Chronic fatigue is a common symptom in primary health care and caused by various organic and functional diseases. Although improvement is attained by controlling underlying organic disease, it is sometimes difficult to relieve fatigue in patients with chronic fatigue syndrome or dysthymia. We have encountered patients with idiopathic chronic fatigue (ICF) successfully treated with sansonintokagen. A 62-year-old female complained of chronic fatigue several years after menopause, and had normal status in routine blood and image analyses at a nearby hospital. Her condition was diagnosed as ICF with sleeplessness. Treatment with sansonintoaogibakumondo for 8 weeks improved her chronic fatigue and sleeplessness, and enabled her to continue housekeeping. This observation suggests that this kampo formula may be a useful agent for ICF.

Using textbooks of Western medicine and Kampo medicine in Japan, we examined descriptions in classification and laxative therapy of chronic functional constipation. In terms of the relationship between stool shape and patient's age, description in Kampo textbooks was contrary to that in the textbook of Western medicine. The opinions on the long-term use of rhubarb also divided between Western medicine and Kampo medicine, although in Kampo medicine there was some opinion that the long-term use should be discouraged.

Medicine, Kampo ; Names ; Disease ; Diagnosis

A patient with systemic lupus erythematosus (SLE), complicated by severe thrombocytopenia was successfully treated with Juzen-taiho-to. The patient was a 38-year-old woman presenting thrombocytopenia in 1974. She was diagnosed as having SLE with the appearance of renal failure in 1975. In 1984, she began blood dialysis due to deterioration of renal function. In addition, she repeatedly suffered from severe bleeding episodes due to thrombocytopenia. In 1989, she visited our clinic to undergo Kampo therapy, with no significant results obtained with any of the formulas tried.
In September 1992, she suffered from duodenal ulcer bleeding and stopped Kampo therapy for some time. However, since she began taking Juzen-taiho-to in June 1993, her thrombocytopenia improved and her platelet count stabilized at 10-15×10⁴/mm³. This made it possible to taper the dosage of the steroids being administered. Since July 1994, the prednisolone (PSL) dosage has been 5mg on alternate days. Since July 1995, the anti-DNA antibody was negative. The platelet count has been maintained at 15-20×10⁴/mm³ (as of December, 1996).

Chronic fatigue is a common symptom in primary health care and caused by various organic and functional diseases. Although improvement is attained by controlling underlying organic disease, it is sometimes difficult to relieve fatigue in patients with chronic fatigue syndrome or dysthymia. We have encountered patients with idiopathic chronic fatigue (ICF) successfully treated with sansonintokagen. A 62-year-old female complained of chronic fatigue several years after menopause, and had normal status in routine blood and image analyses at a nearby hospital. Her condition was diagnosed as ICF with sleeplessness. Treatment with sansonintoaogibakumondo for 8 weeks improved her chronic fatigue and sleeplessness, and enabled her to continue housekeeping. This observation suggests that this kampo formula may be a useful agent for ICF.

We administered daisaikoto to 13 patients with traumatic cervical syndrome and observed complete responses in the following 2 patients. Patient 1 was a 40-year male. He was in the xiaoyang stage, and showed high abdominal tension and marked chest oppression. These findings were indications for daisaikoto. Patient 2 was a female in her 50 s. She was in the xiaoyang stage, showed moderate abdominal tension and chest oppression, and was aware of chest tension and constipation. Evaluation using the VAS in the 13 patients showed a complete response in 3 patients, partial response in 6, minor response in 1 and no response in 3. To clarify indications for daisaikoto in this disease, findings of Japanese Oriental Medicine in the 13 patients were evaluated. Of 9 patients with high abdominal tension, 8 showed partial or complete responses. Of 4 patients with moderate abdominal tension, a complete response, partial response, and no response were observed in 1, 1, and 2, respectively. In addition, objective abdominal coldness was present in both patients with moderate abdominal tension who showed no response but not in the patient showing a complete response.We confirmed the importance of therapy based on oriental medical syndromes when daisaikoto is used for traumatic cervical syndrome. However, patients with moderate abdominal tension without abdominal coldness can be differentiated from others for this therapy.

In 1989, a 17-year-old male patient had fever and was admitted to a hospital in his neighborhood. He was then diagnosed as having Crohn's disease of the colon and ileum. His condition improved when treated with parenteral hyperalimentation via the central vein, an elemental diet, and salazosulfapyridine. Every time a normal diet was introduced, it recurred, which required a second hospitalization. At the third recurrence in July 1992, he expressed the desire to have Kampo medicine and subsequently visited our department. The inflammatory reactions were severe, and he had fever and was losing weight. He was fasted and given parenteral hyperali-mentation via the central vein. He received Kyuki-kyogai-to and Hange-shasin-to concomitantly which were prescribed according to his kampo diagnosis. One month later, CRP was negative and an elemental diet was started. Two months later, he was able to take both elemental and normal diets. Remission is still being maintainned even after he started the normal diet again.
Kampo medicine achieved a prolonged remission in this case where Crohn's disease kept recurring when hyperalimentation therapy was given, This suggests that a combination of an elemental diet and Kampo medicine may play an important role in maintenance therapy for this disease.

The authors would like to report the successful treatment with Hochuekki-to and Keishibukuryo-gan of a case of chronic renal failure that had deteriorated rapidly in a short period of time.
The patient was a 29-year-old woman that had been diagnosed as having IgA renal syndrome in 1987 after a local physician had detected proteinuria and requested a renal biopsy. In November of the same year she came to the authors' clinic requesting Kampo therapy. After her kidney function was stabilized with such formulas as Gorei-san and Byakokaninjin-to, the patient stopped coming to the clinic. In February of 1992, she returned to the clinic with renal failure following an episode of acute pneumonia. She was admitted to the hospital due to hypertension (Cr 2.8mg/dl; BUN 20mg/dl). Dietary therapy and hypertension control were carried out, and administration of 40mg/day of prednisone (PSL) was commenced on the 10th day following admittance. Since the proteinuria remained unchanged, 1g/day of methyl-PSL was given for three days from the 18th day after admittance. However, by the 38th day (4 weeks after commencement of PSL administration) the Cr was 5.0mg/dl. At this point the Kampo formula was changed from Sairei-to to Hochuekki-to in conjunction with Keishibukuryo-gan-ka-kokadaio. Her kidney function began to improve, and by the 108th day the laboratory findings had decreased to Cr 2.7mg/dl and Bun 26mg/dl and the PSL dosage was reduced to 20mg/day. She was discharged from the hospital on the 110th day, and has been progressing well as an out-patient.

Unkei-to was used successfully to treat three patients with primary Sjögren's syndrome (pSjS). The first case was a 67-year-old woman. In April 1993, she visited Tonami General Hospital with the symptom of dry eyes. Her condition was diagnosed as pSjS from being antinuclear antibody (ANA) positive, dry eye, and decrease of saliva secretion. She used eye drops, but her dry eye did not improve, she visited our department in June 1995. Administration of Unkei-to improved her symptoms after 6 months of treatment.
The second case was a 73-year-old woman. In 1987, she was treated in our hospital for lumbago based on spondylosis. In 1991, she began to suffer from pain and swelling of the right sterno-clavicular joint (RSCJ) and was admitted. She was anti-SS-A/Ro ANA positive, schirmer's test was positive, lymphocyte infiltration was observed by lip biopsy, and thus pSjS was diagnosed. Treatment with Unkei-to resulted in the improvement of pain and swelling of RSCJ, as well as a decrease in serum C-reactive protein. But a favorable effect on dry mouth was not attained in this case.
The third case involved a 39-year-old woman who began to experience polyarthralgia and dry mouth in June 1991. She visited a neighborhood hospital and was diagnosed as pSjS from hyper γ-globulinemia, anti SS-A ANA positivity, and decrease of saliva secretion. She first visited our hospital in March 1994. We administered Keishikaryojutubu-to and improvement of polyarthralgia was observed. Subsequently, she suffered from symptoms of dry eye and dry mouth. We treated her with Unkei-to, which improved the symptoms of dryness, but not polyarthralgia in this case.
These observations suggest that Unkei-to might be a useful agent for the treatment of pSjS.