇱ㐷ߦ߅ߌࠆ᛫߇ࠎಣᣇߩ㐓ᩏ߇
⍴❗ߐࠇ㧘ߐࠄߦᵈ⮎ߩᷙว⺞ᤨ㑆ߩ⍴❗ൻ ߣ੍ൻ߇࿑ࠄࠇࠆ㧚ߘߩ⚿ᨐ㧘ᖚ⠪ᓙߜᤨ㑆ࠍ
⍴❗ߒ㧘ᄖ᧪ߢ᛫߇ࠎߩᛩਈࠍฃߌࠆᖚ⠪ߩ 㪨㪦㪣ߩะ߇ᦼᓙߢ߈ࠆ㧚㩷
㩷
㪋㧕ㆡᱜߥක≮⾗Ḯ㧔ක⮎ຠ߅ࠃ߮ක≮↪ᶖ⠻ຠ㧕 ߩ↪㩷
߇ࠎ⮎‛≮ᴺߢ↪ߐࠇࠆක⮎ຠ㧔᛫߇ࠎ㧘 ᡰᜬ≮ᴺ⮎㧕߿ක≮↪ౕེ㧔ࠗࡦࡅࡘࠩࡐࡦ ࡊߥߤ㧕ߪ㜞㗵ߢࠆߚ㧘ㆡᱜߥᣉ⸳ౝណ↪ߦ ක≮ᓥ⠪߅ࠃ߮ോㇱ㐷ߪദߥߌࠇ߫ߥࠄߥ
㧚ߘߩߚߦߪ㧘ណ↪ක⮎ຠᢙߩ❗ᷫ㧘ห⒳ห ല⮎ߩᢛℂ㧘ᓟ⊒ක⮎ຠ߳ߩಾࠅᦧ߃ណ↪㧘ᄢኈ
㊂ߩⓍᭂ⊛ߥណ↪ߣߘߩㅧߦ㑐ߔࠆ⮎ડ
ᬺ߅ࠃ߮ⴕ߳ߩ߈߆ߌ㧘ක≮↪ᶖ⠻ຠߩ❗ᷫ
ߥߤߩᣇ╷߇⠨߃ࠄࠇࠆ㧚㩷
⮎ડᬺ߅ࠃ߮ෘ↢ഭ⋭߳ᄢኈ㊂ߩᣧᦼ
ㅧࠍⷐᦸߒߚࠍ⚫ߔࠆ㧚࿖ౝߢ⽼ᄁߐࠇ ߡࠆᵈ↪᛫߇ࠎ㧔㪌㪏ຠ⋡㧕ߣ㪉૬↪⮎
㧔㷔㪄㪣㪭㧘ࡠࠗࠦࡏࡦࠞ࡞ࠪ࠙ࡓ㧕ߦߟߡ㧘
ຠⷙᩰߣᷝઃᢥᦠਛߩ↪ᴺ߅ࠃ߮↪㊂ߣߩ⊛⏕ᕈ ࠍ⺞ᩏߒߚ㧚ߘߩ⚿ᨐ㧘Ꮢ⽼ߐࠇߡࠆᵈ↪᛫
߇ࠎߩຠⷙᩰࠍ↪ߡ㧘㪈࿁ᛩਈ㊂㧔ᮡḰ⊛ߥ ᣣᧄੱᚑੱ↵ᕈ឵▚㧕ࠍ▚ߔࠆߣ㧘ᐔဋ㪌㪅㪌ᧄߩ ࡃࠗࠕ࡞ࠆߪࠕࡦࡊ࡞ࠍ↪ߔࠆߎߣ߇್
ߒߚ㧚㪍㪇ຠ⋡ਛ㪉㪉ຠ⋡㧔㪊㪎㧑㧕߇㪉ᧄߩ↪ߢᛩਈ
߇น⢻ߢߞߚ߇㧘ᦨᄢ㪐㪇ᧄࠍ↪ߒߥߌࠇ߫ߥ ࠄߥᵈ↪᛫߇ࠎ߽ߞߚ㧚․ߦ㧘❥↪ߐࠇ
ߡࠆ 㷔㪄㪣㪭㧘㪌㪄㪝㪬㧘Ⴎ㉄࠼ࠠ࠰࡞ࡆࠪࡦ㧘Ⴎ㉄
ࠛࡇ࡞ࡆࠪࡦ㧘ࠪ࠲ࡆࡦ㧘ࡔ࠻࠻ࠠࠨ࠻ߢ ߪ㧘⺞ᬺߦᡰ㓚ࠍ↢ߓߡࠆ㧚߹ߚ㧘ᷝઃᢥ ᦠਛߩᛩਈᣇᴺߣߪ⇣ߥࠅ㧘ᷙੂࠍߊක⮎ຠฬ ߢ߽⽼ᄁߐࠇߡߚ㧚ߘߩ⚿ᨐࠍ〯߹߃㧘⮎ડ
ᬺઍ⠪߅ࠃ߮ෘ↢ഭᄢ⤿߳ߩᄢኈ㊂ⷙᩰ
╬ߩᣧᦼㅧߩⷐᦸᦠߣ⾗ᢱ㧔㪉㧕ࠍᚑߒ㧘ᣣ ᧄ≸ᴦ≮ቇળ㧘ᣣᧄ⥃ᐥ⣲≌ቇળ㧘ᣣᧄ∛㒮⮎
Ꮷળߩㅪฬߦࠃࠅឭߒߚ㧚ߘߩᓟ㧘㷔㪄㪣㪭㧘Ⴎ㉄
ࠛࡇ࡞ࡆࠪࡦߪᄢኈ㊂ⷙᩰ߇ㅧ⽼ᄁߐࠇ㧘㩷
㧞 ᄢኈ㊂ⷙᩰߩㅧⷐᦸߩ㜞ᵈ৻ⷩ㧔ਥߦ᛫߇ࠎ㧕
ఝవᐲ㩷 ක⮎ຠฬ㩷 ৻⥸ฬ㩷 ળ␠ฬ㩷 ⷙ ᩰ㩷 Ꮧᦸ㜞ኈ㊂ⷙᩰ ⠨㩷
㪈㩷 ࠕࠗ࠰ࡏࡦᵈ
ᶧ㪉㪌㫄㪾㩷
ࡏࡎ࠽
࠻ࠞ࡞ࠪ࠙ࡓ㩷 ࡢࠗࠬ㩷 㪉㪌㫄㪾㩷 㪈㪇㪇㫄㪾㪆㪭㧔ṁᶧ㧕
㪲ࡏࡎ࠽࠻ࡈ࡞ࠝࡠ࠙ࠪ࡞≮
ᴺ㪴㧘㩷 㪲ࡏࡎ࠽࠻ࡈ࡞ࠝࡠ࠙
ࠪ࡞ᜬ⛯㕒ᵈ૬↪≮ᴺ㪴ߩᷝઃᢥᦠਛߩ ᛩਈ㊂ߪ㪈࿁㪈㪇㪇㨪㪉㪌㪇㫄㪾㪆㫄㪉㩷
㪉㩷 㪌㪄㪝㪬ᵈᶧ㪉㪌㪇 ද㩷
ࡈ࡞ࠝࡠ࠙
ࠪ࡞㩷 ද㉙㉂ࠠࡦ 㪉㪌㪇㫄㪾㩷 㪈㪾㪆㪭㧔ṁᶧ㧕㩷
㪲ࡏࡎ࠽࠻ࡈ࡞ࠝࡠ࠙ࠪ࡞ᜬ
⛯㕒ᵈ૬↪≮ᴺ㪴ߩᷝઃᢥᦠਛߩᛩਈ㊂ ߪ㪈࿁㪋㪇㪇㨪㪊㪇㪇㪇㫄㪾㪆㫄㪉㩷
㪊㩷 ࠕ࠼ࠕࠪࡦᵈ
ᶧ㩷
Ⴎ㉄࠼ࠠ࠰࡞
ࡆࠪࡦ㩷 ද㉙㉂ࠠࡦ 㪈㪇㫄㪾㩷 㪌㪇㫄㪾㪆㪭㧔ṁᶧ㧕ᛩਈ㊂ߩߪᐢߊ㧘ᷝઃᢥᦠߢߪ
㪏㪇㫄㪾㪆㫄㪉ࠍ㒢ߣߒߡࠆ㩷
㪋㩷 ࡈࠔ࡞ࡕ࡞ࡆࠪ
ࡦᵈᶧ㩷
Ⴎ㉄ࠛࡇ࡞ࡆ
ࠪࡦ㩷 ද㉙㉂ࠠࡦ 㪈㪇㫄㪾㩷 㪌㪇㫄㪾㪆㪭㧔ṁᶧ㧕 ᷝઃᢥᦠਛߩᛩਈ㊂ߪ㪈࿁㪈㪌㨪㪍㪇㫄㪾㪆㫄㪉 㪌㩷 ࠠࡠࠨࠗ࠼㪥ᵈ
ᶧ㩷 ࠪ࠲ࡆࡦ㩷 ᣣᧄᣂ⮎㩷 㪋㪇㪇㫄㪾㩷 㪉㪾㪆㪭㧔ṁᶧ㧕㩷 ᷝઃᢥᦠਛߩᛩਈ㊂ߪ㪈࿁㪉㨪㪊㪾㪆㫄㪉㩷
㪍㩷 ࡔ࠰࠻ࠠ
࠻ᵈᶧ㩷
ࡔ࠻࠻ࠠ
ࠨ࠻㩷 ࡢࠗࠬ㩷 㪌㧘㪌㪇㧘㪉㪇㪇㫄㪾 㪉㪾㪆㪭㧔ṁᶧ㧕㩷
㪲ࡔ࠻࠻ࠠࠨ࠻ࡠࠗࠦࡏࡦᢇេ
≮ᴺ㪴ߩᷝઃᢥᦠਛߩᛩਈ㊂ߪ㪈࿁㪊㪇㨪 㪊㪇㪇㫄㪾㪆㫂㪾㩷
߹ߚ㧘㪌㧘㪌㪇㫄㪾ߣ㪉㪇㪇㫄㪾ߢߪㆡ ᔕ∝߇⇣ߥࠆߚ㧘∔ᖚߦࠃߞߡߪ
㪉㪇㪇㫄㪾߇↪ߢ߈ߥ㩷
㪎㩷 ╭ᵈ↪ࡠࠗࠦࡏ
ࡦ㩷
ࡠࠗࠦࡏࡦ
ࠞ࡞ࠪ࠙ࡓ㩷 ࡢࠗࠬ㩷 㪊㫄㪾㩷 㪈㪌㫄㪾㪆㪘㧔ṁᶧ㧕
㪲ࡔ࠻࠻ࠠࠨ࠻ࡠࠗࠦࡏࡦᢇេ
≮ᴺ㪴㧘㪲ࡔ࠻࠻ࠠࠨ࠻ࡈ࡞ࠝࡠ࠙
ࠪ࡞ઍ≮ᴺ㪴ߩᷝઃᢥᦠਛߩᛩਈ㊂ ߪ㪈࿁㪈㪌㫄㪾ࠍ㪉㨪㪐࿁ᛩਈ㧔㕒ᵈߪ╭
ᵈ㧕ߔࠆ㩷
⽼ᄁฬ߇ޟ╭ᵈ↪ࡠࠗࠦࡏࡦޠߦ߽߆ ߆ࠊࠄߕ㧘ᷝઃᢥᦠਛߦߪޟ㕒ᵈߪ╭
ᵈޠߣ⸥タ㩷
㪌㪄㪝㪬߽ㅧ⽼ᄁ੍ቯߢࠆ㧚ޟ╭ᵈ↪ࡠࠗࠦࡏ
ࡦࠞ࡞ࠪ࠙ࡓޠߪ㧘ޟࡠࠗࠦࡏࡦࠞ࡞ࠪ࠙ࡓᵈ
ᶧ㪊㫄㪾ޠߦฬ⒓ᄌᦝߐࠇߚ㧚㩷 㩷
㧟㧚ࠫࡔࡦᮡḰൻߩߚߩ⮎ቇ⊛⥃ᐥ⎇ⓥ㩷 ኾ㐷ᕈߩ㜞⮎Ꮷߣߒߡ߇ࠎᴦ≮ߦ⽸₂ߔࠆߚ
ߦߪ㧘⮎ቇ⊛⥃ᐥ⎇ⓥࠍታᣉߒߡࠛࡆ࠺ࡦࠬࠍ᭴
▽ߒ㧘ᣂߚߥᴦ≮ᴺ߿⮎‛≮ᴺࠍ㐿⊒ߔࠆߎߣ߇㊀ ⷐߣ⠨߃ࠆ㧚㩷
㩷
㪈㧕᛫߇ࠎߩ⥋ㆡᛩਈᴺߦ㑐ߔࠆ⮎ቇ⊛ၮ␆⎇ⓥ㩷
⊕㊄♽᛫߇ࠎ㪣㪄㪦㪟㪧 ߪ㧘㫄㪝㪦㪣㪝㪦㪯㪍≮ᴺߣ ߒߡಾ㒰ਇ⢻ߥㅴⴕౣ⊒ߩ⚿⣺⋥⣺߇ࠎᖚ⠪
ߦᛩਈߐࠇࠆ㧚ߣߎࠈߢ㧘㪣㪄㪦㪟㪧ߪႮൻ‛ṁ ᶧਛߢಽ⸃ߔࠆߚ㧘↢ℂ㘩Ⴎᶧߣߩ㈩วߪਇน ߣߐࠇߡࠆ㧚㪣㪄㪦㪟㪧 ࠍ↢ℂ㘩Ⴎᶧߢ㪈ᰴṁ⸃ߔ ࠆߣ㪍ᤨ㑆ᓟߣ㪉㪋ᤨ㑆ᓟߦߘࠇߙࠇ⚂㪏㪋㧑ߣ⚂
㪎㪎㧑߹ߢ㪣㪄㪦㪟㪧ߩ㊂߇ૐਅߔࠆ㧚ߐࠄߦ㧘㪈ᤨ
㑆ᓟߦ㪏㪏㪅㪋㧑߹ߢ㪣㪄㪦㪟㪧㊂߇ૐਅߔࠆ㧚ߒ߆ߒ㧘
㪣㪄㪦㪟㪧ࠍ↢ℂ㘩Ⴎᶧߢṁ⸃ߒߚߣ߈ߩ㧘ṁ⸃⋥ᓟ
߆ࠄ㪈ᤨ㑆એౝߩቯᕈ࠺࠲ߪߥ㧚㩷
৻ᣇ㧘㫄㪝㪦㪣㪝㪦㪯 ≮ᴺߢߪ 㪣㪄㪦㪟㪧 ߣ૬↪ߐࠇ ࠆ㷔㪄㪣㪭ߩṁ⸃ߦߪ㧘㪌㧑ࡉ࠼࠙♧ᵈᶧࠆߪ
↢ℂ㘩Ⴎᶧߩߕࠇࠍ↪ߡ߽߆߹ࠊߥ㧚㩷
㪣㪄㪦㪟㪧㪆㪌㧑ࡉ࠼࠙♧ᵈᶧߣ㷔㪄㪣㪭 ߪࠦࠕࠬ
࠾࠼࡞࠶࠻㧔㪉࡞࠻ធวㇱߣਛᔃ㕒⣂ࡐ࠻
ࠍೝߔ㊎߹ߢߩ㐳ߐ㪈㪇㨪㪉㪇㪺㫄ߩഥ࡞࠻㧕ࠍㅢ ߓߡᷙߐࠇࠆߎߣ߆ࠄ㧘㷔㪄㪣㪭ߩṁ⸃ᶧ߽ㅢᏱߢ
ࠇ߫㪌㧑ࡉ࠼࠙♧ᵈᶧࠍㆬᛯߔࠆߩ߇ᅷᒰߢ
ࠆ㧚ߒ߆ߒ㧘ᄙߊߩ᛫߇ࠎ⺞ࠍታᣉߒߡ
ࠆᣉ⸳ߢߪ᛫߇ࠎߩᷙว⺞ᤨߩṁ⸃ᶧߪ㧘↢
ℂ 㘩 Ⴎ ᶧ ࠍ ↪ ߒ ߡ ࠆ 㧚 ߒ ߚ ߇ ߞ ߡ 㧘
㫄㪝㪦㪣㪝㪦㪯㪍≮ᴺߩߺ 㷔㪄㪣㪭 ߩṁ⸃ᶧࠍ㪌㧑ࡉ࠼࠙
♧ᵈᶧߦᄌᦝߔࠇ߫㧘ᷙว⺞ࡒࠬࠍ⊒↢ߔࠆ ߎߣ߇੍ᗐߐࠇࠆ㧚ߘߎߢ㧘ᄢႦࠄ㪈㪍㧕ߪࠦࠕࠬ
࠾ ࠼ ࡞ ࠶ ࠻ ਛ ߦ㪌㧑 ࡉ ࠼ ࠙ ♧ ᵈ ᶧ ਛ ߩ
㪣㪄㪦㪟㪧 ߣ↢ℂ㘩Ⴎᶧਛߩ 㷔㪄㪣㪭 ࠍ㈩วߒߚ႐ว㧘
㷔㪄㪣㪭ਛߩ↢ℂ㘩Ⴎᶧߦࠃࠅ㪣㪄㪦㪟㪧ߩ㊂߇ૐਅ ߔࠆ߆ߦߟߡᬌ⸛ߒߚ㧚㩷
ߘߩ⚿ᨐ㧘㈩ว⋥ᓟ߆ࠄ㪈㪇ಽએౝߢߪ 㪣㪄㪦㪟㪧
㊂ߩᄌൻߪࠄࠇߕ㧘㪊ᤨ㑆ᓟߢ߽㪈㪇㧑ߩૐਅ ߇ࠄࠇࠆߦߔ߉ߥ߆ߞߚ㧚߹ߚ㧘㪣㪄㪦㪟㪧ߣ↢
ℂ㘩Ⴎᶧ߇㈩วߐࠇࠆᤨ㑆ߪ㧘ࠦࠕࠬ࠾࠼࡞
࠶࠻ౝߩធ⸅ㅢㆊᤨ㑆ࠍታ᷹ߔࠆߣࠊߕ߆⚂㪈㪇
⑽એౝ㧔㪉㪅㪋㨪㪏㪅㪎⑽㑆㧕ߢࠆߎߣ߇್ߒߚ㧚 ߒߚ߇ߞߡ㧘㪣㪄㪦㪟㪧 ߪ㪌㧑ࡉ࠼࠙♧ᵈᶧߢṁ⸃
ߒߥߌࠇ߫ߥࠄߥ߇㧘หᤨߦᛩਈߐࠇࠆ 㷔㪄㪣㪭 ߪ↢ℂ㘩Ⴎᶧߢṁ⸃ߒ㧘ᛩਈߢ߈ࠆߎߣ߇⏕ߐ ࠇߚ㧚⺞ࡒࠬઙᢙ߽ᷫዋߒ㧘ᖚ⠪ᓙߜᤨ㑆߽ᡷ ༀߒߚ㧚㩷
ߎߩࠃ߁ߦ㧘ᷝઃᢥᦠ߿⮎ડᬺߩឭଏߔࠆ
࠺࠲߿⾗ᢱࠍෳ⠨ߦߔࠆߛߌߢߥߊ㧘Ᏹߦᦨༀ ߩᣇᴺࠍᾫ⠨ߔࠆߎߣ߇㊀ⷐߣ⠨߃ࠆ㧚㩷
㩷
㪉㧕ㆡಾߥฯߩ⮎ቇ⊛⥃ᐥ⎇ⓥ㩷
ᰴߩߪ㧘ࠫࡔࡦߩᮡḰൻߦ⽸₂ߒߚ⎇ⓥ
ߣ߇ࠎᖚ⠪ߩ৻ჿ߆ࠄ⥃ᐥ⹜㛎ߩታᣉ߹ߢ⊒ዷ ߒ㧘࿖ౝߩฯߩ↪ߦᄢ߈ߊᓇ㗀ߒߚ⎇ⓥߢ
ࠆ㧚㩷
㧔㪈㧕ฯߩ↪ታᘒ⺞ᩏ㩷
࿖┙߇ࠎࡦ࠲ਛᄩ∛㒮㧔㪥㪚㪚㪟㧕ߢߪ㧘 ᐕ㑆㪉㪌㪇㨪㪊㪇㪇⒳㘃ߩࠫࡔࡦ߇⊓㍳ߐࠇߡࠆ㧚
ోࠫࡔࡦਛ㪏㪐㧑ߩࠫࡔࡦߦ㪋⒳㘃ߩ㪌㪄㪟㪫㪊 ฃኈᜟ᛫߇૬↪ߐࠇߡߚ㧚߽ߞߣ߽↪
ߐࠇߡߚ㪌㪄㪟㪫㪊ฃኈᜟ᛫ߪࠣ࠾࠻ࡠ ࡦᵈᶧߢ㧘ᛩਈᣇᴺߪ㪍ࡄ࠲ࡦߦࠎߛ㧚ߘ ߩౝ⸶ߪ㧘ὐṢ㊂߇㪌㪇㫄㪣ߣ㪈㪇㪇㫄㪣㧘ὐṢᤨ㑆ߪ 㪈㪌㧘㪉㪋㧘㪊㪇㧘㪍㪇㧘㪎㪌ಽߢߞߚ㧚ߘߩߚᄖ᧪
ൻቇ≮ᴺࠍታᣉߔࠆㅢ㒮ᴦ≮ࡦ࠲ߢߩᛩਈ ࡒࠬ㧘⮎ㇱߢߩ⺞ࡒࠬ߇⊒↢ߒߡߚ㧚⍫
ౝࠄ㪈㪎㧕ߪࠫࡔࡦߩᮡḰൻࠍ࿑ࠆߎߣࠍ⋡⊛ߦ㧘 㪥㪚㪚㪟 ߦ߅ߌࠆᵈ↪㪌㪄㪟㪫㪊ฃኈᜟ᛫ߩ
↪ታᘒ⺞ᩏߣᢥ₂⺞ᩏࠍታᣉߒߚ㧚ߘߩ⚿ᨐ㧘 㪥㪚㪚㪟 ߦ߅ߌࠆᵈ↪㪌㪄㪟㪫㪊ฃኈᜟ᛫ߪࠣ
࠾࠻ࡠࡦᵈᶧ㧘ὐṢᣇᴺߪᵈ↪↢ℂ㘩 Ⴎᶧߦṁ⸃ߒ㪈㪌ಽߢὐṢߔࠆߎߣߦ⛔৻ߐࠇߚ㧚㩷 㧔㪉㧕ฯߩㆡᱜ↪ߦ㑐ߔࠆ⥃ᐥ⹜㛎㩷
㪥㪚㪚㪟ౝߢ⛔৻ߐࠇߚࠣ࠾࠻ࡠࡦᵈᶧ ߢࠆ߇㧘߇ࠎߩⴚᓟഥ≮ᴺߢࠆ㪘㪚≮ ᴺ㧔ฯ㧗࠼ࠠ࠰࡞ࡆࠪࡦᵈᶧ㧗ࠪࠢࡠࡎ
ࠬࡈࠔࡒ࠼ᵈᶧ㧕ࠍὐṢߒߡࠆ߇ࠎᖚ⠪߆ ࠄ㧘ޟߎߩ᛫߇ࠎࠍὐṢߔࠆߣ㧘ߟ߽ଢ⒁ߦ ߥߞߡ࿎ࠆ㧚ޠߣߩ⋧⺣߇⮎Ꮷߦነߖࠄࠇ㧘ᢥ
₂⺞ᩏ㧔ᣣ☨ߩක⮎ຠᷝઃᢥᦠ㧘ᛚ↳⺧ᢥ₂㧘
ࠟࠗ࠼ࠗࡦ㧘㪛㫉㫌㪾㪛㪼㫏㧘㪬㫇㪫㫆㪛㪸㫋㪼╬㧕ࠍⴕߞ ߚ⚿ᨐ㧘ଢ⒁ߩේ࿃⮎ߣߒߡࠣ࠾࠻ࡠࡦ ᵈᶧ㧔㪊㫄㪾㧕߇ᶋ߆߮߇ߞߚ㧔㪊㧕㧚කᏧ㧘
⋴⼔Ꮷࠍߪߓ㧘ࠣ࠾࠻ࡠࡦ↪ᖚ⠪߳ߩ
⡞߈ขࠅߦࠃࠅ㧘ࠣ࠾࠻ࡠࡦᵈᶧࠍ↪
ߒߡࠆᖚ⠪ߢߪଢ⒁߇Ყセ⊛ᄙߊ⊒↢ߒߡ
ࠆߎߣ߇ࠄࠇߚ㧚㩷
ߘߎߢ㧘ࠣ࠾࠻ࡠࡦᵈߩ↪㊂ߦߟߡᢥ
₂⺞ᩏࠍⴕߞߚߣߎࠈ㧘☨࿖㧔㪘㪪㪚㪦㪑㪘㫄㪼㫉㫀㪺㪸㫅㩷 㪪㫆㪺㫀㪼㫋㫐㩷㫆㪽㩷㪚㫃㫀㫅㫀㪺㪸㫃㩷㪦㫅㪺㫆㫃㫆㪾㫐㧘☨࿖⥃ᐥ⣲≌ቇળ㧕 ߅ࠃ᰷߮Ꮊ㧔㪜㪪㪤㪦㪑㪜㫌㫉㫆㫇㪼㪸㫅㩷㪪㫆㪺㫀㪼㫋㫐㩷㪽㫆㫉㩷㪤㪼㪻㫀㪺㪸㫃㩷 㪦㫅㪺㫆㫃㫆㪾㫐㧘᰷Ꮊ≸ᴦ≮ቇળ㧕ߢߪ㪈࿁ߩᛩਈ㊂ߣ ߒߡ㪈㫄㪾㧔㪈㪇Ǵ㪾㪆㫂㪾㧕߇ផᅑ↪㊂ߣߐࠇ㧘ࠊ߇
࿖ߩ㪊㫄㪾㧔㪋㪇Ǵ㪾㪆㫂㪾㧕ߣᄢ߈ߊ⋧㆑ߒߡࠆߎ ߣ߇ࠄࠇߚ㧚᰷☨ߣ⇣ߥࠆ↪㊂߇ࠊ߇࿖ߢ
⸳ቯߐࠇߡࠆℂ↱ߣߒߡߪ㧘ᣣᧄߢߪ᛫߇ࠎ
ߦࠃࠆᖡᔃ߅ࠃ߮ཌྷฯߦኻߒ㧘චಽㆊ߉ࠆᛥ
㊂㨇㪊㫄㪾㧔㪋㪇Ǵ㪾㪆㫂㪾㧕㨉ࠍ⸳ቯߒߚߚߣ⠨߃ ࠄࠇࠆ㧚৻ᣇ㧘⻉ᄖ࿖ߢߪ㧘↪㊂㪄ലᨐᦛ✢ߦ߅
ߡലᨐ߇߶߷৻ቯߦߥࠆᛩਈ㊂㨇㪈㫄㪾㧔㪈㪇Ǵ 㪾㪆㫂㪾㧕㨉ࠍ⸳ቯߒߡࠆ㧚㩷
☨ࠄ㪈㪏㧕ߪ㧘ᣣᧄੱߦ߅ߌࠆࠣ࠾࠻ࡠࡦ ᵈᶧߩㆡಾߥᛩਈ㊂ࠍ⸃ߔࠆߚߦ㧘ൻቇ
≮ᴺ⺃⊒ᶖൻེ∝⁁㧔ᖡᔃཌྷฯ㧕ߦኻߔࠆ
ࠣ࠾࠻ࡠࡦᵈᶧ㧔㪈㫄㪾㧕ߩ㕖ഠᕈߩᬌ⸽
ࠍࠣ࠾࠻ࡠࡦᵈ㧔㪊㫄㪾㧕ߣߩήὑൻᲧセ
⹜㛎ࠍ⮎Ꮷ߇ਥߣߥࠅታᣉߒߚ㧚ޟ㪘㪪㪚㪦㩷 㪩㪼㪺㫆㫄㫄㪼㫅㪻㪸㫋㫀㫆㫅㫊㩷 㪽㫆㫉㩷 㫋㪿㪼㩷 㪬㫊㪼㩷 㫆㪽㩷 㪘㫅㫋㫀㪼㫄㪼㫋㫀㪺㫊㩷 㪈㪐㪐㪐ޠߦ߅ߌࠆ㪿㫀㪾㪿㩷 㫉㫀㫊㫂㩷 㪾㫉㫆㫌㫇ߦಽ㘃ߐࠇࠆ᛫
߇ࠎࠍᴦ≮ࠍฃߌߡࠆ߇ࠎᖚ⠪ࠍኻ⽎
ߣߒߚ㧚ⵍ㛎⮎ᛩਈߪࠣ࠾࠻ࡠࡦ㪊㫄㪾߆㪈㫄㪾 ߩߤߜࠄ߆৻ᣇߣߒ㧘න࿁ᛩਈߢᬌ⸛ߒߚ㧚ਥ ⷐ⹏ଔ㗄⋡ߪ᛫߇ࠎᛩਈ㐿ᆎ߆ࠄ㪉㪋ᤨ㑆એౝ
ߦ߅ߌࠆཌྷฯᕈ⽎ߩቢోᓮ㧔ཌྷฯⓨཌྷฯ ߥߒ㧘⥃ᤨฯಣ⟎ߥߒ㧕ഀวߣߒߚ㧚㩷
⊓㍳ᖚ⠪ᢙߪ㪈㪏㪉ฬ㧔㪝㪘㪪ߣߒߡฦ⟲㪏㪊ฬ㧘ว
⸘㪈㪍㪍ฬ㧕ߢࠅ㧘ᐕ㦂ਛᄩ୯㧔▸࿐㧕ߪ㪌㪏ᚽ 㧔㪉㪊㪄㪏㪇㧕㧘∔ᖚߪ߇ࠎ㪐㪋ฬ㧘ෆᎽ߇ࠎ㪋㪍ฬ㧘ሶ ች߇ࠎ㪈㪈ฬ㧘ේ⊒ਇ߇ࠎ㪐ฬ㧘ሶች㗪߇ࠎ㪏 ฬ㧘ߘߩઁ㪈㪋ฬߢߞߚ㧚↪ࠫࡔࡦߣߒߡ㩷
㧟 㪘㪚≮ᴺߦ߅ߌࠆ↪㧔ᶖൻེ∝⁁㧕ߩᣣ☨Ყセ
㪘㪚≮ᴺ㩷 ࿖ౝ㧔ᷝઃᢥᦠ㧕㩷 ࿖ᄖ㧔㪛㫉㫌㪾㪛㪼㫏̪㧕㩷
ࠣ࠾࠻ࡠࡦ㧔ࠞࠗ࠻࡞㫤 ᵈᶧ㧕㩷
㧔㪇㪅㪈㧑ᧂḩ㧕ଢ⒁㧘ਅ∯㧘⣻∩㧘⢗߽ߚ ࠇᗵ㩷
ࠣ࠾࠻ࡠࡦ㧔ࠞࠗ࠻࡞㫤
㍤⚦☸㧕㩷 㧔㪉㧑ᧂḩ㧕ଢ⒁㩷
㪞㪸㫊㫋㫉㫆㫀㫅㫋㪼㫊㫋㫀㫅㪸㫃㪑㩷 㪘㪹㪻㫆㫄㫀㫅㪸㫃㩷 㫇㪸㫀㫅㪃㩷 㪚㫆㫅㫊㫋㫀㫇㪸㫋㫀㫆㫅㪃㩷 㪛㫀㪸㫉㫉㪿㪼㪸㩷
࠺ࠠࠨࡔ࠲࠱ࡦ㧔࠺ࠠࠨ࠻㫤
ᵈᶧ㧕㩷 ̆㩷 㪞㪸㫊㫋㫉㫆㫀㫅㫋㪼㫊㫋㫀㫅㪸㫃㪑㩷㪛㫀㫊㫆㫉㪻㪼㫉㩷㫆㪽㩷㪾㪸㫊㫋㫉㫆㫀㫅㫋㪼㫊㫋㫀㫅㪸㫃㩷㫋㫉㪸㪺㫋
࠼ࠠ࠰࡞ࡆࠪࡦ㧔ࠕ࠼ࠕࠪ
ࡦ㫤ᵈᶧ㧕㩷 㧔㪌㧑એ㧕ਅ∯㩷 㪞㪸㫊㫋㫉㫆㫀㫅㫋㪼㫊㫋㫀㫅㪸㫃㪑㩷㪥㪸㫌㫊㪼㪸㪃㩷㪭㫆㫄㫀㫋㫀㫅㪾㩷
ࠪࠢࡠࡎࠬࡈࠔࡒ࠼㧔ࠛࡦ࠼
ࠠࠨࡦ㫤ᵈᶧ㧕㩷
㧔㪌㧑ᧂḩ㧕ญᷢ㧘ẩ≌ᕈญౝἻ㧘⣻∩㧘
ଢ⒁㧘ਅ∯㩷 㩷 㪞㪸㫊㫋㫉㫆㫀㫅㫋㪼㫊㫋㫀㫅㪸㫃㪑㩷㪥㪸㫌㫊㪼㪸㩷㪸㫅㪻㩷㫍㫆㫄㫀㫋㫀㫅㪾㩷
̪ක⮎ຠᖱႎ࠺࠲ࡌࠬ㧔㪫㪿㫆㫄㫊㫆㫅㩷㪩㪼㫌㫋㪼㫉㫊㧕㩷
㧠 ᛫߇ࠎᛩਈ㐿ᆎᤨ㑆એౝߦ߅ߌࠆཌྷฯᕈ⽎ߩቢోᓮഀว㪈㪏䋩
㩷
㩷 ኻ⽎ᖚ⠪ᢙ㩷 ཌྷฯቢోᓮᢙ㧔㧑㧕
㨇㪐㪌㩼㪚㪠㨉㩷 ਇቢోᓮᢙ㩷 ቢోᓮഀวᏅ㧔㧑㧕㩷 㨇㪐㪌㩼㪚㪠㨉㩷
ࠣ࠾࠻ࡠࡦ㪈㫄㪾⟲㧔ฬ㧕 㪏㪐㩷
㪎㪇㩷 㩷 㩿㪎㪏㪅㪎㩼㧕㩷 㨇㪍㪏㪅㪎㩼㩷㪄㩷㪏㪍㪅㪍㩼㨉㩷
㪈㪐㩷
ࠣ࠾࠻ࡠࡦ㪊㫄㪾⟲㧔ฬ㧕 㪐㪇㩷
㪎㪊㩷 㩷 㩿㪏㪈㪅㪈㩼㪀㩷 㨇㪎㪈㪅㪌㩼㩷㪄㩷㪏㪏㪅㪍㩼㨉㩷
㪈㪎㩷
㪄㪉㪅㪋㩼㩷 㨇㪄㪈㪉㪅㪊㩼́㪎㪅㪋㩼㨉㩷
㩷
ߪ㧘ࠪࠬࡊ࠴ࡦࠫࡔࡦ߇㪈㪊ฬ㧘ࠞ࡞ࡏ ࡊ࠴ࡦ߇㪎㪌ฬ㧘㪘㪚≮ᴺ߇㪏㪍ฬ㧘ߘߩઁ㪏ฬߢ
ߞߚ㧚㩷
ߘߩ⚿ᨐ㧘ਥⷐ⹏ଔ㗄⋡ߢࠆཌྷฯᕈ⽎ߩ ቢోᓮഀวߪ㧘㪈㫄㪾⟲㪎㪏㪅㪎㧑㧘㪊㫄㪾⟲㪏㪈㪅㪈㧑ߢ
ߞߚ㧔㪋㧕㧚⛔⸘ቇ⊛ߥ㕖ഠᕈߪᬌ⸽ߐࠇߥ ߆ߞߚ㧚ߘߩℂ↱ߣߒߡቢోᓮഀวࠍ㜞ߊ⸳
ቯߒߚߚ㧘ᬌജਇ⿷ߢߞߚน⢻ᕈ߇㜞
ߣ⠨߃ࠄࠇߚ㧚ᖡᔃ߅ࠃ߮ཌྷฯᕈ⽎ߦ㑐ߒߡ
߽ห᭽ߢߞߚ㧚৻ᣇ㧘ᴦ≮ᚑഞᦼ㑆㧘ཌྷฯ࿁
ᢙ㧘ⓨཌྷฯ࿁ᢙߦਔ⟲㑆ߢᗧߥ㆑ߪᬌ⸽ߐ ࠇߥ߆ߞߚ㧚㩷
࿁ߩ࠺࠲߆ࠄߪ㧘ཌྷฯᕈ⽎ߦ߅ߌࠆࠣ
࠾࠻ࡠࡦ㪈㫄㪾ߩ㪊㫄㪾ߦኻߔࠆ㕖ഠᕈߪᬌ⸽
ߐࠇߥ߆ߞߚ߇㧘㪘㪪㪚㪦㪐㧕㧘㪜㪪㪤㪦㪈㪐㧕㧘㪥㪚㪚㪥㧔ో
☨߇ࠎᴦ≮ࡀ࠶࠻ࡢࠢ㧕ߦ߅ߌࠆࠟࠗ࠼ࠗ
ࡦ㧘ࠣ࠾࠻ࡠࡦ㪈㫄㪾߹ߚߪ㪈㪇Ǵ㪾㪆㫂㪾ߩ੍㒐
⊛ᛩਈߩផᅑ㧘ක≮⾌ᛥߦ߅ߌࠆ⚻ᷣ⊛ലᨐ㧘 ᬌജਇ⿷߽㐓ߺ㧘ฯࠬࠢߩ㜞᛫߇ࠎ
ᛩਈᤨߩࠣ࠾࠻ࡠࡦ㪈㫄㪾 ߩ੍㒐⊛ᛩਈߪ㧘 චಽߦࠝࡊ࡚ࠪࡦߩ৻ߟߣߥࠅ߁ࠆߎߣ߇್
ߒߚ㧚ߘߩᓟ㧘ࠊ߇࿖ߦ߅ߡ߽ᣣᧄ≸ᴦ≮ቇ ળޟฯㆡᱜ↪ࠟࠗ࠼ࠗࡦ㧔᩺㧕ޠ߇ࠣ
࠾࠻ࡠࡦ㪈㫄㪾ߩᛩਈࠍផᅑߒߡࠆ㧚㩷
߅ࠊࠅߦ
߇ࠎᴦ≮ߪߘߩᴦ≮ᴺߩⶄ㔀ߐ߆ࠄ㧘කᏧ㧘⮎
Ꮷ㧘⋴⼔Ꮷ㧘࠰ࠪࡖ࡞ࡢࠞߥߤᄙ⡯⒳ߩක≮
ᓥ⠪㑆ߩㅪ៤߇㊀ⷐߢࠆ㧚․ߦ߇ࠎ⮎‛≮ᴺߩ
ోᕈࠍ⏕ߔࠆߚߦߪ㧘ኾ㐷ᕈߩ㜞කᏧ߿⮎
Ꮷߦࠃࠆࠫࡔࡦክᩏ㧘⮎Ꮷߦࠃࠆಣᣇ⋙ᩏ㧘
⺞߅ࠃ߮⺞ߣᖚ⠪ᜰዉ㧔㒮ᄖ᧪㧕ߘߒߡኾ 㐷㧔ࠆߪቯ㧕⋴⼔Ꮷࠍਛᔃߣߒߚᵈᛩਈߣ ᖚ⠪ᜰዉ㧔ᄖ᧪ቛ㧕ࠍ⋧ߦㅪ៤ߒߥ߇ࠄㆇ↪
ߔࠆᔅⷐ߇ࠆ㧚ᓟ㧘ࠫࡔࡦߩᮡḰൻࠍ࿑ࠆߚ
ߦ߽㧘߇ࠎ⮎‛≮ᴺߦ㑐ࠊࠆක≮ᓥ⠪ߩኾ㐷ᕈ ߩߐࠄߥࠆะ߇᳞ࠄࠇࠆ㧚㩷
ᧄⓂߪ㧘ᐔᚑ㪉㪈ᐕ㪎㪉㪎ᣣߦ㐿ߐࠇߚᤘᄢቇ⮎
ቇࡒ࠽ߩ⊒ౝኈࠍขࠅ߹ߣߚ߽ߩߢࠆ㧚㩷
ෳ⠨ᢥ₂
㪈㪀㩷 ߇ࠎߩ⛔⸘✬㓸ᆔຬળ㧦߇ࠎߩ⛔⸘㧘㫇㫇㩷㪋㪋ޔ⽷
࿅ᴺੱ߇ࠎ⎇ⓥᝄ⥝⽷࿅㧘᧲੩㪃㩷㪉㪇㪇㪎㩷
㪉㪀㩷 㪣㪼㪸㫇㪼㪃㩷 㪣㪅㪑㩷 㪜㫉㫉㫆㫉㩷 㫀㫅㩷 㫄㪼㪻㫀㪺㫀㫅㪼㪃㩷 㪡㪘㪤㪘㪃㩷 㪉㪎㪉㪃㩷 㪈㪏㪌㪈㪄㪈㪏㪌㪎㩷㩿㪈㪐㪐㪋㪀㩷
㪊㪀㩷 㪘㫃㫃㪼㫅㪃㩷 㪪㪅㪑㩷 㪛㪸㫅㪸㪄㪝㪸㫉㪹㪼㫉㩷 㫃㪼㪸㫉㫅㫊㩷 㪽㫉㫆㫄㵭㪐㪋㩷 㫄㫀㫊㫋㪸㫂㪼㫊㪅㪃㩷 㪙㫆㫊㫋㫆㫅㩷㪞㫃㫆㪹㪼㪃㩷㪥㫆㫍㪅㩷㪊㪇㪃㩷㩿㪉㪇㪇㪋㪀㩷
㪋㪀㩷 㪡㪸㪺㫆㪹㫊㫆㫅㪃㩷 㪡㪅㪃㩷 㪧㫆㫃㫆㫍㫀㪺㪿㪃㩷 㪤㪅㪃㩷 㪢㫉㫀㫊㫋㪼㫅㩷 㪢㪅㪃㩷 㪼㫋㩷 㪸㫃㪑㩷 㪘㫄㪼㫉㫀㪺㪸㫅㩷 㪪㫆㪺㫀㪼㫋㫐㩷 㫆㪽㩷 㪚㫃㫀㫅㫀㪺㪸㫃㩷 㪦㫅㪺㫆㫃㫆㪾㫐㪆㪦㫅㪺㫆㫃㫆㪾㫐㩷 㪥㫌㫉㫊㫀㫅㪾㩷 㪪㫆㪺㫀㪼㫋㫐㩷 㪚㪿㪼㫄㫆㫋㪿㪼㫉㪸㫇㫐㩷 㪘㪻㫄㫀㫅㫀㫊㫋㫉㪸㫋㫀㫆㫅㩷 㪪㪸㪽㪼㫋㫐㩷㪪㫋㪸㫅㪻㪸㫉㪻㫊㪅㪃㩷㪡㪅㩷㪚㫃㫀㫅㪅㩷㪦㫅㪺㫆㫃㪅㪃㩷㪈㪇㪃㩷㪌㪋㪍㪐㪄㪌㪋㪎㪌㩷 㩿㪉㪇㪇㪐㪀㩷
㪌㪀㩷 㪚㪸㫉㪻㪼㫅㪃㩷 㪚㪅㪃㩷 㪙㪸㫅㪼㫉㫁㫀㪃㩷 㪬㪅㪃㩷 㪢㪸㫐㪼㪃㩷 㪪㪅㪃㩷 㪼㫋㩷 㪸㫃㪑㩷 㪝㫉㫆㫄㩷 㪛㪸㫉㫂㫅㪼㫊㫊㩷 㫋㫆㩷 㪣㫀㪾㪿㫋㩷 㪮㫀㫋㪿㩷 㪙㫀㫆㫄㪸㫉㫂㪼㫉㫊㩷 㫀㫅㩷 㪜㪸㫉㫃㫐㩷 㪚㫃㫀㫅㫀㪺㪸㫃㩷㪫㫉㫀㪸㫃㫊㩷㫆㪽㩷㪚㪸㫅㪺㪼㫉㩷㪛㫉㫌㪾㫊㪃㩷㪚㫃㫀㫅㪅㩷㪧㪿㪸㫉㫄㪸㪺㫆㫃㪅㩷 㪫㪿㪼㫉㪅㪃㩷㪏㪌㪃㩷㪈㪊㪈㵨㪈㪊㪊㩷㩿㪉㪇㪇㪏㪀㩷
㪍㪀㩷 㪪㫄㫀㫋㪿㪃㩷 㪫㪅㪃㩷 㪢㪿㪸㫋㪺㪿㪼㫉㪼㫊㫊㫀㪸㫅㪃㩷 㪡㪅㪃㩷 㪣㫐㫄㪸㫅㪃㩷 㪞㪅㪃㩷 㪼㫋㩷 㪸㫃㪑㩷 㪞㫉㫆㫎㫋㪿㩷 㪝㪸㪺㫋㫆㫉㫊㪑㩷 㪘㫅㩷 㪜㫍㫀㪻㪼㫅㪺㪼㪄㪙㪸㫊㪼㪻㩷 㪚㫃㫀㫅㫀㪺㪸㫃㩷 㪧㫉㪸㪺㫋㫀㪺㪼㩷 㪞㫌㫀㪻㪼㫃㫀㫅㪼㪅㪃㩷 㪡㪅㩷 㪚㫃㫀㫅㪅㩷 㪦㫅㪺㫆㫃㪅㪃㩷 㪉㪋㪃㩷 㪊㪈㪏㪎㪄㪊㪉㪇㪌㩷㩿㪉㪇㪇㪍㪀㩷
㪎㪀㩷 㪩㫆㫎㪼㪃㩷 㪡㪅㪃㩷 㪚㫀㫆㪹㪸㫅㫌㪃㩷 㪥㪅㪃㩷 㪘㫊㪺㪼㫅㫊㪸㫆㪃㩷 㪡㪅㪃㩷 㪼㫋㩷 㪸㫃㪑㩷 㪩㪼㪺㫆㫄㫄㪼㫅㪻㪼㪻㩷 㪾㫌㫀㪻㪼㫃㫀㫅㪼㫊㩷 㪽㫆㫉㩷 㫋㪿㪼㩷 㫄㪸㫅㪸㪾㪼㫄㪼㫅㫋㩷 㫆㪽㩷 㪸㫌㫋㫆㫃㫆㪾㫆㫌㫊㩷 㪸㫅㪻㩷 㪸㫃㫃㫆㪾㪼㫅㪼㫀㪺㩷 㪹㫆㫅㪼㩷 㫄㪸㫉㫉㫆㫎㩷 㫋㫉㪸㫅㫊㫇㫃㪸㫅㫋㪸㫋㫀㫆㫅㪅㩷 㪘㩷 㫉㪼㫇㫆㫉㫋㩷 㪽㫉㫆㫄㩷 㫋㪿㪼㩷 㪜㪸㫊㫋㪼㫉㫅㩷 㪚㫆㫆㫇㪼㫉㪸㫋㫀㫍㪼㩷 㪦㫅㪺㫆㫃㫆㪾㫐㩷 㪞㫉㫆㫌㫇㩷 㩿㪜㪚㪦㪞㪀㪅㪃㩷 㪘㫅㫅㪅㩷 㪠㫅㫋㪼㫉㫅㪅㩷㪤㪼㪻㪅㪃㩷㪈㪉㪈㪃㩷㪈㪋㪊㪄㪈㪌㪏㩷㩿㪈㪐㪐㪋㪀㩷
㪏㪀㩷 㪤㪸㫊㪸㫆㫂㪸㪅㩷 㪫㪅㪑㩷 㪜㫍㫀㪻㪼㫅㪺㪼㪄㪹㪸㫊㪼㪻㩷 㫉㪼㪺㫆㫄㫄㪼㫅㪻㪸㫋㫀㫆㫅㫊㩷 㪽㫆㫉㩷 㪸㫅㫋㫀㫄㫀㪺㫉㫆㪹㫀㪸㫃㩷 㫌㫊㪼㩷 㫀㫅㩷 㪽㪼㪹㫉㫀㫃㪼㩷 㫅㪼㫌㫋㫉㫆㫇㪼㫅㫀㪸㩷 㫀㫅㩷 㪡㪸㫇㪸㫅㪑㩷㪼㫏㪼㪺㫌㫋㫀㫍㪼㩷㫊㫌㫄㫄㪸㫉㫐㪅㪃㩷㪚㫃㫀㫅㪅㩷㪠㫅㪽㪼㪺㫋㪅㩷㪛㫀㫊㪅㪃㩷㪊㪐㪃㩷 㪋㪐㪄㪌㪉㩷㩿㪉㪇㪇㪋㪀㩷
㪐㪀㩷 㪢㫉㫀㫊㪃㩷 㪤㪅㪃㩷 㪟㪼㫊㫂㪼㫋㪿㪃㩷 㪧㪅㪃㩷 㪪㫆㫄㪼㫉㪽㫀㪼㫃㪻㪃㩷 㪤㪅㪃㩷 㪼㫋㩷 㪸㫃㪑㩷 㪘㫄㪼㫉㫀㪺㪸㫅㩷 㪪㫆㪺㫀㪼㫋㫐㩷 㫆㪽㩷 㪚㫃㫀㫅㫀㪺㪸㫃㩷 㪦㫅㪺㫆㫃㫆㪾㫐㩷 㪞㫌㫀㪻㪼㫃㫀㫅㪼㩷 㪽㫆㫉㩷㪘㫅㫋㫀㪼㫄㪼㫋㫀㪺㫊㩷㫀㫅㩷㪦㫅㪺㫆㫃㫆㪾㫐㪑㩷㪬㫇㪻㪸㫋㪼㩷㪉㪇㪇㪍㪅㪃㩷㪡㪅㩷㪚㫃㫀㫅㪅㩷 㪦㫅㪺㫆㫃㪅㪃㩷㪉㪋㪃㩷㪉㪐㪊㪉㪄㪉㪐㪋㪎㩷㩿㪉㪇㪇㪍㪀㩷
㪈㪇㧕㩷⮮ේ ⼾㧘㐳ብ㧦߇ࠎൻቇ≮ᴺߩᣂߒᮡ
⊛̆✚⺰̆㧘㐳ብ㧘㢬የ㓉✬㧘≸ൻቇ≮ᴺ 㫌㫇㪻㪸㫋㪼㧘㫇㫇㩷㪈㪇㪄㪈㪋㪃ਛᄖකቇ␠㧘᧲੩㪃㩷㪉㪇㪇㪌㪅㩷 㪈㪈㪀㩷 㪞㫆㫃㪻㫀㪼㪃㩷㪡㪅㪃㩷㪚㫆㫃㪻㫄㪸㫅㪃㩷㪘㪅㩷㪑㪘㩷㫄㪸㫋㪿㪼㫄㪸㫋㫀㪺㩷㫄㫆㪻㪼㫃㩷㪽㫆㫉㩷
㫉㪼㫃㪸㫋㫀㫅㪾㩷 㫋㪿㪼㩷 㪻㫉㫌㪾㩷 㫊㪼㫅㫊㫀㫋㫀㫍㫀㫋㫐㩷 㫆㪽㩷 㫋㫌㫄㫆㫉㫊㩷 㫋㫆㩷 㫋㪿㪼㫀㫉㩷 㫊㫇㫆㫅㫋㪸㫅㪼㫆㫌㫊㩷㫄㫌㫋㪸㫋㫀㫆㫅㩷㫉㪸㫋㪼㪅㪃㩷㪚㪸㫅㪺㪼㫉㪅㩷㪫㫉㪼㪸㫋㪅㩷㪩㪼㫇㪅㪃㩷 㪍㪊㪃㩷㪈㪎㪉㪎㪄㪈㪎㪊㪊㩷㩿㪈㪐㪎㪐㪀㩷
㪈㪉㪀㩷 㪩㫆㫎㫀㫅㫊㫂㫐㪅㩷 㪜㪅㪃㩷 㪞㫀㫃㪹㪼㫉㫋㪅㩷 㪤㪅㪃㩷 㪤㪺㪞㫌㫀㫉㪼㪅㩷 㪮㪅㪃㩷 㪼㫋㩷 㪸㫃㪑㩷 㪪㪼㫈㫌㪼㫅㪺㪼㫊㩷 㫆㪽㩷 㫋㪸㫏㫆㫃㩷 㪸㫅㪻㩷 㪺㫀㫊㫇㫃㪸㫋㫀㫅㪑㩷 㪸㩷 㫇㪿㪸㫊㪼㩷 㪠㩷 㪸㫅㪻㩷 㫇㪿㪸㫉㫄㪸㪺㫆㫃㫆㪾㫀㪺㩷 㫊㫋㫌㪻㫐㪅㪃㩷 㪡㪅㩷 㪚㫃㫀㫅㪅㩷 㪦㫅㪺㫆㫃㪅㪃㩷 㪐㪃㩷 㪈㪍㪐㪉㪄㪈㪎㪇㪊㩷㧔㪈㪐㪐㪈㧕㩷
㪈㪊㧕㩷ർᵏテ㧦᛫߇ࠎߩో▤ℂߣࠫࡔࡦߩ▤
ℂ㧘⥃ᐥක㪃㪊㪈㪃㪈㪉㪏㪈㪄㪈㪉㪏㪌㩷㪉㪇㪇㪌㩷
㪈㪋㧕㩷㪞㪸㫃㫃㫀㫅㪃㪡㪅㪆ᄦ⋙ୃ㧦㪥㪠㪟⥃ᐥ⎇ⓥߩၮᧄߣ
ታ㓙㧘㫇㫇㩷㪍㪌㪄㪏㪇㪃ਣༀ㧘᧲੩㪃㩷㪉㪇㪇㪉㪆㪉㪇㪇㪋㪅㩷 㪈㪌㧕㩷ፉ ↰ ඳ 㧦ᄢ ⣺ ߇ ࠎ ᮡḰ ൻ ቇ ≮ ᴺߩ ታ 㓙 㧘
㫇㫇㪈㪈㪄㪈㪏㪃㊄ේ 㧘᧲੩㪃㩷㪉㪇㪇㪍㪅㩷
㪈㪍㧕㩷ᄢႦ⍮ାޔ㋈ᧁ⟤ᨑሶ㧘ട⮮ਭઁ㧦㩷 㪝㪦㪣㪝㪦㪯
≮ᴺߦ߅ߌࠆࠝࠠࠨࡊ࠴ࡦᵈ⮎ߩቯ ᕈ㧘ක≮⮎ቇ㪃㩷㪊㪉㪃㩷㪈㪇㪉㪎㪄㪈㪇㪊㪉㩷㪉㪇㪇㪍㪅㩷
㪈㪎㩷 ⍫ౝ⾆ሶ㧘ട⮮ਭ㧘દ⮮Ꭿઁ㧦࿖┙߇ࠎࡦ
࠲ਛᄩ∛㒮ߦ߅ߌࠆ㪌㪄㪟㪫㪊ฃኈᜟ᛫ߩ
↪ታᘒ⺞ᩏ㧘ක≮⮎ቇ㪃㩷㪊㪊㪃㪋㪉㪋㪄㪋㪊㪇㩷㪉㪇㪇㪎㪅㩷 㪈㪏㪀㩷 㪰㫆㫅㪼㫄㫌㫉㪸㪅㩷 㪤㪅㪃㩷 㪢㪸㫋㫊㫌㫄㪸㫋㪸㪅㩷 㪥㪅㪃㩷 㪟㪸㫊㪿㫀㫄㫆㫋㫆㩷 㪟㪅㪃㩷 㪼㫋㩷
㪸㫃㪑㩷 㪩㪸㫅㪻㫆㫄㫀㫑㪼㪻㩷 㪺㫆㫅㫋㫉㫆㫃㫃㪼㪻㩷 㫊㫋㫌㪻㫐㩷 㪺㫆㫄㫇㪸㫉㫀㫅㪾㩷 㫋㫎㫆㩷 㪻㫆㫊㪼㫊㩷㫆㪽㩷㫀㫅㫋㫉㪸㫍㪼㫅㫆㫌㫊㩷㪾㫉㪸㫅㫀㫊㪼㫋㫉㫆㫅㩷㩿㪈㩷㪸㫅㪻㩷㪊㩷㫄㪾㪀㩷㪽㫆㫉㩷 㪸㪺㫌㫋㪼㩷㪺㪿㪼㫄㫆㫋㪿㪼㫉㪸㫇㫐㪄㫀㫅㪻㫌㪺㪼㪻㩷㫅㪸㫌㫊㪼㪸㩷㪸㫅㪻㩷㫍㫆㫄㫀㫋㫀㫅㪾㩷 㫀㫅㩷㪺㪸㫅㪺㪼㫉㩷㫇㪸㫋㫀㪼㫅㫋㫊㪑㩷㪸㩷㫅㫆㫅㪄㫀㫅㪽㪼㫉㫀㫆㫉㫀㫋㫐㩷㫋㫉㫀㪸㫃㪅㪃㩷㪡㫇㫅㪅㩷㪡㪅㩷 㪚㫃㫀㫅㪅㩷㪦㫅㪺㫆㫃㪅㪃㩷㪊㪐㪃㩷㪋㪋㪊㪄㪋㪋㪏㩷㩿㪉㪇㪇㪐㪀㩷
㪈㪐㪀㩷 㪟㪼㫉㫉㫊㫋㪼㪻㫋㪈㪃㩷㪡㪅㪃㩷㪸㫅㪻㩷㪩㫆㫀㫃㪸㪃㩷㪝㪅㪑㩷㪚㪿㪼㫄㫆㫋㪿㪼㫉㪸㫇㫐㪄㫀㫅㪻㫌㪺㪼㪻㩷㫅㪸㫌㫊㪼㪸㩷 㪸㫅㪻㩷 㫍㫆㫄㫀㫋㫀㫅㪾㪑㩷 㪜㪪㪤㪦㩷 㪚㫃㫀㫅㫀㪺㪸㫃㩷 㪩㪼㪺㫆㫄㫄㪼㫅㪻㪸㫋㫀㫆㫅㫊㩷 㪽㫆㫉㩷 㫇㫉㫆㫇㪿㫐㫃㪸㫏㫀㫊㪅㪃㩷㪘㫅㫅㪅㩷㪦㫅㪺㪅㪃㩷㪉㪇㪃㩷㪈㪌㪍㪄㪈㪌㪏㩷㩿㪉㪇㪇㪐㪀㩷
⇛ภ৻ⷩ
㪌㪄㪝㪬㩷 ࡈ࡞ࠝࡠ࠙ࠪ࡞㩷
㪘㪪㪚㪦㩷 ☨࿖⥃ᐥ⣲≌ቇળ㩷
㪜㪪㪤㪦㩷 ᰷Ꮊ≸ᴦ≮ቇળ㩷
㧳㪄㪚㪪㪝㩷 㗰☸ࠦࡠ࠾ೝỗ࿃ሶ㩷
㷔㪄㪣㪭㩷 ࡏࡎ࠽࠻㩷
㧸㪄㪦㪟㪧㩷 ࠝࠠࠨࡊ࠴ࡦ㩷
㪥㪚㪚㪟㩷 ࿖┙߇ࠎࡦ࠲ਛᄩ∛㒮㩷
㪥㪚㪚㪥㩷 ో☨߇ࠎᴦ≮ࡀ࠶࠻ࡢࠢ㩷
㪥㪚㪠㩷 ☨࿖࿖┙߇ࠎ⎇ⓥᚲ㩷 㩷
Significance of Regimen Management and Development of Standard Regimens in Cancer Chemotherapy
Yasuhisa Kato
㪛㪼㫇㪸㫉㫋㫄㪼㫅㫋㩷㫆㪽㩷㪛㫉㫌㪾㩷㪠㫅㪽㫆㫉㫄㪸㫋㫀㫆㫅㩷㪪㪺㪿㫆㫆㫃㩷㫆㪽㩷㪧㪿㪸㫉㫄㪸㪺㫐㩷㪪㪿㫆㫎㪸㩷㪬㫅㫀㫍㪼㫉㫊㫀㫋㫐㩷 㩷
Abstract
Many of the medical accident by anticancer drugs are due to complicated medication method of the anticancer drugs. The regimen describes anticancer drugs, transfusions and combination medicines in a chronological order. The checking of prescription by this regimen makes it possible to prevent medical accidents by anticancer drugs.
When a regimen is to be registered, sufficient regimen examination is required. A regimen reviewing committee must be set up inside the hospital, and a pharmacist who is the expert for chemotherapy should join the examination of the regimen. A pharmacist should be able to show the ability enough.
The management of the regimen is a very effective system as a method to secure medical safety and to perform reasonable chemotherapy. However, we cannot fully utilize such a useful system unless we manage it appropriately and continue improving it.
The aim of our clinical pharmacy study was to assess the non-inferiority of 1 mg/1 mL to 3 mg/3 mL of granisetron injection for the treatment of chemotherapy-related digestive symptoms (nausea and vomiting) and to evaluate the tolerability of granisetron given at 1mg/1 mL in Japanese cancer patients. Our data failed to show the non-inferiority of 1 mg to 3 mg of granisetron administered as a single dose. However, the rate of complete protection from nausea and vomiting was similar in the two groups. Given the recommended dosage in guidelines and the economic effect of reduction of the medical care expenses in Japan, prophylactic administration of granisetron at 1 mg may be an appropriate alternative for chemotherapy-related nausea and vomiting in cancer patients.
Key Words㧦regimen, cancer chemotherapy, medical safety, supportive care, granisetron
㪩㪼㪺㪼㫀㫍㪼㪻㩷㪊㪇㩷㪥㫆㫍㪼㫄㪹㪼㫉㩷㪉㪇㪇㪐㪒㩷㪸㪺㪺㪼㫇㫋㪼㪻㩷㪈㪏㩷㪛㪼㪺㪼㫄㪹㪼㫉㩷㪉㪇㪇㪐㩷
