Successful Treatment of Cardiogenic Shock and Massive Pleural Effusion with Kampo Extract : A Case Report In Critical Care Medicine
- VernacularTitle:心原性ショックと大量胸水に対して漢方エキス製剤が奏効した1例:集中治療医学領域における漢方医学
- Author:
Nozomu KAWASHIMA
1
Author Information
- Keywords: shock; pleural effusion; shimbuto; goshajinkigan; ogikenchuto
- From:Kampo Medicine 2022;73(4):391-397
- CountryJapan
- Language:Japanese
- Abstract: Kampo as the main treatment method in intensive care has been rarely reported. The patient is a 25-year-old man presented with diarrhea and hypotension. Before the current admission, he developed brainstem death after allogeneic bone marrow transplantation for aplastic anemia at age 13, and underwent cystostomy and received mechanical ventilation, gastrostomy nutrition, and in-home medical care. He developed cardiogenic shock with anuria and pleural effusion, due to Pseudomonas aeruginosa urosepsis and was treated with infusion/transfusion and enteral medicine with his family's consent. Tongue was pale and enlarged, with thin white fur. The radial artery was not palpable. The carotid artery pulse was relaxed, large, and faint. He had good abdominal strength, subcutaneous edema, and massive ascites. These indicated yang collapse pattern. Chest X-ray revealed a massive pleural effusion. Shimbuto and goshajinkigan Kampo extract supplemented with powdered cinnamon bark (Cinnamomum cassia Blume) was administered for the cardiogenic shock. Ogikenchuto extract combined with furosemide and goreisan extract was administered to treat the pleural effusion. Shimbuto, goshajinkigan, and powdered cinnamon bark improved the heart rate and blood pressure. The pleural effusion remained after furosemide and goreisan treatment, however, the addition of ogikenchuto induced significant diuresis, and the pleural effusion consequently decreased. This case suggests the potential of Kampo, even in critical illness where modern medicine is generally prioritized. The pleural effusion decreased after adding astragalus root-containing extract, emphasizing the role of tonifying qi for draining fluid.
