ABSTRACT
We report on three RA patients successfully treated with Yokuinin-to-ka-kyokatsu-dokkatsu-bofu (Yokuinin-to-kami). The first patient was a 47-year-old woman. In 1983, she visited a nearby hospital due to bilateral wrist joint pain. Her condition was diagnosed as RA. She was treated with gold sodium thiomalate (GST) and non-steroidal anti-inflammatory drugs (NSAIDs), but her symptoms did not improve. She visited our department in 1989. She was treated with Keishi-ka-ryojutsubu-to, Bushi-to which resulted in decreased arthralgia. However, in September 1995, her condition worsened. Administration of Yokuinin-to-kami improved her symptoms as well as her laboratory data after three months of treatment. The second patient was a 50-year-old woman. In 1986, she visited a nearby hospital with bilateral wrist joint pain. Several Kampo formulas were subsequently administered at a pharmacy. In 1991, she visited our hospital and her condition improved after treatment with Keishi-ka-ryojutsu-to-ka-boi-ogi-yokuinin. However, in May 1996, she complained of severe pain and swelling at the right shoulder joint. Treatment with Yokuinin-to-kami improved her symptoms, as well as decreased serum C-reactive protein (CRP). The third case involved a 42-year-old woman who exhibited polyarthralgia in June 1991. She visited a neighborhood hospital and was diagnosed as having RA. She was treated with NSAIDs and bucillamine. She first visited our hospital in1993. We treated her with Keishi-ni-eppi-itto-ka-ryojutsubu and Keishi-shakuyaku-timo-to, but the polyarthralgia worsened in May 1996. Subsequently, we treated her with Yokuinin-to-kami which resulted in improvement symptoms, as well as decreased serum CRP.<br>To identify the target group for Yokuinin-to-kami, we further analyzed the characteristics of the patients successfully treated with this formula. Yokuinin-to-kami was administered to nine patients with RA, and the symptoms in five patients improved, but the remaining patients did not respond. The score of stasis of body fluids and deficiency of blood was not considerably different between the two groups. Interestingly, there was a difference in the variation of joint symptoms throughout the day. Namely, the successfully treated patients complained of joint symptom in the evening more than in the morning. These observations suggest that Yokuinin-to-kami is a useful agent for the treatment of a subset of patients with RA, and that joint pain in the evening might be an indicator for this treatment.
ABSTRACT
Rats with adjuvant arthritis (AA rats) show obvious inhibition of the local inflammation when steroids (DXM) are administered. But the contraction of thymic or adrenal atrophy, spleen hypertrophy, and reduction of activity of serum dipeptidyl aminopeptidase IV are recognized. In rats where Sokei-kakketsu-to or Yokuinin-to was administered, prominent anti-inflammatory effects like dexamethasone were not found; however the contraction of thymic or adrenal atrophy, spleen hypertrophy, and reduction of activity of serum dipeptidyl aminopeptidase IV was not recognized. In addition, after withdrawal of drugs, rebound in regional joints did not occurr as with steroids, and the reducing effect for arthrocele was prolonged. Therefore, it was concluded that those two formulations have an effect on the immune system —with anti-inflammatory effects for AA rats— and these action mechanisms are different from that of steroids (DXM).
ABSTRACT
The hematological effects of Sokeikakketsu-to, Yokuinin-to, Keisi-ka-jutsubsu-to, Eppi-ka-jutsu-to, and Sairei-to observed on the AA rats were investigated. The time course of blood count and albumin, sialic acid and acid-soluble glycoprotein in the serum whs. were measured. Sokeikakketsu-to had the strongest anti-inflammatory effect on the improvement of Inflammatory Index Substances, platelets, and the Arthritis Score for changes in synovitis. Yokuinin-to was also effective. When these Kampo medicines were administered in the early stages of AA, Sokeikakketsu-to improved the AA signficantly. The results may suggest that Sokeikakketsu-to works for the control of autoimmunity. On the other hand, Keisi-ka-jutsubu-to aggravated the AA when it was administered in the early stages of the AA.
ABSTRACT
The effects of Sokei-kakketsu-to, Yokuinin-to, Keisi-ka-zyutsubu-to, Eppi-ka-jutsu-to, and Saireito extracts on Adjuvant-induced arthritis (AA) in rats were investigated. After administering AA, we measured the volume of rat hindpaw as the inflammation index, and observed the changes of synovitis histologically. Each extract showed different effects on AA rats. Yokuinin-to and Sokei-kakketsu-to had remarkable effects on inflammation and changed the histological observations of synovitis. Eppi-ka-jutsu-to also had effects on the uninjected hindpaw, but Keisi-ka-jutsubu-to and Sairei-to had no effect on hindpaw inflammation, nor did they change synovitis histologically.
ABSTRACT
Oral administration of Yokuinin-to was added to the previous drugs in 4 patients with psoriatic arthritis. All of the cases responded to the therapy without adverse effects. In 3 of 4 cases, the previous drugs, i. e, corticosteroids, etretinate, or non-steroidal anti-inflammatory drugs (NSAIDs), were able to be discontinued after the beginning of the Yokuinin-to therapy. The remainder had favorable control of arthralgia with Yokuinin-to alone. During the course of the therapy, there were no considerable changes in skin eruption in all 4 cases. We consider Yokuinin-to one of the first drugs of choice in the treatment of arthralgia in patients with psoriatic arthritis.