Objectives: We examined the effects of Toki-shigyaku-ka-goshuyu-shokyo-to on chronic constriction injury of the sciatic nerve as a neuropathic pain model in rats.
Methods: Sprague-Dawley rats were randomly divided into 3 groups: group 1, no constriction and no medication (n=8); group 2, constriction without medication (n=8); group 3, constriction with medication (n=8). On each group we performed thermal stimulation tests for pain measurement before the operation and 7 and 14 days after the operation. We also measured body temperature at the tympanum and the planta.
Results and conclusions: A significant increase of pain was observed at 7 and 14 days after constriction in group 2. Toki-shigyaku-ka-goshuyu-shokyo-to relieved their pain 14 days after constriction. Furthermore,
Toki-shigyaku-ka-goshuyu-shokyo-to warmed their feet significantly, while chronic constriction injury induced coldness in the constricted feet. We conclude that Toki-shigyaku-ka-goshuyu-shokyo-to relieves both pain and coldness in a neuropathic pain model.

We report on two cases of patients with chronic pain treated with opioid analgesics. They did not continue their treatment with opioid because of side effects.
An 88 year-old female complained of low back and leg pain caused by lumbar spinal canal stenosis. She also complained of dizziness, nausea and appetite loss after a course of weak oral opioid was administered. We thought it necessary to improve her general condition and digestive sickness following treatment for pain, and administered 5 g/day of hangebyakujutsutemmato. After the administration of this hangebyakujutsutemmato, her general condition improved, and we could administer various analgesics.
A 62 year-old female complained of dull headache, right neck pain and stiffness of tear and mouth due to fibromyalgia and collagen disease dating back several years. Her pain was reduced by the combined administration of a strong opioid and an immunosuppressive agent. However, she complained of severe dizziness, nausea and appetite loss after the commencement of drug therapy. Her general condition improved markedly, through the administration of 5 g/day of hangebyakujutsutemmato, and she was able to continue her treatment of chronic pain without deleterious events.
In conclusion, in patients treated with opioids for chronic pain, dizziness, dull headache, nausea, vomiting and loss of appetite is often seen. Therefore, we emphasize that the combined administration of hangebyakujutsutemmato and opioids can be beneficial for the treatment of chronic pain patients.

We assessed the efficacy of Kampo medicine for lower extremity symptoms caused by lumbar spinal diseases, such as lumbar spondylosis, spinal canal stenosis, and post-spinal surgery syndrome. In particular, we evaluated its usefulness for lower extremity pain, coldness, and numbness. In addition, the efficacy of antecedent drug selection and pain treatment was also assessed. In accordance with Japanese traditional herbal medical practice, keishikajutsubuto, shimbuto, ryokyojutsukanto, tokishigyakukagoshuyushokyoto, goshajinkigan, and shakuyakukanzoto were prescribed primarily for lower extremity symptoms caused by lumbar disease. Thirty-two of 60 (53%) cases with lower extremity pain, 17 of 34 (50%) cases of pain with coldness, and 4 of 19 cases (21%) of pain with numbness were improved by these drugs. We conclude that the addition of keishikajutsubuto, shimbuto, ryokyojutsukanto, tokishigyakukagoshuyushokyoto, goshajinkigan, and shakuyakukanzoto after antecedent pain therapy was effective in treating lower extremity symptoms caused by lumbar disease.