ABSTRACT
In some molecular targeted therapies, skin disorders including acne-like rashes or maculopapular rashes frequently appear, which are often clinically problematic. In Kampo medicine, it has been reported that the combination of jumihaidokuto and orengedokuto (hereinafter called JHT + OGT) is effective for acne. In this study, we report the experiences of JHT + OGT for the treatment of rashes caused by molecular targeted therapies. We extracted patients from June 2013 to June 2017 who took molecular targeted therapies and the treatment with JHT + OGT for skin rashes. The primary endpoint was severity of rashes before and after treatment by JHT + OGT (judged by CTCAE v4.0). In 22 patients (14 males and 8 females), the rashes after treatment with JHT + OGT significantly improved compared with those before treatment (from the median grade of 2 to 1 [p = 0.011]), with 14 cases of improvement, 6 cases of no change, and 2 cases of deterioration. It was suggested that JHT + OGT for skin rashes caused by molecular targeted therapies could be one of the treatment options.
ABSTRACT
Pseudogout is a crystal-induced arthritis that often occurs in senile individuals. We report a case of an acute attack of pseudogout that was successfully treated with bofutsushosan and orengedokuto. The patient was an 87-year-old man who visited our clinic and complained of left wrist joint pain 2 days after onset. His physical examination revealed tenderness in his left wrist joint. Plain roentgenogram revealed slight calcification of the left wrist joint, and an inflammatory reaction was found on blood examination. Thus, he was diagnosed with an acute attack of pseudogout in his wrist joint. We prescribed bofutsushosan and orengedokuto. After internal use, his left wrist joint symptoms gradually improved. At the follow-up visit 3 days after his first visit, his left wrist joint pain was resolved completely, and after 9 days, his laboratory data were normalized. Thus, bofutsushosan and orengedokuto were effective in the treatment of an acute attack of pseudogout.
ABSTRACT
A 72-year-old man with proton pump inhibitor (PPI)-resistant gastroesophageal reflux disease (GERD) had been complaining of ructus, sore throat, and mid-back pain during the night despite the administration of the standard dose of PPI. As his symptoms improved rapidly after taking bukuryoin, he discontinued PPI on his own judgment. However, his nocturnal symptoms relapsed. Adding hangeshashinto before bedtime was so effective that he could cease using PPI. However, upper endoscopy revealed poor mucosal findings such as Grade D in the Los Angeles classification of GERD ; we increased the dose of hangeshashinto to 3 times a day and added orengedokuto before going to bed. His subjective symptoms completely disappeared, however, we could not operate endoscopy again during our intervention. It seems that not only rikkunshito which is recommended in the guideline for GERD but also other Kampo formulas were possibly effective to PPI-resistant GERD. Although endoscopic findings are not always correlative to their subjective complaints, we need further discussion on the endpoint of Kampo therapy to prevent complications.
ABSTRACT
<p>We present a 35-year-old male with palpebral hemispasm, which often occurred while at work. Because there were no ophthalmological findings, he consulted our clinic to receive Kampo therapy. He easily became fatigued and he had subchondral resistance and discomfort (kyo-kyo-kuman), so we treated him with saikokeishito and shakuyakukanzoto. However, they were ineffective, and therefore we reconsidered his symptoms.<br>Although he complained of fatigue, he was well built and had been a heavy drinker until a few years before presenting. Furthermore, he easily blushed and sweated in the upper body during the daytime, and his palpebral hemispasm often occurred during this blushing and sweating, and was accompanied by headache. We considered that this represented an excess-heat pattern rather than a deficiency pattern, and prescribed orengedokuto. His symptoms improved, and disappeared after six months.<br>There has been no detailed report of orengedokuto for the treatment of palpebral hemispasm. Orengedokuto may be useful for palpebral hemispasm in the context of symptoms of excess-heat pattern, such as blushing, sweating in the upper body and headache.</p>
ABSTRACT
<p>Orengedokuto, a Kampo formulation, has traditionally been used to treat various diseases, including hypertension with neuropsychiatric symptoms, gastritis, dermatitis, hematemesis and hemorrhagic stools. We report 8 cases of intractable hemorrhage that could not be controlled by Western medicine, but were successfully treated with orengedokuto. We elaborate on 3 cases, including 1 case treated by enema administration of orengedokuto, which was found to be a useful method. In a representative case, an 80-year-old man with aplastic anemia who was taking anticoagulants due to a history of mitral valve replacement presented with a chief complaint of black stool. Hemorrhagic gastritis was diagnosed. We repeatedly attempted endoscopic hemostatic therapy, but failed to achieve hemostasis. Oral administration of orengedokuto demonstrated hemostatic effects within a few days of starting treatment. In all 8 these cases, moreover, we observed quick clinical responses with no side effects. Although the hemostatic mechanism of orengedokuto remains unclear, we speculate that orengedokuto contains a short-acting component that affects primary hemostasis. As such, conventional orengedokuto may also have potential as a novel hemostatic agent.</p>
ABSTRACT
A patient with intractable glossalgia was successfully treated with a combination of three Kampo medicines : orengedokuto, bukuryoin, and kososan extracts. Then, 3 more patients with glossalgia were administered similar treatment based on the experience of the first case. The clinical features of these four patients and the efficacy of the combination Kampo treatment are reported herein. <br>A 61-year-old man with a 3-year history of glossalgia had been treated with psychopharmaceuticals for 4 months at another hospital, without any relief from symptoms. Upon referral to this Kampo clinic, the patient was treated with goreisan extract, daisaikoto extract, or other Kampo medicines, but these medicines were not effective. The prescription was then changed to a combination of orengedokuto, nichinto, and kososan extracts, which ameliorated the glossalgia symptoms almost by half. Furthermore, the glossalgia improved completely after the nichinto extract in the Kampo combination was replaced with bukuryoin extract. <br>After successful treatment of the first patient, three other patients were treated with the same Kampo combination. Two patients showed improvement within 2 weeks, but the combination treatment was ineffective in the other patient, whose symptoms finally improved with a zinc supplementation from Polaprezinc. The clinical features of the patients with good outcome were generally characterized by a combination of symptoms such as glossalgia, tendency toward depression, and digestive symptoms. <br>The combination treatment was prescribed as a substitute for seinetsugeutsuto decoction, and it was effective in three of the four patients with glossalgia. These results indicate that the combination treatment could be a candidate medicine to treat glossalgia.
ABSTRACT
Case reports of drug-induced liver injury caused by Kampo medicines are on the rise, but most of them are noted for related symptoms such as jaundice. Usually, severe liver injury is detected by chance upon routine medical checkup. Recently, we noted 3 cases of suspected drug-induced liver injury caused by orengedokuto, saikokeishikankyoto and bofutsushosan. In these 3 cases, maximum ALT was under 100 IU/l and no symptoms related to liver injury were observed. Early detection by blood test was useful, and appropriate treatment quickly improved and normalized the abnormal values associated with liver injury. We should always be alert for drug-induced liver injury caused by Kampo medicines, especially when prescribing formulations that include <i>Scutellariae Radix</i>. We also emphasize the importance of scheduling blood tests when prescribing these formulations.
ABSTRACT
We report a case of systemic sclerosis complicated with primary biliary cirrhosis successfully treated with orengedokuto (wanbinghuichun) and sekiganryo. The patient was a 68-year-old female. She had been diagnosed with systemic sclerosis 20 years previously, and primary biliary cirrhosis 17 years previously. She received modern Western medical treatment for skin itching and scleroderma, but her symptoms showed little improvement. Therefore, she consulted our clinic in order to receive Kampo therapy. We prescribed orengedokuto (wanbinghuichun), and the skin itching improved in 5 days. As a result of administering sekiganryo in addition to orengedokuto (wanbinghuichun) for severe coldness, the scleroderma was also ameliorated. We consider this to be a case of diseases overlapping between yin and yang syndrome.
ABSTRACT
A 68-year-old female had been diagnosed with granuloma annulare a year earlier. She was prescribed tranilast and was recovering, but had to discontinue the tranilast because she suffered liver damage as a side effect.<br>She was also suffering from a worsening rash and so decided to try Kampo medicine. We prescribed orengedokuto because of thermal symptoms suggestive of hot flushes, the appearance of her tongue, and the character of her rash. Initially, the rash improved, but from the 3rd day following admission did not change greatly. We suspected the existence of interior cold and started combining maobushisaishinto. Five days later, the granulomas had rapidly shrunk. We believe she had overlapping diseases of a yin and yang pattern from the fact that she improved clinically.
ABSTRACT
We studied the effects of orengedokuto on central hyperthermia after mild hypothermia therapy for cardiac arrest. The subjects in this study were 7 patients who showed central hyperthermia (>38.3 °C) after mild hypothermia therapy. Orengedokuto 7.5-15 g/day was administered and central temperature was monitored. Maximum change in central temperature was 1.55 ± 0.71 °C(from 39.1 ± 0.7 °C to 37.6 ± 0.7 °C) (p < 0.05). Mean change was 0.35 ± 0.77 °C, (from 37.7 ± 0.6 °C to 37.5 ± 0.7 °C). Thus we conclude that orengedokuto is a drug with applications in the treatment of central hyperthermia after mild hypothermia therapy.
ABSTRACT
Rosacea begins with recurrent episodes of blushing that eventually become persistent dark facial erythema. Its etiology is still unknown, and no curative therapy has been established. We successfully treated 10 middle-aged female patients with several Kampo formulas. Ages of the patients ranged from 46 to 81 years old (average 60.6 years old). Periods from disease onset to the beginning of therapy were1month to 6 years (average 2.2 years). The Kampo formulas used were daisaikoto with orengedokuto in 7 cases, and kakkonkokato in 3 cases. All patients healed within 14 months. We thus recommended daisaikoto with orengedokuto, or kakkonkokato as a first choice for the treatment of rosacea.
ABSTRACT
We present the case of 65 year-old male with Behçet's disease who was successfully treated with the Kampo medicine keishibukuryogan. The patient presented with hyperemic conjunctiva, ocular pain and uveitis at the age of 38, and was diagnosed with Behçet's disease. One year later he was affected with ulcerative glossitis, which was also diagnosed as a manifestation of Behçet's disease. At the age of 56 he was presented with acute arthritis of his ankle joint, followed by ulcerative stomatitis and glossitis. He was treated with colchicine and cyclophosphamide. Thereafter, he suffered from recurrent oral aphthous ulcers, and arthritis. Intractable oral ulcers, which did not respond to Western medicine, led him to seek Oriental herbal remedies. Keishibukuryogan was prescribed and, since then, his oral ulcers have completely subsided and his arthritis has not been a problem. He has been relieved from all manifestations of Behçet's disease.Thus, we believe that the Kampo medicine keishibukuryogan should be taken into consideration when treating Behçet's disease.Moreover, liver dysfunction caused by the Kampo medicine orengedokuto arose at an early stage of therapy, but immediately disappeared when its use was stopped. Pharmacoepidemiologically, Scutellariae radix, an ingredient of orengedokuto, was suspected of causing this liver dysfunction.
Subject(s)
Medicine , Medicine, Kampo , ArthritisABSTRACT
A 22-year old man was referred for mental retardation, refractory epilepsy, and chronic renal failure due to congenital anomalies of the kidney and urinary tract since he was an infant. Although hemodialysis was introduced both 3 years and 8 months ago, neither its appropriate safe management nor good quality of life were obtained, because of polyhydruria, psychogenic polydipsia, and his aggressive disruptive behavior in refusing any proper direction. After the fourth making of a shunt vessel with an artificial material, we gave him Orengedokuto to reduce his insomnia, itching, and other indefinite complaints.<br>As a result, his complaints and behaviors improved and he stopped taking too much water on the days before hemodialysis; which then began to work preferably with the proper amount of water exclusion. Moreover, we could reduce the amount of carbamazepine and methylphenidate hydrochloride he required. This case demonstrates that Orengedokuto may have an effect on the central nervous system to improve behavioral problems stemming from developmental disorders in children, or adolescents.
ABSTRACT
Two cases of patients with acute burns, who were treated with Kampo formulas, are herein presented.<br>Case 1: A 53-year-old woman injured her left foot with boiled oil. She had been treated with an anti-inflammatory agent and dressing for four days before Kampo treatment. But the swelling of the foot became worse. Severe swelling, redness, heat and lots of exudate were apparent. She complained of thirst, which was probably due to loss of Shin'eki. Thus, Eppi-ka-jutsu-to was prescribed. Her symptoms improved within two days. Case 2: A 64-year-old-woman had facial burns from boiling water. She was in severe pain. Shiun-ko was applied topically, and Oren-gedoku-to with Kikyo-sekko was prescribed. The pain subsided promptly. On the next day, swelling, redness and heat were recognized. Eppi-ka-jutsu-to was effective. The local symptoms disappeared within a few days. Kampo treatment may be useful for relief of acute burn symptoms.
ABSTRACT
Oren-gedoku-to (ekisuzai) was used together with conventional dermatological administrations for patients with eczema/dermatitis showing the Jitsunetsusho tendency.<br>The extent of erythematous color and perspiration, the degree of dermatitis, heat and itching sensations, and condition of wetness due to scratching were compared before and after the combination therapy, and the effectiveness of the drug was assessed.<br>Considering the data from laboratory examination and ease of use, the usefulness of the drug was estimated. The subjects were 31 patients with atopic dermatitis (15 cases), chronic eczema (11 cases), autosensitization dermatitis (1 case), seborrheic dermatitis (2 cases), abdominal dermatitis (1 case), and nodular prurigo (1 case). The results of the analysis showed 4 cases (13%) of very useful, 16 cases (52%) of useful, 6 cases (19%) of slightly useful, and 5 cases (16%) of not useful. Heaviness for the stomach and increased levels of the serum liver enzymes were seen in one case each. Oren-gedoku-to (ekisuzai) should be used for patients with eczema/dermatitis showing the Jitsunetsusho tendency.
ABSTRACT
Most patients with taste disorders are usually treated with zinc, but there still remain many untreatable patients, including non-responders and those of advanced age. In this study, we report on three patients with hypogeusia who showed improvement after the administration of Kampo medicine. A 49-year-old female diagnosed with hypogeusia and hyposensation of the oral cavity responded to Oren-gedoku-to. A 43-year-old male diagnosed as having schizophrenia and hypogeusia and a 76-year-old female with idiopathic hypogeusia responded to Saiko-ka-ryukotsu-borei-to. Kampo medicines are considered to normalize zinc-related neuro-transmissions originating in the vallate taste buds. Furthermore, the curative effect of Oren-gedoku-to on inflammation-injured oral cavity membranes, and the psychotropic effect of Saiko-ka-ryukotsu-borei-to on improving hypogeusia, were shown in our patients. It should be noted that the recent increase in aged patients complaining of taste disorders might be related to aging-associated depression. Saiko-ka-ryukotsu-borei-to or related Kampo formulations are considered to have wide applications for depressed or aged patients with hypogeusia.
ABSTRACT
Eighteen untreated patients with schizophrenia and other psychotic disorders, all of whom had insomnia among their chief complaints, were randomly divided into two groups. For four weeks, nine patients (group A) were treated with neuroleptics (haloperidol) and Orengedokuto, and the remainder (group B) were treated with neuroleptics alone. Changes in schizophrenic symptoms and the number of doses of hypnotics (nitrazepam) were examined. In group A, the thought disturbance (conceptual disorganization, grandiosity, hallucinatory behavior, unusual thought content) aspect of schizophrenic symptoms improved (p=0.06), and the number of doses of hypnotics (mean=1.9) was smaller (p=0.06), as compared with group B (mean=7.7). These observations suggest that augmentation therapy with Orengedoku-to is potentially effective for the treatment of insomnia associated with schizophrenia and other psychotic disorders.
ABSTRACT
In order to determine the effectiveness of Orengedoku-to in the treatment of schizophrenia, Orengedoku-to was added to the drug regimens of 10 patients who had been hospitalized with onset episodes or acute exacerbation of this condition. Before Orengedoku-to was added, the schizophrenic symptoms associated with the active phase had already been ameliorated with administration of antipsychotic drugs such as haloperidol for 4-12 weeks, with administration continuing at least two weeks after these symptoms had stabilized. Symptoms were evaluated using the Brief Psychiatric Rating Scale (BPRS) three times: before Orengedoku-to was added, immediately following cessation of administration, and four weeks after administration had ended. The BPRS scores indicated significant decreases both immediately following cessation of administration and four weeks later (from 36.3±9.8 to 30.5±6.7). In particular, significant improvement was noted for the symptoms of guilt feelings, depressive mood, suspiciousness and excitement. These improvements were not thought to be due to haloperidol, because the plasma haloperridol levels did not change. No adverse effects were noted.
ABSTRACT
Low anterior rectal resection was performed for lower rectal sm carcinoma. The patient had not complained of staining his underwear while hospitalized but only when he resumed work as a metal sheet worker. He then started to find his underwear stained with mucus.<br>The operation he had undergone was end to end anastomosis of the sigmoid colon and the rectum with EEA mechanical anastomosis. During the operation, there was an insecure site in one part of the doughnut ring, and therefore another three stitches for total layered suturing were made manually. An artificial anus was introduced temporarily. Since IVH was performed for two weeks after operation, no particular sutural insufficiency was noted.<br>It was assumed that underwear staining with mucus was due to some kind of persistent inflammation at the site of anastomosis. Based on Kampo medicine, the patient was diagnosed as “pathogenic dampness-heat combination”, and was given Oren-gedoku-to to clear away “heat-evil and dampness-evil”. This Kampo preparation proved to be very effective. The underwear staining was reduced considerably, though the anal sphincter remained hypotonic. Hochu-ekki-to was given to elevate and resume sphincteral tension. No report has previously been made concerning the use of a Kampo formulation in mucous staining of the underwear after low anterior rectal resection.