Two Cases of Hair Loss Due to Long COVID Treated with Ninjin'yoeito / 日本東洋医学雑誌

Two cases of hair loss due to coronavirus disease 2019 (COVID-19) sequelae as known as Long COVID were successfully treated with ninjin’yoeito. Case 1 was a 45-year-old woman who complained of hair loss about 2 months after COVID-19 (moderate II in Japanese criteria). Case 2 was a 50-year-old woman who complained of hair loss about 2 months after COVID-19 (mild). In all cases, hair loss stopped next month after treatment with ninjin’yoeito. And their hair began to grow 2 months later administration, the depression caused by hair loss improved as the symptoms improved. Hair loss is one of the symptoms with blood [TM1] deficiency, and patients suffering from Long COVID are also with qi deficiency. We gave ninjinʼyoeito for pattern of both qi and blood [TM1] deficiency with reference to traditional key of treatment, and it contributed to the improvement of symptoms.

A Case of Brain Edema Caused by Radiation Necrosis After Stereotactic Radiosurgery Treated with Saireito / 日本東洋医学雑誌

A 60-year-old female patient was treated with gamma knife on the left frontal lobe metastatic brain tumor. After 3 months, the tumor and peri-focal edema turned worse due to radiation necrosis. Despite increasing doses of steroid administration, the deterioration lasted for 6 months. The symptoms and brain edema did not improve for over a year, but we decided to observe the patient without bevacizumab. We performed Methionine-PET to diagnose radiation necrosis of the brain, and confirmed absence of hot spots. The steroid therapy continued and added saireito 9 g/day, because we thought brain edema was concerned with fluid retention. After 9 months, head MRI showed improvements of the brain edema. Saireito may help improve brain edema due to radiation necrosis.

<b>Two Cases of Persistent Hiccups with a Previous History of Cerebral Hemorrhage, Successfully Treated with Hangekobokuto Extract</b> / 日本東洋医学雑誌

We report our experience with two patients who had a previous history of cerebral hemorrhage and presented with persistent hiccups. Hangekobokuto was found to be effective in these patients. Case 1 was a 49-year-old man with a history of cerebral hemorrhage who experienced persistent hiccups as a result of pulmonary aspiration that occurred while he was admitted to the hospital for heat stroke. Abdominal palpation revealed epigastric resistance and tenderness. Metoclopramide and shakuyakukanzoto were administered without any amelioration of the symptoms, but the symptoms disappeared 1 hr after changing the drug regimen to hangekobokuto. Case 2 was a 64-year-old man who experienced persistent hiccups 28 days after suffering a cerebral hemorrhage. Abdominal palpation revealed epigastric resistance and tenderness and a lack of resistance at the lower abdomen. Because a regimen of metoclopramide and shakuyakukanzoto was similarly ineffective, we changed the drug regimen to hangekobokuto, and the symptoms subsequently disappeared 7 hr after administration. The symptoms did not recur in either patient following treatment. Hangekobokuto can be effective in cases of persistent hiccups is worth considering as a treatment option.

<b>Three Stroke Cases with Gastric Reflux during Nasogastric Tube Feeding Successfully Treated with Rikkunshito Extract</b> / 日本東洋医学雑誌

We report three cases of stroke in which rikkunshito was administered to improve the reflux of gastric fluid from a nasogastric tube in a short time.<br>Case 1 : a 63-year old female with right cerebellar hemorrhage who underwent surgical evacuation. Reflux of up to 650 ml gastric fluid from a nasogastric tube was observed after surgery. By the 4 th day of rikkunshito administration, the reflux decreased to 10 ml.<br>Case 2 : a 44-year old male whose consciousness had deteriorated before surgical treatment because of subarachnoid hemorrhage and re-rupture. Endovascular embolization and bilateral external ventricular drainage were performed for the anterior communicating artery aneurysm. Several days later, rikkunshito administration was initiated because of a reflux of 550 ml gastric fluid from the nasogastric tube. By the 3 rd day of rikkunshito administration, almost no episodes of reflux during tube feeding were observed.<br>Case 3 : a 72-year old male who suffered from intratumoral hemorrhage after undergoing surgery for metastatic brain tumor. The intratumoral hemorrhage was treated conservatively. Reflux of 200 ml gastric fluid from the nasogastric tube was observed. By the 3 rd day of rikkunshito administration, the reflux decreased to 10 ml.<br>These findings suggest that rikkunshito is useful in stroke cases with considerable reflux from a nasogastric tube.