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1.
Kampo Medicine ; : 175-179, 2023.
Article in Japanese | WPRIM | ID: wpr-1007187

ABSTRACT

To clarify the educational effect of the acupuncture and moxibustion practical training for a short time, we conducted a questionnaire survey of 112 fifth-year medical students gathering clinical experience for one hour of acupuncture and moxibustion practical training, including the therapeutic experience before and after the practical training. In 8 items out of 10, the percentage of “positively yes” responses after the practical training were significantly higher than before the practical training. The items that showed a large difference (range of change) in the percentage of “positively yes” responses before and after the practical training were “Do you think it is scientific? (+ 47.4% after the practical training),” “What is your general image? (+ 39.3%),” and “Do you want to use acupuncture and moxibustion in the future? (+ 39.3%).” Securing more opportunities to learn traditional medicine is desirable; however, the problem of limited time and personnel requires improvement. This survey showed a beneficial educational effect in a short time signifying the importance of implementing acupuncture and moxibustion practical training. Additionally, the possibility of expecting similar effects in other medical students and overall students in the medical field can also be expected.

2.
Journal of the Japan Society of Acupuncture and Moxibustion ; : 112-120, 2023.
Article in Japanese | WPRIM | ID: wpr-1007111

ABSTRACT

Tongue diagnosis in Kampo medicine is considered to be a diagnostic method that can provide information about a patient's constitution and medical condition. We have identified the following problems in tongue diagnosis: the influence of external environmental factors such as light source, room temperature, and dryness, as well as subjective factors that depend on the knowledge and experience of medical doctors. To overcome these problems and to support Kampo diagnosis, we developed the Tongue Image Analyzing System (TIAS). Regarding color, objective numerical values L*a*b* were measured and standardization and objectification were promoted. We introduce some of the progress that has been made over the past 15 years since the development of TIAS.

3.
Kampo Medicine ; : 247-262, 2022.
Article in Japanese | WPRIM | ID: wpr-986299

ABSTRACT

At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program, “Pre-graduation and post-graduation Kampo medical education for the next generation,” focusing on Kampo medical education. We summarize and report a mock lecture on standard Kampo medicine conducted jointly with the Japan Council for Kampo Medical Education (JCKME) for the purpose of faculty development. The lecture contents were based on the “Basic Curriculum for Pre-Graduate Education in Kampo Medicine 2016” established by the JCKME, and the common model slides prepared by the JCKME were used. The lectures were pre-recorded for 240 minutes on the “History of Kampo medicine,” “basic theory of Kampo medicine,” “physical examination of Kampo medicine,” “composition and effects of typical Kampo medicines, effects and side effects of typical herbal medicines,” “usefulness of Kampo and clinical cases that were effective,” and “overview of acupuncture and moxibustion treatment,” and were delivered from seven days before to seven days after the annual meeting. This was the first nationwide educational activity for the general meeting of the society. These lectures were viewed 1,017 times nationwide, by medical students, educators, and members of the society.

4.
Kampo Medicine ; : 220-227, 2022.
Article in Japanese | WPRIM | ID: wpr-986298

ABSTRACT

In this article, we focus on Japanese traditional (Kampo) medicine for the 1889 “Russian flu (Osome cold)”. The influenza pandemic arrived in Japan in 1890 (Meiji 23), and returned in waves over the next several years. The Kampo medicine at that time is described in “Ryukokanbo Setsu (Influenza Editorial)” by Sohaku Asada and “Tenkojikikanbo Zeisetsu (Epidemic Disorder Editorial)” by Masaharu Okada, in “Wakan Irin Shinshi (New Journal of Japanese-Chinese traditional medicine)”. There are prescriptions in “Shang Han Lun (Treatise on Cold Damage Diseases)” for both daiseiryuto and keishinieppito, as well as for formulas of Gosei School, such as gekito, saikogedokuto, shoyosankato, kyushikososan, wageto, jusshinto and kososan. As candidates to cause this pandemic, both the novel influenzavirus-H3 and the novel coronavirus-OC43 are considered. In contrast to Western medicine, which must deal with each virus, Kampo medicine was as effective for the Russian flu, as it was for the Spanish flu.

5.
Kampo Medicine ; : 214-219, 2022.
Article in Japanese | WPRIM | ID: wpr-986297

ABSTRACT

In response to the increasing numbers of patients with long-term effects of coronavirus disease 2019 (COVID-19), we started using Kampo (traditional Japanese) medicine for some outpatients. We analyzed the patients' characteristics and the treatments used in each case. Our subjects were 9 patients who visited our clinic between May and September 2021. All subjects provided their written informed consent and were followed for several months. Decoctions or extract formulations were prescribed for treatment based on pattern identification, and general guidance related to lifestyle habits based on traditional thought was also provided. Fatigue, lifestyle of intemperance (due to excessive amounts of cold foods and drinks), and mental/physical stress were present in each patient. Some patients also felt strong anxiety about the lack of any established Western medical treatment and insufficient follow-up systems for patients with long-term effects of COVID-19 (long COVID). Tonic formulas and formulas of involving Bupleuri radix were often used. All 9 patients showed a tendency to improve their symptoms within 4 or 5 weeks of treatment. Our impression is that the prompt effect of Kampo medicine was achieved by combining the use of Kampo medicines with instructions to stop eating excessive amounts of cold foods and/or drinks. Further study is needed in the future. For long COVID, no Western medical treatment has yet been established. On the other hand, in our experience with these patients, Kampo medicine based on the concept of mind-body unity was useful.

6.
Kampo Medicine ; : 146-175, 2022.
Article in Japanese | WPRIM | ID: wpr-986288

ABSTRACT

The usage of Kampo medicine has been expanding in hospitals and pharmacies, and the systematic education on Kampo medicines and their components is urgently needed. Although the efficacies of Kampo formulations are approved at the national level, those of the composing crude drugs are not approved individually except for some cases. Consequently, the efficacy description of individual crude drug in textbooks differs much depending on the authors. To clarify this situation, we suggested the standardized description of the efficacy of crude drugs used in ethical Kampo formulation using terms of modern Western medicine in the previous study. In this study, we reviewed the descriptions of efficacies using the terms of Kampo medicine in the books published in Japan from the 17 century to the present to explore the possibility of standardizing the crude drug efficacies using the terms of Kampo medicine. The proposal for standardized description of the efficacy of crude drugs was based on the high frequency of appearance of the terms in successive books.

7.
Kampo Medicine ; : 137-145, 2022.
Article in Japanese | WPRIM | ID: wpr-986287

ABSTRACT

There are few reports on the effects for children using the diagnostic method of Kampo medicine (called sho : pattern diagnosis). Therefore, we investigated the effects of combination therapy with Kampo medicines prescribed by specialists in this ancient form of medicine to children who were refractory to modern medicine. This was a retrospective observational study of 98 children (pre-school children (PS ; n = 21), elementary school students (ES ; n = 37) and junior high school students (JS ; n = 40)) younger than 16 years old at the first visit to our department of Chiba University hospital between April 2007 and April 2017. We collected the following information from their medical records : background, chief complaint, referral source, and efficacy of Kampo medicines. We evaluated efficacy for Kampo medicine as follows : Higher improvement (HI) (symptoms improved by 2/3 or more) ; Improvement (I) (symptoms improved by 1/3-2/3) ; Mild improvement (MI) (symptoms improved by 1/3 or less) ; constant ; aggravated ; and unknown or first visit only. Positive response (HI, I, and MI) due to Kampo medicines was observed in 76% (75/98) of patients. No aggravations were observed. The chief complaint by age was skin diseases in PS, digestive diseases in ES, and cardiovascular diseases in JS. Pediatrics was the primary referral in all ages, while 30% of JS were referred from psychiatry. Kampo medicine was significantly more effective for those in PS and ES compared to those in JS (p = 0.025). Combined use of Kampo medicine and modern medicine therapy is useful for children refractory to modern medicine.

8.
Kampo Medicine ; : 117-125, 2022.
Article in Japanese | WPRIM | ID: wpr-986285

ABSTRACT

The Japan Society for Oriental Medicine (JSOM) has made various efforts against coronavirus disease (COVID-19) to build evidence. JSOM has launched an academic society-led clinical research project on COVID-19 based on the concept and characteristics of Kampo medicine, including (1) prevention of disease by activating the immune system to regulate body conditions (pre-symptomatic stage of illness), (2) symptom alleviation in the mild and moderate stage and prevention of aggravation (acute to subacute stage of illness), and (3) early recovery and improvement of prolonged symptoms (late stage of illness). Since the declaration of the pandemic, the special working group has conducted the following activities : enlightening academic members, lobbying other academic societies, preparing research protocols, establishing research groups, conducting ethical reviews, responding to the research disclosure system, preparing protocol papers and review articles as the basis for the research, reporting research progress, soliciting case reports, warning against Chinese medicine use, requesting for research support funding, and revising the JSOM website. We also discuss the interpretation of COVID-19 from the perspective of Kampo medicine and the direction of the selection of Kampo formulas in this report.

9.
Kampo Medicine ; : 420-451, 2021.
Article in Japanese | WPRIM | ID: wpr-966031

ABSTRACT

Japanese traditional (Kampo) medicine saved many lives during the Spanish influenza pandemic of 1918-­20. In Japan, acute viral respiratory infections represented by influenza have been called shokan (cold damage), and so on since ancient times. These infections were treated by prescriptions that were adopted from Chinese classical texts including “Shanghan lun (Treatise on Cold Damage Diseases),” “Xiaopin fāng (Prescriptions of Sketch),” “Tai ping hui min he jì ju fang (Formulary of the Bureau of Taiping People's Welfare Pharmacy),” and “Wan bing hui chun (Restoration of Health from Myriad Diseases).” Additional materials include (but are not limited to) “Ishimpo (Prescriptions of Medical Sprit),” “Ton-­i-­sho (Abstract of Medical Enlightenment),” and the diaries of some Muromachi aristocrats. In the Edo period (1603-1868), treatment with Kampo medi­cines developed uniquely in Japan, but due to medical and economic disparities, many patients could not be treated by Kampo experts. Ephedra herb, a key drug for treating shokan (cold damage), has shown major problems in terms of quality, because it has been confused with plants of the genus horsetail since at least the 8 th century ; its medicinal effects may therefore have been underestimated. The effectiveness of Kampo medicine against the novel influenza/coronavirus pandemic is anticipated, however, in order to fully exploit its potential, it is important that physicians with sufficient knowledge of Kampo should use Kampo medications properly.

10.
Kampo Medicine ; : 402-414, 2021.
Article in Japanese | WPRIM | ID: wpr-966029

ABSTRACT

Following the Chinese-led global standardization of Chinese medicine, the 9 th edition of the European Pharmacopoeia, published in 2016, listed 66 kinds of crude drugs that are used in traditional Chinese medicine. By the spread of dietary supplements in the United States, the number of herbal medicines listed in United States Pharmacopoeia is tended to be increasing. In this article, we compare the names and origins of crude drugs listed in the European and American Pharmacopoeias and used in ethical Kampo extract formulation with those described in the pharmacopoeias of Japan, China, Taiwan, and South Korea. There were 4 crude drugs that had the same origins and names in the pharmacopoeia of these 6 countries, but only Coix Seed had the same English name. The pharmacopoeia of the 5 countries except the United States had 19 crude drugs with the same origin, but only Platycodon Root and Eucommia Bark had the same English and Latin names. For other crude drugs, the names and origins in the pharmacopoeia of each country were different. When scientists in each country disseminate the information about crude drugs used in their own countries to the world, it is necessary for them to describe the original plant scientific names and their medicinal parts that are unified by International Code of Nomenclature for plants instead of English or Latin names of crude drugs.

11.
Kampo Medicine ; : 107-118, 2021.
Article in Japanese | WPRIM | ID: wpr-936737

ABSTRACT

Although the descriptions of shigyakukachotanto in “Waitaimiyaofang” and tsumyakushigyakukachotanjuto in “Songban Shanghanlun” are quite similar to each other, the specifications of the dosages of crude drugs and the water volume in the books were considerably different. Focused on the specified water volume to decoct these formulas, each reasonable decocting period was estimated, then the decoctions were prepared using hard water that was common in mainland China. The dosages of aconite root were 2­-fold different between these two formulas, but the contents of aconitine-­type diester alkaloids (ADA) in both decoctions were found in the range of 1.2—1.4­-fold. It was suggested that in order to control the efficacy and the safety of aconite, the decocting period was well regulated by the specification of water volume for decocting at this ancient era. Moreover, the dosages of aconite root and glycyrrhiza in bukuryoshigyakuto (BSGT) formula of “Songban Shanghanlun” are equal to those of shigyakuto (SGT) but the specified water volume to begin decocting is as about twice as that of SGT. When prepared using hard water, BSGT resulted to make the contents of ADA lower and those of non-­ester alkaloids higher compared with those of SGT decoction. It was suggested the spe­cific water volume for each formula prescribed in classical Chinese medicine had considerable significance to determine the dosages of chemical ingredients in the decoctions especially in the circumstances using hard water to prepare them.

12.
Kampo Medicine ; : 315-325, 2020.
Article in Japanese | WPRIM | ID: wpr-924507

ABSTRACT

We have previously reported on a predictive model for deficiency-excess pattern diagnosis that was unable to predict the medium pattern. In this study, we aimed to develop predictive models for deficiency, medium,and excess pattern diagnosis, and to confirm whether cutoff values for diagnosis differed between the clinics. We collected data from patients' first visit to one of six Kampo clinics in Japan from January 2012 to February 2015. Exclusion criteria included unwillingness to participate in the study, missing data, duplicate data, under 20 years old, 20 or less subjective symptoms, and irrelevant patterns. In total, 1,068 participants were included. Participants were surveyed using a 153-item questionnaire. We constructed a predictive model for deficiency, medium, and excess pattern diagnosis using a random forest algorithm from training data, and extracted the most important items. We calculated predictive values for each participant by applying their data to the predictive model, and created receiver operating characteristic (ROC) curves with excess-medium and medium-deficiency patterns. Furthermore, we calculated the cutoff value for these patterns in each clinic using ROC curves, and compared them. Body mass index and blood pressure were the most important items. In all clinics, the cutoff values for diagnosis of excess-medium and medium-deficiency patterns was > 0.5 and < 0.5, respectively. We created a predictive model for deficiency, medium, and excess pattern diagnosis from the data of six Kampo clinics in Japan. The cutoff values for these patterns fell within a narrow range in the six clinics.

13.
Kampo Medicine ; : 284-295, 2020.
Article in Japanese | WPRIM | ID: wpr-887342

ABSTRACT

We are planning a study focused on the gathering of clinical data for the purpose of formalizing diagnostic logic at 6 institutions specialized in Kampo-based medical examinations. However, during the planning stage, it has been recognized that there are a large number of Kampo formulas to be studied, and differences among faculties and individuals exist regarding how to identify each Kampo formula, methods of gathering findings, and the evaluation of efficacy. Here we report the solution proposal reached after building consensus among all participating faculties on these issues. After raising the issues, conferences were held for each of them, until a unanimous consensus was obtained. As a result, the following conclusions were reached. Thirty-three Kampo formulas were selected as targets for the formalization of diagnostic logic. In addition, the range of dosage forms, crude drug ingredients, and permissible dosages for each Kampo formula were determined. Regarding clinical findings for these Kampo medicines, the items to be collected and evaluation criteria were also established. The criteria for evaluating the validity and safety of each Kampo medicine were decided, together with the grading and timing of evaluation. We hope that our solution proposal reached after building consensus becomes the basis for Kampo research in the future.

14.
Kampo Medicine ; : 185-192, 2020.
Article in Japanese | WPRIM | ID: wpr-887327

ABSTRACT

We conducted a fact­finding survey about the difficulties of handling the telephone consultations at a Kampo medicine outpatient clinic. We extracted the details of consultations that could not be handled by an outpatient nurse alone from the descriptive data of the telephone responses described by the nurses in the sur­vey. We, then, identified the factors that were involved in the difficulties encountered in these consultations, and countermeasures were established and implemented. One year later, we compared and examined the status of telephone consultations between before and after the fact-­finding survey. We classified the telephone con­sultations that were difficult for the outpatient nurses to handle alone into four categories : (1) consultation about a physical disorder, (2) questions about prescribed Kampo medicines, (3) reports and questions based on the patient's own judgment, and (4) questions about treatment and hospitalization. Some of the questions about Kampo medicines included the continued use of the medicine and drug interactions, and the main topics of the survey's nurse self-­judgment reports were dose reductions and changes in Kampo medicine regimens. As a re­sult of the introduction of guidelines prepared by the nurses together with physicians at the clinics, the outpa­tient nurses became able to handle telephone consultations about frequently asked questions (FAQs). At 1 year after the survey, the number of cases of difficulties in handling telephone consultations decreased to less than half the original value, and no telephone consultations were made within 1 week after the patients' first visits to the outpatient clinic.

15.
Kampo Medicine ; : 313-323, 2019.
Article in Japanese | WPRIM | ID: wpr-811038

ABSTRACT

We investigated the decocting time to prepare the formulas containing unprocessed aconite root, such as shigyakuto, tsumyaku shigyakuto, and kankyobushito, which had been registered in “Shanghanlun” edited in Song Dynasty, using the weights and measures in Houhan Dynasty when the original “Shanghanlun” was regarded to have been established. Also the contents of aconitine-type diester alkaloids (ADA) eluted from unprocessed aconite root in the decoction were analyzed in time-dependent manners. As regards the modified formula for the “physically strong patients” in the texts of tsumyakushigyakuto in “Shanghanlun”, adding dried ginger was found to lead the decocting time to be shorter and the sum of ADA content in the decoction of the modified formula to increase about 20%. It was also found that the compositions of diterpene alkaloids derived from aconite root in kankyobushito decoction were highly different from those in shigyakuto decoction, containing less ADA and more aconine and hypaconine, due to the high pH of the decoction, which was the consequence of lacking glycyrrhiza in kankyobushito formula. It is suggested that the doctors in the era of “Shanghanlun” establishment may have carefully adjusted the contents of ADA in the decoctions using unprocessed aconite root by choosing co-decocted crude drugs.

16.
Kampo Medicine ; : 167-174, 2019.
Article in Japanese | WPRIM | ID: wpr-781933

ABSTRACT

According to the World Health Organization (WHO), mortality by age, sex, and cause of death is the foun­dation of public health both globally and domestically. Comparable mortality statistics over time and investi­gations of mortality were used to develop the International Statistical Classification of Diseases and Related Health Problems (ICD). In the ICD, the WHO states that morbidity statistics are also an essential foundation of public health, but they are much less widely applied. The 10th revision of the ICD (ICD-10) is now in use, but further revisions must be made in the development of the 11th revision (ICD-11) to capture advances in health science and medical practice, to make better use of the digital revolution, and to evaluate traditional medicine (TM). Revision of ICD-10 began in 2007, and an ICD-11 version for preparing implementation was released on July 18, 2018. ICD-11 features a new TM chapter on Japanese traditional medicine, known as Kampo medicine, traditional Chinese medicine, and Korean medicine. ICD-11 will be approved at the next World Health Assembly in May 2019 and will come into effect. This means that the WHO does not currently recognize the effects of TM, but that we as well as the WHO will have hard time to prepare and study the effects of TM on morbidity statistics. It is very important to the study of Kampo medicine that we will be able to properly evaluate the terms and classifications contained in ICD-11.

17.
Kampo Medicine ; : 407-416, 2018.
Article in Japanese | WPRIM | ID: wpr-758210

ABSTRACT

The Koho school has a high regard for formulation corresponding to sho uniquely developed as a conspicuous feature of Kampo medicine, and Ruihobunrui (the classification of formulae based on the main crude drug : CF) has played an important role in structuring the foundation of this development in the Koho school. CF is a classification method used to express the adaptation and characteristics of formulae in the Koho school, and is useful for research on drug compositions. Therefore, CF can be used effectively in both clinical practice and education. CF has shown little development in China after the appearance of Xu Ling Tai ; however, in Japan the development of CF centered on such influential figures as Todo Yoshimasu of the Koho school, and Naohiro Kitamura of the Kosho school. Kenzo Okuda and Keisetsu Otsuka used CF for clinical practice and education during the revival stage of Kampo medicine in the Showa era ; moreover, CF had a large effect on structuring the foundation of clinical application by formulating Kampo extracts for prescriptions. Thus, CF has played an important role in Kampo medicine. However, the research has been stopped in the present circumstances of Japan. We focus here on CF of the Koho school in Edo and Showa eras, and carried out considerations of CF to establish one of the characteristics of Kampo medicine that places importance on Shang Han Za Bing Lun.

18.
Kampo Medicine ; : 336-345, 2018.
Article in Japanese | WPRIM | ID: wpr-758199

ABSTRACT

The decoctions of unprocessed aconite root (uzu) were prepared with the tap water samples collected in Tianjin and Shanghai in China, and the contents of alkaloids in the decoctions were compared to those prepared with purified water or with tap water collected in Niigata, Japan. The contents of aconitine-type diester alkaloids (ADA) in the decoctions prepared with tap water collected in China were significantly lower than those with purified water or tap water in Niigata. It was speculated that this difference appeared by buffering effect of bicarbonic anion in tap water in China to decline pH of the decoction. When uzu was decocted with glycyrrhiza, ginger, or jujube, the contents of ADA in the decoctions exhibited the tendency to have higher levels than those prepared using unprocessed aconite root singly, and also this tendency was observed more remarkably when the decoctions were prepared with tap water collected in China. It was suggested that even the decocting period was fixed, unexpected change of the contents of ADAs might be induced by the differences in the properties of water used for decoction or the crude drugs decocted with aconite root. The physicians in the era when “Songban Shanghanlun” had established may have adjusted the contents of ADA in the decoction by carefully choosing the crude drugs combined to aconite root.

19.
Kampo Medicine ; : 328-335, 2018.
Article in Japanese | WPRIM | ID: wpr-758198

ABSTRACT

We investigated the number of drugs and pharmaceutical cost among 159 patients prescribed Western medicine and hospitalized from August 2006 to August 2015 in the Department of Oriental (Kampo) Medicine at Chiba University Hospital. The number of drugs used in Western medicine among improved patients significantly decreased from 5.6 ± 3.6 at hospitalization to 5.3 ± 3.5 at discharge, but the number of Kampo medicine drugs was not changed. The total number of drugs including both Western medicine and Kampo medicine significantly decreased from 7.0 ± 3.8 to 6.7 ± 3.6. The number of drugs used in Western medicine among nochanged patients decreased from 5.1 ± 3.4 at hospitalization to 5.0 ± 3.7 at discharge, but the number of Kampo medicine drugs significantly increased from 1.0 ± 0.0 at hospitalization to 1.3 ± 0.5. The total number of drugs including both Western medicine and Kampo medicine increased from 6.1 ± 3.4 to 6.3 ± 3.9. We thus conclude that a combination of Kampo medicine with Western medicine can be useful for reducing the number of drugs related to polypharmacy. To achieve these results, it is essential to use the concept of sho (a way of pattern recognition of a patient's symptoms in Kampo medicine).

20.
Kampo Medicine ; : 82-90, 2018.
Article in Japanese | WPRIM | ID: wpr-689005

ABSTRACT

We have developed and operated a browser-based questionnaire system for Kampo medicine based on conventional questionnaires and review of systems to reveal implicit Kampo wisdom both in patients' questionnaire data and in some Kampo specialists' examination data. However, the questionnaire data were found to be inaccurate because too many questions were included and cumbersome input steps were required. The purpose of the present study was to solve these problems and to develop a new patient-centered questionnaire system with fewer questions and an easier input method. After analyzing inquiry database from collaborating institutes and hospitals, we deleted, combined, and added questions. We changed the evaluation method of symptoms from a visual analogue scale to a simple staged evaluation, and introduced another method to evaluate the main symptoms in each time of visit using a visual analogue scale. At the same time, a tool for predicting Kampo pattern diagnoses based on the questionnaire data was implemented. We have already started collecting more accurate and reliable data using the new questionnaire system. It is expected to support routine practices and facilitate more precise clinical research on Kampo medicine.

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