Analysis of Related Factors that Make Daikenchuto Useful for Constipation During Pregnancy / 日本東洋医学雑誌

The purpose of this study is to clarify factors related to the effect of daikenchuto on constipation during pregnancy. The subjects were 21 patients who had constipation during pregnancy and received 15 g/day of daikenchuto. Based on the constipation score that was created independently, the score values before administration, 2 weeks and 4 weeks after administration were retrospectively investigated. Furthermore, from the outcome of the oral status at 4 weeks, we divided the patients into 2 groups (12 in the improvement group and 11 in the non-improvement group), and attempted to extract factors that were considered to be related to efficacy. The total constipation score decreased significantly before and after administration of daikenchuto, and the concomitant symptoms of constipation scores were low, especially such as abdominal distension and abdominal pain. A comparison of the backgrounds of the improved group and the non-improved group revealed that the proportion of the patients with a history of surgery (laparotomy or laparoscopic surgery) was significantly higher in the improvement group. In addition, there were no particular problems with the pregnancy and delivery course of the 23 patients. Daikenchuto was considered to be highly effective against constipation during pregnancy, especially in pregnant women with a history of surgery.

Significance of Combined Use of Kamishoyosan and Tokishakuyakusan for General Infertility Treatment / 日本東洋医学雑誌

We aimed to clarify the significance of using Kampo therapy centered on kamishoyosan and tokishakuyakusan together with general infertility treatment. The subjects were 41 women who visited a Kampo outpatient clinic for infertility and received general infertility treatment with Kampo therapy (Kampo group). The control group was 781 women who received only general infertility treatment at the same time (non-Kampo group). In comparing both groups, we conducted a retrospective survey on the pregnancy rate by cycle and the pregnancy rate by prescription. The pregnancy rate in the first cycle was 24.4% in the Kampo group and 8.5% in the non-Kampo group, and the pregnancy rate was higher in the Kampo group (P = 0.003). There was no difference in pregnancy rates after the second cycle. The pregnancy rate by prescription was 26.7% for kamishoyosan, 22.2% for tokishakuyakusan, and 8.5% for the non-Kampo group. In the comparison between the first cycle pregnant group and the non-pregnant group, the qi counter flow score was clearly higher in the first cycle pregnant group (P = 0.012). It is suggested that combined use of Kampo therapy including kamishoyosan and tokishakuyakusan may be effective from an early stage. Meanwhile, if pregnancy does not occur even after the combined use of Kamp therapy, it would be an opportunity to consider stepping up as Western medical therapy.

A Case of Secondary Amenorrhea with Polycystic Ovary Syndrome Successfully Treated with Shokenchuto / 日本東洋医学雑誌

Here, we report a case of adolescent woman with secondary amenorrhea complicated with polycystic ovary syndrome, which had a normal menstrual period after prescribed shokenchuto under the therapy based on Kampo diagnosis. The case is 14-year-old woman, who had already hormonal therapy due to the secondary amenorrhea, and was difficult to treat because of edema and weight gain. Secondary amenorrhea, multiple cysts in the ovary, and hypertestosteroneemia were confirmed, and the patient was diagnosed with polycystic ovary syndrome. Abdominal pattern was weak and the abnormalities of the abdominal strength were prominent. Therefore, we administered her shokenchuto. After two weeks, menstruation began, and thereafter the menstruation had progressed without any irregularities. Blood examination also showed normal testosterone level. It was suggested that it would be important to focus on the preparation for digestive function and to treat the secondary amenorrhea of adolescent women.

<b>Rikkunshito Improves the Nausea, Vomiting and Anorexia Induced with the Hyperemesis G</b><b>ravidarum</b> / 日本東洋医学雑誌

<p>The aim of this study is to retrospectively examine the efficacy of rikkunshito in comparison with shohangekabukuryoto and metoclopramide, administered to patients with hyperemesis gravidarum, using with the emesis index (EI) proposed by Kitagawa, et al. Total EI score for all groups was decreased with the passage of time, although EI in the rikkunshito group at day 7 was significantly lower than that of the other shohangekabukuryoto and metoclopramide groups. All nausea, vomiting and anorexia, scores were significantly lower in the rikkunshito group. These results suggest that rikkunshito is as effective in hyperemesis gravidarum as shohangekabukuryoto and metoclopramide are, and more effective for the gastrointestinal symptoms of nausea and vomiting, anorexia. The group in which rikkunshito was ineffective tended have a higher <i>qi </i>counterflow score, thus treatment modifications with <i>qi </i>circulating medicine would be required in accordance with <i>sho </i>patterns.</p>

<b>Study on Six Cases of Infertile Women with Clomiphene-Resistant </b><b>Polycystic Ovary Syndrome Successfully Treated </b><b>with Concomitant Saireito Therapy </b> / 日本東洋医学雑誌

Polycystic ovary syndrome (PCOS) occurs in 5 to 8% of females of reproductive age and is one of the leading causes of menstrual abnormalities and infertility. The treatment of PCOS varies, depending on the patient's age and background, particularly on the presence/absence of a desire to have children. In those desiring to have children, clomiphene therapy is the first-line treatment for PCOS. However, the anti-estrogen action of clomiphene may lead to a thinning of the endometrium and decreased cervical mucus production, while some patients show a poor response to the agent. In this study, saireito was administered to clomiphene-resistant PCOS patients, and the ovulation cycle improved in 6. Effective cases of saireito tended to have higher <i>oketsu </i>(blood stagnation) and <i>suitai </i>(water stagnation) statescores before treatment, also serum LH levels and LH/FSH ratios were lower due to the concurrent saireito medication. Furthermore, these effective cases had lower levels of serum testosterone than the non-effective and clomiphene-effective cases. This clinical report suggests the appropriateness of performing this therapy in accordance with <i>sho </i>(oriental patterns or symptoms), before second-line treatments such as gonadotropin therapy or laparoscopic surgery.

Clinical Investigation toward the Relationship between Habitual Bathing and Clinical Health Course during the Pregnancy, Based on the Questionaire Survey / 日本温泉気候物理医学会雑誌

  Habitual bathing varies greatly depending on the country and culture, showering style spreads in recent years in accordance with the age. So we investigate the habitual bathing of modern maternity and the effect of perinatal course.<BR>  An unidentified questionnaire was distributed toward the 204 puerperal women, who were delivered in Shizuoka Kosei hospital from April in 2011 to February in 2012. Questinaire consists of multiple-choice selection and free writing about the habitual and balneum bathing. By way of the combination between these results and the maternal events, we investigated the relationship of them. <BR>  The 204 puerperal women were divided into 99 primipara, 76 unipara and 29 multipara, who underwent the 12 threatened abortion, 35 threatened preterm delivery, 15 preterm delivery, 7 pregnancy induced hypertension (PIH), and 10 weak labor and 26 preterm rupture of the membrane. On the other hand, all the puerperal women had the habitual bathing every day, 38 of puerperal women (35%) had the style of showering every day, 45 of them had the style of bathing from 1 to 3 times a week, and 121 of them had the style of bathing for over 4 times a week. As compared with their distribution, there was the tendency that PIH was increased in the bathing group, otherwise the weak pains was increased in the showering group.<BR>  There is a little evidence how the habitual bathing depends on the factor and promotion of bacterial vaginosis, the style of bathing could encourage the cleanliness and maintain the vaginal flora through the puerperal course in this clinical survey.

Clinical Investigation toward the Relationship between Habitual Bathing and Clinical Health Course during the Pregnancy, Based on the Questionaire Survey / 日本温泉気候物理医学会雑誌

  Habitual bathing varies greatly depending on the country and culture, showering style spreads in recent years in accordance with the age. So we investigate the habitual bathing of modern maternity and the effect of perinatal course.   An unidentified questionnaire was distributed toward the 204 puerperal women, who were delivered in Shizuoka Kosei hospital from April in 2011 to February in 2012. Questinaire consists of multiple-choice selection and free writing about the habitual and balneum bathing. By way of the combination between these results and the maternal events, we investigated the relationship of them.   The 204 puerperal women were divided into 99 primipara, 76 unipara and 29 multipara, who underwent the 12 threatened abortion, 35 threatened preterm delivery, 15 preterm delivery, 7 pregnancy induced hypertension (PIH), and 10 weak labor and 26 preterm rupture of the membrane. On the other hand, all the puerperal women had the habitual bathing every day, 38 of puerperal women (35%) had the style of showering every day, 45 of them had the style of bathing from 1 to 3 times a week, and 121 of them had the style of bathing for over 4 times a week. As compared with their distribution, there was the tendency that PIH was increased in the bathing group, otherwise the weak pains was increased in the showering group.   There is a little evidence how the habitual bathing depends on the factor and promotion of bacterial vaginosis, the style of bathing could encourage the cleanliness and maintain the vaginal flora through the puerperal course in this clinical survey.

A Case of Intestinal Adhesive Ileus, Successfully Treated with Daikenchuto during Pregnancy and Post Cesarean Section / 日本東洋医学雑誌

We report a clinical case of adhesive ileus that was treated with daikenchuto during pregnancy, and post cesarean section. A 29-year woman, who had undergone a laparotomy for small intestinal volvulus at the age of 15, was referred to our hospital for abdominal distention at11weeks gestation. Her severe abdominal distention led to the intestinal adhesive ileus finding. After treatment with daikenchuto, she had mass diarrhea while the abdominal symptoms disappeared. Afterwards, the prenatal course was uneventful. Spontaneous labor began at 36 weeks gestation. Under the indication of fetal distress, an emergent cesarean section was performed. There was widespread adhesion between the small intestine and abdominal wall. On post operative day 4, nausea and vomiting increased. Daikenchuto was orally administered with the diagnosis of recurrent adhesive ileus. On day 6, flatus and soft stool were passed. On day 9, oral food ingestion was begun. Her post operative course was uneventful beyond this, and she was discharged on day 25. Recently, clinical reports of adhesive ileus during pregnancy have been increasing as average maternal ages rise. Adhesive ileus during pregnancy tends to be critical for mothers and babies, so a surgical procedure is necessary in many cases. This report suggests the usefulness of daikenchuto for adhesive ileus during the perinatal period.