ABSTRACT
A 60-year-old female patient was treated with gamma knife on the left frontal lobe metastatic brain tumor. After 3 months, the tumor and peri-focal edema turned worse due to radiation necrosis. Despite increasing doses of steroid administration, the deterioration lasted for 6 months. The symptoms and brain edema did not improve for over a year, but we decided to observe the patient without bevacizumab. We performed Methionine-PET to diagnose radiation necrosis of the brain, and confirmed absence of hot spots. The steroid therapy continued and added saireito 9 g/day, because we thought brain edema was concerned with fluid retention. After 9 months, head MRI showed improvements of the brain edema. Saireito may help improve brain edema due to radiation necrosis.
ABSTRACT
<p><b>Objectives </b>: We examined effect of saireito for prevention and improvement of urethral strictures after transurethral resection of the prostate (TUR-P), also examining the utility of considering the saireito ‘pattern'.<br><b>Materials and Methods </b>: We evaluated 142 benign prostatic hyperplasia patients, and were randomly assigned to a saireito treatment group (3.0 gr. x 3 times per day 30 min. before meal, n = 70) and no treatment control group (n = 72).<br><b>Results </b>: 1) A statistically significant difference was observed in the occurrence of urethral stricture by saireito administration (p = 0.043, Chi-square test, Odds ratio : 0.12 [95% CI ; 0.01-0.95]. 2) For urethral strictures that occurred in the no treatment group, improvement of stricture in five cases was observed by saireito administration. 3) With either the appropriate administration or non-administration of saireito according to correct ‘pattern' diagnoses, the incidence of urethral stricture was significantly reduced (p = 0.042).<br><b>Discussion </b>: Administration of saireito after TUR-P is effective for preventing post-operative urethral stricture. It is also effective for confirmed strictures. Saireito administration is appropriate in patients with saireito ‘pattern' indications.</p>
ABSTRACT
Polycystic ovary syndrome (PCOS) occurs in 5 to 8% of females of reproductive age and is one of the leading causes of menstrual abnormalities and infertility. The treatment of PCOS varies, depending on the patient's age and background, particularly on the presence/absence of a desire to have children. In those desiring to have children, clomiphene therapy is the first-line treatment for PCOS. However, the anti-estrogen action of clomiphene may lead to a thinning of the endometrium and decreased cervical mucus production, while some patients show a poor response to the agent. In this study, saireito was administered to clomiphene-resistant PCOS patients, and the ovulation cycle improved in 6. Effective cases of saireito tended to have higher <i>oketsu </i>(blood stagnation) and <i>suitai </i>(water stagnation) statescores before treatment, also serum LH levels and LH/FSH ratios were lower due to the concurrent saireito medication. Furthermore, these effective cases had lower levels of serum testosterone than the non-effective and clomiphene-effective cases. This clinical report suggests the appropriateness of performing this therapy in accordance with <i>sho </i>(oriental patterns or symptoms), before second-line treatments such as gonadotropin therapy or laparoscopic surgery.
ABSTRACT
Inflammatory swelling after viper bite envenomation has the potential for causing multiple organ dysfunctions. We report 2 cases of viper bite that were successfully treated with saireito. A 79-year-old man suffered viper bite envenomation. Saireito was administered to reduce the swelling of the right lower leg. The patient's symptom was improved without any complications. A 68-year-old man suffered the same condition. The swelling spread over the chest and tako-tsubo-like left ventricular (= apical ballooning cardiomyopathy) dysfunction developed. Saireito was administered to reduce the swelling of the left upper limb. The patient was discharged without any severe complications. Thus, saireito may be useful for the treatment of swelling due to viper bite envenomation.
ABSTRACT
Saireito, a 12-component Japanese herbal medicine, is used to treat immune-related diseases. We investigated the effects of oral administration of Saireito extract in a murine model of cardiac transplantation with fully mismatched allografts. Untreated recipients and those given water rejected their cardiac allografts acutely (median survival time [MST], 7 and 8 days, respectively), as did those treated with either 0.02 or 0.002 g/kg/day of Saireito extract (MST, 7 days in both groups). Recipients given 0.2 g/kg/day of Saireito extract had only moderate prolongation of allograft survival (MST, 41 days). However, all transplant recipients given 2 g/kg/day of Saireito extract had significant prolongation of allograft survival (MST>100 days). None of the single crude drug extracts of Saireito prolonged allograft survival, suggesting that its effects require administration of the combination agent. In mixed leukocyte cultures, proliferation of splenocytes from Saireito-treated CBA recipients was markedly suppressed compared with that of splenocytes from untreated mice, and interferon-γ production was significantly reduced. In flow cytometry experiment, the population of CD 4+CD 25+FOXP 3+cells was increased in the spleens of Saireito-treated CBA recipients compared with the spleens of naïve CBA mice or untreated CBA recipients. Thus, in our model, Saireito treatment induced hyporesponsiveness to cardiac allografts in a dose-dependent manner, and the combination of the components is essential for this effect.
ABSTRACT
We report two cases of nephrotic syndrome successfully treated with saireito. The first patient developed massive proteinuria of 5.2 g/day, was diagnosed with minimal-change nephrotic syndrome upon renal biopsy, and rapidly improved with saireito treatment for 2 months to the reduced urinary protein level of 0.3 g/day. Urinary protein increased to 2.0 g/day just after discharge, then again decreased and was brought to remission soon thereafter. The second patient with biopsy-proven idiopathic membranous nephropathy maintained nephrotic syndrome remission for 8 years with the treatment of small-dose prednisolone, an immunosuppressant, and an angiotensin II receptor blocker, then relapsed with 4.4 g/day proteinuria. In this patient, proteinuria was reduced after 4 weeks with the above combination therapy plus saireito to 1.3 g/day, then remitted again soon thereafter. The former patient presented with mild discomfort and opposition when the subcostal region was pressed ; the latter patient presented with apparent discomfort and opposition together with moderate leg edema. Because rapid remission of massive urinary protein with saireito treatment was observed in these patients, we report here and discuss possible mechanisms.
Subject(s)
Patients , Nephrotic SyndromeABSTRACT
The efficacy of Saireito (a herbal preparation) against autoimmune recurrent abortion was evaluated clinically and immunologically. Saireito therapy was performed with 87 women having experienced 3 or more recurrent abortions in the early stages of pregnancy (less than 12 weeks gestation), and whose antinuclear antibody (ANA) and anti-cardiolipine antibody (ACA) test results were positive. The effects of this therapy on the percentage of women in whom abortion was successfully prevented (the abortion prevention rate), and on the antibody titer were investigated. Among the 49 women who became pregnant during the study period, the abortion prevention rate was 63.3%, the percentage of ANA positive cases was 65.6%(32/49), the percentage of ACA IgG and/or IgM positive cases (as evaluated by SRL methods) was 65.5%(29/49) and the percentage of both ANA and ACA IgG and /or IgM positive cases was 75.0%(12/49). Although the titer of ANA was not significantly reduced by this therapy, the titer of ACA IgM was reduced significantly.These results suggest that Saireito exerts its efficacy by suppressing humoral immunity through its adjustment of the Th1/Th 2 cytokine balance. This therapy is expected to be effective against ACA-positive recurrent abortion by reducing the effects of ACA. Furthermore, in 2 observed child birth cases whose ACA titer were not decreased by Saireito, different effective mechanisms were speculated; for example, suppression of platelet aggregation via saireito's component herbs (ninjin and bukuryou) similar to the effect seen with low-dose aspirin therapy, or its “risui” effect via its components (bukuryou, soujyutu, takusha and chorei).
Subject(s)
AntibodiesABSTRACT
Clinical efficacy of tokishakuyakusan against immunologic recurrent abortion was evaluated using methods of diagnostic statistics. The subjects of this study were 38 women with recurrent abortion who had experienced a spontaneous abortion during their first trimester (within 12 weeks of pregnancy) twice, and who took tokishakuyakusan (extract granules) after development of their third pregnancy, but experienced spontaneous abortion again during their first trimester, with the karyotype of the aborted fetus being rated as 46, XX or 46, XY. The control group consisted of 244 women who had experienced 3 or more spontaneous abortions during their first trimester of pregnancy. The detection rates of autoimmune disorders and alloimmune disorders were compared statistically between the two groups. Neither the detection rate of autoimmune recurrent abortion nor the detection rate of alloimmune recurrent abortion differed significantly between the two groups, suggesting that tokishakuyakusan is not clinically effective against immunologic recurrent abortion. Tokishakuyakusan is estimated to prevent abortion caused by compromised luteal insufficiency of the uterus. Thus, saireito seems to provide a more rational means of Kampo therapy for immunologic recurrent abortion.
Subject(s)
Pregnancy Trimester, FirstABSTRACT
Five patients in the acute stage of reflex sympathetic dystrophy (RSD) of the hand were treated with Sairei-to and Rikkunshi-to, and were evaluated for pain (visual analog scale: VAS), swelling and limitation of finger motion. Four of the five patients had good results, with a decrease in pain to less than 50% of initial pain on VAS within six weeks. Swelling and finger motion tended to improve earlier than pain. In general, symptoms of RSD are limited to those associated with local inflammation during the acute stage, but patients with RSD tend to have psychological factors that can trigger generalized complaints even before the onset of RSD and to feature ‘kikyo, ’ a loss of vitality, after RSD onset. RSD should therefore be recognized as one feature of a generalized disease. Oral Kampo therapy using Sairei-to and Rikkunshi-to appears to be a reasonable treatment for early RSD.
ABSTRACT
A 62-year-old woman showed signs of liver dysfunction of unknown etiology in 1994. She was admitted to our hospital in July 1996 because the liver dysfunction, as well as general fatigue, worsened. Anti-mitochondrial antibodies were present, and a liver biopsy was performed. Pathological findings were compatible with primary biliary cirrhosis. Treatment with ursodeoxycholic acid (600mg/day) was initiated in August 1996, and liver dysfunction improved. However, ESR and IgM did not improve, and general fatigue persisted. In December 1996, Sairei-to was combined with ursodeoxycholic acid. One month later, ESR, IgM, and general fatigue improved. In May 1997, Sairei-to was replaced by Keishibukuryo-gan because of her symptoms (Hie-sho and varix pain), and liver dysfunction and general fatigue reappeared. Keishibukuryo-gan was later discontinued because of suspected drug-induced hepatitis. Two months later, liver dysfunction remained unimproved. Sairei-to was administered again and liver dysfunction and other symptoms disappeared. These results suggest that combined therapy with Sairei-to and ursodeoxycholic acid is effective in the treatment of primary biliary cirrhosis.
ABSTRACT
A 61-year-old female had suffered from diarrhea, abdominal pain and vomiting since 1984. Although she had been treated with anticholinergics, antidiarrhoics, and Lactobacillus derivatives, the symptoms were unchanged. In July 1988, a partial resection of the distal ileum was performed to overcome adhesive ileus, but soft or mucous feces remained after surgery. The pathological diagnosis of the specimen was Crohn's disease. From July 1994, oral administration of Sairei-to (9g/day) was started. Within two weeks, the feces became normal. The patient gained 2kg of weight in 2 months. In May 1996, the dose of Sairei-to was reduced to 6g/day without changing her condition. In September, she started to take 30g of Perilla oil every day. Sairei-to was discontinued in May 1997 after the dose was reduced to 3g/day for a month. The total duration of Sairei-to therapy was 2 years and 10 months. Ordinary defecation has been observed for 1 year and 3 months since Sairei-to was discontinued. In conclusion, a remission was achieved in a patient suffering from Crohn's disease with a long-term administration of Sairei-to, and the prescription was discontinued for more than a year without recurrence.
ABSTRACT
The authors report a case of secondary renal amyloidosis associated with rheumatoid arthritis, which responded well to Kampo therapy. A 68-year-old woman was diagnosed as having rheumatoid arthritis in April 1992. Her disease activity was not controlled well with any anti-rheumatic drugs. In September 1996, proteinuria and hematuria were found, and a renal biopsy showed secondary amyloidosis. Proteinuria and hematuria were progressive. The patient was treated with Sairei-to, and by April 1998, proteinuria and hematuria nearly disappeared. This clinical course suggests that Sairei-to is an effective treatment for secondary renal amyloidosis.
ABSTRACT
The hematological effects of Sokeikakketsu-to, Yokuinin-to, Keisi-ka-jutsubsu-to, Eppi-ka-jutsu-to, and Sairei-to observed on the AA rats were investigated. The time course of blood count and albumin, sialic acid and acid-soluble glycoprotein in the serum whs. were measured. Sokeikakketsu-to had the strongest anti-inflammatory effect on the improvement of Inflammatory Index Substances, platelets, and the Arthritis Score for changes in synovitis. Yokuinin-to was also effective. When these Kampo medicines were administered in the early stages of AA, Sokeikakketsu-to improved the AA signficantly. The results may suggest that Sokeikakketsu-to works for the control of autoimmunity. On the other hand, Keisi-ka-jutsubu-to aggravated the AA when it was administered in the early stages of the AA.
ABSTRACT
The effects of Sokei-kakketsu-to, Yokuinin-to, Keisi-ka-zyutsubu-to, Eppi-ka-jutsu-to, and Saireito extracts on Adjuvant-induced arthritis (AA) in rats were investigated. After administering AA, we measured the volume of rat hindpaw as the inflammation index, and observed the changes of synovitis histologically. Each extract showed different effects on AA rats. Yokuinin-to and Sokei-kakketsu-to had remarkable effects on inflammation and changed the histological observations of synovitis. Eppi-ka-jutsu-to also had effects on the uninjected hindpaw, but Keisi-ka-jutsubu-to and Sairei-to had no effect on hindpaw inflammation, nor did they change synovitis histologically.
ABSTRACT
Sairei-to was administered to 19 women who had experienced recurrent abortion of unknown cause, at a dose of 8.1g/day. Their prognosis of pregnancy was evaluated by observing the changes in autoantibody titer over time. Sixteen of the 19 women became pregnant, and 11 of these patients delivered live newborn infants. All of these newborn infants were within normal range in body weight, and had Apgar scores of 8 points or more (at one minute). Seven women were positive for autoantibodies. Four of these seven women showed a decrease in antibody titer or diasappearance of autoantibodies following treatment with Sairei-to, and became pregnant with good prognosis. The remaining three women, however, showed no changes in antibody titer. Two of these women had unsuccessful pregnancies, and one had a successful pregnancy and delivery. No adverse drug reactions were noted in either mothers or infants. These results suggest that Sairei-to possesses excellent clinical efficacy in women with recurrent abortion of unknown cause. Use of Sairei-to in such cases is thus likely warranted, although further investigation is required to clarify the mode of action and to establish the optimal dosage regimen.
ABSTRACT
In order to evaluate the clinical usefulness of Sairei-to in the treatment of toxemia of pregnancy and to study its influence on the waveform of the umbilical arterial blood flow, a standard curve of the pulsatility index (PI) was constructed for 90 patients in their 19th through 41st weeks of normal pregnancy. A dose of 9.0g/day of Sairei-to was then given to 13 patients with edema (mild toxemia) and 3 patients with severe toxemia. These cases were observed for clinical improvement and changes in the PI. The results were as follows: 1) of the 13 patients with mild toxemia, edema improved in 12 cases (92%), along with a decrease in the PI of all of these cases as a result of administration of this Kampo formula, 2) Regarding the 3 patients with severe toxemia, the clinical usefulness of Sairei-to was not clear. In 2 of these cases, arrest of the endodiastolic velocity was observed 6 to 7 days after the start of administration, making it necessary to perform emergency cesarean sections. These findings suggest that in mild toxemia of pregnancy, due to the hydragogue effect of Sairei-to, alleviation of edema and improvement of the insufficiency of placental blood flow, demonstrated by a decrease in PI, could be expected. In severe toxemia, on the other hand, irreversible change had already occurred in the placenta, and consequently, no positive improvement in the insufficiency of placental blood flow could be expected with the administration of Sairei-to. Thus, administration served only to supplement other treatment methods in this group.
ABSTRACT
Although there are many treatment methods for proteinuria in renal transplanted patients, none have been found to be definitively effective.<br>We examined the clinical effects of the administration of Sairei-to on 11 renal transplanted patients with proteinuria. Clinical evaluation was carried out over six months of administration. The patients were divided into the chronic rejection group, consisting of four patients, and the non-chronic rejection group. Although no improvement was seen in the chronic rejection group, three out of seven patients in the non-chronic rejection group showed improvement in proteinuria, and one exhibited improved kidney function. In one of the improved proteinuria cases, a reduction in nephrotoxicity of the immunosuppressor FK506 was suggested.<br>According to these results, Sairei-to may be effective in the treatment of proteinuria in renal transplanted patients without chronic rejection.
ABSTRACT
We experienced a case of polymyalgia rheumatica (PMR) which responded to Kampo medicine. A 53-year-old female patient first complained of stiffness and pain in the neck. Myalgia was severe and gradually eypanded to both shoulders and both upper extremities. Body weight decreased, and the erythrocyte sedimentation rate (ESR) was greater than 100mm/hour. Because her condition tended to improve when treated with prednisolone 10mg/day, she was diagnosed as having PMR. Her condition was well controlled until the dose of prednisolone decreased. Myalgia then recurred, and the ESR increased to 83mm/hour. The patient visited our outpatient department for treatment with Kampo therapy. Two months after treatment with Sairei-to plus Yokuinin-to, all signs and symptoms disappeared other than the stiff neck. Her body weight showed a tendency to increase. Six months after she first visited us, prednisolone was decreased and then stopped. Her condition still remains well controlled with this Kampo therapy alone. She has no clinical signs and symptoms, and the ESR has improved to 16mm/hour.