RÉSUMÉ
Pulsatile tinnitus results from turbulence that occurs in the vascular lumen of the neck, skull base, and temporal bone region. Here we report two cases in which hachimijiogan was effective for pulsatile tinnitus which was thought to be caused by carotid artery stenosis. Case 1 was a 77-year-old man. He had been aware of left pulsatile tinnitus for more than 10 years, and visited our department. Ultrasonography revealed a 56% stenosis in the left carotid artery, which was considered to be the cause of tinnitus. We administered him hachimijiogan because he had a pattern of kidney yang deficiency. After 12 weeks of administration, his symptom disappeared. Case 2 was an 86-year-old man. He had been aware of pulsatile tinnitus for a year, and visited our department. He was pointed out about 70% stenosis in the left carotid artery at another hospital, and we thought this was the cause of tinnitus. We administered him hachimijiogan because he had a pattern of kidney yang deficiency. After 16 weeks of administration, his symptom improved to about one quarter. It is considered that there are cases where pulsatile tinnitus due to carotid artery stenosis associated with arteriosclerosis can be treated as kidney deficiency, as well as age-related inner ear tinnitus.
RÉSUMÉ
The indications of hachimijiogan formulation include lower limb pain, low back pain, edema, fatigue, coldness, and accompanying symptoms of hypertension. In this study, hachimijiogan was administered to patients who complained of symptoms of coldness, pain, etc., and the subsequent blood pressure was observed. Changes in hachimijiogan, a powder pill formulation of crude drugs, were observed in 12 patients aged 45 years or older, with an average age of 71 years. Various symptoms of jinkyo, blood pressure, and laboratory findings were examined. Coldness and pain improved significantly after 3 months. Of the 9 patients who wanted to take hachimijiogan for more than 9 months, 8 were treated with antihypertensive drugs. Among them, 4 underwent an antihypertensive dose reduction by 9 months, and 3 received angiotensin receptor antagonists, and 1 received a Ca antagonist. The systolic pressure before treatment with hachimijiogan averaged 127 mmHg, and after 9 months it was stable at 128 mmHg despite drug dose reduction. In patients with antihypertensive drugs, the long-term use of hachimijiogan may facilitate dose reduction and protection of the vascular endothelium protection. The usefulness of hachimijiogan in the aging society was suggested.
RÉSUMÉ
Few reports currently exist demonstrating that Kampo medicine is effective for dry nose. Here, we describe three cases of dry nose that were successfully treated with hachimijiogan or rokumigan. The chief complaints of the three cases differed. Dry nose was the second or third most troublesome symptom. The three cases had kidney deficiency and its typical symptom of abdominal numbness in common. Upon administration of hachimijiogan or rokumigan, dry nose improved promptly, along with the improvement of kidney deficiency. In addition, it became easier for all three cases to breathe. According to “Pu ji fang”, dry nose is ascribed to wind-heat or kidney deficiency. The kidney is considered to control the reception of qi inhaled by the lungs. Taken together, we speculate that dry nose of the three cases were due to kidney deficiency, because treatment with hachimijiogan or rokumigan improved their dry nose along with the improvement of their kidney deficiency as well as their breathing which suggests the improvement of the reception of qi inhaled by the lungs. Hachimijiogan or rokumigan is shown to be effective for dry nose in the patients with kidney deficiency.
RÉSUMÉ
We administered Japanese Kampo medicine for seven patients with Grade 3 or more idiopathic sensorineural hearing loss who could not be administered enough amounts of steroids for some reasons. They all exhibited deficiency patterns, and which were all dual deficiency patterns of qi and yin. All patients were administered hochuekkito and hachimijiogan. Six patients were cured, and one patient was recovered.
RÉSUMÉ
This report describes 20 women who underwent in vitro fertilization or microinsemination while receiving a regimen of herbal medicine, of which contents varied according to the treatment stage. Until the ova were harvested, in order to promote maturation, patients were treated with hachimijiogan for reinforcing kidney yang, and keishibukuryogan for removing blood stasis. Following this, during the period between harvesting and implantation, they were treated either exclusively with unkeito for warming meridians, dissipates cold, and replenishes blood, or with unkeito in combination with keishibukuryogan. Following implantation, they were treated with tokishakuyakusan to induce uterine relaxation. The treatment regimen was determined based on traditional herbal evidence of infertile patient's blood stasis and kidney deficiency. We adjusted applied dose depending on the conditions of patients. Fourteen of the 20 women tested positive for pregnancy; 10 of them carried to term, whereas in 4 of them, the pregnancy ended in abortion or miscarriage. Anti-Müllerian hormone concentration, endometrial thickness, estimated follicle count, recovered ova count, fertilized ova count, and numbers of ova to reach the early-embryo stage and blastocyst stage were compared between the continuing pregnancy and the non-pregnancy groups. Improvements were observed in all values after combined use of traditional herbal medicines, except in the case of endometrial thickness, and significant differences appeared in recovered ova count and fertilized ova count. These observations suggest that a regimen of herbal medicine adapted to the various stages of in vitro fertilization may be a useful complementary therapy during pregnancy.
RÉSUMÉ
We report three closely watched cases of intractable Meniere's disease in the elderly that were successfully treated with Kampo medicine. Case 1 is a 75-year-old female. At the time of the 4th Meniere's attack, we gave her western medicines such as isosorbide, but she had a significant hearing loss. Then, we administered hachimijiogan extract granules, and her hearing level improved and she had been free of Meniere's attack for 23 months. Case 2 is a 78-year-old male. We diagnosed as bilateral Meniere's disease and treated him with western medicines such as isosorbide. In September of year X, his hearing level in the left ear worsened despite the treatment, so we prescribed hachimijiogan extract granules. After the treatment, we found the patient's hearing improved and nystagmus decreased gradually. He has also been free of Meniere's attack for 9 months. Case 3 is a 70-year-old male. He had repeated episodes of vertigo in spite of the administration of western medicines. After we prescribed shimbuto extract granules, vertigo attack and nystagmus disappeared. He has been relieved from Meniere's attack for 8 months. These cases indicate that Kampo therapy is one of the useful therapeutic options for intractable Meniere's disease in the elderly.
RÉSUMÉ
<p>In Kampo, respiratory symptoms are treated with prescriptions related not only to “lung”, but also other parenchymatous viscera. We report 2 patients whose stress-induced chronic cough was ameliorated by <i>hachimijiogan</i>. Case 1 was a 25-year-old female who was working under stressful circumstances at her company and reported an oppressive feeling in the chest. She was initially prescribed <i>hangekobokuto </i>because of a feeling that something was stuck in the pit of her stomach on abdominal examination, but her cough did not get better. As she also noted a dull feeling in her back ; she was switched to <i>hachimigan</i>, and her cough disappeared. Case 2 was 42-year-old female who suffered from depression, sore throat and an obstructive feeling in the throat ; she had been receiving infertility treatment for several years. <i>Hangekobokuto </i>and <i>bakumondoto </i>showed insufficient effect on her persistent cough. Her coughing stopped when she was prescribed <i>hachimigan </i>for back pain. Neither of these patients showed lack of resistance of the lower abdomen on abdominal examination.<br>Chronic <i>ki </i>(qi) stagnation under stressful conditions may cause <i>ki </i>deficiency, especially kidney deficiency. The symptom of stress-induced cough in our cases was considered to be due to kidney deficiency, and therefore <i>hachimijiogan</i>, but not <i>hangekobokuto</i>, was effective. The short duration of the complaints and relatively young age (20-40's) of the patients may account for the absence of the typical abdominal sign of kidney deficiency. Back stiffness and pain may also be important signs for cough due to kidney deficiency.</p>
RÉSUMÉ
We evaluated the effect of hachimijiogan in 30 cases of anticholinergic agent and α-blocker resistant LUTS. International Prostate Symptom Scores (IPSS), QOL scores, Benign Prostatic Hyperplasia Impact Index (BII) scores and urinary 8-OHdG of the patients were statistically much improved. This study demonstrated improvement in urinary symptoms, urinary QOL and oxidative stress, in LUTS resistant to anticholinergic agents and α-blockers. Further long-term studies will be needed not only in urinary symptoms, but also in effect as an anti-aging medicine.
RÉSUMÉ
This case involved a 58-year-old male with diabetic foot syndrome complicated with osteomyelitis. He had been diagnosed with diabetes mellitus type 2 twenty years previously, but had ignored it and developed diabetic foot syndrome and diabetic triopathy. His HbA 1 c (NGSP) was 11.2%. Twelve days after diabetic foot onset, he was transferred to our hospital to receive Kampo medicine. His whole right leg was edematous and there were two ulcers on the dorsum (5 × 4 cm in size) and between the fourth and fifth toes (7 × 4 cm in size).We used antibiotics, insulin, and prostaglandin formulation in combination with Kampo medicine, involving hachimijioganryo because of lower abdominal numbness. Simultaneously, we used keishibukuryogan at high dosage (personalized formula, 2 g × 24 pills) for 7 days to improve blood stasis. Seven days after hospitalization, we changed the initial hachimijioganryo to hachimijiogan (personalized formula, 2.3 g × 9 pills) and kigikenchuto (astragalus root, 20 g) to accelerate ulcer granulation. We also decreased the high dose keishibukuryogan gradually. Although the bone of the DIP joint in the fifth toe was exposed, the ulcer dimensions decreased and reached 2.5 × 1.8 cm at the time of discharge (50 days after onset). Two months after onset, the ulcer had epithelialized and medical dressings were unnecessary. Four months after onset, it had completely healed. We propose that Kampo medicine is effective for diabetic foot syndrome when combined with conventional therapy, and that healing occurs earlier than with conventional therapy alone.
RÉSUMÉ
We evaluated the effects of Hachimijiougan and its additional prescription in 11 cases of anticholinergic agent-resistant overactive bladder. The improvements in IPSS, QOL score, BII score and urinary 8-OHdG for the patients were statistically much improved. This study showed improvements of urinary symptoms and QOL in anticholinergic agent-resistant overactive bladder. Further long-term studies will be needed not only in urinary symptoms but also on effects as an anti-aging medicine.
RÉSUMÉ
The Cardio-Ankle Vascular Index (CAVI) is a physical examination method for indicating arterial stiffness non-invasively, as determined by measuring peripheral pressure waveforms on four extremities. We observed two cases in which CAVI was improved with the administration of Hachimijiogan.<br>Case 1 : a 79-year-old woman was suffering from pain of the tongue, dry mouth and numbness of the legs.Hachimijiogan improved the dry mouth and leg numbness, and weakened her tongue pain. R-CAVI and LCAVI before administration were 9.8 and 9.7. After 1-year of administration, her R-and L-CAVI decreased to 9.1 and 8.9.<br>Case 2 : a 77-year-old woman had cold sensation, numbness of the legs and urinary frequency. Six-months of Hachimijiogan administration improved these symptoms. Two-years' administration decreased her R- and L-CAVI from 10.2 and 10.1, to 9.9 and 9.2.<br>These two cases suggest the possibility that Hachimijiogan can improve CAVI in elderly people.
RÉSUMÉ
A 65-year-old woman suffered from swollen parotid and submandibular glands in July 2005, and sicca of the eyes and oral cavity arose in October 2005. We diagnosed her as having Mikulicz's disease based on magnetic resonance imaging of the head, gallium scintigraphy, and a lip biopsy in June 2006. After prednisolone 10 mg/day was commenced, her salivary glands shrank slightly. Although the amount of prednisolone had been tapered to 7 mg/day by May 2007, her serum IgG rebounded. In January 2008, hachimijiogan extract granules 7.5 g/day were introduced. Swelling of the salivary glands disappeared and her serum IgG level decreased. In May 2008, the amount of prednisolone was tapered successfully to 6 mg/day. Mikulicz's disease is a corticosteroid-sensitive disease, but in this case steroid resistance made treatment difficult. Based on this case, we performed functional assays of P-glycoprotein with calcein-AM, which demonstrated that hachimijiogan can reverse drug resistance.
Sujet(s)
Prednisolone , SérumRÉSUMÉ
We present a case of megacolon successfully treated with Kampo medicine. A 65-year-old male diagnosed with megacolon in 1999, came to our department in July 2003 complaining of severe abdominal distention. We successively used different Kampo formulae, in accordance with the diagnostic standard known as “SHO” which were: Daikenchu-to, Koboku-sanmotsu-to, Chukenchu-to, and Koboku-sanmotsu-to again. Daikenchu-to was only partly effective. Koboku-sanmotsu-to made the abdominal distention worse, forcing a change of drug. Chukenchu-to relieved the symptoms for some time, but the patient had to be hospitalized because of pseudoaldosteronism caused by the drug. Koboku-sanmotsu-to, however, worked smoothly on the second occasion and the symptoms disappeared. The efficacy of Koboku-sanmotsu-to was completely different on the two occasions it was used. This suggests that the pathological conditions were in a state of change, and these changes were identical to changes of SHO. This case reinforces the importance of detecting changes of the SHO accurately.
RÉSUMÉ
With the world standardization of inhaled steroids for bronchial asthma, the principle of Kampo medicine has changed from treatment for asthma attack to the prevention of it. The number of severe adult patient cases has decreased, and the number of <i>hojinzai</i> (kidney tonic) users has increased. The number of weaker children has increased, and the number of <i>hohizai</i> (spleen tonic) users has increased. Kampo medicine was not equal to inhaled steroids for the treatment of bronchial asthma, because the number of patients treated with Kampo medicine, having more than one year without an attack, was only 10% to 20%, and this figure would be lower, with inhaled steroids.<br>Nevertheless, Kampo medicine has had a great effect, on patients with milder symptoms, who do not require inhaled steroids, and well as those patients uncontrollable even with inhaled steroids. The Saiboku-to and Maozai groups, including Sho-sei-ryu-to and Ma-kyo-kan-seki-to, are good for milder patients. It is advisable to first check the immediate reaction of Maozai group users, following its administration in the clinic for treating attacks. The Hojinzai group, including Hachimi-jio-gan and Bakumi-jio-gan-ryo, are good for patients with the severe asthma or chronic obstructive pulmonary disease. An increase in the peak-flow rate of these patients with Hachimi-jio-gan might be related to activation of dehydroepiandrosterone, although the mechanism is unknown. Moku-boi-to is indicated for those patients with complicated heart failure.
RÉSUMÉ
Kampo treatment for respiratory diseases on the traditional standard including some care reports lectured. To find adequate Kampo prescription for each patient, it need to discriminate what is the cause of the symptoms, throat, nose, chest or low respiratory function. Some patients whose obstructive feeling at throat was improved by the adiministration of Hange-koboku-to, was introduced. Anxiety at throat was an important sign for its indication in these patients. This prescription was also applicated to sleep-disordered breathing. On treatment for chronic rhinitis that caused respiratory symptoms the pulse diagnosis was an important technique for the diagnosis of stasis of body fluids. Kampo treatment for common cold, chronic bronchitis, bronchial asthma and interstitial pneumonia were told as chest diseases. Kampo prescriptions for chronic bronchitis were classified by the characteristics of cough (dry or wet) and Kyo-Jitsu (asthenia or robust). Pediatric asthma patients who respond to the prescriptions with tonic effect including Sho-kenchu-to, was considered to increase recently. A case with interstital pneumonia improved with Bukuryo-kyonin-kanzo-to, was introduced and adequate Kampo prescription for this disease was discussed with some previous reports. Hachimi jio-gan increased peak flow rate of asthmatic patients with low respiratory function and the difference of indication to Bakumi-jio-gan-ryo was discussed.
RÉSUMÉ
The historical circumstances about the application of the Japanese Kampo-medicine on the point of clinical view are the following that the original directions of the Chinese medical classics have been strictly adhered in China while the directions of those have been remarkably developed in Japan after the import. Now the Japanese Kampo-medecine are based upon these recent developments as well as the current pharmacological studies. Several clinical casereports are demonstrated who are treated with Daisaiko-to, Hachimijio-gan, and Hochuekki-to.<br>Finally the noteworthy opinions by Sensai Nagayo who laid the foundation of the medical system in modern Japan are quoted from his autobiography. Namely the really valuable new medicine should be established with the combination of both the western medicine and the Kampo-medicine.
RÉSUMÉ
We encountered two cases of diabetes mellitus treated with insulin that improved with the administration of Mashinin-gan and Hachimi-jio-gan for constipation.<br>The first case is an 84-year-old woman who had been treated with 16 units of insulin per day. After receiving Mashinin-gan for constipation, as well as the regular dose of insulin, her blood sugar values declined. Her insulin dose was then reduced, her constipation improved and finally she stopped taking insulin. The second case is a 77-year old man who was also being treated with 16 units of insulin per day. He took Mashinin-gan and Hachimi-jio-gan for constipation, which improved his constipation and allowed him to reduce his insulin from 16 units to 4 units per day.<br>Neither Hachimi-jio-gan nor Mashinin-gan caused any serious adverse effects and seemed to be beneficial for aged diabetic patients in preventing side effects such as hypoglycemia. We conclude that these drugs are useful for the treatment of diabetes mellitus for the aged.
RÉSUMÉ
The therapeutic efficacy of Hachimi jio-gan on pain, weakness, numbness and coldness of the limbs and lower back was investigated in 37 aged patients. After administration for 4 weeks, improvement in the global improvement rating was 55.9%, and improvement in pain, weakness, numbness and coldness were 44.8%, 39.3%, 59.1% and 31.8%, respectively. For the improvement of numbness, more significant improvement was seen in patients 60 years old or greater than in those 59 or less. Such symptoms as hair thinning or hair loss, dimming of the eyes, constipation, pain in the upper limbs, numbness in the lower limbs, coldness of the upper limbs and coldness of the lower limbs showed significant improvement. These results suggest that Hachimi jio-gan is effective in the treatment of pain, weakness, numbness and coldness in aged patients.
RÉSUMÉ
In this paper, the authors report four case studies of patients with chronic asthma who improved with the administration of Hachimijio-gan (in pill form). The patients involved were three women aged 63, 57 and 41, and one man, aged 42.<br>In all of the cases, asthma attacks began in adulthood and occurred perennially. They were classified into three grades of severity: patient 1-mild; patient 2-moderate; patients 3 and 4-severe. The standard indications for usage (Sho) in Kampo medicine were confirmed in all four cases. The asthmatic state of patient 1 improved with administration of Hachimi-jio-gan M (Uchida Wakanyaku Inc.), but produced no response in the other three patients. However, when Hachimi-jio-gan pills that were made by hand using the steamed root of Rehmaniae Radix were administered, improvement was seen in the asthmatic state of the other three patients as well. With improvement in the asthmatic state of all patients involved, attack scores decreased, treatment scores decreased and peak expiratory flow rates in the early morning increased. Patient 3 was able to discontinue use of oral corticosteroid drugs, and patient 4 was able to decrease the dosage.<br>The results suggest that Hachimi-jio-gan improves the respiratory function in patients with chronic asthma, and that the clinical effect was increased when the steamed root of Rehmaniae Radix is used in place of the dry root.
RÉSUMÉ
The authors investigated the clinical effects of Hachimi-jio-gan in the form of handmade pills containing the steamed root of Rehmaniae Radix. There were 11 subjects involved in the study (eight women and three men), with a patient age of 56.7±11.1 (mean±S. D.) years old. All of the subjects suffered from chronic asthma, and their attacks had begun in adulthood. The patients were classified into three grades of severity: mild—one patient; moderate—two patients; and severe—eight patients. Ten of the patients received this medication for eight to twelve weeks, but one patient discontinued administration due to epigastrial discomfort.<br>The clinical efficacy of this agent was judged by changes in asthmatic attacks. Treatment scores in seven patients improved, two were unchanged and one worsened. Of seven patients taking oral steroids in conjunction with the Hachimi-jio-gan, two were able to decrease the dosage and two were able to discontinue the oral steroids, The peak expiratory flow rates in improved patients increased about 20% compared to the preadministration rates.<br>The authors considered that this Kampo formula may act to increase the anti-inflammatory action of corticosteroids or theophylline, because the bronchial dilatory effect was remarkable when it was administered in conjunction with these drugs, but less pronounced when used alone. This study suggest that wider application of this Kampo formula in patients with chronic asthma may improve respiratory function.