A main symptom of chronic fatigue syndrome (CFS) is fatigue which continues for more than 6 months and does not improve with rest, leading to a marked decrease in quality of life. Other problems include fever, sleep disorder, and headache. Etiologically, a preceding viral infection, immunological disorder, and changes in the central nervous system, especially in hippocampus have been reported. However, the precise pathogenesis of CFS has not been elucidated, and neither diagnostic markers nor effective treatments have yet to be discovered. Here, we report a case of CFS, successfully treated with Kampo medicines.
The patient was a 16-year-old high school student, who had received medical therapy for one year under the diagnosis of CFS. His chief complaint was a continuing fever and strong malaise after influenza infection. At his visit to our outpatient clinic, we confirmed that his symptoms met the criteria for CFS. A combination treatment with Kampo medicine (sanoshashinto) and duloxetine improved his malaise and fatigue in 4 weeks, but fever and anorexia remained. The addition of hochuekkito to the combination dramatically ameliorated his symptoms. This case suggests that Kampo medicines would contribute to the effective treatment of CFS, which is refractory to Western medicines.

A 70 year-old male with nodular multiple angiitis visited our outpatient clinic because of cold sensation and dysthesia. Although the vascular disease went into remission with steroid and immunosuppressant use, dysthesia continued. An improvement in subjective symptoms was evaluated with a visual analogue scale, after Gosha jinki-gan extract was administered on the basis of Kampo diagnosis. Furthermore, this beneficial effect increased when Syuchibushi matsu administration was added. Thus far, there are no such reports on Goshajinkigan as being useful for nodular multiple angiitis. Although the direct effect was not seen on the peripheral nerve conduction velocity, Goshajinkigan might be useful for the treatment of subjective cold sensation and dysthesia symptoms, in patients with nodular multiple angiitis. The mechanism of the above effect is considered to be similar to that in diabetic peripheral neuropathy.