Recently, the usefulness of herbal medicines has been recognized by many Japanese medical doctors who have been trying to seek alternatives to modern medicine in many diseases. We are currently treating disorders that result in vertigo, dizziness or tinnitus with a combination of herbal and modern medicines. The overall effect of this combination therapy was excellent in vertiginous disorders and in diseases with vertigo and tinnitus. The effect on tinnitus itself was unsatisfactory, probably because of a different etiology and pathophysiology. We will continue our efforts to treat severe vertigo, dizziness and/or tinnitus with this combination therapy.

抄録全体を表示

In order to obtain a better understanding of Kampo medicine from the viewpoint of modern scientific medicine, we have introduced the concept of evidence-based therapy. We present here two lines of evidence for Kampo medicine for the treatment of the upper respiratory diseases. The first line of evidence is to demonstrate the mechanisms underlying the effects of Kampo medicine, including i) the inhibitory effects of Sho-seiryu-to on acetylcholine-induced mucus secretion from the submucosal nasal gland acinar cells, and ii) the stimulatory effects of Sairei-to on Cl- secretion from cultured middle ear surface epithelial cells. The second line of evidence is to present a randomized double-blined trial demonstrating the clinical efficacy of Sho-seiryu-to in the treatment of perennial allergic rhinitis. Thus, the use of Kampo medicine will be further recongnized in the field of modern allopathic medicine.

抄録全体を表示

The efficacy of conventional drugs has been limited in the treatment of xerostoma, lingual pain and abnormal sensations in the throat due to psychosomatic disorders. In addition to these conventional therapies, various Kampo prescriptions have been administered to patients with uncontrollable diseases of the oral cavity, pharynx and larynx. For example, Bakumondo-to and Byaldcokaninjin-to have been used for the treatment of xerostomia, Oren-to for lingual pain, Saiboku-to for abnormal sensations in the throat. Furthermore, Juzen-taiho-to has also been used in cancer patients to improve their immunological status after the primary curative therapy.
The underlying mechanisms and clinical efficacy of each type of Kampo medicine were analyzed based on the pharmacological actions of each of the herbal components, and we report here our recent clinical experiences. In addition, the use of Kampo for refractory diseases and complaints resistant to conventional treatments is discussed.

抄録全体を表示

Oketsu syndrome, a condition characterized by chronic microcircular stagnation in the tissues, is an important concept in Kampo medicine. Since it is often diagnosed by observation of the patient's tongue, we examined the relationship between the status of the back of the tongue (venous expansion of the profound lingual vein and a very small varix: “Sho-ten” means a small point) and magnetic resonance images (MRIs) of the brain in patients (40.0%) who had a very small varix in the back of the tongue had one or more small infarctions in the brain. However, of the 39 patients (7.7%) without a very small varix, only three had infarctions. There was no significant relationship between the venous expansion of the profound lingual vein and the MRI findings. The existence of a very small varix in the back of tongue would appear to be an important indicator of chronic microcircular stagnation in the brain in patients complaining of balance disorders.

抄録全体を表示

Forty patients with tinnitus were treated by Choto-san.
1) The curative rate of those groups receiving treatment based on the clinical diagnosis of the disease and based on SHO was 47.8% and 76.8%, respectively.
2) There was no significant difference in efficacy between those patients with hypertension or headache.
3) There was a significant difference in efficacy between those patients over 70 years of age and those under 70 years old.
Careful observation of the indications for treatment are essential, and treatments based on SHO were more effective.

抄録全体を表示

We used Saiko-keishi-to in an attempt to alleviate tinnitus of over 3 months' duration in 13 patients. Saiko-keishi-to was administered orally at 7.5 grams per day, divided into 3 doses, and a subjective evaluation for efficacy was performed 4 weeks thereafter. Of the 13 patients, one was rated as markedly improved,2 as improved and 2 as slightly improved. In 7 patients who had a favorable response to intravenous lidocaine,2 were rated as improved and 2 as slightly improved following Saiko-keishi-to administration.
Intravenous lidocaine is effective against tinnitus by blocking the hyperirritable auditory pathway. Saiko-keishi-to acts to suppress the bursts of neurons firing in an epileptic state. We presume that Saiko-keishi-to was more effective in those patients with a good response to lidocaine because of the similar actions of both of these therapies.

抄録全体を表示

In a previous paper, we reported a correlation between the efficacy of Gosha-jinki-gan and the results of residual inhibition (RI) tests in patients with tinnitus accompanied by sensorineural hearing loss.
In this study, we examined the test-retest reliability of the RI tests as well as the changes in the test results of patients given the drug on a long-term basis. To examine the test-retest reliability, the RI tests were performed twice consecutively on 13 ears in 13 patients, with a 15 to 60 minute interval between each test. To examine the effects of the long-term administration of this drug, RI tests were performed on 5 out of 9 ears used in the previous study, and the results compared with those obtained prior to the administration. These patients have been receiving Ghosha-jinki-gan for 10 to 13 months.
The following are the results of this study: (1) The test-retest reliability of the RI tests was relatively good. The range of the test reliability was narrow, indicating that this test may be used for clinical applications. (2) In those patients given Ghosha-jinki-gan for an extended period and in whom the drug proved to be effective, the results of the RI test were significantly prolonged. (3)The mechanisms underlying the tinnitus, the etiology of the RI, and the pharmaceutical actions of Gosha-jinki-gan are as yet unclear. However, the findings of this study support the hypothesis that tinnitus is caused by an impairment of peripheral auditory sensation, and that this drug can promote its normalization.

抄録全体を表示

A retrospective study was performed to investigate the clinical usefulness of Sho-seiryu-to treating allergic rhinitis. An examination was also performed on the clnical background of those allergic rhinitis patients in whom Sho-seiryu-to was ineffective, as well as the countermeasures used. The subjects consisted of 16 allergic rhinitis patients (6 men and 10 women; mean age: 30.4years; Sho: 6 Jitsu,8 Chukan, and 2 Kyo). Of these 16 patients, Sho-seiryu-to was ineffective in 5patients (2 men and 3 women; mean age: 48; Sho: 1 Jitsu,3 Chukan, and 1 Kyo).
All of the patients were given 9 grams of Sho-seiryu-to extract granules, three times a day, for 2or 4 weeks. The degree of improvement in symptoms such as sneezing, watery nasal secretion, and nasal obstruction was then evaluated. The checklist for the five non-responsive cases included: (1)their age, Sho, and subjective symptoms other than those of allergic rhinitis; (2) past illnesses; (3)abnormal findings on an Oriental medicinal diagnosis; and (4) their treatment and progress following a single administration of Sho-seiryu-to.
The drug's efficacy rate against sneezing, watery nasal secretion and nasal obstruction was 62.5%,68.8%, and 56.3%, respectively (n = 16). As a side effect, one patient experienced gastrointestinal discomfort. After carefully re-examining the clinical background of those patients in whom Sho-seiryu-to was ineffective, the author found the following pathologies and switched to treatment regimens which better suited each case. Effective or better results were subsequently obtained on all cases. The details of the pathologies and treatments are as follows. Patient No.1: Hi-kyo: 7.5 grams of Hochu-ekki-to was administered three times a day for four weeks; Patient No.2: Jin-yo-kyo: 4.5 grams of Sho-seiryu-to and 7.5 grams of Hachimi-jio-gan were administered three times a day, respectively, for six weeks; Patient No.3: Hi-ki-kyo and Suidoku: 7.5 grams of Rikkunshi-to was administered three times a day for 8 weeks; Patient No.4: a combination of allergy and infection: 3.75 grams of Sho-saiko-to-ka-kikyo-sekko and 4.5 grams of Sho-seiryu-to were administered three times a day, respectively, for 4 weeks, and then 400 mg of curarithromycin was administered twice a day for one week; and Patient No.5: Oketsu and Suidoku: 5 grams of Keishi-bukuryo-gan and 3.75 grams of Kami-shoyo-san were administered three times a day, respectively, for eight weeks.
Sho-seiryu-to was seemed to be effective in treating allergic rhinitis. However, if the drug proved to be ineffective after 4 weeks of administration, then the pathology should be reevaluated and other drugs should be chosen more suited for the new pathology obtained. In this way, the symptoms can be expected to improve even in non-responsive cases.

抄録全体を表示

To evaluate the clinical efficacy of Tsumura Sairei-to in the treatment of chronic otitis media and cholesteatoma after a tympanoplasty, an open randamized trial study was performed on 12 patients. The efficacy rate on the ear drum and fascia was 66.7%, and the efficacy rate on the mastoid was also 66.7%. The efficacy rate against the overall subjective symptoms was 66.6% of the 12 patients significant effects were observed in five patients (41.7%), slight effects were observed in another five patients (41.7%), and no noticeable effects were observed in two patients (16.7%). The general efficacy rate for the 12 patients treated with Tsumura Sairei-to was 83.4%. No side effects were noted in any of the patients, so the general usefulness rate was also 83.4%. These results suggest that Tsumura Sairei-to is clinically effective as an oral therapy against chronic otitis media and cholesteatoma after a tympanoplasty.

抄録全体を表示

Sai-rei-to is believed to have steroid-like properties, and is often used to reduce the amount of steroids prescribed to patients. In facial nerve paralysis, steroids are often used to reduce the amount of edema in the area of the damaged nerve. We have noted Sai-rei-to's steroid-like properties, and thus investigated whether recovery from facial nerve paralysis can be expedited when this drug is used in combination with steroid during periods when the dosage of the steroid is being reduced. Moreover, we administered Sai-rei-to to those patients unable to receive steroids due to complications in order to assess whether it can produce effects similar to steroids.
In patients with facial nerve paralysis, we provided a regular intravenous drip and administered the steroids orally, and then used Tsumura Sai-rei-to in combination during those periods of steroid reduction. This regimen increased the rate of improvement from the paralysis. We also gave Saireito to patients suffering from steroid-related complications during the course of their treatment, and observed remarkable improvements thereafter.

抄録全体を表示

Two hundred and thirty-two patients who complained of abnormal sensations in the throat (AST) were classified with the Cornell Medical Index-Health Questionnaire as neurotic (Area III or IV) patients. The effectiveness of two Kampo drugs, Saiko-ka-ryukotsu-borei-to (Chai-hu-jia-lon ggumu-li-tang) and Saiboku-to (Chai-pu-tang), which were expected to be effective against the various symptoms of neurotic patients, were evaluated in comparison with anti-anxiety drugs (Oxazolam, Diazepam, Ethyl Loflazepate), an anti-depressant drug (Sulpiride), a psycho-vegetative regulator (Tofisopam) and psychotherapy alone without using any drugs for AST symptoms.
When the initial AST was subjectively reduced by 50% or more, we determined the therapy to be “effective”. An evaluation performed after two-weeks of therapy demonstrated that Oxazolam had the best efficacy rate (87%), followed by Tofisopam. The Kampo drugs seemed to be slightly superior or equal to the rest of the drugs, with efficacy rates between 57 and 70%. An evaluation performed at one week after the end of the medication, however, revealed an apparent reduction in the efficacy rate (post-treatment rebound of symptoms) in those patients treated with Oxazolam (67%), which was not significantly different from the Kampo drugs (61-67%).

抄録全体を表示

There are many complaints arising from the oral cavity, for example lingual pain, oral pain, and foreign body sensations. We administered Oren-to (7.5 g/day) to 14 patients who had complained of abnormal sensations in the oral cavity. We didn't consider evidense (Shou) in this study. These patients consisted of 5 males and 9 females. Their mean age was 63.7 years and ranged from 31 to 78.
The clinical efficacy was assessed by the subjective symptoms. Seven patients (50.0%) obtained a complete effect,4 cases (28.6%) had a moderate effect,1 case (7.1%) had a slight effect and 2cases (14.3%) experienced no changes. No cases changed for the worse, and none had any side effects.
In particular, we found that all of the patients who felt that the symptoms had been prodromal for one month got better within a week.
We conclude that Oren-to was effective against these abnormal sensations in the oral cavity, especially during the acute phase.

抄録全体を表示

This study evaluated the effectiveness of Sairei-to and Juzen-taiho-to in the reduction of symptoms caused by radiotherapy in patients suffering from malignant tumors of the head and neck. The subjects included 13 patients (11 males and 2 females) with a mean age of 69.4 years ranging from 51to 83. The primary lesions of the 13 cases were as follows: 6 male patients with laryngeal cancer,4males with hypopharyngeal cancer,1 female with epipharyngeal cancer,1 male with lingual cancer and 1 female with parotid cancer. Sairei-to (TJ-114) 9.0 g/day and Junzen-taiho-to (TJ-48) 7.5 g/day were given to each subject during the course of radiotherapy at 50-60 Gy.
Redness, pain and swelling of the oral and pharyngeal mucosa occurred as local symptoms. These symptoms, the ability to feed, the regularity of the irradiation, and systemic symptoms were observed during the first 2 weeks and at the end of the irradiation. A total of 53.9% of the subjects experienced improvements in their local and systemic symptoms. No side effects were reported. Concurrent combination radiotherapy consisting of Japanese Kampo medicine (Sairei-to and Juzentaihoto) seemed to have a beneficial effect in reducing some of the symptoms caused by radiotherapy.

抄録全体を表示