Mortality rates for breast cancer in Japan have been increasing sharply. Earlier detection leading to early treatment is highly desirable. Despite improvement in imaging techniques for breast cancer, many cases with latent microcarcinoma go undetected each year. In Western medicine, diagnostic hormonal therapy with antiestrogens for mastopathy in order to induce latent carcinoma has been used successfully for diagnosis of such difficult cases. Antiestrogens, however, may cause intolerable side effects for some patients, and sometimes their administration must be stopped. Thus excisional biopsy is required for definitive diagnosis of malignancy. In oriental medicine, Keishi-bukuryo-gan has been shown to be effective for mastopathy and is considered quite safe. We examined it as an alternative to antiestrogens. Keishi-bukuryo-gan was administered to 116 patients out of 218 with mastopathy. In response, four were suspected to have breast cancer. All four were definitively diagnosed with breast cancer: two by fine-needle aspiration cytology, and two by excisional biopsy. Keishi-bukuryo-gan proved to be useful in diagnostic hormonal evaluation of mastopathy and diagnosis of breast cancer.

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.

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.

HMG-CoA reductase inhibitor, routinely utilized in the treatment of hypertriglyceridemia, does not decrease serum levels of triglyceride (TG) as much as it decreases levels of cholesterol. Clofibrates, on the other hand, quite effectively decrease triglyceride levels but severe adverse effects have been reported. Dandao-paishi-tang, a Chinese herb combination, generally used to promote the passage of gallstones, was modified and used to treat three patients with hypertriglyceridemia. A male with hypertriglyceridemia, mild hypertension, and cholelithiasis began to take modified Dandao-paishi-tang when 55 years old. Serum TG level decreased from 634mg/dl to 273mg/dl over four years of treatment. A 66-year-old female patient with hypertriglyceridemia and diabetes took the prescription for four months and TG decreased from 815mg/dl to 442mg/dl. A 76-year-old female with mild hypertriglyceridemia showed a decrease in TG from 154mg/dl to 132mg/dl in four months.

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.

To determine the Kampo therapy indications for global infertility treatment, and the criteria for objective and rational evaluation of its efficacy, we analyzed the sho (Zheng), type of ovarian dysfunction, types of Western drugs used concomitantly, length of treatment, age upon pregnancy, etc., in 100 women with infertility due to ovarian dysfunction as diagnosed by Western medicine who succeeded in becoming pregnant and giving live births, after Kampo therapies diagnosed by sho based on Hakko, Ki, Ketsu and Sui. The diagnosis of the sho in these women was compared with that in 2737 control women. Their types of sho by frequency were Kyo (51%), Shoyo (Hanhyo-Hanri) (69%), Jonetsu-Gekan (52%), Kigyaku (47%), Oketsu (71%) and Suidoku (67%). When compared to the control group, the percentage of women whose Sho was rated as Jitsu, Taiyo, Shoyo, Jonetsu-Gekan, Oketsu or Suidoku was significantly higher. The sho type Hyonetsu-Rikan was lower. The preparation sho, rated on the basis of a general assessment, was most frequently Kamishoyosan(55%). The predominant type of ovarian dysfunction was luteal dysfunction (73%), whose frequency was significantly higher than that in the control group. Of all women studied, 46% were treated with Kampo alone and 54% were treated with Kampo + Western medicine. In terms of the percentage of each type of ovarian dysfunction, there was no significant difference between the two groups. The Western drugs used in combination with Kampo therapy were hCG preparations (33%), terguride preparations (18%), clomiphene preparations (3%) and hMG preparations (6%). The period of treatment until pregnancy was significantly shorter in the Kampo alone group (5.0 ± 4.4months) than in the combined therapy group (9.5 ± 6.8months). These results allow us to make the following conclusions:1.The type of infertility indicated for Kampo medicine is infertility due to ovarian dysfunction as diagnosed by methods of Western medicine.2.Women who successfully became pregnant following Kampo medicine were often cases of Shoyo disease complicated by sho with Jonetsu-Gekan, accompanied by Kigyaku, Oketsu and Suidoku.3.Uncombined Kampo medicine may be effective in cases of severe infertility.4.If pregnancy does not occur within 5 or 6 months after the start of Kampo therapy, combined use of Western medicines should be considered.
Medicine, Kampo ; Therapeutic procedure ; Infertility ; Western Herbs and Botanicals ; Functional disorder

Clinical efficacy of tokishakuyakusan against immunologic recurrent abortion was evaluated using methods of diagnostic statistics. The subjects of this study were 38 women with recurrent abortion who had experienced a spontaneous abortion during their first trimester (within 12 weeks of pregnancy) twice, and who took tokishakuyakusan (extract granules) after development of their third pregnancy, but experienced spontaneous abortion again during their first trimester, with the karyotype of the aborted fetus being rated as 46, XX or 46, XY. The control group consisted of 244 women who had experienced 3 or more spontaneous abortions during their first trimester of pregnancy. The detection rates of autoimmune disorders and alloimmune disorders were compared statistically between the two groups. Neither the detection rate of autoimmune recurrent abortion nor the detection rate of alloimmune recurrent abortion differed significantly between the two groups, suggesting that tokishakuyakusan is not clinically effective against immunologic recurrent abortion. Tokishakuyakusan is estimated to prevent abortion caused by compromised luteal insufficiency of the uterus. Thus, saireito seems to provide a more rational means of Kampo therapy for immunologic recurrent abortion.
Unspecified Abortion ; immunologic ; tokishakuyakusan ; Therapeutic procedure ; Pregnancy Trimester, First

The efficacy of Saireito (a herbal preparation) against autoimmune recurrent abortion was evaluated clinically and immunologically. Saireito therapy was performed with 87 women having experienced 3 or more recurrent abortions in the early stages of pregnancy (less than 12 weeks gestation), and whose antinuclear antibody (ANA) and anti-cardiolipine antibody (ACA) test results were positive. The effects of this therapy on the percentage of women in whom abortion was successfully prevented (the abortion prevention rate), and on the antibody titer were investigated. Among the 49 women who became pregnant during the study period, the abortion prevention rate was 63.3%, the percentage of ANA positive cases was 65.6%(32/49), the percentage of ACA IgG and/or IgM positive cases (as evaluated by SRL methods) was 65.5%(29/49) and the percentage of both ANA and ACA IgG and /or IgM positive cases was 75.0%(12/49). Although the titer of ANA was not significantly reduced by this therapy, the titer of ACA IgM was reduced significantly.These results suggest that Saireito exerts its efficacy by suppressing humoral immunity through its adjustment of the Th1/Th 2 cytokine balance. This therapy is expected to be effective against ACA-positive recurrent abortion by reducing the effects of ACA. Furthermore, in 2 observed child birth cases whose ACA titer were not decreased by Saireito, different effective mechanisms were speculated; for example, suppression of platelet aggregation via saireito's component herbs (ninjin and bukuryou) similar to the effect seen with low-dose aspirin therapy, or its “risui” effect via its components (bukuryou, soujyutu, takusha and chorei).
Therapeutic procedure ; Unspecified Abortion ; Antinuclear Antibody Assay ; Antibodies ; Immunoglobulin M measurement

For two infertile couples with normal tubal function and spermatogenesis, who were diagnosed with infertility attributed to lack of competent ovum with poor grade embryo in spite of having received timing therapy and step-up therapy (artificial fertilization from husband ; AIH and in vitro fertilization and embryo transfer ; IVF-ET), Kampo-only therapies diagnosed according to their “Zheng” syndrome-type consisting of one cycle of tokishigyakukagoshuyushokyoto, and two cycles of kamishoyosan and anchusan was performed. As a result, both women became pregnant and gave live births. The causes of infertility in these two cases were analyzed, and problems with step-up therapy, commonly used in Western medicine and efficacy of Kampo-therapy diagnosed according to their Zheng were evaluated from the standpoint of Western medicine.Kampo-therapy diagnosed by Zheng was found to improve the follicular and luteal functions as well as related functions. The two cases presented were diagnosed as infertile due to ovarian dysfunction on the basis of therapeutic diagnosis. The indications of IVF-ET are tubal and male infertilities, not to be ovarian dysfunctional infertility.For infertility due to ovarian dysfunction, Kampo-therapy diagnosed by Zheng with Kuoketsu and Risui effects are drugs of first choice, rather than clomiphene, which has an anti-estrogen activity.
Therapeutic procedure ; Medicine, Kampo ; Infertility ; Ovarian ; Ovum