Diagnostic procedures in oriental medicine are quite different from those in western medicine because of the difference in basic concepts of medicine. From that oriental point of view, it is claimed that Saiko-ka-ryukotsu-borei-to (Chaff-Hu Jia-Long-Gu-Mu-Li-Tang), like other Kampo prescriptions, should be selected after a diagnostic procedure based on oriental medicine for more effective treatment of patients with abnormal sensation, such as a lump or choking in the throat. However, it is not easy for physicians trained in western medicine to learn these procedures.
In this study, we used the Cornell Medical Index Health Questionnaire (CMI) as an aid for selecting patients for whom Saiko-ka-ryukotsu-borei-to is supposed to be effective, and we evaluated its actual clinical usefulness. Eighty-nine male and 50 female patients with abnormal sensation in the throat were classified as normal (Area I), almost normal (Area II), slightly neurotic (Area III) and neurotic (Area IV) by Fukamachi's method, and normal (Type I), autonomic nerve dysfunctioning (Type II), neurotic (Type III) and psychosomatic (Type IV) by a modification of Abe's analysis of CMI responders. In addition, we chose 13 questions (Saiko-ka-ryukotsu-borei-to Sho questions) from the CMI list which are supposed to be very important from the oriental medicine point of view for selecting Saiko-ka-ryukotsu-borei-to. According to their answers to the 13 questions, the patients were placed in 3 groups: supposedly good, supposedly moderate and supposedly poor responders.
Tsumura Saiko-ka-ryukotsu-borei-to® (7.5g/day) was given orally for 2 weeks and the clinical effect was evaluated 1, 2 and 3 weeks after the start of treatment. When the abnormal sensation as evaluated subjectively by the patient was reduced by more than 50%, treatment was considered to be effective. Evaluation of the answers to the CMI and of the effectiveness of the medicine revealed the following:
1) In both male and female patients, improvement increased gradually and was highest at the end of the 3rd week.
2) Among the male patients, those in Area I or Type I were the best responders, while among the female patients those in Area I or Type I were the worst responders.
3) As expected, good responders of both sexes had much higher effective rates at the end of each week than did poor responders.
These results indicate that an analysis of the answers to the CMI questionnaire is very useful for predicting the efficacy of Saiko-ka-ryukotsu-borei-to in patients with abnormal sensation in the throat.