We evaluated the effect of Kampo therapy in which Kampo formulae were selected based on Japanese traditional theory, on the development of hepatocellular carcinoma (HCC) in patients with hepatitis C virus (HCV)-related chronic liver disease. One hundred forty HCV-infected outpatients without HCC at their first examination and who were observed for more than one year, were included. The patients were divided into three groups according to the initial platelet count (Plt): Plt less than 10×10⁴/μL (Group I), Plt between 10×10⁴/μL and 14×10⁴/μL (Group II), and Pit greater than 14×10⁴/μL (Group III). For each patient, Kampo formulae were selected according to the patient's symptoms and physical findings at each clinic visit. The incidence of HCC calculated by the person-years method, was 0.89% in Group I. 1.55% in Group II and 0.29% in Group III. The annual incidence of HCC among our patients was low compared with that among untreated patients in previous reports. In addition, the incidence of HCC among our patients was low compared with that of previous studies where Shosaikoto or Juzentaihoto was administered for a long period of time. In the present study, age over 60 years was a possible risk factor for HCC. However, sex and patterns of the change in alanine aminotransferase level (ALT) were not associated with the development of HCC. A total of 53 different Kampo formulae were prescribed, for all patients, with Hochuekkito being the most frequent. These results suggest that Kampo treatment in which Kampo formulae are selected based on traditional theory, may be more useful than treatment by a single Kampo formula for preventing the development of HCC in patients with HCV-related chronic liver disease.

We report on five patients with menstrual pain and/or other disorders, whose symptoms improved when treated with Ki-related prescriptions. Hangekobokuto improved severe epigastralgia and menstrual pain in Case 1. Saibokuto showed improvement of menstrual disorders and pain in Case 2, while Hangekobokuto also ameliorated menstrual pain in Case 3. The treatments were based on patient Ki stagnation, although the symptoms of Ketsu stagnation were also observed in these cases. In Case 4, the patient's menstrual pain and disorders were improved by changing her prescription from Kamishoyosan, to Keishikaryukotsuboreito. In Case 5, a menstrual period of more than 40 days became a regular rhythm of 30 days, while treating the patient's chief complaint of urticaria, with Keishikaryukotsuboreito. Symptoms of Ketsu stagnation were not apparent in Cases 4 and 5. We prescribed Keishikaryukotsuboreito—a prescription for Ki regurgitation—because of suggestive symptoms of nightmare, as well as palpitation in the abdomen.
Menstrual problems are often related to Ketsu abnormalities according to Kampo medicine literature. However, symptoms related to Ki regurgitation and Ki stagnation are also observed in women with menstrual problems who are under stress. Therefore, it is important to know that there have been cases, such as ours, of menstrual problems successfully treated with Ki-related prescriptions.

Rehabilitation and exercise are occasionally restricted by intractable pain to an extent greater than that estimated due to physical dysfunction. Here, we report three patients with intractable pain in whom Kampo medicine was highly effective, in cases where common treatments such as the administration of non-steroidal anti-inflammatory drugs and nerve blockade proved ineffective. Sokeikakketsuto extract was prescribed for three patients with different conditions: intermittent claudication of cauda equina due to lumbar spondylolisthesis, posttraumatic chronic psychogenic pain, and complex regional pain syndrome type 1 that occurred after cerebral infarction. Sokeikakketsuto extract alleviated severe pain and therefore facilitated rehabilitation and exercise in all three of these cases. From the viewpoint of Kampo medicine, we hypothesized that all three cases shared some common etiology of blood abnormalities, although conventional medical diagnosis differed for each. We suggest that treatment with Sokeikakketsuto extract corrected the blood abnormalities, thereby resulting in the successful treatment of intractable pain in these patients.

We describe three cases in which the same Kampo formulas were applied to a mother and daughter with different complaints. In cases 1 a, b, a mother with general fatigue after an operation for gastric and colon cancer, and her daughter with migraine and menopausal symptoms were effectively treated with kamishoyosan. In cases 2 a, b, a mother with menstrual disorder, and her daughter with palmar eruption were effectively treated with hangekobokuto. In cases 3 a, b, a mother with lumbago and her daughter with back pain were effectively treated with keishikaryukotsuboreito. These Kampo formulas are thought to improve qi circulation.
It is considered that improving qi disturbance is important for the Kampo treatment of female patients. Taking into account parent-child genetic similarities, it is possible that application of the same Kampo formula to familiarly related patients with different complaints could be effective. It is important to consider not only the patient's complaints, but also the patient's condition, from the Kampo viewpoint so-called “Sho”. Therefore,since our cases all involved a mother-daughter relationships, it may be reasonable to assume that Kampo formulas improving qi circulation were effective for their different complaints.

We report a case of pneumothorax successfully treated with hochuekkito.
The patient was a 56-year-old female, who was diagnosed with right-sided pneumothorax, and who improved after resting cure. However, her condition did not completely resolve. About three years later, we prescribed hochuekkito because her pneumothorax became worse with general fatigue. Five days after taking hochuekkito, the pneumothorax improved in her chest X-ray. But it became worse again, and finally she underwent an endoscopic operation. This case suggests the possibility that hochuekkito can improve pneumothorax temporally. There is no literature on Kampo therapy as it applies to pneumothorax, and we believe this case to be the first report of value on the subject.

We examined the complaints of adult patients with ‘weak’ sho symptoms using their first-visit medical questionnaires. Our subjects were 39 patients (3 males and 36 females) who fatigued easily, and who had a weak constitution with stress and the changing of seasons.
Over 60% of these ‘weak’ patients complained of excessive sensitivity to cold. The majority had stiff shoulders, a stiff neck, low back pain, sleeplessness, headache, fatigue of the eyes and vertigo. Their gastrointestinal constitutions were poor because of over eating.
Although we understood many of the complains these ‘weak’ patients had through their medical questionnaires, their chief complaints were various. We hope these results are useful in understanding treatments for patients with ‘weak’ sho.

We would like to report on the treatment of 15 patients with floating sensation after the Great East Japan Earthquake (2011 Tohoku Earthquake) in 2011.Twelve cases were effectively treated with hangekobokuto, while two cases were effectively treated with hangebyakujutsutemmato, but not with hangekobokuto.One case was effectively treated with ryokeijutsukanto. We discuss how to treat this floating sensation, focusing on the usage of hangekobokuto.
Most patients who were successfully treated with hangekobokuto reported an uneasy feeling with a floating sensation. On the other hand, those who were successfully treated with hangebyakujutsutemmato or ryokeijutsukanto did not feel uneasy, but reported vertigo and upset stomach.Upon abdominal examination, epigastric resistance was frequently observed in the patients treated with hangekobokuto.This resistance decreased as the floating sensation was improved.
Our results indicate that hangekobokuto could be efficacious for patients with floating sensation after an earthquake, who also felt uneasy and showed epigastric resistance upon abdominal examination.

A case of subclavian vein stenosis is reported that was treated with external jugular-cephalic vein bypass, which was performed under local anesthesia and took short time for operation because of single anastomosis. This procedure resulted in salvage of the access and rapid resolution of the associated upper extremity swelling.

[Purpose] In Kampo medicine, blood deficiency is considered to cause systemic symptoms such as insomnia and dizziness, in addition to skin-related symptoms such as xeroderma. Diagnosis of blood deficiency does not appear to be definitive since it is based on subjective judgment. To resolve this problem, we have attempted to establish an objective method for diagnosing blood deficiency by measuring skin moisture.[Methods] Using a skin moisture meter, we measured the skin moisture (at the neck, forearm, and abdomen) of 80 women during their first examination at our clinic. The patients were also classified according to their blood deficiency scores.[Results] A statistically significant difference was observed between patients with blood deficiency and those without blood deficiency with regard to the skin moisture at the neck and forearm. The coefficient of correlation between the skin moisture of the neck and the blood deficiency score was -0.41.The results of statistical analysis performed using a type1quantification method revealed high values even for some conditions not associated with the skin, such as hypomenorrhea and excessive strain of the abdominal muscles, in addition to high values for skin-associated conditions. And in pre-post-treatment comparisons, improvements in blood deficiency scores generally matched transitions in keratinous moisture.[Discussion] Due to the absence of a high correlation between skin moisture and the blood deficiency score, it is unlikely that skin moisture can be used instead of the blood deficiency score as a parameter for the accurate diagnosis of blood deficiency.[Conclusion] Although skin moisture levels may be an indicator of blood deficiency, further studies are required before this parameter can be applied in clinical diagnosis.
deficiency ; In Blood ; Integumentary system ; Neck ; Diagnosis

We examined the complaints of adult patients with ‘weak’ sho symptoms using their first-visit medical questionnaires. Our subjects were 39 patients (3 males and 36 females) who fatigued easily, and who had a weak constitution with stress and the changing of seasons.Over 60% of these ‘weak’ patients complained of excessive sensitivity to cold. The majority had stiff shoulders, a stiff neck, low back pain, sleeplessness, headache, fatigue of the eyes and vertigo. Their gastrointestinal constitutions were poor because of over eating.Although we understood many of the complains these ‘weak’ patients had through their medical questionnaires, their chief complaints were various. We hope these results are useful in understanding treatments for patients with ‘weak’ sho.
seconds ; Weak ; Complaint, NOS ; Sleeplessness ; Financially poor