<b>Three Cases with Intractable Pain Treated with a Dose of Daiuzusen, and an Analysis of Aconite Concentrations in Prescriptions and Patientsʼ </b><b>Serum</b> / 日本東洋医学雑誌

<p>In 2013, we prescribed daiuzusen for 3 patients with intractable pain; pain from complex regional pain syndrome, colic pain of unknown origin after an abdominal operation, and colic pain from advanced colon cancer and ileus. A dose of daiuzusen (containing uzu 0.5-2 g) quickly relieved their pain in several minutes. Another common symptom was “cold” in their bowel or extremities when they were feeling pain. Aconite levels in drugs and patients' serum after taking daiuzusen were analyzed by liquid chromatography tandem mass spectrometry. Daiuzusen per 1 g of uzu contained aconitine 1.28 μg, mesaconitine 2.31 μg, and hypaconitine 92.89 μg, while jesaconitine was not detected; this was about 5 to 35 times the level of tsumyakushigyakuto per 1 g of uzu. Serum concentrations of hypaconitine peaked in the study at 1.11 ng/mL after about an hour of taking daiuzusen (1 g of uzu). We posit that the immediate effect after taking daiuzusen was due to transmucosal absorption of uzu components. However serum hypaconitine, which we are now able to monitor, is at least one practical way of indicating the use of uzu or bushi containing prescriptions.</p>

<b>A Case of Fibromyalgia Complicated by Chronic Fatigue Syndrome and Complex Regional Pain Syndrome Successfully Treated with a Combination of Kampo Treatments Including Uzu and Acupuncture </b> / 日本東洋医学雑誌

A 45-year-old woman had been suffering from fibromyalgia, chronic fatigue syndrome, and complex regional pain syndrome (CRPS) for 2 years before admission. Non-steroidal anti-inflammatory agents, selective serotonin reuptake inhibitors and pregabalin did not affect the various symptoms. A severe feeling of Coldness, the widespread systemic pain and the severe fatigue were decreased by tsumyakushigyakuto (glycyrrihza 4 g, processed ginger 9 g, aconite root 6 g). Attacks of CRPS were relieved by a dose of daiuzusen (aconite root 1 g, honey 10 g). The CRPS attacks presented mainly on the left heart meridian and the small intestine meridian where we treated them with electroacupuncture with reference to the <i>Shigoryuchu </i>(子午流注) methods. Acupuncture and electroacupuncture decreased the frequency of pain attacks, and alleviated the muscles stiffness caused by the CRPS. Thus, the combination of Kampo medicine and acupuncture were effective for the severe pain and other symptoms associated with fibromyalgia, chronic pain syndrome and CRPS.

Two Cases Successfully Treated with Tsumyakushigyakuto of Aconite Root Instead of Processed Aconite Root / 日本東洋医学雑誌

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.

Two Cases Successfully Treated with Tsumyakushigyakuto of Aconite Root Instead of Processed Aconite Root / 日本東洋医学雑誌

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.