Studies on Pharmacological Effects of RYOKEI-JUTSUKAN-TO. A case of acute autonomic neuropathy with persistent orthostatic hypotension.
10.3937/kampomed.44.427
- VernacularTitle:苓桂じゅつ甘湯の作用機序に関する研究 Ａｃｕｔｅ ａｕｔｏｎｏｍｉｃ ｎｅｕｒｏｐａｔｈｙに残存した起立性低血症の一症例について
- Author:
Yuji SHIOTANI
;
Hidetsugu ASANOI
;
Harumi MATSUDA
;
Yutaka SHIMADA
;
Katsutoshi TERASAWA
- Publication Type:Journal Article
- From:Kampo Medicine
1994;44(3):427-436
- CountryJapan
- Language:Japanese
-
Abstract:
Acute autonomic neuropathy is a syndrome where the peripheral nervous system is damaged acutely, primarily, and diffusely. For refractory orthostatic hypotension, which persists in cases where the disorder has not been cured completely, hypertensors or mineralocorticoids are generally administered. We observed that patients who did not respond to such agents did, however, respond to Ryokei-jutsukan-to, although no one has reported previously on the use of this Kampo formulation for acute autonomic neuropathy. In order to define the mechanisms of action of this formulation, we conducted orthostatic tests and drug loading tests and also studied endocrinology and hemodynamics. Blood pressure rose with the treatment of Ryokei-jutsukan-to, and this proved to be due to an increase in peripheral vascular resistance. Furthermore, cardiac output was decreased, and the renin-angiotensin-aldosterone system, which had been slightly activated, was corrected. The increase in peripheral vascular resistance appears to be a result of direct action on the vascular wall, since the formulation inhibited the sympathetic activity and improved the denervation hypersensitivity of peripheral vascular receptors.
