Patients with the best supportive care often get worse and worse, and it is very difficult to improve their symptoms. As cancer is currently a leading cause of death in Japan, and adequate control of the cancer-associated pain is important to improve the quality of life (QOL) in cancer patients. Pain caused by bone metastasis is particularly difficult to control, and the strong analgesic medication which it requires is generally difficult to control. Such metastases result in reduced mobility and markedly reduced activities of daily living (ADL) and the QOL of patients. Our patient was a 67-year-old man who had been treated for metastasis from the left kidney to cancer of the right pelvic bone ; palliative chemotherapy and mild treatment were provided for his sharp pain, but control of his sharp pain was insufficient. Here we expand on our experience in a patient with bone metastasis caused by renal cell carcinoma successfully treated with Kampo medicine, using acupuncture and decoction extract.

The prevalence of allergic diseases such as asthma, allergic rhinitis and atopic dermatitis has increased all over the world during the last two decades. Dietary change is supposed to be associated with this increase. If it is the case, an appropriate intake of foods or drinks with anti-allergic functions is expected to stop the increase. Flavonoids, ubiquitously present in vegetables, fruits or teas possess anti-allergic activities. Flavonoids inhibit histamine release, synthesis of IL-4 and IL-13 and CD40 ligand expression by basophils and mast cells. Analyses of structure-activity relationships of representative flavones showed that luteolin, apigenin and fisetin were the strongest inhibitors of IL-4 production with an IC₅₀ value of 2–5 μM and determined a fundamental structure for the inhibitory activity. Quercetin and kaempferol showed a substantial activity with an IC₅₀ value of 15–18 μM. The inhibitory activity of flavonoids on IL-4 and CD40 ligand expression were thought to be mediated through their inhibitory action on activation of nuclear factor of activated T cells and AP-1. Administration of flavonoids into atopic dermatitis-prone mice prevented the onset of dermatitis and serum IgE elevation and ameliorated the severity of dermatitis even after the onset. In addition a preliminary trial of flavonoids for adult patients with atopic dermatitis showed a significant effect. Recent epidemiological studies reported that a low incidence of asthma was significantly observed by population with a high intake of flavonoids. Thus, these evidences will be helpful for the development of low molecular compounds for allergic diseases and it is expected that an appropriate daily intake of flavonoids may be an effective complementary and alternative medicine and a preventative strategy for allergic diseases.

Saffron (Crocus sativus L.) is classified as a beneficial herb in the treatment of “Oketsu,” eliminating blood stagnation. The clinical symptoms of “Oketsu” include feeling cold and arthralgia. The pathological condition of “Oketsu” is considered to be increased blood viscosity and microvascular disorders.However, no useful biomarker has been reported for evaluation of the degree of “Oketsu.” Here, we investigated the clinical effect of saffron on the symptoms of “Oketsu” in patients with autoimmune diseases. At the same time, we measured the plasma levels of platelet factor 4 (PF-4) and beta-thromboglobulin (β-TG) as platelet activation markers. Seventy-one patients (66 women and 5 men, mean age 52.3 ± 16.1) were studied. They were administered saffron (300mg∼900mg) with traditional Kampo medicine. The clinical symptoms of “Oketsu” improved (80.9%, n=38/47) and we measured PF-4 and β-TG in pre-and post-saffron treatment periods. The plasma levels of PF-4 and β-TG significantly decreased after saffron therapy (PF-4 : before 49.6 ± 29.8, after 24.0 ± 19.6ng/ml, β-TG : before 117.5 ± 64.0, after 64.6 ± 47.1ng/ml;paired t-test, p < 0.0001, respectively). These results suggest that saffron is effective in treatment of the symptoms of “Oketsu” in allergy and collagen disease patients. Moreover, PF-4 and β-TG may be useful biomarkers of the degree of “Oketsu.”

Keishibukuryogankayokuinin (KBGY) is a Kampo formulation that is well known as being suitable for patients with blood and water stagnation. In this study, we retrospectively investigated the efficacy of KBGY for tinnitus patients. The total number of patients was 9 (5 males, 4 females). The average age was 67 years (range : 54-81 years, the median age : 65 years). The progression of 9 patients was cure (1), amelioration (6), no change (2), and deterioration (0). The important pathophysiology of tinnitus in Kampo medicine includes blood stagnation and water stagnation. In these cases, KBGY can single-handedly improve both blood and water stagnation. We recommend KBGY for the treatment of tinnitus caused by the coexistence of blood and water stagnation.

We have experienced a case of response to keishikajutsubuto for stump pain after both femoral amputations. There are few reports on the use of Kampo medicines for stump pain after amputation. In this case, the critical lower-limb ischemia that led to the amputation was due to severe stenosis and occlusion caused by arteriosclerosis in both limbs. From the perspective of Kampo medicine, ischemia is considered to have cold and blood status as a result of deficiency and stagnation of yang qi due to circulatory failure. In this case, we regarded blood stasis as a secondary product of ischemia, and we mainly considered a prescription to remove cold and bring yang qi to the eliminative organs, which was effective for the pain. For stump pain after amputation that is poorly responded to general analgesics, the combination of keishikajutsubuto is expected to provide rapid analgesic effect, suggesting that it is useful for pain control.