<b>Otsujito Found Effective in Enterocutaneous Fistula after Trying Other Kampo T</b><b>reatments</b> / 日本東洋医学雑誌

<p>Otsujito is a well-known Kampo medicine for treatment of hemorrhoidal diseases. In the current report, we present end results for a case of enterocutaneous fistula treated with Kampo medicine in accordance with traditional “sho” indications.<br>An 81 year-old female developed abdominal wall-intestinal fistula right immediately following partial colectomy due to ischemic sigmoid colic perforation 12 years previously. Two years later, she had a fistulectomy and repair using intraperitoneal mesh for abdominal recruitment. Eight years after repair of the enterocutaneous fistula, she had peritonitis caused by the tardive intraperitoneal mesh infection. Since then, she has had frequent repeated ileus and received conservative treatment for two years. Several local operations and abdominal drainages were performed after transfer to Aizu Medical Center. Kigikenchuto was provided for wound healing for approximately 1 year, and one fistula was finally identified. Otsujito dramatically decreased the leakage of intestinal juice and closed her enterocutaneous fistula.<br>Angelicae Radix as an anti-inflammatory agent, and Cimicifugae Rhizoma as originally indicated, may have played pivotal roles in this case with Otsujito.</p>

<b>A Case of Diabetic Foot Syndrome Successfully Treated with </b><b>Combination Kampo Medicine </b> / 日本東洋医学雑誌

This case involved a 58-year-old male with diabetic foot syndrome complicated with osteomyelitis. He had been diagnosed with diabetes mellitus type 2 twenty years previously, but had ignored it and developed diabetic foot syndrome and diabetic triopathy. His HbA 1 c (NGSP) was 11.2%. Twelve days after diabetic foot onset, he was transferred to our hospital to receive Kampo medicine. His whole right leg was edematous and there were two ulcers on the dorsum (5 × 4 cm in size) and between the fourth and fifth toes (7 × 4 cm in size).We used antibiotics, insulin, and prostaglandin formulation in combination with Kampo medicine, involving hachimijioganryo because of lower abdominal numbness. Simultaneously, we used keishibukuryogan at high dosage (personalized formula, 2 g × 24 pills) for 7 days to improve blood stasis. Seven days after hospitalization, we changed the initial hachimijioganryo to hachimijiogan (personalized formula, 2.3 g × 9 pills) and kigikenchuto (astragalus root, 20 g) to accelerate ulcer granulation. We also decreased the high dose keishibukuryogan gradually. Although the bone of the DIP joint in the fifth toe was exposed, the ulcer dimensions decreased and reached 2.5 × 1.8 cm at the time of discharge (50 days after onset). Two months after onset, the ulcer had epithelialized and medical dressings were unnecessary. Four months after onset, it had completely healed. We propose that Kampo medicine is effective for diabetic foot syndrome when combined with conventional therapy, and that healing occurs earlier than with conventional therapy alone.

<b>Five Cases of Patent Eustachian Tube Treated </b><b>with Kigikenchuto for Asthenic Disease </b> / 日本東洋医学雑誌

The patent eustachian tubes (PET) of five patients with a chief complaint of aural fullness were successfully treated with kigikenchuto. A Kampo extract preparation of ogikenchuto and tokikenchuto (daily dose of 9 and 7.5 g, respectively) was applied as a representative prescription for kigikenchuto. The five patients had also been diagnosed with definitive PET on otological examination. Case 1 was a 73-year-old male suffering from aural fullness and autophonia after a common cold. These ear symptoms improved on lying down and resting. He had a history of admission for cerebral hemorrhage with hypertension and weight loss. Bilateral stiffness of the abdominal rectus muscle and an intolerable tickling sensation were noted. After taking kigikenchuto for two weeks, his symptoms improved. An additional study of four patients treated with kigikenchuto, including Case 2, a 75-year-old female, Case 3, a 33-year-old female, Case 4, a 78-year-old female, and Case 5, a 21-year-old male, showed effective cures. Kigikenchuto is a <i>qi</i>-blood supplementing derivative of shokenchuto, a minor center-reinforcing Kampo medicine for asthenic disease. Based on these results, we suggested that kigikenchuto serves as a useful formulation to treat PET. Life guidance to promote health is also essential for cure.

A Case with Lumber Spinal Canal Stenosis Successfully Treated with Kigikenchutokauzu / 日本東洋医学雑誌

We report on a patient with residual complaints after an operation for lumber canal stenosis, successfully treated with the Kampo medicine, kigikenchutokauzu. The patient was 69 year-old woman complaining of severe coldness, numbness, and bilateral leg pain. She was diagnosed as having spinal canal stenosis when she was 67 years of age. Posterolateral fusion with laminectomy was performed at the age of 69, although severe coldness, numbness, and pain persisted even after her surgery. Also, her sutures had not healed. She was referred to our department 26 days after her surgery in order to receive Kampo therapy. Kigikenchutokauzu was prescribed, and her condition markedly improved. Her sutures healed completely 7 days after start of administration. This suggests that kigikenchutokauzu may be effective not only for the residual spinal canal stenosis symptoms, but also for the postoperative healing of sutures.

Case Reports of Diabetic Foot Successfully Treated with Kigi-kenchu-to with Additional Ingredients / 日本東洋医学雑誌

We report on three patients suffering from diabetic foot successfully treated with. Kigi-kenchu-to with additional ingredients.<br>Case 1 was a 68-year-old female with diabetes mellitus and rheumatoid arthritis The bilateral foot sole ulcers present were diagnosed as diabetic gangrene. Her condition had not improved, in spite of Western medical treatment. The ulcers of bilateral foot improved, however, after administration of Kigi-kenchu-to-ka-bushi, while rheumatoid indices also became negative.<br>Case 2 was a 66-year-old male with diabetes mellitus and a history of subarachnoidal hemorrhage. Kigi-kenchu-to-ka-bushi medication, in this instance, caused recurring ulcers of the big toe to disappear.<br>Case 3 was a 72-year-old male. Gangrene of bilateral toes set in, during treatment of diabetic nephropathy. And even though the toes were amputated, recovery was delayed because of poor blood flow to the feet. After administration of Kigi-kenchu-to-ka-hanbi, granulation formation progressed and the patient's outlook improved.<br>We consider that Kigi-kenchu-to, with additional ingredients, may serve as an effective cure for diabetic foot.

Two Cases of Ulcerative Colitis Successfully Treated with Kigi-kenchu-to / 日本東洋医学雑誌

We report two cases of ulcerative colitis successfully treated with Kigi-kenchu-to. Case One was a 35-year-old male. He had been diagnosed with ulcerative colitis at another hospital, had been receiving corticosteroid (prednisolone) treatment, but his symptoms (abdominal pain, diarrhea and hematochezia) improved little. He visited our department and was admitted. Treatment with Kigi-kenchu-to for 2 weeks improved his symptoms and colonoscopic findings, and he was discharged.<br>Case Two was a 28-year-old female. She had been diagnosed with ulcerative colitis at another hospital. She had received modern medicinal treatments, including steroid pulse therapy and granulocytapheresis for 10 years. But her symptoms (abdominal pain, diarrhea and hematochezia more than 10 times a day) showed little improvement. She visited our department, and Kampo treatment with Kigi-kenchu-to-ka-gaiyo-akyo was begun. After 4 weeks, her symptoms and colonoscopic results had improved. Based on these experiences, it is suggested that Kigi-kenchu-to might be an effective formulation in the treatment of ulcerative colitis.