Keishikashakuyakuto Ameliorated Diverse Autonomic Symptoms such as Diarrhea, Abdominal Pain,Urinary Retention and Orthostatic Hypotension in a Case of Pure Autonomic Failure / 日本東洋医学雑誌

Pure autonomic failure (PAF) is a degenerative disorder with diverse autonomic nervous symptoms, but without somatic nervous symptoms. We encountered a patient with PAF who was successfully treated with keishikashakuyakuto. A 61-year-old man complained of diarrhea, abdominal pain, dysuria and orthostatic hypotension. PAF was strongly suspected, based on a low level of plasma noradrenalin at rest and a finding of severe diffuse sympathetic nerve injury on <SUP>123</SUP>I MIBG myocardial scintigraphy. Various Kampo formulas were not effective, or could not be administered continually. Urinary retention was treated with self-catheterization. After the extract of keishikashakuyakuto was administered, his complaints of diarrhea and abdominal pain gradually decreased, and he was able to eat various kinds of food. His daily living activities improved.Moreover, he could urinate by himself, so the self-catheterization was stopped. Five years later, the diagnosis of PAF was clinically confirmed, but his daily living activities did not deteriorate. This suggests that keishikashakuyakuto can be effective for diseases with diverse autonomic nervous symptoms, such as the present case.

Application of Keishikaryojutsubuto for Extraarticular Symptoms / 日本東洋医学雑誌

It is assumed that keishikaryojutsubuto was first described in the Ho-ki medical text, and it has been used to target neuralgia and the arthritic pain. We experienced cases of Crohn's disease, endometriosis, post-operative rectal carcinoma, acute gastroenteritis and Meniere's disease successfully treated with keishikaryojutsubuto. When this formulation is administered, it might be important to keep in mind the definition of prescriptions for keishikashakuyakuto and shimbuto, or ryokeijutsukanto, as described in the Kokan-igaku text. In addition, this formulation might be applicable to various other diseases.

Medical Treatment of Trigeminal Neuralgia with the Combination of Sho-saiko-to and Keishi-ka-shakuyaku-to / 日本東洋医学雑誌

Extract preparations of Shosaiko-to and Keishi-ka-shakuyaku-to were simultaneously prescribed to 34 patients with trigeminal neuralgia. The efficacy of these kampo formulas on painful paroxysms was evaluated two weeks after commencement of formula administration.<br>In 11 out of 19 patients who were also taking carbamazepine (CBZ), dosage reduction or elimination of CBZ administration became possible; from the changes seen in the symptoms, Kampo treatment was thought to be effective in 14 of these cases. Of the 11 cases receiving Kampo alone, reduction in pain or elimination of pain was seen in 8 cases.<br>Excluding 4 cases where effectiveness could not be evaluated, the overall efficacy rate for Shosaiko-to/Keishi-ka-shakuyaku-to was determined to be 73% (22/30 cases).<br>Many basic and clinical studies have verified that Shosaiko-to-go-Keishi-ka-shakuyaku-to acts as an anticonvulsant. There are several common pharmacological characteristics between CBZ, the standard treatment for trigeminal neuralgia, and Shosaiko-to-go-Keishi-ka-shakuyaku-to. The formulas Shosaiko-to and Keishi-ka-shakuyaku-to used by themselves or in combination with CBZ were therefore thought to be a safe and effective option for the treatment of trigeminal neuralgia.