We evaluated the effect of Kampo therapy in which Kampo formulae were selected based on Japanese traditional theory, on the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related chronic liver disease. One hundred forty HCV-infected outpatients without HCC at their first examination and who were observed for more than one year, were included. The patients were divided into three groups according to the initial platelet count (Plt): Plt less than 10×10⁴/μL (Group I), Plt between 10×10⁴/μL and 14×10⁴/μL (Group II), and Pit greater than 14×10⁴/μL (Group III). For each patient, Kampo formulae were selected according to the patient's symptoms and physical findings at each clinic visit. The incidence of HCC calculated by the person-years method, was 0.89% in Group I. 1.55% in Group II and 0.29% in Group III. The annual incidence of HCC among our patients was low compared with that among untreated patients in previous reports. In addition, the incidence of HCC among our patients was low compared with that of previous studies where Shosaikoto or Juzentaihoto was administered for a long period of time. In the present study, age over 60 years was a possible risk factor for HCC. However, sex and patterns of the change in alanine aminotransferase level (ALT) were not associated with the development of HCC. A total of 53 different Kampo formulae were prescribed, for all patients, with Hochuekkito being the most frequent. These results suggest that Kampo treatment in which Kampo formulae are selected based on traditional theory, may be more useful than treatment by a single Kampo formula for preventing the development of HCC in patients with HCV-related chronic liver disease.

We report on five patients with menstrual pain and/or other disorders, whose symptoms improved when treated with Ki-related prescriptions. Hangekobokuto improved severe epigastralgia and menstrual pain in Case 1. Saibokuto showed improvement of menstrual disorders and pain in Case 2, while Hangekobokuto also ameliorated menstrual pain in Case 3. The treatments were based on patient Ki stagnation, although the symptoms of Ketsu stagnation were also observed in these cases. In Case 4, the patient's menstrual pain and disorders were improved by changing her prescription from Kamishoyosan, to Keishikaryukotsuboreito. In Case 5, a menstrual period of more than 40 days became a regular rhythm of 30 days, while treating the patient's chief complaint of urticaria, with Keishikaryukotsuboreito. Symptoms of Ketsu stagnation were not apparent in Cases 4 and 5. We prescribed Keishikaryukotsuboreito—a prescription for Ki regurgitation—because of suggestive symptoms of nightmare, as well as palpitation in the abdomen.
Menstrual problems are often related to Ketsu abnormalities according to Kampo medicine literature. However, symptoms related to Ki regurgitation and Ki stagnation are also observed in women with menstrual problems who are under stress. Therefore, it is important to know that there have been cases, such as ours, of menstrual problems successfully treated with Ki-related prescriptions.

Rehabilitation and exercise are occasionally restricted by intractable pain to an extent greater than that estimated due to physical dysfunction. Here, we report three patients with intractable pain in whom Kampo medicine was highly effective, in cases where common treatments such as the administration of non-steroidal anti-inflammatory drugs and nerve blockade proved ineffective. Sokeikakketsuto extract was prescribed for three patients with different conditions: intermittent claudication of cauda equina due to lumbar spondylolisthesis, posttraumatic chronic psychogenic pain, and complex regional pain syndrome type 1 that occurred after cerebral infarction. Sokeikakketsuto extract alleviated severe pain and therefore facilitated rehabilitation and exercise in all three of these cases. From the viewpoint of Kampo medicine, we hypothesized that all three cases shared some common etiology of blood abnormalities, although conventional medical diagnosis differed for each. We suggest that treatment with Sokeikakketsuto extract corrected the blood abnormalities, thereby resulting in the successful treatment of intractable pain in these patients.

We examined the complaints of adult patients with ‘weak’ sho symptoms using their first-visit medical questionnaires. Our subjects were 39 patients (3 males and 36 females) who fatigued easily, and who had a weak constitution with stress and the changing of seasons.
Over 60% of these ‘weak’ patients complained of excessive sensitivity to cold. The majority had stiff shoulders, a stiff neck, low back pain, sleeplessness, headache, fatigue of the eyes and vertigo. Their gastrointestinal constitutions were poor because of over eating.
Although we understood many of the complains these ‘weak’ patients had through their medical questionnaires, their chief complaints were various. We hope these results are useful in understanding treatments for patients with ‘weak’ sho.

[Purpose] In Kampo medicine, blood deficiency is considered to cause systemic symptoms such as insomnia and dizziness, in addition to skin-related symptoms such as xeroderma. Diagnosis of blood deficiency does not appear to be definitive since it is based on subjective judgment. To resolve this problem, we have attempted to establish an objective method for diagnosing blood deficiency by measuring skin moisture.[Methods] Using a skin moisture meter, we measured the skin moisture (at the neck, forearm, and abdomen) of 80 women during their first examination at our clinic. The patients were also classified according to their blood deficiency scores.[Results] A statistically significant difference was observed between patients with blood deficiency and those without blood deficiency with regard to the skin moisture at the neck and forearm. The coefficient of correlation between the skin moisture of the neck and the blood deficiency score was -0.41.The results of statistical analysis performed using a type1quantification method revealed high values even for some conditions not associated with the skin, such as hypomenorrhea and excessive strain of the abdominal muscles, in addition to high values for skin-associated conditions. And in pre-post-treatment comparisons, improvements in blood deficiency scores generally matched transitions in keratinous moisture.[Discussion] Due to the absence of a high correlation between skin moisture and the blood deficiency score, it is unlikely that skin moisture can be used instead of the blood deficiency score as a parameter for the accurate diagnosis of blood deficiency.[Conclusion] Although skin moisture levels may be an indicator of blood deficiency, further studies are required before this parameter can be applied in clinical diagnosis.
deficiency ; In Blood ; Integumentary system ; Neck ; Diagnosis

We examined the complaints of adult patients with ‘weak’ sho symptoms using their first-visit medical questionnaires. Our subjects were 39 patients (3 males and 36 females) who fatigued easily, and who had a weak constitution with stress and the changing of seasons.Over 60% of these ‘weak’ patients complained of excessive sensitivity to cold. The majority had stiff shoulders, a stiff neck, low back pain, sleeplessness, headache, fatigue of the eyes and vertigo. Their gastrointestinal constitutions were poor because of over eating.Although we understood many of the complains these ‘weak’ patients had through their medical questionnaires, their chief complaints were various. We hope these results are useful in understanding treatments for patients with ‘weak’ sho.
seconds ; Weak ; Complaint, NOS ; Sleeplessness ; Financially poor

[Purpose] We studied the pathophysiology of hot flush and cold feet.[Methods] By using an infrared thermometer, we measured the surface temperature of 98 female patients. We classified the patients into 4 groups : Group A patients without hot flushes or cold feet ; Group B patients with hot flushes but without cold feet ; Group C, patients without hot flushes but with cold feet ; and Group D patients with both hot flushes and cold feet. We measured the surface temperature of their tongues, upper abdomen, lower abdomen, and soles.[Results] The tongue temperature in Group B was significantly higher than that in Group A. The difference in the temperatures between the tongue and upper abdomen in Group B was also significantly greater than that in group A. Groups C and D, on the other hand, showed similar surface temperatures. Then, we examined the relationship between tongue temperatures, and the difference in the temperatures between the tongue and sole (Diff T-S) by using a correlation coefficient test : a significant correlation (r=0.77) was observed in Group C but not in Group D. Next, the patients in Group D were divided into 3 subgroups on the basis of their Diff T-S ; we found that these subgroups were characterized by the constitutionally ordinary symptoms (COS) of “yin and yang” and “deficiency and excess.”[Discussion] The occurrence of hot flush with cold feet was shown to depend on the slope of the body temperature, which was influenced by COS.[Conclusion] The occurrence of hot flush is associated with COS.
Hot flushes ; Feet, unit of measurement ; Tongue ; Group D ; Group B rank

Two brothers with nocturnal enuresis, aged 8 and 7 years, were brought to our clinic. They had had nocturnal enuresis since early childhood, necessitating the use of disposable diapers every night. Their past histories were unremarkable, and a family history revealed that their father had experienced the same disorder until he was 12 years of age. On physical examination, we noted hypertonic abdominal muscles and high sensitivity to tickling in the 8-year-old boy, and no remarkable finding in the 7-year-old boy. Initially, the elder brother was treated with saikokeishito extract ; the younger brother, with kakkonto extract. Because these extracts were ineffective, rokumigan extract was later added. The combination therapies cured the nocturnal enuresis in both the children. The fact that these patients were brothers and that their father had the same disorder as a child indicates that the cause of nocturnal enuresis observed in the parent and the siblings might be related to “kidney qi deficiency”.
Enuresis ; Brother, NOS ; Therapeutic procedure ; success ; Night time

Purpose : Cold sensation of the limbs is a common complaint for which patients seek treatment with Kampo medicine. However, some patients complain of coldness of the limbs despite maintaining normal skin temperature. We studied this condition and its association with ki (energy), ketsu (blood), and sui (body fluids) by measuring surface body temperatures.Methods : Using an infrared thermometer, we measured the surface body temperature of 98 female patients during their first examinations at our clinic. We classified the patients according to the season of their examination and the presence of the abnormalities of ki, ketsu, and sui ; subsequently, we statistically analyzed these findings.Results : No statistical difference was observed in the surface body temperature of the patients with complaints of coldness (Pw/C), and those without such complaints (Pw/oC). However, under particular conditions, the surface body temperature of Pw/C was observed to be higher than that of Pw/oC. In the presence of “ki deficiency” and “sui accumulation,” the surface body temperatures were lower than in the absence of the ki and sui abnormalities, respectively. In contrast, the surface body temperature was higher in patients with the “oketsu (blood stasis) syndrome” than in those without the “oketsu syndrome”.Discussion : Although the dissociation between the subjective cold sensation and actual skin temperature is present only in limited conditions, the presence of this dissociation indicates that factors other than the surface body temperature such as the abnormalities of ki, ketsu, and sui may also determine cold sensation.Conclusion : It is important to treat Pw/C by taking into account their state of coldness and the abnormalities of ki, ketsu, and sui. Measuring surface body temperature using an infrared thermometer appears to be an effective method for analyzing cold sensation of the limbs.
Body Temperature ; seconds ; teratologic ; g <3> ; Measurin

We describe three cases in which the same Kampo formulas were applied to a mother and daughter with different complaints. In cases 1 a, b, a mother with general fatigue after an operation for gastric and colon cancer, and her daughter with migraine and menopausal symptoms were effectively treated with kamishoyosan. In cases 2 a, b, a mother with menstrual disorder, and her daughter with palmar eruption were effectively treated with hangekobokuto. In cases 3 a, b, a mother with lumbago and her daughter with back pain were effectively treated with keishikaryukotsuboreito. These Kampo formulas are thought to improve qi circulation.
It is considered that improving qi disturbance is important for the Kampo treatment of female patients. Taking into account parent-child genetic similarities, it is possible that application of the same Kampo formula to familiarly related patients with different complaints could be effective. It is important to consider not only the patient's complaints, but also the patient's condition, from the Kampo viewpoint so-called “Sho”. Therefore,since our cases all involved a mother-daughter relationships, it may be reasonable to assume that Kampo formulas improving qi circulation were effective for their different complaints.