Two Cases of Abdominal Distension Successfully Treated with Tokishigyakukagoshuyushokyoto / 日本東洋医学雑誌

Abdominal distension is one of the common symptoms and can cause abdominal pain and anorexia, which may raise adverse effect on general well-being and quality of life. In Western medicine, there are specialized treatments for structural lesions associated with abdominal distension, but functional abdominal distension is often difficult to treat. There have been some reports of Kampo medicine for treatment of abdominal distension, but no case reports on tokishigyakukagoshuyushokyoto. We experienced two cases of abdominal distension successfully treated with tokishigyakukagoshuyushokyoto. Case 1 was 86-year-old woman who developed abdominal distension with frequent belching. Case 2 was 59-year-old man who developed abdominal distension associated with opioid. Regulating qi medicine was not effective for abdominal distension in both cases. Both cases had reversal coldness of the extremities, tympanic sounds of abdomen, coldness of abdomen, and inguinal tenderness and resistance. Therefore, we diagnosed them as tokishigyakukagoshuyushokyoto sho. After administration of tokishigyakukagoshuyushokyoto, in Case 1, the frequency of belching decreased and the appetite increased with the improvement of abdominal distension. In Case 2, increasing the dose of goshuyu in tokishigyakukagoshuyushokyoto relieved abdominal distension. Tokishigyakukagoshuyushokyoto can be effective for abdominal distension with interior cold pattern.

A Case of Intractable Pruritus of External Auditory Canal Successfully Treated with Tokishigyakukagoshuyushokyoto / 日本東洋医学雑誌

Pruritus of external auditory canal is often treated with blood-enriching formulation and heat-clearing formula. Here, we report a case of intractable pruritus of external auditory canal successfully treated with tokishigyakukagoshuyushokyoto, which did not improve with blood-enriching formulation or heat-clearing formula. Our patient was a 52-year-old woman. She had itching in her left ear from the age of 45, and was treated by 5 otolaryngologists, but her symptom did not improve. I treated her with tokiinshi, shofusan, yokukansankachimpihange, unseiin, jumihaidokuto and keishibukuryogankayokuinin, but they had no effect. After reconsideration of sho, she was diagnosed as interior cold pattern, and she had tenderness in groin area. So I treated her with tokishigyakukagoshuyushokyoto, and her itching disappeared. We should consider interior cold pattern as one of the differential diagnoses of pruritus of external auditory canal.