Women with undefined climacteric period complaints often have multiple symptoms. To identify the characteristics of and to provide treatment tailored to each patient, Sho diagnosis based on an eight-principle pattern of identification is needed. Furthermore, identification of abnormalities in Ki, Ketsu and Sui, which are the basic elements of all physiological activity, are of great importance in clinical practice.
We determined identification rates of these principles in women with climacteric symptoms using Kampo medicine. Eight hundred and ninety-nine climacteric patients, aged 43-58 years: 52.1±2.4yr, were recruited for this study. We detected heat-or cold-syndrome, and hyper-or hypofunction patterns using the eight-principles with conventional, traditional Japanese Kampo medicine diagnostic procedures as well as disorders of Ki, Ketsu, and Sui metabolism according to the Terasawa score, in retrospective fashion. Ketsu stagnation (36.5%) was found to be the most frequent condition. Ki regurgitation (25.9%) and Ki stagnation (24.8%) were found to be relatively frequent pathological conditions. In women with headache, hot flushes, and dizziness as the principal menopausal symptom, disorders of the Sui metabolism (48.8%), Ketsu stagnation (48.1%), and disorders of the Sui metabolism (48.0%) were the most frequent conditions, respectively.
These results indicate that although climacteric symptoms are diverse in nature, identification of Ki-Ketsu-Sui patterns often makes it possible to obtain a coherent diagnostic picture, leading to a better understanding of the conditions seen in climacteric women. When dealing with climacteric women with undefined complaints, it seems particularly important for physicians to be able to prescribe Kampo preparations precisely for Ketsu stagnation (the most frequently observed) so that the health of these women can be restored. It is also important that physicians perform Sho diagnosis carefully, bearing in mind the finding that Ki-Ketsu-Sui patterns were complex in patients exhibiting hot flushes (one of the main symptoms), although half of these presented with Ketsu stagnation. Incorporating Kampo medicine into therapeutic approaches to the treatment of such patients therefore seems advisable.

This study was designed to investigate the association between autonomic nervous activities and clinical symptoms of climacteric women with qi disturbance. Power spectral analysis of heart-rate variability (HRV) was performed in 55 climacteric patients with undefined symptoms (age;51.9±2.8). The total power of HRV in patients with hot flushes was significantly higher (529.6±529.9ms²) than that of patients without this symptom (295.4±260.8 ms²) (P<0.05). The sympathetic nerve system (SNS) index in patients with hot flushes and with jitters (2.81±2.93 and 3.16±2.78), was significantly higher than those of patients without them (1.03±0.78 and 0.87±0.72) (P<0.001 and P<0.0001, respectively). The parasympathetic nerve system (PNS) index of patients with hot flushes and patients with jitters (0.38±0.19 and 0.33±0.16) was significantly lower than those of patients without them (0.55±0.17 and 0.58±0.14) (P<0.001 and P<0.0001, respectively). These findings indicate that HRV-based assessment of the autonomic nervous system activity of climacteric women with hot flushes and jitters, which have been known as symptoms of qi counterflow in the Kampo medicine, is associated with an increase in sympathetic nerve system and a decrease in parasympathetic nerve system activity. It has been suggested that autonomic nervous activities be included in the part of pathological condition of qi in the Kampo medicine, and that evaluation of qi be used as one diagnostic tool in the practical Kampo medicine, or fusion of western and oriental medicine.