ABSTRACT
Growing evidences indicate that the development of mesenteric phlebosclerosis (MP) is associated with long-term gardenia fruit (GF) intake. Besides duration and total dosage of GF ingestion, other factors associated with the development of MP or the symptoms of MP have not been known. We searched for previous case reports of MP from Japan. MP patients were divided into two groups : asymptomatic group without abdominal symptoms or symptomatic group. Age, gender ratio, body size, and duration of GF ingestion of the both groups were statistically analyzed. We evaluated concomitant diseases that can cause elevated venous pressure in the both groups. Colectomy rate were compared between symptomatic men and symptomatic women. Severe symptoms including ileus, stenosis peritonitis, and perforation were also compared between men and women. Age and sex were analyzed in all 164 cases. The gender ratio of women to men in the symptomatic group was higher than that in the asymptomatic group. However, colectomy rate in the symptomatic group was similar between men and women. Ileus, stenosis, peritonitis, and perforation were similarly found in both men and women. We found 15 symptomatic MP patients with concomitant diseases that can cause phlebostasis. None of the asymptomatic had these diseases. Concomitant diseases that can cause elevated venous pressure might be associated with symptomatic MP. The severity of MP seems to be similar between men and women. Association of gender difference with the development of MP symptoms was uncertain.
ABSTRACT
Berberine-containing goldenseal root has been classified into Group 2B (possibly carcinogenic to humans) by International Agency for Research on Cancer based on evidence of carcinogenicity in experimental animals. It was also confirmed that ultrahigh concentration berberine can induce DNA damage in cultured cells. Thus, two articles in Journal of Japan Medical Association advocated carcinogenicity and reproductive toxicity of oren, obaku, and daio considering that ingredients of daio and berberine contained in oren and obaku can cause DNA damage. However, many fallacies and arbitrary descriptions are observed in the two articles. The concentration of berberine that caused toxicity in the experiments is extremely higher than the possible concentration in humans taking Kampo medicine. Although no studies have shown carcinogenicity and reproductive toxicity of oren or obaku, the advocates in the articles were played up by a weekly magazine causing unreasonable anxiety to patients. Here, we present scientific counterarguments against the fallacies of the articles.
ABSTRACT
It is theoretically thought that Paeoniae Radix (shakuyaku) has a sour taste and astringent action in traditional Chinese medicine. To examine the practical taste of shakuyaku, 12 volunteers sampled the decoction of Paeoniae Radix Rubra (sekishaku) and Paeoniae Radix Alba (byakushaku). Each volunteer determined how sekishaku and byakushaku taste among “five tastes” : sweet, salty, bitter, sour, or spicy. Most volunteers chose bitter taste and none of them chose sour taste as the foremost taste of shakuyaku. At least in the modern age, shakuyaku may have little sour taste. In this article we discussed the astringent action and the muscle relaxant action of shakuyaku with reference to the sour taste.
ABSTRACT
To estimate the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis, all medical records in our clinic were retrospectively examined. Among 2,430 patients who took Kampo medicine containing Scutellaria baicalensis, liver blood tests were performed in 1,547 cases (63.7%). The possibility of liver injury related to Kampo medicine containing Scutellaria baicalensis could not be denied in 19 cases (1.2%) among the 1,547 cases. The clinical features of liver injury in 19 cases were not different from those in previous reports. In agreement with the previous literature, this study also suggests that the incidence of liver injury related to Kampo medicine containing Scutellaria baicalensis is about 1%.
ABSTRACT
A thirty-eight-year old woman with facial pain was diagnosed with trigeminal neuralgia, and treated with conventional carbamazepine therapy. Although the pain was alleviated to a certain degree, she visited our clinic to receive Kampo therapy. Judging from her facial injury in an accident thirty years ago, jidabokuippo was administered in addition to carbamazepine. The trigeminal neuralgia was then relieved, and Takagi's tender point in her abdomen was also reduced or disappeared. She could finally stop carbamazepine therapy. This case suggests that neuralgia patients with previous injury and Takagi's tender point can be treated with jidabokuippo.
ABSTRACT
A 47-year-old woman visited our clinic, and thereafter she had taken various Kampo medicines until she turned 58 years old. She took each medicine, containing 1-3.5 g/day of glycyrrhiza, for one or two months. Hypertension or edema was not observed in those days. From the age of 60, she took 7.5 g of tokishigyakukagoshuyushokyoto, containing 2 g of glycyrrhiza, day after day. Hypertension or edema was not observed for 35 months. However, when she was 63 years old, pseudoaldosteronism with headache, hypertension, edema,and hypopotassemia was observed for the first time. This case suggests that administration period or patient's age influences the development of pseudoaldosteronism.
ABSTRACT
Recently, basophil activation test (BAT) has been applied to the diagnosis of drug allergy. We performed BAT for various Kampo medicines taken by 12 cooperators to evaluate the concentration which arouse nonspecific reaction during incubation in BAT. When whole blood of each was incubated for 24 hours with each Kampo medicine, false positive results were frequently observed. After 1-hour incubation with Kampo medicine at high concentration (1/312.5), false positive results were sometimes observed. These results suggest that in the diagnosis of Kampo-medicine adverse reactions, BAT should be performed in the condition of 1-hour incubation with lower concentration (1/1250 or lower).
ABSTRACT
To diagnose liver injury related to Kampo medicine accurately is not easy. Lymphocyte transformation tests are likely to give a false positive for Kampo medicine. Diagnostic criteria with a scoring system provide low specificity for the diagnosis of Kampo-related liver injury. This article intends to outline the problems with diagnosing Kampo-induced hepatic injury, and to review previous studies to shed light on its incidence and clinical features. Kampo-related liver injury incidence was 0.1% or less, and that related to Scutellariae Radix was 0.5-1.0% in the literature. The symptoms, types, and recovery periods were similar to those for western drug-related liver injuries.
ABSTRACT
Incidence of glycyrrhiza-induced pseudoaldosteronism is not well understood. We examined relationships between pseudoaldosteronism incidence and daily glycyrrhiza dose in previous clinical studies. The incidence in patients administered glycyrrhiza 1 g/day was 1.0% (mean). The incidence with 2 g/day, 4 g/day and 6 g/day were 1.7% (mean), 3.3% and 11.1% (mean), respectively. Thus a dose-dependent trend toward pseudoaldosteronism incidence was suggested by previous literature.
ABSTRACT
We consecutively enrolled all patients who visited our Kampo clinic from October 2004 to September 2008, and examined whether or not milk drinking causes abdominal fullness, pain or diarrhea in the patients. Among 3,175 patients enrolled, 35 patients (1.1%) complained of symptoms of milk intolerance. Granulated Kampo extracts containing lactose were administered to 20 patients among the 35 patients, but these Kampo extracts did not cause symptoms of lactose intolerance in 13 patients among the 20 patients. The true incidence of lactose intolerance caused by granulated Kampo extracts may be smaller than 1% at most.
ABSTRACT
Two theories have been suggested for the etiology of pseudo-aldosteronism with Glycyrrhizae radix intake : 1) Differing sensitivities to Glycyrrhizae radix between patients, 2) Differing daily Glycyrrhizae radix dosages between patients.We treated two patients who were relieved of their pseudo-aldosteronism, through a reduction in their daily Glycyrrhizae radix dosage. These cases suggest that Glycyrrhizae radix intake, rather than individual metabolic differences, influences the development of pseudo-aldosteronism.
Subject(s)
Hyperaldosteronism , Human DevelopmentABSTRACT
The relationship between feces shape and patient age was examined, in one hundred patients with chronic constipation. The scybalum-like feces group was significantly younger than the thick feces group. Kampo's theories about the relationship between feces shape and age should be re-examined.
ABSTRACT
We present a case of prolonged post-herpetic neuralgia (PHN), successfully treated by Uyaku-junki-san-ryo. A 76-year-old woman was referred for PHN for 5 months. Her pain was confined to the area of the maxillary nerve, and waving smart pains trouble her greatly, all day long. The stellate block or the administration of carbamazepine did not avail against her pain at a nearby hospital. She visited our hospital on ******, the degree of her pain was expressed as 7.0cm/10.0cm in visual analogue scale (VAS). We utilized Uyaku-junki-san-ryo three times a day. The therapy of Uyaku junki-san-ryo resulted in the improvement of her pain, as well as the increase of her quality of life (QOL). Additionally, her VAS score was diminished from 7cm to 2cm, after two months.<br>This case demonstrates that Uyaku-junki-san-ryo may be a useful agent for the treatment of PHN.
ABSTRACT
Using textbooks of Western medicine and Kampo medicine in Japan, we examined descriptions in classification and laxative therapy of chronic functional constipation. In terms of the relationship between stool shape and patient's age, description in Kampo textbooks was contrary to that in the textbook of Western medicine. The opinions on the long-term use of rhubarb also divided between Western medicine and Kampo medicine, although in Kampo medicine there was some opinion that the long-term use should be discouraged.
ABSTRACT
We assessed the understanding of Japanese Oriental Medicine, as well as the connection between General Medicine and Japanese Oriental Medicine, among medical students, to improve the effectiveness of clinical practice and lectures. The questionnaires were sent to fifth-year medical students (n=66), and the responses were collected anonymously. Although 22.4% of the responding students were “very” interested in Japanese Oriental Medicine and 68.7% were “slightly” interested, the students who understood Japanese Oriental Medicine even “slightly”comprised only 23.9%. The majority of students considered that the system of Japanese Oriental Medicine was most useful in combination with Western Medicine for practicing General Medicine. Nine (60%) of 15 students who understood Japanese Oriental Medicine considered that the system of Japanese Oriental Medicine was most useful for practicing general medicine. In contrast, among students who did not understand Japanese Oriental Medicine, only 8 of 42 (19%) showed the same response. Similarly, more of the students who understood General Medicine showed this response than students who did not understand General Medicine.<br>These results permit us to speculate that medical students consider that understanding both General Medicine and Japanese Oriental Medicine might contribute to the development of a medical service.
ABSTRACT
We encountered a patient with chronic pain due to reflex sympathetic dystrophy (RSD) that was relieved by Uzu-keishi-to (Wu tou gui zhi tang) therapy. A 69-year-old man was diagnosed with RSD in 1995. Intractable pain of the extremities and trunk persisted despite several therapies such as spinal cord stimulation, local anesthetic blocks, and a variety of conventional medications. The patient was admitted to our hospital in June 2000, and was diagnosed as having stage II RSD. Thermography demonstrated that the left side of the back and the hand were lower in temperature than the corresponding areas of the right side. “Perfusion” images of three-phase bone scintigraphy showed a lower flow in the lower left extremity. Uzu-keishi-to was administered in addition to the Western medicines. After administration of Uzu-keishi-to, the pain was relieved and the value of the face scale decreased from 20 to 11. Moreover, after 16 weeks of Uzu-keishi-to therapy, the decreased blood flow on the left side of the body detected by thermography and three-phase bone scintigraphy increased to a level equal to that of the right side. Uzu-keishi-to is effective not only in reducing the intractable pain of RSD but also in preventing the development of “dystrophy.” Further evaluation of Uzu-keishi-to therapy for patients with RSD is warranted.
ABSTRACT
Repeated relapses of vomiting were treated with Bukuryo-takusha-to in a patient with resistant gastric ulcer. A 77-year-old woman, who had been admitted to our hospital due to manic disorder, presented tarry stool in February 1997. Gastrointestinal endscopy revealed an active gastric ulcer. The ulcer remained at the healing stage even after three years of treatment with H<sub>2</sub> receptor antagonist or proton pump inhibitor. She developed vomiting attacks in February 1998; thereafter, these vomiting episodes recurred repeatedly. During one three-day episode, she vomited the contents of breakfast every evening. Therefore, we regarded this attack as “ihon” from the view of Kampo diagnosis. After the administration of Bukuryo-takusha-to, the vomiting attacks disappeared within a day. The gastric ulcer then reached the scarring stage. In this patient, Bukuryo-takusha-to might have been effective in treating the resistant gastric ulcer as well as the recurring vomiting attacks.
ABSTRACT
We treated two patients with rheumatoid arthritis (RA) who demonstrated different signs from the perspective of traditional medicine. The first case was a 73-year-old woman. In 1977, she consulted a nearby hospital due to bilateral knee joint pain. Her condition was diagnosed as RA. In 1984, she consulted our department for Stage IV and Class III disease. She was treated with Keishi-ni-eppi-itto-ka-ryojutsubu-kagen, and her condition stabilized. In 1994, she received total replacement of the bilateral knee joints. Her ADL increased, but pain at her bilateral wrist, elbow, shoulder and ankle joints persisted. Although she was treated with Yokuininto, as well as bucillamine and salazosulfapyridine, arthralgia persisted. In 1996, her condition was as follows: general malaise, pain at the bilateral shoulder and elbow joints, severe deformity at the wrist joints, dry skin and slender limbs. She walked with a cane. Therefore, we changed the formula from Keishi-shakuyaku-chimoto to Daibofu-to. Thereafter, her symptoms significantly decreased. The second case was a 50-year-old woman. In 1994, she suffered from pain in the right hand, bilateral feet and knee joints. Her condition was diagnosed as RA at a local hospital. In 1996, polyarthralgia increased and she consulted the department of orthopaedic surgery in our hospital. She was administrated bucillamine, but it was discontinued due to eruptions. Then she consulted our department. She was first treated with Keishi-ni-eppi-itto-ka-ryojutsubu, and then with Yokuininto, which did not change her symptoms. Therefore, we tried several DMARDs; however, her condition worsened. In June 2000, her laboratory data were as follows: RF 860U/ml, ESR 72mm/hr, CRP 4.0mg/dl. Although she complained of pain at the bilateral wrist, elbow and ankle joints, there was no deformity in the bilateral wrist or finger joints of either hand. She was a medium-sized person, and without dry skin or edema at the limbs. The administration of Daibofu-to improved her symptoms as well as laboratory data after 3 months of treatment.<br>The clinical signs of case 1 were in accordance with the traditional indications for Daibofu-to. In contrast, those of case 2 differed from these indications with regard to blood-deficiency, since there was no dry skin, change in the nail, dizziness or deformity of the joints. These observations suggest that a subset of patients with RA, who have poor deficiency of blood or Ki, may be another population that can be successfully treated with Daibofu-to.
ABSTRACT
We performed a preliminary study of the reliability of the lymphocyte stimulating test (LST) for Kampo medicine. LST for three kinds of Kampo medicines was performed in both a Kampo-administrated group and a non-administrated group. LST for each of the medicines was negative for seven of eight subjects in the non-administrated group, but was negative for four of 11 subjects in the Kampo-administrated group. The LST-positive participants had no allergic state, and some among them were negative in challenge test. This preliminary study suggests that LST for Kampo medicine is likely to be false-positive.
ABSTRACT
We report on two cases of relapsing aspiration pneumonia caused by dysphagia due to cerebrovascular disease. Sei-hai-to (Qing Fei tang) offered useful palliation in both cases. Case 1 was an 83-year-old-woman who was hospitalized for multiple lacunar infarction and lumbago in 1996. She gradually became bedridden within two years of the admission period. She was admitted to a long-term care hospital affiliated with our department in January 1998. Dysphagia and productive cough appeared in May, and enteral tube feeding was started after she developed pneumonia in August. Pneumonia persisted against some antibiotics, and feverish periods ranged from 8 to 18 days a month. CRP values were elevated to more than 5mg/dl. Administration of Sei-hai-to provided negative CRP values and decreased feverish periods to 0-2 days a month. Case 2 was a 93-year-old-man who suffered from cerebral bleeding in the right thalamus in 1984. He developed many attacks of aspiration pneumonia after starting oral feeding. He was admitted to a long-term care hospital affiliated with our department in April 1999. Sputum culture yielded <i>P. aeruginosa</i> and MRSA. Moreover, fluoroscopy showed aspiration into the lower airway. Aspiration pneumonia relapsed continually without antibiotics. Administration of both Sei-hai-to and clarithromycin decreased feverish periods and provided negative CRP values. Pneumonia relapsed easily either with Sei-hai-to therapy alone or Clarithromycin therapy alone.