ABSTRACT
We studied five untreated patients with plantar fasciitis, 15 chronic cases treated only with Western medicine (non-Kampo group), and 15 chronic cases treated with Kampo in addition to Western medicine (Kampo group). There was no difference in age and pain VAS at the first visit among the three groups. All the non-treated cases were improved with conventional treatment and the duration of treatment was short. In the case of patients who did not respond well to the initial treatment in our department, Kampo medicine was started from three months after the first visit. Therefore, there were more refractory cases in the Kampo group, with poor pain VAS at the last observation and a long treatment period. Among them, two cased were effective in combination with yokuininto and tsudosan, one case was yokuininto only, and one case was combination of yokuininto, tsudosan and keishibukuryogankayokuinin. Sokeikakketsuto used in three patients was not effective. Thus, chronic planter fasciitis may include physiology of not only wind-dampness, cold, and blood deficiency but also qi stangnation and blood stasis.
ABSTRACT
Chronic sciatica is one of the neuropathic pains which assumed to be effective for pregabalin. However, a recent double-blind placebo-controlled trial reported that pregabalin was no more effective than placebo in patients with acute or chronic sciatica. We retrospectively investigated the effect of Kampo medicine including makyoyokukanto extracts combined with powdered cinnamon bark and processed aconite root (makyoyokukanto plus) which were administered to 14 cases with chronic sciatica in the past year. The efficacy of Kampo medicine for lower leg pain relief was assessed using NRS (numerical rating scale). It was effective in 11 of 14 cases (79%, 6 males and 5 females, the mean age : 69), and not effective in 3 of 14 cases (21%, 2 males and 1 female, the mean age : 77). In 7 of 9 cases, who were given pregabalin before prescribing makyoyokukanto plus, makyoyokukanto plus was more effective than pregabalin. Furthermore, we have continued to observe 10 cases for over a year. Two of 10 cases were completely cured even if makyoyokukanto plus was discontinued. In 5 cases we switched from makyoyokukanto plus to yokuininto extracts combined with powdered cinnamon bark and processed aconite root, which was comparable to makyoyokukanto plus in its effect. Makyoyokukanto or yokuininto extracts combined with powdered cinnamon bark and processed aconite root were effective for chronic sciatica.
ABSTRACT
Here I report a case of chronic rheumatic arthritis, which was successfully treated with boiogito, yokuininto and bushi, leading to complete remission. A 38 year-old woman, null gravida, has been suffering from strong pain and frequent sense of numb in both hand joints. Previous orthopedic specialist diagnosed as rheumatic arthritis. Since she had a hope of getting pregnant, she came to our outpatient clinic, seeking Kampo treatment. Clinical examination revealed a positive test of anti-CCP antibody (>200) or rheumatoid factor as 32.4. Kampo treatment was started with keishikajutsubuto besides bushi, or eppikajutsuto with bushi, which were not effective sufficiently. Finally, combined agents with yokuininto and boiogito dramatically reduced pain, visual analogue scale score or CRP level, and relieved pain in bilateral hand joints, leading to complete remission. Yokuininto is applied to the cases with pains, chilliness or sense of numb in limb joints or muscles. Furthermore, boiogito is administered to the patients with edematous, painful and/or swollen joints. Both agents contain several herbal medicines with pain relieving spasmolytics, redistributing of tissue fluid or anti-inflammatory actions. From these findings, agents used in this case appear to work towards redistributing tissue fluid, easing local immune reaction or relieving pains powerfully. It is thought that combined agents with boiogito and yokuininto could be a reliable option for the treatment of rheumatic arthritis.
ABSTRACT
We report on three RA patients successfully treated with Yokuinin-to-ka-kyokatsu-dokkatsu-bofu (Yokuinin-to-kami). The first patient was a 47-year-old woman. In 1983, she visited a nearby hospital due to bilateral wrist joint pain. Her condition was diagnosed as RA. She was treated with gold sodium thiomalate (GST) and non-steroidal anti-inflammatory drugs (NSAIDs), but her symptoms did not improve. She visited our department in 1989. She was treated with Keishi-ka-ryojutsubu-to, Bushi-to which resulted in decreased arthralgia. However, in September 1995, her condition worsened. Administration of Yokuinin-to-kami improved her symptoms as well as her laboratory data after three months of treatment. The second patient was a 50-year-old woman. In 1986, she visited a nearby hospital with bilateral wrist joint pain. Several Kampo formulas were subsequently administered at a pharmacy. In 1991, she visited our hospital and her condition improved after treatment with Keishi-ka-ryojutsu-to-ka-boi-ogi-yokuinin. However, in May 1996, she complained of severe pain and swelling at the right shoulder joint. Treatment with Yokuinin-to-kami improved her symptoms, as well as decreased serum C-reactive protein (CRP). The third case involved a 42-year-old woman who exhibited polyarthralgia in June 1991. She visited a neighborhood hospital and was diagnosed as having RA. She was treated with NSAIDs and bucillamine. She first visited our hospital in1993. We treated her with Keishi-ni-eppi-itto-ka-ryojutsubu and Keishi-shakuyaku-timo-to, but the polyarthralgia worsened in May 1996. Subsequently, we treated her with Yokuinin-to-kami which resulted in improvement symptoms, as well as decreased serum CRP.<br>To identify the target group for Yokuinin-to-kami, we further analyzed the characteristics of the patients successfully treated with this formula. Yokuinin-to-kami was administered to nine patients with RA, and the symptoms in five patients improved, but the remaining patients did not respond. The score of stasis of body fluids and deficiency of blood was not considerably different between the two groups. Interestingly, there was a difference in the variation of joint symptoms throughout the day. Namely, the successfully treated patients complained of joint symptom in the evening more than in the morning. These observations suggest that Yokuinin-to-kami is a useful agent for the treatment of a subset of patients with RA, and that joint pain in the evening might be an indicator for this treatment.
ABSTRACT
Rats with adjuvant arthritis (AA rats) show obvious inhibition of the local inflammation when steroids (DXM) are administered. But the contraction of thymic or adrenal atrophy, spleen hypertrophy, and reduction of activity of serum dipeptidyl aminopeptidase IV are recognized. In rats where Sokei-kakketsu-to or Yokuinin-to was administered, prominent anti-inflammatory effects like dexamethasone were not found; however the contraction of thymic or adrenal atrophy, spleen hypertrophy, and reduction of activity of serum dipeptidyl aminopeptidase IV was not recognized. In addition, after withdrawal of drugs, rebound in regional joints did not occurr as with steroids, and the reducing effect for arthrocele was prolonged. Therefore, it was concluded that those two formulations have an effect on the immune system —with anti-inflammatory effects for AA rats— and these action mechanisms are different from that of steroids (DXM).
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
Oral administration of Yokuinin-to was added to the previous drugs in 4 patients with psoriatic arthritis. All of the cases responded to the therapy without adverse effects. In 3 of 4 cases, the previous drugs, i. e, corticosteroids, etretinate, or non-steroidal anti-inflammatory drugs (NSAIDs), were able to be discontinued after the beginning of the Yokuinin-to therapy. The remainder had favorable control of arthralgia with Yokuinin-to alone. During the course of the therapy, there were no considerable changes in skin eruption in all 4 cases. We consider Yokuinin-to one of the first drugs of choice in the treatment of arthralgia in patients with psoriatic arthritis.