ABSTRACT
The number of patients with novel coronavirus infections (COVID-19) continues to increase with Omicron now the predominant strain, even amidst the three-dense (close-in, dense, and close-out) avoidance and vaccination strategies. In collaboration with the local government, Tohoku University Hospital has provided a large-scale vaccination center, drive-through outpatient PCR testing clinic, outpatient assessment, support for management of residential care facilities for the mildly ill, support for elderly care facilities, and an antibody cocktail center, to minimize deaths due to COVID-19. In residential care facilities for the mildly ill and others in need of medical support, we established an information sharing and house call system. Furthermore, we developed DX in cooperation with a wide-area IT system and have so far continued to achieve zero fatalities in residential care facilities. In addition, the Japanese Society for Oriental Medicine has conducted clinical research using Kampo medicine for the prevention of disease onset, treatment in the acute stage, and treatment of prolonged symptoms, with results suggesting that Kampo medicine has some effect in reducing disease severity in the acute stage. The COVID-19 response is a long-term effort to update the knowledge and techniques in Western, traditional, and Future Medicine. The response and updating of combined knowledge and skills will continue over the longterm. It is also necessary to continue to disseminate and share information among various professions, and give back information in the field and make steady and continuous efforts among multiple professions.
ABSTRACT
The Medical Safety Committee has conducted various activities for patient safety in Japanese traditional Kampo medicines. In this study, we conducted a questionnaire survey to promote the prevention of medical accidents and their recurrence. We received responses from 15 of 19 facilities specializing in Kampo medicine and collected a total of 247 incident and accident cases in the field of Kampo medicine. Cases of side effects included interstitial pneumonia caused by Kampo prescriptions containing Scutellariae Radix, aconite poisoning, and licorice-induced pseudoaldosteronism. Furthermore, we also collected decoction-specific cases, which are unique to facilities specializing in Kampo medicine, for the first time. From the results, we included the following seven points for risk management in the field of Kampo medicine : 1) insufficient recognition to the side effects of Kampo medicines, 2) misunderstanding of the dosages of Kampo products, 3) errors due to similarities in Kampo formulas and crude drug names, 4) preconception of frequently used Kampo prescriptions, 5) contamination in the decoctions, 6) errors related to crude drug items and their dosages that are frequently added or subtracted, 7) errors in hospital wards.
ABSTRACT
At the 71st Annual Meeting of the Japan Society for Oriental Medicine in August 2021, we conducted a special program focusing on education in Kampo medicine, “Pre-graduate and post-graduate Kampo medicine education for the next generation.” As part of this project, we directed a symposium on the model core curriculum (core curriculum) in medicine, dentistry, pharmacy and nursing. The core curriculum in these fields includes Kampo education. Each institution shall promote education in accordance with the core curriculum, considering the characteristics of the field and the circumstances of the educational institution. We introduced the core curriculum in each field, and summarized and reported the current status of Kampo education in the field, points to note and suggestions for multidisciplinary cooperation, issues related to clinical practice and lack of educators, and future prospects.
ABSTRACT
After percutaneous coronary intervention (PCI), the patient developed symptoms of pain, sensory impairment, paralysis, pallor of the skin, and pain during passive extension, and was diagnosed with PCI-induced antebrachial compartment syndrome. Since it was considered to be blood stasis and water stasis in Oriental medicine, we administered jidabokuippo and keishibukuryogan to the patient. Then the subjective and objective symptoms improved promptly, and the symptoms disappeared by the 10th day after the operation. The patient was able to discontinue jidabokuippo 14 days after the operation. It was suggested that the symptomatic treatment with Kampo medicine is effective for compartment syndrome.
ABSTRACT
[Introduction] There is as yet no clear medical treatment for acute phase COVID-19, and treatment of some cases using drugs alone have proved challenging. We report on a severely ill COVID-19 patient whose symptoms improved after receiving acupuncture during recovery from COVID-19.[Case] The patient was a 53-year-old man whose chief complaint was dyspnea. He developed dyspnea and fever on August 24 (20XX) and became aware of taste disturbances on August 27. His respiratory symptoms worsened during the evening of August 29, and he was transported to hospital via ambulance on August 31. He tested positive on a PCR test, and widespread pneumonia was observed, so he was hospitalized following a diagnosis of severe COVID-19.[Treatment] To improve the patient's breathing, acupuncture was used in combination with Chinese medicine (Kampo) to treat lung qi deficiency and kidney failing to receive qi. Chest pain which appeared during the treatment period and low back pain due to long-term bed rest were also treated. At the first acupuncture intervention, the fraction of inspiratory oxygen (FiO2) was 80% with high-flow oxygen therapy, and body movement was difficult. Following treatment, oxygen therapy became unnecessary (FiO2: 21%), and the patient was subsequently discharged from the hospital.[Discussion and Conclustion] This case indicates that acupuncture may be effective for improving respiratory symptoms during the acute phase of COVID-19. In this case, oxygen demand was improved by treatment of relevant acupoints based on Kampo diagnosis. However, one symptom which remained was that the chest did not expand upon inspiration. The relevant locale of this symptom was detected on the kidney meridian. The movement of the thorax was visually improved after performing thoracic acupoint, and oxygen saturation was also improved. In conclusion, it appears that acupuncture is effective for both the acute and chronic phases of COVID-19, and can be applicable for active intervention.
ABSTRACT
In order to avoid the risk of COVID-19 among our clinic staffs, remote medical care using tablet-type devices was conducted in our fever outpatient clinic. In about 5 months, there were 87 patients with COVID-19 diagnosed by PCR test. Among them, 24 patients (15 men and 9 women, average age 36.2 years) were treated with Kampo medicine. Four of 24 patients required hospitalization. All patients, including those hospitalized cases, improved their symptoms during the observation period. We believe that Kampo medicine is effective in the early treatment of COVID-19. In addition, we consider that remote medical care using tablet-type devices is one of the useful methods in the treatment of highly contagious infectious diseases.
ABSTRACT
In the clause of kososan (Xiāng sū sàn), which was added in “Wazaikyokuho (Hé jì jú fāng)” during the shàoxīng period (1131-1162), there is an anecdote that only the clan used this prescription showed defense against the epidemics at that time. Jiangnan area is the near place where COVID-19 became a pandemic in 2020. Considering these backgrounds and the similarities between the patterns (TM1) from the view point of Kampo medicine and prescriptions including kososan listed in the chapter of Cold Damage (Shanghan) of “Wazaikyokuho,” I hypothesized that formulas from this chapter may be effective for COVID-19. Many prescriptions including kososan in the chapter of Cold Damage were developed for the treatment of epidemics in the Jiangnan area during the Southern Song Dynasty. Epidemics were common at that time and place, and the prescriptions were left for posterity. The Kampo patterns (TM1) of COVID-19 were considered to have characteristics similar to those of the epidemics of the 11-13th century. The formulas including kososan from the chapter of Cold Damage in “Wazaikyokuho” may be effective against COVID-19, which warrants further investigation.
ABSTRACT
At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program focusing on Kampo medicine education, “Pre-graduation post-graduation Kampo medicine education for the next generation.” The following is a summary report on the practical training in Kampo medicine at each educational facility where the project was conducted. We recorded videos with explanations of topics in advance : “Four examinations,” “Decoction and crude drugs,” and “Acupuncture and moxibustion.” The report on the hands-on training in Kampo medicine was viewed 501 times by medical students, educators, and the society members across the country. This initiative was the first nationwide educational activity of the society.
ABSTRACT
The usage of Kampo medicine has been expanding in hospitals and pharmacies, and the systematic education on Kampo medicines and their components is urgently needed. Although the efficacies of Kampo formulations are approved at the national level, those of the composing crude drugs are not approved individually except for some cases. Consequently, the efficacy description of individual crude drug in textbooks differs much depending on the authors. To clarify this situation, we suggested the standardized description of the efficacy of crude drugs used in ethical Kampo formulation using terms of modern Western medicine in the previous study. In this study, we reviewed the descriptions of efficacies using the terms of Kampo medicine in the books published in Japan from the 17 century to the present to explore the possibility of standardizing the crude drug efficacies using the terms of Kampo medicine. The proposal for standardized description of the efficacy of crude drugs was based on the high frequency of appearance of the terms in successive books.
ABSTRACT
There are few reports on the effects for children using the diagnostic method of Kampo medicine (called sho : pattern diagnosis). Therefore, we investigated the effects of combination therapy with Kampo medicines prescribed by specialists in this ancient form of medicine to children who were refractory to modern medicine. This was a retrospective observational study of 98 children (pre-school children (PS ; n = 21), elementary school students (ES ; n = 37) and junior high school students (JS ; n = 40)) younger than 16 years old at the first visit to our department of Chiba University hospital between April 2007 and April 2017. We collected the following information from their medical records : background, chief complaint, referral source, and efficacy of Kampo medicines. We evaluated efficacy for Kampo medicine as follows : Higher improvement (HI) (symptoms improved by 2/3 or more) ; Improvement (I) (symptoms improved by 1/3-2/3) ; Mild improvement (MI) (symptoms improved by 1/3 or less) ; constant ; aggravated ; and unknown or first visit only. Positive response (HI, I, and MI) due to Kampo medicines was observed in 76% (75/98) of patients. No aggravations were observed. The chief complaint by age was skin diseases in PS, digestive diseases in ES, and cardiovascular diseases in JS. Pediatrics was the primary referral in all ages, while 30% of JS were referred from psychiatry. Kampo medicine was significantly more effective for those in PS and ES compared to those in JS (p = 0.025). Combined use of Kampo medicine and modern medicine therapy is useful for children refractory to modern medicine.
ABSTRACT
The Japan Society for Oriental Medicine (JSOM) has made various efforts against coronavirus disease (COVID-19) to build evidence. JSOM has launched an academic society-led clinical research project on COVID-19 based on the concept and characteristics of Kampo medicine, including (1) prevention of disease by activating the immune system to regulate body conditions (pre-symptomatic stage of illness), (2) symptom alleviation in the mild and moderate stage and prevention of aggravation (acute to subacute stage of illness), and (3) early recovery and improvement of prolonged symptoms (late stage of illness). Since the declaration of the pandemic, the special working group has conducted the following activities : enlightening academic members, lobbying other academic societies, preparing research protocols, establishing research groups, conducting ethical reviews, responding to the research disclosure system, preparing protocol papers and review articles as the basis for the research, reporting research progress, soliciting case reports, warning against Chinese medicine use, requesting for research support funding, and revising the JSOM website. We also discuss the interpretation of COVID-19 from the perspective of Kampo medicine and the direction of the selection of Kampo formulas in this report.
ABSTRACT
To help medical doctors practicing Kampo medicine suggest appropriate acupuncture treatments for individual patients, a study group made up of 7 acupuncturists and 5 medical doctors developed an acupuncture curriculum. The group provided a learning program based on the curriculum for 16 medical doctors in charge of outpatient Kampo services in a research institute. The learning program consisted of a lecture and practical training, and a total of 4 sessions were held. At the end of each session, a test was conducted to examine the participants' level of understanding. After the completion of the learning program, a questionnaire survey was conducted to confirm the usefulness of the acupuncture curriculum for the practice of Kampo medicine. The mean number of participants per session was 10.8 ± 1.3. The mean test score was 9.3 ± 0.5 (full score : 10). In the questionnaire, 14 out of the 16 (88%) answered that the acupuncture curriculum was useful or relatively useful for the practice of Kampo medicine. On comparing the numbers of new acupuncture patients with a history of outpatient Kampo service use before and after the acupuncture curriculum, there was a 1.8-fold increase after it. The results support the usefulness of the acupuncture curriculum to understand acupuncture and practice Kampo medicine. Further evaluation is necessary.
ABSTRACT
Five cases of various diseases associated with breast cancer treatment including arthralgia, menopausal symptoms, chemotherapy-associated symptoms (nausea, vomiting, numbness, pain, general fatigue), and anxiety neuroses during follow-up were treated with Kampo medicine and a favorable course was obtained. Combined use of Kampo treatment can reduce the suffering caused by the side effects of breast cancer treatment, alleviate mental symptoms, prevent recurrence, and improve the patients' health. Kampo medicine plays a role in cancer supportive care for breast cancer.
ABSTRACT
We report two cases in which the quality of life of children with chromosomal aberration improved with Kampo treatment. Case 1 : Six-year-old boy with 5p deletion syndrome. We prescribed kambakutaisoto for the purpose of treating excitability and insomnia. After adding shokenchuto, and further using with yokukansan, the degree of excitement was obviously reduced, and he began to sleep well until morning. Case 2 : Two-year-old boy with chromosome 8 abnormality. He had failed extubation after thoracotomy, thus he needed tracheostomy and gastrostomy. Frequent sputum suction was required every 5 to 15 minutes, and he suffered chronic diarrhea. The number of suctioning was decreased after treatment with bukuryoingohangekobokuto. Moreover, after the addition of shokenchuto, suction became unnecessary for more than 2 hours, and diarrhea also improved. After surgery to close tracheostomy site, he has been receiving ogikenchuto + shoseiryuto + ninjinto and is very well enough to go to a nursery school. Although it is a small improvement not involved in life prognosis, it has contributed to the improvement of the quality of life and the reduction of burden on caregivers. We believe that it is one of the significance of providing Kampo treatment for children.
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
Kampo medicine is widely used in Japan for neuro-otologic disease (e.g. tinnitus, dizziness, hearing loss). Some patients with these diseases suffer from comorbidity of other non-otologic symptoms. We reviewed typical Kampo medicine formulations for neuro-otologic disease. Kampo extracts have indications not only the neuro-otologic but also other systemic diseases. Kampo medicine would facilitate the care of patients with both neuro-otologic diseases and comorbid symptoms.
ABSTRACT
[Objective] We report a successfully treated case by a combined therapy of acupuncture and Kampo medicine for a patient with lower limb pain associated with Guillain-Barre syndrome (GBS).[Case] The patient was a 74-year-old man whose chief complaints were severe lower limb pain, gait difficulty, and hyposthenia. Clinical history: In late September in X year, the patient had a cold infection. On October 14, he became aware of weakness in his lower limbs on both sides, difficulty in walking, and severe pain in his lower limbs. He visited our hospital's general internal medicine department and was diagnosed with GBS. The patient was hospitalized and started to receive intravenous immunoglobulin therapy for GBS. Since pain in the lower limbs continued after treatment, he received analgesics, which was not effective. Therefore, acupuncture treatment was started on October 30 aiming to alleviate lower limb pain. Evaluation: Pain and burning sensation were evaluated using a numerical rating scale (NRS), and Hughes' function grade scale (FG) as an objective evaluation. [Acupuncture treatment] The acupuncture treatment was based on Chinese medicine. The basic combination of meridian points for treatment of the case were LR3 (Taichong), LI4 (Hegu), KI6 (Zhaohai), KI3 (Taixi), ST36 (Zusanli), PC6 (Neiguan), and SI8 (Xiaohai). The patient received acupuncture treatments once a day for 12 weeks.[Progress] The first evaluation of the patient's pain in his lower limbs on both sides was 10 points in NRS and 4 units in FG. Pain was alleviated immediately after acupuncture treatment was started, and a significant improvement in pain was observed by the seventh acupuncture treatment. However, the patient started to complain of burning sensation on his soles. Therefore, the combined use of Kampo medicine (Choutousan, Rokumijiougan) were introduced in addition to the acupuncture treatment, and his burning sensation disappeared. Since then, rehabilitation was enhanced, and after three months from the start of acupuncture treatment, he was discharged since the FG was improved to 2 units. [Discussion] Lower limb pain and burning sensation in this case were considered to be neuropathic pain associated with GBS, and conventional analgesics were only temporarily effective. In contrast, the combined use of acupuncture and Kampo medicine alleviated the pain and burning sensation, and ADL was improved. Acupuncture and Kampo medicine were effective for lower limb pain and burning sensation from GBS.
ABSTRACT
We are planning a study focused on the gathering of clinical data for the purpose of formalizing diagnostic logic at 6 institutions specialized in Kampo-based medical examinations. However, during the planning stage, it has been recognized that there are a large number of Kampo formulas to be studied, and differences among faculties and individuals exist regarding how to identify each Kampo formula, methods of gathering findings, and the evaluation of efficacy. Here we report the solution proposal reached after building consensus among all participating faculties on these issues. After raising the issues, conferences were held for each of them, until a unanimous consensus was obtained. As a result, the following conclusions were reached. Thirty-three Kampo formulas were selected as targets for the formalization of diagnostic logic. In addition, the range of dosage forms, crude drug ingredients, and permissible dosages for each Kampo formula were determined. Regarding clinical findings for these Kampo medicines, the items to be collected and evaluation criteria were also established. The criteria for evaluating the validity and safety of each Kampo medicine were decided, together with the grading and timing of evaluation. We hope that our solution proposal reached after building consensus becomes the basis for Kampo research in the future.
ABSTRACT
Various measures are being undertaken all over the world to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Artificial respirators and extracorporeal membrane oxygenators (ECMO) have been introduced for severely ill patients, and antiviral pharmacotherapy has been attempted. However, in the current situation, it is not feasible to wait for evidence-based effective treatments, and it is imperative to deal with daily situations. It would be very helpful to retrospectively evaluate the doctors who worked during the Spanish flu pandemic without access to medical devices such as ventilators, or drugs including antibacterial and antiviral agents. Based on the fact that Kampo medicine was used to treat patients with the Spanish flu, this article demonstrates the high pathogenicity of the Spanish flu virus, the mechanism of action of antiviral drugs, and clinical evidence. As one of the measures against the COVID-19 pandemic, we propose the role of Kampo medicine, which has relative clinical safety with few side effects, and can be expected to induce antiviral action by autoimmune activation.
ABSTRACT
The Japan society of oriental medicine created a committee of medical safety in 2017. The first activity was to summarize the representative side effects of Kampo medicine and to enlighten members of our society about them. In this report, we documented the knowledge to keep in mind at present on pseudoaldosteronism, drug-induced liver injury, and drug-induced lung injury. Since these three major side effects may cause clinically severe conditions, it is very important to detect them early and take appropriate measures. Therefore, proper examinations at the right time are necessary while taking Kampo medicine.