ABSTRACT
A 74-year-old woman presented to our clinic with a history of vascular-and stent-graft insertion for aortic dissection developed a tendency to bleed from a palmar wound due to chronic disseminated intravascular coagulation (DIC). Initially, she sustained the palmar wound due to a fall. On the second day after the injury, she experienced continuous bleeding and consulted the orthopedic department of a general hospital, where her dressing was changed. On the third day after injury, she sought consultation at our clinic. The clot and wound remained intact even 12 days after the injury. Therefore, the clot was removed and the bleeding was stopped surgically. On the same day, 5 hours after the surgical treatment, the patient presented to our clinic because of continuous bleeding. She was then administered kyukikyogaito and kamikihito to stop the bleeding. Her laboratory findings revealed thrombocytopenia, and additional inspection was performed. The bleeding stopped on the next day. On the third day after administration, the bleeding remained controlled and an additional inspection revealed DIC. In the cardiology hospital, the cause of tendency to bleed of chronic DIC was pointed out as being due to a leakage at the end of the stent-graft. Kampo medicine was thought to be useful for temporal hemostasis for bleeding due to chronic DIC.
ABSTRACT
An eight-year-old girl was referred and admitted to our hospital with the chief complaint of purpura on her lower legs. Blood tests revealed pancytopenia, and bone marrow findings showed marrow hypoplasia. Refractory cytopenia of childhood (RCC) was diagnosed based on the central diagnostic system of the Myelodysplastic Syndrome Committee of the Japanese Society of Pediatric Hematology. Immunosuppressive therapy was performed with the administration of rabbit antithymocyte globulin, methylprednisolone and cyclosporin A,but it was not effective. Eight months after admission to our hospital, Kampo treatment was started based on traditional Kampo diagnosis. After treatment with oral administration of kamikihito and kyukikyogaito, her pancytopenia gradually improved. Erythrocyte transfusion was discontinued after 2 months, and concentrated platelet transfusion also became unnecessary after 3 months. As a result of improvement in pancytopenia, her white blood cell count, hemoglobin value, and platelet count reached almost normal levels after 16 months. The scheduled bone marrow transplantation was canceled. The action mechanisms of kamikihito and kyukikyogaito for RCC are not clear, and their effective rates are also unknown. However, Kampo treatments are less invasive, inexpensive, and have few side effects. We believe that Kampo medicine is a therapeutic method that should be actively attempted in cases of RCC with poor response to standard treatment.
ABSTRACT
We investigated the number of days necessary to stop bleeding in a total of 183 cases of dysfunctional uterine bleeding in mature women (average age 41.3+/-7.2). We compared 93 cases given Kyuki-kyogai-to extract with 90 cases given the occidental hematostatic drug, Transamin (tranexamic acid in tablet form) plus Ophthalm K tablets (carbazochrom+VitaminK+Vitamin C) for 7 days from the first day of medical examination until the diagnosis of endometrium was determined by histologic examination. The total number of days required for the bleeding to stop showed a mean of 4.29+/-1.54 days in the Kyuki-kyogai-to administration group and 5.54+/-2.13 days in Transamin and others group. The bleeding was stopped significantly faster in the Kyuki-kyogai-to group than in the Transamin group (P<0.01 to χ<sup>2</sup> calibration [chi-square test]). The effective rates were 94.6% and 72.2% respectively. Considering the Kyojitsusho (condition of excess or deficiency), this was significant in Kyosho (condition of deficiency) and Kyojitsu-kansho (condition of between deficiency and excess), but not significant in Jitsusho (condition of excess). In terms of histological findings of endometrium, this was significant in the proliferation stage and in simple hyperplasia, but not significant in the stillness stage with an atrophic pattern, the stage of intermingled proliferation and secretion, or the secretion stage. The action mechanism of bleeding cessation remains unclear. However, it seems that Kyuki-kyogai-to is an effective herbal medicine to stop bleeding in dysfunctional uterine.