Case 1 was a 24-year-old female suffered from the feeling that her throat was obstructed ; this occurred after she had to talk loudly in front of many people. Case 2 was a 51-year-old female who complained of a palpitation attack ; this occurred after she underwent a hysterectomy. We diagnosed these symptoms as “hontonki.” Hontonki is a case of symptoms rising from the lower abdomen into the chest and throat with feelings of anxiety. When these symptoms appeared, the patients felt as if death were upon them, but when they disappeared, the patients soon felt healthy. There are certain medicines that can be used to treat hontonki. We administered Kinkiyoryaku hontonto (i.e. hontonto as described in Kinkiyoryaku) to them, and it was very effective.
We undertook a retrospective analysis of these two cases, along with 8 other cases successfully treated with Kinkiyoryaku hontonto at our hospital over the last 11 years. We found the common clinical characteristics of hontonki events were paroxysmal symptoms with feelings of anxiety. There are some differences between the clinical characteristics of Kinkiyoryaku hontonto from those of Chugobikyuho hontonto (hontonto as described in Chugobikyuho). The cases of Kinkiyoryaku hontonto are not kyosho (hypofunction) as those of Chugobikyuho hontonto are. Either they have heat symptoms or they do not have coldness, and they have shoulder stiffness or headache as some of the other oketsu symptoms.

This report describes a case of cluster headaches that was successfully treated with Senkito. The patient was a 46-year-old female. She had been having attacks of cluster headaches that had continued for 3 days at the change of seasons since she was 30 years old. During an attack, she took a triptan preparation and non-steroid anti-inflammatory drug (NSAID), but they were not effective. Recently, the attacks had been increasing in frequency and continued for 1-2 weeks. She visited our hospital for Kampo treatment. We diagnosed her as having oketsu and kiutsu ; therefore, we prescribed tsudosan, and the frequency and strength of the attacks decreased. Even if NSAIDs were effective for headaches, they were not consistently effective. We re-examined her and found she had inside biryokotsu, which is tenderness in the orbital part of the frontal bone. We diagnosed her headache as including biryokotsu pain. We prescribed Senkito as required for her biryokotsu pain. It was very effective and the headache vanished after only 30 min. Generally, the potency of Kampo medicines with few structural components is higher than that of those with many structural components. Senkito has only five structural components ; therefore, we concluded that Senkito is effective not only for everyday use but also for use when required. Senkito is one of the most effective formulations for treatment of biryokotsu pain,especially the patient with inside of biryokotsu tenderness.

Treating tinnitus with modern Western medicines is difficult. Several studies have reported that Kampo medicines are efficacious for treating tinnitus, and therefore, it is expected that these medicines will gain widespread use in the future for tinnitus treatment. We retrospectively examined the efficacy of Kampo medicines prescribed on the basis of Kampo diagnoses for chronic tinnitus patients. The study population included 331 patients (114 men, 217 women) and average age was 57.8 years. The overall effective rate of Kampo medicines in tinnitus was 38.4% and increased to 64.6% after including effects for the accompanying symptoms (e.g., dizziness, insomnia, and headache). Hangekobokuto was prescribed most frequently. The effective rate for hangekobokuto in tinnitus was 32.1% and significantly increased when it was used in combination with a herb, chotoko (Hook of Uncaria, rhynchophylla Miquel) (p < 0.05, Fisher's exact test). The effects and modern pharmacological action of chotoko indicate that it may be effective for tinnitus. Given that tinnitus was intractable in study subjects who had been treated using other therapy approaches earlier (84% of the population), the findings indicate that Kampo medicine may be partially effective for tinnitus.

Background : Kampo, or traditional Japanese medicine education, was accepted into the education system after a new requirement of being able “to roughly explain Wakan (Japanese/Chinese) medicines" was added to the core curriculum model.
Purpose : Kampo medicine has been taught at all 80 medical schools and universities since 2007. We con ducted a nationwide survey to understand the present situation, gain insights from several Kampo education viewpoints, and elucidate any challenges for the Japan Society for Oriental Medicine (JSOM) in future.
Method : A postal questionnaire survey was sent to 80 medical schools and universities from the Liaison Committee of JSOM.
Results : 67 out of the 80 medical institutions (83.8% return rate) responded to the survey. The answered survey results were as follows : Kampo medicine is needed in regular clinical practice (91%), studies are needed to evaluate the outcome of Kampo Medicine education (77%), and dedicated staff members are being trained (46%).
Conclusions : Further development of graduate education and its standardization as well as improvement of bedside training is needed for Kampo education. In addition, establishment of a post-graduate Kampo education system will be crucial in the future.

We analyzed the clinical features of 21 cases with drug-induced liver injury due to Kampo medicines between the years 2000 and 2009 in our institute. The mean age in these cases was 55.2 ± 13.4 years. Five of the cases were men, and 16 were women. In 17 of the 21 cases, drug-induced liver injury had occurred within 3 months after beginning Kampo medicines. There were no subjective symptoms in 11 cases. Nine cases of both hepatocellular injury, and of mixed-type injury were seen. Causative Kampo medicines included an Ogon (Scutellariae Radix) component in 19 cases. A drug-induced lymphocyte stimulation test (DLST) was performed in 5 cases. The test was positive for Kampo medicines in only one of the 5 cases. Liver injury improved or normalized in 18 cases (85.7%) after discontinuing causative Kampo medicines. In another 2 cases, liver injury normalized after changing a Kampo medicine to the same prescription without Ogon. These results suggest that even if patients complain of no symptoms we must perform blood tests to check liver function within 3 months of prescribing Kampo medicines, especially those including Ogon, to facilitate early diagnosis of drug-induced liver injury.

The patient with atopic dermatitis is often dissatisfied with the long-term nature of treatment for his/her disease. The aims of this study were to examine the effect of Kampo therapy on the skin manifestation of atopic dermatitis as well as the patient's mental state, and to evaluate the relation between severity of symptoms and satisfaction with the Kampo therapy. Kampo medicine was administered to 15 in-patients with atopic dermatitis for 6 months. Their clinical conditions, quality of life (QOL) assessments, and psychosomatic scores before and after treatment were observed and comparatively evaluated. We evaluated patients' symptom severity with the atopic dermatitis severity classifications of the Japanese Dermatological Association, and the European SCORAD (Scoring of Atopic Dermatitis). We evaluated QOL with the SF-36 and DLQI (Dermatology Life Quality Index), and mental state with the PSS-AD (Psychosomatic Scale for Atopic Dermatitis). Clinical conditions, QOL and mental states were improved after treatment with Kampo medicine. However, when we examined individual cases, severity of symptoms and satisfaction with treatment did not correlate. Patients' satisfaction ratings and the severity of their symptoms do not necessarily correspond in patients with atopic dermatitis, because evaluations vary with each individual. Therefore, clinicians treating patients for atopic dermatitis must make an effort to recognize each patient's psychological condition.

Tokishakuyakusan has been used widely to treat various diseases including gynecological disorders. Currently, tokishakuyakusan is frequently used to treat female patients, while indications for use in male patients are unclear. Furthermore, there are few reports of male patients having been effectively treated with tokishakuyakusan or tokishakuyakusanryo. Here, we report four male patients successfully treated with tokishakuyakusanryo. Case 1 was an 84-year-old man who had uncontrolled nasal allergy, and treatment with tokishakuyakusanryo was effective in relieving the patient's allergy symptoms that were accompanied by chills and oketsu (blood stasis) findings. Case 2 was a 63-year-old man whose chief complaints were bronchial asthma, benign prostate hypertrophy, and nasal allergy. All his symptoms improved considerably with tokishakuyakusanryo and hangekobokuto, especially the symptoms of nasal allergy. Case 3 was a 70-year-old man whose chief complaint was persistent proteinuria. Tokishakuyakusanryo was prescribed, in consideration of his clinically observed condition, which included sensitivity to cold, blood stasis and fluid retention. His proteinuria disappeared four months later, along with his other complaints of chills, oketsu, and fluid retention. Case 4 was a 56-year-old man whose chief complaint was ulcerative colitis. He had responded well to treatment with ifuto, but he developed hypertension. His prescription was changed to tokishakuyakusanryo, a similar prescription that does not contain the Glycyrrhiza radix which can cause hypertension. Afterwards, his blood pressure decreased to normal levels and his abdominal symptoms remained stable. Nangai Yoshimasu published the opinion that tokishakuyakusan could be applied not only in female patients but also male patients. Additional reports on male cases would provide helpful information to clarify tokishakuyakusan indications in male patients.

We report the case of a 46-year-old man with hypertension whose blood pressure decreased due to saiko-karyukotsuboreito consumption.The patient also presented with some symptoms that suggested autonomic imbalance. After consuming 7.5g/day of a spray-dried powder of saikokaryukotsuboreito (Tsumura & Co.) for 3 months, his blood pressure measured at office was considerably lower. Twenty-four hour ambulatory blood pressure monitoring revealed that the surge in morning blood pressure, which is considered to be a risk factor for cerebrovascular disease, diminished in addition to the 24-hour mean blood pressure. A postural test revealed that his autonomic balance, which had been in a sympathetic dominant state, was inversely inclined to a parasympathetic dominant state.Our case report suggests that saikokaryukotsuboreito acts on the autonomic nervous system, which in turn exerts an antihypertensive effect, and that this effect is helpful in lowering the blood pressure in hypertensive patients whose autonomic balance is impaired due to stress.
Blood Pressure ; Assessment of balance ; Hour ; Effective ; Equilibrium

We have limited evidence as to the clinical indications for Kampo medicines, especially as they relate to gastrointestinal function. Thus, we investigated the efficacy of the Kampo medicine hangekobokuto (HKT) on patients with functional dyspepsia (FD), with special reference to its clinical indications for gastrointestinal function, including gastric emptying and bowel gas volume.Gastric emptying rate (GER) in FD patients was significantly facilitated by HKT. HKT also improved the gastrointestinal symptoms of the patients. Among these, patients who had inchuusharen, or a symptom of globus sensation, and a representative indication for HKT, showed significant improvement of both their GER and gastrointestinal symptoms compared with patients who did not have inchuusharen. As for bowel gas, the bowel gas volume calculated from a plain abdominal radiogram (gas volume score, GVS) in FD patients decreased significantly, after administration of HKT. Patients who had fukuman, or a feeling that one's stomach is full or bloated, and another representative indication for HKT, showed significant decrease of their GVS to normal levels, compared with patients who did not present with fukuman.These results suggest that the presence of clinical indications, such as inchuusharen or fukuman, are strongly related to HKT efficacy in patients with FD, and that these are useful, scientifically validated markers for the efficient use of HKT.
Clinical ; Final diagnosis (discharge) ; Gases ; seconds ; Volume

Takushato is a Kampo formula used for the treatment of dizziness and vertigo. Signs and symptoms suggestive of fluid retention have been regarded as clinical indications for takushato administration, but it is not clear if improvement of these signs and symptoms is related to the clinical efficacy of takushato, so we analyzed the correlation among these factors. Twenty patients who suffered from dizziness and vertigo were treated with takushato for 4 weeks. Before and after treatment, subjective symptoms and objective data including vestibular function tests were assessed, and correlation among the factors was analyzed. Improvement of patients' total symptoms was significantly correlated with improvement of fluid retention scores. Furthermore, improvement in vestibular function tests showed a trend toward correlation with that of fluid retention scores.These results suggest that improvement in the signs and symptoms of fluid retention is related to the clinical efficacy of takushato. We conclude that the presence of fluid retention is a reasonable clinical indication for takushato administration.