Kampo Therapies for Children Difficult to Attend School who Were Presenting Somatic Complaints / 日本東洋医学雑誌

We experienced 8 cases of children who presented with somatic complaints and found it difficult to attend school successfully treated with Kampo medicine. We evaluated them objectively by using the evaluation scale in the guideline for medical care of school refusal. Four cases were orthostatic dysregulation, 2 cases were migraine, 1 case was involuntary movement in upper abdomen and the other case was autonomic dysfunction. Kampo medicines were selected according to conventional method, so-called sho. Among 8 cases, 5 cases had a major response, 2 cases had a minor response and one case had no beneficial response. These results suggest that Kampo therapy can be effective therapeutic means. Kampo therapy is quite personalized and beneficial especially for children who find it difficult to attend school and need individualized care. This is the first report evaluating many cases objectively by using the evaluation scale and there have been no reports similar to ours. We have to continue to enlighten general pediatricians about the effectiveness of Kampo therapy.

A Case of Trigeminal Neuralgia Effectively Treated with Jidabokuippo: Hint from Past Injury and Tender Point / 日本東洋医学雑誌

A thirty-eight-year old woman with facial pain was diagnosed with trigeminal neuralgia, and treated with conventional carbamazepine therapy. Although the pain was alleviated to a certain degree, she visited our clinic to receive Kampo therapy. Judging from her facial injury in an accident thirty years ago, jidabokuippo was administered in addition to carbamazepine. The trigeminal neuralgia was then relieved, and Takagi's tender point in her abdomen was also reduced or disappeared. She could finally stop carbamazepine therapy. This case suggests that neuralgia patients with previous injury and Takagi's tender point can be treated with jidabokuippo.

<b>A Case of Pneumothorax Successfully Treated with Hochuekkito </b> / 日本東洋医学雑誌

We report a case of pneumothorax successfully treated with hochuekkito.<br>The patient was a 56-year-old female, who was diagnosed with right-sided pneumothorax, and who improved after resting cure. However, her condition did not completely resolve. About three years later, we prescribed hochuekkito because her pneumothorax became worse with general fatigue. Five days after taking hochuekkito, the pneumothorax improved in her chest X-ray. But it became worse again, and finally she underwent an endoscopic operation. This case suggests the possibility that hochuekkito can improve pneumothorax temporally. There is no literature on Kampo therapy as it applies to pneumothorax, and we believe this case to be the first report of value on the subject.

<b>Efficacy of Kampo Therapy in Chronic Tinnitus Patients </b> / 日本東洋医学雑誌

Treating tinnitus with modern Western medicines is difficult. Several studies have reported that Kampo medicines are efficacious for treating tinnitus, and therefore, it is expected that these medicines will gain widespread use in the future for tinnitus treatment. We retrospectively examined the efficacy of Kampo medicines prescribed on the basis of Kampo diagnoses for chronic tinnitus patients. The study population included 331 patients (114 men, 217 women) and average age was 57.8 years. The overall effective rate of Kampo medicines in tinnitus was 38.4% and increased to 64.6% after including effects for the accompanying symptoms (e.g., dizziness, insomnia, and headache). Hangekobokuto was prescribed most frequently. The effective rate for hangekobokuto in tinnitus was 32.1% and significantly increased when it was used in combination with a herb, chotoko (Hook of Uncaria, rhynchophylla Miquel) (p < 0.05, Fisher's exact test). The effects and modern pharmacological action of chotoko indicate that it may be effective for tinnitus. Given that tinnitus was intractable in study subjects who had been treated using other therapy approaches earlier (84% of the population), the findings indicate that Kampo medicine may be partially effective for tinnitus.

<b>Three Cases of Fever Successfully Treated with Daijokito </b> / 日本東洋医学雑誌

Nowadays, it is rare to see Yang min disease in the acute fever phase. We report three cases of acute fever successfully treated with daijokito.<br>Case 1 : An 82-year-old male with suspected viral infection. He had a persistent fever of 38 °C. Because of abdominal fullness, constipation and wheeze, we administered daijokito. These symptoms disappeared, his hypoxemia improved, and his fever went down to 36 °C, accompanied by considerable defecation.<br>Case 2 : A 67-year-old female with suspected central hyperthermia. She had a persistent fever of 38 °C. Because of abdominal fullness and constipation, we administered daijokito. These symptoms disappeared and her fever went down to 36 °C with considerable defecation.<br>Case 3 : A 43-year-old male who was diagnosed with paralytic ileus accompanied by cyclic neutropenia. Three days after his temperature rose to 38 °C, and constipation, abdominal fullness and pain appeared. After administering daijokito, these symptoms disappeared and his fever went down to 36 °C with considerable defecation.<br>When abdominal fullness and constipation appear after a fever continues, we believe the administration of daijokito should be considered whether western medicine has been applied or not.

Assessment of the Satisfaction of Patients of Atopic Dermatitis with Kampo Therapy / 日本東洋医学雑誌

The patient with atopic dermatitis is often dissatisfied with the long-term nature of treatment for his/her disease. The aims of this study were to examine the effect of Kampo therapy on the skin manifestation of atopic dermatitis as well as the patient's mental state, and to evaluate the relation between severity of symptoms and satisfaction with the Kampo therapy. Kampo medicine was administered to 15 in-patients with atopic dermatitis for 6 months. Their clinical conditions, quality of life (QOL) assessments, and psychosomatic scores before and after treatment were observed and comparatively evaluated. We evaluated patients' symptom severity with the atopic dermatitis severity classifications of the Japanese Dermatological Association, and the European SCORAD (Scoring of Atopic Dermatitis). We evaluated QOL with the SF-36 and DLQI (Dermatology Life Quality Index), and mental state with the PSS-AD (Psychosomatic Scale for Atopic Dermatitis). Clinical conditions, QOL and mental states were improved after treatment with Kampo medicine. However, when we examined individual cases, severity of symptoms and satisfaction with treatment did not correlate. Patients' satisfaction ratings and the severity of their symptoms do not necessarily correspond in patients with atopic dermatitis, because evaluations vary with each individual. Therefore, clinicians treating patients for atopic dermatitis must make an effort to recognize each patient's psychological condition.

Usage of Ogonto to Address the High Prevalence of Vomiting and Diarrhea amongst Senior Citizens in Nursing Home / 日本東洋医学雑誌

Norovirus infection is a common cause of epidemic winter vomiting and diarrhea. The symptoms that present, such as vomiting, diarrhea, fever and abdominal pain, normally disappear within 1 to 3 days, although some fatal cases are reported in the elderly.During the two months from December 1, 2005 to January 31, 2006, we prescribed ogonto to twenty patients who presented with vomiting or diarrhea in a nursing home, and examined prescription times and illness durations, other drugs used, and whether there were any transfusion or complications.The number of ogonto doses given was from 1 to 12. Fifteen cases (75%) were dosed 3 times or less, and four cases were only dosed once. In terms of illness duration: eleven cases were cured in less than 24 hours; six cases were cured from 24 hours to less than 48 hours; two cases were cured from 48 hours to less than 72 hours; and one case was cured from 72 hours to less than 96 hours. Overall, seventeen cases (85%) were cured in less than 48 hours.Regarding the other treatment and complications: domperidone was used in four cases; and a transfusion was given in six cases. Aspiration pneumonia occurred in one case, but no patient required hospital treatment. Norovirus infection is usually treated only with symptomatic therapy, so we think Kampo therapy should be available because when started at an early stage, it can prevent this disease from becoming severe.

A Strategy of Kampo Therapy that use Eatable Crude Drugs to Allergic Disease of Pregnant / 日本東洋医学雑誌

The drug therapies for pregnant woman should consider the safety of the mother, and the embryo. And safety during pregnancy has not been well-established with Kampo therapies.Therefore, it would be best to refrain from administering these medicines except when there is serious disease, or when a pregnant woman's QOL might be degraded. Even so, it would be advantageous if there were still a way to treat pregnant women with no risk.Thus, we treated6pregnant women suffering from allergic conditions such as allergic rhinitis, urticaria or atopic dermatitis, by using herbs which are also used as foods, in an attempt to offer Kampo treatments which were also safe. As a result, efficacy was demonstrated, and no problems were caused.Accordingly, we propose the use of edible Kampo herbs as a safety standard. The safety of each herb used in this report was examined clinically, and in the literature.Other edible herbs not used in this report are tabulated and shown.

How I Learn Kampo Medicine : The Learning Process of An Ex-surgeon who has been Charmed by Kampo / 日本東洋医学雑誌

I have been an ordinary surgeon. But, for about eight years, I have frequently been prescribing Kampo drugs. So, at first, I'd like to tell my story about how to learn Kampo and how to improve my Kampo skill. In this part, I introduce my interesting career, my character and my favorite Kampo books and masters (lecturers). Then, in my experience, I try to clear the property of Kampo, and show the key points of the Kampo therapy. At last, I refer to my attitude of the daily Kampo therapy.

Three Cases of Pneumonia Successfully Treated by Kampo Therapy / 日本東洋医学雑誌

We report three cases of pneumonia successfully treated with Kampo therapy. Case 1 was a 69-year-old female who was hospitalized with a fever and cough. Administration of Keishinieppiitto led to an improvement in her cough and a rapid reduction of fever, and we continued her treatment using Kampo medicine only. By the 7th day of admission, the infiltration shadow had disappeared, and on the 11th day, laboratory data on WBC and CRP had decreased to a normal range. Case 2 was a 66-year-old female who was hospitalized with cough, sputum and fever. She received modern western medical treatment, including antibiotics for one month, but her symptoms showed little improvement. After we administered Saiko-keishi-kankyo-to-go-Hange-koboku-to, her symptoms gradually improved. By the 15 th day of admission, her CRP levels had decreased to 0.7mg/dL, and the infiltrative shadow had disappeared. Case 3 was a 78-year-old male who was hospitalized with cough, sputum, anorexia and general malaise. A multiple nodular lesion in the lung was also detected by chest CT. Consequent diagnostic examinations were conducted, while providing him with Saikokeishito. Although the final diagnosis was pneumonia, of unknown etiology, his fever decreased and on further examination his laboratory data had improved. If a Kampo formula is selected in accordance with the diagnosis of Kampo medicine, we consider that pneumonia can be treated with Kampo medicine without the use of antibiotics.

Impact of Kampo Therapy on the Second Derivative of the Photoplethysmogram (SDPTG) / 日本東洋医学雑誌

The effect of Kampo therapy (Japanese traditional herbal medicine) on the second derivative of the photoplethysmogram (SDPTG) was investigated. The SDPTG is the second derivative of the fingertip photoplethysmogram (PTG), which expresses the characteristics of the vascular system, the properties of peripheral vessels, and the state of blood flow. The subjects comprised 13 normal volunteers, 101 patients (21 males and 80 females; mean age 53±11 years) with 1 month of Kampo therapy, and 19 patients (4 males and 15 females; mean age 60±9 years) with 3 months of medication. Control subjects showed no significant changes in their vascular age after 1 month. Patients with a higher vascular age than expected before therapy showed improvement of their vascular age, after treatment for 1 month and 3 months. The difference between the vascular age and calendar age decreased from about 10 to 7 years after 1 month of therapy (n=65. p<0.001), and from about 9 to 4 years, after 3 months (n=11, p<0.01). Vascular age not only reflects organic vessel wall sclerosis due to arteriosclerosis, but also a vascular wall tone that is closely related to the autonomic nervous system. The change of vascular age within a relatively short period suggested a functional change rather than an organic change of the vessels.

Gender Specific Medicine and Kampo Therapy / 日本東洋医学雑誌

In the United States, gender-specific medicine has advanced since 1980, and medical centers dealing with women's disease have been established. In Japan, number of the outpatient care units which address women's disease exclusively, have been established over the past two to three years. We believe that this is because the following kinds of medical care are being sought:<br>1) The gender-specific medical care<br>2) Medical treatments that are tailored individually, based on specific female body structures and psychology<br>3) All-round medical care, based on mind-body correlations<br>4) Care which improves the patients' quality of life<br>The goal of Kampo medicine is not only all-round medical care, but also therapy tailored to the individual. In the climacteric period of a woman's life, ovary activity declines against increased secretion of gonadotropin in the sexual center. In other words, endocrine disorders such as a rapid decline of estrogen secretion, affect the autonomic nervous system via catecholamine in the hypothalamus, patients consequently present with various indefinite complaints. This phenomenon is called climacteric disorder. In addition, this decrease of estrogen increases the frequency of the bone mass loss, lipid metabolism abnormalities, urinary disease, and vaginal wall atrophies seen. Not to mention the increased frequency of life-style related diseases (diabetes mellitus, obesity, malignant tumor, liver cirrhosis, etc.) that will arise.<br>Although climacteric disorder is triggered by endocrine disturbance, it takes on the symptoms of autonomic instability as time passes, and therefore cannot necessarily be called an estrogen deficiency syndrome. Kampo drugs are very effective in the treatment of such functional diseases. However, Kampo therapy must be carried out in accordance with oriental medical concepts, and their diagnostic techniques. It is useful to introduce the concept of “ki-ketsu-sui”, when treating climacteric symptoms. From a Kampo standpoint, many climacteric symptoms are pathological conditions, with “oketsu” at their core, which can be modified by “ki” and “sui”.<br>Here we show prescriptions which are frequently used in clinical practice. In addition, we review the effectiveness and limitations of Kampo therapy, for the treatment of climacteric diseases other than climacteric disorder. Finally, we refer to future issues, concerning outpatient care exclusively for women.

Inhibitory Effect of Kampo (Japanese Traditional Herbal Medicine) Therapy on the Development of Hepatocellular Carcinoma in Patients with HCV-related Chronic Hepatic Disease-Usefulness of Kampo Therapy based on Traditional Theory- / 日本東洋医学雑誌

We evaluated the effect of Kampo therapy in which Kampo formulae were selected based on Japanese traditional theory, on the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related chronic liver disease. One hundred forty HCV-infected outpatients without HCC at their first examination and who were observed for more than one year, were included. The patients were divided into three groups according to the initial platelet count (Plt): Plt less than 10×10⁴/μL (Group I), Plt between 10×10⁴/μL and 14×10⁴/μL (Group II), and Pit greater than 14×10⁴/μL (Group III). For each patient, Kampo formulae were selected according to the patient's symptoms and physical findings at each clinic visit. The incidence of HCC calculated by the person-years method, was 0.89% in Group I. 1.55% in Group II and 0.29% in Group III. The annual incidence of HCC among our patients was low compared with that among untreated patients in previous reports. In addition, the incidence of HCC among our patients was low compared with that of previous studies where Shosaikoto or Juzentaihoto was administered for a long period of time. In the present study, age over 60 years was a possible risk factor for HCC. However, sex and patterns of the change in alanine aminotransferase level (ALT) were not associated with the development of HCC. A total of 53 different Kampo formulae were prescribed, for all patients, with Hochuekkito being the most frequent. These results suggest that Kampo treatment in which Kampo formulae are selected based on traditional theory, may be more useful than treatment by a single Kampo formula for preventing the development of HCC in patients with HCV-related chronic liver disease.

A Case of Subacute Thyroiditis Satisfactorily Treated with Kampo-therapy / 日本東洋医学雑誌

We report the case of a 77-year-old female with subacute thyroiditis who was successfully treated with traditional herbal medicine (Kampo-therapy). On 18th December 2001, the patient was admitted to our hospital because of malaise and loss of appetite.<br>The patient complained of what she thought was a sore throat that began one month prior to admission, with a fever rising to 37.8°C 4 days before admission. Physical examination showed tenderness and swelling of the thyroid. Blood examination showed hyperthyroidism (TSH 0.02μIU/ml fT₃ 20.18ng/dl fT₄ 5.21ng/dl) and high inflammation (CRP 13.7 ESR 122mm/hr). We then diagnosed subacute thyroiditis and treated her with Kampo-therapy only. We arranged herbs according to the “Sho-kan-ron (_??__??__??_)” and gave her Keishi-ni-eppi-ichi-to (_??__??__??__??__??__??__??_) and Choi-joki-to (_??__??__??__??__??_). Four days after admission, her intermittent fever disappeared. After 10 days, her CRP became negative. After 13 days, almost all the symptoms had disappeared. Thyroid function (fT₃, fT₄) returned to normal after 17 days of Kampo-therapy. Subacute thyroiditis is a self limiting disease, but steroid therapy is often needed to reduce the symptoms and avoid thyrotoxicosis. In this case, the patient made a relatively quick recovery without steroid therapy. We suggest Kampo-therapy can be an effective treatment for subacute thyroiditis.

Kampo Therapy for Reflex Sympathetic Dystrophy of the Hand / 日本東洋医学雑誌

Five patients in the acute stage of reflex sympathetic dystrophy (RSD) of the hand were treated with Sairei-to and Rikkunshi-to, and were evaluated for pain (visual analog scale: VAS), swelling and limitation of finger motion. Four of the five patients had good results, with a decrease in pain to less than 50% of initial pain on VAS within six weeks. Swelling and finger motion tended to improve earlier than pain. In general, symptoms of RSD are limited to those associated with local inflammation during the acute stage, but patients with RSD tend to have psychological factors that can trigger generalized complaints even before the onset of RSD and to feature ‘kikyo, ’ a loss of vitality, after RSD onset. RSD should therefore be recognized as one feature of a generalized disease. Oral Kampo therapy using Sairei-to and Rikkunshi-to appears to be a reasonable treatment for early RSD.

Two Cases of Graves' Disease Successfully Controlled with Kampo Therapy / 日本東洋医学雑誌

Two cases of hyperthyroidism were treated with Kampo therapy alone, without the use of antithyroid drugs. The first case was a 47-year-old female who had been experiencing palpitations, weight loss, nervousness, tinnitus and vertigo for two years. She was diagnosed as having Graves'disease because of serum thyroid stimulating hormone (TSH) and increases in free T3 (fT3), free T4 (fT4), TSH binding inhibiting immunoglobulin (TBII), and 24-hour thyroid radioactive iodine uptake (24-h RAIU). Shakanzo-to was given for palpitations and other symptoms. Saiko-ka-ryukotsu-borei-to was later added in accordance with the Kampo diagnosis. After about one year and ten months, serum levels of TSH and fT3, fT4, and TBII are normalized.<br>The second case was a 40-year-old female, in whom palpitations had appeared about 3 years previously. Three months ago she was diagnosed as having hyperthyroidism. Thiamazole had been administered for two months. Serum TSH was decreased and fT3, fT4, TBII were increased when she first came to our clinic. Shakanzo-to was given for palpitations and other symptoms. After three weeks she refused to take thiamazole of her own accord. Saiko-ka-ryukotsu-borei-to was given concomitantly in accordance with the Kampo diagnosis. The serum levels of fT3 and fT4 increased gradually, but the palpitations were reduced. After about 10 months, the fT3 and fT4 levels were observed to decrease. This suggests that some of the hyperthyroidism can be imprgved by Kampo therapy without antitnyroid drugs.

The Effects of Kampo Therapy on Throat Discomfort in Patients with Autonomic Nervous Disfunction / 日本東洋医学雑誌

The effectiveness of three Kampo formulas expected to be effective for AST (abnormal sensation in the throat) and AND (autonomic nervous dysfunction) was evaluated. The Kampo formulas used were Hange-koboku-to (Ban xia hou pu tang), Saiko-ka-ryukotsu-borei-to (Chai hu jia long gu mu li tang) and Saiboku-to (Chai pu tang). The subjects involved in this study were 165 patients who complained of AST and were classified by the Cornell Medical Index Health Questionnaire as having AND or AND+N (neurotic condition). The results were then compared with those obtained with Ethyl Loflazepate (an anti-anxiety drug), Tofisopam (a deriv-ative of 2, 3-benzodiazepines) and psychotherapy.<br>Therapy was considered ‘effective’ if a subjective 50% or greater reduction in AST was achieved. The evaluation after two weeks of each therapy revealed that Tofisopam was most effective in both the AND and AND+N type patients. The Kampo drugs seemed to be slightly superior or equal in effectiveness to Ethyl Loflazapate in the treatment of AND+N type patients, but not in the treatment of patients with AND alone.

A Case of Male Infertility, who Induced Natural Pregnancy with Treatment using Hochu-ekki-to and Keishi-bukuryo-gan After In Vitro Fertilization Failure / 日本東洋医学雑誌

The authors report a case of primary male infertility with Grade I varicocele that responded well to Kampo therapy. The duration of infertility was 8 years. During that time, the authors tried AIH (artificial insemination with husband's semen) 26 times and HIT (hysteroscopic insemination into tube) twice, but both these measures failed. IVF-ET (in vitro fertilization-embryo transter) was then attempted twice. In the first attempt, the authors succeeded in fertilization and cleavage of one of ten extracted eggs, but implantation failed to occur. In the second trial, none of the five eggs extracted were successfully fertilized. The authors then prescribed a combination of Hochuekki-to and Keishibukuryo-gan. Three months later, natural pregnancy occurred that resulted in the birth of a healthy boy by natural delivery. Although the authors have sometimes seen cases of natural pregnancy after the failure of IVF-ET, none of such cases suffered from reduced fertility. Male infertility is frequently involved with cases of decreased fertility. In such cases, success is rarely achieved with ordinary IVF-ET. For this reason, the science of microscopic fertilization is developing rapidly. There is currently no remedy for low fertility. In this type of situation, Kampo may help to improve fertility.

Effects of Kampo Therapy on Serum Estrogen Levels and Bone Mineral Content in Climacteric Disorder / 日本東洋医学雑誌

Serum estrogen levels and bone mineral contents were measured to study their changes during treatment of climacteric disorder with Kampo therapy.<br>Sixty-five patients who visited the outpatient department of climacteric hormones received either (1) estrogen, (2) Kampo therapy (Saiko-ka-ryukotsu-borei-to, Keishi-bukuryo-gan, or Tokaku-joki-to) or (3) a calcium preparation alone or only psychological therapy (no drug treatment), for six months. Group (3) was treated as the control. Serum E2 levels, bone mineral contents, and cortical bone width index, etc., were determined before and after treatment.<br>In patients treated with Saiko-ka-ryukotsu-borei-to, blood E2 levels increased. In patients treated with Saiko-ka-ryukotsu-borei-to or Tokaku-joki-to, reductions in bone mineral content and the cortical bone width index were suppressed. We therefore concluded that Saiko-ka-ryukotsu-borei-to is effective in preventing osteoporosis. This study also suggests that a combination of Kampo therapy and a calcium preparation may be highly beneficial in preventing menopausal osteoporosis.