Chronic obstructive pulmonary disease (COPD) is characterized by chronic pulmonary inflammatory process, and the chief complaint is aggravating dyspnea. COPD itself also has significant extrapulmonary (systemic) effects that lead to comorbid conditions. Weight loss, nutritional abnormalities and skeletal muscle dysfunction are well-recognized extrapulmonary effects of COPD. The impact of the systemic manifestations of COPD on the prediction of mortality using a multidimensional index has been reported. Although not much is known regarding the underlying mechanisms of the systemic inflammation, any new therapeutic strategy would have to improve this chronic inflammatory process. The principal goals of the treatment for COPD are to reduce symptoms, improve quality of life, and increase physical and emotional participation in everyday activities. Exercise de-conditioning, relative social isolation, altered mood states (especially depression), muscle wasting, and weight loss have complex interrelationships, and improvement in any one of these interlinked processes can interrupt the vicious circle in COPD. Some Japanese traditional herbal medicines have been used to improve the physical and mental conditions of patients suffering from various diseases. Among them, hochuekkito is known as a drug for recovery from immune dysfunctions that has been reported useful in protecting infection. Hochuekkito may improve systemic inflammation as well as nutritional status in moderate to severe COPD, although the mechanisms of hochuekkito have not been defined. In addition, the incidences of common cold and its exacerbation can be decreased with administration of hochuekkito, suggesting that hochuekkito may have some biodefensive effect against viruses or bacterias.

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Swelling and pain appear when blood flow is delayed in states of “oketsu.” Until now “oketsu” as a circulatory disturbance has been studied from profiles of vascular resistance characteristics and blood fluidity. Blood fluidity is influenced by blood cell function, plasma ingredients and reactive oxygen. In this study, we administered the various Chinese herbal medicines, tokishakuyakusan, saikokaryukotsuboreito, tokakujokito, keishibukuryogan and juzentaihoto to determine the effect of these medicines on “oketsu” by observing reactive oxygen dynamics and blood fluidity in rats.
SPF male Wistar rats weighing 200 g were used. Each experimental group was given feed containing 3% extract of one Chinese herbal medicine for1week. Blood samples were mixed with heparin, EDTA-2K or sodium citrate to block coagulation. Blood fluidity was measured with a Micro Channel Array Flow Analyzer (MC-FAN). A PA-20 examined platelet aggregation by the reaction to ADP, which activates platelet aggregation. Reactive oxygen dynamics were measured with a Free Radical Elective Evaluator (FREE).
As a result, anti-oxidative ability and blood fluidity increased in all Chinese herbal medicine-administered groups. Furthermore, an inverse correlation between the fluidity of erythrocyte suspensions and anti-oxidative ability was shown. We speculate that an anti-oxidative influence of Chinese herbal medicines affected erythroid deformability or stickiness. In addition, tokishakuyakusan, tokakujokito and keishibukuryogan decreased platelet aggregation ability.
This study shows that “oketsu” improves blood properties and suggests that Chinese herbal medicine improves decrease in blood fluidity, the causes of conditions such as thrombosis or embolism.

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Patients with relapsing eye diseases can be treated using Kampo medicine to prevent recurrence. In our 30-year experience, only 27 patients have been treated with a Kampo formula aimed at preventing recurrence. Their conditions have included hordeolum, multiple chalazion, subconjunctival hemorrhage, filamentary keratitis, corneal herpes, Posner-Schlossman syndrome, central serous chorioretinopathy and vitreous hemorrhage. Of our patients with these conditions, the number with a successful Kampo treatment outcome for more than 3 years has been 12, when following the principles of Kampo medicine, i.e., “treatment according to a Kampo pattern of identification.”
It is considered difficult to prevent recurrence in patients with relapsing eye disease, but our results indicate the effectiveness of Kampo medicine for such patients and, therefore, we believe Kampo medicine should be used continuously for these conditions in the future.
In addition, there are no standard guidelines regarding a treatment time required to confirm success in preventing a recurrence in patients with relapsing disease, but we assume that it should to be more than 3 or 4 years.

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Aim:Shakuyakukanzoto is a Japanese herbal medicine that is known to be useful for the treatment of urinary stone pain. In this study, we investigated the effects of shakuyakukanzoto for acute renal colic.
Methods:Twenty-five patients were enrolled in this study. Eleven patients took 5.0 g of shakuyakukanzoto powder, and 14 control patients took non-steroidal anti-inflammatory drugs (NSAIDs) for their acute renal colic. The effects were evaluated before and 15, 30, and 60 minutes after treatment with a numerical rating scale (NRS). We defined scale point zero as not having pain, and scale point ten as having the strongest pain.
Results:Mean NRS scores improved from 6.7 ± 2.3 to 3.4 ± 3.5 after 15 minutes (shakuyakukanzoto group), and from 8.3 ± 1.8 to 7.0 ± 1.9 after 15 minutes (control group). NRS scores were improved immediately and significantly in both groups. The NRS score of shakuyakukanzoto group was significantly lower than that of control group at the any time after treatment. No side effects were observed in this study.
Conclusion : Shakuyakukanzoto has an immediate effect, and it is more effective than NSAIDs. Shakuyakukanzoto was a useful treatment for acute renal colic.

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We report the case of a 76-year-old woman diagnosed with refractory anemia arising from myelodysplastic syndrome. Vitamin K 2 was administered, but pancytopenia continued to progress. At the initial visit to our department, her white blood cell count was 2150/μL, hemoglobin (Hb) was 9.6 g/dL and platelet count was 2.3×10⁴/μL. Juzentaihoto was administered for Qi and blood deficiency. A dosage of shimotsuto was increased from 3 to 5 g, and juzentaihoto was changed to ogikenchuto go shimotsuto, but the anemia did not improve. Juzentaihoto was again administered, and the dosage of shimotsuto was increased to 6 g. Malt sugar, 10 g, was added to the decoction, after which her Hb and platelet count markedly increased. There was no significant difference between pre- and post-treatment bone marrow findings. It is possible that malt sugar enhances the hematopoietic function of juzentaihoto.

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We experienced two cases of postherpetic neuralgia (PHN) improved with Kampo medicines that include uzu (i.e. uzu-zai).
The pain from PHN was improved via the administration of an uzu-zai in these 2 cases, worsened by its discontinuation, and improved again by its re-introduction.
Case 1 : A 76-year-old male suffering from PHN of the right L 2-3 area was administered uzukeishito and obtained pain reduction. After 12 months, his prescription was changed from uzukeishito to keishikaryoju-tsubuto. Then, after only 2 days his pain worsened again. Uzukeishito treatment was re-instated, and he again obtained pain reduction. Case 2 : An 82-year-old male suffering from PHN of the right C 4-5 area was given uzuto and obtained pain relief. After 3 months his prescription was changed from uzuto to keishikajutsubuto. Then, after only1week his pain worsened again. Uzuto was then re-introduced, and pain reduction was achieved again. These two cases led to two suggestions. First, that the uzu-zais were very effective against the PHN pain. Second, that this effect of an uzu-zai against PHN pain might be a symptomatic rather than a radical treatment.
These two cases highlight the fact that the use of an uzu-zai was instrumental in reducing PHN-associated pain, but further studies will be needed to determine a dosage protocol, including when and at what pace uzu-zais might be reduced/discontinued.

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Background and objective : Diet has been recognized as an important part of Kampo medicine, and various plants with which we often cook are included as components of many Kampo formulations. Accordingly, nutritional science is closely related to Kampo medicine. So there is a need for national registered dietitian and nutritional science students to learn Kampo medicine. Despite this, no survey has reported on the awareness of nutritional science students toward Kampo medicine in Japan. We conducted for the first time a survey on this awareness amongst nutritional science students about Kampo medicine.
Methods : A 13-item anonymous questionnaire was distributed to the third-year students in a national registered dietitian training program in Japan.
Results : We obtained answers from 509 students in 9 institutions. Of the respondents, 59.3% answered that they were interested in Kampo medicine, and 86.4% of the students who were not interested in Kampo medicine answered that the reason was they had no chance to learn it. However, 81.3% of the students answered that they would attend lectures on Kampo medicine if it was adopted as part of their curriculum.
Conclusions : These results suggest that Kampo medicine should be included in educational programs for nutritional science students.

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The authors studied the doses and usage directions for some of the first Traditional Japanese Medicines (TJM) and reached the following conclusions. Since Dosan Manase, who had strong influence on TJM, adopted a method of selecting drugs one by one and refused to use fixed prescriptions, it has been hard to comprehend how much of any drug he administered. As criterion, he showed a half common system of weights. Ekiken Kaibara defined an extremely small dose as 1 ∼ 2 qian. Todo Yoshimasu set around 3 qian as the quantity for one dose, although he calculated that 1 liang was equivalent to about 2 qian (7.5g). Additionally, the Koshogaku school proposed that 1 liang was equivalent to 1.4g.

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