Since many patients are still dying from asthma and COPD, developing more effective drugs with little side-effect which can be taken for a long time, is very important. Clinical usage of herbal medicines for chronic airway diseases has been increasing. Bakumondo-to is a useful herbal medicine with little side-effect for the treatment of chronic airway diseases. There are some similarities of pharmacological profile of herbal medicines to those of glucocorticoids. Although the regulation of gene expression by glucocorticoids has been clarified, that of Bakumondo-to is not well known. Elucidation of the mechanism of Bakumondo-to will be helpful in establishing a more effective treatment of chronic airway diseases. This article focuses on the regulation of gene expression by Bakumondo-to in airway epithelial cells, and describes the increase in mRNA expression for β-adrenergic receptors by Bakumondo-to and in glucocorticoid-sensitive promoter activity. We also discuss the mechanisms of the regulatory action of Bakumondo-to.

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Modern Western medicine made rapid progress in the last century. The theory of modern Western medicine attaches importance to universality, objectivity, and logic. Consequently, Western physicians favor a body-oriented approach to the human being, and sometimes place a minimal value on the mental status and quality of life (QOL) of patients. In Oriental (Kampo) medicine, the human being is regarded as an entity consisting of body, soul and spirit, and patient complaints are usually highly valued. The development of new medicine that harmonizes both medicines is now required. In this article, initially the efficacy and limitations of each style of medicine in patients with influenza, Sjögren syndrome, chronic renal failure, chronic C hepatitis, and atherosclerosis are discussed, and the potential benefit from combining these disciplines to form new medicine was outlined. Secondly, N-of-1 design and double blind study after selection of patients by Kampo diagnosis, “Sho”, are proposed as methods for evaluating the efficacy of Kampo medicine.

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Five patients in the acute stage of reflex sympathetic dystrophy (RSD) of the hand were treated with Sairei-to and Rikkunshi-to, and were evaluated for pain (visual analog scale: VAS), swelling and limitation of finger motion. Four of the five patients had good results, with a decrease in pain to less than 50% of initial pain on VAS within six weeks. Swelling and finger motion tended to improve earlier than pain. In general, symptoms of RSD are limited to those associated with local inflammation during the acute stage, but patients with RSD tend to have psychological factors that can trigger generalized complaints even before the onset of RSD and to feature ‘kikyo, ’ a loss of vitality, after RSD onset. RSD should therefore be recognized as one feature of a generalized disease. Oral Kampo therapy using Sairei-to and Rikkunshi-to appears to be a reasonable treatment for early RSD.

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The only extract preparations listed in either the “Shokan-ron” or the “Kinki-yoryaku” are the “Daio-oren-shashin-to.” It is thought that the term “extract preparation” is used because of the speed of efficacy required of these formulas. The author tried three different varieties of these percolate extracts, “Daio, ” “Oren, ” and
“Ogon, ” in a group of hypertensive patients (5 men, 27 women). Blood pressure was measured both 30 minutes before and after administration. As a result, an antihypertensive effect of 10mmHg systolic blood pressure or more was seen across 68.8% of the group. There was even an antihypertensive effect in those not normally considered “Yo-jisshou” (resistant and robust constitution). And with this administration, none of the patients developed diarrhea. Extract preparations seemed to have more of an enhancing effect on sedative action, rather than on purgative action. And they are considered effective as antihypertensive agents in emergency cases of elevated blood pressure.

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We investigated the change of “Kyo-kyo-kuman, ” after the administration of Saiko-zai (including Bupleuri Radix) or Non-saiko-zai (not including Bupleuri Radix). Subjects were 44 patients (7 males, 37 females, with a mean age of 42.8±16.4). We evaluated their levels of the Kyo-kyo-kuman, with blood biochemical tests, their depressive levels using Zung's Self Depression Scale (SDS), and their subjective well-being levels using the Subjective Well-being Inventory (SUBI) scale, at baseline and 3 and 6 months after the administration of Kampo formula. In the S-group (20 patients), administered Saiko-zai for 6 months, the K-scale (Keio's Kyo-kyo-kuman scale) scores showed significant decreases at 3 and 6 months. In the C-group (16 patients), administered Non-saiko-zai for 6 months, the K-scale scores did not change significantly. There was a statistically significant decrease in the K-scale scores of the patients of S-group as compared to the patients of C-group. The decreases in the left K-scale scores correlated significantly with the rises in plasma protein concentrations.

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This report describes the cases of three patients suffering from severe atopic dermatitis resistant to steroid therapy who were successfully treated by Japanese herbal medicine. For the therapy, the formulas were decided on the basis of the combination therapy of Honchi and Hyochi. Honchi was administered to improve the constitution of each patient, and Hyochi was performed when indicated by skin conditions. All three patients showed erythroderma, with exudation on large areas of their bodies, and complained of severe itching.
Case 1 was a 38-year-old man with striking edema and oliguria, and who complained of a sense of coldness (HIE). He recovered promptly after being treated with Kei-hi-to as Honchi, and Chorei-to and Sanmotsu-ogon-to as Hyochi. Case 2 was a 58-year-old woman who was allergic to Keishi and Ogon. She complained of dizziness, mild headaches and digestive problems. Hange-byakujutsu-tenma-to and Haino-san-kyu-to were effective as Honchi and as Hyochi respectively. Case 3 was a 23-year-old man afflicted with dryness and exudation of the skin. He was treated with Hyochi and Honchi, alternatively or simultaneously. Juzen-dai-ho-to, Saiko-keishi-to and Byakko-ka-ninjin-to were used as Honchi, and Oren-gedoku-to, Keigai-rengyo-to and Jumi-haidoku-to were used as Hyochi. Those formulas were altered according to his systemic and cutaneous conditions.
All three patients showed striking improvement within 18 months of beginning the Japanese herbal medicine therapies.

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We report three elderly patients in the extended care unit who were successfully treated orally with Chotosan. Case 1 was an 84-year-old male who was hospitalized for lowered volition after aspiration pneumonia in 1999. He received nutrition through a stomach fistula. Administration of Choto-san increased his volition, and he resumed eating normally after practicing swallowing. Case 2 was a 99-year-old woman who was hospitalized for lower volition after a thighbone fracture in 2000. She also could not eat orally, and received nutrition via nasal-tube feeding. After the administration of Choto-san, she developed a will to eat, and she could again have meals orally. Case 3 was an 84-year-old woman who was hospitalized for lowered volition after aspiration pneumonia in 1999. She had pressure ulcers and was often feverish, so she was fed by nasal tube. She was treated with Choto-san, and was able to eat normally again after practicing swallowing. Her pressure ulcers were cured. This suggests that the administration of Choto-san may be successfully utilized as part of a strategy for overcoming swallowing trouble in the elderly.

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The basis of the present writer's study is the ancient literature of manipulation and anma-therapy, which was edited before and after the time that “Huang-ti nei-ching” was formed in the Han Period.
The conclusions are drawn from the results as follows:
In China, it may be said that the origin of anma-therapy may be traced back to the Yin Chou Period, because it was described in “Chia-ku-wên” and “Chou-li.” It may be said, too, that its origins may back to the Chunchiu chan-kuo Period, because there are the descriptions of a name, resembling anma-therapy, and its effects in “Pien-chüeh Chuán.”
And it is corroborated in “Wu-shih-erh Ping Fang” that anma-therapy was actually performed before the Chin Han Period. Furthermore, because the technique of the term “ma” with plastering is described in “Yãng-shêng Fang, ” “Shên-nung pên-tsao-ching, ” and so on, it proves that anma-therapy was in existence, though the expression of the term “ma” is different from that of the term “an” in “Huang-ti nei-ching.”
For these reasons, it appears that anma-therapy had already been used, together with other treatments, in the Chou Period.
But the fact that the technique of “an” differs from the process of the development of “ma” needs to be studied further.

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