Saikokeishikankyoto was Effective for the Patient who Suffered from Chills and General Fatigue After Taking a COVID-19 Vaccine : A case Report / 日本東洋医学雑誌

A 47-year-old woman with body temperature 35.6 ℃ took the 3rd COVID-19 vaccine shot at our clinic on Day 1. Since she felt chills and suffered from genital bleeding on Day 3, she visited our clinic to take a gynecological examination. Her temperature was 37.1 ℃ at that time. On Day 15, she suffered sustained symptoms of chills and general fatigue, and she went to another internal medicine clinic to take a medical care. However, her condition was unexplained and she was referred to a general hospital. On Day 16, she came to our clinic to confirm results of the gynecological examination. Her symptoms persisted even though the data showed no problems, so we prescribed her saikokeishikankyoto (SAKK) for only 3 days. On Day 19, SAKK dramatically improved her symptoms. On Day 37, her temperature was 36.2 ℃ without any symptoms.

The Role of Kampo Medicines in the Pandemic of Viral Infections : Learning from the Spanish Flu / 日本東洋医学雑誌

Various measures are being undertaken all over the world to control the spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Artificial respirators and extracorporeal membrane oxygenators (ECMO) have been introduced for severely ill patients, and antiviral pharmacotherapy has been attempted. However, in the current situation, it is not feasible to wait for evidence-based effective treatments, and it is imperative to deal with daily situations. It would be very helpful to retrospectively evaluate the doctors who worked during the Spanish flu pandemic without access to medical devices such as ventilators, or drugs including antibacterial and antiviral agents. Based on the fact that Kampo medicine was used to treat patients with the Spanish flu, this article demonstrates the high pathogenicity of the Spanish flu virus, the mechanism of action of antiviral drugs, and clinical evidence. As one of the measures against the COVID-19 pandemic, we propose the role of Kampo medicine, which has relative clinical safety with few side effects, and can be expected to induce antiviral action by autoimmune activation.

<b>Clinical Usefullness of a Database Obtained from the Experience of Physicians Prescribing Herbal Medicines : Report on a </b><b>Questionnaire Regarding Treatment for Chillness of the Limbs</b> / 日本東洋医学雑誌

Aim of the present study was to statistically evaluate the examination rule with use of a questionnaire obtained from physicians regarding treatment for chillness of the limbs, and to prove the clinical usefulness of the database. The database showed that tokishigyakukagoshuyushokyoto was the most frequently used to treat chillness of the limbs, and subsequently keishikajutsubuto, hachimijiogan, and tokishakuyakusan were ranked as drugs with wide use. When physicians determined a kampo formulation suitable for each patient, they used findings specific for the kampo formulation, but not uniform findings obtained from the four traditional examination methods (i.e., inspection, listening and smelling, interviewing, palpitation). There was a statistical difference in the selection mode of drugs among physicians. In a simulation obtained from a questionnaire, there was a positive association between time (time X) to the start of becoming physically warm in the limbs, and time (time Y) to remission (<i>R</i>²= 0.971, <i>P </i>= 0.014). The formula (Y = 4.379 X−0.519), which could predict time Y on the basis of information on time X, was able to accurately monitor the clinical courses of 7 responders to treatment for chillness of the limbs. Taken together, these results strongly suggest that the database constructed in the present study may be useful for evaluation of traditional Kampo medicine, and might allow us to perform more fittingly personalized Kampo medicine in the near future.

<b>Two Cases of Viper Bite Envenomation Treated with Saireito </b> / 日本東洋医学雑誌

Inflammatory swelling after viper bite envenomation has the potential for causing multiple organ dysfunctions. We report 2 cases of viper bite that were successfully treated with saireito. A 79-year-old man suffered viper bite envenomation. Saireito was administered to reduce the swelling of the right lower leg. The patient's symptom was improved without any complications. A 68-year-old man suffered the same condition. The swelling spread over the chest and tako-tsubo-like left ventricular (= apical ballooning cardiomyopathy) dysfunction developed. Saireito was administered to reduce the swelling of the left upper limb. The patient was discharged without any severe complications. Thus, saireito may be useful for the treatment of swelling due to viper bite envenomation.

<b>Treatment of Painful Muscle Cramp Due to Heat Injury Using Shakuyakukanzoto </b> / 日本東洋医学雑誌

We treated 5 patients with painful muscle cramp due to heat injury using Shakuyakukanzoto. According to their severities, 4 patients were classified with 1 st degree and 1 patient with 3rd degree heat injury. Painful muscle cramps in 4 patients with 1st degree were cured through a single dose of Shakuyakukanzoto. On the other hand, painful muscle cramps in 1 patient with 3rd degree was managed for 4 days after administration of Shakuyakukanzoto. No Shakuyakukanzoto complications were observed in any patient, nor contribution to rhabdomyolysis in 3 patients. Shakuyakukanzoto may be useful to prevent acute kidney injury due to rhabdomyolysis by controlling painful muscle cramps in heat injury.

<b>A Case of Repeated Recurrent of Genital Herpes </b><b>Successfully Treated with Hochuekkito </b> / 日本東洋医学雑誌

Continuous suppressive antiviral medication for the treatment of repeated genital herpes is often carried out, but few treatments with Kampo have been reported. Here, we report experience with a case in which the repeated recurrence of genital herpes was treated successfully with hochuekkito.<br>A 34-year-old woman had experienced pregnancy twice and delivered twice. She had also had repeated recurrences of genital herpes from several years earlier, and been treated at a nearby doctor. Her recurring herpes did not resolve, however, and she visited our department. In addition to these recurrences, general fatigue and appetite loss were observed, which were regarded as Qi deficiency, and she was started on hochuekkito 7.5 g/day. The general fatigue disappeared two weeks after the treatment. Herpes recurrences also decreased gradually, and symptoms were no longer observed after medication was stopped less than a year later.<br>In this case, genital herpes recurrences were decreased, while symptoms such as general fatigue and appetite loss were also improved. Here, genital herpes recurrence was regarded as Qi deficiency, which was possible to treat with hochuekkito.

Efficacy of Kakkonkajutsubuto in Patients with Neck, Shoulder, and Upper-extremity Pain / 日本東洋医学雑誌

Kakkonkajutsubuto belongs to the Ephedra herb drug group and has useful properties for stiff shoulders, scapular neuralgia, and rheumatoid arthritis of the upper body. In this study, we assessed the effectiveness of kakkonkajutsubuto in patients with neck, shoulder, and upper-extremity pain from the viewpoint of decrease in a Visual Analog Scale (VAS) and adverse reactions. One hundred and twenty-four patients who had no gastrointestinal disorder, hot flashes, excessive sweating or other select symptoms were treated with kakkonkajutsubuto (5.0-7.5g/day). The VAS was used for the assessment of pain-relieving effect.Eighty-one patients improved dramatically (their pre/post administration VAS ratio was less than 50%), 21 improved (between 51 to 75%), and 22 did not improve (more than 76%). Eighty-two point three percent of patients improved in total. Five patients showed adverse reactions, such as general fatigue, stomachache, and edema, but these were not clinically significant. This study suggests that kakkonkajutsubuto can be used more widely for neck, shoulder, or upper-extremity pain.

Clinical Evaluation of Oxidative Stress after Taking Jidabokuippo / 日本東洋医学雑誌

We measured the level of derivatives of reactive oxygen metabolites (d-ROMs test) and total antioxidant capacity (OXY-adsorbent test) in adult volunteers and assessed whether jidabokuippo affects the oxidative stress regulation system. Twenty subjects received jidabokuippo 7.5 g/day, and the d-ROMs test and the OXY-adsorbent test were carried out 72 hours after taking the study drug. The subjects were also assigned to one of two groups : a Favorable response group (n = 6) or a Non-favorable response group (n = 14). The Favorable response group had improvement of such signs and symptoms as stiff shoulders, constipation, and bruises.No significant difference was observed in the d-ROMs test.However, the OXY-adsorbent test at 72 h was significantly lower than that at the pre-administration (p = 0.0290). No significant differences were observed in either the d-ROMs test or the OXY-adsorbent test in the favorable response group. On the other hand, the d-ROMs test and the OXY-adsorbent test at 72 h were significantly lower than those at pre-administration in the non-favorable response group (p = 0.0279, p = 0.0413, respectively). These results indicate that jidabokuippo affects the oxidative stress regulation system in human.

Clinical Evaluation of Oxidative Stress after Taking Jidabokuippo / 日本東洋医学雑誌

We measured the level of derivatives of reactive oxygen metabolites (d-ROMs test) and total antioxidant capacity (OXY-adsorbent test) in adult volunteers and assessed whether jidabokuippo affects the oxidative stress regulation system. Twenty subjects received jidabokuippo 7.5 g/day, and the d-ROMs test and the OXY-adsorbent test were carried out 72 hours after taking the study drug. The subjects were also assigned to one of two groups : a Favorable response group (n = 6) or a Non-favorable response group (n = 14). The Favorable response group had improvement of such signs and symptoms as stiff shoulders, constipation, and bruises. No significant difference was observed in the d-ROMs test. However, the OXY-adsorbent test at 72 h was significantly lower than that at the pre-administration (p = 0.0290). No significant differences were observed in either the d-ROMs test or the OXY-adsorbent test in the favorable response group. On the other hand, the d-ROMs test and the OXY-adsorbent test at 72 h were significantly lower than those at pre-administration in the non-favorable response group (p = 0.0279, p = 0.0413, respectively). These results indicate that jidabokuippo affects the oxidative stress regulation system in human.

Clinical Evaluation of Oxidative Stress after Taking Powdered Processed Aconiti Tuber / 日本東洋医学雑誌

‘Processed bushi powder for ethical dispensing’, or TJ-3022, is an Aconiti tuber (PAT) herbal drug, and TJ-3023 is newly-developed to contain a higher proportion of diester aconitine alkaloid. We measured reactive oxygen metabolite derivative levels (d-ROMs tests), and total antioxidant capacity (OXY-adsorbent tests) in healthy adult volunteers, to assess whether PAT affects the oxidative stress regulation system. Thirty-four subjects were assigned to one of two groups: a TJ-3022 group and a TJ-3023 group. No significant chronological differences were observed in the TJ-3022 group. No significant chronological differences were observed in the TJ-3023 group, either. These results indicate that PAT dose not affect the oxidative stress regulation system in humans.

A Case of Tetanus Treated with Propofol and Shakuyakukanzoto / 日本東洋医学雑誌

Shakuyakukanzoto is effective for pain primarily related to muscle contractions and the powder works rapidly after oral intake. We successfully treated a patient who presented with spastic convulsions by using shakuyakukanzoto. A 32-year-old man had injury to his left hand from a dog bite, resulting in tetanus. Intravenous propofol was chosen as a sedative at first. On day1, shakuyakukanzoto was also administered to control his spastic convulsions. It was effective in reducing his propofol dose and improving various symptoms such as priapism, abdominal pain, tremor, and insomnia. The patient was discharged from our hospital on day 14. This is the first report we know of tetanus treated with shakuyakukanzoto. And we believe that shakuyakukanzoto may be useful for the control of muscle spasms and the management of dysautonomia caused by generalized tetanus.

Efficacy of Aconite Tuber Powder in Patients with Arthralgia and Somatic Pain / 日本東洋医学雑誌

Heat-treated and detoxified Aconite tuber has many useful properties such as analgesic, diuretic, and cardiotonic effects. Two hundred forty-seven patients were treated with Aconite Tuber powder (1.5 - 8.0g/day) added to Kampo extract granules. The Visual Analog Scale (VAS) was used for the assessment of its pain-relieving effect. One hundred two patients improved dramatically (the pre/post administration VAS ratio was less than 50%), 84 improved (between 51 to 75%), and61did not improved (more than 76%). Three patients(1.2%) showed adverse reactions, such as tongue numbness, squeezing sensation of the bladder, anasarca. These reactions were not serious. This study suggests that Aconite tuber powder can be used more widely, especially for arthralgia and somatic pain with coldness in elderly patients.

Clinical Evaluation of the Finger Tissue Blood Volume during Shuchi-Bushi Powder Administration / 日本東洋医学雑誌

In order to evaluate the effect of shuchi-bushi, a powder form of the aconite tuber, we examined changes in finger temperature (FT) and tissue blood flow (TBF). No significant differences were observed in FT between pre-administration and 90 min post-administration, however, FT at 72 min was significantly higher than that at the pre-administration (p=0.0736and p=0.0219, respectively). The FT at 72 h was also significantly higher than that at 90 min (p=0.0253). No significant differences were observed in TBF between pre-administration and 90 min, nor between the 90 min and 72 h. However, the TBF at 72 h was significantly higher than that at pre-administration (p=0.0219). A significant correlation was observed between the FT and TBF (p=0.0052). Our results suggest that shuchi-bushi may play a role in warming and increasing tissue blood flow in human.

Three Cases of Acute Abdomen Treated with Daikenchuto in Emergency Room / 日本東洋医学雑誌

Daikenchuto has been attracting nationwide attention in recent years, with its therapeutic efficacy on posto-perative complaints and complications. We treated three patients with acute abdomen using daikenchuto. They suffered from severe abdominal pains and abdominal radiographs showed small intestine gases. All three recovered from their pains or nausea after taking daikenchuto, and were discharged home without hospital admission. The use of daikenchuto against acute abdomen is recommended in emergency medicine.

Two Cases of Severe Burn with MRSA Infections Successfully Treated with Juzentaihoto / 日本東洋医学雑誌

Systemic infection by MRSA (Methicillin-resistant Staphylococcus aureus) is a risk in immunodeficient patients such as those with severe burn injuries. Hozai, formulations with tonic effects, may enhance the immune system and we treated two severe burn patients with MRSA infections using Juzentaihoto, which is a remedy for kikyo (deficiency of vital energy) and kekkyo (ketsu deficiency). Both patients suffered flame burns [85% body surface area (BSA) and 40% BSA] and inhalation injuries committing self-immolation. They contracted MRSA in due course and antibiotics such as Arbekacin or Teicoplanin did not control MRSA. Therefore, Juzentaihoto was administered through a nasogastric tube and both of them were finally cured without complications. Juzentaihoto may be useful against fatigue, anemia, malaise, ulcer, and purulent wounds due to severe burns.