今回産褥期発症の肺水腫症例において

全例呼吸困難を訴え，湿性ラ音を聴取，胸部X線では肺野の透過性低下と肺血管陰影の増強，心胸郭比の増大，肋骨横隔膜角鈍化，さらに漢方医学的に心下痞鞕と下肢，足背の浮腫所見から肺水腫と診断した。診断後

心不全に対する西洋医学的治療のエビデンスは確立されつつあるが，慢性腎臓病（CKD）合併心不全患者の治療に関してのエビデンスは確立されていない。このような CKD 合併心不全患者に対して標準治療への漢方薬の追加治療の安全性と有用性は明らかにされていない。今回，当院において過去2年間に，標準治療の効果が不十分であり五苓散7.5g/日を追加投与したstageⅢ以上の CKD 合併心不全患者20名を後ろ向きに検討した。11名で，息切れや浮腫などの症状，胸部レントゲンでのうっ血や胸水は改善し，血清 BNP も低下し心不全の改善を認め，腎機能，血漿浸透圧の悪化は認めず，臨床的に問題となる電解質悪化も認めなかった。 CKD 合併心不全患者に対する標準治療に加えた五苓散投与は安全かつ有用である可能性が示唆された。

Heart failure is a rapidly growing public health problem, affecting over 30 million people worldwide. Current therapeutic approaches aim to regress cardiac hypertrophy but have limited efficacy. In this context, Japanese Kampo medicines are gaining attention as safe and potentially effective therapeutic agents. This study focuses on understanding the impact and mechanisms by which Moku-boi-to (MBT), a Japanese Kampo medicine, provides potential cardioprotective benefits against AngII-induced cardiomyocyte hypertrophy. By addressing this knowledge gap, we aim to contribute to the development of novel therapeutic strategies. Here, we found that MBT exhibited preventive effects against AngII-induced cardiomyocyte hypertrophy and cell death. One of the ways MBT exerted its benefits was by enhancing intracellular Ca²⁺ signaling regulation and improving mitochondrial function. However, it was unexpected that MBT did not provide additional effects when combined with the AT₁ receptor blocker losartan. These findings shed light on the AT₁ receptor-mediated cardioprotective potential of MBT and provide valuable insight into the underlying mechanisms responsible for alleviating AngII-induced dysfunction in cardiomyocytes. Our results suggest that MBT holds promise as a safe and effective prophylactic agent for cardiac hypertrophy.