ABSTRACT
Vogt-Koyanagi-Harada (VKH) disease is the second most common uveitis in Japan. This is considered an autoimmune disease as the immune system attacks self-melanocytes, and it is characterized by neurological, auditory, and dermatological symptoms in addition to panuveitis. Standard treatment is systemic steroid mass therapy. Also, an inadequate amount of corticosteroid can cause the disease recur or become protracted.<br>Here, we report a case of new-onset VKH disease successfully treated with a combination of ryutanshakanto prepared at Ikkando and goreisan, without any corticosteroids, in a hepatitis B virus carrier.<br>The patient was a 40-year-old male. He visited an eye clinic with bilateral blurred vision, and was diagnosed with bilateral maculopathy at this clinic. He was then referred to our hospital. We diagnosed him with VKH disease and, in accordance with (traditional Japanese) Kampo medicine, also with dampness-heat (shitsunetsu) of the foot's liver meridian with reverting yin (<i>ashi-ketchin-kankei</i>), mild water retention (<i>suitai</i>) and blood stasis (<i>oketsu</i>). We then administered the ryutanshakanto prepared at Ikkando, plus goreisan. His visual acuity consequentially began to improve gradually from the next day, and the disease was finally cured without the administration of any corticosteroid. Thus we believe this suggests that Kampo therapy for VKH disease can be a viable alternative.
ABSTRACT
Saiko-sokan-to has been traditionally used for the amelioration of symptoms such as anxiety, insomnia, Shigyaku-san-sho (sho = pattern of symptoms determined by Kampo diagnosis) with left hypochondralgia and Shigyaku-san-sho with a feeling of obstruction in the costal region. However, there are still aspects that remain to be elucidated concerning the indications for this formula.<br>This study involved 7 cases with stiff shoulders, headaches, abdominal distension, meteorism and flushing which responded to Saiko-sokan-to. The experience of these cases suggests that conditions indicating Saiko-sokan-to have the following features: (1) there is resistance or tenderness upon pressure in the subcostal region (traditionally referred to as Kyokyokuman), (2) there is resistance or tenderness upon pressure in the epigastric region (traditionally referred to as Shinkahiko), (3) there are signs of Ki-depression, (4) for severe “blood stagnation” syndrome (traditionally called oketsu), Ikkando Saiko-sokan-to was found to be more effective than Igakutoshi Saiko-sokan-to.