Abstract
A 72-year-old male patient had been receiving treatment for diabetes since 1970. He first experienced an attack of postprandial syncope in 1994, but he did not consult a physician. In 2004, the frequency of attacks increased, and he was admitted to hospital for detailed examination and treatment. A 75 g oral glucose tolerance test (OGTT) was performed in the supine position, and a 26-mmHg decrease in blood pressure accompanied by sleepiness was observed, suggesting postprandial hypotension. In addition, the baseline blood level of noradrenaline (NA) and reactivity increased (before the test: 476 pg/ml, at 30 min: 561 pg/ml, and at 60 min: 689 pg/ml). To reduce postprandial sleepiness, hochuekkito (TJ-41), a traditional Chinese herbal medicine, was administered. After 1 week of treatment, a 75 g OGTT showed a 12-mmHg decrease in blood pressure along with the disappearance of sleepiness. Furthermore, there were changes in the baseline blood level of NA and reactivity (before the test: 242 pg/ml, at 30 min: 270 pg/ml, and at 60 min: 254 pg/ml). Hochuekkito inhibited reduction in blood pressure following the 75 g OGTT and reduced postprandial sleepiness, suggesting that peripheral sympathetic function is involved in its mechanism of action.
