RESUMEN
We report a case of serous gonarthritis with nonproductive cough successfully treated with Eppikajutsuto. A 37-year-old Japanese man developed a right genicular arthrocele with nonproductive cough, in October X. Over 100 ml of serous synovial fluid was drained via an arthrocentesis puncture procedure. Although he was treated with nonsteroidal anti-inflammatory agents by an orthopedist, under a diagnosis of serous gonarthritis, his symptoms did not improve. Laboratory findings suggested inflammatory conditions (serum CRP 3.4 mg/dl, ESR 76 mm/h). At the time of his first visit in January X+1, orthopedic examinations revealed that rheumatoid arthritis was unlikely, based on negative physical and laboratory findings. A contrast MRI knee joint scan did not demonstrate any tumor-like mass of synovium which would indicate pigmented villonodular synovitis. And orthopedists found it difficult to specify the cause of his serous gonarthritis. After a common cold in December X, cough stimulated by cold exposure was superimposed on serous gonarthritis.We utilized Eppikajutsuto under the interpretation that both his genicular arthrocele and nonproductive cough were due to a “sui” disturbance. This Eppikajutsuto therapy reduced his genicular arthrocele and nonproductive cough in1month. His symptoms and inflammatory reactions were completely improved in 3 months, regardless of gradual withdrawal of his medication.
RESUMEN
We report a case with an intractable jugular sense of discomfort, with dryness and nonproductive cough successfully treated with soshikokito. A 62-year-old Japanese man developed jugular sense of discomfort with dryness and nonproductive cough, after odontotherapy in October. Although he was treated with Western drugs by an otolaryngologist, under the diagnosis of xerostomia with no mechanical problems, his symptoms did not disappear. The symptoms followed a protracted course, and he further developed a loss of appetite. At the time of first visit in October, otorhinolaryngological studies showed no structural lesions or problems, with the exception of minimum salivation in the normal range on a gum test. There was no evidence of dry eyes. With the diagnosis of xerostomia, Bakumondoto-go-hangekobokuto was administered for a month but showed no sign of improvement. Making a shift to bukuryoin-go-hangekobokuto regained his appetite, but did not produce any improvement on dryness. We then utilized soshikokito under the interpretation that both dryness and nonproductive cough is ki-gyaku. The soshikokito therapy reduced his dryness in a month's time. Additionally, his nonproductive cough gradually decreased, and within 11 months after, he had no symptoms, regardless of a gradual medication withdrawal.
RESUMEN
Objective To investigate the important role of bronchial provocation test with hypertonic saline and induced sputum in the diagnosis and treatment of chronic nonproductive cough by assessing its feasibility and the side effects which may occur during the procedure.Methods The diagnosis procedure was based on the anatomical protocol for diagnosing chronic nonproductive cough,howerer,hypertonic saline bronchial provocation test and induced sputum were conducted for unconfirmed 38 pafients who suffered chronic congh.Results 23(23/38,60.5%)patients with airway hyperresponsiveness,the forced expiratory volume in one second(FEV1)was decreased 27%?5.8)%,Side effects occurred in 3 patients(3/38,7.8%).Appropriate sputum samples were obtained after hypertonic saline challeng,The percentage of eosinophi1 counts in induced sputum was high in 24 patients(24/38,63.2%),including cough variant asthma(CVA)(17/23,73.9%)and eosinophilic bronchitis(EB)(7/38,18.4%).After treatment,the percentage of eosinophi1 counts in induced sputum of patients was significantly reduced in CVA and EB.Conclusion Bronchial provocation test with hypertonic saline and induced sputum were an effective method for diagnosing chronic nonproductive cough and little side effects occurred during the procedure.