To determine the body constituents patterns comprised of “qi, blood, fluid” factors associated with oral health-related QOL (OHRQOL) of patients with Sjögren's syndrome (SS), 41 SS patients and 32 RA patients in remission were enrolled. The body constituents patterns were measured by using Terasawa's “qi, blood, fluid” score, and the simple version of yin deficiency questionnaire (yin-deficiency score). OHRQOL were evaluated using the oral health impact profile (OHIP-14). In the first study, the body constituents pattern scores were compared between SS group and RA (in remission) group, using the univariate and multivariate analysis. In the second study, the association between OHIP14 and the body constituents pattern scores was analyzed. In the first study, all the scores were significantly higher in SS group, and the multivariable logistic regression identified yin deficiency (p = 0.02) and blood stasis (p = 0.01) as the significantly associated factors with SS group. In the second study, all the scores, except for the blood stasis pattern, showed positive correlation with OHIP-14. The multiple regression analysis identified qi stagnation (p = 0.003) as the significantly associated factors with OHIP-14. This study revealed that yin deficiency and blood stasis are the significant body constituent patterns in SS patients. In the low OHRQOL cases, qi stagnation should be taken into consideration.
Kampo formulations can be prescribed for patients with different symptoms. We report two cases with different symptoms : a girl in her early teens and her grandmother. Case 1 was a 13-year-old girl and the grandchild of Case 2. She was unable to attend school. Case 2 was a 73-year-old woman who presented with increased fatigability. After treatment with saikokaryukotsuboreito, both cases experienced improved symptoms. It was suggested that they had the same Kamp pathology because they were related by blood and shared a common environment. Consequently, both cases were effectively treated using one formulation : saikokaryukotsuboreito.
There are many reports that keisikajutsubuto is effective against inflammation of finger and wrist joints, such as from snapping the fingers or scleroderma. We prescribed keisikajutsubuto for 16 orthopedic outpatients with DIP joint arthralgia and pain (Heberden nodes) on the basis of this information. The 16 cases were all women, and the age ranged from 57 to 80 years with an average of 63.4 years. The disease period ranged from 6 months to 15 years with an average of 4 years and 6 months. Eleven cases were diagnosed with deficiency pattern indicating a weak constitution and poor circulation, and 5 cases were medium pattern. Seven of the 16 patients were thin with a BMI of 20 or less. In 4 cases the inflammation of a tendon sheath on the finger was complicated. It took 3 months (from 2 to 8 months) for joint pain to be reduced. Eight patients continued taking 2.5 g of keisikajutsubuto afterwards. The joint deformity was not worse in any case. In all patients, the pain completely disappeared, or partial recovery was obtained. In addition, the local feeling of heat in the joints disappeared in all cases. Keishikajutsubuto was an effective Kampo medicine against finger joint arthritis.
We report two cases in which the quality of life of children with chromosomal aberration improved with Kampo treatment. Case 1 : Six-year-old boy with 5p deletion syndrome. We prescribed kambakutaisoto for the purpose of treating excitability and insomnia. After adding shokenchuto, and further using with yokukansan, the degree of excitement was obviously reduced, and he began to sleep well until morning. Case 2 : Two-year-old boy with chromosome 8 abnormality. He had failed extubation after thoracotomy, thus he needed tracheostomy and gastrostomy. Frequent sputum suction was required every 5 to 15 minutes, and he suffered chronic diarrhea. The number of suctioning was decreased after treatment with bukuryoingohangekobokuto. Moreover, after the addition of shokenchuto, suction became unnecessary for more than 2 hours, and diarrhea also improved. After surgery to close tracheostomy site, he has been receiving ogikenchuto + shoseiryuto + ninjinto and is very well enough to go to a nursery school. Although it is a small improvement not involved in life prognosis, it has contributed to the improvement of the quality of life and the reduction of burden on caregivers. We believe that it is one of the significance of providing Kampo treatment for children.
We report a case of sleep terrors complicated with sleepwalking. The patient was 9-year-old boy who suddenly woke up, walked, or screamed in his sleep. These symptoms were sometimes induced by such as fever elevation or school events. In order to prevent injury while sleeping, he was suggested taking medicine to suppress the nocturnal behavior. After taking shokenchuto based on his findings of qi deficiency, the episodes gradually disappeared and the frequency of fever elevation decreased. In this report, we present the improvements of sleep parameters provided by overnight polysomnography, performed before and after treatment. Shokenchuto is known as one of the curative medicines for sleep terrors, but this is the first report showing objective therapeutic effects using overnight polysomnography.
We herein report a case of 91-year-old woman with antiresorptive agent-related osteonecrosis of the jaw (ARONJ) developed during treatment for osteoporosis with intravenous ibandronate. Although she was treated with several antibiotics and had an incision for the drainage of a pus discharge at a dental clinic for two months after the onset of ARONJ, the discharge persisted. We then added hochuekkito to her treatment, which resulted in a gradual decreased in pus discharge and decrease in wound size and the wound resolved after approximately one month. ARONJ is considered a refractory disease, however, it was successfully treated with hochuekkito in this patient. ARONJ is also a rare condition and to our knowledge, this is considered to be the first case of ARONJ, which has been successfully treated with Kampo medicine.
Pruritus of external auditory canal is often treated with blood-enriching formulation and heat-clearing formula. Here, we report a case of intractable pruritus of external auditory canal successfully treated with tokishigyakukagoshuyushokyoto, which did not improve with blood-enriching formulation or heat-clearing formula. Our patient was a 52-year-old woman. She had itching in her left ear from the age of 45, and was treated by 5 otolaryngologists, but her symptom did not improve. I treated her with tokiinshi, shofusan, yokukansankachimpihange, unseiin, jumihaidokuto and keishibukuryogankayokuinin, but they had no effect. After reconsideration of sho, she was diagnosed as interior cold pattern, and she had tenderness in groin area. So I treated her with tokishigyakukagoshuyushokyoto, and her itching disappeared. We should consider interior cold pattern as one of the differential diagnoses of pruritus of external auditory canal.
Five cases of various diseases associated with breast cancer treatment including arthralgia, menopausal symptoms, chemotherapy-associated symptoms (nausea, vomiting, numbness, pain, general fatigue), and anxiety neuroses during follow-up were treated with Kampo medicine and a favorable course was obtained. Combined use of Kampo treatment can reduce the suffering caused by the side effects of breast cancer treatment, alleviate mental symptoms, prevent recurrence, and improve the patients' health. Kampo medicine plays a role in cancer supportive care for breast cancer.
We experienced 2 patients with clinical diagnosis of subacute necrotizing lymphadenitis who were successfully treated with shosaikoto. Case 1 is a 37-year-old woman. Left neck swelling and pain appeared from 12 days before, and temperature went up thereafter. Antibiotics were administered at another hospital, but she did not improve. There were multiple swollen lymph nodes of the left neck, and blood test showed decreased white blood cells and increased LDH. So we clinically diagnosed her as subacute necrotizing lymphadenitis. After administration of shosaikoto, fever resolved, and cervical swelling also markedly improved on the third day. On day 10, both symptom and findings disappeared. Case 2 is a 12-year-old man. Left neck swelling and pain appeared and temperature went up from 8 days before. An antibiotic was administered at another hospital, but he did not improve. There were multiple swollen lymph nodes of the left neck, and blood test showed decreased white blood cells and increased LDH. So we clinically diagnosed him as subacute necrotizing lymphadenitis, and administered shosaikoto. Then fever resolved on the third day, and cervical swelling diminished and tenderness disappeared on day 10. On day 18, both symptom and findings disappeared.
Although saikanto has often been used for infectious pleuritis, there are few reports on the usefulness of it in recent years. We experienced a patient successfully treated with saikanto, who was suffering from bacterial pleuritis with residual pleural effusion, which was difficult to drain and treat with antibacterial drugs. Kampo treatment including saikanto should be used for pleuritis that is not sufficiently improved by Western medical treatment alone.
[Objective] To clarify the utilization of characteristics and reactions of acupuncture points, and the frequency of using acupuncture points in acupuncture and moxibustion treatment in Japan.
[Methods] We conducted a questionnaire survey involving members of the Japan Society for Oriental Medicine and those of the Japan Society of Acupuncture Course in Universities. The contents of the questions included age, sex, profession, length of clinical experience of acupuncture/moxibustion, treatment method, utilization of characteristics and reactions of acupuncture points, and frequency of using acupuncture points in both acupuncture and moxibustion treatment.
[Results] The number of valid questionnaires was 59 (59 for acupuncture treatment and 50 for moxibustion treatment). The respondents were as follows : average age of 52 ± 12 years, 45 males and 14 females, 13 medical doctors and 46 acupuncturists, clinical experience of 21.1 ± 11.5 years. Most practitioners utilized ill ness-specific features of acupuncture points, de qi, and reactions they feel with their needling and pressing hands. Ten acupuncture points were used in 50% of patients in acupuncture treatment, and ST 36 and SP 6 were the most frequently used. On the other hand, no single acupuncture point was used in more than 50% of patients in moxibustion treatment. Thirteen acupuncture points were used in 30% of patients in moxibustion treatment, and BL 23, SP 6, and ST 36 were the most frequently used.
[Conclusion] Our survey clarified the usage of acupuncture points in acupuncture and moxibustion treatment in Japan.
Low back pain (LBP) is one of the most common complaints of Japanese citizens, and is a symptom for which acupuncture has been applied since ancient times. We empirically recognize that acupuncture is effective for LBP, but in recent years, it became necessary to show evidence regarding its efficacy and effectiveness.
Currently, to elucidate the effect of a medical intervention, randomized controlled trials (RCTs) are considered the gold standard and outcomes of RCTs are integrated as a systematic review (SR), and these are used to establish the degree of recommendation in the clinical practice guidelines (CPGs). Eventually, practitioners make their clinical decisions according to the recommendations in CPGs.
In this report, the author compared CPGs of acupuncture for LBP between those of the United Kingdom (UK) and United States of America (USA). The NICE guideline development group of the UK did not fully understand Japanese-style acupuncture, and they considered clinical trials with placebo/sham as a control to be the most important, leading to underestimating the effect of acupuncture. On the other hand, the ACP guideline of the USA considers clinical trials with conventional treatment as a control to be more important, and accordingly the effect of acupuncture was evaluated realistically.
In the pharmaceutical department of Iizuka Hospital, larvae of the cigarette beetle (Lasioderma serricorne) were found in Plantago seed for the first time since the Department of Japanese Kampo Medicine started in 1992. The larvae grew into pupae and then adults. The plastic-packaged Plantago seed was left for about 3 months, during which several larvae and adult cigarette beetles appeared. Cigarette beetles are very common insects in summer and it is important that we store crude drugs in hard closed containers in our refrigerators. The larvae can bite strongly and puncture plastic packaging, however they cannot live under 15 ℃. Education of crude drug storage for patients is very important.
To help medical doctors practicing Kampo medicine suggest appropriate acupuncture treatments for individual patients, a study group made up of 7 acupuncturists and 5 medical doctors developed an acupuncture curriculum. The group provided a learning program based on the curriculum for 16 medical doctors in charge of outpatient Kampo services in a research institute. The learning program consisted of a lecture and practical training, and a total of 4 sessions were held. At the end of each session, a test was conducted to examine the participants' level of understanding. After the completion of the learning program, a questionnaire survey was conducted to confirm the usefulness of the acupuncture curriculum for the practice of Kampo medicine. The mean number of participants per session was 10.8 ± 1.3. The mean test score was 9.3 ± 0.5 (full score : 10). In the questionnaire, 14 out of the 16 (88%) answered that the acupuncture curriculum was useful or relatively useful for the practice of Kampo medicine. On comparing the numbers of new acupuncture patients with a history of outpatient Kampo service use before and after the acupuncture curriculum, there was a 1.8-fold increase after it. The results support the usefulness of the acupuncture curriculum to understand acupuncture and practice Kampo medicine. Further evaluation is necessary.