Successful Treatment of Cardiogenic Shock and Massive Pleural Effusion with Kampo Extract : A Case Report In Critical Care Medicine / 日本東洋医学雑誌

Kampo as the main treatment method in intensive care has been rarely reported. The patient is a 25-year-old man presented with diarrhea and hypotension. Before the current admission, he developed brainstem death after allogeneic bone marrow transplantation for aplastic anemia at age 13, and underwent cystostomy and received mechanical ventilation, gastrostomy nutrition, and in-home medical care. He developed cardiogenic shock with anuria and pleural effusion, due to Pseudomonas aeruginosa urosepsis and was treated with infusion/transfusion and enteral medicine with his family's consent. Tongue was pale and enlarged, with thin white fur. The radial artery was not palpable. The carotid artery pulse was relaxed, large, and faint. He had good abdominal strength, subcutaneous edema, and massive ascites. These indicated yang collapse pattern. Chest X-ray revealed a massive pleural effusion. Shimbuto and goshajinkigan Kampo extract supplemented with powdered cinnamon bark (Cinnamomum cassia Blume) was administered for the cardiogenic shock. Ogikenchuto extract combined with furosemide and goreisan extract was administered to treat the pleural effusion. Shimbuto, goshajinkigan, and powdered cinnamon bark improved the heart rate and blood pressure. The pleural effusion remained after furosemide and goreisan treatment, however, the addition of ogikenchuto induced significant diuresis, and the pleural effusion consequently decreased. This case suggests the potential of Kampo, even in critical illness where modern medicine is generally prioritized. The pleural effusion decreased after adding astragalus root-containing extract, emphasizing the role of tonifying qi for draining fluid.

Modified Hoyokangoto Added with Ogikenchuto Improved Multiple Complaints in a Patient with Electromagnetic Hypersensitivity and Multiple Chemical Sensitivity / 日本東洋医学雑誌

Objective : To examine how to treat patients suffering from electromagnetic hypersensitivity (EHS) combined with multiple chemical sensitivities (MCS) with herbal medicines. Methods : The patient was diagnosed as having blood stagnation (血瘀), yang deficiency (陽虚) and spleen qi deficiency (脾気虚) based on the traditional Chinese medicine (TCM) theory. Hoyokangoto which had been applied to patients with hemiplegia for a long time in China, was prescribed with cinnamon and processed aconite root. For her persistent diarrhea, ogikenchuto was administered. Results : Headache, sense of exhaustion, insomnia, and various symptoms debasing her quality of life (QOL) were shortly decreased, which made her lead a normal life. Discussion : The administration of hoyokangoto combined with cinnamon and processed aconite root added qi (気), removed blood stagnation and accelerated blood circulation and collateral channels, implying that elimination is the first (先瀉). The administration of ogikenchuto for diarrhea (spleen qi deficiency) means that tonic is the second (後補), which improved her symptoms of EHS combined with MCS. Herbal medicines may be one of the choices for treating degraded QOL of patients with EHS and/or MCS.

A Case of Child Anxiety Disorder with Orthostatic Dysregulation Successfully Treated with Ogikenchuto in Combination with Western Medicine / 日本東洋医学雑誌

We treated a pediatric patient suffered from anxiety disorder with ogikenchuto in combination with Western medicine. The case was a teenage girl with long-term neck pain. After entering junior high school, she had palpitations and was afraid while interacting with other students, experienced headaches, struggled to get out of bed in the morning, and developed anorexia and dizziness upon standing up. She was diagnosed with anxiety disorder and orthostatic dysregulation (OD) associated with autistic disorder at a pediatrics department. Pediatricians prescribed aripiprazole and midodrine hydrochloride. And she was referred to our department for treatment with Kampo medicine. Her condition was presumed to be various deficiencies with kikyo, kigyaku, suitai, and kankikyo. She was prescribed 9 g of ogikenchuto extract per day, and the symptoms improved. Kankikyo should be considered for OD patients with psychosomatic symptoms, and ogikenchuto may be one of the prescription drugs for such condition.

A Case of Septic Patient Treated with Ogi-kenchu-to / 日本東洋医学雑誌

We report a case of an 84-year-old septic patient who was treated with Ogi-kenchu-to (Huang-qj-jian-zhong-tang). The patient had remained positive for <i>Klebsiella pneumoniae</i>. The focus of infection had not been detected, but bacterial translocation from the digestive tract was suspected from the clinical course. After two weeks of antibiotic therapy, he still had a high fever and positive blood culture. In addition, multiple cultures showed the destruction of normal flora and an increase of antibiotics-resistant bacteria.<br>Antibiotics were then suspended, and he was treated with Ogi-kenchu-to alone. His fever and inflammatory signs gradually disappeared, and his blood cultures became negative without restarting antibiotic treatment. He recovered completely. Ogi-kenchu-to is indicated for treating “generally weakened” patients or patients with intestinal problems. However, we could not find any reports of its application to septic patients. Although we still need to determine the mechanism for its efficacy, we consider that this case adds further evidence that Ogi-kenchu-to may be helpful for those suffering from severe infection, especially in elder patients and immuno-suppressed patients.

Clinical Effect of the Ogi-Kenchu-To and Therapeutic Exercise for a Patient with Spinocerebellar Degeneration. Electrophysiological Study / 日本東洋医学雑誌

To investigate the effects of Kampo and a rehabilitation approach on patients with spinocerebellar degeneration (SCD), a 65-year-old female patient with SCD was treated with Ogi-kenchu-to and therapeutic exercise based on the Bobath concept.<br>She had a gait disturbance (unable to walk) with slightly increased muscle tonus and deep sensory disturbance in the left leg before therapy. In Kampo confirmations, there was a generalized cold feeling and fatigue due to decreased physical fitness. In the electrophysiological study, the amplitude of Auditory Brainstem Responses (ABR) and Somatosensory Evoked Potentials (SEP) in the left side showed a greater decrease than those in the right side. The amplitude of the F-wave in the left side showed a greater increase than that of the right side.<br>After two months of this therapy, the patient was able to walk unassisted. Improvement in the neurological and general findings, along with normalization of the ABR, SEP and F-wave were also observed.<br>It was suggested that Kampo therapy using Ogi-kenchu-to and therapeutic exercise based on the Bobath concept were effective in the treatment of this patient with SCD.

Two Cases of Report of Bedridden Aged Patients Effectively Treated with a Kampo Prescription Ogi-kenchu-to / 日本東洋医学雑誌

Two cases of bedridden patients effectively treated with the Kampo formula Ogikenchu-to are reported. The first case was a 76-year-old female. She had been admitted to a hospital for about five months due to subarachnoid hemorrhage and had been bedridden because of a lack of volition. She was transferred to Riverside Hospital for rehabilitation. At the time of her admittance, her legs were paralyzed with disuse atrophy and her activity of daily living was very restricted. The authors prescribed Ogikenchu-to for her. Her activity of daily living (ADL) showed improvement day by day, and she was finally able to walk with the help of a walking supporter.<br>The second case involved an 86-year-old female who was hospitalized in a clinic with a compression fracture of the lumbar spine. She had been bedridden for about two years. After being transferred to Riverside Hospital for rehabilitation. Ogikenchu-to was administered. Her willingness to participate in rehabilitation gradually improved. She regained the ability to sit up straight, and could walk with a cane. She now enjoys her life with her family.<br>These clinical case studies suggest that Ogikenchu-to may be useful in the treatment of aged bedridden patients.