ABSTRACT
A 44-year-old woman became easily fatigued after her second childbirth. Her symptoms improved with shimbuto and ninjinto as a substitute for bukuryoshigyakuto, and the prescriptions were continued. Recently, she suffered from fever, pain around thyroid glands, palpitation, and tremor of hands. She was diagnosed with subacute thyroiditis and prescribed acetaminophen, but the symptoms did not resolve. Based on the clinical signs of inappetence and her thick yellow tongue coating, we suspect the late yang stage and administered shosaikoto. Her body temperature remained below 37 degrees Celsius thereafter, and the pain around thyroid glands disappeared. Out of all the Kampo formulae used in 310 cases of subacute thyroiditis including past reported cases and this case, we found that 53% of the effective formulae were what we call formulae of involving Bupleuri radix that contain both of Bupleuri radix and Scutellariae radix. It is considered that formulae of involving Bupleuri radix are often effective to control the inflammatory process in subacute thyroiditis.
ABSTRACT
A 28-year-old man had been experiencing occasional stomach upset and heartburn for 14 years. The symptoms started after he suffered from vomiting and diarrhea in the winter when he was fourteen. He had always suffered from loss of appetite during the last couple of years, and his symptoms got worse whatever he ate. In a terrible time, he had a palpitation and grew cold his limbs. He defecated once in one or two days with painful diarrhea. These symptoms were considered as functional gastrointestinal disorders with functional dyspepsia and irritable bowel syndrome. First, saishakurikkunshito was tried but it had no effect. Shokenchuto was prescribed next and had some effect. Chukenchuto, a combination of shokenchuto and daikenchuto, showed better effectiveness. The results of this case suggest that saishakurikkunshito was ineffective because qi deficiency was not the main cause, and that chukenchuto was effective because of qi depression.
ABSTRACT
A42-year-old man presented with a history of tidal fever almost every evening to night with 10-year duration. We could not find out the cause of his fever, so we thought he was classified in fever of unknown origin. The patient suffered from an anhydrosis phase during the temperature rose, but his fever broke after perspiration occurred at the end. The lack of perspiration with fever is a typical symptom of excess pattern of tai yang stage, and fever at night is suggestive of shao yang stage. Saikatsugekito was thought to be best suited as it would address both stages. The formula promoted perspiration, and the body temperature remained stable thereafter. It is not unusual to encounter complicated symptoms due to combined or overlapped pattern in clinical setting. This case represented successful outcome by identifying and analyzing the concept of gobyo and heibyo and prescribing a formula accordingly.
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
Case 1 was a 72-year-old man with a generalized pain after 6 months of heavy physical work. Kakkonto was prescribed based on his symptoms of severe shoulder stiffness and pain, and keishibukuryoganryo was added to treatoketsu. It caused dysuria because of ephedra herb, so the dosage was reduced. Atractylodes lancea rhizome and processed aconite root were added to enhance the effect of treatment. And then, his pain was alleviated. Case 2 was a 53-year-old man with a generalized pain. He had a previous history of whiplash and two surgical operations. Daisaikoto was prescribed based on his symptom of bilateral costal arch pain, and keishibukuryoganryo was added because of oketsu. It caused an increased frequency of bowel movement due to crude drug of rhuharb, so the dosage was reduced. Pueraria root was added for the purpose of relieving severe shoulder stiffness. And then, his pain went away. It is often difficult to treat fibromyalgia. The decoction can be effective with increase or decrease and deleting or adding of the dosage of crude drug. Decoctions become handy as it allows dosage adjustment of crude drug to minimize the side effects and improve the efficacy.
ABSTRACT
A 31-year-old woman started to have a yellowish-white scab with exfoliation on her lip after delivery. Her exfoliative cheilitis did not improve with kigikenchuto nor juzentaihoto for treating deficiency of vital energy and lack of blood. After she developed upset stomach, her prescription was changed to hochuekkito which supports the digestive system. Her symptom improved dramatically. The characteristic of exfoliative cheilitis consists of chronic inflammation of lips which is considered to be yang-syndrome, therefore hochuekkito was effective as it covers yang-syndrome as well as yin-syndrome. It is suggested that psychological factors play a role for a pathogenesis of exfoliative cheilitis. We consider that antistress effect of bupleurum root and sedative effect of citrus unshiu peel in hochuekkito might also be key factors.
ABSTRACT
A 48-year-old woman started to have dizziness after experiencing an earthquake. Her clinical signs improved with the use of shimbuto that was prescribed based on her symptom of yin-syndrome and hypofunction. At the same time, there was a decrease in reading errors with her finger, in a vein authentication device. One of the common reading errors that the security system makes is due to a change in blood flow due to vasoconstriction caused by low temperature. It is speculated that the use of a warming formula increased peripheral blood circulation, which contributed to the improvement of vein authentication.
ABSTRACT
We report a case of hot flush successfully treated with formulations for yin-syndrome. A 56-year-old female patient experienced hot sensations and sweating on her face post menopause. Her hot flush was improved slightly with kamishoyosan and ryokeijutsukanto, but her symptoms were aggravated whenever she became tired. The patient was reevaluated and her prescription was changed to hachimigan, based on symptoms related to yin-syndrome and hypofunction, and a lack of resistance at the lower abdomen with the abdominal palpation. The patient appeared to respond favorably. However, the patient was easily fatigued and her symptoms returned when she felt tired. Ninjinto was added to the prescription based on the patient's “stuck feeling in pit of the stomach”. Her hot flush resolved and she no longer became tired easily. Although the use of formulations for yang-syndrome are known to be useful for the treatment of hot flush, formulations for yin-syndrome may be effective for the treatment of hot flush depending on the state of the patient.
ABSTRACT
We report a 68 year-old woman being treated for anorexia. Despite our treatment, her body weight decreased to 22 kg and she was admitted to our hospital ER for Wernicke's encephalopathy and a hypoglycemic attack, which both occurred on January 21 st. She experienced respiratory failure and was placed on a respirator. On March 24 th she developed a fever due to a respiratory tract infection, and antibiotics and keishinieppiichito were administered.<br>On March 26 th she again developed a fever. One tenth of the normal daily dose of daisaikotokabosho was administered successfully. However, she had a fever again on March 31 st. The following day, one tenth of the normal daily dose of daiaikotokabosho was administered successfully. The formula was continued and the fever disappeared after April 3rd.<br>Whether the base formula of saikokaboshoto is daisaikoto or shosaikoto remains controversial. Our case was suspected of rinetsu, excessive pathogenic heating of the interior body, and her abdominal symptoms indicated daisaikoto. Therefore daisaikotokabosho, which is closely related to yomeibyo as a shoyobyo, was administered effectively.<br>This case suggests that a grossly underweight patient, in whom hypo function or yin condition would usually be seen, has the potential to change to hyper function or a yang condition. In such a case, dose adjustment for physical size and body energy is necessary.
ABSTRACT
We report a situation involving Kampo therapies on an isolated island and three cases treated with Kampo medicine on the island. The first author received outpatient training at the department of Japanese Oriental Medicine in Iizuka Hospital and provided medical care on the island for 3 years, using Kampo therapies.<BR>About one quarter of patients (total, 134) were prescribed Kampo therapies in April 2009, and we surveyed the number of patients who had taken each Kampo medicine for 2 years from April of 2008 to March of 2010. As to prescriptions of less than 4 weeks, Kampo medicines used for a cold ranked high. As to prescriptions exceeding 4 weeks, hachimijiogan, daiokanzoto and keishibukuryogan were the most prescribed medications, in descending order.<BR>We consider Kampo therapies to have been effective on this isolated island where there are many elderly people, and patients who must be treated comprehensively while giving consideration to their familial states. We also presume the environment of an isolated island to cause certain clinical conditions, water imbalances included, such that Kampo medicines for water imbalances tended to be prescribed frequently.<BR>Finally, learning Kampo therapies has highly motivated the first author to practice community medicine.
ABSTRACT
Shohangekabukuryoto, an herbal mixture, was administered to 15 patients with postnasal drip. Ten patients responded to this therapy and 5 failed to respond to it. Subjective symptoms and objective findings were analyzed and compared between the responders and nonresponders. Nausea was not observed in any patient. In the responders, watery rhinorrhea and <I>shinsuion</I> was often noted. Patients showing viscous rhinorrhea without <I>shinsuion</I> were considered nonresponders. These results suggest that shohangekabukuryoto is an herbal mixture that may be used for treating patients with postnasal watery rhinorrhea accompanied by <I>shinsuion</I>, despite the absence of evident nausea.
ABSTRACT
We encountered 4 cases of calf cramps in which the herbal mixture shakuyakukanzoto was ineffective but another herbal mixture sokeikakketsuto was effective. In case 1, the patient was a 73-year-old man. He had a history of calf cramps, and started experiencing calf cramps more frequently about1month before he made his first visit to our department. Shakuyakukanzoto (7.5g/day) was initially prescribed, but the frequency of cramps did not change. Then, shakuyakukanzoto was replaced with sokeikakketsuto (7.5g/day), and this resulted in rapid alleviation of the symptom. In case 2, the patient was a 67-year-old woman undergoing outpatient care for shoulder stiffness, low back pain, etc. She started experiencing calf cramps at night and underwent shakuyakukanzoto (7.5g/day) treatment. The frequency of cramps did not change, and hence, shakuyakukanzoto was replaced with sokeikakketsuto (2.5g at bedtime). The symptom was alleviated in response to this therapy. In case 3, the patient was a 66-year-old woman undergoing treatment for low back pain at our department. She experienced calf cramps and was treated with shakuyakukanzobushito (3.0g/day). The response was poor, and the herbal mixture was replaced with sokeikakketsuto (7.5g/day), which resulted in the disappearance of her cramps. In case 4, the patient was a 75-year-old man undergoing treatment for a cold sensation in the left leg. He experienced calf cramps and was treated with shakuyakukanzobushito (1.5g/day). This therapy resulted in only temporary relief from the symptom. After the herbal mixture was replaced with sokeikakketsuto (2.5g/day), the cramps disappeared rapidly. Thus, sokeikakketsuto, which improves blood flow and is thought to manifest analgesic effects, may be used for treating patients with calf cramps who do not respond to shakuyakukanzoto.
ABSTRACT
We encountered 2 cases of vomiting that were successfully treated with daisaikoto. In case1, the patient was a 16-year-old girl. She was vomiting in the hospital with pneumonia. Referring to the vomiting and kyokyo-kuman (Subchondrial resistance and discomfort), vomiting gradually disappeared after administration of daisaikoto. In case 2, the patient was a 73-year-old woman. After aspiration pneumonia, she developed nausea and vomiting and experienced constipation and kyokyo-kuman. The nausea and vomiting gradually disappeared after the administration of daisaikoto. These findings suggested that daisaikoto, in combination with a large amount of Zingiberis Rhizoma on classic text, suppresses nausea.
ABSTRACT
We report two cases successfully treated with tsumyakushigyakuto containing aconite root (<I>uzu</I>), instead of processed aconite root (<I>bushi</I>). The first case was a 33-year-old female. She had suffered from itching rashes in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because she was in an extreme cold state, we changed the processed aconite root in her tsumyakushigyakuto to aconite root. Her itching rashes subsequently improved. The second case was a 42-year-old male. He had suffered from watery diarrhea and general fatigue in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because he was in an extreme cold state, we changed the processed aconite root in his tsumyakushigyakuto to aconite root, and his watery diarrhea and general fatigue improved.<BR>We consider that using tsumyakushigyakuto with aconite root may be more effective than using it with processed aconite root in an extreme cold state.
ABSTRACT
A 51-year-old male with cyclic neutropenia, on whom we previously reported, was admitted to our hospital with severe abdominal pain and diarrhea four years and seven months after his last hospitalization. Since then, he has received Kampo treatment at our hospital every three weeks, with good clinical results. This time, he was at first treated with Kampo daikenchuto combined with bushikobeito, which had been effective during his last hospitalization, although this time the remedy had no effect. From the viewpoint of Japanese traditional (Kampo) medicine, it was considered that the patient had severe cold syndrome. He was given uzukeishito three times a day (at 10.00, 15.00 and 20.00 hours). The dose of uzu in uzukeishito was gradually increased. Daiuzusen, in which the dose of uzu (an aconite) was 1g or 2g, was also administered five times a day due to the patient's very severe abdominal pain. On the fourth day of uzukeishito administration, the patient felt very hot and still had severe abdominal pain, although this pain was different from the previous pain, thirty minutes after daiuzusen (with 2g dose of uzu) was administered. This reaction can better be explained as <I>mengen</I> rather than uzu poisoning. Very soon he had a good appetite, his abdominal pain was reduced and the cycle of neutropenia was normalized. The case suggests that in cases of very severe cold syndrome, frequent and high-dose administration of aconite component medicine can be effective.
ABSTRACT
We report 5 patients with polymyalgia rheumatica (PMR) successfully treated with Kampo medicines. In total, we investigated 10 patients with PMR, including the 5 patients here treated in our department. Results showed that Kampo medicine was effective in 6 cases. One of the 6 refused steroid drug administration, and tapering dosage steroid was difficult in the other 5 patients due to myalgia or inflammation. Except for one case, C-reactive protein in most of the effective cases was below 3.0 mg/dl. On the other hand, the non-effective cases had severe inflammation levels and needed steroid therapy. The effective cases were treated with sokeikakketsuto, tokakujokito, keishibukuryogan, choyotokasyakuyaku, yokuibushihaishosan and tokishakuyakusan, which have the effect of improving oketsu states. Thus, it was considered that Kampo medicine has the potential for treatments in PMR patients who have difficulty tapering steroid dosage and mild inflammation. Moreover, this suggests Kampo medicines that improve oketsu state are useful for PMR treatment.
ABSTRACT
We report two cases successfully treated with tsumyakushigyakuto containing aconite root (<i>uzu</i>), instead of processed aconite root (<i>bushi</i>). The first case was a 33-year-old female. She had suffered from itching rashes in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because she was in an extreme cold state, we changed the processed aconite root in her tsumyakushigyakuto to aconite root. Her itching rashes subsequently improved. The second case was a 42-year-old male. He had suffered from watery diarrhea and general fatigue in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because he was in an extreme cold state, we changed the processed aconite root in his tsumyakushigyakuto to aconite root, and his watery diarrhea and general fatigue improved.We consider that using tsumyakushigyakuto with aconite root may be more effective than using it with processed aconite root in an extreme cold state.
ABSTRACT
We report a case of intractable diarrhea successfully treated with daikenchuto. The patient was a 60-year-old female. She had suffered from diarrhea in spite of being prescribed Shimbuto, Kanzoshashinto, Shigyakuto and so on. After daikenchuto was administered her intractable diarrhea improved. However, she had not symptoms such as abdominal pain, coldness in the abdomen and abdominal movement disorder that often appear in daikenchuto-syo. We consider daikenchuto may be effective not only for diarrhea but also constipation in yin-syndrome and hypofunction when intestinal juice and gas are stagnated.