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Ménière’s Disease is an unexplained inner ear lymphedema disease. We report a case of atypical Ménière’s Disease with frequent urination in which choreitogoshimotsuto (CRTST) was effective. A 47-year-old woman had repeated bilateral tinnitus and hearing loss for the past 3 years, and was diagnosed with an atypical case of Ménière’s Disease at a local otolaryngologist. She continued oral administration of isosorbide, but repeated exacerbations and remissions. Given the pathology of fluid retention, blood deficiency, static blood, and yin deficiency, we prescribed her CRTST referring to the symptom of frequent urination. The symptoms of frequent urination and tinnitus subsequently improved and CRTST was naturally discontinued after 1 year and 3 months. CRTST has the effects of fluid regulation, heat clearance, nourishment of yin, tonifying blood, and resolving blood stasis. Goreisan and Saireito are generally used for Ménière’s Disease because inner ear lymphedema is regarded as fluid retention. This case shows that CRTST can be an effective option for treatment of Ménière’s Disease caused by pathological conditions such as fluid retention, blood deficiency, static blood, and yin deficiency.
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We have experienced a case of response to keishikajutsubuto for stump pain after both femoral amputations. There are few reports on the use of Kampo medicines for stump pain after amputation. In this case, the critical lower-limb ischemia that led to the amputation was due to severe stenosis and occlusion caused by arteriosclerosis in both limbs. From the perspective of Kampo medicine, ischemia is considered to have cold and blood status as a result of deficiency and stagnation of yang qi due to circulatory failure. In this case, we regarded blood stasis as a secondary product of ischemia, and we mainly considered a prescription to remove cold and bring yang qi to the eliminative organs, which was effective for the pain. For stump pain after amputation that is poorly responded to general analgesics, the combination of keishikajutsubuto is expected to provide rapid analgesic effect, suggesting that it is useful for pain control.
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We report a case of 2X-year-old man with G4 chronic kidney disease (CKD G4). He had a decline in estimated glomerular filtration rate (eGFR) after the initiation of BEP (cisplatin, etoposide, bleomycin) therapy followed by VelP (ifosfamide, cisplatin, vinblastine) therapy for mixed germ cell testicular tumor. The patient’s eGFR did not recover during 59 months after chemotherapy, but showed a tendency to improve after treatment with yojinkodakuto. Yojinkodakuto was prepared by the IPCD (immersing powdered crude drugs) method. The IPCD method was adopted to ensure convenience and good quality prescription herbal medicines. Although eGFR fluctuated after yojinkodakuto treatment, at 3 years, serum creatinine (sCr) and eGFR progressed well, with sCr reducing from 3.98 mg/dL at initiation to 2.6 mg/dL and eGFR increasing from 16 mL/min/1.73 m2 to 25.4 mL/min/1.73 m2. In addition, a long-term eGFR plot analysis confirmed the 3-year improvement trend.
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Usually, chronic pain is difficult to treat because this is often accompanied by none-organic factors such as psychiatric symptoms, which complicate the pathological condition. For this reason, the guidelines also call for coping with peripheral symptoms except pain. This time, we report that facial pain as well as peripheral symptoms such as mental anxiety gradually improved by a combination of decoction extract and acupuncture and moxibustion. The case was a man in his 60s, who received all kinds of treatments such as taking Western medicines and blocking trigger points for chronic facial pain of unknown cause with mental anxiety. However, even after one year the side effects were strong and the treatment was ineffective. Acupuncturists and Kampo specialists made the diagnosis and treatment based on a common concept of Kampo medicine. Treatment focused on shin abnormalities and oketsu suppressed the vicious cycle of pain and improved psychiatric symptoms and QOL. It was suggested that Kampo medicine based on the idea “the same in mind and body” is effective for chronic pain in which various symptoms are intricately intertwined.
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At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program, “Pre-graduation and post-graduation Kampo medical education for the next generation,” focusing on Kampo medical education. We summarize and report a mock lecture on standard Kampo medicine conducted jointly with the Japan Council for Kampo Medical Education (JCKME) for the purpose of faculty development. The lecture contents were based on the “Basic Curriculum for Pre-Graduate Education in Kampo Medicine 2016” established by the JCKME, and the common model slides prepared by the JCKME were used. The lectures were pre-recorded for 240 minutes on the “History of Kampo medicine,” “basic theory of Kampo medicine,” “physical examination of Kampo medicine,” “composition and effects of typical Kampo medicines, effects and side effects of typical herbal medicines,” “usefulness of Kampo and clinical cases that were effective,” and “overview of acupuncture and moxibustion treatment,” and were delivered from seven days before to seven days after the annual meeting. This was the first nationwide educational activity for the general meeting of the society. These lectures were viewed 1,017 times nationwide, by medical students, educators, and members of the society.
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The patients with foreign body sensation in the throat often visit the hospital. However, they have no problem in Western medicine and may be prescribed with anxiolytics. In Kampo medicine, hangekobokuto is effective in most cases for the symptom of qi stagnation. This time, we report that 2 cases, in which hangekobokuto was ineffective, responded to the combination of ryokeijutsukanto and goshuyuto. The combination, which is a mixture of hontonto (Zhouhou fang), bukuryo, jutsu, and taiso, excluding hange, was effective in these 2 cases as running piglet.
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The Japan Society for Oriental Medicine has established various committees, which are working every day to disseminate Japanese traditional herbal medicine (Kampo) and support the activities of academic members. As the members of the International Committee and the medical doctors who conduct research and clinical practice of Kampo at the university hospital, the authors participated in the 14th International Congress on Complementary Medicine Research held in Australia in May 2019. To improve the international recognition and international dissemination of Japanese Kampo, we held the Japanese Kampo Symposium on gastrointestinal diseases successfully. While it was realized that there was an international big interest in Japanese Kampo, it seemed that Kampo researchers in Japan lack the ability to dispatch of information at international conferences compared to neighboring countries such as Korea and China.
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Keishibukuryogankayokuinin (KBGY) is a Kampo formulation that is well known as being suitable for patients with blood and water stagnation. In this study, we retrospectively investigated the efficacy of KBGY for tinnitus patients. The total number of patients was 9 (5 males, 4 females). The average age was 67 years (range : 54-81 years, the median age : 65 years). The progression of 9 patients was cure (1), amelioration (6), no change (2), and deterioration (0). The important pathophysiology of tinnitus in Kampo medicine includes blood stagnation and water stagnation. In these cases, KBGY can single-handedly improve both blood and water stagnation. We recommend KBGY for the treatment of tinnitus caused by the coexistence of blood and water stagnation.
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Night owl is one of the painful symptoms for cancer patients. Patients with advanced cancer, who tend to bed on bed rest, often sleep during the day and are awake at night, especially. Night owl may make worse the QOL of patients. We controlled night owl and cancer pain of a patient with advanced cancer by treatment with Kampo, Japanese herbal medicine. The case was a 53-year-old female patient with metastatic head and neck cancer. She tended to be a night owl. So, we administered maobushisaishinto and keishikaryukotsuboreito to her, because we regarded her as qi obstruction. During the night, she was able to sleep successfully. After that, administration of hainosankyuto and bukuryoingohangekobokuto reduced the use of rescue medication. Moreover, Kampo was useful for pain control.
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<p>Patients with the best supportive care often get worse and worse, and it is very difficult to improve their symptoms. As cancer is currently a leading cause of death in Japan, and adequate control of the cancer-associated pain is important to improve the quality of life (QOL) in cancer patients. Pain caused by bone metastasis is particularly difficult to control, and the strong analgesic medication which it requires is generally difficult to control. Such metastases result in reduced mobility and markedly reduced activities of daily living (ADL) and the QOL of patients. Our patient was a 67-year-old man who had been treated for metastasis from the left kidney to cancer of the right pelvic bone ; palliative chemotherapy and mild treatment were provided for his sharp pain, but control of his sharp pain was insufficient. Here we expand on our experience in a patient with bone metastasis caused by renal cell carcinoma successfully treated with Kampo medicine, using acupuncture and decoction extract.</p>
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Jiinshihoto, a Kampo formulation described in the textbook, <i>Wanbinhuichun</i>, is well known as a suitable formulation for patients troubled by chronic cough with qi obstruction. The components of jiinshihoto have several effects including nourishing yin, clearing empty heat, replenishing qi, and improving digestive function. We report three cases with glossodynia and abnormal sensation in the throat which were treated successfully with jiinshihoto. We therefore recommend jiinshihoto for the treatment of glossodynia and abnormal sensation in the throat associated with signs of yin deficiency including thirst, dry mouth, and viscous sputum,and signs of qi obstruction such as a tympanic sound on the right side of the abdomen.
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The International Research Congress on Integrative Medicine and Health (IRCIMH) 2014 was held from May 13th to 16th at Hyatt Regency in Miami, USA. The theme of the convention was "Strengthening Research in Integrative Healthcare Around the World'';IRCIMH's mission is to foster the development of new collaborations and to strengthen existing partnership.<BR>There were 5 oral and 22 poster presentations in the field of acupuncture. Especially in North America, acupuncture plays an important role in integrative medicine and several large scale of randomized controlled studies are reported. We have to be proactive and to give more and more information about Kampo.
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Despite the development of radiotherapy machines and technologies, a proportion of patients suffer from radiation-induced enteritis or oral mucositis. It has been reported that hangeshashinto has been used for not only enteritis but also oral mucositis. This study reports the effect of hangeshashinto on enteritis or oral mucositis caused by radiotherapy. Three patients with enteritis and 5 patients with oral mucositis were treated with hangeshashinto at a dose of 7.5 g/day. The severity of enteritis or oral mucositis was evaluated using the Common Terminology Criteria for Adverse Events version 4 and Numerical Rating Scale both before and after hangeshashinto treatment. After the treatment with hangeshashinto, 3 of 5 patients with oral mucositis and 2 of 3 patients with enteritis showed apparent improvement. In conclusion, it is important to control the side effects of radiotherapy, which lead to improved tumor control rates. Prospective randomized studies are necessary to confirm the findings of this case series study.
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In Kampo medicine, a tongue examination, whereby the shape and color of the tongue is observed, is thought to reveal the constitution and condition of the patient. In Japan, numerous books on this tongue examination have been published. However, tongue findings are expressed differently in these books, and a standard description for such findings has yet to be established. A standard description would be useful when examining the tongue, and when educating students of Kampo medicine. We therefore compared how tongue colors and shapes were expressed in the Japanese literature on tongue examinations (12 publications).<br>Using these results, we have arrived at a standardized description for tongue findings in accordance with Kampo specialists of tongue diagnoses at many facilities. In the process, we focused on easily recognizable findings that can be noted with short clinical examination times, and that can also be understood by beginners.
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We investigated the relationship between daily physical activity level and response inhibition control aspect of cognitive function in older adults using event-related potentials. Twenty-eight Japanese older adults (70.6 ± 3.8 years) participated in the present study. Daily physical activity (PA) was measured using an accelerometer, including step count and the intensity of PA. Participants were divided on the basis of their step count into “Higher PA group” (more than 10,000 steps/day, n = 14) and “Lower PA group”(less than 10,000 steps/day, n = 14). Cognitive function was evaluated by performance, NoGo-N2, and NoGo-P3 while they performed a Go/NoGo task. The results indicated that the Higher PA group exhibited shorter reaction time on Go trials, relative to the Lower PA group. NoGo-P3 amplitude was larger in the Higher PA group compared to the Lower PA group, but NoGo-P3 latency did not differ between groups. PA was positively correlated with NoGo-P3 amplitude. NoGo-N2 component was not related to PA. Thus, PA was more sensitive to monitoring of the outcome of response inhibition rather than pre-motor inhibition in Go/NoGo task. These findings suggest that daily PA is associated with preservation of age-related declines in response inhibition control.
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In the Guideline for treatment of chronic headache published by Japanese Headache Society, Ibuprofen and Acetaminophen are proposed for the acute treatment of migraine in children. But prophylactic treatment of pediatric migraine is not established. We report the efficacy of Kampo medicine for preventing migraine in children and childhood periodic syndromes. We use a variety of Kampo medicine for 9 pediatric migraine and periodic syndromes patients from 8 to 15 years old. All 9 patients improve their headache and associated symptoms including abdominal pain, vertigo, nausea and vomiting. After treatment the mean average of Headache Impact Test-6 (HIT-6) improve from 63.66 points to 45.77 points. Kampo medicines is effective for migraine in children and childhood periodic syndromes.
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We experienced a case of post-operative complication and chronic pain due to left pyeloplasty and uterine myomectomy successfully treated with Kampo medicine. A 55-year-old woman underwent pyeloplasty for ureteropelvic junction obstruction, and ureteral stent for ureteral stenosis caused by synechia after uterine myomectomy. She suffered from post-operative complication and chronic pain, which was becoming severe, and had a depressed mood. She visited our outpatient clinic for Kampo therapy. We prescribed bukuryoingohangekobokuto on the diagnoses such as qi deficiency, qi stagnation, and water retention. Her symptoms disappeared with this formulation. This case suggests the importance of considering qi disturbance when we treat patients with chronic pain using Kampo medicine.
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It is essential to prolong the term as possible in the treatment of threatened premature delivery. We report a case of threatened abortion successfully treated with hochuekkito. The patient was 31 year-old pregnant woman with lower abdominal pain. She was diagnosed to be at the risk of premature delivery on 21 weeks and 5 days of gestation. Intravenous ritodrine hydrochloride was started and she had to stay in bed. Severe side effects of ritodrine hydrochloride such as palpitation, tachycardia, tremor, nausea, and loss of appetite were appeared and she was consulted to our department on 23 weeks and 1 day of gestation. Those symptoms were markedly improved after administration of hochuekkito extract. She delivered a male infant of 1230g birth weight on 28 weeks of gestation. Hochuekkito suppressed severe side effects, and enabled to continue the infusion of ritodrine hydrochloride, suggesting the usefulness of Kampo therapy in the treatment of threatened premature delivery.
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Boiogito is mentioned in Synopsis of the Golden Chamber, in which it is written to add ephedra herb for patients with cough at the end of the chapter. We experienced 4 chronic cough cases of wind-wetness syndrome or edema caused by pathogenic Wind successfully treated with boiogitokamao. Subjective symptoms such as heaviness when moving, heavy sweating, and body chills, as well as objective findings such as pallor, and a weak pulse in the most distal region of the right wrist were common in these patients. Moreover, not only cough, but also accompanying symptoms such as obesity, dysmenorrhea, and eczema were improved. Observation of these four cases suggests that boiogitokamao can be effective for the treatment of the patients with chronic cough due to wind-wetness syndrome / edema caused by the pathogenic Wind.
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We report six cases with honton disease successfully treated with a combination of goshuyuto extract and ryokeijutsukanto extract. Five of the cases were diagnosed as panic disorder, and the remaining case as generalized anxiety disorder. All six cases complained of palpitation, nausea, dizziness, headache and anxiety attacks. We diagnosed them as a hontonto (Zhouhou fang) indication. Their various complaints disappeared after combination therapy with those extracts. Furthermore, efficacy of the combination therapy was proven to be equal to hontonto. These cases suggest that the combination therapy with goshuyuto extract and ryokeijutsukanto extract is useful in place of hontonto.