Two Cases of Intractable Upper Abdominal Pain with Ipsilateral Induration of Hikon (pigen, ExB4) and Past Histories of Injury or Surgery Successfully Treated with Tokishigyakukagoshuyushokyoto
- VernacularTitle:同側の外傷/手術歴と痞根の硬結を有し当帰四逆加呉茱萸生姜湯が奏効した難治性上腹部痛の2症例
- Author:
Atsuhiko SAKAMOTO
1
;
Mosaburo KAINUMA
2
;
Maki MAEDA
3
;
Toshiro MAEDA
2
;
Junko MIYATA
2
;
Keiko KAWANO
4
;
Kazumichi KURIYAMA
5
Author Information
- Keywords: hikon (pigen, ExB4); tokishigyakukagoshuyushokyoto; injury scar; operation scar; upper abdominal pain
- From:Kampo Medicine 2020;71(1):18-23
- CountryJapan
- Language:Japanese
- Abstract: We report two cases of patients with intractable upper abdominal pain and histories of injury or surgery. The patients' pains were successfully treated with tokishigyakukagoshuyushokyoto (TSG). Case 1 involved a 59-year-old woman with left upper abdominal and thoracodorsal pain lasting 5 years. Kampo drugs such as tokito or prescriptions containing saiko were ineffective. Two years after her first visit, we noticed an injury scar from childhood that passed near the left hikon (pi-gen, ExB4) and induration and tenderness of the left hikon. TSG was administered, and the pain promptly improved. Case 2 involved a 66-year-old woman. She complained of epigastric, right-upper-quadrant abdominal and back pain lasting 7 years. Two years before presentation, the pain had worsened, but the cause was unclear. Although keishibukuryogan or Kampo drugs containing saiko were ineffective, her pain improved when TSG plus bushi was administered. A wound from a cholecystectomy was observed on her right abdomen. Induration and tenderness of the right hikon were demonstrated. The combination of past history of injury or surgery of the upper abdomen or back and induration of hikon can be associated with development of indications for TSG.
