ABSTRACT
Tokishakuyakusan has been used widely to treat various diseases including gynecological disorders. Currently, tokishakuyakusan is frequently used to treat female patients, while indications for use in male patients are unclear. Furthermore, there are few reports of male patients having been effectively treated with tokishakuyakusan or tokishakuyakusanryo. Here, we report four male patients successfully treated with tokishakuyakusanryo. Case 1 was an 84-year-old man who had uncontrolled nasal allergy, and treatment with tokishakuyakusanryo was effective in relieving the patient's allergy symptoms that were accompanied by chills and oketsu (blood stasis) findings. Case 2 was a 63-year-old man whose chief complaints were bronchial asthma, benign prostate hypertrophy, and nasal allergy. All his symptoms improved considerably with tokishakuyakusanryo and hangekobokuto, especially the symptoms of nasal allergy. Case 3 was a 70-year-old man whose chief complaint was persistent proteinuria. Tokishakuyakusanryo was prescribed, in consideration of his clinically observed condition, which included sensitivity to cold, blood stasis and fluid retention. His proteinuria disappeared four months later, along with his other complaints of chills, oketsu, and fluid retention. Case 4 was a 56-year-old man whose chief complaint was ulcerative colitis. He had responded well to treatment with ifuto, but he developed hypertension. His prescription was changed to tokishakuyakusanryo, a similar prescription that does not contain the Glycyrrhiza radix which can cause hypertension. Afterwards, his blood pressure decreased to normal levels and his abdominal symptoms remained stable. Nangai Yoshimasu published the opinion that tokishakuyakusan could be applied not only in female patients but also male patients. Additional reports on male cases would provide helpful information to clarify tokishakuyakusan indications in male patients.