ABSTRACT
Team-based learning (TBL) is an educational method developed to cultivate the ability to solve problems by learning and applying knowledge on one's own, as well as the ability to make decisions, take responsibility, and collaborate by working on issues in small groups. TBL in Kampo medicine was held as a special program : active learning at the 71st Annual Meeting of the Japan Society for Oriental Medicine. A total of 57 students participated in the TBL session. The theme of the session was the common cold with the theory of yin and yang. According to the results of a questionnaire survey, the students answered that they were able to understand the flow of diagnosis in Kampo medicine, which was the goal of the course. As a bridge from classroom lectures to clinical practice, TBL in Kampo medicine was considered to be useful in Kampo medical education.
ABSTRACT
At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we performed a special program focusing on education in Kampo medicine, “Pre-graduation and post-graduation education in Kampo medicine for the next generation.” As a part of this project, we constructed the “Common Kampo test” based on the “Standard lectures on Kampo” as a web-based test using Moodle, and then the test was conducted in the form of a web test with 163 participants. The commentary of the “Common Kampo test” was live-streamed and was viewed by many participants, including students, educators and academics from all over Japan. In this paper, we report on the series covering the construction of the web system, creation of questions, answer results, and commentary on answers. With the recent popularization of tablet devices and smartphones, this web-based test system has the potential to become a scientifically based and optimal learning system not only for students but also for medical professionals such as doctors, pharmacists, and nurses.
ABSTRACT
Ninety percent of the crude drugs consumed in Japan depend on imports. Recently, the Japanese government has been promoting the domestic production of crude drugs. We investigated the history and current situation of the cultivation of medicinal plants and the production of crude drugs in the Tohoku region, where the 71st annual meeting of the Japan Society for Oriental Medicine was held in August 2021. In the Tohoku region, the cultivation of medicinal plants expanded after the Kyoho era of the Edo period. Several medicinal plants in this region have been successfully cultivated and distributed as local specialty products and are being preserved (e.g., Panax ginseng in Aizu, Carthamus tinctorius in Dewa). In some other areas, cultivation has just begun. In each cultivation area, a contractual relationship was established in which local governments, cultivation experts, farmers, Kampo-related associations, and pharmaceutical companies collaborated to continue and expand the cultivation business. To generate revenue, they have been trying to find sales channels not only for crude drugs but also for foods, cosmetics, textiles, and processed products. Although many issues remain to be solved in the distribution of medicinal plants as the source of crude drugs, this survey clarified the ingenuity of medicinal plant cultivation in various areas of the Tohoku region. The results of the investigation are available as videos on the website for members of the Japan Society for Oriental Medicine.
ABSTRACT
At the 71st Annual Meeting of the Japan Society for Oriental Medicine in August 2021, we conducted a special program focusing on education in Kampo medicine, “Pre-graduate and post-graduate Kampo medicine education for the next generation.” As part of this project, we directed a symposium on the model core curriculum (core curriculum) in medicine, dentistry, pharmacy and nursing. The core curriculum in these fields includes Kampo education. Each institution shall promote education in accordance with the core curriculum, considering the characteristics of the field and the circumstances of the educational institution. We introduced the core curriculum in each field, and summarized and reported the current status of Kampo education in the field, points to note and suggestions for multidisciplinary cooperation, issues related to clinical practice and lack of educators, and future prospects.
ABSTRACT
At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program focusing on Kampo medicine education, “Pre-graduation post-graduation Kampo medicine education for the next generation.” The following is a summary report on the practical training in Kampo medicine at each educational facility where the project was conducted. We recorded videos with explanations of topics in advance : “Four examinations,” “Decoction and crude drugs,” and “Acupuncture and moxibustion.” The report on the hands-on training in Kampo medicine was viewed 501 times by medical students, educators, and the society members across the country. This initiative was the first nationwide educational activity of the society.
ABSTRACT
At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program, “Pre-graduation and post-graduation Kampo medical education for the next generation,” focusing on Kampo medical education. We summarize and report a mock lecture on standard Kampo medicine conducted jointly with the Japan Council for Kampo Medical Education (JCKME) for the purpose of faculty development. The lecture contents were based on the “Basic Curriculum for Pre-Graduate Education in Kampo Medicine 2016” established by the JCKME, and the common model slides prepared by the JCKME were used. The lectures were pre-recorded for 240 minutes on the “History of Kampo medicine,” “basic theory of Kampo medicine,” “physical examination of Kampo medicine,” “composition and effects of typical Kampo medicines, effects and side effects of typical herbal medicines,” “usefulness of Kampo and clinical cases that were effective,” and “overview of acupuncture and moxibustion treatment,” and were delivered from seven days before to seven days after the annual meeting. This was the first nationwide educational activity for the general meeting of the society. These lectures were viewed 1,017 times nationwide, by medical students, educators, and members of the society.
ABSTRACT
We report three cases of patients with mental illness suffering from symptoms associated with menstruation, which were improved with Kampo treatment. Case1: A 39-year-old female had been in a depressive state after delivery and diagnosed with persistent mood disorder in the Neuropsychiatry Department of Fukushima Medical University (FMU). During treatment for the disorder, she developed premenstrual dysphoric disorder (PMDD) and was immediately hospitalized. After she was introduced to the Obstetrics/Gynecology Department, we treated her with Kampo medicine such as tokakujokito considering the meaning of the pattern (sho), and then she recovered from PMDD. Case2: A 29-year-old female with schizophrenic disorder treated in the Neuropsychiatry Department of FMU was referred to the Obstetrics/Gynecology Department due to PMDD. We administered Kampo medicine such as kamishoyosan, nyosinsan and saikozai when yang pattern was observed, and ninjinto and daikenchuto in yin sho. Then, her condition then gradually improved. Case3: A 37-year-old female diagnosed with borderline personality disorder and attention deficit hyperactivity disorder was hospitalized in the Neuropsychiatry Department of FMU. She was introduced to the Obstetrics/Gynecology department due to dysmenorrhea and PMS. After she was treated with keishibukuryogan and hangekobokuto, her symptoms improved. In conclusion, Kampo treatment appears to be effective for symptoms associated with menstruation in women with mental illness.
ABSTRACT
[Objective] We report a successfully treated case by a combined therapy of acupuncture and Kampo medicine for a patient with lower limb pain associated with Guillain-Barre syndrome (GBS).[Case] The patient was a 74-year-old man whose chief complaints were severe lower limb pain, gait difficulty, and hyposthenia. Clinical history: In late September in X year, the patient had a cold infection. On October 14, he became aware of weakness in his lower limbs on both sides, difficulty in walking, and severe pain in his lower limbs. He visited our hospital's general internal medicine department and was diagnosed with GBS. The patient was hospitalized and started to receive intravenous immunoglobulin therapy for GBS. Since pain in the lower limbs continued after treatment, he received analgesics, which was not effective. Therefore, acupuncture treatment was started on October 30 aiming to alleviate lower limb pain. Evaluation: Pain and burning sensation were evaluated using a numerical rating scale (NRS), and Hughes' function grade scale (FG) as an objective evaluation. [Acupuncture treatment] The acupuncture treatment was based on Chinese medicine. The basic combination of meridian points for treatment of the case were LR3 (Taichong), LI4 (Hegu), KI6 (Zhaohai), KI3 (Taixi), ST36 (Zusanli), PC6 (Neiguan), and SI8 (Xiaohai). The patient received acupuncture treatments once a day for 12 weeks.[Progress] The first evaluation of the patient's pain in his lower limbs on both sides was 10 points in NRS and 4 units in FG. Pain was alleviated immediately after acupuncture treatment was started, and a significant improvement in pain was observed by the seventh acupuncture treatment. However, the patient started to complain of burning sensation on his soles. Therefore, the combined use of Kampo medicine (Choutousan, Rokumijiougan) were introduced in addition to the acupuncture treatment, and his burning sensation disappeared. Since then, rehabilitation was enhanced, and after three months from the start of acupuncture treatment, he was discharged since the FG was improved to 2 units. [Discussion] Lower limb pain and burning sensation in this case were considered to be neuropathic pain associated with GBS, and conventional analgesics were only temporarily effective. In contrast, the combined use of acupuncture and Kampo medicine alleviated the pain and burning sensation, and ADL was improved. Acupuncture and Kampo medicine were effective for lower limb pain and burning sensation from GBS.
ABSTRACT
We are planning a study focused on the gathering of clinical data for the purpose of formalizing diagnostic logic at 6 institutions specialized in Kampo-based medical examinations. However, during the planning stage, it has been recognized that there are a large number of Kampo formulas to be studied, and differences among faculties and individuals exist regarding how to identify each Kampo formula, methods of gathering findings, and the evaluation of efficacy. Here we report the solution proposal reached after building consensus among all participating faculties on these issues. After raising the issues, conferences were held for each of them, until a unanimous consensus was obtained. As a result, the following conclusions were reached. Thirty-three Kampo formulas were selected as targets for the formalization of diagnostic logic. In addition, the range of dosage forms, crude drug ingredients, and permissible dosages for each Kampo formula were determined. Regarding clinical findings for these Kampo medicines, the items to be collected and evaluation criteria were also established. The criteria for evaluating the validity and safety of each Kampo medicine were decided, together with the grading and timing of evaluation. We hope that our solution proposal reached after building consensus becomes the basis for Kampo research in the future.
ABSTRACT
We report a case of a 71 year-old woman treated for diffuse panbronchiolitis (DPB). She received home oxygen therapy and was administered erythromycin ; however, sputum production, cough and respiratory distress worsened. After hospitalization, she was treated with keishikyoshakuyakukasokyoto and acupuncture. After 30 days, respiratory distress, respiratory resistance measured with the pulseoscillation technique and the distance walked in the 6-minute walk test improved. Thus, combination therapy comprising keishikyoshakuyakukasokyoto and acupuncture seemed to be a beneficial therapy for an advanced case of DPB.
ABSTRACT
Abdominal pain and marked coldness were observed in a 56-year-old male with cancerous ascites associated with cancer of unknown primary, and the patient was treated with sekiganryo. The abdominal pain resolved from day 2 after the initiation of sekiganryo administration, and the ascites markedly decreased with an increase in the urine volume on day 3. Although the mechanism of the effect of sekiganryo on cancerous ascites was unclear, it was considered that the improvement of coldness promoted the metabolism and subsequently promoted diuresis. No case of the improvement of cancerous ascites by sekiganryo has been reported to date. We report this case along with a literature review.
ABSTRACT
The patient was an 84-year-old woman living in a nursing home. Her chief complaint was difficulty in moving her body due to extreme pain. She could not lie down especially in a supine position because of severe unidentified somatic pain from left side of lower chest to flank. According to her family, she had been taking 2-3 L of water daily at her nursing home to avoid dehydration even in the wintertime. Therefore she urinated frequently, but she also had constipation for several days. Since NSAIDs had been not effective, byakujutsubushito was administered from the first day of her hospitalization. Accordingly, her constipation improved and her pain quickly faded away. We inferred that her pain resulted from “fluid disturbance” caused by massive intake of water in the wintertime in Aizu region. We believe that byakujutsubushito is a useful Kampo medicine for the treatment of pain resulting from “wind-dampness” along with keishibushito and kanzobushito.
ABSTRACT
We examined 57 patients treated with Kampo decoctions containing uzu for 5 years and 3 months from September 2013. Sekiganryo, which was administered to 32 patients, was the most commonly used decoction. The value of uzu dosage and duration of administration were spread widely and the medians (ranges) are 8.0 (1.0-41.0)g/day and 180 (3-1700) days, respectively. Complete recovery, partial recovery, no recovery, and deterioration in terms of the chief complaint, were observed in 36, 11, 9, and 1 patients, respectively. The number of patients exhibiting complete or partial recovery was higher than that of patients showing no recovery or deterioration when the duration of uzu administration was more than one month and the dosage was higher than 4 g/day (p < 0.05). The patients treated with uzu more than 20 g/day were all sekiganryo administrated ones. Side effects were observed in three patients. Thus, under careful observation, uzu was safely used over a long term and at high doses.uzu: aconite root before processing
ABSTRACT
A 48-year-old man presented with knee pain and general fatigue. He had been diagnosed with sarcoidosis 15 years previously. Prednisolone was administered, but the pain and fatigue persisted. Morphine, fentanyl, and a tramadol/acetaminophen combination were then administered, but their effects were not sufficient. Finally, the patient was treated with sekiganryo, uzuto, uzukeishito, and daiuzusen, all of which contained uzu (aconite root without processing). His pain and fatigue improved after administration of these drugs, and he became able to perform various activities of daily living. In this case, uzu alleviated knee pain and general fatigue in a patient with sarcoidosis.
ABSTRACT
<p>Otsujito is a well-known Kampo medicine for treatment of hemorrhoidal diseases. In the current report, we present end results for a case of enterocutaneous fistula treated with Kampo medicine in accordance with traditional “sho” indications.<br>An 81 year-old female developed abdominal wall-intestinal fistula right immediately following partial colectomy due to ischemic sigmoid colic perforation 12 years previously. Two years later, she had a fistulectomy and repair using intraperitoneal mesh for abdominal recruitment. Eight years after repair of the enterocutaneous fistula, she had peritonitis caused by the tardive intraperitoneal mesh infection. Since then, she has had frequent repeated ileus and received conservative treatment for two years. Several local operations and abdominal drainages were performed after transfer to Aizu Medical Center. Kigikenchuto was provided for wound healing for approximately 1 year, and one fistula was finally identified. Otsujito dramatically decreased the leakage of intestinal juice and closed her enterocutaneous fistula.<br>Angelicae Radix as an anti-inflammatory agent, and Cimicifugae Rhizoma as originally indicated, may have played pivotal roles in this case with Otsujito.</p>
ABSTRACT
<p>In 2013, we prescribed daiuzusen for 3 patients with intractable pain; pain from complex regional pain syndrome, colic pain of unknown origin after an abdominal operation, and colic pain from advanced colon cancer and ileus. A dose of daiuzusen (containing uzu 0.5-2 g) quickly relieved their pain in several minutes. Another common symptom was “cold” in their bowel or extremities when they were feeling pain. Aconite levels in drugs and patients' serum after taking daiuzusen were analyzed by liquid chromatography tandem mass spectrometry. Daiuzusen per 1 g of uzu contained aconitine 1.28 μg, mesaconitine 2.31 μg, and hypaconitine 92.89 μg, while jesaconitine was not detected; this was about 5 to 35 times the level of tsumyakushigyakuto per 1 g of uzu. Serum concentrations of hypaconitine peaked in the study at 1.11 ng/mL after about an hour of taking daiuzusen (1 g of uzu). We posit that the immediate effect after taking daiuzusen was due to transmucosal absorption of uzu components. However serum hypaconitine, which we are now able to monitor, is at least one practical way of indicating the use of uzu or bushi containing prescriptions.</p>
ABSTRACT
<p>Case 1 : A 56-year-old woman had been suffering from insomnia for 10 years, and multiple joint pains on her shoulders, wrists and fingers for 2 years. She complained of headache, dizziness, heart palpitations, and irritable bowel syndromes. Case 2 : A 72-year-old woman presented with cold and painful feeling in her legs that she had had for 10 years, as well as insomnia, excessive sweating, alopecia and pollakiuria that she had had for two years. In both cases, organic diseases of the joints or muscles were ruled out by several doctors, and the patients had been suffering from malaise and insomnia for which they had been taking brotizolam for several years. Consequently, the patients consulted our department of traditional Japanese medicine (Kampo). Medical interviews revealed that they had been under a lot of stress for a long time because of family problems. Sansoninto (roasted Zizyphi spinosa semen 15 g, Poria 3 g, Cnidii Rhizoma 3 g, Anemarrhenae Rhizoma 3 g,Glycyrrhizae Radix 1.5 g) was prescribed, which reduced the pain in their joints and muscles, and their other complaints, in several weeks. Sansoninto seemed not to alleviate insomnia as effectively as it did the pain and other multi complaints, because the patients were not able to discontinue brotizolam. Patients with multiple complaints including insomnia with fatigue induced by long-term stressful lifestyle may sometimes possibly express non-organic joint or muscle pain. Sansoninto may be an effective prescription for non-organic joint and muscle pain.</p>
ABSTRACT
A 45-year-old woman had been suffering from fibromyalgia, chronic fatigue syndrome, and complex regional pain syndrome (CRPS) for 2 years before admission. Non-steroidal anti-inflammatory agents, selective serotonin reuptake inhibitors and pregabalin did not affect the various symptoms. A severe feeling of Coldness, the widespread systemic pain and the severe fatigue were decreased by tsumyakushigyakuto (glycyrrihza 4 g, processed ginger 9 g, aconite root 6 g). Attacks of CRPS were relieved by a dose of daiuzusen (aconite root 1 g, honey 10 g). The CRPS attacks presented mainly on the left heart meridian and the small intestine meridian where we treated them with electroacupuncture with reference to the <i>Shigoryuchu </i>(子午流注) methods. Acupuncture and electroacupuncture decreased the frequency of pain attacks, and alleviated the muscles stiffness caused by the CRPS. Thus, the combination of Kampo medicine and acupuncture were effective for the severe pain and other symptoms associated with fibromyalgia, chronic pain syndrome and CRPS.
ABSTRACT
A 54-year-old female had left femoral incarcerated hernia. One month later, she received a radical operation for it, but was admitted to our hospital twice because of ileus. Various tests showed no mechanical intestinal obstruction, but small-intestinal edema. She was transferred to our department to receive Kampo medicine. She could not eat any food and her weight decreased from 47 to 37.5 kg. We therefore administered intravenous hyperalimentation. She had a cold sweat on her face and was prone to bed rest because of severe abdominal pain as if in labor, and general fatigue. Her skin was dry, her radial pulse was weak and her abdominal tonus was weak. In addition, lower abdominal tension was more intense than upper and we could observe bowel movements from her skin. At first, we administered bushikobeito, but it had no effect. Referring to her abdominal findings, we considered that daikenchuto and tokikenchuto were compatible in her case, and after changing to chukenchutokatoki her abdominal pain disappeared in 5 days. Thus, Kampo medicine was effective for post-operative pseudo-obstruction.
ABSTRACT
In general, keishikashakuyakuto or shokenchuto is used to treat abdominal pain. We experienced 2 cases that kanbakutaisoto were effective in treating abdominal pain, however keishikashakuyakuto and shokenchuto did not have any favorable effect on these cases. Case 1 : A 17-year-old female who consulted us because of abdominal distension and pain. We treated her with keishikashakuyakuto and shokenchuto, but they had no effect on her. As the abdominal pain was increased by anxiety, we prescribed for kanbakutaisoto to her and her symptoms disappeared after one and half months. Case 2 : A 13-year-old male who visited our clinic complaining of upper abdominal pain. He was treated with shokenchuto, but it had no favorable effect. As we knew that he had some anxiety over his club activities and school life, we changed the prescription to kanbakutaisoto, and he recovered after about 1 month. When keishikashakuyakuto or shokenchuto has no effect against abdominal pain, we posit that kanbakutaisoto is useful for the symptom if the patient has psychological problems.