Drug-induced Cystitis Following Administration of Two Kampo Medicines Containing Scutellariae Radix : A Case Report / 日本東洋医学雑誌

We report a case of drug-induced cystitis caused by the administration of two different Kampo medicines containing Scutellariae radix. The patient was prescribed bofutsushosan for weight gain at the age of 55. She visited her primary care physician approximately one month later for micturition pain and other symptoms, and was prescribed antibacterial agents based on a diagnosis of bacterial cystitis. The patient’s symptoms persisted even after she was treated for one month ; therefore, she was referred to the urology department of a general hospital. All medicines including Kampo medicines were discontinued ; her subjective symptoms and urinary findings improved within 2 weeks. Her symptoms of cystitis flared up after a few days of re-administration of bofutsushosan. Four months later, she developed cystitis-like symptoms again after using nyoshinsan for menopausal symptoms. Based on the aforementioned clinical observations, she was diagnosed with drug-induced cystitis due to bofutsushosan and nyoshinsan administration. The components of these two Kampo medicines and past history of Kampo medicine use were reviewed and Scutellariae radix was considered to be the causative agent. Drug-induced cystitis caused by herbal medicines generally takes a long time to develop, and symptoms resolve within a relatively short period following discontinuation of the causative agent. Several reports in the literature implicate Scutellariae radix as the etiological agent in such cases. We believe that it is necessary to pay close attention to the risk of cystitis in patients receiving long-term Kampo therapy.

Investigation for the Effect of jingizai on Long-term Prognosis and Differences Between Histopathological types in 139 Cases of Ovarian Cancer / 日本東洋医学雑誌

Using the data of 139 ovarian cancer cases at our hospital, we investigated the effect of jingizai on prognosis when it was combined with standard therapy for ovarian cancer and prognosis by histopathological types. Combining jingizai with standard therapy was not effective in cases of stage I-II ovarian cancer, but it was effective in cases of stage III-IV ovarian cancer. Upon examination the effectiveness of jingizai according to histopathological types, we observed some improved prognosis in serous adenocarcinoma and mucinous adenocarcinoma cases ; however, prognosis didn't improve in endometrioid adenocarcinoma and clear cell adenocarcinoma. These results indicate that the effectiveness of combining jingizai with standard therapy may differ depending on histological type of ovarian cancer. When we investigated the difference between the distribution of histopathological types by cancer staging, we frequently found clear cell adenocarcinoma in stage I-II cancer cases. Also, serous adenocarcinoma and poorly differentiated adenocarcinoma had a high frequency among stage III-IV cancer cases. This difference may be the reason that the effectiveness of jingizai is different depending on the advances of each stage. However, no statistical difference was confirmed due to the small number of subjects analyzed. Analysis of larger sample size, which can be collected by performing collaborative studies with other facilities, will be required for more detailed investigation.