ABSTRACT
A 71-year-old woman was referred to our hospital with complaints of gross hematuria. She had been administered 50mg/day of cyclophosphamide for 13 years to treat idiopathic thrombocytopenic purpura (ITP). Cystoscopy revealed irregular surface of bladder mucosa. On suspicion of bladder cancer, we performed transurethral resection of bladder tumor (TURBT). The pathological examination showed polypoid cyst, and we diagnosed hemorrhagic cystitis. Two months after the operation, gross hematuria was observed again. Although we administered choreitogoshimotsuto and then saireito, both were ineffective. Then we administered kamikihito, considering the findings of deficiency of ki (qi) and ketsu (blood) in Kampo diagnosis and the underlying disease ITP. One month after administering kamikihito, gross hematuria disappeared, urinary sediment test showed RBC 1-4/HPF. After one year of follow-up, bladder tumor was suspected by cystoscopy, but the pathological result of the second TUR-BT was inflammatory change. Since then, kamikihito was continued during the 44-month observation period, and no gross hematuria was observed.
ABSTRACT
A 74-year-old woman presented to our clinic with a history of vascular-and stent-graft insertion for aortic dissection developed a tendency to bleed from a palmar wound due to chronic disseminated intravascular coagulation (DIC). Initially, she sustained the palmar wound due to a fall. On the second day after the injury, she experienced continuous bleeding and consulted the orthopedic department of a general hospital, where her dressing was changed. On the third day after injury, she sought consultation at our clinic. The clot and wound remained intact even 12 days after the injury. Therefore, the clot was removed and the bleeding was stopped surgically. On the same day, 5 hours after the surgical treatment, the patient presented to our clinic because of continuous bleeding. She was then administered kyukikyogaito and kamikihito to stop the bleeding. Her laboratory findings revealed thrombocytopenia, and additional inspection was performed. The bleeding stopped on the next day. On the third day after administration, the bleeding remained controlled and an additional inspection revealed DIC. In the cardiology hospital, the cause of tendency to bleed of chronic DIC was pointed out as being due to a leakage at the end of the stent-graft. Kampo medicine was thought to be useful for temporal hemostasis for bleeding due to chronic DIC.
ABSTRACT
An eight-year-old girl was referred and admitted to our hospital with the chief complaint of purpura on her lower legs. Blood tests revealed pancytopenia, and bone marrow findings showed marrow hypoplasia. Refractory cytopenia of childhood (RCC) was diagnosed based on the central diagnostic system of the Myelodysplastic Syndrome Committee of the Japanese Society of Pediatric Hematology. Immunosuppressive therapy was performed with the administration of rabbit antithymocyte globulin, methylprednisolone and cyclosporin A,but it was not effective. Eight months after admission to our hospital, Kampo treatment was started based on traditional Kampo diagnosis. After treatment with oral administration of kamikihito and kyukikyogaito, her pancytopenia gradually improved. Erythrocyte transfusion was discontinued after 2 months, and concentrated platelet transfusion also became unnecessary after 3 months. As a result of improvement in pancytopenia, her white blood cell count, hemoglobin value, and platelet count reached almost normal levels after 16 months. The scheduled bone marrow transplantation was canceled. The action mechanisms of kamikihito and kyukikyogaito for RCC are not clear, and their effective rates are also unknown. However, Kampo treatments are less invasive, inexpensive, and have few side effects. We believe that Kampo medicine is a therapeutic method that should be actively attempted in cases of RCC with poor response to standard treatment.
ABSTRACT
In dentistry, it is empirically known that the acute exacerbation of periodontal disease often occurs at the time of fatigue, but scientific verification has never been made about the relationship of fatigue and bleeding. In Kampo medicine, there is the concept of spleen failing to control the blood as bleeding at the time of fatigue. Kihito and kamikihito are often used for this condition. Spleen failing to control the blood means that lack of vital energy causes the bleeding. Kamikihito is most often used in the treatment of idiopathic thrombocytopenic purpura. Moreover, there have been some reports on the use of kamikihito in the treatment of gynecological fraud bleeding and aplastic anemia. However, there has been no report on the use of it in the treatment of gingival bleeding. In this case, neither cytopenia nor obvious coagulopathy was recognized. In Kampo medicine, not only spleen failing to control the blood but also blood stasis or blood heat is considered to be the cause of bleeding, but the effectiveness of kamikihito for this case suggested pathophysiology of spleen failing to control the blood. Kamikihito could be a choice to treat gingival bleeding at the time of fatigue.
ABSTRACT
The efficacy of gemcitabine (GEM) monotherapy for recurrent ovarian cancer has been confirmed. Although it induces adverse reactions due to bone marrow toxicity, such as thrombocytopenia, there are no other effective treatments other than blood transfusion. Kamikihito has been reported effective for thrombocytopenia in about 20% of idiopathic thrombocytopenic purpura (ITP) cases, but there has been no report on its efficacy for thrombocytopenia caused by GEM administration. We encountered a patient with grade-2 thrombocytopenia in whom concomitant kamikihito improved thrombocytopenia, and it was also effective in improving response to chemotherapy. A 59-year-old patient developed thrombocytopenia in the first cycle of GEM therapy, and the dose was reduced or the drug was withheld appropriately until the 8th cycle. When kamikihito was concomitantly administered in the 9th cycle, thrombocytopenia was improved. The patient is now being treated in a 17th cycle, and is in a stable disease (SD) state. This suggests that kamikihito improves GEM-induced thrombocytopenia, as well as mental symptoms.
ABSTRACT
We describe three cases of premenstrual syndrome (PMS) and menstrual pain successfully treated with kamikihito. Case 1 was a 26-year-old female who became irritated and had breast pain before menstruation, as well as suffering from menstrual pain. She was treated with kamikihito, because she easily became fatigued, which is a symptom of <i>qi </i>deficiency, and had insomnia. After taking kamikihito, the fatigue and insomnia initially improved, and then her PMS and menstrual pain were also ameliorated. Case 2 was a 38-year-old female with general fatigue that prevented her from performing daily housekeeping tasks, insomnia, and irritability before menstruation. Case 3 was a 31-year-old female who frequently suffered from cystitis, as well as general fatigue, insomnia, and depression. After taking kamikihito, the PMS and menstrual pain were improved, and her cystitis did not recur.<br>Kamikihito is based on kihito, with the addition of bupleurum root and gardenia fruit. Kamikihito could be a suitable herbal medicine for patients with PMS and menstrual pain, who have symptoms of <i>qi </i>deficiency and report insomnia or show signs of <i>qi </i>stagnation.
ABSTRACT
Case 1 was a 40-year-old woman who used a facial treatment machine and felt burning facial pain at night.She then felt unpleasantness in her facial skin all day long and was too uncomfortable to leave her home. We prescribed kamikihito. Ten days later, she felt the positive effects of treatment. Forty-five days later, she did not feel the unpleasantness on her facial skin, and she was able to go out again. Case 2 was a 36-year-old woman who had intense inflammation of her face, because she had stopped treatment with a steroid ointment.After 6 months, her face still felt hot and strange, which decreased her quality of life. We prescribed yokukan sankachinpihange. Four weeks later, she felt the positive effects of the treatment, and 14 weeks later, she was able to restart her part-time job. Because both of these cases had received various types of conventional medi cal therapy in the beginning that were not effective, their Kampo therapy was begun a long after the start of their abnormal facial sensation symptoms. Kampo therapy demonstrated a positive effect after approximately one month in both of these refractory cases. Thus we recommend Kampo medicines for the treatment of abnor mal facial sensations.
ABSTRACT
Myelodysplastic syndrome (MDS) is very difficult to treat, especially in case requiring blood transfusion therapy. Kami-kihi-to (Jia-Wei-Gui-Pi-Tang) was reported to have had a hematological effect on a case of idiopathic thrombocytopenic purpura. As it is well known that Kami-kihi-to improves anemia, we tried Kami-kihi-to for a case of MDS needing frequent blood transfusion, and analyzed its hematological and systemic effects. A 74-year-old man with MDS suffered from appetite loss and general fatigue-probably due to hemochromatosis with liver dysfunction after chemotherapy with prednisolone, metenolone and blood transfusion-for about eight years. Kami-kihi-to was administered to the patient, and two months later, his leukocyte and platelet count of peripheral blood increased, while the red cell count did not increase. Bone marrow findings remained constant before and after Kami-kihi-to therapy. The appetite loss and general fatigue improved after six weeks of this treatment. Kami-kihi-to is an appropriate treatment option for MDS with hemochromatosis that induces appetite loss or general fatigue.
ABSTRACT
In order to examine the effectiveness of Kami-kihi-to for changing bone mass, we measured for osteopenia in ovariectomized (OV) rats using two methods: computed X-ray absorptiometry and a metabolism measuring system.<br>Materials and methods: 24 female Wistar rats (8 weeks old, 160-180g) were divided into three groups. Group one and group two Wistar rats were OV rats in which systemic osteoporosis was induced. After that group one (OVX [Kampo]) was administered Kami-kihi-to (500mg/kg) for 6 months. Group two (OVX [CTL]) was administered only water. Group three (NR) was untreated as the control. In each group, bone mineral density was measured before starting treatment and after 1, 3, and 6 months of treatment, and locomotor activity was determined before starting treatment and after 6 months of treatment.<br>Result: Bone mineral density showed little change over 6 months in the NR group. However, it was significantly lower in the OVX (CTL) group than in the NR group 3 months after ovariectomy. But in the OVX (Kampo) group, its decrease was obviously inhibited after 6 months of treatment compared with the OVX (CTL) group.<br>Moreover, in the NR group, the pattern of activity was regular. In the OVX groups, there was no clear difference between the active and resting phases and the pattern of activity was irregular. In the OVX (Kampo) group, the pattern of activity became diphasic, with clear active and resting phases as was observed in the NR group.<br>Conclusion: These results demonstrated that the pattern of regular activity affected increase of bone mass secondary due to the administration Kami-kihi-to.
ABSTRACT
We administered active vitamin D (AVD) to female patients with osteoporosis at a dose of 1μg, or Kami-kihi-to (KKT) at a dose of 7.5g every day for 6 months. To measure bone mass in patients with osteoporosis we employed the computed X-ray densitometer (CXD) method and examined change of bone mass and blood biochemical analysis in patients on long-term therapy with AVD or KKT. Patients with osteoporosis were divided into three groups: Control group, AVD group and KKT group. One year after administration, the bone mass of AVD and KKT groups significantly increased compared to that of the control group. Moreover, the KKT group clearly showed an increased red blood cell (RBC) count and an improvement of the simple menopause index (SMI) which correlated with bone mass and induced hemopoiesis. Two years after administration, the difference in bone mass between the AVD and control groups further increased. In contrast, the KKT group did not show any recovery of osteoporosis, anemia or SMI compared with 1 year previously. This indicates that the increase in bone mass associated with AVD is transient. These results demonstrate that KKT gradually activated bone metabolism and indirectly increased bone mass. Further modified methods of KKT administration such as increasing dose and duration may have potential for the treatment of osteoporosis with reduced cortical bone formation.
ABSTRACT
The patient was a 64-year-old woman who was admitted to the authors' hospital with purpura. Her platelet count was 4.3×10<sup>4</sup>/μl. Oral administration of Kamikihi-to alone did not produce an increase in the platelet count. After oral administration of prednisolone, the platelet count increased to maximum of 20.0×10<sup>4</sup>/μl. However, the platelet count decreased to 4.4×10<sup>4</sup>/μl after the prednisolone was tapered off. Upon supplementary oral administration of Kamikihi-to, the platelet count again increased to a maximum of 27.1×10<sup>4</sup>/μl. Thereafter, the dose of prednisolone could be reduced. Thus, Kamikihi-to is recommended for cases of idiopathic thrombocytopenic purpura not controlled by corticosteroids.
ABSTRACT
The effect of Kami-kihi-to on elderly patients with mild depression (HRS score<30 points) was studied. After 3.5 weeks of treatment with Kami-kihi-to, 76.6% showed improvement. For insomnia, anxiety, and anorexia, benzodiazepines or Juzentaiho-to were added. Provided that there is no suicidal ideation and asthenia, Kami-kihi-to is considered to be effective for elderly patients with mild depression.
ABSTRACT
Hypersplenism is an intolerable postoperative complication of biliary atresia. Partial splenic embolizatoin (PSE) is usually performed on patients with severe hypersplenism. However, the results of this procedure are not uniform, and repeated embolization is sometimes needed. Furthermore, the procedure is unavailable or unacceptable for some patients. There are no adequate drugs for this condition. The authors administered Kamikihi-to, Hochuekki-to, and Ninjinyoei-to for five patients with hypersplenism. The results of this study suggest that these Kampo formulas can stop further deterioration of this condition. Sairei-to was also used for two patients after PSE. Sairei-to was useful for support of the post PSE condition.
ABSTRACT
A study of the classical references to the Kampo formulas Kihi-to and Kamikihi-to was conducted. The common constituents for Kihi-to today are Ginseng Radix, Atractylodis Rhizoma, Hoelen, Longanae Arillus, Zizyphi Spinosi Semen, Astragali Radix, Polygalae Radix, Angelicae Radix, Saussureae Radix, Glycyrrhizae Radix, Zingiberis Rhizoma and Zizyphi Fructus. The Kihi-to noted in the ‘Saiseiho’ (‘Ji Sheng Fang) did not contain Angelicae Radix and Polygalae Radix, and the Kihi-to in the ‘Gyokukibigi’ (‘Yu Ji Wei Yi’) adds Angelicae Radix to the formula found in the ‘Saiseiho, ’ The ‘Sesshi-ian’ (‘Xue Shi Yi An’) also adds Polygalae Radix. In the ‘Sesshi-ian’ there are three formulas given for Kamikihi-to: one with Bupleuri Radix and Gardeniae Fructus, one containing Bupleuri Radix, Moutan Radicis Cortex and Gardeniae Fructus, and one with Moutan Radicis Cortex and Gardeniae Fructus. Although all three variations can be found in the formula guidelines in circulation during the Edo period in Japan, at present, the formula containing Bupleuri Radix and Gardeniae Fructus is the most prevalent. This is most likely due to the influence of the ‘Futsugo-yakushitsu-hokan’ and ‘Futsugo-yakushitsu-hokan-kuketsu’.<br>In summary, the classical texts which included Kihi-to and Kamikihi-to were found to be the ‘Saiseiho’, ‘Gyokukibigi’, and the ‘Sesshi-ian’