ABSTRACT
We report a case of refractory transient ischemic attack (TIA) successfully treated with chotosan. A 64-year-old woman with recurrent right hemiparesis and dysarthria was seen in our clinic. Twenty-three months before coming to our clinic, she had a history of right hemiparesis and dysarthria, which resolved soon after treatment. Magnetic resonance imaging (MRI) revealed an ischemic legion in the left corona radiata. Then 4 months before coming, she had repeated transient right hemiparesis and dysarthria, which lasted for 40 to 50 minutes and recurred 3 to 4 times a week. She was hospitalized and treated with an intensive TIA therapy including direct thrombin inhibitor, dual antiplatelet therapy, statin, calcium channel blocker and benzodiazepine. Though she continued the therapy for 4 months, it proved ineffective. She was referred to our clinic, and we started to administer chotosan 7.5 g per day for anxiety and dizziness during an attack. Chotosan attenuated TIA within a week, but aggravated after discontinuation on her own. The medication was resumed and TIA diminished within three months. Chotosan treatment has now been continued for 17 months without a single TIA for 14 months. Multiple studies have shown the protective effect of chotosan against cerebrovascular diseases including cerebral infarction and TIA. Therefore, chotosan may be an effective prescription for refractory TIA.
ABSTRACT
The case was a 70-years-old man whose chief complaint was tinnitus. After the administration of chotosan, his tinnitus was improved in 10 months. In addition, his headache, which had not been his main complaint, also disappeared. However, hypertension, which had not been reported in his history, was newly observed, when his chotosan dosage was reduced. After the usual dosage of chotosan was prescribed again, his blood pressure promptly decreased from the day that the administration started. Chotosan can improve tinnitus, especially in elderly people. Furthermore, this case suggested that chotosan is potentially useful as a primary medication in mild hypertension, when there are no severe coexisting illnesses. And, it may exhibit its anti-hypertensive effects quite rapidly.
ABSTRACT
We successfully treated 2 patients with ophthalmic symptoms due to post herpetic infection using chotosan. Case1was a 78-year-old woman who had been suffering from ophthalmic symptoms such as foreign body sensation and irritation pain due to post herpetic infection for almost 20 years, and had a history of hypertension. We treated her with stellate ganglion block every week and orally administered keishikajutsubuto, amitriptyline, and later mexiletine. Initially, stellate ganglion block was very effective, but its effect gradually decreased over about one month. Considering the same action of stellate ganglion block and chotosan, both of which might increase intracranial blood flow, we administered chotosan instead of keishikajutsubuto. Her ophthalmic symptoms subsided for 5 days, and had completely disappeared almost two and half months after initiating chotosan. Case 2 was a 65-year-old man who had also complained of foreign body sensation due to post herpetic infection for 11 months. He also had a history of hypertension. Initial stellate ganglion block was also effective for relieving his symptom, but the effect was transient as in Case 1. Taking into consideration of our experience in Case 1,we administered chotosan. His foreign body sensation gradually subsided for 2 weeks, and had almost disappeared 2 months after initiating chotosan. Our experiences suggest that chotosan may be an optimal formulation for the patients suffering from ophthalmic disorders due to post herpetic inflammation and hypertension.
ABSTRACT
We successfully treated 2 patients with ophthalmic symptoms due to post herpetic infection using chotosan. Case1was a 78-year-old woman who had been suffering from ophthalmic symptoms such as foreign body sensation and irritation pain due to post herpetic infection for almost 20 years, and had a history of hypertension. We treated her with stellate ganglion block every week and orally administered keishikajutsubuto, amitriptyline, and later mexiletine. Initially, stellate ganglion block was very effective, but its effect gradually decreased over about one month. Considering the same action of stellate ganglion block and chotosan, both of which might increase intracranial blood flow, we administered chotosan instead of keishikajutsubuto. Her ophthalmic symptoms subsided for 5 days, and had completely disappeared almost two and half months after initiating chotosan. Case 2 was a 65-year-old man who had also complained of foreign body sensation due to post herpetic infection for 11 months. He also had a history of hypertension. Initial stellate ganglion block was also effective for relieving his symptom, but the effect was transient as in Case 1. Taking into consideration of our experience in Case 1,we administered chotosan. His foreign body sensation gradually subsided for 2 weeks, and had almost disappeared 2 months after initiating chotosan. Our experiences suggest that chotosan may be an optimal formulation for the patients suffering from ophthalmic disorders due to post herpetic inflammation and hypertension.
ABSTRACT
We evaluated the efficacy of chotosan for headache patients via multiple regression analysis. The subjects were 46 patients with headache (31 migraine, 14 tension-type, and1combination headache), consisting of 1 3males and 33 females, mean age 48 years (range 19-77 years), who were treated with chotosan according to their Sho (symptoms) for more than1month. The relationships between the improvement of headache and 38 factors, including age, sex, height, body weight, hypertension and other symptoms noted upon first medical examination, were examined through multi-dimensional cross-sectional analysis. Morning headache, dizziness, insomnia, body weight, tinnitus and vasodilatation of sublingual veins were significant factors. Morning headache is traditionally an indication for the use of chotosan, and our results support its efficacy for this purpose. Three factors, i.e. morning headache, vasodilatation of sublingual veins and stiff shoulder, were the best subset of explanatory variables. Stiff shoulder is a key symptom for the application of chotosan, while stiffness in the back is a key symptom for the application of yokukansan.
Subject(s)
HeadacheABSTRACT
Japanese pharmacopoeia prescribes a crude drug, Uncaria hook, or the hook-like structures of Uncaria rhynchophylla (Miq.) Jacks, U. sinensis (Oliv.) Havil., and U. macrophylla Wall., while Chinese pharmacopoeia prescribes the hooks with attached stems of above3species, in addition to2other species of Uncaria hook; U. hirsuta Havil. and U. sessilifructus Roxb (all in the Rubiaceae family). Our herbological study has found that the botanical origin was Uncaria rhynchophylla before the Ming Dynasty, and that the part used was not the hook itself, but the plant's bark till the early Ming Dynasty. Use of the hooks with stems began in the late Ming Dynasty. On the other hand, in Japan, the hooks themselves have been mainly collected from wild U. rhynchophylla plants growing in southern warm-temperate zone of Japan, for use in Kampo medicines. We considered this differing Japanese custom was influenced by the descriptions in the Ben Cao Gan Mu (1596)written in the Ming dynasty by Li Si Chen, which state that the hook itself had medicinally sharp power. And we conclude that use of Uncaria bark alone is reasonable for prescriptions which originated before the early Ming dynasty, such as chotosan.
ABSTRACT
Choto-san was administered to 6-week-old spontaneously hypertensive rats (SHR) at the usual dose used for humans and at a 10-times higher dose, and its effects on blood pressure and the autonomic nervous system were examined. Significant blood pressure elevation was noted in the SHRs administered with the 10-fold dose, but no such changes were observed in the SHRs that were administered the usual human dose. Since the urinary levels of adrenaline and noradrenaline and the granulocyte count significantly increased in the 10-fold dose group, the elevation in blood pressure in this group appears to be attributable to stimulation of the sympathetic nervous system. Accelerated sympathetic nervous activity is noted in SHRs during the growing stage, and the excessively high dose of Choto-san probably further stimulated the sympathetic nervous activity.
ABSTRACT
We report three elderly patients in the extended care unit who were successfully treated orally with Chotosan. Case 1 was an 84-year-old male who was hospitalized for lowered volition after aspiration pneumonia in 1999. He received nutrition through a stomach fistula. Administration of Choto-san increased his volition, and he resumed eating normally after practicing swallowing. Case 2 was a 99-year-old woman who was hospitalized for lower volition after a thighbone fracture in 2000. She also could not eat orally, and received nutrition via nasal-tube feeding. After the administration of Choto-san, she developed a will to eat, and she could again have meals orally. Case 3 was an 84-year-old woman who was hospitalized for lowered volition after aspiration pneumonia in 1999. She had pressure ulcers and was often feverish, so she was fed by nasal tube. She was treated with Choto-san, and was able to eat normally again after practicing swallowing. Her pressure ulcers were cured. This suggests that the administration of Choto-san may be successfully utilized as part of a strategy for overcoming swallowing trouble in the elderly.
ABSTRACT
Although the treatment of Parkinson's disease is well established, side effects and weaning effects in the long term are a problem. In this context, it is reasonable to establish an alternative medicine for Parkinson's disease. Hange-byakujutsu-tenma-to in traditional Japanese medicine (Kampo) is similar to Teishingan, a formula for Parkinson's disease in traditional Chinese medicine, in that both formulas contain tenma and qi-supplying agents. We therefore administered Hange-byakujutsu-tenma-to (TJ-37, Tsumura, Tokyo) to a 77-year-old woman with Parkinson's disease. After taking Hange-byakujutsu-tenma-to, her symptoms of rigidity of the upper limbs, frozen gait, propulsion and retropulsion improved. These results suggest that Hange-byakujutsu-tenma-to is useful for treating Parkinson's disease.
ABSTRACT
It has been reported that Choto-san (diao teng san) is effective for the treatment of patients suffering from hypertension. Narrowing of the retinal arterioles is one of the important findings in hypertension.<br>The authors examined the pharmacological effects of Choto-san on the blood pressure and narrowing of the retinal arterioles in spontaneously hypertensive rats (SHR) and strokeprone SHR (SHRSP).<br>SHR and SHRSP rats (nine treatment cases and five control cases) were used. 200mg/kg/day of Choto-san was administered orally to the SHR and SHRSP for 12 weeks. After the 12 weeks of administration, the blood pressure was measured by the tailcuff method. Narrowing of the retinal arterioles was measured by the percentage ratio of the artery to vein caliber.<br>After three months of administration of Choto-san, the blood pressure of the SHR and SHRSP was shown to be significantly lower than that of the control. The percentage ratio of the artery to vein caliber in the treatment group was shown to be significantly higher than that of the control group SHR and SHRSP.<br>These findings suggest that Choto-san may lower the blood pressure and inhibit narrowing of the retinal arterioles in SHR and SHRSP.
ABSTRACT
Choto-san was given to a patient with narcolepsy. Four days later, symptoms such as paroxysmal sleep, impulsive cataplexy and hypnagogic hallucinations had disappeared.<br>In the Kampo treatment of narcolepsy, although there have been reports of remarkable reduction in symptoms upon administration of Kakkon-to 1) 3) and Hochuekki-to-ka-miho 4), this is the first report of the symptoms disappearing so rapidly upon administration of Choto-san.