Résumé
We report a case of qi-deficiency fever that was successfully treated with hochuekkito. A 26-year-old woman presented to our clinic with a complaint of pain of her fingers. Clinical findings revealed no evidence of rheumatoid arthritis. Since she wanted treatment for the recent mild fever, additional examination was performed. Infection, malignant tumor, and collagen disease were ruled out as probable cause of the fever. Clinically, she was diagnosed with qi-deficiency fever. After treatment with hochuekkito, her body temperature normalized, indicating that treatment with hochuekkito was effective. Hochuekkito was originally prescribed for treatment of qi deficiency due to yin fire ; however, it is currently used for treatment of other diseases. In this report, we described a case using hochuekkito.
Résumé
Carpal tunnel syndrome is a common orthopedic disease. Western medicine treatments for carpal tunnel syndrome include conservative drug treatments, temporary external fixations, and operative treatments. Cases of patients being treated with Kampo medicine have been reported. The patient was an 80-year-old woman, who visited our clinic because of numbness in her right hand. She was diagnosed with carpal tunnel syndrome. She was administrated with a Kampo medicine, keishito. After 7 days, her symptoms were relieved, and after 14 days her symptoms had resolved. We could not find any reports showing that keishito was effective in treating carpal tunnel syndrome. We believe that her symptoms of carpal tunnel syndrome were caused by eiefuwa (nutrient-defense disharmony) and were successfully treated with keishito.
Résumé
We herein report a case of 91-year-old woman with antiresorptive agent-related osteonecrosis of the jaw (ARONJ) developed during treatment for osteoporosis with intravenous ibandronate. Although she was treated with several antibiotics and had an incision for the drainage of a pus discharge at a dental clinic for two months after the onset of ARONJ, the discharge persisted. We then added hochuekkito to her treatment, which resulted in a gradual decreased in pus discharge and decrease in wound size and the wound resolved after approximately one month. ARONJ is considered a refractory disease, however, it was successfully treated with hochuekkito in this patient. ARONJ is also a rare condition and to our knowledge, this is considered to be the first case of ARONJ, which has been successfully treated with Kampo medicine.
Résumé
A 74-year-old woman presented to our clinic with a history of vascular-and stent-graft insertion for aortic dissection developed a tendency to bleed from a palmar wound due to chronic disseminated intravascular coagulation (DIC). Initially, she sustained the palmar wound due to a fall. On the second day after the injury, she experienced continuous bleeding and consulted the orthopedic department of a general hospital, where her dressing was changed. On the third day after injury, she sought consultation at our clinic. The clot and wound remained intact even 12 days after the injury. Therefore, the clot was removed and the bleeding was stopped surgically. On the same day, 5 hours after the surgical treatment, the patient presented to our clinic because of continuous bleeding. She was then administered kyukikyogaito and kamikihito to stop the bleeding. Her laboratory findings revealed thrombocytopenia, and additional inspection was performed. The bleeding stopped on the next day. On the third day after administration, the bleeding remained controlled and an additional inspection revealed DIC. In the cardiology hospital, the cause of tendency to bleed of chronic DIC was pointed out as being due to a leakage at the end of the stent-graft. Kampo medicine was thought to be useful for temporal hemostasis for bleeding due to chronic DIC.
Résumé
Painful orthopedic diseases are sometimes aggravated because of weather changes ; this is referred to as meteorological pain. We report two cases of great occipital neuralgia (GON) due to traffic accident in patients whose pain was aggravated by weather changes. Case 1 involved a 41-year-old woman who developed lumbago and cervical pain following a traffic accident. Two months after the accident, she had irregular occipital pain. Three months after the accident, a great typhoon occurred, and she suffered from severe occipital pain since that morning. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Case 2 involved a 31-year-old woman who developed cervical pain following a traffic accident. Three months after the accident, she experienced severe occipital pain due to weather changes. She was diagnosed with GON as meteorological pain and was administered goreisan ; her occipital pain then improved. Goreisan is dramatically effective for GON as meteorological pain caused by cervical sprain.
Résumé
Crowned dens syndrome (CDS) is a pseudogout of the cervical vertebra, which shows calcification around the dens of the axis. We report a case of CDS that was successfully treated with daiobotampito and shimotsuto. An 83-year-old woman visited our clinic because of neck pain. She was diagnosed with CDS and was initially administered daiobotampito and eppikajutsuto. Her neck pain improved slightly, but recurred. She was then administered daiobotampito and shimotsuto, after which her neck pain disappeared. We considered that daiobotampito and shimotsuto were effective for this prolonged illness based on persistent stasis and blood deficiency according to her treatment course and laboratory findings.
Résumé
In daily medical examinations of orthopedic surgery, treatment for chronic pain is sometimes needed. We report a case of chronic pain developed after an open fracture 15 years ago and successfully treated with sokeikakketsuto. A 35-year-old man unfortunately sustained an open fracture in his right lower leg in a traffic accident at his age of 20 years. He underwent 12-13 surgeries for osteosynthesis, post-operative focal infection, and leg extension. Subsequently, he developed periodic pain in his right ankle joint. He consulted our clinic because of the severe pain; although non-steroidal anti-inflammatory drugs were ineffective, sokeikakketsuto was dramatically effective. To treat chronic pain after an old fracture, sokeikakketsuto may be considered as a choice of treatment.
Résumé
Tokishakuyakusan is well-known to be useful in infertility. We report 3 cases of infertility that resulted in pregnancy and childbirth due to oral administration of tokishakuyakusan after being led to tokishakuyakusan pattern by symptomatic treatment resolving blood stasis or regulating qi. Case 1 was a 39-year-old woman with unexplained infertility. She visited our hospital because of irritability and was initially administered keishibukuryogankayokuinin and yokukansankachinpihange, and then tokishakuyakusan. After a month of treatment, she conceived. Case 2 was a 33-year-old woman who was diagnosed with ovarian dysfunction and received ovarian stimulation. To support infertility therapy she was administered keishibukuryogan, and subsequently, tokishakuyakusan based on her pattern. After 3 months of treatment, she conceived. Case 3 was a 37-year-old woman who was diagnosed with unexplained infertility and was administered kamishoyosan and hochuekkito for premenstrual syndrome at another hospital. She visited our hospital because of sensitivity to cold and fatigability. The previous treatment was discontinued, and she was administered tokishakuyakusan based on her pattern. After 2 months of treatment, she conceived. All 3 patients continued tokishakuyakusan treatment during pregnancy and successfully delivered live babies. These 3 cases initially received other Kampo medicines and then, tokishakuyakusan, according to the changed Kampo medical pattern. It is important to administer tokishakuyakusan to patients with infertility, following administration of appropriate Kampo medicine to correct their imbalance of qi, blood and fluid and after further confirming the abdominal signs suitable for tokishakuyakusan.
Résumé
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.
Résumé
Arthritis of the carpometacarpal joint of the thumb is typically treated with oral anti-inflammatory drugs, external medicines, and temporary external fixation. We report 3 cases of arthritis of carpometacarpal joint of the thumb that were successfully treated with sokeikakketsuto. In cases 1 and 2, a 50-year-old woman and 68-year-old man, respectively, were diagnosed with arthritis of the carpometacarpal joint and were successfully treated with sokeikakketsuto. In case 3, a 66-year-old man complained of pain in the second carpometacarpal joint caused by gout, and was successfully treated with eppikajutsuto and daiobotampito. However, the pain in the carpometacarpal joint of the thumb due to arthritis remained, and was successfully treated with sokeikakketsuto. Eppikajutsuto and daiobotampito were effective for acute arthritis such as gout, and sokeikakketsuto was effective for osteoarthritis. Overall, patients with different diseases in the various local regions may have slightly different clinical presentations even in the same case.
Résumé
Carpal tunnel syndrome is a common condition caused by compression of the median nerve. Patients usually present with numbness and pain along the distribution of the median nerve in the hand. We report 2 cases of carpal tunnel syndrome successfully treated with kakkonto after their pattern diagnosis. We treated a 57-year-old women and a 59-year-old man. Two patients presented with hand pain and numbness and were diagnosed with carpal tunnel syndrome. Kakkonto treatment was successfully in two cases. We observed that median nerve compression persisted in these patients even after disappearance of numbness and pain ; therefore, we recommended operative management. The 2 patients underwent an operation for carpal tunnel syndrome. Kakkonto can be considered useful palliative treatment before considering operative management for numbness and pain in the patients with carpal tunnel syndrome.
Résumé
Heberden's and Bouchard's nodes are clinical manifestations of osteoarthritis of the interphalangeal joints. Heberden's nodes typically affect the distal interphalangeal (DIP) and Bouchard's nodes, the proximal interphalangeal (PIP) joints of a fingers in patients with osteoarthritis. We describe osteoarthritis of the interphalangeal joints in 3 women who were successfully treated with sokeikakketsuto. Case 1 : A 58-year-old woman presented with pain in the DIP joint of her left middle finger and was diagnosed with a Heberden's node. Case 2 : A 60-year-old woman presented with pain in the DIP joint of her left ring finger and was diagnosed with a Heberden's node. Case 3 : A 37-year-old woman presented with pain in PIP joint of her left ring finger and was diagnosed with a Bouchard's node. All women were successfully treated with sokeikakketsuto. In conclusion, sokeikakketsuto is a useful Kampo medication to treat mild-to-moderate pain secondary to bone, joint, or spinal conditions, as well as non-steroidal antiinflammatory drugs.
Résumé
Poor eating is a life-threatening condition in senior citizens. Herein, we report a case of poor eating due to stomach yin deficiency (wei yin xu), which was successfully treated with bakumondoto. The patient was a 91-year-old woman who expected treatment for her poor food intake. She was diagnosed as poor eating with stomach yin deficiency and was administered with bakumondoto, which increased her food intake and weight. To treat poor eating with Kampo medicine, rikkunshito and various other Kampo drugs are commonly used. In this case, bakumondoto, which is usually used for respiratory diseases such as dry cough, was effective. Bakumondoto is useful for stomach yin deficiency of poor eating.
Résumé
We present two cases of night sweats due to eiefuwa (deficiencies of nutrients and defenses) that were successfully treated with Kampo medicine. Case 1 was that of a 64-year-old man with perspiration during sleep and slight fever, and Case 2 was that of a 78-year-old man with perspiration during sleep and common cold-like symptoms. Case 1 was administered with saikokeishito, and his symptoms quickly disappeared. Case 2 was administered with common cold drugs and saikokeishito initially, but the treatment was ineffective. Therefore, keishito was administered, and the patient's symptoms disappeared within 2 days. Sweating and common cold-like symptoms were successfully treated with Kampo medicine for the diagnosis of eiefuwa. Further, we discuss the various descriptions of eiefuwa in the literature.
Résumé
In our clinic, patients with relatively positive diseases, which form the orthopedic conditions with inflammation, were successfully treated with eppikajutsuto and daiobotampito after reisenjotsuin. Patients with pain due to orthopedic disorders where NSAIDs (non-steroidal anti-inflammatory drugs) were difficult to be used or ineffective were successfully treated with eppikajutsuto and daiobotampito. We present the representative cases and bibliographically discuss them.
Résumé
We report the case of a 36-year-old male who presented with an abdominal complaint after straightening of irregular teeth. He was examined and treated, however, the cause of the abdominal complaint could not be determined and the treatment was ineffective. He was treated in our clinic with yokukansankachinpihange for obvious pulsation in the supraumbilical region following the oral tradition of Kampo medicine, and the symptom gradually disappeared. We discussed the mechanism of the stomachache in Kampo medicine. After treatment, this case was diagnosed as somatoform autonomic dysfunction in psychiatric medicine. Advanced treatment by a psychiatrist was necessary to treat this disease in psychiatric medicine. In this case it is suggested that treatment following the oral tradition of Kampo medicine was effective.
Résumé
Shomakakkonto is usually used for the treatment in patients with initial cold or dermatitis symptoms. We herein reported our experience with two cases of common cold accompanied by watery eyes and floating pulse that were successfully treated with shomakakkonto. The patients were an 81-year-old man and a 69-year-old woman who presented with common cold-like symptoms and watery eyes at our clinic, and were diagnosed with common cold of middle yang. Both patients were successfully treated with shomakakkonto. Common cold with watery eyes may be considered as an indication for treatment with shomakakkonto.
Résumé
Pseudogout is a crystal-induced arthritis that often occurs in senile individuals. We report a case of an acute attack of pseudogout that was successfully treated with bofutsushosan and orengedokuto. The patient was an 87-year-old man who visited our clinic and complained of left wrist joint pain 2 days after onset. His physical examination revealed tenderness in his left wrist joint. Plain roentgenogram revealed slight calcification of the left wrist joint, and an inflammatory reaction was found on blood examination. Thus, he was diagnosed with an acute attack of pseudogout in his wrist joint. We prescribed bofutsushosan and orengedokuto. After internal use, his left wrist joint symptoms gradually improved. At the follow-up visit 3 days after his first visit, his left wrist joint pain was resolved completely, and after 9 days, his laboratory data were normalized. Thus, bofutsushosan and orengedokuto were effective in the treatment of an acute attack of pseudogout.
Résumé
De Quervain disease and carpal tunnel syndrome are major problems that occur after delivery. During pregnancy, hormone confusion readily causes inflammation of tendons ;furthermore, overuse of hands during care of other children contributes to symptom onset. We report four cases of de Quervain and carpal tunnel syndrome occurred after delivery. All patients were women, aged 33-39 years. All patients breast-fed after birth. One patient was diagnosed with de Quervain disease, two were diagnosed with carpal tunnel syndrome, and one was diagnosed with de Quervain disease accompanied by carpal tunnel syndrome. All patients received tokishakuyakusan ;thereafter, their pain decreased, but slight numbness from the carpal tunnel syndrome remained. Drugs that can be used during breastfeeding are limited ;however, tokishakuyakusan can be prescribed safely and effectively.
Résumé
We report three patients with acute lumbago who did not respond to nonsteroidal anti-inflammatory drugs (NSAIDs), but were treated successfully with daiobotampito and shimotsuto. Case 1 (86-year-old man) and Case 2 (56-year-old woman) were diagnosed with acute lumbago. Case 3 (69-year-old man) was diagnosed with acute lumbago and mild left sciatica. All three patients were initially administered orally NSAIDs, but this treatment was ineffective. Therefore, daiobotampito and shimotsuto were administered after choeikatsurakuto according to “Manbyokaishun.” Following this treatment, the patients' acute lumbago and sciatica resolved within 1-2 weeks. In conclusion, daiobotampito in combination with shimotsuto seems to be a useful Kampo medicine for treatment of lumbago.