Medicine, Kampo ; Recent ; Therapeutic procedure

It is difficult to treat vulvar pain of an unknown cause. We report a case of vulvodynia with dysuria treated effectively with goshajinkigan. The case was 92 years-old female who could not sleep well because of vulvar pain. She did not have inflammation of the vulva or vagina. Moreover, she was sometimes treated with urethral catheterization for urinary retention. Goshajinkigan was prescribed, and her pain was decreased so much, that she could sleep well. Furthermore, she was relieved of her urinary retention.

The aim of the current nationwide survey was to investigate the Kampo medicine experiences of Japanese physicians working at hospitals designated as core cancer centers by the Ministry of Health, Labour and Welfare. Among the 900 physicians surveyed, 92.4% reported having prescribed Kampo medications, of whom 73.5% reported having prescribed them for cancer patients. Despite this high percentage, only 28.7% of the physicians had studied Kampo medicine.
This survey found that over 40% of physicians in each generation had no intention of learning Kampo medicine. When asked to categorize their expectation of Kampo efficacy, about 30% said they had an ‘expectation’, a ‘no and yes expectation’, and ‘no expectation’ respectively.
However, physicians who had experience learning Kampo medicine had more expectation than physicians who had not. And the same expectation tendency for prophylaxis treatment was shown in physicians with that experience and those without. This difference is disadvantageous to patients. We therefore believe it necessary to create an environment in which physicians can learn Kampo medicine and methodology, which engenders cooperation between Kampo specialists and Japanese physicians in the treatment of cancer.

Traditional East Asian medicines, Kampo included, are to be incorporated into International Classification of Diseases11 (ICD-11) which will be released in2015.To understand the significance of this plan, ICD itself needs to be understood. In this article, we describe ICD history, its significance and problems, and why the WHO became interested in traditional medicine. In the beginning, the ICD was only for classifying causes of mortality, and has since expanded to cover disease information according to the diverse needs of a changing society. And in Japan today, it is widely used not only for death certificate and disease information, but also for research purposes. There are many problems with the ICD, however:e.g. it is not clinically convenient, and it lacks certain terminology. Revision from IDC-10 to ICD-11 is now ongoing. It will be expanded and electronic. At the same time, plans are to have it broadly implemented in Asia by including traditional East Asian medicine.

This study was conducted to assess the appropriateness of preparation fees for dispensing herbal medicines, which were revised in 2006. We investigated the amount of time needed to dispense herbal, and general medicines. For prescriptions of1to 15 days length, the average time needed for herbal prescriptions was 13.4 minutes, which was about 3 times longer than for other prescriptions, which took only 4.4 minutes. For prescriptions of over 30 days length, this was about 7 times longer. Next we comparatively investigated fees charged per minute to prepare herbal medicines, with those for other medicines. Fees for all prescriptions of 1 to 15 days length were nearly equal, while fees for herbal prescriptions of over 15 days length were approximately 1/3 to 1/5l ess. Finally, we investigated the number of prescriptions filled out at one university hospital. In 2003 the number of herbal prescriptions exceeding 30 days length was 2.7% overall, while in 2008 this had increased approximately 14 times, to 42%. We would like to recommend an increase in herbal medicine preparation fees, based on the number of days a prescription is for, as the number of long-term prescriptions is increasing.

Pouchitis is the most common complication following ileal pouch-anal anastomosis in patients with ulcerative colitis and is strongly correlated with the risk of pouch failure and malignant mucosal transformation in the pouch. Here we report a case treated successfully with the Kampo decoction, daitokato. A 41-year-old male treated with ileal pouch-anal anastomosis due to severe ulcerative colitis suffered from repeated pouchitis and stenosis of the ileal pouch post-operatively. He complained of general fatigue, chills, continuous lower abdominal pain and discomfort, and severe pain with evacuation. Initial treatment with antibiotics and painkillers was ineffective, so the patient came to our hospital's Kampo clinic, where he was initially prescribed the decoction, shokenchuto. This proved ineffective at resolving his fatigue. Subsequent treatment with ogikenchuto improved physical strength but was ineffective for pouchitis. Antibiotic resistant pouchitis occurred afterwards and we attempted treatment with saikokeishito decoction and the extracts, hochuekkito and juzentaihoto, which similarly improved fatigue but not pouchitis. Following administration of daitokato, instances of pouchitis were reduced with no recurrence 6 months post-treatment. This case illustrates the therapeutic efficacy of daitokato in improving ileal pouch disorders resistant to treatment with Western medicine.

Background : Kampo, or traditional Japanese medicine education, was accepted into the education system after a new requirement of being able “to roughly explain Wakan (Japanese/Chinese) medicines" was added to the core curriculum model.
Purpose : Kampo medicine has been taught at all 80 medical schools and universities since 2007. We con ducted a nationwide survey to understand the present situation, gain insights from several Kampo education viewpoints, and elucidate any challenges for the Japan Society for Oriental Medicine (JSOM) in future.
Method : A postal questionnaire survey was sent to 80 medical schools and universities from the Liaison Committee of JSOM.
Results : 67 out of the 80 medical institutions (83.8% return rate) responded to the survey. The answered survey results were as follows : Kampo medicine is needed in regular clinical practice (91%), studies are needed to evaluate the outcome of Kampo Medicine education (77%), and dedicated staff members are being trained (46%).
Conclusions : Further development of graduate education and its standardization as well as improvement of bedside training is needed for Kampo education. In addition, establishment of a post-graduate Kampo education system will be crucial in the future.

Traditional medicine educational systems in Japan and China were compared.
In Japan, Kampo medicine has been integrated into the core curriculum of undergraduate education in all medical colleges since 2001. Japanese university medical schools give 6,000 hours of western medical educa tion, and only 30 hours of Kampo education. In China at Traditional Chinese Medicine (TCM) universities, nearly half of teaching hours are devoted to TCM, and half to Western medicine. And even at medical univer sities that specialize in Western medicine, students will usually have 80 hours in TCM courses. Usually it takes five years to graduate. In Japan, Kampo education puts a special focus on the Shang-han-lun and Jin-kui-yao lue texts, which still influence daily practice. In China, on the other hand, TCM doctors rely on traditional theories of Chinese medicine such as the Yin-Yang theory, the Five Elements theory or relationships between meridians and organs. Kampo specialists have been increasing in recent years, although in China, the number of TCM doctors has been decreasing. However, better traditional medicine education would play a role in in creasing our inheritance of both in Japan and in China.