We examined the effect of acupuncture treatment in the supine position, sitting position, and horseback riding posture on a horseback riding simulator at a standstill from the aspects of physical movement, psychological assessment, and autonomic nerve activity.
Twenty-nine university students suffering from pain and stiffness during lateral hip flexion and extension movement of the Straight Leg Raising and movement of the neck and shoulders were randomly assigned to the supine position, sitting position, and horseback riding posture, and a tape-type press needle was attached at four acupuncture points on both lower limbs. Regarding the measuring method, we conducted M-Test movement assessment, two-dimensional mood standard (TDMS-ST), and heart rate variability analysis.
There was no difference in the baseline among the three groups prior to the experiment and the improvement in the movement of the neck, SLR, and hip flexion (knee flexed position) for all three groups along with the comfort level of TDMS-ST significantly increased following treatment. Moreover, while we also observed a significant increase in HF (parasympathetic activity index) for all three groups following treatment, no change was observed in the LF/HF ratio (sympathetic activity index).
These findings suggest that the stimulation from the press needle by the M-Test method achieved a relaxing effect regardless of the posture because the stimulation had a low degree of invasiveness, and it was also not associated with any pain.

A 48-year-old man presented with knee pain and general fatigue. He had been diagnosed with sarcoidosis 15 years previously. Prednisolone was administered, but the pain and fatigue persisted. Morphine, fentanyl, and a tramadol/acetaminophen combination were then administered, but their effects were not sufficient. Finally, the patient was treated with sekiganryo, uzuto, uzukeishito, and daiuzusen, all of which contained uzu (aconite root without processing). His pain and fatigue improved after administration of these drugs, and he became able to perform various activities of daily living. In this case, uzu alleviated knee pain and general fatigue in a patient with sarcoidosis.

We report two cases effectively treated with Kampo medicines for comorbid sleep disorder in developmental disorder. Case 1 was a 15-year-old woman diagnosed Asperger's syndrome, and her main complaints were difficulty in rising, difficulty in falling asleep and fatigability. We thought that the symptoms might be caused by in and ketsu deficiency, which lost control of kanki hyperactivity and evoked tension/excitement state easily. The difficulty in rising was improved with yokukansan and kambakutaisoto and she was able to go to school every day. Case 2 was a 17-year-old man diagnosed the attention-deficit/hyperactivity disorder. His symptoms were difficulty in rising, feeling of weariness, fatigability, and frequent tension/excitement state. The previous use of shokenchuto had improved the symptoms slightly. After shigyakusan was added to cure kanki dysregulation, he succeeded in going to school every day. In the oriental medicine, ketsu has important roles in mental stability and sleep, whereas qi and ketsu tend to be insufficient in childhood. Our results suggest that replacement of in and ketsu would be useful in treating comorbidities in developmental disorder.

This report describes 20 women who underwent in vitro fertilization or microinsemination while receiving a regimen of herbal medicine, of which contents varied according to the treatment stage. Until the ova were harvested, in order to promote maturation, patients were treated with hachimijiogan for reinforcing kidney yang, and keishibukuryogan for removing blood stasis. Following this, during the period between harvesting and implantation, they were treated either exclusively with unkeito for warming meridians, dissipates cold, and replenishes blood, or with unkeito in combination with keishibukuryogan. Following implantation, they were treated with tokishakuyakusan to induce uterine relaxation. The treatment regimen was determined based on traditional herbal evidence of infertile patient's blood stasis and kidney deficiency. We adjusted applied dose depending on the conditions of patients. Fourteen of the 20 women tested positive for pregnancy; 10 of them carried to term, whereas in 4 of them, the pregnancy ended in abortion or miscarriage. Anti-Müllerian hormone concentration, endometrial thickness, estimated follicle count, recovered ova count, fertilized ova count, and numbers of ova to reach the early-embryo stage and blastocyst stage were compared between the continuing pregnancy and the non-pregnancy groups. Improvements were observed in all values after combined use of traditional herbal medicines, except in the case of endometrial thickness, and significant differences appeared in recovered ova count and fertilized ova count. These observations suggest that a regimen of herbal medicine adapted to the various stages of in vitro fertilization may be a useful complementary therapy during pregnancy.

We experienced a patient, who complained severe fatigue in spite of adequate hormonal supplement after pituitary tumor removal, was successfully treated with Kampo therapy. The pharmacological effect of this Kampo formulation i.e. bukuryoshigyakuto is still unknown, but this formulation has been used for pre-shock conditions in the terminal stage of infectious diseases. According to the description in the classic textbook, this formulation is suggested to encourage metabolic function and maintain core temperature of the human body. The authors propose that Kampo medicine is a hopeful alternative way in the management of such patients.

We report three closely watched cases of intractable Meniere's disease in the elderly that were successfully treated with Kampo medicine. Case 1 is a 75-year-old female. At the time of the 4th Meniere's attack, we gave her western medicines such as isosorbide, but she had a significant hearing loss. Then, we administered hachimijiogan extract granules, and her hearing level improved and she had been free of Meniere's attack for 23 months. Case 2 is a 78-year-old male. We diagnosed as bilateral Meniere's disease and treated him with western medicines such as isosorbide. In September of year X, his hearing level in the left ear worsened despite the treatment, so we prescribed hachimijiogan extract granules. After the treatment, we found the patient's hearing improved and nystagmus decreased gradually. He has also been free of Meniere's attack for 9 months. Case 3 is a 70-year-old male. He had repeated episodes of vertigo in spite of the administration of western medicines. After we prescribed shimbuto extract granules, vertigo attack and nystagmus disappeared. He has been relieved from Meniere's attack for 8 months. These cases indicate that Kampo therapy is one of the useful therapeutic options for intractable Meniere's disease in the elderly.

The number of elderly people with chronic heart failure is increasing ; they have acute exacerbations at a high rate due to mergers of infections and others. At that time, they received furosemide intravenous injection and tolvaptan oral medication as internal treatments. However, there are refractory patients (tolvaptan nonresponder) at a certain frequency. In these cases we experienced two cases in which goreisan were effective for untreatable congestive heart failure. Goreisan administration resulted in an increase in urine volume in both cases, marked improvements in symptoms, physiological findings and various laboratory findings. In addition, they continued taking these medicines after discharge. As a result, for about a year, they were never rehospitalized due to heart failure. It is conceivable that goreisan normalized the uneven distribution of water in organs and tissues, and reactivated the action of tolvaptan in the renal collecting duct. These results suggest that the combined use of goreisan will be useful for untreatable congestive heart failure.

We report a case of a 39-year-old female who suffered from generalized anxiety disorder for 3 years after a spontaneous abortion and was successfully treated with kyukichoketsuin. She got generalized anxiety disorder and had difficulty to stay in a crowd after she had a spontaneous abortion at the age of 36. She visited our Kampo clinic because of the anxiety at her age of 39. We prescribed her yokukansankachimpihange for 6 months, but she still suffered from anxiety. After we changed yokukansankachimpihange to kyukichoketsuin, her anxiety improved. Kyukichoketsuin is a formula for various kinds of bad conditions during the postpartum period, which was described as the first therapeutic agent in “Manbyokaishun.” In this case, although the patient had suffered from mental disorder for three years after a spontaneous abortion, she showed a favorable response to kyukichoketsuin treatment. This result suggests that kyukichoketsuin may be effective for years of mental problems after parturition.

Teikosan is an herbal medicine that was developed from the Japanese herbal (Kampo) medicine hochuekkito. Unlike hochuekkito, teikosan does not include Zizyphi fructus and Zingiberis rhizoma. Instead, Cnidii rhizoma, Scutellariae radix, Coptidis rhizoma, Angelicae dahuricae radix, and shakusekishi are included as constituents of teikosan. The clinical indication of teikosan is anal prolapse with pain that is more severe than that considered appropriate for hochuekkito treatment, but there have been few clinical reports before. Here, we describe a case of anal prolapse with anal pain, which was successfully treated with teikosan. A case was a 47-year-old woman whose chief complaint was anal prolapse of internal hemorrhoids with pain. She was considered as indication for hochuekkito, but her symptoms including anal pain were so severe that we prescribed teikosan, especially because Angelicae dahuricae radix, Scutellariae radix, Coptidis rhizome in teikosan were expected to improve her anal pain. After the administration of teikosan, her symptoms including anal pain have much improved. Teikosan should be considered as a therapeutic option for anal prolapse with severe anal pain or inflammation.

The goal is to evaluate the efficacy of Kakkonto in the pregnant women who contacted the family member with influenza. Five pregnant women who did not want to take anti-influenza drugs were enrolled in this study. The pregnant weeks were : 5 weeks (Case A), 7 weeks (Case B), 8 weeks (Case C), 11 weeks (Case D), and 31 weeks (Case E), respectively. There was 1 infected influenza kid with (A) pregnant woman, and, there were 4 infected influenza husbands with another pregnant women. Study design was that these women took 7.5 g Kakkonto/5 days after contacting infected influenza families. After 3 weeks, Case A, who contacted a kid with influenza, had a fever up to 38 ℃. However, twice influenza tests showed negative. Other 4 cases (B, C, D, and E) had neither fever nor any kind of symptom. Finally, there were no side effect sign among these women and their neonatal babies. Kakkonto may prevent the onset of influenza among pregnant women who contacted the family member with influenza.

Gastroesophageal reflux disease (GERD) can cause not only esophageal symptoms, but also extraesophageal symptoms such as globus pharyngis. Here, we describe a case of globus pharyngis in GERD successfully treated with seinetsuhoketsuto. A 72-year-old female began to have tingling in her pharyngolarynx in February 20XX. Otolaryngologist did not point out abnormal findings. However, reflux esophagitis was detected by upper gastrointestinal endoscopy. Although treatment with rabeprazole relieved the tingling, she experienced a relapse in September 20XX and visited our clinic in November. We prescribed seinetsuhoketsuto because she exhibited numerous blood deficiency-related symptoms including dryness of the skin and eyes, shallow sleep, coldness in the feet, etc. The tingling then decreased rapidly and disappeared in two months. In addition, dryness of the skin and eyes and her sleep also improved markedly. Seinetsuhoketsuto has been regarded as a medication for inflammation in the mouth such as oral ulcers and erosions. However, this case indicated that seinetsuhoketsuto could also be utilized to treat symptoms in the pharyngolarynx due to GERD.

ART (Assisted Reproductive Technology) is making impressive advancements. However, not all patients will successfully conceive even with this technique. Patients undergoing infertility treatment are predominantly in a state of mental stress for being unable to conceive, and the importance of stress care in treating infertility has been reported. This time, to investigate the relationship between infertility, mental stress and Kampo treatment, we have conducted a retrospective study on 7 patients who achieved conception by a combination treatment of Kampo medicine and ovulation day prediction. Patients'occupation, menstruation history, pregnancy history, premenstrual symptoms, and oriental medical examination findings were extracted from their medical records. The clinical background were age (mean age: 36 [29-39]), time to pregnancy (mean: 6 months [2-9 months]), and outcome (normal vaginal delivery [3 cases], caesarean section [2 cases], abortion [1 case], transfer to other facility [1 case]). The oriental medical diagnosis in all cases found stagnation of liver qi. Two cases had only stagnation of liver qi. As comorbidities, kidney deficiency (3 cases), blood stasis syndrome (1 case), and blood stasis syndrome with syndrome of dual deficiency of qi and blood (1 case) were found. The Kampo prescriptions were as follows: nyoshinsan (2), kamishoyosan (2), tsudosan (1), shigyakusan (1) and kyukichoketsuin (1). Stagnation of liver (TM) qi was considered to play a role in infertility and is one of the important factors in Kampo prescriptions.