1.A Case Series of Post-COVID Conditions with Fatigability Treated with Saikokeishito
Rie ONO ; Shin TAKAYAMA ; Natsumi SAITO ; Ryutaro ARITA ; Akiko KIKUCHI ; Kota ISHIZAWA ; Takeshi KANNO ; Akito SUGAWARA ; Minoru OHSAWA ; Michiaki ABE ; Ko ONODEARA ; Tetsuya AKAISHI ; Tadashi ISHII
An Official Journal of the Japan Primary Care Association 2024;47(2):49-55
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.
2.A Report on an Annual Kampo Medicine Conference Held by Medical Students in the Hokkaido and Tohoku Areas
Shohei OKADA ; Fumiya OMATA ; Takafumi TOGASHI ; Takahisa OKUDA ; Tesshin MIYAMOTO ; Miho OOSUGA ; Kohei TANAKA ; Mami ISHIYAMA ; Aiseio AISO ; Hiromichi YASUI ; Minoru YAEGASHI ; Kahori KUBO ; Soichiro KANEKO ; Tetsuharu KAMIYA ; Natsumi SAITO ; Ryutaro ARITA ; Hidekazu WATANABE ; Hitoshi NISHIKAWA ; Yuka IKENO ; Junichi TANAKA ; Minoru OHSAWA ; Akiko KIKUCHI ; Takehiro NUMATA ; Hitoshi KURODA ; Michiaki ABE ; Shin TAKAYAMA ; Tadashi ISHII
Kampo Medicine 2017;68(1):72-78
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.
3.The Current Status and Evolution of Clinical Trials on Kampo Medicine : Examining “Evidence Reports of Kampo Treatment”
Hideaki OTOTAKE ; Ibuki HIGASHI ; Satoshi KUBOKAWA ; Ryoichiro KONDO ; Ryutaro ARITA ; Takehiro NUMATA ; Minoru OHSAWA ; Akiko KIKUCHI ; Shin TAKAYAMA ; Tadashi ISHII
Kampo Medicine 2019;70(4):419-429
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.
4.Development and Validation of The Questionnaire for Assessing Qi-blood-fluid Patterns for Pre-graduate Kampo Medicine Education
Ryutaro ARITA ; Tetsuharu KAMIYA ; Soichiro KANEKO ; Akiko KIKUCHI ; Minoru OHSAWA ; Natsumi SAITO ; Yoshiyasu MURAKAMI ; Satoko SUZUKI ; Rie ONO ; Shinichi NAGATA ; Shin TAKAYAMA ; Tadashi ISHII
Kampo Medicine 2024;75(2):152-167
Some simulation-based education tools have been introduced in Kampo medicine. However, there are only a few brief simulation tools to learn qi-blood-fluid (QBF) patterns of traditional Chinese medicine (TCM). In this study, we developed a self-diagnostic questionnaire that allows students learn TCM interviews and QBF patterns by answering the questionnaire and evaluated its reliability and validity. We extracted questionnaire items to classify six QBF patterns (qi deficiency, blood deficiency, yin deficiency, qi stagnation, blood stasis, and phlegm-fluid retention) based on some textbooks of TCM and Kampo medicine. Then we developed an initial questionnaire comprising 35 items. Fifth year medical students at Tohoku University School of Medicine answered the questionnaire of small group teaching during 2017-2020. We evaluated the accuracy of the questionnaire if compared with the diagnosis of academic supervisors. To improve the accuracy, we adjusted the questionnaire’s thresholds and created a predictive model of the patterns using logistic regression analysis. The questionnaire’s sensitivity improved by adjusting the thresholds. Logistic regression analysis resulted in a predictive model that could determine QBF patterns with the same level of accuracy as the original for 20 items overall. The results suggest that the use of a simple questionnaire with ensured accuracy may contribute to better pre-graduate education by making it easier for students to understand their own Kampo medicine patterns.
5.Clinical Characteristics of Chronic Otolaryngeal Patients Treated with Kampo Medicines
Hitoshi NISHIKAWA ; Shin TAKAYAMA ; Akiko KIKUCHI ; Takehiro NUMATA ; Yuka IKENO ; Soichiro KANEKO ; Tetsuharu KAMIYA ; Ryutaro ARITA ; Natsumi SAITO ; Minoru OHSAWA ; Michiyo KOJIMA ; Hiroyo SASAKI ; Kazuyoshi YAMASHITA ; Tadashi ISHII
Kampo Medicine 2019;70(1):18-24
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.