Fourteen Cases of Appetite Loss Treated with Shoyogan / 日本東洋医学雑誌

Shoyogan is a Kampo prescription described in the <I>Junqui Yaolue</I>. Few cases have been reported using this medicine. This time, we prescribed shoyogan for 14 patients who suffered from severe appetite loss. We had positive outcomes as follows. We administered shoyogan to 8 patients with malignant disease. Six of them suffered from lung cancer. Shoyogan was effective in these patients. Shoyogan was not effective for the other 2 patients, with bile duct carcinoma and malignant lymphoma. The dietary intake was increased from 28 percent of meals supplied to 79 percent in the appetite-improved group. We also administered shoyogan to 6 patients with nonmalignant disease. It was effective for 3 patients: 1 with congestive heart failure and 2 with great trochanteric fractures of the femur. It was not effective for the other 3 patients, who suffered from anorexia, pneumonia and depression associated with diabetes mellitus. Shoyogan seems to be effective for patients with terminal lung cancer and maintains their quality of life.

A Consideration for the Indication of Daikankyoto or Daikankyoganryo / 日本東洋医学雑誌

We studied contemporary indication of daikankyoto and daikankyoganryo. We administered either of these Kampo prescriptions for thirty-three patients with intractable muscle stiffness of neck, shoulder and back.Twenty-four patients were able to take the prescriptions for more than four weeks (long term group), and nine patients stopped taking the prescriptions less than four weeks (interrupted group). In long term group, fourteen patients (58%) improved their chief compliant. The Kampo formulations of fourteen effective cases were daikankyoto (13 cases) and daikankyoganryo (1 case). Comparative analysis has been done between long term group and nine cases of interrupted group. The characteristics of long term group were higher body mass index, firmer abdomen and more positive cases of epigastric resistance sign. Kansui root dose was 0.81 gram a day in long term group and 0.57 gram a day in interrupted group, which showed statistically-significant difference. We found twenty-seven side-effects in twenty four patients (73%) including eighteen patients with nausea and six patients with diarrhea. In side effects, there was no statistically significant difference between two groups. These side effects were promptly improved after discontinuation or dose reduction of Kansui root. We report clinical courses of six improved cases in this paper, two severe stiff neck, shoulder and back cases, each one case of psychosomatic disorder, depression, spasmodic torticollis and gastroesophageal reflux. These prescriptions should be administered more commonly to the patients with severe stiff neck, shoulder and back.

A Case of Patient with Lung Cancer in the Terminal Stage whose Appetite and General Condition had been Maintained Following the Oral Administration of \it{Shoyogan} / 日本東洋医学雑誌

Shoyogan is a Kampo prescription described in the Jinkuiyaolue text, but there have been no case reports regarding this medicine. We report a patient with terminal stage lung cancer, whose appetite and general well-being was maintained following oral administration of this medicine.A 62-year old woman had her main tumor in the left pulmonary lobe, which invaded to the bilateral peritoneum and the mediastinum. Metastasis was recognized in the left femoral bone which had been broken, the ilium, chest and lumbar vertebral bones, and the liver. Her general condition was very poor in spite of the administration of corticosteroids and narcotic medicines, when she began to take shoyogan 5 months after the onset of her symptoms. Cytological examination of her pleural effusion revealed adenocarcinoma. Following the administration of shoyogan, her appetite recovered, nutrition improved, and she was able to survive while maintaining her quality of life for another 2 months.In this paper we discuss the efficacy of shoyogan in improving the general well-being of patients having the above-mentioned conditions, or jueyinbing in Kampo parlance. Although preparing shoyogan is laborious, we believe this medicine should be used more frequently.

The Effect of Bofutsushosan on Weight Reduction in Humans / 日本東洋医学雑誌

We administered Bofutsushosan (Bo) to 127 obese patients who consulted our clinic, and investigated the effect of this herbal formula on reducing body weight in 33 obese patients who received continuous adminis tration for more than six months. The abdominal muscle tension of these 33 patients was assessed mainly as “strong” (four) under the five-grade scale of Kampo diagnostics, which was higher than that of 9 other patients with side effects (including diarrhea and abdominal pain) assessed mainly as “middle” (three). Sixteen patients reported a decrease in appetite following administration of Bo. Weight before medication in the patients with decreased appetite was 67.1±2.5kg, and that in 17 patients with unchanged appetite was 75.9±2.4kg. There was a significant difference between the two. Weight change in the patients with decreased appetite was -4.8±1.0kg and was significantly lower than -1.4±0.7kg in the patients with unchanged appetite. Their blood triglycerides levels decreased significantly following administration of Bo. This decrease in appetite was considered to be due not only to activation of the adrenaline β₃ receptor, through the administration of Ephedrae Herba, Schizonepetae Spica, Rhei Rhizoma, Forsythiae Fructus and Glycyrrhizae Radix but also to the psychotropic actions of Ephedra Herba, Rhei Rhizoma and Gardeniae Fructus. Recently severe side effects of Bo have been reported. This study suggested that patients showing a grade of strong (four) or more in abdominal muscle tension, were indicated for this treatment and that the long-term administration of this herbal formula should be continued in patients whose appetite was identified as being suppressed.