The purpose of this study was to verify the concept of Kampo medicine epidemiologically and demonstrate the objective bases of the Kampo treatment. For this purpose, a population based survey of subjective symptoms based on Kampo medicine was conducted among 1,486 residents of Hase village, Nagano prefecture, ages 20 and older. The completion rate was 80.7% and 1,199 residents provided favorable responses. An investigation of gender differences showed a higher rate of blood deficiency among female residents, while spleen and qi deficiency were more common in males. Considering age differences, symptoms related to blood deficiency and water-dampness affected younger females, symptoms related to qi deficiency primarily affected younger males, and symptoms of liver afflictions were common in younger both genders. Among the elderly residents, symptoms of kidney deficiency were overwhelmingly predominant in both genders. Though younger people with subjective sense of health had few diseases in western medicine, most of the elderly with perceived health actually had some kind of diseases for medical treatment. Physical symptoms in the chest area such as shortness of breath correlated positively with the perception not to be healthy, and these may be regarded as both the manifestation and factors contributing to ill health. Approximately 1 out of 12 residents reported currently receiving the treatment of oriental medicine or demonstrated the potential to benefit from such intervention. These results may clinically be useful as the objective bases to perform the Kampo treatment.

Purpose: Endoscopic submucosal dissection is a promising method for the resection of superficial gastric neoplasms. To date, several institutions have used proton pump inhibitor injections over the perioperative period. However, there is very little evidence regarding their efficacy. To overcome this limitation, we compared procedural outcomes and the prevention of adverse events of proton pump inhibitor injection with an orally administered active potassium-competitive acid blocker alone.Participants and Methods: We enrolled a total of 150 patients treated for superficial gastric neoplasms at a single institution between April 2015 and December 2018. Patients treated for 2 days with proton pump inhibitor injections following 12 days of oral potassium-competitive acid blocker (proton pump inhibitor group=80) were compared with patients treated for 14 days orally with potassium-competitive acid blocker alone (potassium-competitive acid blocker group=70) using propensity score analysis. We evaluated intragastric pH levels prior to endoscopic submucosal dissection, frequency of intraoperative major bleeding, procedure time, en bloc resection rate, curability, ulcer reduction rate 14 days after endoscopic submucosal dissection, and adverse events (including perforation and postoperative bleeding).Results: Propensity score analysis yielded 43 matched pairs. The comparison demonstrated similar values for the outcomes. For all cases, we observed intragastric pH levels >6.4 prior to endoscopic submucosal dissection. Postoperative bleeding rates were 2.3% (1/43) in the proton pump inhibitor group and 0.0% (0/43) in the potassium-competitive acid blocker group (P=0.315).Conclusions: Oral potassium-competitive acid blocker alone was as effective as proton pump inhibitor injection, with a low incidence of adverse events. Based on these results, proton pump inhibitor injection might be omitted during gastric endoscopic submucosal dissection.