Significance of Combined Use of Kamishoyosan and Tokishakuyakusan for General Infertility Treatment / 日本東洋医学雑誌

We aimed to clarify the significance of using Kampo therapy centered on kamishoyosan and tokishakuyakusan together with general infertility treatment. The subjects were 41 women who visited a Kampo outpatient clinic for infertility and received general infertility treatment with Kampo therapy (Kampo group). The control group was 781 women who received only general infertility treatment at the same time (non-Kampo group). In comparing both groups, we conducted a retrospective survey on the pregnancy rate by cycle and the pregnancy rate by prescription. The pregnancy rate in the first cycle was 24.4% in the Kampo group and 8.5% in the non-Kampo group, and the pregnancy rate was higher in the Kampo group (P = 0.003). There was no difference in pregnancy rates after the second cycle. The pregnancy rate by prescription was 26.7% for kamishoyosan, 22.2% for tokishakuyakusan, and 8.5% for the non-Kampo group. In the comparison between the first cycle pregnant group and the non-pregnant group, the qi counter flow score was clearly higher in the first cycle pregnant group (P = 0.012). It is suggested that combined use of Kampo therapy including kamishoyosan and tokishakuyakusan may be effective from an early stage. Meanwhile, if pregnancy does not occur even after the combined use of Kamp therapy, it would be an opportunity to consider stepping up as Western medical therapy.

The Features of Oriental Medicine and Kampo Treatment for Undifferentiated Finger Arthritis / 日本東洋医学雑誌

There are cases of finger pain in which a definite diagnosis including rheumatoid arthritis cannot be made even after thorough examinations. We herein report the results of Kampo treatment in such cases with so called undifferentiated arthritis. Sixty­-two patients (male, n = 5 ; female, n = 57 ;average age, 49.7 years) were included in the present study. There is a tendency of the Kampo concept of a cold pattern (n = 39 ; 63%), static blood (oketsu, n = 47;76%), and qi stagnation (n = 44 ;71%). Among the 62 cases, excellent results were ob­tained in 29 cases (47%), good results were obtained in 10 cases (16%), and no effect was obtained in 23 cases (37%). Kamishoyosan, which was administered in 30 cases, was the most commonly used Kampo medicine. In most cases, Kampo treatment was given with a combination of two or more formulas. A paired formula of kamishoyosan and keishikaryojutsubuto was used in 9 cases, 8 of which showed good or excellent results (efficacy rate : 89%). Qi- and/or ketsu-­tonifying formulations and formulations with warming effects were often used for the treatment of undifferentiated finger arthritis.

A Combination of Kamishoyosan and Hochuekkito was Affective to Improve Negative Symptoms of a Patient with Schizophrenia, Paranoid Type / 日本東洋医学雑誌

We experienced a case of paranoid schizophrenia whose negative symptoms such as fatigue and depression were successfully treated with kamishoyosan and hochuekkito. The combination of medical herbal extracts did not affect positive symptoms. Herbal medicine may play not only a supporting role in treating mental disorders in general but also an important role in improving negative symptoms of schizophrenia.

<b>Indicators for Treatment of Coldness with Tokishakuyakusan and Kamishoyosan </b> / 日本東洋医学雑誌

<i><b>Objectives </b></i>: We evaluated the efficacy of tokishakuyakusan and kamishoyosan for patients who complained of feeling cold, and identified key symptoms that would predict positive treatment outcomes for coldness with these medicines.<br><i><b>Design </b></i>: A retrospective cohort study<br><i><b>Subjects and Methods </b></i>: The subjects were 188 patients who reported feeling cold. They were treated with tokishakuyakusan or kamishoyosan according to their <i>Sho </i>for more than one month. The relationships between improvement of cold sensation and 62 factors, including other symptoms noted at the first medical examination, were evaluated by means of cross-sectional analysis, followed by logistic regression.<br><i><b>Results </b></i>: The factors of coldness of the abdomen (odds ratio, 5.0), vertigo (7.7), dimness of sight (16) and blushing (5.6), without anger (0.11) or tinnitus (0.025), were found to be predictors of a positive effect with tokishakuyakusan treatment (p < 0.001). The factors of hot flushes (14), without coldness of the whole body (0.099), and faint feeling (0.21) were significant for kamishoyosan (p < 0.001). This suggests that kamishoyosan can improve subjective coldness of the extremities (AIC -8.64), especially of the legs (-2.23).<br><i><b>Conclusions </b></i>: Coldness in the abdomen was an important indicator for treatment with tokishakuyakusan, while coldness in the legs, but not in the whole body, was important in the case of kamishoyosan.

<b>Three Cases of the Same Kampo Treatment Applied to a Mother and Daughter with Different Complaints </b> / 日本東洋医学雑誌

We describe three cases in which the same Kampo formulas were applied to a mother and daughter with different complaints. In cases 1 a, b, a mother with general fatigue after an operation for gastric and colon cancer, and her daughter with migraine and menopausal symptoms were effectively treated with kamishoyosan. In cases 2 a, b, a mother with menstrual disorder, and her daughter with palmar eruption were effectively treated with hangekobokuto. In cases 3 a, b, a mother with lumbago and her daughter with back pain were effectively treated with keishikaryukotsuboreito. These Kampo formulas are thought to improve <i>qi </i>circulation.<br>It is considered that improving <i>qi </i>disturbance is important for the Kampo treatment of female patients. Taking into account parent-child genetic similarities, it is possible that application of the same Kampo formula to familiarly related patients with different complaints could be effective. It is important to consider not only the patient's complaints, but also the patient's condition, from the Kampo viewpoint so-called “Sho”. Therefore,since our cases all involved a mother-daughter relationships, it may be reasonable to assume that Kampo formulas improving <i>qi </i>circulation were effective for their different complaints.

Analysis of 100 Women with Infertility Due to Ovarian Dysfunction Who Succeeded in Delivering Live Children after Kampo Therapy Diagnosed by \lq\lqZheng\rq\rq / 日本東洋医学雑誌

To determine the Kampo therapy indications for global infertility treatment, and the criteria for objective and rational evaluation of its efficacy, we analyzed the sho (Zheng), type of ovarian dysfunction, types of Western drugs used concomitantly, length of treatment, age upon pregnancy, etc., in 100 women with infertility due to ovarian dysfunction as diagnosed by Western medicine who succeeded in becoming pregnant and giving live births, after Kampo therapies diagnosed by sho based on Hakko, Ki, Ketsu and Sui. The diagnosis of the sho in these women was compared with that in 2737 control women. Their types of sho by frequency were Kyo (51%), Shoyo (Hanhyo-Hanri) (69%), Jonetsu-Gekan (52%), Kigyaku (47%), Oketsu (71%) and Suidoku (67%). When compared to the control group, the percentage of women whose Sho was rated as Jitsu, Taiyo, Shoyo, Jonetsu-Gekan, Oketsu or Suidoku was significantly higher. The sho type Hyonetsu-Rikan was lower. The preparation sho, rated on the basis of a general assessment, was most frequently Kamishoyosan(55%). The predominant type of ovarian dysfunction was luteal dysfunction (73%), whose frequency was significantly higher than that in the control group. Of all women studied, 46% were treated with Kampo alone and 54% were treated with Kampo + Western medicine. In terms of the percentage of each type of ovarian dysfunction, there was no significant difference between the two groups. The Western drugs used in combination with Kampo therapy were hCG preparations (33%), terguride preparations (18%), clomiphene preparations (3%) and hMG preparations (6%). The period of treatment until pregnancy was significantly shorter in the Kampo alone group (5.0 ± 4.4months) than in the combined therapy group (9.5 ± 6.8months). These results allow us to make the following conclusions:1.The type of infertility indicated for Kampo medicine is infertility due to ovarian dysfunction as diagnosed by methods of Western medicine.2.Women who successfully became pregnant following Kampo medicine were often cases of Shoyo disease complicated by sho with Jonetsu-Gekan, accompanied by Kigyaku, Oketsu and Suidoku.3.Uncombined Kampo medicine may be effective in cases of severe infertility.4.If pregnancy does not occur within 5 or 6 months after the start of Kampo therapy, combined use of Western medicines should be considered.

Investigations of Two Cases Initially Diagnosed as Having Absence of Competent Ovum at \it{in vitro} Fertilization but Having Succeeded in Obtaining Live Births after Short-Term Kampo-therapy Diagnosed by \lq\lq\it{Zheng}\rq\rq / 日本東洋医学雑誌

For two infertile couples with normal tubal function and spermatogenesis, who were diagnosed with infertility attributed to lack of competent ovum with poor grade embryo in spite of having received timing therapy and step-up therapy (artificial fertilization from husband ; AIH and in vitro fertilization and embryo transfer ; IVF-ET), Kampo-only therapies diagnosed according to their “Zheng” syndrome-type consisting of one cycle of tokishigyakukagoshuyushokyoto, and two cycles of kamishoyosan and anchusan was performed. As a result, both women became pregnant and gave live births. The causes of infertility in these two cases were analyzed, and problems with step-up therapy, commonly used in Western medicine and efficacy of Kampo-therapy diagnosed according to their Zheng were evaluated from the standpoint of Western medicine.Kampo-therapy diagnosed by Zheng was found to improve the follicular and luteal functions as well as related functions. The two cases presented were diagnosed as infertile due to ovarian dysfunction on the basis of therapeutic diagnosis. The indications of IVF-ET are tubal and male infertilities, not to be ovarian dysfunctional infertility.For infertility due to ovarian dysfunction, Kampo-therapy diagnosed by Zheng with Kuoketsu and Risui effects are drugs of first choice, rather than clomiphene, which has an anti-estrogen activity.

Practice of the Assimilation of Kampo and Western Medicine / 日本東洋医学雑誌

Chinese herbal remedy (KAMPO) is no longer an out-of-date medicine. It is now transforming into a new medical care system that attracts world-wide attention. The therapeutic system of Oriental Medicine is different in various aspects from that of Occidental Medicine. In this regard, appropriate harmonization of East and West (Oriental Medicine and Occidental Medicine) by comparison with merits and demerits in the understanding of diseases, methods of consultation, usage of drugs, etc. is expected to improve the quality of medical care. Considering that most of the drugs used in the Occidental Medicine are based on “single effective ingredient” that is artificially synthesized while herbal drugs are produced by combining crude drugs that contain various ingredients, the method of administration should naturally be changed.Such stance of Kampo medicine is based on the “respect for and understanding of individual constitution and disposition while paying attention to the gender difference and individuality” with the patient as the protagonist (treatment that is centered on client) and is also based on understanding and respecting the gender difference and individuality that are the basis of so-called “Science and Art” of practical medicine.

Efficacy of Kampo Medical Treatment Focused on Kami-syoyo-san against Premenstrual Syndrome (PMS) / 日本東洋医学雑誌

Approximately 40% of women during the course of their menstrual cycles suffer from premenstrual syndrome (PMS). The cause of this syndrome is unknown, furthermore diagnostic criteria and treatments have not been established. Kampo medicines were applied using Kami-shoyo-san as a first choice, and several other alternative Kampo medicines, to 33 PMS patient cases. To evaluate the effectiveness of this therapy, PMS scores were recorded prior to treatment. Patients' scores were recorded as; score 0 (symptomless), score 1 (endurable), score 2 (unbearable without medicine), as well as the five major characteristics of PMS, 1) psychiatric symptoms, 2) headache, 3) breast pain, 4) swelling, 5) lower abdominal pain or lumbago. The scores were verified subsequent to two menstrual cycles. Kampo medicine was found to be effective in 24 cases, with scores declining in average from 4.4 to 1.5. Further treatments were requested in 4 cases, moreover, 5 cases were discounted altogether. Thus Kampo medicine proved to be a very useful method for patients suffering from PMS.

Evaluation of the Effect of Kampo(herbal) Medicine to Diminish Climacteric Symptoms Induced by the GnRH Agonist / 日本東洋医学雑誌

In the hormonal treatment of uterine myomas, which are estrogen dependent, GnRH agonist (GnRHa) therapy has become widespread. However, GnRHa therapy causes uncomfortable or harmful side effects such as climacteric symptoms. The aim of this study is to evaluate the effect of Kampo (herbal) medicine to diminish climacteric symptoms induced by the GnRHa. Twenty-six patients with symptomatic uterine myoma were recruited, and informed consent was obtained from all subjects. Leuprolide acetate depot 3.75mg (LA) as GnRHa was given with subcutaneous injection every four weeks for six months. After LA therapy was initiated, Toki-shakuyaku-san, Kami-shoyo-san, or Keishi-bukuryo-gan was given from the second month of treatment. Climacteric symptoms were evaluated with Simplified Menopausal Index, which was improved for Japanese women. In the present study, we found all three Kampo medicines were useful. In particular, Kami-shoyo-san was useful for climacteric symptoms induced by LA. Also, LA therapy combined with Keishi-bukuryo-gan had beneficial effects in uterine myomas. However, the precise mechanism by which results were achieved remains unclear. Therefore, further research may be necessary to evaluate the ability of Kampo medicines to diminish climacteric symptoms induced by GnRHa.

A Case of Chronic Hepatitis C, in which Elimination of Hepatitis C Virus was Achieved by Kampo Treatment / 日本東洋医学雑誌

Chronic hepatitis C has a high incidence of proceeding to liver cirrhosis, and a natural healing from chronic hepatitis C is extremely rare. We observed a case of chronic hepatitis type C, in which the virus was eliminated after Kampo treatment. The patient was a 37-year-old female who underwent a blood transfusion following delivery of her first child in 1982. In January 1983, she became aware of general malaise, and was diagnosed as having chronic hepatitis. She was treated with Stronger Neo Minophagen C, but her symptoms and laboratory data were unchanged. A liver biopsy disclosed chronic active hepatitis in 1988, and she was transferred to our hospital for Kampo treatment in May. Although the symptoms rapidly disappeared after treatment with the Kampo formulas, Hochu-ekki-to and Keishi-bukuryo-gan, her transamilase values did not change. Her transamilase level decreased gradually after the prescription was changed to Saiko-keishi-to-go-Toki-shakuyaku-san-ryo, and returned to normal after her prescription was changed to Kami-shoyo-san-ryo in May 1996.<br>Concerning HCV-RNA in the serum, in March 1995, when Saiko-keishi-to-go-Toki-shakuyaku-san was administered, the amount of HCV-RNA in the serum was 10⁴ Kcopies/ml. But that was less than the detectable sensitivity in April 1998. We believe this to be a case in which elimination of HCV was achieved by Kampo treatment alone.

Four Cases of Chronic Constipation Treated with Kami-shoyo-san / 日本東洋医学雑誌

In Japan chronic constipation is divided into two groups: atonic constipation and spastic constipation. Stimulant laxatives are unsuitable for patients with spastic constipation, and routine use of stimulant laxatives over long periods of time should be discouraged. Nevertheless stimulant laxatives are often used continually among these patients because their stools are too hard and infrequent without stimulant laxatives.<br>In this report, we present 4 cases of chronic constipation treated with Kami-shoyo-san. Cases 1, 2 and 3 were patients with spastic constipation and case 1, 3 and 4 had used stimulant laxatives continually. In all cases both stimulant laxatives and Kampo medicines containing Rhei Rhizoma caused adverse effects such as abdominal discomfort and pollakisuria. Kami-shoyo-san improved bowel movement as well as other complaints: irritability, heat in the upper part of the body, painful tension of shoulder muscles, fatigue, dysmenorrhea and pollakisuria. Withdrawal from stimulant laxatives was achieved in the patients except for case 2. In drug treatment of chronic constipation, Kampo medicines such as Kami-shoyo-san seem to be useful in withdrawal from stimulant laxatives.

Clinical Features of Patients with Indefinite Complaints. Comparison between Saiko-ka-ryukotsu-borei-to and Lami-shoyo-san / 日本東洋医学雑誌

Before the administration of conventional medicines, outpatients with indefinite complaints answered 51 questions (six mental categories) from the Cornell Medical Index (CMI) and 43 questions (seven physical categories) from the Abe questionnaire for vegetative syndrome. The subjects of this study were 18 cases with CMI III-IV scores who were effectively treated with Saiko-ka-ryukotsu-borei-to (n=9; SR group) or Kami-shoyo-san (n=9; KS group). In order to compare the clinical features of both groups, the average complaint rates responding to the mental and physical categories were evaluated in each group.<br>Psychologically, the average complaint rates related to depression and tension were high in the SR group, and the average complaint rates related to hyper-sensitivity and anger were high in the KS group. Discriminant analysis revealed that three categories —tension, hyper-sensitivity and depression— contributed to a difference between the SR and KS groups. Physically, the average complaint rates responding to all of 7 categories of the SR group were not significantly different from those of the KS group.

Effects of Kami-shoyo-san on the Indefinite Complaints / 日本東洋医学雑誌

Physical and psychological symptoms were evaluated in 9 cases with unidentified clinical syndromes who were effectively treated with kami-shoyo-san (KS). Before and after administration, the patients were tested with the 43-question Abe questionnaire for vegetative syndrome and 51 questions (M-R) of the Cornell Medical Index. After administering KS for three months, the mean number of physical symptoms decreased from 19.9 to 9.1, and the psychological symptoms decreased from 16.7 to 9.3.<br>In order to clarify the clinical features for which KS is efficacious, the physical and psychological symptoms were divided into 7 and 6 categories, respectively. The average complaint rates responding to those categories before administration were evaluated. Physically, the average complaint rates related to locomotion and fatigue were high, and those related to digestion were low. Psychologically, the average complaint rates related to hypersensitivity and anger were high, and those relating to depression and tension were low.

The Sources of Kampo Formulae, Kami-shoyo-san and its Combination with Shimotsu-to / 日本東洋医学雑誌

The source of Kami-shoyo-san varies in the literature. The current formula contains ten kinds of medicine. Only Shoyo-san is described in “He ji ju fang”. In “Nü ke cuo yao” and “Nei ke zhai yao”, a formula containing eight medicines without ginger and mentha was descrided. It was in “Wan bing hui chun” after Xue Ji that a formula containing ten kinds of medicine was first specified. The source of its combination with Shimotsu-to also varies in the literature. There is no mention of this combination in the “He ji ju fang”. In the “Nei ke zhai yao”, there is a case where eight-medicine formulations in combination with Shimotsu-to were used. Although ten-medicine plus Shimotsu-to are, in fact, described in “Futsugo-yakushitsu-houkan-kuketsu”, my investigation found that such a combination formula was used for general pruritus in “Ryo-chikeiken-hikki” about 90 years previously. I believe that if the process of establishing a formula is complicated, as in the case of Kami-shoyo-san, every activity contributing to each step in establishing the formula is generally included as a part of its source and that any activity, in which a combination of formulae was very effective, is regarded, in principle, as its source.