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
We examined 57 patients treated with Kampo decoctions containing uzu for 5 years and 3 months from September 2013. Sekiganryo, which was administered to 32 patients, was the most commonly used decoction. The value of uzu dosage and duration of administration were spread widely and the medians (ranges) are 8.0 (1.0-41.0)g/day and 180 (3-1700) days, respectively. Complete recovery, partial recovery, no recovery, and deterioration in terms of the chief complaint, were observed in 36, 11, 9, and 1 patients, respectively. The number of patients exhibiting complete or partial recovery was higher than that of patients showing no recovery or deterioration when the duration of uzu administration was more than one month and the dosage was higher than 4 g/day (p < 0.05). The patients treated with uzu more than 20 g/day were all sekiganryo administrated ones. Side effects were observed in three patients. Thus, under careful observation, uzu was safely used over a long term and at high doses.uzu: aconite root before processing
ABSTRACT
We investigated the decocting time to prepare the formulas containing unprocessed aconite root, such as shigyakuto, tsumyaku shigyakuto, and kankyobushito, which had been registered in “Shanghanlun” edited in Song Dynasty, using the weights and measures in Houhan Dynasty when the original “Shanghanlun” was regarded to have been established. Also the contents of aconitine-type diester alkaloids (ADA) eluted from unprocessed aconite root in the decoction were analyzed in time-dependent manners. As regards the modified formula for the “physically strong patients” in the texts of tsumyakushigyakuto in “Shanghanlun”, adding dried ginger was found to lead the decocting time to be shorter and the sum of ADA content in the decoction of the modified formula to increase about 20%. It was also found that the compositions of diterpene alkaloids derived from aconite root in kankyobushito decoction were highly different from those in shigyakuto decoction, containing less ADA and more aconine and hypaconine, due to the high pH of the decoction, which was the consequence of lacking glycyrrhiza in kankyobushito formula. It is suggested that the doctors in the era of “Shanghanlun” establishment may have carefully adjusted the contents of ADA in the decoctions using unprocessed aconite root by choosing co-decocted crude drugs.
ABSTRACT
A 48-year-old man presented with knee pain and general fatigue. He had been diagnosed with sarcoidosis 15 years previously. Prednisolone was administered, but the pain and fatigue persisted. Morphine, fentanyl, and a tramadol/acetaminophen combination were then administered, but their effects were not sufficient. Finally, the patient was treated with sekiganryo, uzuto, uzukeishito, and daiuzusen, all of which contained uzu (aconite root without processing). His pain and fatigue improved after administration of these drugs, and he became able to perform various activities of daily living. In this case, uzu alleviated knee pain and general fatigue in a patient with sarcoidosis.
ABSTRACT
The decoctions of unprocessed aconite root (uzu) were prepared with the tap water samples collected in Tianjin and Shanghai in China, and the contents of alkaloids in the decoctions were compared to those prepared with purified water or with tap water collected in Niigata, Japan. The contents of aconitine-type diester alkaloids (ADA) in the decoctions prepared with tap water collected in China were significantly lower than those with purified water or tap water in Niigata. It was speculated that this difference appeared by buffering effect of bicarbonic anion in tap water in China to decline pH of the decoction. When uzu was decocted with glycyrrhiza, ginger, or jujube, the contents of ADA in the decoctions exhibited the tendency to have higher levels than those prepared using unprocessed aconite root singly, and also this tendency was observed more remarkably when the decoctions were prepared with tap water collected in China. It was suggested that even the decocting period was fixed, unexpected change of the contents of ADAs might be induced by the differences in the properties of water used for decoction or the crude drugs decocted with aconite root. The physicians in the era when “Songban Shanghanlun” had established may have adjusted the contents of ADA in the decoction by carefully choosing the crude drugs combined to aconite root.
ABSTRACT
The crude drug Aconite Root (<i>bushi </i>in Japanese) contains toxic compounds called bushi diester alkaloids(BDA), and the raw material with high BDA content has been considered suitable for processing into prepared <i>bushi</i>. Moreover, processing methods and an upper BDA content limit are prescribed in the 16th edition of Japanese Pharmacopoeia. In this study, we closely examined descriptions of high quality <i>bushi </i>in ancient herbal literature, and elucidated the relationship between <i>bushi </i>forms and BDA contents. The results showed that large-sized <i>bushi </i>with enlarged rootlets called “horns” (<i>tsuno </i>in Japanese) were considered higher quality, and the horns and the root tops (<i>hozo </i>in Japanese) were cut off when used as <i>bushi</i>. Meanwhile, chemical studies have shown that larger <i>bushi </i>contains less BDA, and the root tops and the horns contain more BDA than the root body. These results suggest that selecting larger roots and cutting off the more potent parts were processes for reducing BDA. Therefore we conclude that consistently less toxic <i>bushi </i>was considered a higher quality product in ancient times.
ABSTRACT
We report two cases successfully treated with tsumyakushigyakuto containing aconite root (<I>uzu</I>), instead of processed aconite root (<I>bushi</I>). The first case was a 33-year-old female. She had suffered from itching rashes in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because she was in an extreme cold state, we changed the processed aconite root in her tsumyakushigyakuto to aconite root. Her itching rashes subsequently improved. The second case was a 42-year-old male. He had suffered from watery diarrhea and general fatigue in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because he was in an extreme cold state, we changed the processed aconite root in his tsumyakushigyakuto to aconite root, and his watery diarrhea and general fatigue improved.<BR>We consider that using tsumyakushigyakuto with aconite root may be more effective than using it with processed aconite root in an extreme cold state.
ABSTRACT
We report two cases successfully treated with tsumyakushigyakuto containing aconite root (<i>uzu</i>), instead of processed aconite root (<i>bushi</i>). The first case was a 33-year-old female. She had suffered from itching rashes in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because she was in an extreme cold state, we changed the processed aconite root in her tsumyakushigyakuto to aconite root. Her itching rashes subsequently improved. The second case was a 42-year-old male. He had suffered from watery diarrhea and general fatigue in spite of being prescribed tsumyakushigyakuto with processed aconite root. Because he was in an extreme cold state, we changed the processed aconite root in his tsumyakushigyakuto to aconite root, and his watery diarrhea and general fatigue improved.We consider that using tsumyakushigyakuto with aconite root may be more effective than using it with processed aconite root in an extreme cold state.
ABSTRACT
Objective To establish a method for the determination of Alkaloid in cut crude drug of aconite root.Method Contents of aconitine,hypaconitine and mesaconitine incrude drug of aconite root were determined by LC-MS.It was carried out on Inertsil ODS-3 column(150 mm?4.6 mm,5 ?m),with acetonitrile-ammonium acetate buffer solution(60:40) as mobile phase,at a flow rate of 0.2 mL/min and temperature of 30 ℃.Result The method of determining Alkaloid content in crude drug of aconite root was established and 25 lots of crude drugs were determined.Conclusion The method was sensitive and specifical,can be used to control the quality of cut crude drug from aconite root.
ABSTRACT
Objective To study the solubility of lipo-alkaloids from prepared aconite root(Radix Aconiti Lateralis Preparata) and identify the sources of lipo-alkaloids in Sini Decoction.Methods The electrospray ionization mass spectrometry was employed to analyze the alkaloids in crude aconite roots,Sini Decoction,the gruffs of concocted aconite roots and the decoction of prepared aconite root and pinellia tuber(Rhizoma Pinellae).Results Lipo-alkaloids were observed in Sini Decoction,however,no lipo-(alkaloids) were found in the decoction of aconite roots with pinellia tuber.Lipo-alkaloids were the dominant components in the gruffs of concocted aconite roots.Conclusion Lipo-alkaloids are barely soluble in boiling water.The alkaloids existed in the Sini Decoction stem from the ester-exchange reactions of diester-diterpenoid alkaloids and fatty acid in the boiling water.