Nasolacrimal duct stenosis, which causes epiphora and eye mucus, is generally treated with probing and irrigation of the nasolacrimal duct. A 57-year-old woman was treated with probing and irrigation of the nasolacrimal duct three times, however, her symptoms of refractory nasolacrimal duct stenosis did not improve. Following 3 days administration of saisoin, her epiphora ameliorated. Based on this experience, we treated 11 adult patients with nasolacrimal duct stenosis using saisoin, and 10 (90.9%) achieved remission within a week. All the adult patients had received treatment by probing and irrigation of the nasolacrimal duct at an ophthalmological clinic, and their symptoms had not improved. Two such cases in infants, moreover, were cured with saisoin in a week. This is the first report on the efficacy of saisoin for the treatment of nasolacrimal duct stenosis in Japan.

View full abstract

The IPCD (Immersing Powdered Crude Drugs) method, inspired by the “zhu san fa” which was widely used in the Song period of China, has been developed to prepare Kampo decoctions quickly and easily, with highyield extract from crude drugs. One trouble with the IPCD method occurs when separating the decoction from the muddy residue of the crude drug powder. When powdered ephedra herb is packed in a nonwoven fabric bag and immersed in hot water, yield of the marker compounds is much lower than that obtained when ephedra herb powder is dispersed freely in hot water without a nonwoven fabric bag. Thus the use of a nonwoven fabric bag was shown to be unsuitable with the IPCD method. In investigating an easy and more efficient separation method, we tried decanting with a commercially available wine carafe to separate the decoction and residue. With IPCD followed by decantation using the wine carafe, yields of about 80% decoction volume were obtained as compared with those when cut crude drugs are decocted and filtered using a tea strainer, in 6 of the 7 formulas tried. We find that decantation using a wine carafe is a more practical way of separation in the IPCD method.

View full abstract

[Objective] In this study, we retrospectively investigated the efficacy of Kampo medicine for refractory acne patients with standard therapy in Japan.
[Patients] Two hundred and thirty nine patients with inflammatory acne completed the study. Six Patients discontinued their systemic treatment because of adverse events. The patients included 193 females and 46 males, with a mean age of 26.5 years. They took Kampo medicine three times daily for 3 months, in a manner according to our protocol.
[Result] For females, 163 of 199 patients (82%) were in the KUOKETSUZAI Group taking medicines such as keisibukuryogankayokuinin, tokishakuyakusan, tokakujyokito, and kamishoyosan. Here, 124 of 163 patients (76%) had a significant decrease in new and inflammatory eruptions after taking the Kampo medicines alone or in combinations with other KUOKETSUZAI medicines. Fourteen of 19 patients (74%) took seijobofuto, of which 6 of 7 females (86%), and 1 of 3 males (33%) had decreased acne eruptions. Also in KUOKETSUZAI group, significant efficacy was shown in females over 21 years of age on combinations. For males, 18 of 23 patients (78%) taking keigairengyoto and 14 of 20 patients (70%) taking seijobofuto, also had decreased inflammatory acne eruptions.
[Conclusion] Kampo medicines exhibit significant efficacy for the treatment of the refractory acne.
KUOKESTUZAI : category of oriental medicines that improve peripheral blood flow while concurrently facilitating wound healing, and that regulate hormone balance, and improve gastrointestinal motility ; e.g. keisibukuryogankayokuinin, tokishakuyakusan, tokakujyokito, kamishoyosan.

View full abstract

We conducted a study to evaluate the efficacy of mashiningan for constipation in Parkinson's disease. Twenty-three patients with constipation in Parkinson's disease were enrolled and were evaluated after 1 month in this study. The mashiningan efficacy endpoint in the study was bowel movement frequency. We categorized treatment effect as “effective”, “ineffective”, and “worsened” to calculate increased, unchanged, and decreased bowel movement frequencies, respectively. Previously administered laxative was also switched to mashiningan and subsequent effect was evaluated as well. Mashiningan was effective in 78.3% of patients, and there were no patients determined to have “worsened”. The only adverse effect was diarrhea which was noted in 13.0% of patients. Mashiningan was effective in 86.7% of the 15 patients without laxative administration history, and was effective in 62.5% of 8 patients who had taken laxative previously. Therefore, mashiningan showed a higher degree of efficacy in the patients off medication for constipation. Additionally, mashiningan could be safely switched to from other laxatives without worsening constipation. In conclusion, mashiningan is a useful medication for the treatment of constipation in Parkinson's disease.

View full abstract

PURPOSE : To examine the therapeutic efficacy of contact needle therapy (CNT) for peripheral facial paralysis
STUDY DESIGN : Case series study
METHODS : A total of 15 patients (Bell's palsy, 13 cases ; Ramsay Hunt syndrome) with peripheral facial paralysis who first visited between April 1, 2008 and March 31, 2013 and received CNT were examined in this study. Using the Yanagihara paralysis score, complete recovery was defined as a score improved to 36 within about 6 months of paralysis onset, and without moderate or worsened residual morbid synergic movements.
RESULTS : In all cases, the patient had received standard otological treatment. Median age was 65 years (range, 23-84 years). Median interval from onset of paralysis to first acupuncture treatment was 13 days (range, 4-105 days). Eight patients had an electroneurography (ENoG) value of < 10%. Eight patients achieved complete recovery. Two of the 8 patients with complete recovery had an ENoG value of < 10%.
CONCLUSION : Not only in-situ acupuncture and electroacupuncture treatments, but also CNT may represent effective acupuncture treatments for peripheral facial paralysis.

View full abstract

Irritable bowel syndrome (IBS), one of the most common gastrointestinal disorders, and is common in childhood. It is characterized by abdominal pain or discomfort with no organic or metabolic etiology. The abdominal pain and discomfort are associated with changes in defecation or stool form. We report a pediatric patient with IBS, who was successfully treated with acupuncture and moxibustion.
The patient was a 10-year-old girl, who had developed IBS 3 years previously. She had abdominal pain accompanied by bowel movements with soft stool five times per day. The patient was treated with acupuncture and moxibustion according to the theories of traditional Chinese medicine. In addition, we used the Gastrointestinal Symptoms Rating Scale (GSRS) to evaluate her quality of life. She received acupuncture and moxibustion treatment at two sessions/week during the first 6 weeks, followed by only one session/week later. One month after the treatment was started, her GSRS score began to improve and her abdominal pain and bowel movements were reduced. Compared with baseline, her GSRS score was improved at 2 months and 1 year after the acupuncture was started. In conclusion, acupuncture and moxibustion treatment was effective in the present pediatric IBS patient.

View full abstract

We report our experience with two patients who had a previous history of cerebral hemorrhage and presented with persistent hiccups. Hangekobokuto was found to be effective in these patients. Case 1 was a 49-year-old man with a history of cerebral hemorrhage who experienced persistent hiccups as a result of pulmonary aspiration that occurred while he was admitted to the hospital for heat stroke. Abdominal palpation revealed epigastric resistance and tenderness. Metoclopramide and shakuyakukanzoto were administered without any amelioration of the symptoms, but the symptoms disappeared 1 hr after changing the drug regimen to hangekobokuto. Case 2 was a 64-year-old man who experienced persistent hiccups 28 days after suffering a cerebral hemorrhage. Abdominal palpation revealed epigastric resistance and tenderness and a lack of resistance at the lower abdomen. Because a regimen of metoclopramide and shakuyakukanzoto was similarly ineffective, we changed the drug regimen to hangekobokuto, and the symptoms subsequently disappeared 7 hr after administration. The symptoms did not recur in either patient following treatment. Hangekobokuto can be effective in cases of persistent hiccups is worth considering as a treatment option.

View full abstract

A 56-year-old woman visited our hospital with a persistent fever of 38 °C. Chest radiography and plain computed tomography (CT) showed scattered infiltrative shadows in both lung fields. She was diagnosed as having pneumonia and received antimicrobial therapy. Subsequently, the pneumonia was improved and defervescence was observed. Although pneumonia appeared 1 and 5 months later, antimicrobial therapy again recovered the patient's condition. At that point, we noticed from the patient's medical history that she had developed pneumonia 2—3 times a year over the past 4 years. Therefore, we prescribed low-dose macrolide therapy and an expectorant as prophylactic treatment. However, she developed pneumonia again after 4 months, but recovered with antibiotics.
Jiinshihoto was administered, because the pneumonia repeated over short periods. Subsequently, no pneumonia developed during the 1.5 years following Jiinshihoto administration. In Japan's aging society, death due to pneumonia has increased and will increase. In many patients, antimicrobial therapy alone results in recurrent pneumonia despite of temporary improvement. Furthermore, because it is important to prevent the development of pneumonia, this case is considered of value in Japan, as Jiinshihoto proved effective in preventing recurrent pneumonia.

View full abstract

The patient was a 54 year-old woman who suffered from systemic pain and augmented coldness since receiving trauma injury at her office about 1 year previously. She was diagnosed as yang-deficiency and accumulation of water caused by kidney impairment induced by psychological trauma. The combination of keishikaryojutsubuto with added hachimijiogan was effective for her symptoms. The author considers this benefit was mainly caused by the efficacy of keishikaryojutsubuto to reinforce the ki of kidney, and eliminate accumulation of sui.

View full abstract

We report five cases of acute hyperventilation attack, with bilateral fullness of the chest and hypochondrium, and bilateral rectus abdominis muscle strain, that were successfully treated with shigyakusan. Case 1 was a 47-year-old female ; case 2 was an 18-year-old female ; case 3 was a 23-year-old female ; case 4 was a 39-year-old male ; and case 5 was a 40-year-old male. All five patients visited the emergency department with complaints of severe dyspnea and tetany. Their abdominal signs were characteristic, with remarkable bilateral fullness of the chest and hypochondrium and bilateral rectus abdominis muscle strain. In cases 1 to 4, the patients were given 2.5 g of shigyakusan extract, and their symptoms promptly improved. In case 5, as the patient could not swallow the prescribed medication at presentation, intramuscular diazepam was given. Thereafter, he complained of continuous severe numbness ; we subsequently gave him shigyakusan, and his numbness promptly improved. In conclusion, shigyakusan seems to be a useful Kampo drug for the treatment of acute hyperventilation attack.

View full abstract

Although western medical treatment for heart failure has dramatically improved, limitation still exists where such treatment together with mechanical support fails to manage heart failure. It is unclear whether the addition of Kampo medicine to standard recommended therapy can improve clinical manifestations. To address this issue, we retrospectively evaluated the effects of Mokuboito used in 12 consecutive heart failure patients from April 2013 to April 2015 by analyzing endpoints such as symptoms, BNP concentration, and left ventricular ejection fraction (LVEF). Mokuboito significantly decreased plasma BNP concentration from 796.8 ± 830.8 to 215.6 ± 85.5 pg/ml (p < 0.01) and improved symptoms. There were no significant differences in other parameters including LVEF. In conclusion, the present study suggests that Mokuboito is a useful treatment on top of the standard heart failure medication in severe heart failure patients.

View full abstract

We report the case of a 17-year-old male who had involuntary movements treated with yokukansankashakuyakukoboku. He had first recognized the involuntary movement 6 years previously. His symptom could not be alleviated with neurological and psychological treatments, and he visited our clinic for treatment with Kampo medicine. His symptom gradually alleviated with yokukansankashakuyakukoboku. The ancient physician Sekki (薛已) created yokukansan in China's Ming Dynasty. Yokukansan and its various add-on combinations were used in the Edo Era of Japan. Keisetsu Ohtsuka then created yokukansankashakuyakukoboku, which is however now rarely used because there is no extract drug in Japan. There are markedly nervous patients however, who can be treated with this formula. Thus, the authors feel that more research needs to be done on the differences between yokukansan and yokukansankashakuyakukoboku.

View full abstract

The number and the nature of reported side effects caused by over-the-counter Kampo formulations (OKF), as well as their changes over 10 years (fiscal years 2005 through 2014), were investigated using the data published on the website of the Japanese Ministry of Health, Labour and Welfare. The total number of side effects reports regarding OKF was 367 during the period, including 151 reports of liver dysfunction, 54 reports of drug eruption/hypersensitivity, and 51 reports of lung injury. Annual incidence of reported side effects increased nearly threefold over the period, from 16 in 2005 to 43 in 2014. Bofutsushosan was involved in 110 cases, kakkonto in 45 cases, hachimijiogan in 15 cases, and daisaikoto in 14 cases. The number of side effects due to bofutsushosan and kakkonto showed an increasing trend during the period from 2005 to 2014. Bofutsushosan was associated with 65 cases of liver dysfunction and 23 cases of lung injury. Kakkonto was associated with 21 cases of drug eruption/hypersensitivity. Under the current circumstances, severe side effects requiring medical treatments such as liver dysfunction and lung injury are showing a tendency to increase. To improve safety, we recommend tighter control over the sale of OKF, especially bofutsushosan and kakkonto,which accounted for nearly half of all reported side effects.

View full abstract

In Japan, controlled devices for medical professionals have been often purchased by people other than acupuncturists or doctors, using the Internet sales system. Press Tack Needle (PYONEX^®) allows easy handling by combining a plastic part with an adhesive tape. Since it has been reported to be relatively safe with limited adverse events such as adhesive-related dermatitis or similarly mild disorders, it is widely used. We report a case that when the patient removed a PYONEX^® which applied by himself, the needle tip was broken and remained in his body. It might lead to an accident such as injury due to a broken needle left in the body. The patient had purchased the PYONEX^® on his own judgments, storing it for a long period of time, applied it to his body 10 months after its expiration date and kept it attached for approximately 3 weeks. Plastics are characterized by deterioration and can be damaged by environmental factors including ultraviolet rays, water, and shocks. In this paper as an urgent issue, we note that when using these products, in addition to paying attention to their expiration dates, precautions should be considered since deterioration may also progress due to prolonged attachment.

View full abstract

“Mi-byo” (pre-disease) is a special concept in Chinese Medicine proposed about 2,200 years ago in the ancient text Ko-tei-nai-kei, which states that “a Saint-like Doctor” can cure “mi-byo”. However, no one has been saintly enough to explain an actual “mi-byo” status to date. In the 21 th century, as immunology has developed, the novel notion of “homeostatic inflammation” began to be postulated. Here, “homeostatic inflammation” means the self-repairing steps initiated by innate immune sensors when they encounter either PAMPs (pathogen-associated molecular patterns) or with DAMPs (danger signal-or damage-associated molecular patterns) composed of either lipids-or nucleic acids-related substances through their own TLRs (toll-like receptors) or NLRs (NOD-like receptors), respectively. If such “homeostatic inflammation” does correlate with the “mi-byo”, perhaps we can control it by using herbal medicines containing various saponins, essential oils, alkaroids, and flavonoids that may reinforce innate barriers by regulating the effect of lipids and nucleic acids.

View full abstract