Differentiation between Hangekobokuto and Kososan based on pupillary dynamics

-Evaluation of autonomic nerve function-

Abstract

Hangekobokuto and Kososan are representative Kampo medicines for the treatment of autonomic abnormalities and are used for Ki stagnation with neurosis or depressive states. Since the targets of the treatment with these two Kampo medicines largely overlap, the differentiation between the precise indications for which each is used is difficult. In order to clarify the relationship between the treatment effects of Kampo medicines and the autonomic nervous system, we performed studies by binocular infrared video pupillography (Iriscorder® C-7364, Hamamatsu Photonics, Hamamatsu, Japan). This study was performed to determine whether an objective differentiation between Hangekobokuto and Kososan is possible based on the pupillary dynamics in terms of autonomic nerve function. A comparison between the observed states before and after the administration of Hangekobokuto has revealed that sympathetic nerve activity is inhibited in the group of patients belonging to the sympathetic nerve domination type. After the administration of Kososan, sympathetic nerve activity is stimulated in the group of patients belonging to the non-sympathetic nerve domination types. Thus, the regulatory actions of the Kampo medicines on the autonomic nervous system were confirmed. This method of using an Iriscorder® was useful for evaluating the treatment effects of Kampo medicines.