RÉSUMÉ
We report a case of burning mouth syndrome (BMS) in a woman in her 70s whose pain was relieved by goshajinkigan alone. Five years ago, she became aware of tongue pain when she was under emotional stress. We diagnosed it as BMS. Since she had been taking antidepressants for depression for a long time and was more bothered by symptoms of kidney deficiency, such as back pain and numbness in the lower limbs, than tongue pain, we first prescribed goshajinkigan to improve her general condition. After that, not only her kidney deficiency but her BMS was relieved. The patient is currently under follow-up, but there is no tendency to relapse BMS. We presume that the correction of the patient’s general condition by Kampo medicine would lead to the improvement of her BMS.
RÉSUMÉ
Kampo as the main treatment method in intensive care has been rarely reported. The patient is a 25-year-old man presented with diarrhea and hypotension. Before the current admission, he developed brainstem death after allogeneic bone marrow transplantation for aplastic anemia at age 13, and underwent cystostomy and received mechanical ventilation, gastrostomy nutrition, and in-home medical care. He developed cardiogenic shock with anuria and pleural effusion, due to Pseudomonas aeruginosa urosepsis and was treated with infusion/transfusion and enteral medicine with his family's consent. Tongue was pale and enlarged, with thin white fur. The radial artery was not palpable. The carotid artery pulse was relaxed, large, and faint. He had good abdominal strength, subcutaneous edema, and massive ascites. These indicated yang collapse pattern. Chest X-ray revealed a massive pleural effusion. Shimbuto and goshajinkigan Kampo extract supplemented with powdered cinnamon bark (Cinnamomum cassia Blume) was administered for the cardiogenic shock. Ogikenchuto extract combined with furosemide and goreisan extract was administered to treat the pleural effusion. Shimbuto, goshajinkigan, and powdered cinnamon bark improved the heart rate and blood pressure. The pleural effusion remained after furosemide and goreisan treatment, however, the addition of ogikenchuto induced significant diuresis, and the pleural effusion consequently decreased. This case suggests the potential of Kampo, even in critical illness where modern medicine is generally prioritized. The pleural effusion decreased after adding astragalus root-containing extract, emphasizing the role of tonifying qi for draining fluid.
RÉSUMÉ
The use of hearing aids may not be sufficiently helpful for elderly people with advanced bilateral hearing loss when conversing with others. The patient in this case was an 82-year-old man whose main complaint was difficulty in verbal communication with his family despite using hearing aids. He was diagnosed with advanced bilateral sensorineural hearing loss using Western medicine techniques. He was first prescribed the Kampo formulation, ryokeijutsukanto, followed by goshajinkigan. Later, he took a combination of both of these Kampo formulations, and his hearing ability improved. Pure tone audiometry and speech audiometry demonstrated hearing loss ;however, speech audiometry better reflected his improvement in hearing speech sounds after he began taking the Kampo formulations. Thus, in this case, the patient's hearing and communication abilities improved with Kampo formulations combined with the use of hearing aids. In the future, speech audiometry (maximum discrimination score) can be applied to evaluate the efficacy of Kampo treatment for hearing loss.
RÉSUMÉ
We evaluated the effect of gosyajinkigan in 30 cases of anticholinergic agent or α-1 blockers resistant nocturia with a sign of jinkyo which is the hypofunction of the kidney organ unit at Kampo medicine. As to subjective outcomes, storage symptoms and quality of life (QOL) of International Prostate Symptom Score, and sleep and energy items of King's Health Questionnaire and Nocturia QOL Questionnaire were statistically much improved. Concerning objective outcomes, nocturnal frequency of urination, nocturnal polyuria index and hours of undisturbed sleep by means of frequency volume chart, and total body water by body composition analyser were also statistically much improved. This study might demonstrate that normalization of body composition leads to reduce nocturnal urinary volume and improve nocturia.
RÉSUMÉ
<p>Kampo <i>goshajinkigan </i>is effective for the improvement of urinary tract function. Moreover, the origin of ganglion cysts is said to be varied and is not clear.<br>We report a case of ganglion cyst disappearance, which was successfully achieved with <i>goshajinkigan </i>for urinary tract discomfort.<br>The patient, a 35-year-old woman, who complained of nocturia, had difficulty in urinating, and a feeling of incomplete emptying. There were no findings of note in the urine or blood tests, and she was negative for cystitis. The patient did however show symptoms of kidney yang-ki deficiency.<br>She was started on <i>goshajinkigan </i>7.5 g/day for cold of the hands and feet, edema, and nocturia ; her feeling of incomplete emptying gradually reduced, and the nocturia, and feeling of incomplete emptying disappeared after 6 weeks. At the same time, her right wrist ganglion cyst also disappeared.<br>This suggests that <i>goshajinkigan </i>is effective in alleviating ganglion cysts in cases with symptoms of kidney yang-ki deficiency.</p>
RÉSUMÉ
We often meet the patient suffer from skin pruritus caused by jaundice. Those patients are treated with various methods and care, but there therapy are often ineffective. Japanese herbal medicine Gosha‒Jinki‒Gan has been successfully used to reduce skin pruritus in two patients caused by jaundice associated with advanced cancer. Case 1： A 68‒yearold man had suffered from pruritus caused by obstructive jaundice associated with cholangioma. He had treated with endoscopic nasobiliary drainage (ENBD) and other methods, but pruritus was not reduced. Gosha‒Jinki‒Gan (7.5g/day) imploved sleep disturbance. Case 2： A 81‒year‒old man had suffered from pruritus caused by jaundice associated with liver cirrhosis and hepatoma. He had treated with various methods, but pruritus was not reduced. Gosha‒Jinki‒Gan (5.0g/day) reduced his Numeric Rating Scale (NRS) of pruritus (10→3). Gosha‒Jinki‒Gan is recommended for skin pruritus due to jaundice.
RÉSUMÉ
As the 21st century advances, evidence-based medicine (EBM) has come to be regarded as essential in all field of medical sciences and practical medicine. Creating medicines have been searching for based on EBM and development of new medicine has been carried out.In Japan the number of diabetic patients has increased to 129% during recent 10 years. The number of diabetic complications has also increased and hemodyalysis has been introduced in approximately 16,000 patients/year with diabetic nephropathy in Japan in 2008.Additinally many diabetic patients are suffering from numbness, cold sensation and pains in extremities derived from diabetic neuropathy. Therefore reduction of diabetic complications is one of the most important considerations in the field of diabetic patient care.Diabetes mellitus is equivalent to wasting-thirst in Jomgiiyaolue.We have reported the effectiveness of Goshajinkigan (GJG) for the treatment of nembness associated with diabetic neuropathy for the first time in Japan in 1984.In controlled comparative study, GJG showed significantly higher rates of improvement of this symptom versus mechobalamin.Insulin resistance has an important role on the occurrence of type 2 diabetes and metabolic syndrome.We have studies the effects of Kampo medicine on the insulin resistance using the euglycemic clamp and molecular biological techniques.1) Animal experimental studies: The improvement of insulin resistance in STZ rats by the administration of GJG might be via NO pathway and due, at least in part, to correct in the abnormal early steps of insulin signaling pathway in skeletal muscle.2) Clinical Studies: Effects of GJG on insulin resistance in patients with type 2 diabetes were investigated. HOMA-R was significantly decreased after GJG treatment (P=0.019). On the other hand, HOMA-R in the control group did not show significant difference. HOMA-R returned to the pre GJG treatment level1month after GJG discontinuation (P=0.018). The high-dose clamp resulted in a significantly increased insulin action (MCR levels) after GJG treatment.These animal experimental and clinical studies suggest that GJG might be effective for improving insulin resistance in the patients with type 2 diabetes.Kampo formulations might be useful not only for the prevention and the treatment of diabetic complications but also effective for the prevention and treatment of type 2 diabetes.In conclusion GJG has been used for the treatment of numbness and dysnuria since the statement in Yanshijishengfang. We have found the effectiveness of GJG on the treatment of diabetic neuropathy and on the prevention and the treatment of type 2 diabetes. We would like to continue these scientific activities.
RÉSUMÉ
It is difficult to treat vulvar pain of an unknown cause. We report a case of vulvodynia with dysuria treated effectively with goshajinkigan. The case was 92 years-old female who could not sleep well because of vulvar pain. She did not have inflammation of the vulva or vagina. Moreover, she was sometimes treated with urethral catheterization for urinary retention. Goshajinkigan was prescribed, and her pain was decreased so much, that she could sleep well. Furthermore, she was relieved of her urinary retention.
RÉSUMÉ
It is difficult to treat vulvar pain of an unknown cause. We report a case of vulvodynia with dysuria treated effectively with goshajinkigan. The case was 92 years-old female who could not sleep well because of vulvar pain. She did not have inflammation of the vulva or vagina. Moreover, she was sometimes treated with urethral catheterization for urinary retention. Goshajinkigan was prescribed, and her pain was decreased so much, that she could sleep well. Furthermore, she was relieved of her urinary retention.
RÉSUMÉ
A 70 year-old male with nodular multiple angiitis visited our outpatient clinic because of cold sensation and dysthesia. Although the vascular disease went into remission with steroid and immunosuppressant use, dysthesia continued. An improvement in subjective symptoms was evaluated with a visual analogue scale, after Gosha jinki-gan extract was administered on the basis of Kampo diagnosis. Furthermore, this beneficial effect increased when Syuchibushi matsu administration was added. Thus far, there are no such reports on Goshajinkigan as being useful for nodular multiple angiitis. Although the direct effect was not seen on the peripheral nerve conduction velocity, Goshajinkigan might be useful for the treatment of subjective cold sensation and dysthesia symptoms, in patients with nodular multiple angiitis. The mechanism of the above effect is considered to be similar to that in diabetic peripheral neuropathy.
RÉSUMÉ
In order to examine the effectiveness of moxibustion and Goshajinkigan for diabetes we investigated using Otsuka Long-Evans Tokushima Fatty (OLETF) rats and Long-Evans Tokushima Otsuka (LETO) rats. 18 male OLETF rats (5 weeks old) and 6 male LETO rats (5 weeks old) were divided into 4 groups. Group I rats were given trial moxibustion (BL 20, BL 23). Group II rats were administered Goshajinkigan (100mg/kg). Group III (OLETF) and IV (OLETF) rats were untreated as controls. In each group, we measured body weight (BW), blood sugar (BS), urine albumin (UA), pain-related time (PRT) and blood flow volume (BFV) before and after the experiment. Moreover, kidney and pancreas tissues were observed.<br>In groups I, II and III, BW, BS and UA increased in comparison with that of group IV, as the rats grew older. But groups I and II showed suppressed increases, in comparison with that of III group. After stimulation groups I and II showed reaction sensitivity, in comparison with group III. Group I showed a suppressed decrease of BFV. Tissue samples showed no serious change.<br>These findings suggest that moxibustion and Goshajinkigan inhibited some quantity of the progress of diabetic disease.
RÉSUMÉ
We have recently seen an increasing number of patients with osteoporosis of the type that occurs as a chronic illness in the elderly, and particularly in elderly female patients. It is important not only to treat pain but to follow-up with treatments to prevent further bone mass loss. To measure bone mass in patients with osteoporosis, we employed Digital Imaging Processing (DIP). In this study, the authors examined changes in the bone mass of patients in long-term therapy with Keishi-ka-Jutsubu-to and Gosha-Jinki-Gan. As a comparative-control group, or non-treatment group, we selected 11 patients who had been diagnosed as having osteporosis in an outpatient clinic, and whose bone mass had been measured with DIP. These patients discontinued treatment, but returned to the outpatient clinic six months to one year later. The average duration of non-treatment in the control group was 9.8 months. Metacarpal index (MCI) and metacarpal bone mineral density (m-BMD) at the first visit were 0.40±0.07 and 2.22±0.38, but 10 months later they were 0.36±0.05 and 1.97±0.38, which represents a significant decrease.<br>In 20 cases given Keishi-ka-Jutsubu-to, the initial bone mass data were: MCI, 0.39±0.08; m-BMD, 2.07±0.32. Measurements performed after three, six, and nine months of treatment showed no difference or increase from the initial values.<br>In 12 cases given Gosha-Jinki-Gan, the initial data were: MCI, 0.40±0.07; m-BMD, 2.06±0.27. Measurements performed after three, six and nine months of treatment showed no difference from the initial values.<br>The severity of pain was equally reduced by treatment with Kampo formulation or NSAIDs (non-steroidal anti-inflammatory drugs) by four weeks, but after eight weeks low back pain in patients treated with the Kampo formulation was significantly reduced compared with low back pain in the group treated with NSAIDs.