ABSTRACT
Oketsu is a characteristic pathophysiology in Kampo and traditional East Asian medicine that includes multiple aspects of hemodynamic disorder. Anti-oketsu drugs or the Kampo formulation used for oketsu show significant clinical effects on various disorders; however, their underlying mechanisms still remain unclear. We aimed to clarify the characteristics of the pharmacological effects of anti-oketsu drugs on the microcirculation using a microscopic live imaging technique. Three Kampo formulations, namely tokakujokito, keishibukuryogan, and tokishakuyakusan were orally administrated to C57BL/6 mice at a dose of 300 mg/kg diluted in distilled water. Live imaging was performed on the subcutaneous vessels of the mice, including the arteries (diameter > 50 μm), arterioles (diameter 10-50 μm) and capillaries (diameter < 10 μm). Tokakujokito widely increased erythrocyte flow velocity and blood flow volume from arteries to capillaries within 60 min of administration. The effects of keishibukuryogan on the vasodilation of the arterioles were remarkable, and continued up to 120 min after administration. The pharmacological target of tokishakuyakusan was the capillaries, increasing their erythrocyte velocity and blood flow volume;its effect was more slowly expressed than those of the other formulations. Our results clearly demonstrate the sequential and special effects of anti-oketsu drugs on hemodynamics. These differences may provide pharmacological information on the clinical usage of traditional Kampo formulations.
ABSTRACT
We report a case of recurrent chronic subdural hematoma (CSDH) successfully treated with jidabokuippo. The patient was an 81 year-old woman who was performed burr hole surgery for left CSDH. Residual hematoma was gradually increased in postoperative serial brain CT. Although goreisan and saireito were administrated to prevent recurrence, the treatment was not effective. Thereafter, reoperation was performed because of the appearance of aphasia and right hemiparesis. Intraoperative findings revealed that the hematoma was viscous and was not enough drained. Since there was little improvement in clinical and CT findings, a phenomenon of the hematoma was considered as oketsu and jidabokuippo was administrated. Three weeks after the medication, right hemiparesis was improved. Seven weeks after the medication, the hematoma was markedly reduced. Taken together, these results strongly suggest that jidabokuippo is effective for postoperative recurrent CSDH which is difficult for drainage and has no response to the administration of goreisan and saireito.
ABSTRACT
Case 1 was a 72-year-old man with a generalized pain after 6 months of heavy physical work. Kakkonto was prescribed based on his symptoms of severe shoulder stiffness and pain, and keishibukuryoganryo was added to treatoketsu. It caused dysuria because of ephedra herb, so the dosage was reduced. Atractylodes lancea rhizome and processed aconite root were added to enhance the effect of treatment. And then, his pain was alleviated. Case 2 was a 53-year-old man with a generalized pain. He had a previous history of whiplash and two surgical operations. Daisaikoto was prescribed based on his symptom of bilateral costal arch pain, and keishibukuryoganryo was added because of oketsu. It caused an increased frequency of bowel movement due to crude drug of rhuharb, so the dosage was reduced. Pueraria root was added for the purpose of relieving severe shoulder stiffness. And then, his pain went away. It is often difficult to treat fibromyalgia. The decoction can be effective with increase or decrease and deleting or adding of the dosage of crude drug. Decoctions become handy as it allows dosage adjustment of crude drug to minimize the side effects and improve the efficacy.
ABSTRACT
The mind-body unity is a fundamental doctrine in Kampo medicine. In this report, the author tried to consider oketsu syndrome as a concrete object because this syndrome consists of both emotional and physical disorders. The oketsu syndrome has been recognized as blood stagnation in the microcirculatory vessels. On the other hand, the emotional aspect of this syndrome correlates with anger or aggressive affection. It is well known that emotional disorders are brought by very complicated neural circuit in the cerebral limbic system, so that this report referenced suitable articles among numerous scientific evidences, and discussed about mindbody unity.
ABSTRACT
<p>It is well known that a painful lump around para-naval, ileo-cecal and sigmoid regions are correlated with <i>oketsu </i>syndrome, although, the physiological mechanism for these signs is still unknown. Recently, the author made clear that these signs disappear by acupunctural procedure at the meridian points Hikon (ExB4), Kekkai (SP10) and/or the lump itself. And also the author found out that these abdominal lumps are located in the most peripheral position of the superior or inferior epigastric artery. This evidence may indicate that abdominal lumps are brought by diminished blood flow of the superior or inferior epigastric artery, and acupunctural input from a meridian point or lump itself inhibits not only the excited gamma and alpha motor-neuron in the thoracic 11 and 12 segment of spinal cord but also excites sympathetic neurons. The author speculates that the initial noxious stimuli occur with stagnation of the pelvic vein associated with homeostatic inflammation.</p>
ABSTRACT
<p>Pelvic congestion syndrome is a condition in women caused by congestion or varicosity of the intrapelvic vein. We report a case of pelvic congestion syndrome managed with keishibukuryogan. The syndrome was diagnosed based on expansion of the left periuterine and ovarian veins.<br>A 61-year-old female presented to our clinic with left lower abdominal pain. NRS was 9 and Terasawa's oketsu score was 40, indicating marked blood stasis. A CT scan revealed vascular expansion (10 mm) of the left ovarian vein. Transvaginal ultrasonography also revealed vascular expansion (6.0 mm) of the left periuterine vein. Based on these findings, a diagnosis of pelvic congestion syndrome was established. She was treated with keishibukuryogan (7.5 g/day). NRS was improved to 1 and Terasawa's oketsu score was improved to 20. The symptoms were resolved within 6 months, and the medication was discontinued.<br>Three months after discontinuation, she presented to our clinic again with left lower abdominal pain. The medication was resumed and the symptom was improved. After 5 months, a contrast enhanced CT scan showed no change of vascular expansion of the left ovarian vein (from 10 to 9 mm). Keishibukuryogan treatment has now been continued for 10 months.</p>
ABSTRACT
Otsujito is a well-known herbal preparation used for treating hemorrhoidal disease. However, we considered the anatomical similarities between the lips and the anus, and here report a case of inflammation of the lips with blood stasis successfully treated with otsujito as well.<br>The case was a 59-year-old woman suffering from eczema on her face and neck. The eczema showed a tendency to improve with herbal treatment, but inflammation and pruritus of the lips continued. Taking into account the presence of blood stasis, we included otsujito in the treatment and her symptoms improved.<br>Otsujito contains bupleurum, cimicifuga, scutellaria, and rhubarb, which dissipates heat, and angelica,which resolves blood stasis. Therefore, we consider that inflammation of the lips with blood stasis can be treated with otsujito.
ABSTRACT
Saffron (<i>Crocus sativus</i> L.) is classified as a beneficial herb in the treatment of “Oketsu,” eliminating blood stagnation. The clinical symptoms of “Oketsu” include feeling cold and arthralgia. The pathological condition of “Oketsu” is considered to be increased blood viscosity and microvascular disorders.However, no useful biomarker has been reported for evaluation of the degree of “Oketsu.” Here, we investigated the clinical effect of saffron on the symptoms of “Oketsu” in patients with autoimmune diseases. At the same time, we measured the plasma levels of platelet factor 4 (PF-4) and beta-thromboglobulin (β-TG) as platelet activation markers. Seventy-one patients (66 women and 5 men, mean age 52.3 ± 16.1) were studied. They were administered saffron (300mg∼900mg) with traditional Kampo medicine. The clinical symptoms of “Oketsu” improved (80.9%, n=38/47) and we measured PF-4 and β-TG in pre-and post-saffron treatment periods. The plasma levels of PF-4 and β-TG significantly decreased after saffron therapy (PF-4 : before 49.6 ± 29.8, after 24.0 ± 19.6ng/ml, β-TG : before 117.5 ± 64.0, after 64.6 ± 47.1ng/ml;paired t-test, p < 0.0001, respectively). These results suggest that saffron is effective in treatment of the symptoms of “Oketsu” in allergy and collagen disease patients. Moreover, PF-4 and β-TG may be useful biomarkers of the degree of “Oketsu.”
ABSTRACT
Swelling and pain appear when blood flow is delayed in states of “<i>oketsu</i>.” Until now “<i>oketsu</i>” as a circulatory disturbance has been studied from profiles of vascular resistance characteristics and blood fluidity. Blood fluidity is influenced by blood cell function, plasma ingredients and reactive oxygen. In this study, we administered the various Chinese herbal medicines, tokishakuyakusan, saikokaryukotsuboreito, tokakujokito, keishibukuryogan and juzentaihoto to determine the effect of these medicines on “<i>oketsu</i>” by observing reactive oxygen dynamics and blood fluidity in rats.SPF male Wistar rats weighing 200 g were used. Each experimental group was given feed containing 3% extract of one Chinese herbal medicine for1week. Blood samples were mixed with heparin, EDTA-2K or sodium citrate to block coagulation. Blood fluidity was measured with a Micro Channel Array Flow Analyzer (MC-FAN). A PA-20 examined platelet aggregation by the reaction to ADP, which activates platelet aggregation. Reactive oxygen dynamics were measured with a Free Radical Elective Evaluator (FREE).As a result, anti-oxidative ability and blood fluidity increased in all Chinese herbal medicine-administered groups. Furthermore, an inverse correlation between the fluidity of erythrocyte suspensions and anti-oxidative ability was shown. We speculate that an anti-oxidative influence of Chinese herbal medicines affected erythroid deformability or stickiness. In addition, tokishakuyakusan, tokakujokito and keishibukuryogan decreased platelet aggregation ability.This study shows that “<i>oketsu</i>” improves blood properties and suggests that Chinese herbal medicine improves decrease in blood fluidity, the causes of conditions such as thrombosis or embolism.
ABSTRACT
Schamberg disease is a subtype of idiopathic pigmentary purpura, which manifests with petechiae. It is assumed to be caused by venous microcirculatory disturbance, or an immunological and allergic mechanism. We report a 55-year-old Japanese male with Schamberg disease successfully treated with keishibukuryogan prepared at a hospital pharmacy. The patient had purpuric eruptions in his both lower legs at first, and brownish pigmentation enlarged with purpura. A dermatologist had diagnosed this, from the clinical findings, as Schamberg disease. We administered keishibukuryogan to the patient because his pathological condition was considered as oketsu. In order to improve effectiveness, keishibukuryogan was manufactured according to our own modification. The eruptions have reduced gradually, and about four months later, have mostly resolved. A Kampo therapy utilizing unseiin has been reported to be effective against idiopathic pigmentary purpura in previous studies. We suggest that a Kampo treatment with keishibukuryogan seems to be effective against idiopathic pigmentary purpura through improvements of microcirculation and inflammation.
ABSTRACT
We report 5 patients with polymyalgia rheumatica (PMR) successfully treated with Kampo medicines. In total, we investigated 10 patients with PMR, including the 5 patients here treated in our department. Results showed that Kampo medicine was effective in 6 cases. One of the 6 refused steroid drug administration, and tapering dosage steroid was difficult in the other 5 patients due to myalgia or inflammation. Except for one case, C-reactive protein in most of the effective cases was below 3.0 mg/dl. On the other hand, the non-effective cases had severe inflammation levels and needed steroid therapy. The effective cases were treated with sokeikakketsuto, tokakujokito, keishibukuryogan, choyotokasyakuyaku, yokuibushihaishosan and tokishakuyakusan, which have the effect of improving oketsu states. Thus, it was considered that Kampo medicine has the potential for treatments in PMR patients who have difficulty tapering steroid dosage and mild inflammation. Moreover, this suggests Kampo medicines that improve oketsu state are useful for PMR treatment.
ABSTRACT
Schamberg disease is a subtype of idiopathic pigmentary purpura, which manifests with petechiae. It is assumed to be caused by venous microcirculatory disturbance, or an immunological and allergic mechanism. We report a 55-year-old Japanese male with Schamberg disease successfully treated with keishibukuryogan prepared at a hospital pharmacy. The patient had purpuric eruptions in his both lower legs at first, and brownish pigmentation enlarged with purpura. A dermatologist had diagnosed this, from the clinical findings, as Schamberg disease. We administered keishibukuryogan to the patient because his pathological condition was considered as oketsu. In order to improve effectiveness, keishibukuryogan was manufactured according to our own modification. The eruptions have reduced gradually, and about four months later, have mostly resolved. A Kampo therapy utilizing unseiin has been reported to be effective against idiopathic pigmentary purpura in previous studies. We suggest that a Kampo treatment with keishibukuryogan seems to be effective against idiopathic pigmentary purpura through improvements of microcirculation and inflammation.
ABSTRACT
We report 5 patients with polymyalgia rheumatica (PMR) successfully treated with Kampo medicines. In total, we investigated 10 patients with PMR, including the 5 patients here treated in our department. Results showed that Kampo medicine was effective in 6 cases. One of the 6 refused steroid drug administration, and tapering dosage steroid was difficult in the other 5 patients due to myalgia or inflammation. Except for one case, C-reactive protein in most of the effective cases was below 3.0 mg/dl. On the other hand, the non-effective cases had severe inflammation levels and needed steroid therapy. The effective cases were treated with sokeikakketsuto, tokakujokito, keishibukuryogan, choyotokasyakuyaku, yokuibushihaishosan and tokishakuyakusan, which have the effect of improving oketsu states. Thus, it was considered that Kampo medicine has the potential for treatments in PMR patients who have difficulty tapering steroid dosage and mild inflammation. Moreover, this suggests Kampo medicines that improve oketsu state are useful for PMR treatment.
ABSTRACT
Thalamic pain is known as intractable central pain caused by thalamic bleeding and infarction. Although some physical and surgical therapies have been tried, there is no established method for its improvement. We attempted the treatment of 6 cases of thalamic pain, and 4 of them showed improvements in their symptoms. Our patients were aged 27-70 years, 4 men and 2 women. Their diagnoses were 3 cases of right thalamic bleedings, 1case of left thalamic bleeding, and 2 cases of right thalamic infarctions. The periods from onset to consulting our department were from6months to 12 years. In the 4 cases whose symptoms improved, the symptoms had almost disappeared or were decreased by at least 40%. These improved cases used formulas containing uzu or bushi. Yokukansankachimpihange was effective for two cases with mental disturbances. One case showing major improvement was treated by only the formula against oketsu. The cases whose symptoms had continued for a long time were more intractable, with the symptoms remaining to some degree in spite of their decreasing tendency. Finally, in intractable cases, their symptoms remained fixed and they had severe paralysis.
ABSTRACT
To determine the Kampo therapy indications for global infertility treatment, and the criteria for objective and rational evaluation of its efficacy, we analyzed the sho (Zheng), type of ovarian dysfunction, types of Western drugs used concomitantly, length of treatment, age upon pregnancy, etc., in 100 women with infertility due to ovarian dysfunction as diagnosed by Western medicine who succeeded in becoming pregnant and giving live births, after Kampo therapies diagnosed by sho based on Hakko, Ki, Ketsu and Sui. The diagnosis of the sho in these women was compared with that in 2737 control women. Their types of sho by frequency were Kyo (51%), Shoyo (Hanhyo-Hanri) (69%), Jonetsu-Gekan (52%), Kigyaku (47%), Oketsu (71%) and Suidoku (67%). When compared to the control group, the percentage of women whose Sho was rated as Jitsu, Taiyo, Shoyo, Jonetsu-Gekan, Oketsu or Suidoku was significantly higher. The sho type Hyonetsu-Rikan was lower. The preparation sho, rated on the basis of a general assessment, was most frequently Kamishoyosan(55%). The predominant type of ovarian dysfunction was luteal dysfunction (73%), whose frequency was significantly higher than that in the control group. Of all women studied, 46% were treated with Kampo alone and 54% were treated with Kampo + Western medicine. In terms of the percentage of each type of ovarian dysfunction, there was no significant difference between the two groups. The Western drugs used in combination with Kampo therapy were hCG preparations (33%), terguride preparations (18%), clomiphene preparations (3%) and hMG preparations (6%). The period of treatment until pregnancy was significantly shorter in the Kampo alone group (5.0 ± 4.4months) than in the combined therapy group (9.5 ± 6.8months). These results allow us to make the following conclusions:1.The type of infertility indicated for Kampo medicine is infertility due to ovarian dysfunction as diagnosed by methods of Western medicine.2.Women who successfully became pregnant following Kampo medicine were often cases of Shoyo disease complicated by sho with Jonetsu-Gekan, accompanied by Kigyaku, Oketsu and Suidoku.3.Uncombined Kampo medicine may be effective in cases of severe infertility.4.If pregnancy does not occur within 5 or 6 months after the start of Kampo therapy, combined use of Western medicines should be considered.
Subject(s)
Medicine, Kampo , InfertilityABSTRACT
The diagnostic criteria for oketsu syndrome which was proposed by K. Terasawa et al. High scores in paranavel resistance and tenderness was characteristic in it. It's evidence was obtained by that blood viscosities of oketsu patients increased than ones of non-oketsu patients. The numbness of seven patients with cerebrovascular accidents in fourteen patients were improved following the four weeks of administration of keishibukuryogan. In this study we could also recognize improvement of intra-vascular erythrocyte aggregation in their conjunctival microcirculation by using the video-microscopic system. These studies had been clarifying that oketsu state might be accompanied to microcirculatory distubance and kampo prescriptions treated for oketsu syndrome could improve it. Important point in using these prescriptions under the traditional standard is to check kyojitsu (robust or asthenia), face color (red or pale) and constipation/or not. I emphasized that role of checking kyojitsu might be bigger in prevention from the adverse effects than in searching drug to treat patient's illness.
Subject(s)
Syndrome , Disease PreventionABSTRACT
The outline of COE program at University of Toyama entitled “Advanced Approach to Personalized Medicine Based on Oriental Philosophy” was presented. This program consists of two parts, i.e., basic research group and clinical research group. On the basic researches, we performed field work for natural resources of medicinal plants both in Mongolia and China. And we revealed the differences of the chemical ingredients in rhubarb family. Furthermore, we developped a new DNA microarray to detect the panax ginseng family. In this paper, we also reported that the chemical ingredients of medicinal herbs convert new substances by the action of intestinal bacterias. In the clinical research group, we revealed that the characteristic protein pattern of “blood stagnant (Oketsu) syndrome” in Kampo medicine by means of protein chip array system. We showed the result of the midway evaluation by Japan Society for the Promotion of Science.
Subject(s)
Universities , Basic Research , ProteinsABSTRACT
Rehabilitation and exercise are occasionally restricted by intractable pain to an extent greater than that estimated due to physical dysfunction. Here, we report three patients with intractable pain in whom Kampo medicine was highly effective, in cases where common treatments such as the administration of non-steroidal anti-inflammatory drugs and nerve blockade proved ineffective. Sokeikakketsuto extract was prescribed for three patients with different conditions: intermittent claudication of cauda equina due to lumbar spondylolisthesis, posttraumatic chronic psychogenic pain, and complex regional pain syndrome type 1 that occurred after cerebral infarction. Sokeikakketsuto extract alleviated severe pain and therefore facilitated rehabilitation and exercise in all three of these cases. From the viewpoint of Kampo medicine, we hypothesized that all three cases shared some common etiology of blood abnormalities, although conventional medical diagnosis differed for each. We suggest that treatment with Sokeikakketsuto extract corrected the blood abnormalities, thereby resulting in the successful treatment of intractable pain in these patients.
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We analyzed the differences between responder and non-responder groups using Choyoto for hand eczema. In 7 cases the drug was effective, and in 6 cases it was not. Most patients in the effective group had white-complexioned skin, and the eczema tended to localize on the hands. In contrast, most patients in the non-effective group had with sleep difficulties and/or a smoking habit. In addition, they showed marked symptoms of Oketsu such as dark red gingiva, indicating that many of the non-effective hand eczema cases had elevated Oketsu scores. It was shown that objective and subjective symptoms could be indicators for the choosing of Choyoto for hand eczema treatment.
ABSTRACT
Choyo-to, which has long been used for acute and chronic intestinal disease, dermatological disorders and pulmonary abscess, is attributed to the writings of 7th Century physician Sun Simiao, known as the “Qian-jinyao-fang”. We have also successfully treated nine different patients suffering from various diseases, using Choyo-to. In most of these cases, patients complained of constipation. Thus far, our modern experience suggests that Choyo-to may be indicated for not only right-side pain upon naval palpitation, pressure sensation at the ileocecum and excessive strain of abdominal muscles, but also for cases of dry skin, edematous skin and tendency of normal tongue color.