RESUMO
In this report, the author describes a case of recurrent ileus (intestinal obstruction) successfully treated with shimbuto. The patient was a 58-year-old man having been undergoing maintenance hemodialysis (HD) for 8 years. He had a history of laparotomy in his childhood. He had been admitted to the hospital frequently for recurrent ileus over the past 2 years. Although he was prescribed pantothenic acid, dinoprost, daikenchuto, and hangeshashinto, these medicines did not work. Eventually, he was transferred to our hospital. On admission, he suffered from abdominal pain and vomiting. Abdominal radiographics showed small intestine gases. Ab dominal CT, PET-CT, gastrointestinal endoscopy, colonoscopy, enteroscopy, and enterography through an ileus tube were performed to examine the cause of obstruction, however, no mass nor volvulus was observed. He recovered from the nausea and pain subsequent to ileus after taking shimbuto. At present, he has been pre scribed shimbuto without any recurrence of ileus for over 10 months. Patients undergoing maintenance HD are generally in a state of chronic water metabolism abnormality (<i>suitai</i>), abnormal defecation, and coldness in the extremities. Thus, the use of shimbuto for ileus might be recommended in patients undergoing HD.
RESUMO
Goreisan, a well-known hydrostasis modulating formula, has been traditionally used against edema, thirst, spontaneous sweating, and oliguria. Patients undergoing maintenance hemodialysis (HD) have a condition of chronic water metabolism abnormality. Acute changes in water metabolism due to HD therapy frequently cause disdialysis syndrome (including muscle cramps), therefore, the prevention and treatment of disdialysis syndrome is of importance. In this study, 20 patients with history of disdialysis syndrome undergoing HD were administered goreisan (5.0 g/day) and its effect was investigated. After 8 weeks of goreisan therapy, diagnostic <i>suitai </i>syndrome criteria (pre-treatment 40.9 ± 8.7, post-treatment 33.2 ± 7.8 points), total 10% NaCl dosages (20 mL/syringe) to treat muscle cramps during HD (pre 2.9 ± 0.6, post 1.9 ± 0.6 syringes/week), serum brain natriuretic peptide (BNP) concentrations after HD (pre 165.4 ± 48.3, post 148.4 ± 39.0 pg/mL), and systolic blood pressures (pre 90.8 ± 15.0, post 100.1 ± 13.5 mmHg) indicted statistical improvement (p < 0.01).These effects were observed not only in patients with no diabetes mellitus (DM), but also in patients with DM.These results indicate the possibility that goreisan is effective for prevention of disdialysis syndrome and muscle cramps in patients under HD.