A 19-year-old man was referred to our clinic for frequent nausea and vomiting. At age 16, he started to have periodic bouts of nausea and vomiting. During an attack, he would experience vomiting more than ten times a day and was unable to eat, which resulted in hospitalization for a week. Inpatient investigations did not reveal any abnormalities except dehydration. Between attacks, he was asymptomatic. Initially, he had attacks a few times a year. However, beginning at age 19, the attacks occurred almost every month. At our clinic, routine physical examination and laboratory tests were unremarkable. On Kampo medical examination, he had qi stagnation and qi counter-flow. He was diagnosed with cyclic vomiting syndrome. Hangekobokuto was administered with improvement of his symptoms. Hangekobokuto may be effective for cyclic vomiting syndrome with qi stagnation and qi counter-flow as diagnosed with Kampo medicine. This suggests the effectiveness of Kampo medicine in functional gastrointestinal disorders.

The treatment of palpitation with a weak constitution through the use of modern western medicines is often difficult. We report here 4 cases of palpitation with weak constitution, which were successfully treated with shokenchuto. Case 1 was a 67-year-old female, who complained of palpitation, as well as anorexia and easy fatigability. An electrocardiogram (ECG) showed premature supraventricular contractions. Case 2 was an 83-year-old female, who also complained of palpitation and gastrointestinal dysfunction. ECG revealed premature ventricular contraction. Case 3 was a 34-year-old male, who complained of palpitation with gastrointestinal dysfunction and diarrhea. ECG findings were characteristic of Brugada syndrome. Case 4 was a 71-year-old female, who complained of palpitation and concomitant diarrhea and anorexia. All patients demonstrated tension of bilateral rectus abdominis muscles. After we prescribed shokenchuto, most of their symptoms improved. Thus, shokenchuto may be a suitable herbal medicine for patients with weak constitution presenting with palpitation.

Vasospastic angina (VSA) is a condition in which a relatively large coronary artery transiently exhibits abnormal vasoconstriction. Although an angina attack by VSA can usually be controlled with nitrates and calcium channel blockers (CCB), there are some patients whose VSA cannot be controlled even by combinations of these drugs. We report here two cases of VSA successfully treated with a combination of the traditional Japanese herbal (Kampo) medicines shigyakusan and keishibukuryogan. Case 1 was a 73-year-old male with chest discomfort during effort and at rest. A 24-h Holter monitoring showed a short period of marked ST segment elevation associated with his chest pain. Although nitrates and a CCB were administered, his symptoms persisted. We then prescribed shigyakusan and keishibukuryogan, and his chest pain improved. Case 2 was a 58-year-old male with chest discomfort at rest. Acetylcholine-provoked coronary spasm was observed. Although he was prescribed nitrates and a CCB, these medicines were not effective. After we prescribed shigyakusan and keishibukuryogan, his chest pain improved. The results experienced in these two cases suggest that shigyakusan and keishibukuryogan could be useful formulations for the treatment of VSA uncontrolled by conventional medical treatment.

We investigated the clinical efficacy of concomitant Kampo treatments, expected to have immediate effect in improving outcomes with western drug therapies for Japanese cedar pollinosis. Twenty cases using shoseiryuto, considered a first-line drug for allergic rhinitis, were studied. The resultant efficacy rate was 45%. The efficacy rate for 24 cases using eppikajutsuto, by contrast, was 64%. The latter cases demonstrated far better therapeutic result than the former. In 7 cases using maoto + eppikajutsuto (as simplified daiseiryuto), another prescription we often use for serious illness, the resultant efficacy rate was 72%. Of these, the most favorable effect resulted in 16 cases using shoseiryuto + gokoto, which resulted in an efficacy rate of 87%. We had originally developed this prescription in order to improve the effectiveness of mao and sekko as anti-inflammatories. There were no cases where patients needed to be dosed with an oral steroid. The only notable event was one patient who complained of stomachache as an adverse drug reaction. In conclusion, we can say that the overall therapeutic outcome with 11 different Kampo medicines was extremely satisfactory: an efficacy rate of 83%. These marked improvements in clinical efficacy were made by using Kampo medicines together with a western drug used for the treatment of Japanese cedar pollinosis.
Medicine, Kampo ; Japanese language ; Clinical ; Therapeutic procedure ; Western Herbs and Botanicals

Objective : To examine how to treat patients suffering from electromagnetic hypersensitivity (EHS) combined with multiple chemical sensitivities (MCS) with herbal medicines. Methods : The patient was diagnosed as having blood stagnation (血瘀), yang deficiency (陽虚) and spleen qi deficiency (脾気虚) based on the traditional Chinese medicine (TCM) theory. Hoyokangoto which had been applied to patients with hemiplegia for a long time in China, was prescribed with cinnamon and processed aconite root. For her persistent diarrhea, ogikenchuto was administered. Results : Headache, sense of exhaustion, insomnia, and various symptoms debasing her quality of life (QOL) were shortly decreased, which made her lead a normal life. Discussion : The administration of hoyokangoto combined with cinnamon and processed aconite root added qi (気), removed blood stagnation and accelerated blood circulation and collateral channels, implying that elimination is the first (先瀉). The administration of ogikenchuto for diarrhea (spleen qi deficiency) means that tonic is the second (後補), which improved her symptoms of EHS combined with MCS. Herbal medicines may be one of the choices for treating degraded QOL of patients with EHS and/or MCS.

Many patients with palpitation consult outpatient cardiology departments. They may present with cardiac tuning abnormality (arrhythmia), which manifests as morbid palpitations. Appropriate diagnosis and treatment of palpitation are crucial to prevent adverse cardiac events. However, palpitations, in addition to anxiety and dyspnea, are often not considered as significant factor for morbidity in Western medicine. Conversely, Kampo (traditional Japanese medicine) can be used to treat the constitution of the patients, including those with or without disease diagnosed by Western medicine. However, there are no reports on the efficacy of Kampo in many examples. In this study, we diagnosed and provided appropriate Western medicine treatment for 101 outpatients with palpitation who consulted our department. We give priority to it if we evaluate the treatment of the disease of Western medicine was required (group W : n = 19). When an appropriate diagnosis could not be made by Western medicine, or when no therapeutic effect was noted with Western medicine, we administered Kampo medicine alone (group K : n = 62) or combination therapy (Kampo and Western medicine ; group KW : n = 20). The treatment efficacy was evaluated in each of the three groups. We observed high efficacy in all 3 groups (group W = 100%, group K = 96%, and group KW = 100%). Therefore, for patient with palpitation, combined treatment with both Kampo and Western medicine could improve their symptoms.