ABSTRACT
After percutaneous coronary intervention (PCI), the patient developed symptoms of pain, sensory impairment, paralysis, pallor of the skin, and pain during passive extension, and was diagnosed with PCI-induced antebrachial compartment syndrome. Since it was considered to be blood stasis and water stasis in Oriental medicine, we administered jidabokuippo and keishibukuryogan to the patient. Then the subjective and objective symptoms improved promptly, and the symptoms disappeared by the 10th day after the operation. The patient was able to discontinue jidabokuippo 14 days after the operation. It was suggested that the symptomatic treatment with Kampo medicine is effective for compartment syndrome.
ABSTRACT
Mokuboito is a Kampo formulation consisting of four flavors of Sinomeni Caulis Radix (防已), Gypsum Fibrosum (石膏), Cinnamomi Cortex (桂皮) and Ginseng Radix (人参). From a modern medical interpretation of the source “Kinkiyoryaku” it can be indicated for pulmonary edema, and if administered early in the onset, respiratory management by tracheal intubation can be avoided, which may contribute to improving the patient's QOL. We experienced 10 cases of pulmonary edema that occurred during the postpartum period and were able to avoid tracheal intubation with mokuboito already. All patients complained of dyspnea and moist rales were heard. Their chest X-rays showed decreased permeability of the lung field and increased pulmonary vascular shadow, increased cardiothoracic ratio (CTR), costophrenic angle (CP angle) blunting, therefore, they were diagnosed as pulmonary edema. After X-ray confirmation, mokuboito was administered, and in 6 cases,the subjective symptoms decreased from 7 to 4 in NRS (numerical rating scale), the CTR decreased from 60 to 40%, and CP angle, lung field findings, moist rales also improved. In 3 cases, mokuboito+choreito or mokuboito+choreito+choijokito were administered, and the X-ray findings were similarly improved. Mokuboito was useful for respiratory management of pulmonary edema during puerperium.
ABSTRACT
A 51-year-old woman with a 10-year history of diabetes visited our clinic for treatment of stiff shoulder and constipation. She was 156 cm tall and weighed 68 kg. The blood pressure was normal. Physical examination revealed no significant abnormalities. After she took the usual amount of tokakujokito for 3 days, hypertension and facial edema, legs edema, weight gain, and headache were observed. Pseudoaldosteronism inhibits 11 β-hydroxysteroid dehydrogenase Type 2, which is an active glycyrrhizin (GL) and its metabolites glycyrrhizic acid, 3-monoglucuronyl-glycyrrhizic acid metabolize and inactivate cortisol to cortisone. As a result, excessive cortisol acts on the mineralocorticoid receptor and promotes sodium reabsorption and excretion of potassium (K+), resulting in water retention and hypokalemia in the body. Insulin also causes hypokalemia because it also takes K+ at the same time as it takes blood glucose in the cell. As a result of these two different processes, it was thought that pseudoaldosteronism developed in low dose licorice. Glycyrrhizin-containing preparation should be careful used in patients receiving insulin.