Kampo therapy for premenstrual syndrome: efficacy of Kamishoyosan quantified using the second derivative of the fingertip photoplethysmogram.

AIM: Premenstrual syndrome (PMS) affects 40-80% of women. Japanese herbal medicine, known as Kampo, is frequently prescribed for PMS, so we examined the efficacy of Kamishoyosan using two methods: first, the second derivative of the fingertip photoplethysmogram (SDPTG) evaluating vascular age (VA), and second, a self-assessment questionnaire on subjective symptoms. METHODS: The SDPTG was recorded in 45 patients with PMS (mean +/- SD = 32 +/- 6 years of age) before (0 M), on the first (1 M) and third (3 M) month of therapy. Patients answered a questionnaire (44 questions) on their complaints every month. The reproducibility of the SDPTG was confirmed with 15 normal volunteers (33 +/- 9 years of age). RESULTS: In patients with older VA than their chronological age (Age) before therapy, we found linear correlations of the VA-Age differences at 1 M versus 0 M (y = 0.45x + 1.59, standard error of estimate [SEE] = 6.13 years), and at 3 M versus 0 M (y = 0.18x + 4.09, SEE = 6.03 years). The VA-Age decreased from 11.3 +/- 6.4 (0 M) to 6.6 +/- 6.7 (1 M) and 6.1 +/- 6.0 years (3 M) (P < 0.01). The score on the self-assessment questionnaires for the five most frequent symptoms significantly improved from 13.4 +/- 3.3 (0 M) of 20 to 10.7 +/- 3.9 (1 M) and 8.2 +/- 4.6 (3 M) (P < 0.01). CONCLUSION: The improvement of PMS symptoms as a result of using Kamishoyosan was quantified by means of SDPTG and the self-assessment questionnaire.

An assessment of bone mineral density in patients with Addison's disease and isolated ACTH deficiency treated with glucocorticoid.

Glucocorticoid replacement therapy needs to be tailored to individual patient's requirements in order to avoid risk of over or under medication. We measured bone mineral density (BMD) of lumbar spine using dual X-ray absorptiometory in 10 patients with Addison's disease and 5 patients with isolated ACTH deficiency receiving glucocorticoid replacement therapy. We also examined the effect of glucocorticoid replacement on BMD. Decreased %BMD (less than 80% of age-matched controls) was found in 2 female patients who had received hydrocortisone at a dose of 14.8 and 15.4 mg/m(2)/day. In contrast, no patient receiving a hydrocortisone dose of less than 12.4 mg/m (2)/day had decreased %BMD. There was no correlation between %BMD and hydrocortisone dose (mg/m(2)), duration of therapy, or cumulative hydrocortisone dose when treated with appropriate dose of hydrocortisone (<13.6 mg/m(2)). There was also no statistically significant difference in %BMD with age. We concluded that long-term glucocorticoid replacement therapy does not induce bone loss in patients with glucocorticoid deficiency unless an excessive dose of hydrocortisone is given.