RESUMO
For many patients with trigeminal neuralgia, oral administration of carbamazepine is highly effective. Micro decompression surgery (Jannetta's operation) is also considered a fundamental treatment. However, there are patients who do not respond to carbamazepine and who hesitate to have surgery. Here, we report 14 cases whose pain was relieved solely by Kampo (7 cases) or by a combination of Kampo and carbamazepine (7 cases). The Kampo formulations used were Goshuyu-to (2 cases), Gorei-san (9 cases), Saiko-keishi-to (1 case), Toki-shigyaku-ka-goshuyu-shokyo-to (1 case) or Mao-bushi-saishin-to (1 case), depending on the “Zheng” of each patient. In trigeminal neuralgia, the nerve root is compressed or adhered to surrounding vessels, such as the superior cerebellar artery. It is highly possible that localized edema at the point of compression is responsible for the pain. The diuretic action of the Kampo may diminish the localized edema around the trigeminal nerve root.
RESUMO
A total of 20 chronic headache cases in which other Kampo medicines were ineffective or hardly effective were treated with Kumi-binro-to extract, and the effect of this medicine was investigated.<br>At the start of administration, we investigated the following items: any deficiency or excess, presence or absence of stagnation of vital energy (facial erythema, ophthalmologic injection, bitter taste in the mouth, etc.) and disease caused by contaminated water (tendency of edema, sound of fluctuating liquid in the region of the stomach, decreased urine volume) as well as the presence or absence of grasping pain (pressure pain) in the gastrocnemius muscle which is a characteristic symptom as a target of this drug. The efficacy of Kumi-binro-to was assessed by a pain score after weeks from the start of administration.<br>Kumi-binro-to was markedly effective in 5 cases, effective in 11 cases and ineffective in 4 cases, indicating that the ratio of markedly effective and effective cases accounted for 80% of the patients treated. There was no adverse reaction. When the characteristics of 16 cases assessed as markedly effective or effective were investigated, disease caused by contaminated water and stagnation of vital energy was observed in 13 and 14 of the 16 cases respectively. The grasping pain in the gastrocnemius muscle that is a characteristic target of this drug was noted in only one case.<br>The above result suggests that Kumi-binro-to promotes diuresis to eliminate wetness-evil and regulates vital energy, and is effective against chronic headache, especially when the disease caused by contaminated water is accompanied with stagnation of vital energy.
RESUMO
We have recently seen an increasing number of patients with osteoporosis of the type that occurs as a chronic illness in the elderly, and particularly in elderly female patients. It is important not only to treat pain but to follow-up with treatments to prevent further bone mass loss. To measure bone mass in patients with osteoporosis, we employed Digital Imaging Processing (DIP). In this study, the authors examined changes in the bone mass of patients in long-term therapy with Keishi-ka-Jutsubu-to and Gosha-Jinki-Gan. As a comparative-control group, or non-treatment group, we selected 11 patients who had been diagnosed as having osteporosis in an outpatient clinic, and whose bone mass had been measured with DIP. These patients discontinued treatment, but returned to the outpatient clinic six months to one year later. The average duration of non-treatment in the control group was 9.8 months. Metacarpal index (MCI) and metacarpal bone mineral density (m-BMD) at the first visit were 0.40±0.07 and 2.22±0.38, but 10 months later they were 0.36±0.05 and 1.97±0.38, which represents a significant decrease.<br>In 20 cases given Keishi-ka-Jutsubu-to, the initial bone mass data were: MCI, 0.39±0.08; m-BMD, 2.07±0.32. Measurements performed after three, six, and nine months of treatment showed no difference or increase from the initial values.<br>In 12 cases given Gosha-Jinki-Gan, the initial data were: MCI, 0.40±0.07; m-BMD, 2.06±0.27. Measurements performed after three, six and nine months of treatment showed no difference from the initial values.<br>The severity of pain was equally reduced by treatment with Kampo formulation or NSAIDs (non-steroidal anti-inflammatory drugs) by four weeks, but after eight weeks low back pain in patients treated with the Kampo formulation was significantly reduced compared with low back pain in the group treated with NSAIDs.