Case 1 : A 56-year-old woman had been suffering from insomnia for 10 years, and multiple joint pains on her shoulders, wrists and fingers for 2 years. She complained of headache, dizziness, heart palpitations, and irritable bowel syndromes. Case 2 : A 72-year-old woman presented with cold and painful feeling in her legs that she had had for 10 years, as well as insomnia, excessive sweating, alopecia and pollakiuria that she had had for two years. In both cases, organic diseases of the joints or muscles were ruled out by several doctors, and the patients had been suffering from malaise and insomnia for which they had been taking brotizolam for several years. Consequently, the patients consulted our department of traditional Japanese medicine (Kampo). Medical interviews revealed that they had been under a lot of stress for a long time because of family problems. Sansoninto (roasted Zizyphi spinosa semen 15 g, Poria 3 g, Cnidii Rhizoma 3 g, Anemarrhenae Rhizoma 3 g,Glycyrrhizae Radix 1.5 g) was prescribed, which reduced the pain in their joints and muscles, and their other complaints, in several weeks. Sansoninto seemed not to alleviate insomnia as effectively as it did the pain and other multi complaints, because the patients were not able to discontinue brotizolam. Patients with multiple complaints including insomnia with fatigue induced by long-term stressful lifestyle may sometimes possibly express non-organic joint or muscle pain. Sansoninto may be an effective prescription for non-organic joint and muscle pain.

We studied the effects of orengedokuto on central hyperthermia after mild hypothermia therapy for cardiac arrest. The subjects in this study were 7 patients who showed central hyperthermia (>38.3 °C) after mild hypothermia therapy. Orengedokuto 7.5-15 g/day was administered and central temperature was monitored. Maximum change in central temperature was 1.55 ± 0.71 °C(from 39.1 ± 0.7 °C to 37.6 ± 0.7 °C) (p < 0.05). Mean change was 0.35 ± 0.77 °C, (from 37.7 ± 0.6 °C to 37.5 ± 0.7 °C). Thus we conclude that orengedokuto is a drug with applications in the treatment of central hyperthermia after mild hypothermia therapy.

Twenty patients with bilateral localized lower leg edema were treated with acupuncture alone followed by combination therapy with acupuncture and Kampo formulas. The effects of treatment were examined after the first acupuncture session. Lower limb circumference significantly decreased from 29.1 ± 6.8 cm to 28.1 ± 7.0 cm (mean ± SD) (p < 0.01). In addition, the area of ankle edema decreased from 22.6 ± 10.6 cm2 to 14.2 ± 7.2 cm2 (p < 0.05). Subcutaneous tissue thickness, as measured via ultrasound, significantly decreased at the lower limbs and ankles from 10.4 ± 3.8 mm to 7.8 ± 3.4 mm and 10.1 ± 2.9 mm to 8.2 ± 3.0 mm, respectively (p < 0.05). In contrast, there was no change in subcutaneous echogenicity observed in the lower limbs. Following acupuncture, patients underwent combination therapy with acupuncture and Kampo formulas. As a result, area of ankle edema significantly decreased from 24.1 ± 2.5 cm2 to 3.0 ± 2.1 cm2 (p < 0.01). Moreover, symptoms resolved with respect to edema and coldness (p < 0.05). However, no change was observed in laboratory parameters. This study highlights the efficacy of acupuncture in improving lower leg edema. In addition, combination therapy with acupuncture and Kampo formulas seemed to be effective in the treatment of leg edema.

We examined 57 patients treated with Kampo decoctions containing uzu for 5 years and 3 months from September 2013. Sekiganryo, which was administered to 32 patients, was the most commonly used decoction. The value of uzu dosage and duration of administration were spread widely and the medians (ranges) are 8.0 (1.0-41.0)g/day and 180 (3-1700) days, respectively. Complete recovery, partial recovery, no recovery, and deterioration in terms of the chief complaint, were observed in 36, 11, 9, and 1 patients, respectively. The number of patients exhibiting complete or partial recovery was higher than that of patients showing no recovery or deterioration when the duration of uzu administration was more than one month and the dosage was higher than 4 g/day (p < 0.05). The patients treated with uzu more than 20 g/day were all sekiganryo administrated ones. Side effects were observed in three patients. Thus, under careful observation, uzu was safely used over a long term and at high doses.uzu: aconite root before processing

A 48-year-old man presented with knee pain and general fatigue. He had been diagnosed with sarcoidosis 15 years previously. Prednisolone was administered, but the pain and fatigue persisted. Morphine, fentanyl, and a tramadol/acetaminophen combination were then administered, but their effects were not sufficient. Finally, the patient was treated with sekiganryo, uzuto, uzukeishito, and daiuzusen, all of which contained uzu (aconite root without processing). His pain and fatigue improved after administration of these drugs, and he became able to perform various activities of daily living. In this case, uzu alleviated knee pain and general fatigue in a patient with sarcoidosis.

We report a case of a 71 year-­old woman treated for diffuse panbronchiolitis (DPB). She received home oxygen therapy and was administered erythromycin ; however, sputum production, cough and respiratory dis­tress worsened. After hospitalization, she was treated with keishikyoshakuyakukasokyoto and acupuncture. After 30 days, respiratory distress, respiratory resistance measured with the pulseoscillation technique and the distance walked in the 6-­minute walk test improved. Thus, combination therapy comprising keishikyo­shakuyakukasokyoto and acupuncture seemed to be a beneficial therapy for an advanced case of DPB.