A Case of Severe Knee Osteoarthritis Successfully Treated with Daibofuto / 日本東洋医学雑誌

We report a case in which daibofuto was effective for knee osteoarthritis in the elderly. The case was an 84-year-old woman, who tried various drugs for right knee pain at multiple hospitals, but the effect was insufficient, so she visited the hospital hoping for Kampo treatment. Although no qi deficiency was observed systemically, joint swelling and mild heat sensation were observed locally. Additionally, in plain X-ray findings, severe knee osteoarthritis including joint space narrowing, osteophyte formation, and osteosclerosis was observed. We administered sokeikakketsuto and hachimigan, but no effect was obtained. Since daibofuto was effective to some extent, we changed to a decoction and increased the amount of crude drug, and then sufficient effect was obtained. Daibofuto has an effect on qi deficiency, and it is frequently used for rheumatoid arthritis with mild synovitis. Daibofuto was also effective for knee osteoarthritis in the elderly ; therefore we believe that both diseases have a common pathological condition.

Experience of Kampo Treatment for Chronic Plantar Fasciitis / 日本東洋医学雑誌

We studied five untreated patients with plantar fasciitis, 15 chronic cases treated only with Western medicine (non-Kampo group), and 15 chronic cases treated with Kampo in addition to Western medicine (Kampo group). There was no difference in age and pain VAS at the first visit among the three groups. All the non-treated cases were improved with conventional treatment and the duration of treatment was short. In the case of patients who did not respond well to the initial treatment in our department, Kampo medicine was started from three months after the first visit. Therefore, there were more refractory cases in the Kampo group, with poor pain VAS at the last observation and a long treatment period. Among them, two cased were effective in combination with yokuininto and tsudosan, one case was yokuininto only, and one case was combination of yokuininto, tsudosan and keishibukuryogankayokuinin. Sokeikakketsuto used in three patients was not effective. Thus, chronic planter fasciitis may include physiology of not only wind-dampness, cold, and blood deficiency but also qi stangnation and blood stasis.

Efficacy of Adding Kampo Medicine for Rheumatoid Arthritis / 日本東洋医学雑誌

We added Kampo medicine (Japanese traditional herbal medicine) to disease-­modifying anti-­rheumatic drugs (DMARDs) to treat rheumatoid arthritis (RA) in 41 patients. After 1 year, disease activity assessments showed improvement in the number of tender joints and DAS 28-­CRP, and Boolean remission increased from 3 cases to 6 cases. However, 16 of 41 patients had an insufficient therapeutic effect with Kampo medicine ; therefore, their DMARD treatment was strengthened. Disease activity in the 16 patients with strengthened DMARD therapy (Western group) was compared with that in the 25 patients who did not require strengthened DMARD therapy (Kampo group). The Western group had high disease activity at the beginning of Kampo medicine, and a year later CRP and DAS 28­-CRP improved. In the Kampo group, disease activity was relatively good at the beginning of Kampo medicine, and patient global assessment (PGA) improved. We believe that combination therapy, with DMARDs controlling synovitis and Kampo medicine improving PGA, is an effective way to achieve Boolean remission.