Kampo Medicine in the 21st Century / 日本東洋医学雑誌

ABSTRACT

As the 21st century advances, evidence-based medicine (EBM) has come to be regarded as essential in all field of medical sciences and practical medicine. Creating medicines have been searching for based on EBM and development of new medicine has been carried out.In Japan the number of diabetic patients has increased to 129% during recent 10 years. The number of diabetic complications has also increased and hemodyalysis has been introduced in approximately 16,000 patients/year with diabetic nephropathy in Japan in 2008.Additinally many diabetic patients are suffering from numbness, cold sensation and pains in extremities derived from diabetic neuropathy. Therefore reduction of diabetic complications is one of the most important considerations in the field of diabetic patient care.Diabetes mellitus is equivalent to wasting-thirst in Jomgiiyaolue.We have reported the effectiveness of Goshajinkigan (GJG) for the treatment of nembness associated with diabetic neuropathy for the first time in Japan in 1984.In controlled comparative study, GJG showed significantly higher rates of improvement of this symptom versus mechobalamin.Insulin resistance has an important role on the occurrence of type 2 diabetes and metabolic syndrome.We have studies the effects of Kampo medicine on the insulin resistance using the euglycemic clamp and molecular biological techniques.1) Animal experimental studies: The improvement of insulin resistance in STZ rats by the administration of GJG might be via NO pathway and due, at least in part, to correct in the abnormal early steps of insulin signaling pathway in skeletal muscle.2) Clinical Studies: Effects of GJG on insulin resistance in patients with type 2 diabetes were investigated. HOMA-R was significantly decreased after GJG treatment (P=0.019). On the other hand, HOMA-R in the control group did not show significant difference. HOMA-R returned to the pre GJG treatment level1month after GJG discontinuation (P=0.018). The high-dose clamp resulted in a significantly increased insulin action (MCR levels) after GJG treatment.These animal experimental and clinical studies suggest that GJG might be effective for improving insulin resistance in the patients with type 2 diabetes.Kampo formulations might be useful not only for the prevention and the treatment of diabetic complications but also effective for the prevention and treatment of type 2 diabetes.In conclusion GJG has been used for the treatment of numbness and dysnuria since the statement in Yanshijishengfang. We have found the effectiveness of GJG on the treatment of diabetic neuropathy and on the prevention and the treatment of type 2 diabetes. We would like to continue these scientific activities.