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Eruption as a dermatological disease is often localized, which is not fully explained by Western medicine. However, localization of eruption is interpreted in Kampo medicine according to meridian and collateral theories, and here, we report two cases of successful treatment with Kampo medicine. Case 1 was of a 32-year-old woman who visited our clinic because of localized eruption around her mouth and was diagnosed with acne vulgaris. She was administered rikkunshito effectively. Case 2 was of a 37-year-old man who visited our clinic because of localized eruption in the anterior portion of the neck and was diagnosed with atopic dermatitis. He was administered shin'iseihaito effectively. Rikkunshito and shin'iseihaito are generally not adapted for dermatological diseases but were effective. After treatment we considered meridian and collateral theories. These two cases are depended on stomach meridian of foot-yangming and large intestine meridians of hand-yangming, rikkunshito and shin'iseihaito were consisted of herbs concerning with spleen and lung meridians. Two cases were successfully treated through spleen meridian of greater yin and hand great yin lung meridian, which make exterior and interior with stomach meridian of foot-yangming and large intestine meridians of hand-yangming. Kampo medicine was effective for treating these diseases based on meridian and collateral theories.
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OBJECTIVE: Rikkunshito, an herbal medicine, is widely prescribed in Japan for the treatment of anorexia and functional dyspepsia, and has been reported to recover reductions in food intake caused by cisplatin. We investigated whether rikkunshito could improve chemotherapy-induced nausea and vomiting (CINV) and anorexia in patients treated with cisplatin. METHODS: Patients with uterine cervical or corpus cancer who were to receive cisplatin (50 mg/m² day 1) and paclitaxel (135 mg/m² day 0) as first-line chemotherapy were randomly assigned to the rikkunshito group receiving oral administration on days 0–13 with standard antiemetics, or the control group receiving antiemetics only. The primary endpoint was the rate of complete control (CC: no emesis, no rescue medication, and no significant nausea) in the overall phase (0–120 hours). Two-tailed p<0.20 was considered significant in the planned analysis. RESULTS: The CC rate in the overall phase was significantly higher in the rikkunshito group than in the control group (57.9% vs. 35.3%, p=0.175), as were the secondary endpoints: the CC rate in the delayed phase (24–120 hours), and the complete response (CR) rates (no emesis and no rescue medication) in the overall and delayed phases (63.2% vs. 35.3%, p=0.095; 84.2% vs. 52.9%, p=0.042; 84.2% vs. 52.9%, p=0.042, respectively), and time to treatment failure (p=0.059). Appetite assessed by visual analogue scale (VAS) appeared to be superior in the rikkunshito group from day 2 through day 6. CONCLUSION: Rikkunshito provided additive effect for the prevention of CINV and anorexia.
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Humanos , Administración Oral , Anorexia , Antieméticos , Apetito , Cisplatino , Quimioterapia , Dispepsia , Ingestión de Alimentos , Medicina de Hierbas , Japón , Náusea , Paclitaxel , Tiempo de Tratamiento , VómitosRESUMEN
<p>The aim of this study is to retrospectively examine the efficacy of rikkunshito in comparison with shohangekabukuryoto and metoclopramide, administered to patients with hyperemesis gravidarum, using with the emesis index (EI) proposed by Kitagawa, et al. Total EI score for all groups was decreased with the passage of time, although EI in the rikkunshito group at day 7 was significantly lower than that of the other shohangekabukuryoto and metoclopramide groups. All nausea, vomiting and anorexia, scores were significantly lower in the rikkunshito group. These results suggest that rikkunshito is as effective in hyperemesis gravidarum as shohangekabukuryoto and metoclopramide are, and more effective for the gastrointestinal symptoms of nausea and vomiting, anorexia. The group in which rikkunshito was ineffective tended have a higher <i>qi </i>counterflow score, thus treatment modifications with <i>qi </i>circulating medicine would be required in accordance with <i>sho </i>patterns.</p>
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We report three cases of stroke in which rikkunshito was administered to improve the reflux of gastric fluid from a nasogastric tube in a short time.<br>Case 1 : a 63-year old female with right cerebellar hemorrhage who underwent surgical evacuation. Reflux of up to 650 ml gastric fluid from a nasogastric tube was observed after surgery. By the 4 th day of rikkunshito administration, the reflux decreased to 10 ml.<br>Case 2 : a 44-year old male whose consciousness had deteriorated before surgical treatment because of subarachnoid hemorrhage and re-rupture. Endovascular embolization and bilateral external ventricular drainage were performed for the anterior communicating artery aneurysm. Several days later, rikkunshito administration was initiated because of a reflux of 550 ml gastric fluid from the nasogastric tube. By the 3 rd day of rikkunshito administration, almost no episodes of reflux during tube feeding were observed.<br>Case 3 : a 72-year old male who suffered from intratumoral hemorrhage after undergoing surgery for metastatic brain tumor. The intratumoral hemorrhage was treated conservatively. Reflux of 200 ml gastric fluid from the nasogastric tube was observed. By the 3 rd day of rikkunshito administration, the reflux decreased to 10 ml.<br>These findings suggest that rikkunshito is useful in stroke cases with considerable reflux from a nasogastric tube.
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The 38-years old woman was hospitalized due to peritonitis carcinomatosa after 8 months, since the operation for advanced gastric cancer. Although the dosage of domperidone suppository, metoclopramide injection and haloperidol injection was started to prevent her from vomiting, it was stopped because of the complication of extrapyramidal symptoms. Instead of previous prescription, the traditional Japanese medicine, ice candy of rikkunshito, was prepared and started to give her. After its dosage, the number of vomit was gradually decreased, and she was permitted to go back her home. Before a dosage of ice candy of rikkunshito, it was impossible for her to eat orally even if she felt hungry and had appetite, which caused a strong grief to her. Ice candy of rikkunshito is a smooth medicine and expected to prevent from vomiting while an intake of ice candy orally. Hence, it is considered that there is possibility to have effectiveness both physically and psychologically. After few days from going back home, she caused a consciousness impediment. Her last stay at home was only few hours. After one month since then, she died leaving her message,“I was tired out, but happy to stay at my home.”
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Rikkunshito is comprised of 8 crude drugs and is used for the treatment of gastrointestinal dysfunctions such as anorexia and heavy stomach feeling. These symptoms are often caused by delay in gastric emptying. Cisplatin is a representative cancer chemotherapeutic drug with severe adverse effects such as anorexia and nausea, that gives rise to a delay in gastric emptying. However, it is still unknown whether rikkunshito has effects on improving the delayed gastric emptying induced by cisplatin. In the present study, we examined the effects of rikkunshito (an Atractylodis rhizoma-containing formula) on cisplatin-induced delay in gastric emptying in the rat. Rikkunshito improved this. Among the crude drugs that comprise rikkunshito, Atractylodis rhizoma, Ginseng radix, Poria and Aurantii nobilis pericarpium individually improved the delay in gastric emptying, suggesting that they all contribute to the action of rikkunshito. Moreover, the effects of these 4 crude drugs in combinations were also examined, and as a result, tended to be stronger when Atractylodis rhizoma was included. On the other hand, when Atractylodis rhizoma was excluded from rikkunshito, the effects were weaker. Meanwhile, atractylenolide III, a specific chemical constituent of Atractylodis rhizoma, improved delay in gastric emptying in a manner similar to that of rikkunshito with Atractylodis rhizoma. These results, taken together, suggest that Atractylodis rhizoma likely contributes greatly to the improving effect of rikkunshito on cisplatin-induced delay in gastric emptying.
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Rikkunshito is known as a drug used for recovery from epigastric distress and loss of appetite. However, here we report four patients with symptoms involving non-gastrointestinal disorders successfully treated with rikkunshito. In Case 1 there was a complaint of erythema around the right eye, in Case 2 of hot flushes, in Case 3 of gonarthrosis, and in Case 4 of urticaria. After taking rikkunshito, these symptoms improved. The four cases were instances of <i>hikyo</i>, because in Cases 1, 3, 4 their disorders of the stomach were so severe that they couldn't take shishihakuhito, boiogito, jumihaidokuto and inchingoreisan, and in Case 2 there was poor appetite in summer. Thus we believe it is important to improve gastrointestinal symptoms with rikkunshito when various <i>hikyo </i>disorders arise.
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It is important to treat patients with spleen <i>qi</i> deficiency not only with formulations for their deficiency, but also with formulations to improve <i>qi</i> stagnation. Rikkunshito plus Cyperi Rhizoma, Amomi Semen and Agastache rugosa, which improve <i>qi</i> circulation, was effective in cases 1 and 2 herein. We examined when and how to prescribe kososan with formulations for spleen <i>qi</i> deficiency, with reference to kosharikkunshito. Kososan and rikkunshito were effective in cases 3 and 4. Based on rikkunshito indication, a patient with weaker constitution was prescribed shikunshito (case 8), a patient with diarrhea and vertigo was prescribed shinbuto (cases 5 and 6), and a patient with severe coldness was prescribed ninjinto (case 7). Kososan played a supplementary role in treatment, and can be prescribed with other medicines. Not only gastrointestinal symptoms, but also various other complaints were improved by adding kososan to prescriptions for spleen <i>qi</i> deficiency.
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It is important to treat patients with spleen <I>qi</I> deficiency not only with formulations for their deficiency, but also with formulations to improve <I>qi</I> stagnation.Rikkunshito plus Cyperi Rhizoma, Amomi Semen and Agastache rugosa, which improve <I>qi</I> circulation, was effective in cases 1 and 2 herein.We examined when and how to prescribe kososan with formulations for spleen <I>qi</I> deficiency, with reference to kosharikkunshito. Kososan and rikkunshito were effective in cases 3 and 4.Based on rikkunshito indication, a patient with weaker constitution was prescribed shikunshito (case 8), a patient with diarrhea and vertigo was prescribed shinbuto (cases 5 and 6), and a patient with severe coldness was prescribed ninjinto (case 7).Kososan played a supplementary role in treatment, and can be prescribed with other medicines.Not only gastrointestinal symptoms, but also various other complaints were improved by adding kososan to prescriptions for spleen <I>qi</I> deficiency.
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From a point of stress, the competitive sports are totally different from exercises for the health promotion. It would be even harmful especially for middle-distance or long-distance women runner. It brings them paramenia, defatigation and other orthopedic troubles which makes them unable to exercise further more.We have investigated the possibility of the preventive use of Kampo Medicine for those athletes and found that it is useful. The nine women who belong to the Tohoku-Region women team of long-distance relay road race had received Kampo medical treatment for 7 months. Serum CPK and AST were elevated with training exercise. In the cases whose CPK level was above 500 IU/l, most of them suffered from fatigue, leg pain, low back pain, and lower abdominal pain, which is very important for Kampo diagnosis. Because these symptoms unable athletes to exercise as planned, we understand that for the improvement of physical capacity, it is important to prevent those symptoms. For the treatment and prevention of the symptoms, we prescribed Keishibukuryogan, Rikkunshito, and Shimotsuto. We defined preventive medication period as “Mibyou” and continued to use Kampo medicine for 7 months. During the period, they were free from any troubles that would make them unable to exercise. These medicines enabled them to improve their records drastically. This study shows that preventive use of Kampo Medicine is extremely effective for any athletes to maintain their good conditions.
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Medicina Kampo , Atletas , Ejercicio FísicoRESUMEN
We report a case of an anorectic 71-year-old male post-gastrectomy patient who was successfully treated with Koso-san and Rikkunshi-to. The patient underwent resection for early gastric cancer (0-IIa+IIc). After partial gastrectomy, he suffered from nausea and vomiting. He was treated with endoscopic balloon dilatation at the anastomotic site, and was simultaneously treated with some western drugs. However, he was completely unable to eat because of nausea and vomiting. Oriental medicine was then recommended. We treated him with Kampo medicines in combination with parenteral nutrition. After the administration of Koso-san, his nausea and vomiting disappeared immediately and he could ingest a fluid diet. Further, after the administration of Koso-san and Rikkunshi-to, his food intake increased. Finally, he could eat ordinary meals and his food intake reached an adequate level. This suggests that Koso-san and Rikkunshi-to are useful in the treatment of anorectic patients after gastrectomy.
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During the administration of Rikkunshi-to, hematological findings and complications of underlying disease were examined in patients with refractory anemia treated with oral iron preparations. In all 11 evaluative cases, hemoglobin levels before the administration of Rikkunshi-to were 10.7±0.8g/dL, and 11.5±0.8g/dL post-administration (mean administration period 17.3±11.6 months), indicating a significant hemoglobin level increase. In 9 out of 11 cases (82%), an improvement in anemia was observed. Eight out of 11 cases (73%) had atrophic gastritis, reflux esophagitis, or other gastrointestinal disease complications. Rikkunshi-to is considered to be effective such factors as: an improvement in hematopoiesis through a promotion of DNA synthesis in bone marrow cells with prostisol; and an improvement in iron absorption and utilization with improving appetite, although, the exact mechanisms have yet to be elucidated.<br>In conclusion, Rikkunshi-to can be considered an appropriate medication for the improvement of refractory anemia treated with the administration of oral iron preparations. However, its mechanism of action, as well as its recommended administration for specific disease states remain important issues for the future.
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The effects of four Kampo medicines, Ninjin-to, Hange-shashin-to, Rikkunshi-to and Sho-hange-ka-bukuryo-to, were investigated in a rat model of postoperative ileus. The postoperative ileus model was made by incising the abdomen and exposing the small intestine and caecum for five minutes under ether anesthesia. The gastrointestinal transit was estimated by the migration of a charcoal marker. In contrast to the animals anesthetized only, the gastrointestinal transit was markedly decreased in control animals. First, we studied the gastrointestinal prokinetic drugs (cisapride, mosapride and metoclopramide), the anti-inflammatory drug indomethacin, and the Kampo medicine Dai-kenchu-to in this model. They significantly increased the transit as compared with the control. Using the same method, Rikkunshi-to and Sho-hange-ka-bukuryo-to were demon-strated to be almost inactive. However, Ninjin-to and Hange-shashin-to not only significantly improved the gastrointestinal mobility compared to the control, but also showed stronger effects than those of Dai-kenchu-to. These results suggest that in addition to Dai-kenchu-to, Ninjin-to and Hange-shashin-to are also effective Kampo medicines for postoperative ileus.
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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.
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Idiopathic thrombocytopenic purpura is an autoimmune disease and is caused by a blood antiplatelet antibody that reacts to thrombocyte membrane. The platelet associated immunoglobulin G (PAIgG) is admitted in idiopathic thrombocytopenic purpura.<br>Adrenocortical steroids are our first choice as a treatment for idiopathic thrombocytopenic purpura.<br>However, a sufficient thrombocyte increase is not obtained even when adrenocortical steroids are administered to the idiopathic thrombocytopenic purpura patient.<br>On the other hand, we use Kampo medicine widely clinically. We are admitting the effectiveness of Kampo medicine in treating many refractory diseases. Even if it corresponds to idiopathic thrombocytopenic purpura that is one of a chronic refractory disease effective Kampo medicine is reorted several Kampo pharmaceutical preparations that are assumed when it is effective in idiopathic thrombocytopenic purpura are Sairei-to, Sho-saiko-to, Kami-kihi-to, etc.<br>This time we carried out Kampo therapy (Rikkunshi-to, Shimatsu-to) on patients with digestive and cutaneous problems but no other symptoms of hemopathy. A blood specialist at this university hospital tentatively diagnosed the patients' condition as thrombocytopenic purpura. Kampo therapy increased the thrombocyte count and alleviated the symptoms.<br>This result might suggest the possibility of a therapy for idiopathic thrombocytopenic purpura and even the importance of the therapy in accordance with the oriental medical syndromes.
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The effects of Rikkunshi-to (Liu jun zi tang), Hochu-ekki-to (Bu zhong yi qi tang), and Hange-shashin-to (Ban xia xie xin tang) on morphological changes in the small intestinal mucosa of mice with age were observed. The results indicated that Rikkunshi-to and Hochu-ekki-to had a beneficial effect on intestinal mucosal changes in 36-weeks-old mice. In particular, the improvement of the absorptive area of the intestinal villi and microvilli depending on the concentration of medicine was found. Ninjin-yoei-to had a strong effect on aged mice of 50 and 70 weeks. The morphology and absorptive function were significantly improved.
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Oren-to was orally administered to 18 patients with acute aphthous stomatitis, followed by an examination of the results. As a control, the natural course of the condition was observed without treatment in five patients, and local application of oral steroid ointment (dexarutin ointment for the oral cavity; 0.1%) was given to an additional five patients.<br>Compared with the control groups, the number of days until the disappearance of pain as well as the attainment of a complete cure was reduce significantly in the Oren-to group. When Oren-to was abministerad to two patients with chronic recurrent stomatitis, transient remission of the symptoms was noted, as in the acute Stomatitis cases, but the condition recurred. In one case, Oren-to was continued for one month but proved ineffective; replacement with Rikkushi-to brought about a disappearance of the condition after one week of treatment. In another patient, the condition was cured after administration of Oren-to for four months, and has not recurred to date.<br>These findings suggest that Oren-to is useful in the treatment of aphthous stomatitis, especially in the acute phase.