RESUMO
We report a case of a 74-year-old woman who suffered from uncomfortable heat under her right shoulder blade and felt anxiety about general fatigue that had been worsening mainly in the summer. She visited our Kampo clinic because of insufficient effect of various types of drug that had been prescribed by 3 doctors for about a year. We made the diagnosis of somatic symptom disorder and suggested Kampo therapy with decoction. We thought this might be caused by liver qi depression, blood deficiency, and blood stasis because he had symptoms of dry skin, cold of feet, deeply located fine pulse, pale and purple tongue with yellow thick fur, fullness in the chest and hypochondrium. Therefore we administered keppuchikuoto modified formula. Her symptom improved within about a month after taking this formulation. There was no recurrence of the physical symptom and fatigue in the summer during taking medicine for about 20 months. Evidence-based treatment in somatic symptom disorder has not been established and some cases are resistant to treatments in modern Western medicine. Kampo medicine may be useful and hopeful.
RESUMO
We report a case of prolonged lumbago with severe cold intolerance successfully treated with keppuchikuoto and uzushakusekishigan. The patient was a 71-year-old female with lumbar spinal canal stenosis which was refractory to several nerve and intervertebral disc block therapies and oral medications. She had been also suffering from constipation, leg cramps, intermittent chest pains, and severe cold intolerance. We prescribed keppuchikuoto for chronic blood stagnation and deficiency and uzushakusekishigan for intermittent chest pains in order to improve those symptoms all together. The severity of her lumbago and severe cold intolerance were remarkably reduced after the administration of the two formulas. This case suggests that the two formulas exerted their effectiveness by ameliorating chronic severe cold intolerance, blood stagnation, and blood deficiency and resulted in remarkable improvement in lumbago.
RESUMO
Oketsu-night sweat was first mentioned in the “Yi lin gai cuo” by Wang Qing ren and the “Xue zheng lun” by? Tang Rong chuan, but there are few explanations of its disease condition. Thus we made pathological studies in Oriental medicine based on three cases (women), where Oketsu-sho was alleviated with Keppu-chikuo-to modification, and Teitou-gan and Tokaku-joki-to (Tao he cheng qi tang) modification. Common disease conditions were Netsu-sho or heat syndrome (summer incidences, redness, flushing during night sweat), and lower Oketsu symptoms (lower abdominal distention, distention and cramping of the lower abdomen, and increased urinary frequency). The theory of these disease conditions is as follows: During sleep, Wei-energy enters the blood. Because of this, Wei-energy of the body surface becomes asthenia making it easier to break out in sweat. The Wei-energy in the blood is depressed by Oketsu, and heat of Oketsu becomes stronger during the night. This fever heats and evaporates bodily fluids, and as a result fluids are pushed outward and cause night sweat. Therefore heat syndrome appears to be a pre-condition of Oketsu-night sweat. If the lower aspect of the body is taken to mean the liver, one would hypothesize that Oketsu-night sweat is more likely to emerge because blood accumulates in the lower area because it returns to the liver at night. Thus, it is thought to be necessary to consider Oketsu as one of the causes of night sweat.
