Mechanism of Linggui Zhugantang in Promoting Astrocyte Endocytosis and Degradation of Amyloid β / 中国实验方剂学杂志

ObjectiveTo investigate the effects of Linggui Zhugantang （LGZGT）-containing serum on primary astrocytes （AS） induced by β amyloid 1-42 （Aβ1-42） in a rat model of Alzheimer's disease （AD） and explore the phagocytic and degradative effects of LGZGT on Aβ. MethodAn AD model was established by inducing AS with Aβ1-42. The cells were divided into normal group， model group， LGZGT low-， medium-， and high-dose （LGZGT-L， LGZGT-M， and LGZGT-H） groups， and donepezil hydrochloride group. The model group was treated with Aβ1-42 at a final concentration of 10 μmol∙L-1. The LGZGT-L， LGZGT-M， and LGZGT-H groups were treated with 10% serum containing LGZGT on the basis of the model group. Cell viability was assessed using a cell counting kit-8 （CCK-8）， lactate dehydrogenase （LDH） activity was measured using an LDH assay kit， and cell morphology was observed using an inverted microscope. The expression of Aβ-related degradation enzymes insulin-degrading enzyme （IDE） and cathepsin D （CTSD） was detected using Western blot， and the fluorescence intensity of cathepsin B （CTSB） was measured using immunofluorescence. The content of Aβ1-42 in cells was determined using an enzyme-linked immunosorbent assay （ELISA）. ResultCompared with the normal group， the viability of AS in all groups decreased， and Aβ1-42 at different concentrations had inhibitory effects on AS proliferation. After administration， compared with the normal group， the cell survival rate of the model group decreased significantly （P<0.05）. Compared with the model group， the cell survival rates of the LGZGT-H group and donepezil hydrochloride group increased significantly （P<0.05）. The LDH activity of cells in the model group was significantly increased compared with that in the normal group （P<0.05）， and cell bodies were swollen and enlarged with increased protrusions and elongation， suggesting more obvious cell damage. Compared with the model group， the LDH activity of cells in the donepezil hydrochloride， LGZGT-L， LGZGT-M， and LGZGT-H groups decreased significantly （P<0.05）. After administration， the cell swelling in the LGZGT-M， LGZGT-H， and donepezil hydrochloride groups improved， cell protrusions shortened， and cell clustering decreased. Compared with the normal group， the expression of IDE and CTSD in the model group decreased significantly （P<0.05）. Compared with the model group， the expression of IDE increased significantly in the LGZGT-M and LGZGT-H groups （P<0.05）. Compared with the model group， the expression of CTSD increased significantly in the LGZGT-L， LGZGT-M， LGZGT-H， and donepezil hydrochloride groups （P<0.05）. The average fluorescence intensity of CTSB in the model group was significantly lower than that in the normal group （P<0.05）. Compared with the model group， the average fluorescence intensity of CTSD in the LGZGT-L， LGZGT-M， LGZGT-H， and donepezil hydrochloride groups increased significantly （P<0.05）. The intracellular content of Aβ1-42 in cells in the model group was significantly higher than that in the normal group （P<0.05）. After administration， compared with the model group， the intracellular content of Aβ1-42 in cells in the LGZGT-L， LGZGT-M， LGZGT-H， and donepezil hydrochloride groups decreased significantly （P<0.05）， and LGZGT-containing serum reduced Aβ1-42 in a dose-dependent manner （P<0.05）. ConclusionLGZGT has a protective effect on Aβ1-42-induced AS and can promote the degradation of Aβ. Its mechanism may be related to reducing Aβ toxicity， enhancing cell viability， promoting the expression of IDE， CTSD， and CTSB， and restoring lysosomal function.

Two Cases of Compulsive Behavior Successfully Treated with Ryokeijutsukanto / 日本東洋医学雑誌

To date, there have been limited reports on the efficacy of Kampo medicine in treating obsessive compulsive behaviors. To the best of our knowledge, there have been no previous reports on the efficacy of ryokeijutsukanto for obsessive compulsive behaviors. Here, we describe 2 cases of obsessive-compulsive behavior successfully treated with ryokeijutsukanto. Case 1 involved a 30-year-old female patient who presented with vague anxiety. As a result, she spent significant time engaging in compulsive behavior related to checking and was frequently tardy to work. She met the diagnostic criteria for obsessive compulsive disorder. We prescribed ryokeijutsukanto. Her compulsive behavior then improved from 40 minutes to 5 minutes in 56 days. Case 2 involved 57-year-old female patient who complained of not feeling refreshed in the morning. In addition, she had a feeling of gloom, daytime sleepiness and compulsive behavior of checking about 5 times whether windows were locked. We prescribed ryokeijutsukanto. In 14 days, her checking behavior then improved from 5 times to once. Other troublesome symptoms also improved. Ryokeijutsukanto is usually utilized for patients with fluid retention, dizziness, and qi counterflow. However, these 2 cases have qi stagnation rather than qi counterflow. These results suggested that ryokeijutsukanto could also be utilized to treat compulsive behaviors when patients had fluid retention, dizziness and qi stagnation.

Four Cases of Upper Gastrointestinal Symptoms Successfully Treated with Ryokeijutsukanto / 日本東洋医学雑誌

Case 1 was a 28-year-old female who had epigastric discomfort and epigastralgia for three months. These symptoms were accompanied with dizziness, faintness and hot flush. Right after taking ryokeijutsukanto, her dizziness, faintness and chillness of foot disappeared with improvement of gastrointestinal symptoms after two weeks. Case 2 was a 40-year-old female who presented prolonged nausea and epigastralgia for eight months. She also complained of dizziness and strong globus sensation when taking meals. After taking ryokeijutsukanto, her appetite improved in a week and gastrointestinal symptoms improved in 3 weeks. Case 3 was a 15-year-old female whose complaints were nausea, epigastric discomfort, palpitation, dizziness and globus sensation consequent to swaying feeling after riding a roller coaster. These symptoms including nausea improved after taking ryokeijutsukanto with 3g of magnolia bark for a week. Case 4 was a 28-year-old male who presented severe appetite loss and epigastric discomfort when he got tired. He also complained of faintness. His faintness disappeared after taking ryokeijutsukanto for 2 weeks. His appetite also improved after four weeks. Clinical courses of these cases suggest that ryokeijutsukanto may be useful for the treatment of upper gastrointestinal symptoms including functional dyspepsia, i.e. fluid retention with qi-counterflow.

Umbilical needling therapy of I-Ching at 1 PM to 3 PM for cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention / 中国针灸

OBJECTIVE@#To observe the clinical efficacy of umbilical needling therapy of I-Ching at 1 PM to 3 PM for cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention.@*METHODS@#Forty-eight patients of cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention were randomly divided into an observation group and a control group, 24 cases in each one. Both groups were treated with routine treatment of western medicine combined with TCM decoction. In addition, the patients in the observation group were treated with umbilical needling therapy of I-Ching at locations of , , and . The treatment was given at 1 PM to 3 PM, once a day; 10-d treatment was a course of treatment, and a total of 20-d treatment was given. The abdominal circumference, urine volume, body mass, liver function and prothrombin time were observed before and after treatment in the two groups, and the clinical efficacy of the two groups was compared.@*RESULTS@#The total effective rate was 91.7% (22/24) in the observation group, which was higher than 87.5% (21/24) in the control group (<0.05). After treatment, the improvement of abdominal circumference, urine volume, body mass, liver function and prothrombin time between the two groups was significantly different (<0.05), the observation group was better.@*CONCLUSION@#Based on the western medicine treatment, the combination of TCM decoction and umbilical needling therapy of I-Ching shows significant efficacy for cirrhosis ascites with syndrome of spleen-deficiency and fluid-retention.

Effect of Nature and Flavor Subdivision of Ephedrae Herba on Rats Model of Harmful Fluid Retention in Upper Jiao / 中国实验方剂学杂志

Objective: To study the effective substance foundation of Ephedrae Herba and explore its mechanism, in order to further enrich the theory of drug resistance of Ephedrae Herba.Method: In this experiment, a compound model was used to establish rat model of Harmful Fluid Retention in upper Jiao. The Rats were randomly divided into model group, captopril group (4.38 mg·kg-1), Ephedrae Herba decoction group(468 mg·kg-1), polysaccharide group (265.36 mg·kg-1), volatile oil group (2.34 mg·kg-1), alkaloid group(40.71 mg·kg-1) and phenolic acid group (210.60 mg·kg-1), and normal group (10 mL·kg-1). The normal group and the model group were given the same volume of normal saline for four weeks. The 24 h urine volume of rats was collected by metabolic cage method. The changes of heart and lung tissue morphology were observed under light microscope. The heart index, lung index, left ventricular ejection fraction(LVEF), left ventricular short axis shortening rate(LVFS) and pulmonary permeability index, number(LPI), lung dry-wet ratio(W/D), creatine kinase isoenzyme(CK-MB), angiotensin Ⅱ(Ang Ⅱ), aldosterone(ALD), cardiac aquaporin 1(AQP1), lung AQP1, aquaporin-3(AQP3) and kidney AQP1, aquaporin-2(AQP2), interleukin-6(IL-6) and tumor necrosis factor-α(TNF-α) change were detected.Result: Compared with the normal group, heart and lungs of the model group were significantly damaged. The amount of 24 h urine, LVEF, LVFS of model rats were significantly reduced(Pα were significantly increased(PPα were significantly increased (PPα were significantly reduced (PPConclusion: Alkaloid components "Wen" and "Xin" are the effective substance basis of its action. The mechanism may be related to the inhibition of renin angiotensin aldosterone system (RAAS) and the anti-inflammatory effect.

Advances in Pharmacological Mechanism of Linggui Zhugan Tang / 中国实验方剂学杂志

Linggui Zhugan Tang(LGZG), a representative of warming spleen to resolve fluid retention, is widely used in various diseases caused by spleen deficiency and fluid retention (SDFR). Ancient doctors mostly focused on the theme of SDFR to analysis the composition of LGZG. Modern research has now found that most of the components of LGZG contain anti-inflammatory, anti-tumor and immune-modulating effects. At present, the pharmacological research of LGZG mainly involves clearance of β-amyloid (Aβ) and anti-neuroinflammation, regulation of lipid metabolism and insulin resistance, protection of myocardial cells and regulation of liquid metabolism as follow. LGZG can promote the clearance of Aβ by regulating the expression of Aβ transporters, including low-density lipoprotein receptor-associated protein-1 and terminal glycosylation product receptors, as well as reduce the inflammation of nerve cells by inhibiting the secretion of pro-inflammatory factors such as interleukin(IL) -1β,IL-6 and tumor necrosis factor-α(TNF-α) by microglia. The prescription can also affect the lipid metabolism and insulin resistance by regulating the levels of adiponectin, insulin and leptin, thus producing therapeutic effects on metabolic syndrome and non-alcoholic fatty liver disease. The protective mechanism of LGZG on myocardial cells mainly contains inhibition of the over-activation of nuclear transcription factor-κB(NF-κB) signaling pathway,up-regulation of Smad7 expression and down-regulation of Smad3 expression, regulation of inhibitor of nuclear factor kappa-B kinase (IKK)/NF-κB inhibitor (IκB)/NF-κB signaling pathway, inhibition of inflammatory factor production, and down-regulation of Caspase-3 and Caspase-8 expression. In addition,LGZG can also regulate aquaporins to affect water metabolism. And it also has significant antioxidant effects. As is known to all,the functional mechanism of traditional Chinese medicine (TCM) compound is closely related to the network regulation of TCM disease syndromes. Considered from this angle, it is helpful to carry out the "disease-syndrome-formula" research by means of network pharmacology characterized by "disease-target-drug", thus organically exploring the relationship between LGZG and SDFR from the microscopic perspective,and helping to explain the scientific connotation of SDFR and the biological mechanism of warming spleen to resolve fluid retention.

The effect of the yang-warming and fluid retention-resolving method on AngⅡ, TNF-α and IL-6 expression in rats with chronic heart failure / 国际中医中药杂志

Objective To observe the effect of the yang-warming and fluid retention-resolving mothed on neuroendocrine and inflammatory factors in chronic heart failure (CHF) rats. Methods A total of 50 healthy adult male SD rats were randomly divided into blank group (10), CHF group (40). In CHF group, the rat model of chronic heart failure was replicated by intraperitoneal injection of adriamycin (ADR). After the completion of the model making, doppler echocardiography was used to determine the cardiac function of rats. There rats were randomly divided into the model group, the yang-warming and fluid retention-resolving group, the Xuefu-Zhuyu group and the captopril group. After continuous administration for 28 d and 2 h after the last dose, the HE staining was used to observe the pathological morphological changes of myocardium in each group. The levels of AngⅡ, TNF-α and IL-6 in serum were by ELISA. Results Compared with model group, the content of serum AngⅡ(294.33 ± 25.45 pg/ml, 265.86 ± 27.80 pg/ml, 301.87 ± 41.67 pg/ml vs. 615.44 ± 22.31 pg/ml), TNF-α(117.15 ± 11.33 pg/ml, 114.02 ± 11.57 pg/ml, 133.35 ± 34.80 pg/ml vs. 185.72 ± 36.53 pg/ml), IL-6 (23.97 ± 4.77 pg/ml, 27.61 ± 7.01 pg/ml, 28.38 ± 5.78 pg/ml vs. 58.45 ± 6.36 pg/ml) in the yang-warming and fluid retention-resolving group, Xuefu-Zhuyu group and captopril group significantly decreased (P<0.01 or P<0.05). Compared with Xuefu-Zhuyu group, the content of serumAngⅡ (301.87 ± 41.67 pg/ml vs. 265.86 ± 27.80 pg/ml) in the captopril group significantly increased (P<0.05). Conclusions The yang-warming and fluid retention-resolving mothed can reduce early CHF rats through reducing the serum TNF-α, Ang and ILⅡ -6 content, which could be one of the mechanism of action of the treatment of CHF.

Two Cases of Leg Pain Successfully Treated Using the Kampo Medicine Chikujountanto in Consideration of Phlegm-Fluid Retention / 日本東洋医学雑誌

Few reports have described the effect of phlegm-­fluid retention on the development of pain. We herein rep­ort two successful treatment cases of lower leg pain using chikujountanto in consideration of phlegm-­fluid re­tention. Case 1 (a 63-year-old woman) complained dull pain in the right calf. The pain persisted despite the ad­ministration of sokeikakketsuto for over two weeks. Case 2 (a 42-year-old woman) suffered from right buttock pain that had developed after a traffic accident. The pain persisted even at three months following the accident. The pain in both patients resolved within one week after treatment with chikujountanto, which was given on the basis of the patients' insomnia, thickened yellow fur on the tongue, and pain in the gallbladder meridian. We concluded that the concept of phlegm-­fluid retention should be considered for differential diagnosis when we treat pain.

Sociodemographic Correlates of Psychological Symptoms of Premenstrual Syndrome

Background: Premenstrual syndrome is a multifactorial psychoneurendocrine disorder. Etiology of PMS is still not demarcated & research continues in this area. Role of corelates age, parity, marital, educational & occupational status of PMS is being explored in various regions. Objective: To study sociodemographic correlates of psychological symptoms of premenstrual syndrome in woman of reproductive age group. Material and Methods: Prospective observational study was carried on 247 females in the reproductive age group. The participants were given the list of 18 preliminary symptoms and asked to encircle the symptoms they suffer during later part of the menstrual cycle in any of the last 3 cycles. In participants reporting ≥3 symptoms, the psychological symptoms were analysed and their association was observed with various sociodemographic parameters (age, location- rural/urban, marital status, parity, education, occupation). Results: 155(62.57%) reported 3 or more symptoms during later part of the menstrual cycle in the last 3 cycles. 149(96.1%) females reported at least one psychological symptom. These women showed following demographic correlates. 74.5% of females belonged to 18-26 years age group. 75.8% were unmarried. 81% had no child. 87.2% were from urban area. 71.1% were senior secondary. 96% females had mental work occupation. Conclusion: On retrospective screening there was 62.57% prevalence but on prospective follow up with PMTS & daily diary prevalence was found to be only 4.05%. Most common psychological symptom reported was irritability & there was significant association of irritability with educational status, type of work & parity. Mood swings were significantly more in females doing mental work.

Acupuncture Treatment Ideas of Allergic Rhinitis from the Perspective of“Fluid Retention ;Disease”in TCM / 中国中医药信息杂志

Abstact: Biqiu is equivalent to allergic rhinitis in modern medicine. Ancient and modern literature has shown that acupuncture has a good clinical efficacy on this disease. However, there is no uniform specification in the choice of acupuncture methods (such as acupuncture, moxibustion, warm acupuncture and so on) and the selection of acupoints. According to the etiology and pathogenesis of allergic rhinitis and its clinical manifestations, Biqiu can be classified as“fluid retention disease”in TCM. This article tried to provide a new idea for acupuncture treatment of Biqiu from the perspective of the treatment of“fluid retention disease”in TCM.

Effect of Astragali Radix and its components on rats model of harmful fluid retention in upper jiao / 中草药

Objective: To study the effect of Astragali Radix and its components, which were astragalus polysaccharides, astragaloside IV and astragalus calycosin, on the rats model of harmful fluid retention in the upper warmer. Methods: Rats were randomized into the blank group (0.5% CMC Na), the model group (0.5% CMC Na), the water decoction of Astragali Radix group (5.40 g/kg), the astragalus polysaccharides group (1.41 g/kg), the astragaloside IV group (50 mg/kg), the astragalus calycosin group (30 mg/kg), and the positive control group with Qili Qiangxin Capsule (1 g/kg), ten rats in each group. In addition to the control group, the harmful fluid retention in the upper warmer rats model were established in other groups which were induced by combined intervention factors of SC isoproterenol in the scapular region and tracheal intubation. After two weeks of gavage administration, the changes of body weight (BW), heart weight index (HWI), left ventricular mass index (LVWI), lung weight index (LWI), left ventricular ejection fraction (LVEF), left ventricular fractional shortening (LVFS), plasma creatine kinase (CK), the lung permeability index, the pulmonary alveolus pumpback amount, and the pulmonary dry wet ratio (W/D) in rats model were detected. Results: Compared with model group, the water decoction of Astragali Radix group and its components groups can improve the general condition of rats in varying degrees, BW increased significantly (P < 0.05) and the levels of HWI, LVWI and CK were all decreased in different degrees (P < 0.05 or < 0.01). In the astragalus polysaccharides group, astragaloside IV group and astragalus calycosin group, the levels of LVEF, LVFS and the pulmonary alveolus pumpback amount in rats were significantly increased (P < 0.05), and LWI, the lung permeability index and W/D were significantly decreased (P < 0.05). Conclusion: Astragali Radix and its components can improve the function of heart and lung in response to injury in rats model of harmful fluid retention in the upper warmer.

Changes and influence factors of body fluid volume and distribution after abdominal surgery / 肠外与肠内营养

Objective:TThe aim of this study was to observe the changes of the volume and distribution of body fluid after abdominal surgery,and further to explore its characteristics and influence factors.Methods:Sixtyone patients were included between March and June in 2016.The volume of intracellular water (ICW),extracellular water (ECW) and total body water (TBW) was estimated by InbodyS 10 on preoperative day 1 (PreD 1) and postoperative day (POD) 1,3,5 and 7.Furthermore,the patients were grouped according to the age,sex,type of operation,operation time and the daily liquid input,and the influence factors of postoperative fluid volume were analyzed in each subgroup.Results:Comparing to that of PreD1,the ICW,ECW,and TBW,mainly ECW,were increased significantly on POD1 (P＜ 0.05),and the level of postoperative fluid volume was decreased to that of PreD1 between POD3 and POD7.It showed that there was difference in the net increasing of body fluid on POD1 between different type of the patients.Obviously,the net increasing of fluid volume in woman on POD 1 was more than that in man.The net increasing of fluid volume on POD1 was correlated with the operation time and net liquid input.Conclusion:The fluid retention was found in the early stage of postoperative patients,and mainly exists in ECW.The main influence factors resulting postoperative fluid retention were prolonged operation time and increased net fluid input.

Therapeutic Observation of Acupuncture for Malignant Pleural Effusion of Moderate Volume / 上海针灸杂志

Objective To observe the clinical efficacy of acupuncture in treating malignant pleural effusion (MPE).Method Eighteen MPE patients confirmed by histopathological and/or cytological examinations were treated by acupuncture by selecting Yunmen (LU 2), Qimen (LR 14), Zhangmen (LR 13), Jingmen (GB 25), Guanyuan (CV 4), Zhongji (CV 3), Shuidao (ST 28), and Guilai (ST 29) as the major points. The treatment was given once every other day, 3 times a week, 4 weeks as a treatment course, and the therapeutic efficacy was evaluated 1 course later.Result Of the 18 patients, 6 got complete remission, 9 got partial remission, 2 achieved stable condition, while 1 didn’t respond to the treatment, and the total effective rate was 83.3%. Of the 5 cases with encapsulated pleural effusion, 2 got complete remission and 3 got partial remission, and the total effective rate was 100.0%. The amount of pleural effusion (anteroposterior diameter of the fluid), comprehensive score of symptoms, item scores of the symptoms, and Karnofsky Performance Status (KPS) score were changed significantly after treatment (P<0.01).Conclusion Acupuncture is an effective method in treating MPE of moderate volume, and it can swiftly improve the symptoms and promote the quality of life.

Fluid Retention Associated with Imatinib Treatment in Patients with Gastrointestinal Stromal Tumor: Quantitative Radiologic Assessment and Implications for Management

OBJECTIVE: We aimed to describe radiologic signs and time-course of imatinib-associated fluid retention (FR) in patients with gastrointestinal stromal tumor (GIST), and its implications for management. MATERIALS AND METHODS: In this Institutional Review Board-approved, retrospective study of 403 patients with GIST treated with imatinib, 15 patients with imaging findings of FR were identified by screening radiology reports, followed by manual confirmation. Subcutaneous edema, ascites, pleural effusion, and pericardial effusion were graded on a four-point scale on CT scans; total score was the sum of these four scores. RESULTS: The most common radiologic sign of FR was subcutaneous edema (15/15, 100%), followed by ascites (12/15, 80%), pleural effusion (11/15, 73%), and pericardial effusion (6/15, 40%) at the time of maximum FR. Two distinct types of FR were observed: 1) acute/progressive FR, characterized by acute aggravation of FR and rapid improvement after management, 2) intermittent/steady FR, characterized by occasional or persistent mild FR. Acute/progressive FR always occurred early after drug initiation/dose escalation (median 1.9 month, range 0.3-4.0 months), while intermittent/steady FR occurred at any time. Compared to intermittent/steady FR, acute/progressive FR was severe (median score, 5 vs. 2.5, p = 0.002), and often required drug-cessation/dose-reduction. CONCLUSION: Two distinct types (acute/progressive and intermittent/steady FR) of imatinib-associated FR are observed and each type requires different management.

Establishment of Rat Model of Syndrome of Cold Fluid Retention in Lung / 广州中医药大学学报

Objective To compare different methods for developing rat model of the syndrome of cold fluid retention in lung ( CFRL) , so as to find an easier and more reliable modeling method for CFRL. Methods Twenty rats were divided into 4 groups, namely normal group, lipopolysaccharide (LPS) group, tobacco group, and cold bath group, 5 rats in each group. Lipopolysaccharide group was given intratracheal drip of LPS, tobacco smoking and cold bath, tobacco group was given tobacco smoking and cold bath, and cold bath group was given cold bath and intragastric gavage of cold water. The modeling time in the three groups lasted for 15 days. After the experiment, we compared the general health state, body weight, sputum volume and pathological changes in rats of the four groups. Results (1) Compared with the normal group, activities of rats in the three modeling groups were lowered, body temperature decreased, and the signs of panting, cyanotic nose and lips with excretion, and sneezing (cough) were obvious. (2) Compared with the normal group, the decrease of body weight was obvious (P0.05). ( 3) The results of lung tissue slice examination showed that the injury of lung tissue was severe in LPS group, mild in tobacco group and slight in cold bath group. Conclusion Rat model of CFRL has been established successfully in all of the three modeling groups, and in consideration with all respects, the method for tobacco group is the best.

Analyze the Meaning of the Article“Shortness of Breath with Minor Fluid Retention Should Be Eradicated by Urination” / 浙江中医药大学学报

[Objective]To study and clarify the philosophy and method used by Zhang Zhongjing for diagnosing and treating fluid retention diseases. [Method]To analyze the meaning of article No.17 from the“Chapter of Fluid Retention Disease”by studying related classic literatures including the“Golden Chamber”.[Result] It was found that to provide prescriptions for treating minor fluid retention disease was not the only meaning of the article, but also the basic principle of treating fluid retention disease“Moderate by medicine with warm in nature”, which meant to restore the normal circulation of water in human, reflected the thought of patient-oriented treatment was revealed. [Conclusion] A better understanding of the principle of diagnosis and treatment would be obtained if the knowledge of the classic literatures is integrated when studying the articles of the “Golden Chamber”. The ability of diagnosing and treating diseases wil then be improved.

Efficacy of Takushato on Patients with Dizziness and Vertigo in Relation to Signs and Symptoms of Fluid Retention / 日本東洋医学雑誌

Takushato is a Kampo formula used for the treatment of dizziness and vertigo. Signs and symptoms suggestive of fluid retention have been regarded as clinical indications for takushato administration, but it is not clear if improvement of these signs and symptoms is related to the clinical efficacy of takushato, so we analyzed the correlation among these factors. Twenty patients who suffered from dizziness and vertigo were treated with takushato for 4 weeks. Before and after treatment, subjective symptoms and objective data including vestibular function tests were assessed, and correlation among the factors was analyzed. Improvement of patients' total symptoms was significantly correlated with improvement of fluid retention scores. Furthermore, improvement in vestibular function tests showed a trend toward correlation with that of fluid retention scores.These results suggest that improvement in the signs and symptoms of fluid retention is related to the clinical efficacy of takushato. We conclude that the presence of fluid retention is a reasonable clinical indication for takushato administration.

Four Cases of Male Patients Successfully Treated with Tokishakuyakusanryo / 日本東洋医学雑誌

Tokishakuyakusan has been used widely to treat various diseases including gynecological disorders. Currently, tokishakuyakusan is frequently used to treat female patients, while indications for use in male patients are unclear. Furthermore, there are few reports of male patients having been effectively treated with tokishakuyakusan or tokishakuyakusanryo. Here, we report four male patients successfully treated with tokishakuyakusanryo. Case 1 was an 84-year-old man who had uncontrolled nasal allergy, and treatment with tokishakuyakusanryo was effective in relieving the patient's allergy symptoms that were accompanied by chills and oketsu (blood stasis) findings. Case 2 was a 63-year-old man whose chief complaints were bronchial asthma, benign prostate hypertrophy, and nasal allergy. All his symptoms improved considerably with tokishakuyakusanryo and hangekobokuto, especially the symptoms of nasal allergy. Case 3 was a 70-year-old man whose chief complaint was persistent proteinuria. Tokishakuyakusanryo was prescribed, in consideration of his clinically observed condition, which included sensitivity to cold, blood stasis and fluid retention. His proteinuria disappeared four months later, along with his other complaints of chills, oketsu, and fluid retention. Case 4 was a 56-year-old man whose chief complaint was ulcerative colitis. He had responded well to treatment with ifuto, but he developed hypertension. His prescription was changed to tokishakuyakusanryo, a similar prescription that does not contain the Glycyrrhiza radix which can cause hypertension. Afterwards, his blood pressure decreased to normal levels and his abdominal symptoms remained stable. Nangai Yoshimasu published the opinion that tokishakuyakusan could be applied not only in female patients but also male patients. Additional reports on male cases would provide helpful information to clarify tokishakuyakusan indications in male patients.

Goreisan Effective for Two Cases of Post-Dural Puncture Headache / 日本東洋医学雑誌

Post-dural puncture headache is a headache caused after lumbar puncture. We report two cases of post-dural puncture headache improved with goreisan. Case 1 was 37-year-old man, Case 2 was 36-year-old woman, and they both had orthostatic headache after lumbar puncture. We diagnosed them as having post-dural puncture headache, and their headaches were improved with goreisan. Based on the international classification of headache disorders, 2 nd edition (ICHD-II), post-dural puncture headache is classified as headache attributed to low cerebrospinal fluid pressure. We treated their cerebrospinal fluid as a “shin-eki” (a body fluid other than blood), and their low cerebrospinal pressure as “suidoku” (fluid retention or depletion, or mal-distribution of “shin-eki”). Goreisan is effective for “suidoku”, so we believe that goreisan was good for their low cerebrospinal pressure. These results suggest that goreisan is a useful option for the treatment of post-dural puncture headache.

The Recognitions of Treatment based on Syndrome Differentiation of Phlegm and Fluid-retention by Chinese Japanese Doctors / 国际中医中药杂志

This article introduced the recognitions of the ovigin and development of phlegm and fluid-retention by ancient Chinese and Japanese doctors,as well as the formation of phlegm,the idenfification,and the treatment based on syndrome differentiation.Chinese and Japanese doctors enriched the understanding of phlegm together with the therapeutic methods.