A Case of Fibromyalgia Successfully Treated Using the Kampo Medicine Jumizasan / 日本東洋医学雑誌

The main symptoms of fibromyalgia are systemic pain and fatigue. The pharmacological treatments are usually performed for fibromyalgia in Western medicine. However, in some cases, pain that impairs everyday life continues even after medical treatment. We herein report a case in which fibromyalgia was successfully treated using jumizasan. The patient was a 28-year-old woman. Prior to admission to the author's clinic, she had complained of dull pain in the left upper arm for 4 years, and the pain had spread throughout the body for 2 years. Various other symptoms including fatigue, headache, heart palpitation, and shortness of breath coexisted. The pain resolved within 3 months after the initiation of treatment with jumizasan (a Japanese herbal medicine decoction), which was given based on pallid complexion, skin drying, strong upper arm pain, and walking difficulty. We concluded that jumizasan may be considered to be used for patients with blood deficiency, upper arm pain, and walking difficulty in Kampo concept of treatment.

The Features of Oriental Medicine and Kampo Treatment for Undifferentiated Finger Arthritis / 日本東洋医学雑誌

There are cases of finger pain in which a definite diagnosis including rheumatoid arthritis cannot be made even after thorough examinations. We herein report the results of Kampo treatment in such cases with so called undifferentiated arthritis. Sixty­-two patients (male, n = 5 ; female, n = 57 ;average age, 49.7 years) were included in the present study. There is a tendency of the Kampo concept of a cold pattern (n = 39 ; 63%), static blood (oketsu, n = 47;76%), and qi stagnation (n = 44 ;71%). Among the 62 cases, excellent results were ob­tained in 29 cases (47%), good results were obtained in 10 cases (16%), and no effect was obtained in 23 cases (37%). Kamishoyosan, which was administered in 30 cases, was the most commonly used Kampo medicine. In most cases, Kampo treatment was given with a combination of two or more formulas. A paired formula of kamishoyosan and keishikaryojutsubuto was used in 9 cases, 8 of which showed good or excellent results (efficacy rate : 89%). Qi- and/or ketsu-­tonifying formulations and formulations with warming effects were often used for the treatment of undifferentiated finger arthritis.

Two Cases of Leg Pain Successfully Treated Using the Kampo Medicine Chikujountanto in Consideration of Phlegm-Fluid Retention / 日本東洋医学雑誌

Few reports have described the effect of phlegm-­fluid retention on the development of pain. We herein rep­ort two successful treatment cases of lower leg pain using chikujountanto in consideration of phlegm-­fluid re­tention. Case 1 (a 63-year-old woman) complained dull pain in the right calf. The pain persisted despite the ad­ministration of sokeikakketsuto for over two weeks. Case 2 (a 42-year-old woman) suffered from right buttock pain that had developed after a traffic accident. The pain persisted even at three months following the accident. The pain in both patients resolved within one week after treatment with chikujountanto, which was given on the basis of the patients' insomnia, thickened yellow fur on the tongue, and pain in the gallbladder meridian. We concluded that the concept of phlegm-­fluid retention should be considered for differential diagnosis when we treat pain.

<b>A Case of Diabetic Foot Syndrome Successfully Treated with </b><b>Combination Kampo Medicine </b> / 日本東洋医学雑誌

This case involved a 58-year-old male with diabetic foot syndrome complicated with osteomyelitis. He had been diagnosed with diabetes mellitus type 2 twenty years previously, but had ignored it and developed diabetic foot syndrome and diabetic triopathy. His HbA 1 c (NGSP) was 11.2%. Twelve days after diabetic foot onset, he was transferred to our hospital to receive Kampo medicine. His whole right leg was edematous and there were two ulcers on the dorsum (5 × 4 cm in size) and between the fourth and fifth toes (7 × 4 cm in size).We used antibiotics, insulin, and prostaglandin formulation in combination with Kampo medicine, involving hachimijioganryo because of lower abdominal numbness. Simultaneously, we used keishibukuryogan at high dosage (personalized formula, 2 g × 24 pills) for 7 days to improve blood stasis. Seven days after hospitalization, we changed the initial hachimijioganryo to hachimijiogan (personalized formula, 2.3 g × 9 pills) and kigikenchuto (astragalus root, 20 g) to accelerate ulcer granulation. We also decreased the high dose keishibukuryogan gradually. Although the bone of the DIP joint in the fifth toe was exposed, the ulcer dimensions decreased and reached 2.5 × 1.8 cm at the time of discharge (50 days after onset). Two months after onset, the ulcer had epithelialized and medical dressings were unnecessary. Four months after onset, it had completely healed. We propose that Kampo medicine is effective for diabetic foot syndrome when combined with conventional therapy, and that healing occurs earlier than with conventional therapy alone.

A Case of Hypertrophic Pachymeningitis with Erythema Nodosum Successfully Treated with Shosaikoto / 日本東洋医学雑誌

A 59-year-old woman presented with a 2-month history of headache with left eyelid swelling, and erythema in her lower extremities. She also had persistent low-grade fever and weight loss of 3 kg over 2 months. Blood biochemistry tests performed elsewhere indicated an inflammatory reaction. One week before hospitalization, she was treated at our hospital using the Japanese herbal medicines, keishito and shosaikoto. On hospitalization, her headache and eyelid swelling had slightly decreased ; therefore, she was advised to continue the Japanese herbal medicine, shosaikoto. Contrast-enhanced brain MRI showed meningeal thickening extending from the right anterior cranial fossa to the left cavernous sinus, suggesting a diagnosis of hypertrophic pachymeningitis. Cerebrospinal fluid examination revealed mild pleocytosis with mononuclear leukocyte predominance. Biopsy of the erythematous lesion on her leg was carried out, and analysis of the obtained specimen led to the diagnosis of erythema nodosum. In this case, exhaustive efforts to identify the cause of the combined hypertrophic pachymeningitis and erythema nodosum were unsuccessful. However, the symptoms and signs were alleviated after treatment with the Japanese herbal medicine, shosaikoto. We did not administer steroid therapy, which is generally prescribed for such an immune-inflammatory disease, because of the possible presence of an infectious disease. The Japanese herbal medicine was found to be a candidate therapeutic agent in this case.