ABSTRACT
A 40-year-old woman had suffered from genital herpes twice a year since approximately age 25 years. A year and a half before her first visit to our department, the frequency of her genital herpes had increased from 2 to 5 times a month. Continuous suppressive antiviral medication had not worked, and the patient was referred to our department. We discontinued the anti-herpes medication, and started treatment with Kampo (Japanese herbal) medicine. Initially, the patient’s symptoms did not improve with tokishigyakukagoshuyushokyoto for coldness of the hands and feet or hochuekkito for general fatigue. Then, on the basis of her symptoms of irritability, nightmares, dry skin and hair loss, we changed her prescription to juzentaihoto before meals and saikokeishikankyoto after meals. The frequency of genital herpes thereafter gradually decreased, and finally no further recurrences of herpes were observed as long as the patient was taking these two medicines. This result showed that some patients with recurrent genital herpes who fail to respond to antiviral therapy could be managed with Kampo medicine alone.
ABSTRACT
This report describes a case of cluster headaches that was successfully treated with juzentaihoto. A 39-year-old male had been having attacks of cluster headaches for 7 years. During an attack, he took a triptan and nonsteroid anti-inflammatory drug (NSAID), but they were not effective and he had lost his good eyesight after the attack. Recently, as the attacks had become more frequently and stronger, he visited our hospital. Physical examination including dry skin suggested that he had kikyo and kekkyo. Therefore, we prescribed juzentaihoto. After 3 months of treatment, the frequency and strength of the attacks decreased. The underlying pathophysiology of cluster headaches incompletely solved. When the responsible localization of organic disease is not clear, Western medicine sometimes have difficulty in relieving pain. On the other hand, we can analyze the case through “yin-yang and xu-shi categorization,” “life force, blood and colorless bodily fluids (3 elements that constitute an organism)” and Gozo-roppu-setsu according to traditional Chinese medicine. Understanding the bodily functions from an Oriental medicine viewpoint, we can prescribe effective oriental medicine to relieve pain.
ABSTRACT
In female patients with migraine, the triggering or exacerbating factors for migraine including stress, menstruation and fatigue, should be treated intensively in addition to treatment for headache. Patients with coldness and weak constitution become a state of qi and blood deficiency in terms of Kampo medicine under the circumstances of severe fatigue, lack of sleep and menopausal symptoms. They tend to suffer from migraine at around the 4th or 5th day of menstrual period after rather heavy menstrual bleeding on the 2nd or 3rd day. We experienced 4 patients with headache during the late period of menstruation whose symptoms were successfully treated by juzentaihoto known to improve qi and blood. In Case 1, daily prescription was changed from unkeito to juzentaihoto. In Case 2, during the 7 days of menstrual period, juzentaihoto was added to tokishigyakukagoshuyushokyoto, while juzentaihoto was substituted for tokishakuyakusan in Case 3 and Case 4. In 9 cases of headache, including these 4 cases, juzentaihoto was efficacious against migraine headache during the late period of menstruation with coldness (9/9 cases), fatigability (9/9 cases) and dryness symptoms (7/ 9 cases). These results indicate that juzentaihoto is effective for migraine during the late period of menstruation, especially in patients with fatigue after menstrual bleeding. The administration period of juzentaihoto should be individualized for each patient depending on the severity of qi and blood deficiency.
ABSTRACT
<p>Peripheral arterial disease is a serious complication that can arise in hemodialysis patients. Prognosis in critical limb ischemia (CLI) due to peripheral arterial disease is extremely poor. A dialysis patient may experience symptoms of both <i>qi </i>and <i>ketsu </i>deficiency and <i>ketsu </i>stagnation during the long-term treatment of CLI. Herein, we report three hemodialysis patients with refractory postoperative skin ulcers who were successfully treated with juzentaihoto and keishibukuryogan after limb amputation. Case 1 was a 68-year-old man who had skin ulcers of the right second, third, and fifth toes. After amputation of the third toe, juzentaihoto and keishibukuryogan were initiated. Case 2 was a 67-year-old man who had skin ulcers after amputation of the left fourth and fifth toes. Postoperatively, juzentaihoto and keishibukuryogan were initiated, and good granulation was observed. Case 3 was a 76-year-old man who had skin ulcers after left below-the-knee amputation. Because of the extremely poor tissue granulation, juzentaihoto and keishibukuryogan were initiated, and good granulation was gradually observed. After an operation for CLI, prompt return to activities of daily living is desirable. The appropriate addition of Kampo treatment to Western treatment may improve chronic refractory skin ulcers.</p>
ABSTRACT
We experienced 2 cases in which Kampo (Chinese medicine) treatment was effective for septic osteoarthritis. Case 1 : a 34-year-old female. Septic coxarthritis developed with no left hip joint abnormality being noted, while DIC (disseminated intravascular coagulation) from MRSA pneumonia was treated. Surgeries were carried out five times, but there was no wound closure, and exudate discharge continued. At first, she was treated with Hochuekkito, did not run a fever, and good granulation tissue was formed in the wound. After a change to Senkinnaitakusan, exudate quantity decreased. Moreover, after an external fixation operation and being treated with Juzentaihoto, epithelization progressed, and the wound eventually closed. Case 2 : a 79-year-old female. One year and 6 months after osteosynthesis with compression hip screw was carried out for a femoral neck fracture, operation scar complications and large quantities of exudate were seen, so we diagnosed her with late onset septic osteomyelitis. She gained weight with Juzentaihoto treatment, while a decrease in exudates and fistula closure with Astragali Radix and Ginseng Radix were confirmed by MRI, and her nutritional state improved. Generally speaking, septic arthritis and osteomyelitis are difficult to treat, but Kampo medicines were curatively effective for these diseases, particularly when increasing Astragali Radix and Ginseng Radix quantity.
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We report the case of an 84-year-old woman with advanced biliary tract cancer and accompanying colonic invasion and hepatic metastasis, who was successfully treated with single-agent gemcitabine chemotherapy in combination with juzentaihoto (a traditional Japanese herbal medicine). Response to this combination chemo therapy was extremely good, and the patient's tumors disappeared. There have been no reports like our case until today. These findings suggest that combined treatment with juzentaihoto and gemcitabine is effective not only for reducing tumor size, decreasing the side effects of chemotherapy, and maintaining general condition but also for mediating immune antitumor activity.
ABSTRACT
We report the case of a 76-year-old woman diagnosed with refractory anemia arising from myelodysplastic syndrome. Vitamin K 2 was administered, but pancytopenia continued to progress. At the initial visit to our department, her white blood cell count was 2150/μL, hemoglobin (Hb) was 9.6 g/dL and platelet count was 2.3×10<sup>4</sup>/μL. Juzentaihoto was administered for <i>Qi</i> and blood deficiency. A dosage of shimotsuto was increased from 3 to 5 g, and juzentaihoto was changed to ogikenchuto go shimotsuto, but the anemia did not improve. Juzentaihoto was again administered, and the dosage of shimotsuto was increased to 6 g. Malt sugar, 10 g, was added to the decoction, after which her Hb and platelet count markedly increased. There was no significant difference between pre- and post-treatment bone marrow findings. It is possible that malt sugar enhances the hematopoietic function of juzentaihoto.
ABSTRACT
Although glycyrrhizin (SNMC), and ursodeoxycholic acid (UDCA), alone or in combination have been administered in patients with active HCV-associated chronic hepatitis (HCV-CH) or liver cirrhosis (HCV-LC), there are many patients who do not respond well to these anti-inflammatory treatments. In this study, we examined retrospectively the possibility for juzentaihoto to alleviate inflammation in such patients. We calculated average ALT levels every 6 months for all 67 patients. If we assume an improvement in average serum ALT levels of more than 25% after juzentaihoto administration to be significantly effective, as compared with average ALT levels before juzentaihoto administration, 23 out of 40 patients (57.5%) showed significant improvement within one year. In the 32 patients with HCV-associated liver disease who were treated with combination SNMC and UDCA therapy, and whose average ALT levels did not decline to less than 80 IU/L, 18 (56.3%) showed significant improvement when juzentaihoto was added. Juzentaihoto was effective in 62.5% of patients with CH, and 54.2% of those with LC. Moreover, juzentaihoto was effective in 41.2% of male, and 69.6% of female patients. And in about 40% of patients, average ALT levels lowered increasingly over time, out to 2 years. Juzentaihoto may be an effective anti-inflammatory agent for intractable cases of active HCV-CH, or HCV-LC.
ABSTRACT
We report three cases of skin disease successfully treated with juzentaihoto. Juzentaihoto has been used traditionally for deficiency of both Ki and Ketsu, and, at present, clinically for the treatment of various skin diseases. Toll-like receptors (TLRs) have recently been characterized as the receptors of innate immunity, which are mainly expressed on antigen-presenting cells. We previously reported that juzentaihoto enhanced interleukin-12 (IL-12) and interferon-γ (IFN-γ) production through modulation of TLR4signaling pathways in murine peritoneal exudative macrophages. Since Langerhans cells, a kind of the antigen-presenting cell, are known to exist in epidermis, we speculate that juzentaihoto improves T helper1and 2 (Th 1/2) balance through modulation of TLR signaling pathways in Langerhans cells. Our cases suggest that influence to acquired immunity through the innate immune signaling is assumed to be one of the mechanisms of juzentaihoto for controlling morbid states of the skin.
Subject(s)
Skin DiseasesABSTRACT
Systemic infection by MRSA (Methicillin-resistant Staphylococcus aureus) is a risk in immunodeficient patients such as those with severe burn injuries. Hozai, formulations with tonic effects, may enhance the immune system and we treated two severe burn patients with MRSA infections using Juzentaihoto, which is a remedy for kikyo (deficiency of vital energy) and kekkyo (ketsu deficiency). Both patients suffered flame burns [85% body surface area (BSA) and 40% BSA] and inhalation injuries committing self-immolation. They contracted MRSA in due course and antibiotics such as Arbekacin or Teicoplanin did not control MRSA. Therefore, Juzentaihoto was administered through a nasogastric tube and both of them were finally cured without complications. Juzentaihoto may be useful against fatigue, anemia, malaise, ulcer, and purulent wounds due to severe burns.
ABSTRACT
Two experiments were conducted to determine effects of Juzen-taiho-to on endometrial carcinogenesis in mice. In the first experiment, Juzen-taiho-to treatment (2 weeks) decreased the levels of estradiol-17 β (E<sub>2</sub>)-stimulated expression of c-fos/jun mRNA and their oncoproteins, determined by reverse transcription-polymerase chain reaction and Southern blot analysis, and immunohistochemical method, in the uteri of ovarectomized mice. For the second experiment, 93 female ICR mice were given N-methyl-N-nitrsourea (MNU) solution (1mg/100g body wt.) and normal saline (as controls) into their left and right uterine corpora, respectively, and were divided into four groups. Group 1 was given 0.2% Juzen-taiho-to and 5 ppm E<sub>2</sub>-containing diet. Group 2 was given 5ppm E<sub>2</sub>-containing diet alone. Group 3 was exposed to 0.2% Juzen-taiho-to containing diet alone. Group 4 was kept on the basal diet alone and treated as a control. Juzen-taiho-to treatment significantly decreased incidences of the uterine endometrial atypical (P<0.01), complex (P<0.05) and simple hyperplasias (P<0.01), under estrogenic stimulation. It is suggested that Juzen-taiho-to has an inhibitory effect on E<sub>2</sub>-related endometrial carcinogenesis in mice, relevantly through suppression of estrogeninduced c-fos/jun-expression.
ABSTRACT
Kampo medicines, boiling water extracts of several kinds of herbal medicines, has been widely used for the clinical treatments in Japan. This medicine was created in China and brought to Japan via Korean peninsula at 5th century and has followed an independent course of development in Japan. But a modern scientific knowledge on Kampo medicines are still lacking, so this precious properties are slighted by modern medical treatment.<br>Last twenty five years, we have investigated the Kampo medicine chemically and pharmacologically to change this situation. In this paper, few topics will be discussed as shown bellow.<br>1) Difference between Kampo medicines and modern western medicines<br>2) Structural transformation of ingredients of crude drug<br>3) What is Kampo medicines based on components<br>4) Biological evaluation of some Kampo medicines<br>a. Effects of Sho-saiko-to toward the expression of P450mRNA<br>b. Effects of some Kampo formula toward the AD models<br>c. Effects of some Kampo formula toward the rheumatic models
ABSTRACT
Although the combined administration of glycyrrhizin (SNMC) and ursodeoxycholic acid (UDCA) is usually used for intractable patients with active HCV-associated chronic hepatitis (HCV-CH) or cirrhosis (LC), there are many cases that do not respond to this combination therapy. In this study, we examined the effects of adding Juzen-taiho-to (TJ-48) to lower the serum alanine aminotransferase (s-ALT=s-GPT) levels in such cases. Methods: The average s-ALT levels for 6 months were compared before and after 7.5g of Juzen-taiho-to was added to the combined therapy of SNMC and UDCA for 9 HCV-CH and 12 HCV-LC patients. In some cases, the effectiveness of the therapy over 12 months was also evaluated. Results: In the HCV-CH cases s-ALT levels were significantly decreased in 3 of 9 (33%) cases in 6 months (about 30 INU in average). In the HCV-LC cases, s-ALT levels were significantly decreased in 5 of 12 (42%) cases in 6 months (more than 40 INU in average). There were some patients whose s-ALT levels decreased significantly after 6 months. As to the improvement of clinical symptoms, general fatigability improved in 12 out of 20 cases (60%) and anorexia improved in 10 out of 19 cases (53%). Conclusions: Juzen-taiho-to (TJ-48, 7.5g daily) added to the combined therapy of SNMC and UDCA may be an effective therapy for intractable cases of active HCV-CH or LC.
ABSTRACT
We investigated the clinical effect of Juzen-taiho-to and macrophage-colony stimulating factor (M-CSF) on thrombocytopenia induced by anti-cancer chemotherapy in gynecologic malignancies. We discussed 31 courses in 20 patients. Juzen-taiho-to and/or M-CSF were given when indicated from serum platelet level. Twenty-eight courses (90.3%) in 17 patients did not need transfusion of platelet, and 3 courses in 3 patients needed it. It suggested that Juzen-taiho-to and M-CSF might be effective. As platelet-free plasma TGF-β1 level during the treatment of Juzen-taiho-to alone was remarkably increased, it might enhance the antitumoral action. Accordingly, combination treatments of Juzen-taiho-to and M-CSF might be effective for thrombocytopenia induced by anti-cancer chemotherapy.
ABSTRACT
In hemodialysis patients, malaise is a common compliant. We tried to use Juzen-taiho-to as a treatment for malaise. Seventeen patients took 5g of Juzen-taiho-to twice a day for 8 weeks, and then responded to questionaires regarding their condition. Twelve patients experienced a decreased feeling of malaise, but 4 patients dropped out of the study, and 1 patient was ineffective. Hemodialysis patients usually feel cold and their skin is dry; these are symptoms of weak Ki (elemental energy) and anemia. Juzen-taiho-to is a medicine for Ki and blood deficiency. Juzen-taiho-to is a useful drug for treatment of malaise in hemodialysis patients.
ABSTRACT
A patient with systemic lupus erythematosus (SLE), complicated by severe thrombocytopenia was successfully treated with Juzen-taiho-to. The patient was a 38-year-old woman presenting thrombocytopenia in 1974. She was diagnosed as having SLE with the appearance of renal failure in 1975. In 1984, she began blood dialysis due to deterioration of renal function. In addition, she repeatedly suffered from severe bleeding episodes due to thrombocytopenia. In 1989, she visited our clinic to undergo Kampo therapy, with no significant results obtained with any of the formulas tried.<br>In September 1992, she suffered from duodenal ulcer bleeding and stopped Kampo therapy for some time. However, since she began taking Juzen-taiho-to in June 1993, her thrombocytopenia improved and her platelet count stabilized at 10-15×10<sup>4</sup>/mm<sup>3</sup>. This made it possible to taper the dosage of the steroids being administered. Since July 1994, the prednisolone (PSL) dosage has been 5mg on alternate days. Since July 1995, the anti-DNA antibody was negative. The platelet count has been maintained at 15-20×10<sup>4</sup>/mm<sup>3</sup> (as of December, 1996).
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Background: The present study investigates the effect of Juzentaiho-to on normal weight increase in rats. Juzentaiho-to is a traditional Japanese ‘Kampo’ medicine and causes increased appetite in patients.<br>Method: Ten male 4-week-old wistar rats were divided into two groups. The five rats of the J group were fed CE-2 including 1% Juzentaiho-to, and the five rats of the C group were fed CE-2. The animals weights were measured weeekly.<br>Results: The J group had grown significantly heavier than the C group at 15 weeksold.<br>Conclusions: Juzentaiho-to causes an increase in body weight in rats.
ABSTRACT
Post-inflammatory or post-operative fistula formation is a troublesome complication. As these fistulae are not amenable to closure, surgical excision is usually indicated afterwards. In order to close these fistulae, Juzen-taiho-to was administered to nine children. The location of these fistulae were: cervical region in 1 patient, abdominal wall in 4 patients and external genitalia (perineum) in 4 patients. The fistulae located in the cervical and abdominal regions closed within three weeks of administration, and those located in the external genitalia within six months, including anal fistula. These results suggest the applicability of Juzen-taiho-to for fistula closure.