A Case of Recurrent Nausea with Vomiting for Past Sixteen Years Successfully Treated with a Kampo Formulation Shimbuto / 日本東洋医学雑誌

We herein report a 36-year-old male patient, who complained of persistent and recurrent nausea with vomiting for 16 years in spite of various standard treatments, was successfully treated with Kampo formulation Shimbuto, which selected based on the left para-navel tender point. We speculated that the clinical disorder in this case was related to suitai i.e. water imbalance syndrome in Kampo medicine. However, there has never been such a case report in the field of Kampo, and no related papers have been found in the standard database Medline. We believe this report is valuable from the viewpoint of therapeutics in both Western and Kampo medicine.

Two Cases of Elderly Heart Failure Patients who Improved Pulmonary Congestion and Maintained Functional Capacity with Tokishakuyakusan / 日本東洋医学雑誌

We report two cases of older heart failure (HF) patients who improved pulmonary congestion and maintained functional capacity with tokishakuyakusan. Case 1 was an 83-year-old woman who previously treated with percutaneous coronary intervention for angina and had multiple comorbidities such as chronic kidney disease and rheumatoid arthritis. Despite of multiple medications including 3 kinds of diuretics, general fatigue that interferes with her daily life, marked pulmonary congestion, and leg edema remained. After prescription of tokishakuyakusan, urine volume increased rapidly and HF symptoms were alleviated so that 2 diuretics were successfully discontinued. Case 2 was an 88-year-old man with chronic atrial fibrillation and severe mitral regurgitation with worsening dyspnea on effort, paroxysmal nocturnal dyspnea, and leg edema. Tokishakuyakusan was effective for improving these HF symptoms and he returned to normal life without additional HF treatment. For elderly HF patients, tokishakuyakusan is considered to be effective to improve blood deficiency/stasis pattern and fluid retention, which enables these patients to make their daily life without being disturbed by severe HF symptoms.

The Role of Kampo Therapy to Treat Cellulitis / 日本東洋医学雑誌

In this report, we present three cases of lower limb cellulitis. The first case was an 88-year-old woman and the second case was a 36-year-old man. In addition to standard therapy, both of them received Kampo therapies with keishinieppiitto and jidabokuippo during the acute phase of cellulitis and were promptly cured. The third case was a 52-year-old woman with severe obesity suffering from repeated and intractable cellulitis. She received Kampo therapy including keishibukuryogan. The redness and swelling in her leg gradually disappeared. Administration of adequate antibiotics and elevation of affected areas are important for the treatment of cellulitis. Even with appropriate therapy, some patients are slow to respond and difficult to treat. The skin findings in cellulitis are swelling, redness, heat, and pain, which can be recognized and treated as water imbalance, heat, and blood stasis in Kampo medicine. This case report suggests that cellulitis during the acute phase can be treated with keishinieppiitto and the treatment of water imbalance and heat is important. After the acute phase, the treatment of blood stasis is important. Considering the time of onset and skin findings in cellulitis, Kampo therapy can contribute to the rapid recovery of cellulitis.