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Objective:To investigate the changes in gray matter volume (GMV) and abnormalities in structural covariant network (SCN) patterns in patients with chronic pontine infarction (PI).Methods:Patients with unilateral chronic PI (case group) with the first onset admitted to the First Affiliated Hospital of Zhengzhou University and Tianjin Medical University General Hospital from October 2014 to June 2021 were prospectively included. At the same time, healthy subjects matched with age, gender and education years (normal control group) were included. High-resolution three-dimensional T 1 structural MRI images and behavioral scores of the subjects were collected. The voxel-based morphometry and two-sample t test were used to explore the differences in GMV between the groups. Using GMV differential brain regions as seed points, SCN was constructed to explore the abnormality of structural covariant patterns in patients with PI. Spearman rank correlation analysis was used to analyze the correlation between GMV in differential brain regions and behavioral scores. Results:A total of 60 patients with PI were enrolled, including 33 left PI and 27 right PI, while 34 healthy controls were also enrolled. Compared with the normal control group, the GMV in bilateral posterior cerebellar lobe decreased significantly in the left PI group, and the GMV in left anterior and posterior cerebellar lobes and the right posterior cerebellar lobe decreased significantly in the right PI group (Gaussian random field correction with voxel level P<0.001 and cluster level P<0.05, cluster voxel >20), and there was a significant correlation between GMV values in the left anterior and posterior cerebellar lobes and the right posterior cerebellar lobe and the motor function score ( P<0.05). In addition, compared with the normal control group, the right PI group had broader covariate brain regions and a significant increase in the number of structural connections between covariate brain regions (family-wise error correction with voxel level P<0.05, cluster voxel >20). Conclusions:The GMV in bilateral posterior cerebellar lobe decreases significantly in patients with chronic PI, and were secondary to broader covariate brain regions and structural connections. This may be the neural mechanism of impaired behavioral function in patients with PI.
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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.
ABSTRACT
Chi-no-michi-sho involves neuropsychiatric and physical symptoms that appear with hormonal changes, such as those during pregnancy and menopause. Until now, there were many case reports, which were within 2 years from the start of treatment. We present a case of chi-no-michi-sho that was successfully treated with Kampo formulations for 7 years. A 43-year-old woman had complaints of candida eczema in the vulva, palpitations, and headache. Tokishakuyakusan and shakanzoto were then administered for kekkyo (blood deficiency), oketsu (blood stasis), and suidoku (fluid retention), and a topical antifungal agent was administered for candida eczema. The headache and palpitations were reduced. Subsequently, tokishigyakukagoshuyuto and keishibukuryogan were administered because of skin rash and deterioration of sensitivity to cold. However, various symptoms, such as weight loss amenorrhea due to self-determination, eczema, feeling heavy in the head, and edema, remained. We prescribed tokishakuyakusan again in addition to Western medical treatment. Her menstruation then resumed ; her eczema, palpitations, and headache also improved. However, she developed hyperthyroidism. While paying attention to organic diseases such as thyroid dysfunction, prescription of tokishakuyakusan may be effective when chi-no-michi-sho is long-lasting and there are blood deficiency and stasis with fluid retention.
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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.
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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).
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Objective To evaluate the therapeutic effect of sho-saiko-to silymarin on liver fibrosis due to chronic hepatitis B.Methods 90 patients with liver fibrosis due to chronic hepatitis B virus(HBV) were randomly divided into therapy group and control group.50 patients in therapy group were given sho-saoko-to and silymarin;While 40 patients in control group were given silymarin only,they were all treated for 6 months.The changes were observed including liver function,serum liver fibrosis and virology indexes before and after treatment in two groups.Resuits Indexes of liver function and serum liver fibrosis in therapy group were improved obviously(P<0.05 or P<0.01),while better clearance to HBV is comparable to control group(P<0.05).Conclusion The treatment with sho-saiko-to combined silymarin on liver fibrosis due to chronic hepatitis B had explicit clinical effect.
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The fight against pestilence has been the major theme of both western and eastern medicine since ancient times, and bacteriology has been founded on the modern scientific idea of ensuring reproducibility, the socalled Koch's four postulates, by identifying and isolating pathogenic bacteria, then proving their infectious cause.<br>However, although the major factors surrounding infectious disease are host/parasite relationships and drugrelated causes, more importance has been placed on developing new drugs. With the emergence of compromised hosts as treatment methods become widespread, such thinking is no longer valid.<br>There is now no clear logic to the question of reproducibility in clinical medicine, against a background of the enormous contributions the human system makes. Kampo medicine, the study of therapeutics in humans, has long been used to treat people through an understanding of the pathological conditions humans express as a system, with their Six Stages of Disease (<I>rikkei</I>) theory, yin-yang, hypo- and hyper-function <I>sho</I> (symptoms), and through those <I>sho</I> that people present with, it can provide highly reproducible therapies. Moreover, the oral traditions (<I>koketsu, gugyeol</I>) of Japanese Kampo which bring increased therapeutic efficacy and reproducibility through the achievements of predecessors, provide indispensable therapeutic bias. In future, the systematic medical concepts of Kampo will also become essential in Western medicine.
ABSTRACT
The fight against pestilence has been the major theme of both western and eastern medicine since ancient times, and bacteriology has been founded on the modern scientific idea of ensuring reproducibility, the socalled Koch's four postulates, by identifying and isolating pathogenic bacteria, then proving their infectious cause.However, although the major factors surrounding infectious disease are host/parasite relationships and drugrelated causes, more importance has been placed on developing new drugs. With the emergence of compromised hosts as treatment methods become widespread, such thinking is no longer valid.There is now no clear logic to the question of reproducibility in clinical medicine, against a background of the enormous contributions the human system makes. Kampo medicine, the study of therapeutics in humans, has long been used to treat people through an understanding of the pathological conditions humans express as a system, with their Six Stages of Disease (rikkei) theory, yin-yang, hypo- and hyper-function sho (symptoms), and through those sho that people present with, it can provide highly reproducible therapies. Moreover, the oral traditions (koketsu, gugyeol) of Japanese Kampo which bring increased therapeutic efficacy and reproducibility through the achievements of predecessors, provide indispensable therapeutic bias. In future, the systematic medical concepts of Kampo will also become essential in Western medicine.
ABSTRACT
In Japanese Kampo, we use abdominal palpation as a clinical examination method. Abdominal palpation, a kind of tactile inspection method, which in turn is one of the four mainstays inspection methods (palpation, visual, auditory, and verbal), is the most effective technique giving one information to determine a patient's sho diagnosis. Moreover, abdominal palpation is the only clinical examination method of those traditional techniques passed down to the countries and regions of East Asia, which was developed solely in Japan. Abdominal palpation as it is practiced today stems mainly from the Koho-ha Old School of thought, which traces back to ancient Shokanron (Treatise of Cold Damage Disorders) text medicine, although it also influences the Secchu-ha Compromise School of thought. And although an awareness of abdominal palpation is perfunctory, it does require a certain amount of training and proficiency, as it is a skill. In this paper, we discuss abdominal palpation findings amassed over many long years since ancient times.
Subject(s)
Palpation , SchoolsABSTRACT
We examined the complaints of adult patients with ‘weak’ sho symptoms using their first-visit medical questionnaires. Our subjects were 39 patients (3 males and 36 females) who fatigued easily, and who had a weak constitution with stress and the changing of seasons.Over 60% of these ‘weak’ patients complained of excessive sensitivity to cold. The majority had stiff shoulders, a stiff neck, low back pain, sleeplessness, headache, fatigue of the eyes and vertigo. Their gastrointestinal constitutions were poor because of over eating.Although we understood many of the complains these ‘weak’ patients had through their medical questionnaires, their chief complaints were various. We hope these results are useful in understanding treatments for patients with ‘weak’ sho.
Subject(s)
Sleep Initiation and Maintenance DisordersABSTRACT
In Japanese Kampo, we use abdominal palpation as a clinical examination method. Abdominal palpation, a kind of tactile inspection method, which in turn is one of the four mainstays inspection methods (palpation, visual, auditory, and verbal), is the most effective technique giving one information to determine a patient's sho diagnosis. Moreover, abdominal palpation is the only clinical examination method of those traditional techniques passed down to the countries and regions of East Asia, which was developed solely in Japan. Abdominal palpation as it is practiced today stems mainly from the <I>Koho-ha</I> Old School of thought, which traces back to ancient <I>Shokanron</I> (Treatise of Cold Damage Disorders) text medicine, although it also influences the <I>Secchu-ha</I> Compromise School of thought. And although an awareness of abdominal palpation is perfunctory, it does require a certain amount of training and proficiency, as it is a skill. In this paper, we discuss abdominal palpation findings amassed over many long years since ancient times.
ABSTRACT
We examined the complaints of adult patients with ‘weak’ <I>sho</I> symptoms using their first-visit medical questionnaires. Our subjects were 39 patients (3 males and 36 females) who fatigued easily, and who had a weak constitution with stress and the changing of seasons.<BR>Over 60% of these ‘weak’ patients complained of excessive sensitivity to cold. The majority had stiff shoulders, a stiff neck, low back pain, sleeplessness, headache, fatigue of the eyes and vertigo. Their gastrointestinal constitutions were poor because of over eating.<BR>Although we understood many of the complains these ‘weak’ patients had through their medical questionnaires, their chief complaints were various. We hope these results are useful in understanding treatments for patients with ‘weak’ <I>sho</I>.
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Background : A system for measuring electrical resistance along meridian routes, using a built-in, standardized electrode mechanism with fixed-load, 10 mA (JIS allowance value) current generating IC circuit was newly devised, and the route impedance of 12 meridians (Rm kΩ) were obtained at each source acupoint in situ. These values were clinically investigated in 259 ambulant patients with a background of eastern sho (symptoms), and statistical analysis.Measurement and Result:Rm ranged from 156 to 1520 kΩ in 6 6males (age : 3 ∼ 48 years) and 99 females (age : 10 ∼ 87 years).1) Rm over 300 kΩ, denoted as qi deficiency, was recognized in the LR, GB, ST, SP, HT, BL and KI meridians of the males, and additionally in the SI meridians of the females older than 50 years, and only in the GB meridians of those younger than 50 years.2) A positive correlation with age was only recognized in the Lu, L1and S1meridian flow of those younger than 50 years in the male patient group, while in females younger than 50 years, this correlation was recognized in ST, SP, HT and BL meridians, while in those over 50 years, it was only recognized in ST meridians.3) Among the 54 cases of qi deficiency, a positive correlation between age and Rm was recognized only in 10 meridians of the females and in 52 “blood-emptiness” cases, 4 meridians of the males, and 2 meridians of the females and in 51 cases of “blood stasis” group, 8 meridians of the males and 2 meridians of the females.Conclusion : The Rm values found with the newly-devised meridian route impedance measurement system were significant in an eastern medicine way with qi rather, than “Blood” in sho pathogenesis.
Subject(s)
Electrodes , Equipment and SuppliesABSTRACT
If we consider the internal and external circumstances surrounding our acupuncture-and-moxibustion (Harikyu) community in Japan, it will become clear that we are required to construct a Japanese Harikyu Study immediately. Thinking one of the traits of Harikyu is to assume the natural healing energy is a basis, searching for the root are the subjects of this announcement. If we examine the natural healing energy that is thought to be used in our clinical scene now, the hypothesis that it is not what was inherited the Chinese traditional medicine, but it is a property of the Dutch studies imported in the middle of the Edo period will emerge. The keyword is "the natural action power"described in the greatest Edo period care of health document "Byoka Suchi (Knowledge that every patient and his/her family should have)"published at the end of the Edo period. Looking back upon the thought of "the natural right ability"used as the basis of the Chinese medicine revival movement of Keijuro Wada in the Meiji period, the author argues that the natural healing energy thought with which Japanese acupuncturists is familiar was derived from Occidental Hippocrates medicine. The author also submits the hypothesis that the Japanese original healing capacity thought "Ja-Sho Ichinyo (Wrong and right are but two faces of the same coin)"served as a backdrop for the Edo period Japanese accepting the natural healing energy thought of Hippocrates medicine.
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The purpose of this study was to reevaluate the sho of goshuyuto, which has been established in an unscientific manner, and to create a new concept of the sho of goshuyuto. Eighty-four patients suffering from chronic headache were instructed to orally consume 7.5g. day of a spray-dried powder of goshuyuto (TJ-31) for 4 weeks. Before consuming the TJ-31, all subjects underwent Kampo examinations that were based on 43 diagnostic items. After the 4-week period of medication, all the subjects were classified as either responders or nonresponders. After excluding insignificant items from the 43 diagnostic items, discriminant analysis, which discriminated between responders and nonresponders, was conducted. Of the 80 subjects who completed the trial period, 57 were judged to be responders and 23 to be nonresponders. “Cold feet,” “fluid and gas retention in the stomach,” “kyokyo-kuman,” “tenderness at side of navel,” and “pulsation at abdomen” were selected by stepwise selection. The results of the discriminant analysis using these 5 items suggest that 28 subjects were misclassified and that the misclassification rate was 35%. Of the actual 23 nonresponders, 20 were accurately discriminated as nonresponders. The 5 selected items are suggested to be more useful in selecting the nonresponders than the responders. In conclusion, the empirically established sho of goshuyuto seemed to not be abele to completely explain the indication of goshuyuto. However, the inclusion of “tenderness at side of navel” and “pulsation at abdomen,” as new components comprising the sho of goshuyuto, may facilitate a more accurate indication of goshuyuto.
Subject(s)
Data Interpretation, Statistical , Discriminant Analysis , AbdomenABSTRACT
Advantage of oriental medicine of Japan has been stressed in this paper. This advantage should be utilized for globalization of the oriental medicine of Japan.
Subject(s)
Asian People , Medicine, East Asian Traditional , Medicine , JapanABSTRACT
The practice of Chinese medicine has continued for more than 2,000 years, based on its long record of effectiveness. In this regard, Kampo medicine has also been used successfully for these many years, and it is still equally effective today, reflecting the fact that humans have changed little during that duration. In fact, it is said that humans have not undergone much evolutionary change in the last four million years. In contrast to this, however, are the ongoing changes in our environment and surroundings, which are giving rise to a host of new diseases, including many that are allergy-related.In the Japanese system of Kampo medicine, the pathophysiological diagnosis (Sho) and treatment are decided on the basis of two venerable texts, Shokanron and Kinkiyoryaku. There is, as a matter of fact, a prevailing, and possibly too extreme, opinion among Kampo practitioners that Kampo methods and medications not found in these two manuals are not to be applied. However, it is thought that changes had already been made to these texts in 1065-1066 by Rinoku et al., and possibly also by others earlier during the Song Dynasty (960-1279). Furthermore, two other texts, Ishimpo and Taiheiseikeiho, present many points that differ from those found in Shokanron. Thus, it is highly likely that Sho is also based on other revisions possibly carried out on these texts (originally authored by Cho Chukei) before Rinoku et al., if not on their own revised versions. From this, it must be realized that revision itself is not a bad process, and rather that the changes for which Rinoku et al. were responsible are quite in harmony with the present age.We must not be afraid to break with an old style. From the early days of Kampo medicine, Sho was assessed on the basis of the four available examination methods (visual examination, examination according to hearing and smell, questions and answers, and palpation). The field of medicine has since undergone some remarkable transitions, and its current state is one of tremendous development. As part of these newly acquired abilities, elevated levels of leucocytes and CRP as reflecting the state of the disease, for example, can be incorporated into the assessment of Sho. In this sense, Kampo practitioners should adopt and apply useful methods also originating from Western medicine. As a matter of fact, this is in line with the preface of Shokanron, which states that useful medications and methods should be gathered as broadly as possible ( ?? ).
Subject(s)
Medicine, Kampo , MedicineABSTRACT
The outline of COE program at University of Toyama entitled “Advanced Approach to Personalized Medicine Based on Oriental Philosophy” was presented. This program consists of two parts, i.e., basic research group and clinical research group. On the basic researches, we performed field work for natural resources of medicinal plants both in Mongolia and China. And we revealed the differences of the chemical ingredients in rhubarb family. Furthermore, we developped a new DNA microarray to detect the panax ginseng family. In this paper, we also reported that the chemical ingredients of medicinal herbs convert new substances by the action of intestinal bacterias. In the clinical research group, we revealed that the characteristic protein pattern of “blood stagnant (Oketsu) syndrome” in Kampo medicine by means of protein chip array system. We showed the result of the midway evaluation by Japan Society for the Promotion of Science.
Subject(s)
Universities , Basic Research , ProteinsABSTRACT
The form of modern Kampo Medicine is made after the influence of the schools at past time. This medicine was at first imitation of TCM in China and slowly had acquired the own Japanese form. At 16 century, Dosan Manase introduced the system of TCM from Ming-China to Japan successfully and made a great school called Goei-School. Late stage of 17 century, the influence of “Shang han Lun” research boom in China came to Japan and the new school called Koho-school which was based on this Classic has established. Especially Todo Yoshimasu researched the prescriptions in this book and invented new system named “Ho sho so tai”. After then, doctors had to compromise the thinking of both school. The form of eclectic school was so various that the doctors made individual medicines. After the Meiji Restoration, Kampo Medicine was out of political system but soon obtained revival. The several great doctors of Kampo Medicine have written “Practice of Kampo Medicine” at 1941 which made the base of the modern Kampo Medicine. Current Kampo Medicine adopted a lot of modern medical researches and there are new schools which are different from the past time.
Subject(s)
Medicine, Kampo , Schools , China , JapanABSTRACT
The author has attempted to reveal the evolution behind the great Chinese classic “Shokanron”, through historical study. Results suggest that it originally evolved from human anatomical trials in the Xin Dynasty (AD 16). Subsequently, some person or persons engaged in these anatomical trials created a new standard, i. e. verification. This newly developed school created the methodology for describing clinical cases, according to a standard format. The followers of this school then accumulated clinical case studies over several generations, with Chochukei finally compiling “Shokanron” (AD 200). In this classic, Chochukei put forth the theory of six disease stages, and presented a manual for acute febrile disease treatment.