The clinical effects of tokishigyakukagoshuyushyokyoto for vascular intermittent claudication were investigated by treadmill test with 2.4 km/hour and 12 degree. Thirty three patients with Arteriosclerosis Obliterans (ASO) chose either administration of cilostazol (Group I) or tokishigyakukagoshuyushyokyoto (Group II). After limitation of improvement by cilostazol in Group I, tokishigyakukagoshuyushyokyoto was administered (Group III). The distance where patients were able to walk to the limit was assumed to be the maximum walking distance. Change rate of absolute claudication distance (ACD) was calculated as ratio of maximum walking distance after and before treatment.
The median of change rate of ACD in Group I one and three month after treatment were 130.5% and 145.5%, respectively. The median of change rate of ACD in Group II one and three month after treatment were 111.6% and 122.7%, respectively. Finally, the median of change rate of ACD in Group III one and three month after treatment were 112.0% and 112.3%, respectively.
Either cilostazol or tokishigyakukagoshuyushyokyoto was effective for vascular intermittent claudication. Moreover, tokishigyakukagoshuyushyokyoto showed additional effect after limitation of improvement by cilostazol.

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We studied contemporary indication of daikankyoto and daikankyoganryo. We administered either of these Kampo prescriptions for thirty-three patients with intractable muscle stiffness of neck, shoulder and back.
Twenty-four patients were able to take the prescriptions for more than four weeks (long term group), and nine patients stopped taking the prescriptions less than four weeks (interrupted group). In long term group, fourteen patients (58%) improved their chief compliant. The Kampo formulations of fourteen effective cases were daikankyoto (13 cases) and daikankyoganryo (1 case). Comparative analysis has been done between long term group and nine cases of interrupted group. The characteristics of long term group were higher body mass index, firmer abdomen and more positive cases of epigastric resistance sign. Kansui root dose was 0.81 gram a day in long term group and 0.57 gram a day in interrupted group, which showed statistically-significant difference. We found twenty-seven side-effects in twenty four patients (73%) including eighteen patients with nausea and six patients with diarrhea. In side effects, there was no statistically significant difference between two groups. These side effects were promptly improved after discontinuation or dose reduction of Kansui root. We report clinical courses of six improved cases in this paper, two severe stiff neck, shoulder and back cases, each one case of psychosomatic disorder, depression, spasmodic torticollis and gastroesophageal reflux. These prescriptions should be administered more commonly to the patients with severe stiff neck, shoulder and back.

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Saffron (Crocus sativus L.) is classified as a beneficial herb in the treatment of “Oketsu,” eliminating blood stagnation. The clinical symptoms of “Oketsu” include feeling cold and arthralgia. The pathological condition of “Oketsu” is considered to be increased blood viscosity and microvascular disorders.
However, no useful biomarker has been reported for evaluation of the degree of “Oketsu.” Here, we investigated the clinical effect of saffron on the symptoms of “Oketsu” in patients with autoimmune diseases. At the same time, we measured the plasma levels of platelet factor 4 (PF-4) and beta-thromboglobulin (β-TG) as platelet activation markers. Seventy-one patients (66 women and 5 men, mean age 52.3 ± 16.1) were studied. They were administered saffron (300mg∼900mg) with traditional Kampo medicine. The clinical symptoms of “Oketsu” improved (80.9%, n=38/47) and we measured PF-4 and β-TG in pre-and post-saffron treatment periods. The plasma levels of PF-4 and β-TG significantly decreased after saffron therapy (PF-4 : before 49.6 ± 29.8, after 24.0 ± 19.6ng/ml, β-TG : before 117.5 ± 64.0, after 64.6 ± 47.1ng/ml;paired t-test, p < 0.0001, respectively). These results suggest that saffron is effective in treatment of the symptoms of “Oketsu” in allergy and collagen disease patients. Moreover, PF-4 and β-TG may be useful biomarkers of the degree of “Oketsu.”

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Maoto has been reported to be effective in controlling fever caused by influenza. But Maoto's effects on respiratory complications of influenza have been unknown so far. We performed a comparative study on the respiratory complication (bronchitis, pneumonia, asthma attack) rates of pediatric cases of influenza after the administration of Maoto (n = 80), Oseltamivir or Zanamivir (n = 166). Rate of using other respiratory medication at the same time is higher in Oseltamivir/Zanamivir group (64/166 = 39%) than Maoto one (12/80 = 15%) (P < 0.01). Respiratory complication rates were equal between Maoto group (34/166 = 21%) and Oseltamivir/Zanamivir one (9/80 = 11%) (P = 0.07). In the patients who had not history of bronchial asthma, respiratory complication rate is higher in Oseltamivir/Zanamivir group (19/107 = 18%) than Maoto one (4/67 = 6%) (P = 0.045). In the patients who had history of bronchial asthma and age under10, respiratory complication rate is higher in Maoto group (4/5 = 80%) than Oseltamivir/Zanamivir one (15/57 = 26%) (P = 0.047).

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We administered daisaikoto to 13 patients with traumatic cervical syndrome and observed complete responses in the following 2 patients. Patient 1 was a 40-year male. He was in the xiaoyang stage, and showed high abdominal tension and marked chest oppression. These findings were indications for daisaikoto. Patient 2 was a female in her 50 s. She was in the xiaoyang stage, showed moderate abdominal tension and chest oppression, and was aware of chest tension and constipation. Evaluation using the VAS in the 13 patients showed a complete response in 3 patients, partial response in 6, minor response in 1 and no response in 3. To clarify indications for daisaikoto in this disease, findings of Japanese Oriental Medicine in the 13 patients were evaluated. Of 9 patients with high abdominal tension, 8 showed partial or complete responses. Of 4 patients with moderate abdominal tension, a complete response, partial response, and no response were observed in 1, 1, and 2, respectively. In addition, objective abdominal coldness was present in both patients with moderate abdominal tension who showed no response but not in the patient showing a complete response.
We confirmed the importance of therapy based on oriental medical syndromes when daisaikoto is used for traumatic cervical syndrome. However, patients with moderate abdominal tension without abdominal coldness can be differentiated from others for this therapy.

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We report a patient with Multiple system atrophy that was successfully treated with the herbal formulation Hachimijiougan.
A 79-year-old man was hospitalized with Multiple system atrophy. He showed slow movement, frozen gait, finger tremor, dizziness on standing up with slowly progressive characteristics. Various medications had been administered for orthostatic hypotension, but the effect was insufficient.
So we administered Hachimijiougan without changing the other oral medications. After administration, orthostatic hypotension was improved, and he became able to perform various activities of daily living.
In this case, we thought that Hachimijiougan improved autonomic nervous system disorders such as the orthostatic hypotension in a patient with Multiple system atrophy.

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Generally, as for the Bell paralysis in facial nerve paralysis, about 70% are cured spontaneously, and, as for the remainder, steroid and antiviral agent (aciclovir) medical treatment are taken, but treatment of the Western medicine is invalid in the serious case. As a result, the paralysis remains and the aftereffects of the morbid synkinesis is caused. Finally, it becomes the result of greatly damaging QOL because of features of a peculiar face for the patient.
The case is 29-year-old pregnant woman and primipara. Abnormality was not especially found in the previous history without what had to be mentioned specially while getting pregnant. A right paralysis of facial nerve developed suddenly cold early morning of 35 gestational weeks (paralysis score 0/40). She gave birth naturally without the effect though the steroid was treated by otorhinolaryngologist. After birth, Kampo treatments were begun with Kakkonto and Saireito for two months. Place where those medicines changed to Daisangoshichisanryo and Kososan because of invalidity, an eye closure and open eyes would become smooth in two weeks, and it recovered in almost one month. Here is a first reported case that concurrent Kampo therapy with Daisangoshichisanryo and Kososan were effective for patient with paralysis of facial nerve that developed during pregnancy.

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In the Guideline for treatment of chronic headache published by Japanese Headache Society, Ibuprofen and Acetaminophen are proposed for the acute treatment of migraine in children. But prophylactic treatment of pediatric migraine is not established. We report the efficacy of Kampo medicine for preventing migraine in children and childhood periodic syndromes. We use a variety of Kampo medicine for 9 pediatric migraine and periodic syndromes patients from 8 to 15 years old. All 9 patients improve their headache and associated symptoms including abdominal pain, vertigo, nausea and vomiting. After treatment the mean average of Headache Impact Test-6 (HIT-6) improve from 63.66 points to 45.77 points. Kampo medicines is effective for migraine in children and childhood periodic syndromes.

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In this report, we describe four hemodialysed patients with upper abdominal discomfort successfully treated with Heiisan, one of the known traditional oriental herbal medicine.
Case 1 was a 61-year-old man suffering from upper abdominal discomfort after each meal even though daily taking some medicine for gastritis. Case 2 was a 45-year-old man, who has also been suffering from upper abdominal discomfort after breakfast and supper despite daily taking H₂-blocker. Case 3 was a 61-year-old man complaining of upper abdominal discomfort. He has had loss of appetite despite being treated with H₂-blocker and gastroprokinetic medication. Case 4 was a 69-year-old woman complaining of upper abdominal discomfort with dull pain before eating. She was diagnosed as chronic gastritis and healing stage of duodenal ulcer and prescribed H₂-blocker. However, this medicine did not work.
We diagnosed that upper abdominal discomfort in all the patients came from shitsu-jya (pathogenic dampness) in hii (Spleen-Stomach functional unit), and treated them with Heiisan, which was popular to remove shitsu-jya in Hii. Their symptom disappeared soon after taking this medicine.
It is also difficult for hemodialysed patients to control their weight due to anuria and they tend to easily gain the weight due to inappropriate eating and drinking, leading to shitsu-jya in such patients. Therefore, our reports suggested that Heiisan was good for hemodialysed patients to control various upper abdominal symptoms that might be caused by shitsu-jya in Hii.

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We encountered 2 cases of vomiting that were successfully treated with daisaikoto. In case1, the patient was a 16-year-old girl. She was vomiting in the hospital with pneumonia. Referring to the vomiting and kyokyo-kuman (Subchondrial resistance and discomfort), vomiting gradually disappeared after administration of daisaikoto. In case 2, the patient was a 73-year-old woman. After aspiration pneumonia, she developed nausea and vomiting and experienced constipation and kyokyo-kuman. The nausea and vomiting gradually disappeared after the administration of daisaikoto. These findings suggested that daisaikoto, in combination with a large amount of Zingiberis Rhizoma on classic text, suppresses nausea.

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