Fatigue is a common symptom of long COVID. Fatigue can majorly disrupt daily life and be challenging to treat. Herein, we describe the effect of saikokeishito, a Kampo medicine, on fatigue in patients with long COVID.Between October 2020 and March 2023, we prescribed saikokeishito to 22 patients with long COVID in the general medicine outpatient department of our hospital. Among them, seven patients (age: 15-58 years, two females) had fatigue, a previously confirmed diagnosis of COVID-19, and no concomitant use of other Kampo formulas. We compared their condition at the start of saikokeishito administration to that 3 months later. Five patients had a slight fever, and four had inflammatory findings on blood tests. Within 3 months, all patients had a 20% or greater reduction in fatigue on a visual analogue scale. Six patients had a 20% or greater increase in health-related QOL and were able to return to society. On the other hand, one patient required a transition to an alternative medication, and one patient's follow-up was prematurely discontinued. Fatigue after COVID-19 may be improved by saikokeishito, especially for the treatment of patients with slight fever or inflammatory findings.

Since students who would like to study Kampo medicine more have no opportunity to communicate each other in Northern Japanese Universities, we newly started joint study conferences held by medical students in 2013. The objectives of this paper are to report on these annually held student-based Kampo study conferences in the Hokkaido and Tohoku areas, and the ways each university studies Kampo medicine. In the conference, the students reported on their club activities. Then they studied the history of Kampo medicine and simulation of abdominal diagnosis, and performed group work on case reports together. The number of student participants in these conferences has tripled over 3 years from 18 to 58 (for a total of 111 participants). All members were satisfied with the content. And this reflects medical students' need for a wider perception of Kampo medicine, rather than a limited one gained in their university club activities. We hope this conference will play a major role in other nationwide student-based Kampo study conferences in the years to come.

The Japan Society for Oriental Medicine has summarized randomized controlled trials (RCTs) using Japanese traditional (Kampo) medicine in structured abstracts, named “Evidence Reports of Kampo Treatment” (EKAT). In this study, we developed a method of classification based on study design, method of intervention, study aim, journal credibility, and year of publication. Then we classified 416 RCTs in EKAT and examined the current status and evolution of RCTs using Kampo medicine in Japan. Double-­blinded RCTs (DB-RCTs) accounted for only 8.9% of the RCTs in EKAT, and 86.5% of DB-RCTs were placebo-controlled. Among the RCTs that aimed to investigate the efficacy of Kampo medicine for diseases without standard Western medical treatment, DB-­RCT accounted for 64.9%. In recent years, there have been fewer envelope RCTs and quasi-­RCTs, which are prone to an increased risk of bias. The proportion of articles reporting RCTs in journals with an impact factor ( > 0.79 points reported by Journal Citation Reports) has been increasing with each passing year. This implies that the recent research in Kampo medicine has improved its quality and has gained an appreciation in modern medicine. The present study was conducted in “Problem-based Learning” in the 2nd grade of Tohoku University School of Medicine.

The background and course of Kampo treatment in 39 patients with uncontrollable otolaryngeal symptoms treated between April 2013 and March 2016, in the Department of Kampo Medicine at Tohoku University Hospital, were analyzed retrospectively. An improvement in overall symptoms was noted with Kampo treatment in 28 of 39 cases (71%). The commonly reported subjective symptoms included glossodynia (7 cases), postnasal drip (4 cases), oral discomfort (4 cases), dizziness (3 cases), and taste disorder (3 cases). Analysis using the classification of qi, blood, and fluid revealed that cases with qi stagnation pattern (15 of 18 cases) were effectively treated with Kampo treatment. Prior reports support our finding that smoothing qi with Kampo medicine is effective in alleviating some chronic symptoms. The symptoms improved within 6 weeks after the treatment was initiated. Therefore, a 6-week period can be considered sufficient to determine the effectiveness of Kampo medicine. Many of the patients for whom Kampo treatment was not effective had depression and domestic stress. In conclusion, Kampo treatment may be effectively used to treat uncontrollable, chronic otolaryngeal symptoms in selected cases that are unresponsive to Western medicine.