Five Cases of Frequent Hypertensive Urgency Successfully Treated with Shichimotsukokato / 日本東洋医学雑誌

Hypertensive urgency is sometimes repeated and difficult to treat with anti-hypertensive agents or anxiolytics. There were few reports on treatment of hypertensive urgency with Kampo medicine. We experienced five cases of frequent hypertensive urgency, successfully treated with shichimotsukokato only. All cases had deficiency pattern and symptoms of blood deficiency. It took relatively short term to stabilize blood pressure after taking shichimotsukokato, and the efficacy of this drug had been continued. Shichimotsukokato can attribute to rapid and continuous stabilization of blood pressure for frequent hypertensive urgency of those who have deficiency pattern and blood deficiency.

The renoprotective effect of shichimotsukokato on hypertension-induced renal dysfunction in spontaneously hypertensive rats.

Antihypertensive treatment is highly important to prevent the progression of chronic kidney disease. Shichimotsukokato (SKT), a traditional Japanese medicine (i.e., Kampo formula), lowered systolic blood pressure (SBP) in experimental animal models of hypertension. However, its mechanism of action has not been fully elucidated. We investigated the potential renoprotective mechanism of SKT in spontaneously hypertensive rats (SHRs). Ten-week-old SHRs were randomly divided into four groups (six rats per group). In the SHR control group, the SBP increased remarkably during the 8-week experimental period. In the SHRs, SKT extract administered orally at a daily dose of 0.45 or 0.15 g/kg significantly suppressed the increase in SBP to the same extent as telmisartan administered orally at a daily dose of 0.01 g/kg. At the end of the experiment, blood, urine, and kidney cortex tissue samples were examined. The SKT treatment significantly decreased urinary albumin excretion to nearly the same level as the telmisartan treatment. A notable loss of chloride channel 5 (ClC-5), a chloride channel in the proximal renal tubules, occurred in the SHR control group. Thus, we concluded that SKT administration significantly ameliorated this decrease. The mechanism of SKT in reducing urinary albumin excretion is mediated, at least partly, by prevention of the loss of ClC-5 in the renal cortex of SHRs.

<b>Three Cases of Dermatitis Successfully Treated with Shichimotsukokato</b> / 日本東洋医学雑誌

Shichimotsukokato is composed of shimotsuto with chotoko, ogi, obaku, and this formula has been frequently used for the treatment of hypertension, eye-fundal hemorrhage and headaches. Here we describe three cases of chronic dermatitis with hypertension and dry skin of legs, which were successfully treated with shichimotsukokato. Case 1 was a 67-year-old man whose chief complaint was pruritus and skin eruption on his chest. He also had dry skin accompanied with pruritus on his legs, and hypertension. Case 2 was a 59-year-old man who had skin eruption accompanied with pruritus on his trunk and extremities. He also showed diastolic hypertension and renal insufficiency due to the side effect of an immunosuppressant. Case 3 was a 64-year-old man who had dry skin with eruption on the upper trunk. Furthermore, his blood pressure fluctuated within the high normal range. After medication with shichimotsukokato, both the hypertension and dermatitis improved in all three cases. <br>According to these observations, shichimotsukokato may alleviate dermatitis along with dry skin of legs and hypertension, and it may be worth noting that shichimotsukokato is an option for the treatment of skin lesion.