A Case of Anorexia Successfully Treated with Byakkokaninjinto / 日本東洋医学雑誌

Traditional western medical diagnosis and treatment strategies for a patient with persistent anorexia and weight loss failed to yield any positive results, and thus we changed to an eastern treatment modality employ­ing the use of byakkokaninjinto, which resulted in successful treatment of the anorexia and its associated symptoms. An 83-­year-­old man presenting with phlegm and anorexia visited our hospital. Upon examination, we iden­tified subpleural ground-­glass and reticular opacities via chest CT. The patient was diagnosed with idiopathic interstitial pneumonia in the outpatient setting. Due to persistent anorexia and weight loss, we conducted thor­ough examinations of gastrointestinal system to supplement our overall workup ;however, the cause of the anorexia could not be identified. Meanwhile the patient lost 30 kg within a span of 6 months and was hospital­ized. He failed to present with any neurological disorders, collagen/endocrine disease or mental illnesses. A full systemic review was unable to identify the cause of the underlying anorexia but we focused on the pa­tient's complaint of coldness in the neck, upper limbs, ankles/feet and abnormal warmth in the forehead, which made him seek and ingest cold foods. Given these findings, we have established an eastern medical diagnosis for the anorexia as ketsugyaku, netsuketsu and initiated treatment using byakkokaninjinto. After starting a regimen of byakkokaninjinto, the patient noticed increased dietary intake and the various cold and heat sensa­tions distributed throughout his body dissipated. Assuming an open stance on adopting traditional Chinese medical practice into anorexia treatment could prove valuable in certain cases.

The Effectiveness of Byakkokaninjinto Added Gypsum Powder in 12 Patients with Atopic Dermatitis Refractory to Treatment Including Steroid Repellents / 日本東洋医学雑誌

We prospectively studied the effectiveness of byakkokaninjinto added gypsum powder for the treatment of atopic dermatitis (AD) by using the skin disease severity score, visual analogue scale (VAS) score for assessing itch severity, and Skindex-16 for assessing the quality of life (QOL) in 12 patients who were refractory to conventional treatments including steroid repellents. In addition, we retrospectively investigated for what types of “sho” (Kampo diagnosis) and eruptions this treatment was more effective. The results showed that the skin disease severity score and Skindex-16 significantly improved in 4 weeks. There was no significant improvement in eosinophil counts, IgE antibody levels, thymus and activation-regulated chemokine levels. Byakkokaninjinto added gypsum powder was found to be effective for the “sho” of “sensitive to heat” and “excessive sweating.” Thus, it can be one of the options in oral medicine for treating patients with intractable AD including steroid repellents because the rash improved in a short period of 4 weeks in our patients.

<b>Two Cases in which Byakkokaninjinto was Effective for </b><b>General Malaise in Aging Males </b> / 日本東洋医学雑誌

We report 2 cases in which byakkokaninjinto was effective for general malaise in aging males. In 1939, climacterium disorders with general malaise were reported in aging men in America. Later, late-onset hypogo nadism (LOH) was defined, and guidelines for LOH syndrome were made.<BR>We distinguished two cases of climacterium disorder with LOH syndrome in aging males. We used the AMS score (which is a diagnostic criteria for LOH syndrome) at the first medical examination.<BR>Case 1 was a 48-year-old man suffering from serious headaches every day for which he took many analge sics. His AMS score was 27/85 at the first medical examination. Mild LOH syndrome was suspected in this case. Case 2 was a 48-year-old man suffering from frequent daily hot flashes. His AMS score was 42/85 and moderate LOH syndrome was suspected.<BR>General malaise in aging males arises from a decrease in male hormone with aging and is treated with an drogen hormone replacement therapy (androgen HRT), while Kampo treatment is also a consideration. As Kampo treatments, hachimijiougan and kamishouyousan are usually chosen. Byakkokaninjinto was effective these patients who showed thirst and polydipsia.

Study for Clinical Effects of Byakkokaninjinto on the Patients with Atopic Dermatitis / 日本東洋医学雑誌

We medicated14atopic dermatitis patients who had erythema of the face with byakkokaninjinto. Before prescribing byakkokaninjinto for each patient, a questionnaire on their subjective symptoms or constitutions was carried out. Moreover, in order to evaluate the effect of byakkokaninjinto and the transition of subjective symptoms, such as a hot flushes and thirst of the throat, condition diaries were prepared, and the grade of each symptom was scored by the patients themselves during treatment.These results demonstrated that byakkokaninjinto was effective for patients who had severe hot flushes of the face.

Effect of Byakko-ka-ninjin-to on Interdialytic Body Weight Gain in Chronic Hemodialysis Patients / 日本東洋医学雑誌

To assess the effects of Byakko-ka-ninjin-to on thirst and body weight gain in chronic hemodialysis patients with excessive interdialytic body weight gain, 8 patients (4 men and 4 women, ranging in age from 47 to 75) were prescribed Byakko-ka-ninjin-to extract tablets, 6-12 tablets per day, for 10 weeks. In 4 of the patients, thirst symptoms improved, resulting in significant reduction of interdialytic weight gain. This effect continued to be significant even after cessation of the agent. In the cases of 4 patients whose thirst symptoms did not improve, interdialytic weight gain was not reduced either during or after treatment. For all 8 patients, there were no significant changes in cardiothoracic index, and no adverse effects or events were observed either during or after treatment. Significant reduction in interdialytic weight gain was observed only in the patients with reduced thirst, which suggests that Byakko-ka-ninjin-to allows patients to limit their weight gain by drinking less. These results suggest that Byakko-ka-ninjin-to could be a useful and safe agent to reduce excessive interdialytic body weight gain, at least in a significant cohort of chronic hemodialysis patients.

A Case Report on Generalized Eczema Successfully Treated with Byakko-ka-ninjin-to / 日本東洋医学雑誌

The author treated a 43-year-old woman suffering from generalized eczema with Kampo medicine. During the two months prior to coming to the author's hospital, the patient had been given topical corticosteroids for eruptions with itching in the lower extremities by a local dermatologist. The topical corticosteroids improved her skin lesions, but the effect was temporary. When she stopped using these topical corticosteroids, the eruptions not only recurred, but were larger than before. When she visited this hospital for the first time, exudative erythema and macules were seen over the upper and lower limbs and trunk. The author prescribed Byakko-ka-ninjin-to for her skin lesions. Within two weeks, her erythema and itching had improved, and within four months, her eczema had almost entirely disappeared. One year and seven months later, administration of Kampo was stopped, and there has been no recurrence since she first came for treatment (two years and five months).

The Effects of Byakko-ka-ninjin-to on Patients in whom Thirst has been induced by Disopyramide Phosphate / 日本東洋医学雑誌

Disopyramide phosphate, administered to treat arrhythmias, has an anti -cholinergic effect and produces thirst. As the herbal preparation Byakko-ka-ninjin-to is known to ameliorate the symptom of thirst, Kanebo Byakko-ka-ninjin-to extract was administered orally at a dose of 6.0g/day for 12 weeks. Its efficacy was monitored in the 11 patients receiving this treatment for thirst resulting from Disopyramide phosphate in the form of time-release tablets.<br>No adverse influence on the effectiveness of the Disopyramide phosphate in the treatment of arrythmias was observed upon administration of this Kampo formula. No side effects were observed in 81.8% of the cases. “Remarkable improvement” in thirst was reported by 18.2% of the cases, “improvement” was described by 27.3%, “slight improvement” was presented by 18.2% and “no remarkable change” was experienced by 18.2%. No cases (0%) had “worsening” and no evaluation was possible in 18.2% of the cases. The overall efficacy, which included cases in which the Kampo formula was considered “slightly effective” or better, and which also included the safety of the formula, was 63.6%.<br>This study suggested that Byakko-ka-ninjin-to is useful in the amelioration of the symptom of thirst, a common side-effect of Disopyramide phosphate.

Effect of Byakko-ka-Ninjin-to on Xerostomia in elderly patients. Analysis of the relationship between improvement of subjective symptom and Kampo diagnosis / 日本東洋医学雑誌

The effect of Byakko-ka Ninjin-to-on xerostomia in elderly patients and the relationship between the improvement of subjective symptoms and kampo diagnosis were studied. Xerostomia improved in 60 percent of 30 patients treated with Byakko-ka-Ninjin-to. There were significantly more patients who were less advanced in years and with a good constitution in the effective group than in the non-effective group.<br>Although the occurrence of appetiteoss was significantly higher in the non-effective group, there was no significant difference between the groups with respect to the occurence of constipation, diarrhoea, boborysmus, upper abdominal bloatedness or cold constitution. No significant differences between the groups were shown in the occurrence of oral kampo diagnosis such as bitter taste in the mouth, thirst, stickiness in the mouth, and mucosal dryness.<br>From these results it is concluded that Byakko-ka-Ninjin-to is effective for elderly patients who are not too advanced in year and who have a good constitution and (<i>sthenia</i>).