Résumé
Typically, Japanese Kampo doctors use formulas classified for treating blood stasis, to treat pain. However,there have been few reported cases where pain was treated with formulas classified for treating qi stagnation. Here, we report a case of right lateral epicondylitis in a 48-year-old woman who was treated with a focus on qi stagnation and with uyakujunkisan. She underwent conservative treatment at an orthopedic clinic for ten months, but her pain was not relieved. Hence, she opted for Kampo treatment. She was in a state of melancholy, felt heaviness throughout her body, and had irregular menstruation. These symptoms were mainly related to qi stagnation, and hence, we chose uyakujunkisan without white silkworm, but with aconite root. One month later, the stiffness in her shoulder improved and the pain was reduced. Magnetic resonance imaging taken 2 months later showed an improvement in the lesion. Nine months later, her menstruation became regular, and 11 months later, the pain had almost completely resolved and she could comfortably perform activities of daily living. Uyakujunkisan is introduced in the classical textbooks, and we interpret uyakujunkisan as a formula that can treat pain with qi stagnation. In Kampo treatment, effective pain treatment involves consideration of not only local blood stasis but also general qi stagnation.
Résumé
Japanese Kampo doctors usually understand amenorrhea as caused by <i>oketsu </i>(blood stasis) and <i>kekkyo </i>(blood insufficiency). In recent years, there have been a few case reports which describe patients treated only with prescriptions for <i>junki </i>function (the treatment of <i>kiutsu </i>or <i>ki </i>stasis). Our case was 37 year-old woman with amenorrhea from osteopathy manipulation a half year previously in London. Her usual menstruation had been normal. She had thoracic and sacral pain, joint click, epigastric pain, lower abdominal pain, hematuria and muscle stiffness but her usual daily living was not affected. No abnormality was noted with laboratory or imaging, or endocrinological tests. From a Kampo examination, she was diagnosed with <i>hiesho </i>(coldness) and kiutsu. We chose uyakujunkisan without white silkworm, with aconite root. Her arthralgia and <i>hiesho </i>improved one month later, and her menstruation re-started three months later. Uyakujunkisan is introduced in the <i>Wazaikyokuho</i>, and we believe this classical textbook indicates that this prescription can be used to treat amenorrhea. <i>Ki </i>abnormality is one of the most important complications of secondary amenorrhea and a prescription with <i>junki </i>function is important treatment option. Thus, in assessment of patients with amenorrhea,we feel it is important to focus on <i>ki </i>abnormality.