Background and objective : Diet has been recognized as an important part of Kampo medicine, and various plants with which we often cook are included as components of many Kampo formulations. Accordingly, nutritional science is closely related to Kampo medicine. So there is a need for national registered dietitian and nutritional science students to learn Kampo medicine. Despite this, no survey has reported on the awareness of nutritional science students toward Kampo medicine in Japan. We conducted for the first time a survey on this awareness amongst nutritional science students about Kampo medicine.Methods : A 13-item anonymous questionnaire was distributed to the third-year students in a national registered dietitian training program in Japan.Results : We obtained answers from 509 students in 9 institutions. Of the respondents, 59.3% answered that they were interested in Kampo medicine, and 86.4% of the students who were not interested in Kampo medicine answered that the reason was they had no chance to learn it. However, 81.3% of the students answered that they would attend lectures on Kampo medicine if it was adopted as part of their curriculum.Conclusions : These results suggest that Kampo medicine should be included in educational programs for nutritional science students.

Case 1 was a 40-year-old woman who used a facial treatment machine and felt burning facial pain at night.She then felt unpleasantness in her facial skin all day long and was too uncomfortable to leave her home. We prescribed kamikihito. Ten days later, she felt the positive effects of treatment. Forty-five days later, she did not feel the unpleasantness on her facial skin, and she was able to go out again. Case 2 was a 36-year-old woman who had intense inflammation of her face, because she had stopped treatment with a steroid ointment.After 6 months, her face still felt hot and strange, which decreased her quality of life. We prescribed yokukan sankachinpihange. Four weeks later, she felt the positive effects of the treatment, and 14 weeks later, she was able to restart her part-time job. Because both of these cases had received various types of conventional medi cal therapy in the beginning that were not effective, their Kampo therapy was begun a long after the start of their abnormal facial sensation symptoms. Kampo therapy demonstrated a positive effect after approximately one month in both of these refractory cases. Thus we recommend Kampo medicines for the treatment of abnor mal facial sensations.

We report a case of chronic heart failure successfully treated with bukuryokyoninkanzotokaboiogi. The case was an 87-year-old woman whose chief complaint was chest oppression at rest. She had been diagnosed with chronic heart failure and treated at a university hospital for 6 years, including several episodes of hospitalization. The patient's chest oppression was so strong that she felt depressed. Therefore, she consulted our institute to receive a Kampo treatment in addition to the western medications she was taking. At the patient's first visit to our institute, her serum brain natriuretic peptide (BNP) value was 545pg/ml, and her cardiothoracic rate (CTR) on chest radiogram was 64.1. The severity of the patient's chest oppression was class IV, according to the classification system of the New York Heart Association (NYHA). After we prescribed bukuryokyoninkanzotokaboiogi, her chest oppression and depressive mood gradually improved. Approximately one year later, the patient's BNP value had lowered to 104pg/ml, and CTR was reduced to 57.5. Eventually, her chest oppression and depressive mood disappeared completely. At that time, the chest oppression was categorized as class I in NYHA classification. Treatment with western medicines was not changed over the total clinical course of this case. These results suggest that bukuryokyoninkanzotokaboiogi could be a useful formulation for the treatment of chronic heart failure.

We experienced 2 cases in which Kampo (Chinese medicine) treatment was effective for septic osteoarthritis. Case 1 : a 34-year-old female. Septic coxarthritis developed with no left hip joint abnormality being noted, while DIC (disseminated intravascular coagulation) from MRSA pneumonia was treated. Surgeries were carried out five times, but there was no wound closure, and exudate discharge continued. At first, she was treated with Hochuekkito, did not run a fever, and good granulation tissue was formed in the wound. After a change to Senkinnaitakusan, exudate quantity decreased. Moreover, after an external fixation operation and being treated with Juzentaihoto, epithelization progressed, and the wound eventually closed. Case 2 : a 79-year-old female. One year and 6 months after osteosynthesis with compression hip screw was carried out for a femoral neck fracture, operation scar complications and large quantities of exudate were seen, so we diagnosed her with late onset septic osteomyelitis. She gained weight with Juzentaihoto treatment, while a decrease in exudates and fistula closure with Astragali Radix and Ginseng Radix were confirmed by MRI, and her nutritional state improved. Generally speaking, septic arthritis and osteomyelitis are difficult to treat, but Kampo medicines were curatively effective for these diseases, particularly when increasing Astragali Radix and Ginseng Radix quantity.

We report a patient with Philadelphia chromosome-positive acute lymphoblastic leukemia (Ph+ALL) in whom saikanto was effective against pleural effusion induced by dasatinib, which is a second-generation tyrosine kinase inhibitor. The patient was a 43-year-old female. After she was diagnosed with Ph+ALL, she received imatinib and other chemotherapy. One year later, she started to receive dasatinib because of imatinib intolerance (vomiting and diarrhea). After about seven months of taking dasatinib, she experienced chest/back pain and a cough; at that time her chest x-ray showed right-sided pleural effusion. She consulted our clinic three months later, for treatment of the hydrothorax that frequently recurred. We prescribed saikanto because she presented with epigastric tenderness diagnosed as shokekkyo, and the pleural effusion and clinical symptoms improved remarkably. Because of the good clinical course in this case, we consider that the decrease of pleural effusion was caused mainly by the immunoregulatory and anti-inflammatory activities of saikanto in addition to its activities to alleviate fluid retention.

Orthopedic symptoms are not rare in palmoplantar pustulosis, but standardized treatments have not yet been established.Here we report a case of palmoplantar pustulosis followed by joint pain that was successfully treated with the Kampo formulation saikokeishito. The patient was a 44-year-old Japanese man. He was suffering from pustules on the soles of his feet due to palmoplantar pustulosis, and joint pain of the sternoclavicular area, hip and lumbo-sacral area, which had not been controlled with diclofenac sodium suppositories. We prescribed saikokeishito for 1 month, and he felt less joint pain and experienced less pustulosis. After that, he suffered from an upper respiratory tract infection, and he again developed plantar pustulosis. We added kikyo (Platycodon grandiflorum root) to treat the sore throat, and his symptoms almost disappeared following this treatment. No author has reported a patient with palmoplantar pustulosis accompanied by joint pain who was treated with saikokeishito. The results experienced in this case suggest that saikokeishito could be a useful formulation for the treatment of palmoplantar pustulosis accompanied by joint pain.

We conducted a survey to measure the change of awareness about Kampo medicine following through four lectures of educational interventions delivered to the third-year students in a national registered dietitian training program. Awareness with regard to Kampo medicine was surveyed before and immediately after the interventions. We also collected the same questionnaire again five months after the interventions. The students' scores changed significantly between before and immediately after the interventions in the favorable direction regarding their interest in Kampo medicine, the necessity of including Kampo medicine in future educational programs, and the potential usefulness of Kampo medicine at their future workplaces, and the changes were maintained for five months.
About 70% of students answered that they became more familiar with Kampo medicine as a result of the classes, but their knowledge of Kampo medicine was poor before the lectures and even immediately after the interventions. These results suggest that education about Kampo medicine for students in a national registered dietitian training program is important, because it could be a positive incentive for them to learn about Kampo medicines and herbs and to accept the use of Kampo medicine at their future workplaces.

Ryokito is a Kampo formulation which has been administered for right upper quadrant pain since the Edo Era in Japan. Yet there are but a few reported cases in multiple clinical exams at one institution, on the usage of this formulation. We undertook a precise retrospective analysis of ryokito-prescribed cases at our institute over ten years, and reported cases published in the past to illuminate the clinical characteristics of ryokito effective cases.
Among the 21 cases at our institute, ryokito was effective in 11 cases and 10 of these 11 cases had right upper quadrant pain. Additionally, 7 of them reported abdominal distention.
Overall, this retrospective analysis revealed that amongst those ryokito effective cases, not a few patients had the right upper quadrant pain. This fact suggests that right upper quadrant pain is a reasonable characteristic for a usage of ryokito.
Likewise, abdominal distention was also a common symptom among the effective cases. It is likely that abdominal distention could be a characteristic for a usage of ryokito as well.

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.

Soshikokito is a Kampo formulation used in the treatment of bronchial asthma, especially in those patients with hot flushes and cold sensation in their feet. But there is also a description in classical textbooks for its usage for the treatment of tinnitus. We report two typical cases of prolonged tinnitus treated successfully with soshikokito. Case1was a 70-year-old woman who visited our clinic complaining of tinnitus, dizziness and insomnia. She had a history of bilateral otitis media in her childhood, and had been suffering from tinnitus after being operated for it. The tinnitus had worsened during the three months prior to her first visit to us. After 3 months' treatment with soshikokito with additional shisoyo, her symptoms improved, so much so that after 8 months, she could live her life normally. Case 2 was a 58-year-old man who presented with tinnitus, hearing disturbance and a sense of irritation. He also complained of insomnia and cold sensation in his limbs. After1month's treatment with soshikokito with additional shisoyo and bushi, most all of his symptoms resolved. In addition, we also evaluated the clinical efficacy of soshikokito for prolonged tinnitus, retrospectively, and found that it was effective in five out of the ten cases we treated with this formulation. Most of the successfully treated patients presented with hot flushes or cold sensation in their feet. These case reports suggest that soshikokito may be a useful formulation for the treatment of not only bronchial asthma, but also of prolonged tinnitus.
Tinnitus ; therapeutic aspects ; seconds ; month ; Esthesia