ABSTRACT
Nightmares are common in patients with advanced cancer. However, there are no standard treatment of nightmare in patients with cancer. We experienced a case with nightmares improved by Saikokaryukotsuboreito (SRBT). An 82-year-old man with malignant lymphoma experienced insomnia and nightmares. Antidepressants, orexin receptor antagonists, and atypical antipsychotics failed to improve the symptoms, but SRBT immediately eliminated his insomnia and nightmares. SRBT, an herbal medicine, has been used in a variety of clinical situations for treatment of stress-induced psychiatric symptoms, i.e., anxiety, depression, and insomnia, without serious adverse events. Several reports suggest that SRBT improves depression and anxiety with the effects on chronic stress-induced disruption of hypothalamo-pituitary-adrenal axis. The effects of SRBT might have improved nightmares in this case. SRBT may be a drug of choice in the treatment of nightmares in patients with cancer.
ABSTRACT
In cases of pulsatile tinnitus, the presence of organic disease should be suspected, and many of them can be treated once the cause is identified. However, there are idiopathic cases in which the cause cannot be identified, and there is no established treatment for them. Here, we report 2 cases in which Kampo medicine was effective for idiopathic pulsatile tinnitus. Case 1 was a 50-year-old man. He had been stressed for half a year due to the change of job title in his workplace, and he had left pulsatile tinnitus a month ago. We administered saikokaryukotsuboreito, and his tinnitus disappeared in a week. Case 2 was a 30-year-old woman. She gave birth 4 months ago, and after giving birth, she had less sleep and was tired and stressed. She started to notice right pulsatile tinnitus and dizziness from a month ago. We administered nyoshinsan, and her tinnitus and dizziness disappeared in 2 months. In both cases, they were aware of hot flashed on their face as a symptom of qi counterflow, and Kampo treatment improved the symptom together with pulsatile tinnitus. It is possible that blood flow in the head increased with qi counterflow, causing relative stenosis of the blood vessels in the head, leading to turbulence in the lumen of the blood vessels, and hearing pulsatile tinnitus.
ABSTRACT
Kampo formulations can be prescribed for patients with different symptoms. We report two cases with different symptoms : a girl in her early teens and her grandmother. Case 1 was a 13-year-old girl and the grandchild of Case 2. She was unable to attend school. Case 2 was a 73-year-old woman who presented with increased fatigability. After treatment with saikokaryukotsuboreito, both cases experienced improved symptoms. It was suggested that they had the same Kamp pathology because they were related by blood and shared a common environment. Consequently, both cases were effectively treated using one formulation : saikokaryukotsuboreito.
ABSTRACT
Paroxysmal atrial fibrillation (pAf) is an arrhythmia that often occurs in the elderly. The quality of life often declines due to severe palpitations caused by pAf. We present a case of recurrent pAf that occurred on postoperative day 2 of coronary artery bypass grafting and pulmonary vein isolation for unstable angina pectoris and pAf. The patient was a 62-year-old man who complained of palpitations, which was consistent with pAf on the monitor ECG. During hospitalization, the patient was constantly wearing an ECG monitor. During pAf, the heart rate was around 120 bpm, and pAf could continue for up to and beyond 24 hours. Paroxysmal atrial fibrillation with strong palpitations was observed every day, even after starting beta-blockers and anticoagulants. After discharge, a Japanese Kampo medicine called shakanzoto was taken for a month, but there was no improvement. After that, it was changed to another Japanese Kampo medicine called saikokaryukotsuboreito, because abdominal examination revealed kyokyokuman (hypochondriac discomfort and distension (resistance)) and saiboki (brisk pulsation in the para-umbilical region). Palpitations quickly improved dramatically. It was speculated that not only palpitations but also pAf had been improved.
ABSTRACT
The low back pain is often intractable and leads to the drop of the daily living activity. These symptoms are good indications of Kampo medicine. We report 5 cases of low back pain that saikokaryukotsuboreito treatment succeeded regardless of psychogenetic presence. These patients complained of low back pain and lower melagra or numbness of limbs. Four of 5 cases did not have any psychogenetic presence. After administration of saikokaryukotsuboreito, their pain decreased and walking distance was improved in to 4 weeks and analgesics were not required. Generally, saikokaryukotsuboreito is prescribed for patients with psychogenetic symptoms, but these treatments based on abdominal patterns were effective even if they do not have subjective psychogenetic symptoms. Saikokaryukotsuboreito may be the differential prescription for such low back pain cases.
ABSTRACT
Vulvodynia is defined as vulvar pain of at least three months duration without a clearly identifiable cause. Currently, there are few established treatments. We report two cases of vulvodynia treated successfully with relief of insomnia, using Japanese herbal medicine including saiko. Case 1: A 29-year-old female had been in a poor physical condition for two years. Initially, she had vulvar itching, which gradually became vulvar pain. At the first consultation, she complained of not only vulvar pain but also insomnia and feeling cold. Additional symptoms included severe fatigue, constipation, frustration, stiff shoulder, and heart palpitations. There were no abnormal findings in the genital region. We began treating the insomnia and coldness using saikokeishikankyoto. By the time of the second consultation two weeks later, her insomnia and coldness completely resolved, vulvar pain disappeared, and other symptoms improved. Case 2: A 46-year-old female experienced vulvar pain two months before the first visit to the hospital. The pain increased gradually and she awakened every 30 minutes in the night with severe vulvar pain. However, there were no abnormal findings in the genital region. We used saikokaryukotsuboreito, an antidepressant and a sleeping pill. Her insomnia improved gradually, and vulvodynia resolved two weeks after the improvement of the insomnia. These results suggest that saiko is effective on vulvodynia with insomnia.
ABSTRACT
Blepharospasm is classified as a focal dystonia, and involves involuntary contraction of muscles such as the orbicularis oculi muscle and the corrugator muscle, which are associated with eyelid movement. Thus blepharospasm involves difficulties to eyelid opening. A 61-year-old woman came to our hospital complaining of a sense of discomfort of the eyes since a half year earlier. Blepharospasm was diagnosed based on current medical history and neurological examination. Oral saikokaryukotsuboreito was started and the blepharospasm improved gradually. After a week, oral treatment with one-third of the amount of shakuyakukanzoto was added and the blepharospasm further improved. The patient wanted to increase the dose of shakuyakukanzoto and to stop the saikokaryukotsuboreito. Once oral shakuyakukanzoto monotherapy was started, however, the blepharospasm worsened. Oral saikokaryukotsuboreito and low dose shakuyakukanzoto was started again, and her blepharospasm improved again.<br>The mechanism behind a focal dystonia such as blepharospasm is explained as a disorder of the basal ganglia motor loop. Saikokaryukotsuboreito is used for the diseases of the central nervous system. Thus there is the possibility that, here, saikokaryukotsuboreito improved a central nervous system disorder, and the blepharospasm. To our knowledge, this is the first report demonstrating that saikokaryukotsuboreito is effective for blepharospasm. It suggests that saikokaryukotsuboreito is a useful option for the treatment of blepharospasm.
ABSTRACT
Benzodiazepines are frequently used for the treatment of insomnia, although these drugs cause dose-related centrally mediated respiratory depression. Moreover, benzodiazepines are contraindicated in patients with my asthenia gravis, so treating myasthenia gravis patients with insomnia is difficult.<BR>A 67-year-old woman developed myasthenia gravis on December 20XX. Her myasthenia gravis went into remission with oral high-dose prednisolone medication and plasma exchange, after which her oral predniso lone medication was continued. On January 20XX+2, she suffered from insomnia. She had poor sleep quality, nocturnal awakenings and middle-of-the-night insomnia. She had high abdominal resistance and fullness, ten derness, and discomfort of the hypochondrium. She was treated with saikokaryukotsuboreito and could then sleep comfortably soon afterwards.<BR>According to the <i>Shang Han Lun</i>, saikokaryukotsuboreito is effective for susceptibility to fright and deliri ous speech. Although our patient had no psychological symptoms such as these, an abdominal palpation examination led to diagnosis of a <i>Sho </i>(indication) for saikokaryukotsuboreito. So we started therapy with saikokaryukotsuboreito and her insomnia began improving immediately. To our knowledge, this is the first report of an insomnia patient with myasthenia gravis successfully treated with saikokaryukotsuboreito. Saiko karyukotsuboreito is not contraindicated in patients with myasthenia gravis. Thus we conclude that saikoka ryukotsuboreito is effective and safe for insomnia patients with myasthenia gravis.
ABSTRACT
We report the case of a 46-year-old man with hypertension whose blood pressure decreased due to saiko-karyukotsuboreito consumption.The patient also presented with some symptoms that suggested autonomic imbalance. After consuming 7.5g/day of a spray-dried powder of saikokaryukotsuboreito (Tsumura & Co.) for 3 months, his blood pressure measured at office was considerably lower. Twenty-four hour ambulatory blood pressure monitoring revealed that the surge in morning blood pressure, which is considered to be a risk factor for cerebrovascular disease, diminished in addition to the 24-hour mean blood pressure. A postural test revealed that his autonomic balance, which had been in a sympathetic dominant state, was inversely inclined to a parasympathetic dominant state.Our case report suggests that saikokaryukotsuboreito acts on the autonomic nervous system, which in turn exerts an antihypertensive effect, and that this effect is helpful in lowering the blood pressure in hypertensive patients whose autonomic balance is impaired due to stress.
Subject(s)
Blood Pressure , Postural BalanceABSTRACT
We studied the effect of Kampo for the size-limitation of myocardial infarct with morphometrical analysis, utilizing total of 19 male swine. A hand made metal-coil (2×1mm) was inserted in the left anterior descending coronary artery (LAD) of swine with catheterization, in order to induce acute myocardial infarction (AMI). After occurrence of AMI, the swine were divided into two groups, experimental group: Saiko-ka-ryukotsu-borei-to (n=10) and control (n=9). This Kampo formula (0.66/kg/day) was administered via stomach tubes for 4 weeks. The control group received basal rations alone. After serial cross sections of heart, total infarct areas were weighed.<br>An infarct weight to heart weight of the experimental group (2.9±1.6%, n=10) was significantly decreased than that of the control group (8.2±4.8%, n=9). The infarct weight to left ventricular weight of the experimental group (4.9±2.6%) was significantly decreased than that of the control group (13.4±8.0%). Thus the infarct size of the experimental group was significantly smaller than that of the control. The histological character of the infarct in the control was numerous inflammatory cell infiltration and foci of fresh coagulate necrosis in the border zone, while the infarct of the experimental group was apparent in the border zone with marked fibrosis and few inflammatory cells. Angiogenesis in both the infarct and border zone was marked in the experimental group than in the control. We summarize that this Kampo formula inhibits size development of AMI in animal model.
ABSTRACT
[Objectives] Repeated episodes of anger are a risk factor for cardiac diseases such as ischemic heart disease and arrhythmia. In this context, controlling anger may ameliorate the severity of effective cardiac diseases. In traditional Chinese and/or Japanese (Kampo) medicine, anger is one of the five basic emotions and is related to the <i>liver</i>, and formulas coursing, clearing and calming the <i>liver</i> are thought to be able to control anger. Accordingly, it is possible that formulas targeted to the <i>liver</i> are useful for preventing and managing cardiac diseases. However, it has not been established how to use formulas that target the <i>liver</i> in modern cardiology. The objective of this study is to examine the usefulness and therapeutic implications of Saiko-ka-ryukotsu-borei-to (Chaff-Hu-Jia-Long-Gu-Du-Li-Tang) as a formula targeted to the <i>liver</i> in modern cardiology.<br>[Methods] We analyzed nine patients aged 44±13 years (mean±SD) who took Saiko-ka-ryukotsu-borei-to in our cardiological clinic. We examined the influence of selected formulas on the symptoms.<br>[Results and discussions] The total effectiveness of Saiko-ka-ryukotsu-borei-to was 78%. Saiko-ka-ryukotsu-borei-to improved symptoms such as palpitation, chest discomfort, cough and insomnia in patients with supraventricular arrhythmia, psychosomatic cough, hypertension and cardiac neurosis. Saiko-ka-ryukotsu-borei-to also showed an anti-hypertensive effect, an anti-arrhythmic effect and an advantage over β-blockers in terms of its safety. These results suggest that Saiko-ka-ryukotsu-borei-to may be useful for treating and preventing cardiac diseases through its effects on palpitation and insomnia caused by emotional disturbances. We should therefore consider using Saiko-ka-ryukotsu-borei-to in cardiological clinics.
ABSTRACT
Most patients with taste disorders are usually treated with zinc, but there still remain many untreatable patients, including non-responders and those of advanced age. In this study, we report on three patients with hypogeusia who showed improvement after the administration of Kampo medicine. A 49-year-old female diagnosed with hypogeusia and hyposensation of the oral cavity responded to Oren-gedoku-to. A 43-year-old male diagnosed as having schizophrenia and hypogeusia and a 76-year-old female with idiopathic hypogeusia responded to Saiko-ka-ryukotsu-borei-to. Kampo medicines are considered to normalize zinc-related neuro-transmissions originating in the vallate taste buds. Furthermore, the curative effect of Oren-gedoku-to on inflammation-injured oral cavity membranes, and the psychotropic effect of Saiko-ka-ryukotsu-borei-to on improving hypogeusia, were shown in our patients. It should be noted that the recent increase in aged patients complaining of taste disorders might be related to aging-associated depression. Saiko-ka-ryukotsu-borei-to or related Kampo formulations are considered to have wide applications for depressed or aged patients with hypogeusia.
ABSTRACT
The size of myocardial infarct has been proposed as one of the important prognosis factors. In this study, we examined the effect of Kampo for the size limitation of myocardial infarct. Twenty male swine were used. A metal-coil was inserted in the left anterior descending coronary artery (LAD) of swine, in order to induce acute myocardial infarction (AMI). After occurrence of AMI, the swine were divided into four groups: Saiko-ka-ryukotsu-borei-to (TJ-12) group (n=5), Tokishakuyaku-san (TJ-23) group (n=5), Mokuboi to (TJ-36) group (n=5), and control group (n=5). Three kinds of Kampo formula were administrated via stomach tubes for four weeks. The control group received basal rations alone. The infarct size of the TJ-36 group was significantly smaller than that of the control (p<0.05). Each size of the TJ-12 and TJ-23 group had smaller tendency than that of the control, without significant difference. The histological character of the infarct in the control was numerous inflammatory cell infiltration and small foci of fresh coagulative necrosis in the border zone, which was not apparent in any Kampo administration group. We summarize that these Kampo, especially Moku-boi-to, inhibit the infarct size development. This inhibition is probably caused by suppression of harmful free radicals production from inflammatory cells, or by microcirculation improvement. This inhibitory effect by Kampo medicine led to rescue the border zone indicated as “jeopardized zone”.
ABSTRACT
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.
ABSTRACT
Two cases of hyperthyroidism were treated with Kampo therapy alone, without the use of antithyroid drugs. The first case was a 47-year-old female who had been experiencing palpitations, weight loss, nervousness, tinnitus and vertigo for two years. She was diagnosed as having Graves'disease because of serum thyroid stimulating hormone (TSH) and increases in free T3 (fT3), free T4 (fT4), TSH binding inhibiting immunoglobulin (TBII), and 24-hour thyroid radioactive iodine uptake (24-h RAIU). Shakanzo-to was given for palpitations and other symptoms. Saiko-ka-ryukotsu-borei-to was later added in accordance with the Kampo diagnosis. After about one year and ten months, serum levels of TSH and fT3, fT4, and TBII are normalized.<br>The second case was a 40-year-old female, in whom palpitations had appeared about 3 years previously. Three months ago she was diagnosed as having hyperthyroidism. Thiamazole had been administered for two months. Serum TSH was decreased and fT3, fT4, TBII were increased when she first came to our clinic. Shakanzo-to was given for palpitations and other symptoms. After three weeks she refused to take thiamazole of her own accord. Saiko-ka-ryukotsu-borei-to was given concomitantly in accordance with the Kampo diagnosis. The serum levels of fT3 and fT4 increased gradually, but the palpitations were reduced. After about 10 months, the fT3 and fT4 levels were observed to decrease. This suggests that some of the hyperthyroidism can be imprgved by Kampo therapy without antitnyroid drugs.
ABSTRACT
In Chinese medicine, Saiko-ka-ryukotsu-borei -to (SRT; Chai-hu-jia-long-gu-mu-li-tang) and Saiko-keishi-kankyo-to (SKT; Chai-hu-gui-zhi-gan-jiang-tang) are frequently used for patients with nervous constitutions who exhibit psychoneurotic symptoms. Specifically, SRT is used for patients of the excessive constitution type (Shi Zheng), and SKT is used for patients of the deficient constitution type (Xu Zheng).<br>In this study, in order to clarify the action of SRT and SKT on the central nervous system, the effects of these formulas on the monoamines and their metabolism in discrete brain regions in mice were examined.<br>1) Single-dose administration of SRT and SKT increased the levels of neurotransmitters and stimulated the metabolism in the dopaminergic nervous system of the corpus striatum (including the serotonergic nervous system for SRT).<br>2) Repeated administration of SRT stimulated the metabolism in the dopaminergic nervous system of the hypothalamus and hippocampus, and inhibited metabolism in the adrenergic nervous system. On the other hand, SKT stimulated dopamine metabolism in the hippocampus and inhibited the metabolism of serotonin.<br>From these results, it became apparent that single-dose administration of SRT and SKT caused the hyperfunction of the dopaminergic nervous system, and that repeated administration of the agents caused the hyperfunction of the dopaminergic nervous system and the dysfunction of the serotonergic nervous system. This suggests that the actions of SRT and SKT on the central nervous systems may exert an influence on the regulation of psychoneuroic symptoms by stimulating the doperminergic nervous system and inhibiting the serotonergic nervous system.