Kampo Medicine

The regulatory effects of Gorei-san (Wu-Ling-San) on circulatory, metabolic and diuretic function were investigated analyzing the perioperative transition of serum sodium levels, peripheral platelet counts and urinary 6-keto-prostaglandin F₁α levels in fifty-eight female patients who underwent cholecystectomy because of cholelithiasis or gallbladder polyps.
The endothelial cells were considered to be activated by administration of Goreisan as shown by an increase of prostaglandin I₂ production, resulting in circulatory and metabolic stimulation and partly promotion of diuretic function by a dilatation of the renal vessels. The urinary 6-keto-prostaglandin F₁α, a metabolite of serum prostaglandin I₂ and also excreted by the interstitial cells in the renal medulla or by the epithelial cells of the renal collecting tubules, was considered to regulate diuretic function through suppressing the antidiuretic hormone.
The phenomena mentioned above were not recognized when Sho-saiko-to (Xiao-Chai-Hu-Tang) was administered instead of Gorei-san.

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Abstract Combined treatment with high-dose methylprednisolone and Kampoherbal medicine (Xiao-Chai-Hu-Tang and Jia-Wei-Gui-Pi-Tang) brought about a striking clinical improvement in a 24-year-old woman with severe hepatitis-associated aplastic anemia. Laboratory findings on admission were summarized as follows: granulocytes 325/μl, erythrocytes 2, 450, 000/μl, platelets 10, 000/μl, bone marrow nucleated cells 27, 000/μl, and GPT 569IU/l. Neither anti-lymphocyte globulin, high-dose methylprednisolone alone nor oxymetholone was effective on any hematological finding although intravenous administration of high-dose glycyrrhizin improved the liver dysfunction. The patient needed repeated transfusions of leukocyte-poor washed red blood cells and HLA-matched platelet concentrates for a period of 1.5 years until the hematopoietic function recovered 3 months after combined treatment with high-dose methylprednisolone and Kampo-herbal medicine. Laboratory findings on discharge were as follows: granulocytes 1, 050/μl, erythrocytes 3, 460, 000/μl, reticulocytes 100, 000/μl, platelets 47, 000/μl, bone marrow nucleated cells 118, 000/μl, and GPT 52IU/l. Six months later hematopoietic depression recurred, and this combined treatment was performed again with favorable response.

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