The present article reviews the current and possibility of Japanese Kampo medi­cine yokukansan for behavioral dysfunction in several experimental dementia models. Basic researches of yokukansan for behavioral dysfunction have progressed rapidly in the past decade. Accumulating clinical randomized controlled trials have also showed effect of yokukansan on patients with behavioral and psychological symptoms of dementia (BPSD). Clinical benefits in yokukansan should require more basic studies before definitive treatment for BPSD.

It was reported that jidabokuippo was effective for swelling after trauma. In this study, we investigated the efficacy for the treatment of swelling after trauma and surgery. Of the 53 patients, 20 were unknown. Of the 33 patients, 10 were im­proved (30%), 23 were unchanged (70%), and no patients were worsened. Ten out of 13 doctors who had prescribed the drug to those patients thought that the drug was effective for the swelling. The current study suggests that jidabokuippo is a good candidate drugs for the treatment of swelling after trauma and surgery.

We investigated the side effects of saireito in patients who had received it for prevention of the recurrence of chronic subdural hematoma. The subjects were 561 patients who had undergone surgery for chronic subdural hematoma at 3 centers. Seventy-two patients received saireito, and five (6.9%) of them experi­enced the side effects: 2 patients had interstitial pneumonia, one with liver dysfunction, hypokalemia and cramps calf. We need to be careful of these side effects when administering saireito for prevention of the recurrence of chronic subdural hematoma.

Background. The author reported the results of Kampo therapy including goshajinkigan combined with some other prescriptions for anticancer chemo­therapy-induced peripheral neuropathy.

Objectives. From April, 2014 to March, 2015, the following two groups of patients were treated with Kampo therapy. Group 1: 104 patients (male ⁄ female: 15 ⁄ 89), 33–82 years old (mean age 59.8) who had developed peripheral neuropathy complicated by chemotherapy. Group 2: 25 patients (male ⁄ female: 0 ⁄ 25), 39–73 years old (mean age 55.9) who received kampo treatment for preventing peripheral neuropathy.

Methods. The effectiveness of the treatment was evaluated with numerical rating scale when the neurological improvement was stabilized. The degree of improve­ment of group 1 was evaluated into four categories from 0 to 100% by 25%. They are described as excellent, good, fair, and no change, respectively. Group 2 was assessed based on the residual nerve disorder at the completion of chemotherapy.

Results. Group 1: excellent 32 cases (30.8%), good 27 cases (26.0%), fair 10 cases (9.6%), no change 21 cases (20.1%), and drop out 14 cases (13.5%). Group 2: No residual neuropathy 14 cases (56.0%), Residual neuropathy 8 cases (32.0%), and Drop out 3 cases (12.0%).

Discussion. Peripheral neuropathy due to anticancer chemotherapy is a serious complication. Then proper therapies are expected to prevent or relieve the complication. Chemotherapy-induced peripheral neuropathy may produce blood and qi stagnation and fluid retention around affected peripheral nerves. The major aim to treat peripheral neuropathy is just to resolve such pathophysiological conditions and to promote self-sustained recovery of the peripheral nerves.

Conclusions. In this study, goshajinkigan combined with Kampo formulation for overcoming blood stagnation, and tonifying qi yielded good outcomes.

The efficacy of Kampo treatment in patients with migraine was studied. 1,094 patients with miraine with or without aura under the international classification of headache disorders 3rd edtition (berta version) were treated by Kampo. The Kampo used were: tokishakuyakusan 96 (23.4%), gosyuyuto 72 patients (17.6%), goreisan 90 (21.9%), kakkonto 106 (25.9%), tokishigyakukagoshuyushokyoto 29 (7.1%), kamisyoyosan 29 (7.1%), hangebyakujyutsutemmato 10 (2.4%), chotosan 10 (2.4%). Patients who treated by Kampo 3 months, reduction of frequency and severity were estimated in 208 patients (50.7%). In conclusion, Kampo treatment was suggested to be an effective option for the treatment of patients with migraine.

We examined the effect of hochuekkito on improving awareness. Methods: Our study included seven patients who were in a state of Glasgow Coma Scale (GCS) score < 8 for one week or more. Subjects were administered hochuekkito, and the detailed state of awareness was evaluated using various assessment scales. These data were analyzed statistical methods. Results: All patients exhibited a significant improvement in awareness after administration of hochuekkito. Many patients (71~86%) exhibited this improvement within 7 days from the start of medicine. Cases in which treatment was initiated in the sub-acute and chronic phases tended to exhibit a greater final improvement in scores compared with cases in which treatment was initiated during the acute phase. However, there was no statistically significant difference. The current study is the first report which suggests that hochuekkito improves awareness.

A 78-year-old male was admitted our hospital suffered from epidural and subdural abscess which were not identified causative bacteria. Antibiotics treatment for this case was intravenous administration of meropenem for 6 weeks and the next was oral administration of sulfamethoxazole ⁄ trimethoprim (ST). Eight weeks after the treatment of antibiotics, MRI findings of abscess shrank. But 6 weeks after ST administration, recurrence of abscess was doubted because of the increase of CRP and the aggravation of MRI findings. Then hochuekkito was administered com­bined with ST and 4 weeks later, the improvements of CRP and MRI findings were obtained. ST administration was finished after 16 weeks after initial administra­tion, afterwards only hochuekkito was continued and recurrence of abscess was not found.

It is reported that hochuekkito has the effects of improvement of digestive func­tion and immunological function. It is considered that the immunological improve­ment due to hochuekkito is useful for this case.

Bell’s palsy is a good progress disease. However, there is the case to suffer from treatment. We report a case treated effectively with keishibukuryogan.

In cerebrovascular disease, aquaretic treatment is often needed in maintaining the adequate cerebral perfusion without blood pressure reduction. We experienced 3 cases of pulmonary edema in acute stage, such as caused by cardiac and pul­monary complications, associated with stroke. After administration of goreisan pulse therapy, all three cases obtained dehydration without blood pressure reduc­tion, and pulmonary edema improved. However, there is no upper limit of dose and duration in kampo medicine, we need to administer goreisan carefully，considering side effects.

In Japanese traditional medicine, intracerebral hemorrhage (ICH) caused by intraparench­ymal bleeding can be recognized as “oketsu” syndrome, or so-called blood stasis syndrome. We treated nine patients with acute-phase ICH with keishibukuryogan (2.5 g three times a day before each meal), a formulation from the kuoketsu drug group. Of the patients treated with keishibukuryogan, two patients showed early improvement of cerebral edema, early hematoma absorp­tion, and corresponding improvement of neurologic symptoms. We did not discuss the usefulness of keishibukuryogan in this paper, as the number of cases was small. More cases of ICH treated with keishibukuryogan must be accumulated, and appropriate studies must be conducted to evaluate its usefulness.