ABSTRACT
A 75-year-old woman visited a hospital complaining of nausea and anorexia. She was diagnosed with stomach malignant lymphoma, and 6 courses of R-CHOP therapy were performed. Since complete remission was obtained, consolidation radiotherapy was decided. When performing radiation therapy on the stomach, it is desirable to carry it out in an empty stomach. For this reason, it is necessary to skip meals before irradiation. However, in this case, scar stenosis remained in gastric vestibular, and there was always a complaint of stomach discomfort. The treatment plan CT was taken without meals, and full stomach was observed. The patient was judged to be unavoidable due to an organic passage disorder, and a treatment plan was made with a full stomach, and radiotherapy was started. However, she was administered hangeshashinto from the first day of radiation therapy, and stomach discomfort quickly improved. CT was performed again, confirming that the stomach volume was reduced. In this case, in addition to scar stenosis in the stomach, it seems that functional dyspepsia was also involved. It is considered that the promoting effect on gastric emptying function of hangeshashinto was confirmed by CT images.
ABSTRACT
Purpose: The purpose of this study is to evaluate hangeshashinto rinse for oral discomfort in terminally-ill cancer patients and to compare the effectiveness of hangeshashinto rinse with or without honey rinse. Methods: Patients with oral discomfort were randomized to receive either hangeshashinto rinse or hangeshashinto with honey rinse as first-line treatment. Patients performed oral rinse three to five times a day for 2 weeks. Further, oral wetness, halitosis, oral mucositis, mouth discomfort, compliance of rinse were then evaluated before and after the intervention. Results: 144 patients were enrolled during this period and 22 patients completed the study (hangeshashinto 13 / hangeshashinto with honey 9). After the intervention, oral wetness was improved, and end-tidal concentration of hydrogen sulfide was decreased in both cases. Although there was no statistically significant difference, oral discomfort by subjective and objective evaluations, also and symptom of oral mucositis were improved. Other volatile sulfur compounds decreased. Frequency of rinsing between groups receiving hangeshashinto or hangeshashinto with honey did not differ, however, the acceptability was slightly better in the honey combination group. Conclusion: Both hangeshashinto rinse and hangeshashinto with honey rinse reduced end-tidal concentration of hydrogen sulfide and improved oral wetness. Oral rinse by hangeshashinto or hangeshashinto with honey may be effective for oral discomfort in terminally-ill cancer patients.
ABSTRACT
Objective : To evaluate the clinical usefulness of gargling with hangeshashinto (HST) for treatment of oral mucositis (OM) caused by sunitinib in patients with metastatic renal cancer. Patients and methods : The study included 22 patients with sunitinib-induced OM. Among them, 12 patients were instructed to gargle with 2.5 g of HST for 30 seconds after each meal, 3 times a day, and to refrain from eating and drinking afterward (gargling group). The remaining 10 patients were treated without gargling (non-gargling group). The changes in the following outcome measures after treatment were analyzed and compared between the two groups : the Karnofsky Performance Status (KPS), OM grade, body weight, albumin (Alb) levels, hemoglobin (Hb) levels, and eating status. Results : In the non-gargling group, the OM grade and eating status were not well improved, and KPS, body weight, Alb and Hb levels decreased. In the gargling group, despite a decrease in KPS, both OM grade and eating status improved from the day after the start of gargling, while no significant decreases were observed in body weight, Alb levels, or Hb levels after treatment. The gargling group showed better responses in all measures than the non-gargling group. Discussion : OM associated with cancer chemotherapy interferes with treatment completion. HST is a typical Kampo medicine belonging to the shashinto group, gargling with HST is also effective for treating OM. It appears that gargling with HST improves earlier stage of OM and eating status, thereby suppressing a decrease in KPS, body weight, Alb, and Hb levels.
ABSTRACT
A 72-year-old man with proton pump inhibitor (PPI)-resistant gastroesophageal reflux disease (GERD) had been complaining of ructus, sore throat, and mid-back pain during the night despite the administration of the standard dose of PPI. As his symptoms improved rapidly after taking bukuryoin, he discontinued PPI on his own judgment. However, his nocturnal symptoms relapsed. Adding hangeshashinto before bedtime was so effective that he could cease using PPI. However, upper endoscopy revealed poor mucosal findings such as Grade D in the Los Angeles classification of GERD ; we increased the dose of hangeshashinto to 3 times a day and added orengedokuto before going to bed. His subjective symptoms completely disappeared, however, we could not operate endoscopy again during our intervention. It seems that not only rikkunshito which is recommended in the guideline for GERD but also other Kampo formulas were possibly effective to PPI-resistant GERD. Although endoscopic findings are not always correlative to their subjective complaints, we need further discussion on the endpoint of Kampo therapy to prevent complications.
ABSTRACT
It is not a few cases that present with fever and fatigability of an unknown cause. We report a case of fever and fatigability treated effectively with hangeshashinto. The case was 47 year-old woman who had been having fever and fatigability for three years. Sometimes she could not go to work because of this malaise. She was diagnosed with patterns of qi deficiency, upper body heat and lower body cold, qi stagnation and stagnant blood. We carefully considered shinkahiko (epigastric tightness and resistance).<br>Hangeshashinto was prescribed, and her complaints improved remarkably. Hangeshashinto is a well-known Kampo formulation for treating disorders of digestion. But this suggested that hangeshasinto is effective for a variety of symptoms in patients with digestional disorders, who also have a shinkahiko condition.
ABSTRACT
Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced enteritis or oral mucositis. It has been reported that hangeshashinto has been used for not only enteritis but also oral mucositis. This study reports the effect of hangeshashinto on enteritis or oral mucositis caused by radiotherapy. Three patients with enteritis and 5 patients with oral mucositis were treated with hangeshashinto at a dose of 7.5 g/day. The severity of enteritis or oral mucositis was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale both before and after hangeshashinto treatment. After the treatment with hangeshashinto, 3 of 5 patients with oral mucositis and 2 of 3 patients with enteritis showed apparent improvement. In conclusion, it is important to control the side effects of radiotherapy, which lead to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.
ABSTRACT
Imatinib mesylate, a specific inhibitor of BCR-ABL tyrosine kinase, has been mainly used for the management of chronic myeloid leukemia (CML). Common side effects of imatinib include hematologic toxicity, liver dysfunction, edema, fluid retention, gastrointestinal symptoms, and skin rashes among others. We experienced a patient with imatinib-associated diarrhea, who was successfully treated with hangeshashinto. The patient was 61 year-old female, who first consulted our clinic in June, 2005. Her complaint was frequent diarrhea(4 or 5 times a day) which occurred after the introduction of imatinib. Four weeks after hangeshashinto was administered, her bowel movement improved from watery diarrhea to loose stool twice a day. Eight weeks later, her symptom disappeared. It is generally accepted that imatinib should be administered continuously to obtain a complete clinical remission of CML. From the viewpoint of eastern and western medicine integration, it is significant that a Kampo medicine contributed to continuous therapy with imatinib.
Subject(s)
Imatinib Mesylate , DiarrheaABSTRACT
The effects of four Kampo medicines, Ninjin-to, Hange-shashin-to, Rikkunshi-to and Sho-hange-ka-bukuryo-to, were investigated in a rat model of postoperative ileus. The postoperative ileus model was made by incising the abdomen and exposing the small intestine and caecum for five minutes under ether anesthesia. The gastrointestinal transit was estimated by the migration of a charcoal marker. In contrast to the animals anesthetized only, the gastrointestinal transit was markedly decreased in control animals. First, we studied the gastrointestinal prokinetic drugs (cisapride, mosapride and metoclopramide), the anti-inflammatory drug indomethacin, and the Kampo medicine Dai-kenchu-to in this model. They significantly increased the transit as compared with the control. Using the same method, Rikkunshi-to and Sho-hange-ka-bukuryo-to were demon-strated to be almost inactive. However, Ninjin-to and Hange-shashin-to not only significantly improved the gastrointestinal mobility compared to the control, but also showed stronger effects than those of Dai-kenchu-to. These results suggest that in addition to Dai-kenchu-to, Ninjin-to and Hange-shashin-to are also effective Kampo medicines for postoperative ileus.
ABSTRACT
A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.
ABSTRACT
Helicobacter pylori (HP) is associated with gastroduodenal disease. Although it has been reported that HP is highly sensitive to beta-lactams and macrolides, the efficacy of these monotherapies for eradicating HP is rather poor. Recent pharmacological studies have shown the effectiveness of combined therapy using PPI, antibiotics, and bismuth agents or metronidazole, but it has been known to lead to side effects and poor patient compliance. In Japan, mucosal protective agents are principally used for the treament of gastritis and gastric ulcers, and as previously reported, some mucosal protective agents, such as sofalcon and plaunotol, have anti-HP properties. Although they are not sufficiently effective to be used as monotherapy in the eradication of HP, in combination with antibiotics and PPI, eradication rates were elevated and side effects were uncommon.<br>Chinese medicinal formulas have been used for stomach disease in traditional Oriental medicine. The authors studied the effects of combined therapy with Omeprazole (OPZ), AMPC and Chinese medicine (Hangeshashin-to and Sanoshashin-to) instead of mucosal protective agents in the eradication of HP. The study was conducted on a total of 137 HP positive patients with endoscopic evidence of ulcers or gastritis. Dual therapy with OPZ and AMPC had a weak eradicating effect on HP (75%), but combined therapy using OPZ, AMPC and a Chinese medical formula was successful in eradicating HP in 20 out of 24 patients (85%).<br>The antibacterial effects of pharmaceutical preparations and crude drug extracts of Chinese medicine against HP were examined in an <i>in vitro</i> study. No antibacterial action against HP was demonstrated by these agents at concentrations of less than 2000μg/m<i>l</i> concentration. Chinese medicinal preparations should be used in combined therapy with antibiotics and PPI for optimum efficacy in eradicating HP.<br>This new eradication regimen including OPZ, AMPC and Hangeshashin-to is well tolerated; side effects are minimal and uncommon. This triple therapy may be useful in the treatment of HP infection, and is referred to as a “new Japanese regimen.”