Three Hemodialysis Patients with Postoperative Amputation Wounds Due to Critical Limb Ischemia Successfully Treated with Juzentaihoto and Keishibukuryogan
- VernacularTitle:血液透析患者の重症虚血肢切断術後の創部に対し十全大補湯と桂枝茯苓丸の併用が奏功した3例
- Author:
Shinya FUKUHARA
;
Sadahiro SEMPUKU
- Keywords: critical limb ischemia; skin ulcers; Juzentaihoto; Keishibukuryogan; hemodialysis
- From:Kampo Medicine 2017;68(2):140-147
- CountryJapan
- Language:Japanese
-
Abstract:
Peripheral arterial disease is a serious complication that can arise in hemodialysis patients. Prognosis in critical limb ischemia (CLI) due to peripheral arterial disease is extremely poor. A dialysis patient may experience symptoms of both qi and ketsu deficiency and ketsu stagnation during the long-term treatment of CLI. Herein, we report three hemodialysis patients with refractory postoperative skin ulcers who were successfully treated with juzentaihoto and keishibukuryogan after limb amputation. Case 1 was a 68-year-old man who had skin ulcers of the right second, third, and fifth toes. After amputation of the third toe, juzentaihoto and keishibukuryogan were initiated. Case 2 was a 67-year-old man who had skin ulcers after amputation of the left fourth and fifth toes. Postoperatively, juzentaihoto and keishibukuryogan were initiated, and good granulation was observed. Case 3 was a 76-year-old man who had skin ulcers after left below-the-knee amputation. Because of the extremely poor tissue granulation, juzentaihoto and keishibukuryogan were initiated, and good granulation was gradually observed. After an operation for CLI, prompt return to activities of daily living is desirable. The appropriate addition of Kampo treatment to Western treatment may improve chronic refractory skin ulcers.