Diet therapy is an effective method for treating obesity. However, its effectiveness varies from person to person. With that in mind and working towards the implementation of personalized nutrition education, we investigated the relationship between aspects of oriental medicine and genes related to obesity. We analyzed three genes associated with obesity (ADRB 3, UCP 1, and ADRB 2) and classified them as either wild type or mutant. The presence or absence of gene polymorphisms in the obesity-related genes was analyzed by using PCR-CTPP. We conducted a survey using questions that would be comprehensible to people unfamiliar with oriental medicine in order to assess their body constitution, by diagnosing two elements of body constitution according to oriental medical theory (stomach heat [wei re] and spleen vacuity [pi xu]). The study was conducted in 81 women and 28 men (mean age, 42.6 years ; mean BMI, 22.3 kg/m2). Among them, 7 participants were underweight, 83 were of normal weight, and 19 were overweight. The results of the analysis revealed that BMI was highest in those with stomach heat and lowest in subjects with spleen vacuity. Wild type ADRB 3 increased susceptibility to stomach heat, which led to higher body weight ; whereas, the presence of mutated ADRB 3 increased the likelihood of spleen vacuity, which led to lower body weight. These results suggest that by making comprehensive assessments of body characteristics, it is possible to identify individuals with a predisposition to obesity or low body weight.
PURPOSE : To create a receiver operating characteristic curve (ROC curve) to screen for excessive sensitivity to cold (ESC). PARTICIPANTS AND METHODS : Subjects were 99 women who visited a specialty outpatient clinic for ESC. The controls were 371 female nurses. A numerical rating scale (NRS ; from 0 indicating someone is asymptomatic to 10 indicating profound discomfort) was used to determine the extent of chills in both groups. ROC curves were created to distinguish ESC based on their score on the NRS. An ROC curve was created for each premenopausal and postmenopausal woman. RESULTS : The ESC group had a mean score on the NRS of 7.3 (95% confidence interval [CI] : 6.9 to 7.6) while normal subjects had a mean score of 4.0 (CI : 3.7 to 4.3). The ESC group had a significantly higher mean score on the NRS. When the cut-off point for the NRS was set at ≥5, it had 98% sensitivity and 54% specificity for distinguishing premenopausal ESC. Similarly, that cut-off point had 96% sensitivity and 67% specificity for distinguishing postmenopausal ESC. CONCLUSION : If an individual with chills has an NRS score of ≥5, that individual may be experiencing discomfort sufficient to warrant being seen by a medical facility. Using an NRS to assess chills should help to screen for ESC.
The treatment of tinnitus is difficult with modern medicine. We encountered three cases of tinnitus for which press tack needle was effective. The first case was a 65-year-old woman. She suffered from sudden deafness, and bilateral tinnitus continued for 5 years, at which point she consulted us. Her Tinnitus Handicap Inventory (THI) score was 66 points. We administered press tack needle on the bilateral Yifeng (TE 17) points. Her THI score fell to 14 points after 1 month and zero points after 2 months, at which time treatment was completed. The second case was a 69-year-old man. Forty years before his initial visit, a gun was fired near his left ear, and tinnitus developed. The tinnitus repeatedly improved and aggravated. The tinnitus continued for 8 years before his initial visit. His THI score was 18. Press tack needle was administered to his Yifeng points. The THI score lowered to 2 points after 3 months. The third case was a 31-year-old woman. Her bilateral tinnitus started 15 days before her initial visit. Her THI score was 34 points. Press tack needle was administered to the bilateral Yifeng points. Her THI score dropped to 8 points after 4 months. Press tack needle to the Yifeng points is simple and straightforward. This suggested that it is a valuable method to consider.
An 8-year-old girl was admitted with vision loss. She had no history of amblyopia or other eye diseases. On examination, both eyes showed vision loss and uncorrected myopia, regardless of visual acuity correction by glasses. Her symptoms were considered exacerbated by fatigue. We diagnosed tonic accommodation because a regulatory paralysis agent provided relief. The patient had been treated with tropicamide methyl sulfate and neostigmine, but her visual acuity did not change. Based on a Kampo diagnosis, she was prescribed Shokenchuto. After 4 months' administration, her uncorrected vision improved by 1.2 in both eyes, and her visual acuity was maintained even when fatigued. Kampo medicine can be a treatment option for tonic accommodation in cases where standard treatments are ineffective.
Patients with the best supportive care often get worse and worse, and it is very difficult to improve their symptoms. As cancer is currently a leading cause of death in Japan, and adequate control of the cancer-associated pain is important to improve the quality of life (QOL) in cancer patients. Pain caused by bone metastasis is particularly difficult to control, and the strong analgesic medication which it requires is generally difficult to control. Such metastases result in reduced mobility and markedly reduced activities of daily living (ADL) and the QOL of patients. Our patient was a 67-year-old man who had been treated for metastasis from the left kidney to cancer of the right pelvic bone ; palliative chemotherapy and mild treatment were provided for his sharp pain, but control of his sharp pain was insufficient. Here we expand on our experience in a patient with bone metastasis caused by renal cell carcinoma successfully treated with Kampo medicine, using acupuncture and decoction extract.
Background : Menstrual migraine is more resistant to treatment than that of nonmenstrual episodes. Hormonal progesterone changes may cause sui (water/fluid) disturbance, in Kampo medicine terms. We therefore treated patients with menstrual migraine in which goshuyuto was ineffective, with the combination of goreisan and goshuyuto. Subjects & Methods : Subjects were 37 female patients with coldness (mean age 37 years, age range 23-48 years), whose migraine during their intra-menstrual periods was successfully treated with goshuyuto for 3 months. In order to treat migraine in the menstrual period, goreisan was added to goshuyuto from 1 week before onset, until the end of their menstrual period. Results : Among 37 patients, the treatment was effective in 26 patients (70%). Significant variables were found to be dull headache (p = 0.003), edema (p = 0.006), vertigo (p = 0.014) and oliguria (p = 0.014) during attacks, as well as worsening before rain (p = 0.004). Conclusion : The periodical combination of goreisan and goshuyuto seems to be effective in patients with menstrual migraine who report symptoms of sui disturbance, such as dull headache and oliguria during their attacks.
Sokeikakketsuto was administered to 33 patients with recurrent cramps of the calf appearing once a week or more and persisting for 2 weeks or more. Treatment response was evaluated 1 month after the start of drug therapy. Patients whose cramps disappeared immediately after starting were regarded as showing a complete response, those with disappearance after 1 month as showing a partial response, those with a reduction to <50% after 1 month as showing a slight response, and those in whom 50% or more of cramps persisted after 1 month as showing no response. A complete response was achieved in 12 patients, a partial response in 11, a slight response in 9, and no response in 1. In 23 (69.6%) of the 33 patients, cramps disappeared within 1 month after the start of drug therapy. In 32 (96.9%), there was a reduction to <50%. In 29 (87.8%) of the 33 patients, cramps disappeared within 3 months, suggesting the efficacy of this drug. Two-package administration in the evening/at bedtime was more effective than 1-package administration for controlling cramps of the calf at night until early in the morning. The intensive pre-attack administration of 2 packages before sleep was the most effective. Sokeikakketsuto may be useful for treating recurrent cramps of the calf.
Orengedokuto, a Kampo formulation, has traditionally been used to treat various diseases, including hypertension with neuropsychiatric symptoms, gastritis, dermatitis, hematemesis and hemorrhagic stools. We report 8 cases of intractable hemorrhage that could not be controlled by Western medicine, but were successfully treated with orengedokuto. We elaborate on 3 cases, including 1 case treated by enema administration of orengedokuto, which was found to be a useful method. In a representative case, an 80-year-old man with aplastic anemia who was taking anticoagulants due to a history of mitral valve replacement presented with a chief complaint of black stool. Hemorrhagic gastritis was diagnosed. We repeatedly attempted endoscopic hemostatic therapy, but failed to achieve hemostasis. Oral administration of orengedokuto demonstrated hemostatic effects within a few days of starting treatment. In all 8 these cases, moreover, we observed quick clinical responses with no side effects. Although the hemostatic mechanism of orengedokuto remains unclear, we speculate that orengedokuto contains a short-acting component that affects primary hemostasis. As such, conventional orengedokuto may also have potential as a novel hemostatic agent.
We present a 35-year-old male with palpebral hemispasm, which often occurred while at work. Because there were no ophthalmological findings, he consulted our clinic to receive Kampo therapy. He easily became fatigued and he had subchondral resistance and discomfort (kyo-kyo-kuman), so we treated him with saikokeishito and shakuyakukanzoto. However, they were ineffective, and therefore we reconsidered his symptoms. Although he complained of fatigue, he was well built and had been a heavy drinker until a few years before presenting. Furthermore, he easily blushed and sweated in the upper body during the daytime, and his palpebral hemispasm often occurred during this blushing and sweating, and was accompanied by headache. We considered that this represented an excess-heat pattern rather than a deficiency pattern, and prescribed orengedokuto. His symptoms improved, and disappeared after six months. There has been no detailed report of orengedokuto for the treatment of palpebral hemispasm. Orengedokuto may be useful for palpebral hemispasm in the context of symptoms of excess-heat pattern, such as blushing, sweating in the upper body and headache.
Kampo medicine has been incorporated into Japan's medical curriculum nationwide. However, it has not been adopted into its postgraduate medical education. The present study assessed Kampo medicine educational needs for residents in Japanese postgraduate training programs. A questionnaire-based survey was conducted in residents at Japanese Red Cross Ishinomaki Hospital, regarding their experience in prescribing Kampo formulae and the Kampo medicine curriculum they expect in their postgraduate education. Twenty-one residents completed the questionnaires. Seventy-five percent of junior and all senior residents had used Kampo medications. They were mostly provided with on-the-job instruction by attending doctors, senior residents, and fellows during their residency rotations. All residents needed Kampo medicine education opportunities. They expected guidance with respect to the basics of Kampo medicine, and the treatment of common diseases with Kampo formulae. The results of our study demonstrates that residents believe Kampo medicine education should be provided in postgraduate training programs.
We conducted a survey of Kampo medicine prescribing rates, and Kampo medicine awareness in first- and second-year resident physicians at three general hospitals in Hiroshima, Japan, to inform future Kampo medicine education strategies. Overall, 85.7% of the resident physicians were interested in Kampo medicine, and 70.8% wanted to practice it. Furthermore, 57.8% of the resident physicians had prescribed Kampo medicine, and of these, about 30% were prescribing it a few times per month, with both the percentage of prescribing physicians and the frequency of prescription being higher than expected. In total, 90.8% of the resident physicians wanted to observe outpatient Kampo medicine clinics and learn about Kampo medicine in their postgraduate clinical training. Overall, 97.4% of the resident physicians thought that seminars and lectures on Kampo medicine are needed, choosing responses that Western medicine is insufficient in some cases (27.0%) and that Kampo medicine is better than Western medicine in some cases (26.4%) among the choices for answers to the need for seminars and lectures. Meanwhile, the reasons for not having an interest in Kampo medicine were : having fewer opportunities to study it ; and feeling that it has a negative image (seeing it as outdated and unscientific). We think that appropriate Kampo medicine education for these physicians would reduce its negative image. The results of this survey suggest that resident physicians need a substantial education in Kampo medicine.
Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.
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