ABSTRACT
BACKGROUND: A patient developed paralysis of the small intestine following an acute traumatic hyperextension cervical spinal cord injury attributed to the ossification of the posterior longitudinal ligament (OPLL) C3-C6. The persistent ileus finally resolved utilizing Kampo medications (traditional Chinese therapy) consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16). CASE DESCRIPTION: A 63-year-old male became acutely quadriplegic secondary to a hyperextension injury incurred during a fall. Radiographic studies confirmed mixed OPLL extending from C3-C6 resulting in marked cord compression, there was a clear spinal cord contusion. His neurological status using the American Spinal Injury Association (ASIA) Scale was Grade "A;" there were was complete motor and sensory loss below the C5 level. After a C3-C6 expansive laminoplasty, the ASIA scale improved to Grade B. However, he then developed a persistent small intestine ileus resulting in marked abdominal distention. When conventional therapies failed to resolve the problem, Kampo medicines, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), were administered. The ileus improved within 2 days and fully resolved within the 1st postoperative week. CONCLUSION: The utilization of Kampo medications, consisting of both bukuryoin (TJ-69) and hangekobokuto (TJ-16), or the combined bukuryoingohangekobokuto (TJ-116) effectively resolved a postoperative paralytic small bowel ileus following a cervical laminoplasty performed in a quadriplegic patient. KEYWORDS: Acute cervical cord injury, Cervical ossification of the posterior longitudinal ligamentOPLL, Complication management, Integrative medicine, Paralytic small intestine.
ABSTRACT
There are patients who suffer from persistent dentoalveolar pain disorder (PDAP) which is a pain of the teeth, either dentoalveolar pain or nonodontogenic toothache, and its cause has not yet been identified. An effective intervention for PDAP has not yet been established. Interventions for patients with PDAP are generally pharmacological treatments such as antidepressants, anticonvulsants, and pregabalin. However, these medicines are not always effective for patients. The pain disorder in the orofacial region including temporomandibular disorder (TMD) and PDAP was effectively treated with our original exercise therapy. However, we did observe some intractable cases of PDAP even when our original exercise therapy was used. This paper presents our findings in which Kamishoyosan improved the pain intensity in 14 out of 15 PDAP patients refractory to our original exercise therapy.
ABSTRACT
BACKGROUND: The Japanese medical system is unique because it is the only country in the world where Western medicine and traditional Japanese medicine including Kampo medicine, traditional Japanese herbal medicine, are used in our daily clinical practice. Pain is essentially an interactive psychophysiological behavior pattern. Thus, an interdisciplinary approach is often recommended in providing appropriate therapeutic care for the patients suffering from chronic and intractable pain. In addition, we have been prescribing Kampo medicines in combination with Western medicines as personalized medicine in order to treat patients with chronic pain at our pain center. The aim of our study was to conduct a survey on the current use and the effect of Kampo medicines in our multidisciplinary pain center. METHODS: Retrospective analysis was performed on 221 out of 487 patients suffering from chronic pain. RESULTS: The most frequent medical complaints for which Kampo medicines were prescribed were lower back/lower limb pain, neck/upper limb pain, various facial pains, headache/migraine, whiplash-associated disorder, and frozen shoulder. Kampo medicines were prescribed based on patient-centered Kampo diagnosis. Moreover, several Kampo medicines generally for the management of psychological symptoms were prescribed for about 70% of the patients. Pain improvement in the patients was categorized as follows: 26.3% with marked improvement, 12.7% with moderate improvement, 38.9% with some improvement, and 19.9% with no improvement. CONCLUSIONS: Two thirds of the chronic pain patients with the use of Kampo medicines combined with Western medicine experienced further pain improvements.
