A Case of Rheumatic Arthritis Successfully Treated by Boiogito and Yokuininto with Bushi / 日本東洋医学雑誌

Here I report a case of chronic rheumatic arthritis, which was successfully treated with boiogito, yokuininto and bushi, leading to complete remission. A 38 year-old woman, null gravida, has been suffering from strong pain and frequent sense of numb in both hand joints. Previous orthopedic specialist diagnosed as rheumatic arthritis. Since she had a hope of getting pregnant, she came to our outpatient clinic, seeking Kampo treatment. Clinical examination revealed a positive test of anti-CCP antibody (>200) or rheumatoid factor as 32.4. Kampo treatment was started with keishikajutsubuto besides bushi, or eppikajutsuto with bushi, which were not effective sufficiently. Finally, combined agents with yokuininto and boiogito dramatically reduced pain, visual analogue scale score or CRP level, and relieved pain in bilateral hand joints, leading to complete remission. Yokuininto is applied to the cases with pains, chilliness or sense of numb in limb joints or muscles. Furthermore, boiogito is administered to the patients with edematous, painful and/or swollen joints. Both agents contain several herbal medicines with pain relieving spasmolytics, redistributing of tissue fluid or anti-inflammatory actions. From these findings, agents used in this case appear to work towards redistributing tissue fluid, easing local immune reaction or relieving pains powerfully. It is thought that combined agents with boiogito and yokuininto could be a reliable option for the treatment of rheumatic arthritis.

<b>2 Cases of Children Successfully Administered Kampo Formulae that Included Bushi or Uzu </b> / 日本東洋医学雑誌

We administered a Kampo decoction containing bushi (prepared aconiti tuber) or uzu (un-prepared aconiti tuber) to two children in Aso Iizuka hospital. Case 1 was a thirteen year-old girl with atopic dermatitis that worsened after her topical steroid was stopped. When her itching sensation was reduced following a bath, we considered that she was suffering from coldness. Therefore we administered a half dose of bukuryoshigyakuto.The next morning her old skin flaked off and her skin appeared healthy. We administered bukuryoshigyakuto before every meal and there was rapid improvement in her dermatitis. Case 2 was a twelve year-old girl with orthostatic dysregulation who was unable to attend school. She had become aware of coldness the previous autumn and had not been able to go to school, nor even sit up, since the previous winter because of severe fatigue. We diagnosed her with severe coldness and so started sekiganryo administration, and included 2 g of uzu. We gradually increased the uzu. At a result, her severe fatigue improved to the extent that she could eat breakfast and go to school inside the hospital. Children may have severe coldness if they suffer from a long-term illness. Moreover, particular attention should be given to toxicity caused by aconiti tuber.

<b>Herbological Study on the Quality and Toxicity of Aconite Root </b> / 日本東洋医学雑誌

The crude drug Aconite Root (<i>bushi </i>in Japanese) contains toxic compounds called bushi diester alkaloids(BDA), and the raw material with high BDA content has been considered suitable for processing into prepared <i>bushi</i>. Moreover, processing methods and an upper BDA content limit are prescribed in the 16th edition of Japanese Pharmacopoeia. In this study, we closely examined descriptions of high quality <i>bushi </i>in ancient herbal literature, and elucidated the relationship between <i>bushi </i>forms and BDA contents. The results showed that large-sized <i>bushi </i>with enlarged rootlets called “horns” (<i>tsuno </i>in Japanese) were considered higher quality, and the horns and the root tops (<i>hozo </i>in Japanese) were cut off when used as <i>bushi</i>. Meanwhile, chemical studies have shown that larger <i>bushi </i>contains less BDA, and the root tops and the horns contain more BDA than the root body. These results suggest that selecting larger roots and cutting off the more potent parts were processes for reducing BDA. Therefore we conclude that consistently less toxic <i>bushi </i>was considered a higher quality product in ancient times.

Trial of the Treatment of Kampo Medicines for Thalamic Pain / 日本東洋医学雑誌

Thalamic pain is known as intractable central pain caused by thalamic bleeding and infarction. Although some physical and surgical therapies have been tried, there is no established method for its improvement. We attempted the treatment of 6 cases of thalamic pain, and 4 of them showed improvements in their symptoms. Our patients were aged 27-70 years, 4 men and 2 women. Their diagnoses were 3 cases of right thalamic bleedings, 1case of left thalamic bleeding, and 2 cases of right thalamic infarctions. The periods from onset to consulting our department were from6months to 12 years. In the 4 cases whose symptoms improved, the symptoms had almost disappeared or were decreased by at least 40%. These improved cases used formulas containing uzu or bushi. Yokukansankachimpihange was effective for two cases with mental disturbances. One case showing major improvement was treated by only the formula against oketsu. The cases whose symptoms had continued for a long time were more intractable, with the symptoms remaining to some degree in spite of their decreasing tendency. Finally, in intractable cases, their symptoms remained fixed and they had severe paralysis.

Clinical Evaluation of the Finger Tissue Blood Volume during Shuchi-Bushi Powder Administration / 日本東洋医学雑誌

In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.

Two Cases of Fibromyalgia Syndrome Succesfully Treated with Kampo Medicine / 日本東洋医学雑誌

We demonstrated two patients with fibromyalgia syndrome (FMS), successfully treated with Kampo medicine, and considered the resemblance between the clinical manifestation of FMS and SHO for Kanzo-bushi-to.The first case was a 52-year-old women who consulted a local hospital in 2001 due to althralgia and myalgia in the left hand, bilateral elbows, shoulders and foot. Her condition was diagnosed as FMS without abnormal findings in the thorough medical examination. Treatment with NSAIDs was not effective, so she consulted our department in 2004. She was treated with Keishi-ni-eppi-itto-ka-ryojutsu-ka-boi-ogi-kakkon. After two mouths, her symptoms had reduced to 50% by visual analog scale (VAS). By March 2006, her symptoms had significantly decreased to 20% by VAS and NSAIDs became unnecessary.The second case was a 58-year-old woman who had suffered from tolerable pain in her right elbow for 10 years. In 2004, she visited the Department of Orthology at her local hospital due to pain in the neck, bilateral arms and shoulders. There were no findings on cervical X-ray or neurological examination, and NSAIDs were administered. Her symptoms did not resolve, therefore, she consulted our department in 2005. She was diagnosed with FMS, based on fulfilling the diagnostic criteria for FMS of ACR (American college of rheumatology) in 1990. She was treated with Kanzo-bushi-to. After 3 months, her symptoms had reduced to 30% by VAS. By Mar. 2006, her pain had redused to 25% by VAS and she was physically fit enough for a daily life.

A Case of Painful Bedridden Patient with Multiple Fractures due to Osteoporosis Successfully Treated with Keishi-bushi-To / 日本東洋医学雑誌

A 68-year-old female who had suffered from lumbar vertebral fractures due to osteoporosis six years before was admitted to our hospital because of thoracodorsal pain of an unknown origin, and systemic contact dermatitis, on November 2000. The patient had been forced into a bedridden state due to severe pain. A bone scintigram showed multiple high accumulations in the thoracispinal region, but malignant disease could not be detected. Furthermore, a MRI demonstrated multiple thoracolumber vertebral compression fractures. Keishi-bushi-to was administered to control severe and superficial pain, and the presence of cold limbs. Pain was gradually diminished and the patient could be started on rehabilitation one month after treatment. Furthermore, several Kampo formulas, such as Ogi-kenchu-to, Keikyososo-oshinbu-to and Hachimi-jio-gan were administered on the basis of pain and skin condition. In the end, the patient could stand up with support eleven months after treatment.<br>Based on this experience, it is suggested that Keishi-bushi-to may be an effective treatment for severe pain arising from multiple fractures with osteoporosis.

A Case of Rheumatoid Arthritis with Malaise after Taking Methotrexate Treated with Toki-shakuyaku-san-ka-bushi / 日本東洋医学雑誌

We treated one rheumatoid arthritis (RA) patient with Toki-shakuyaku-san-ka-bushi. A 51-year-old woman was diagnosed as RA in another hospital and was treated with salazosulfapyridine (SASP) and methotrexate (MTX). She was living a restricted daily life while taking MTX. She had to lie down for almost 48 hours after taking MTX once a week because of general fatigue. She was also suffering from depression. After the administration of Toki-shakuyaku-san-ka-bushi, her malaise after taking MTX and her depressive-mood disappeared. Her quality of life improved measurably.

Difference of Immediate Effect between Mao-bushi-saishin-to Extract Granule and Its Extract Capsule on Allergic Nasal Obstruction Shown in Two Adults / 日本東洋医学雑誌

The author evaluated immediate effects of a single dose of Mao-bushi-saishin-to extract granules (TJ-127) and extract capsules (NC127) on allergic nasal obstruction using acoustic rhinometry in two adult male patients. In case 1, no apparent increase of right+left nasal cavity volume (NCV) was shown during a period of 95 minutes after the administration of NC127. However, an increase was noted 50 minutes after the administration of TJ-127. In case 2, NCV started increasing 15 minutes after the administration of TJ-127 and 50 minutes after the administration of NC127. The result indicates that Mao-bushi-saishin-to extract granules might take effect more quickly than extract capsules.

Four Cases Report of Intractable Pressure Ulcers Effectively Treated with Kigi-kenchu-to-ka-bushi / 日本東洋医学雑誌

Four intractable decubitus ulcer patients who had not responded to any Western medicine were treated effectively with Kigi-kenchu-to-ka-bushi. Case 1 was a 82-year-old female patient who had been admitted due to multiple-cerebral infarction. She had been bedridden and suffered repeatedly from pressure ulcers. Her bed sores were controlled successfully with Kigi-kenchu-to-ka-bushi. After treatment by Kigi-kenchu to-ka-bushi, any decubitus ulcer was not recurrence. Case 2 was a 85-year-old female patient. The pressure ulcer was 2cm in diameter and extent of soft tissue fissure underlying it was about 10cm in diameter. Skin color around pressure sore changed to purple. After administration of Kigi-kenchu-to-ka-bushi, skin color returned to normal and decubitus ulcer recovered. Case 3 was a 59-year-old male patient who had undergone operation on an intractable decubitus ulcer with fistula, but he did not get well. Two weeks later, after treatment with Kigi-kenchu-to-ka-bushi, he felt pain when we sterilized his ulcer. It was thought to be a sign of improvement of the wound. Physical status became better as the ulcer healed. Case 4 was a 64-year-old female patient with brain death because of acute myocardial infarction. Her pressure ulcer was treated effectively with Kigi-kenchu-to-ka-bushi, too.

A Case of diabetic patient with intractable pain successfully treated with Mao-bushi-saishin-to and Hochu-ekki-to / 日本東洋医学雑誌

A 43-year-old diabetic man with a diabetic history of 8 years had been treated with insulin (Penfil 30R), 12μ in the morning and 4μ in the evening, for two months. The patient had only slight numbness and pain of the inferior limbs until **********, when he complained of intractable pain in the left back. The pain spread generally except for the face, bilateral palms and the pen-anal area in a few days. Although vitamin E, epalrestat, nonsteroidal anti-inflammatory drugs (NSAIDs) and Gosha-jinki-gan were not effective, Mao-bushi-saishin-to was very effective for the intractable pain, Hochu-ekki-to was effective at reducing succeptibility to fatigue, but had no effect on the intractable pain. Diabetic control gradually became good with combination of Mao-bushi-saishin-to and Hochu-ekki-to in two months. HbAlc improved from 10.2 to 6.5% about two months after the beginning of treatment with Mao-bushi-saishin-to and Hochu-ekki-to. Therefore, insulin was discontinued five months later. In conclusion, combination of Mao-bushi-saishin-to and Hochu-ekki-to was useful for diabetic control in a patient with intractable pain.

A Case of Postherpetic Neuralgia Successfuly Controlled with 3 Kampo Medicines which Bushi Commonly / 日本東洋医学雑誌

A 77-year-old woman who had suffered from herpes zoster five months previously in her right T5, 6 region consulted the author with complaints of insomnia and appetite loss due to postherpetic neuralgia. Administration of the Kampo extract Mao-bushi-saishin-to (NC127) brought about marked improvement in the pain, and the patient was able to sleep from that night onward. Later, Keishi-ka-jutsubu-to (TJ18) was given, reducing the pain still further. When Kakou-Bushi-Matsu (SO1) was added, the pain disappeared almost entirely.<br>This clinical course suggests that it was the Bushi (Aconiti Tuber), which was the only crude drug common to all three Kampo products, that was largely responsible for the analgesic effect.

Kampo Therapy for Nasal Allergy-like Complaints with Keishi-to plus Mao-saishin-bushi-to / 日本東洋医学雑誌

Twenty-four patients, who had been diagnosed by specialists as having nasal allergy and had not benefited from western medicine in terms of symptomm relief, visited us for Kampo therapy and received Keishi-to plus Mao-saishin-bushi-to. of these, 21 patients improved, of these, eightpatients with other allergic disorders which had not responded to Kampo medicine mainly consisting of Sho-seiryu-to did improve markedly with the above combination. We herein report their Kampo diagnosis and also make a comarison with Sho-seiryu-to.