Obesity, the most common metabolic disease, and its associated disorders are reaching epidemic proportions in the modern and industrialized world. Abdominal obesity in particular has been linked with elevations in total cholesterol (TC), low-density lipoprotein cholesterol (LDL-C), triacylglycerol (TG), and apolipoprotein-B, as well as with decreased high-density lipoprotein cholesterol (HDL-C).
1) It is also associated with elevated blood pressure. It denotes that excessive fat tissues in and around the abdomen lead to metabolic syndrome, which has become increasingly common not only in the United States of America but also in Japan, however, relevant prophylactic agents and methods have not been discovered. In this environment, herbal weight-loss supplements have been marketed with claims of effectiveness, although adverse events, including hepatic injury and death, have been reported with the use of herbal supplements. While Japanese already know about traditional herbal medicines - called Kampo medicines -, they may have a place in modern medicine. A formula, Bofutsushosan (BF) was selected for treatment as an antiobesity drug to improve metabolic disorders. BF was introduced in the Chinese classic "Xuan Ming Lun" written in around 1200 as a medication which acted to remove heat after influenza and to promote bowel movement. Japanese specialists of Kampo medicine prescribed BF for "Himan-Shou" by applying their own Kampo diagnosis of "Shou", but not the Western style method for disease diagnosis, therefore, they have never diagnosed Himan-Shou as the same disease as the worldwide - prevalent obesity. In order for BF to be accepted in modern medicine as an antiobesity drug, however, more data must be collected on the mechanism of reducing fat and safety. Furthermore, ethical guidelines for its use as an antiobesity drug in modern medicines should be shown. First, basic experiments with obese mice were tried; second, clinical trials were conducted double-blind, randomized controlled trials in an obesity clinic. The aim of this review was to indicate whether BF could be effectively applied to obesity with impaired glucose tolerance (IGT), which increased the risk of cardiovascular events compared to normal individuals, under Western medical methods and evaluations.
Finally, we will briefly discuss, comparing with other drugs, the relative benefits and drawbacks of using currently available Kampo medicine in the Western clinical management of visceral obesity.
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