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Treatment Results between Matched Pair of L-dopa Medication Treatment and Acupuncture Treatment Combination on Parkinson Disease

Takeo MIZUSHIMA

Kampo Medicine.2011;62(6):691-694. doi:10.3937/kampomed.62.691

Parkinson's disease is an incurable nerve disease.
We treated two groups randomly assigned to therapy with medications, or therapy with medications and acupuncture in combination.
The first group included 95 patients prescribed L-dopa medications and dopaminergic drugs, and the second group included 103 patients prescribed L-dopa and acupuncture treatment twice a month. We conducted follow-ups using Hoehn-Yahr index surveys and the UPDRS II and III for 5 years from treatment start.
Mean changes in the L-dopa group were 2.1±0.8 for the H-Y index, 12.2±7.2 for the UPDRS II, and 18.2±9.8 for the UPDRS III, while changes in the acupuncture combination group were 1.3±0.4 for the H-Y index, 7.6±5.0 for the UPDRS II, and 11.9±6.8 for the UPDRS III after 5 years.
Each result indicated a significant difference with repetition decentralization and statistical analysis methods.
Therefore, we believe acupuncture is a treatment for Parkinson's disease able to control its progress.

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A Re-examination of Siebold's Study on Acupuncture Based on Documents Held in Leiden

Senjuro MACHI

Kampo Medicine.2011;62(6):695-712. doi:10.3937/kampomed.62.695

Past research on Siebold and his contribution to acupuncture, such as seen in Ootori Ransaburo's work among others, relied either on documents translated into Dutch by Siebold's disciples or on Ishizaka Sotetsu's original Japanese text : Chiyo-ichigen. However, the latter was published after Siebold had actually requested its translation of his disciple Mima Junzo. Therefore past research has not been able to identify what the original text the Dutch translations are based on. From our analysis of Ishizaka Sotetsu's acupuncture manuscripts held in the Leiden University Library, we came to the conclusion that they were originally written by Sotetsu and given to Siebold during his journey to Edo and are thus the original texts used for the Dutch translation. We also argue that the acupuncture texts held in the National Museum of Ethnology were probably also given to Siebold by Ishizaka Sotetsu.

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Recovery from Recurrence of Post-operative Pouchitis Due to Ulcerative Colitis through Daitokato

Keiko MATSUURA ; Hideaki TOKUNAGA ; Yoshihiro IMAZU ; Ko NISHIMURA ; Tetsuo AKIBA ; Kenji WATANABE

Kampo Medicine.2011;62(6):713-717. doi:10.3937/kampomed.62.713

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.

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Effectiveness of Syouhangekabukuryoto in Post Nasal Dripping

Eiichi TAHARA ; Masafumi MURAI ; Jun IWANAGA ; Minoru OHTAKE ; Junichirou DOKURA ; Hiromi YANO ; Hideo KIMURA ; Tadamichi MITSUMA

Kampo Medicine.2011;62(6):718-721. doi:10.3937/kampomed.62.718

Shohangekabukuryoto, an herbal mixture, was administered to 15 patients with postnasal drip. Ten patients responded to this therapy and 5 failed to respond to it. Subjective symptoms and objective findings were analyzed and compared between the responders and nonresponders. Nausea was not observed in any patient. In the responders, watery rhinorrhea and shinsuion was often noted. Patients showing viscous rhinorrhea without shinsuion were considered nonresponders. These results suggest that shohangekabukuryoto is an herbal mixture that may be used for treating patients with postnasal watery rhinorrhea accompanied by shinsuion, despite the absence of evident nausea.

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A Case of Palmoplantar Pustulosis Followed by Joint Pain Successfully Treated with Saikokeishito

Hiromitsu HOTTA ; Tetsuro OIKAWA ; Go ITO ; Toshihiko HANAWA

Kampo Medicine.2011;62(6):722-726. doi:10.3937/kampomed.62.722

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.

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Fourteen Cases of Appetite Loss Treated with Shoyogan

Ryo FUKATANI ; Masataka SUGAO ; Kengo SHIMAZU ; Takeharu CHIJIWA ; Haruhiko AOYAGI ; Tomoaki OZAWA ; Yutaka SHIMADA ; Takashi ITOH

Kampo Medicine.2011;62(6):727-735. doi:10.3937/kampomed.62.727

Shoyogan is a Kampo prescription described in the Junqui Yaolue. Few cases have been reported using this medicine. This time, we prescribed shoyogan for 14 patients who suffered from severe appetite loss. We had positive outcomes as follows. We administered shoyogan to 8 patients with malignant disease. Six of them suffered from lung cancer. Shoyogan was effective in these patients. Shoyogan was not effective for the other 2 patients, with bile duct carcinoma and malignant lymphoma. The dietary intake was increased from 28 percent of meals supplied to 79 percent in the appetite-improved group. We also administered shoyogan to 6 patients with nonmalignant disease. It was effective for 3 patients: 1 with congestive heart failure and 2 with great trochanteric fractures of the femur. It was not effective for the other 3 patients, who suffered from anorexia, pneumonia and depression associated with diabetes mellitus. Shoyogan seems to be effective for patients with terminal lung cancer and maintains their quality of life.

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Keishikashakuyakuto Ameliorated Diverse Autonomic Symptoms such as Diarrhea, Abdominal Pain,Urinary Retention and Orthostatic Hypotension in a Case of Pure Autonomic Failure

Hiroaki HIKIAMI ; Kanoko YAMAMOTO ; Shinji NAKATA ; Tatsuya NOGAMI ; Makoto FUJIMOTO ; Hirozo GOTO ; Naotoshi SHIBAHARA ; Yutaka SHIMADA

Kampo Medicine.2011;62(6):736-743. doi:10.3937/kampomed.62.736

Pure autonomic failure (PAF) is a degenerative disorder with diverse autonomic nervous symptoms, but without somatic nervous symptoms. We encountered a patient with PAF who was successfully treated with keishikashakuyakuto. A 61-year-old man complained of diarrhea, abdominal pain, dysuria and orthostatic hypotension. PAF was strongly suspected, based on a low level of plasma noradrenalin at rest and a finding of severe diffuse sympathetic nerve injury on ¹²³I MIBG myocardial scintigraphy. Various Kampo formulas were not effective, or could not be administered continually. Urinary retention was treated with self-catheterization. After the extract of keishikashakuyakuto was administered, his complaints of diarrhea and abdominal pain gradually decreased, and he was able to eat various kinds of food. His daily living activities improved.Moreover, he could urinate by himself, so the self-catheterization was stopped. Five years later, the diagnosis of PAF was clinically confirmed, but his daily living activities did not deteriorate. This suggests that keishikashakuyakuto can be effective for diseases with diverse autonomic nervous symptoms, such as the present case.

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Efficacy of Kakkonkajutsubuto in Patients with Neck, Shoulder, and Upper-extremity Pain

Hajime NAKAE ; Yuko HIROSHIMA ; Aya YOKOI ; Kumiko KAMADA

Kampo Medicine.2011;62(6):744-749. doi:10.3937/kampomed.62.744

Kakkonkajutsubuto belongs to the Ephedra herb drug group and has useful properties for stiff shoulders, scapular neuralgia, and rheumatoid arthritis of the upper body. In this study, we assessed the effectiveness of kakkonkajutsubuto in patients with neck, shoulder, and upper-extremity pain from the viewpoint of decrease in a Visual Analog Scale (VAS) and adverse reactions. One hundred and twenty-four patients who had no gastrointestinal disorder, hot flashes, excessive sweating or other select symptoms were treated with kakkonkajutsubuto (5.0-7.5g/day). The VAS was used for the assessment of pain-relieving effect.Eighty-one patients improved dramatically (their pre/post administration VAS ratio was less than 50%), 21 improved (between 51 to 75%), and 22 did not improve (more than 76%). Eighty-two point three percent of patients improved in total. Five patients showed adverse reactions, such as general fatigue, stomachache, and edema, but these were not clinically significant. This study suggests that kakkonkajutsubuto can be used more widely for neck, shoulder, or upper-extremity pain.

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Significance Today of Character Types in Huangdi Neijing

Toshihiro ISHIKAWA ; Te Sung KIM ; Chol Ju YANG

Kampo Medicine.2011;62(6):750-759. doi:10.3937/kampomed.62.750

Two different types, called “Yin-Yang Wu Tai” and “Yin-Yang Er Shi Wu Ren,” respectively, are described in the Huang Di Nei Jing, Ling Shu section. Each type can be divided into four closely interrelated sub-items: character, physique, constitution and therapy. These relations can be explained with the concept of the “unity of the physical and spiritual,” which is based on a holistic perspective with physical referring to the body and spiritual referring to mental activity.
If we regard these types as psychologic, we can compare them with present western psychological types. E. Kretschimer and L. Corman discussed this in relation to “character and physique” or “character and countenance.” Kampo examination of the physique and countenance are anthroposcopic. In contrast, the examination of character includes both anthroposcopy and medical interviews. Applying this knowledge, it may be possible to improve diagnostic techniques in Kampo medicine.

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The Historical Development of Theories on Night Sweat Pathophysiology

Oto MIURA ; Takanori MATSUOKA ; Yoshinari KONO ; Hidetoshi ITAKURA ; Koichiro TANAKA ; Mikumo UEMATSU ; Kazuhiko NARA ; Keiko SERIZAWA ; Asuka NAKAYAMA ; Makoto HASHIGUCHI ; Atsushi FUKUSHIMA ; Takaaki KOSUGE ; Teruo SAITO

Kampo Medicine.2012;63(1):1-14. doi:10.3937/kampomed.63.1

Until the Sui Dynasty in China, night sweat and spontaneous perspiration had been thought to be caused by same pathophysiology, that is, lowered superficial resistance by deficiency of Qi.In the Tang Dynasty, these were considered to have different pathophysiologies and a new principle indicated that pathogenic heat caused night sweat.In the Song and Jing Dynasties, deficiency of blood and pathogenic heat by deficiency of Yin was also considered to cause night sweat.In the Jing Dynasty, exogenous pathogens, such as Cold were considered to cause night sweat, which indicated the principle that not only the deficiency syndrome but also the excess syndrome caused night sweat.In the beginning of the Yuan and Ming Dynasties, it was concluded that the deficiency of Yin caused night sweat and the deficiency of Yang caused spontaneous perspiration.In the middle of the Ming Dynasty, another new theory indicated that deficiency of Yang also possibly caused night sweat; therefore we should diagnose abnormal sweat depending on the pathophysiology in each case.In the Qing Dynasty, new theories were established stating that not only exogenous pathogens but also Damp-heat, undigested food and stagnation of blood, all of which are included in excess syndrome, cause night sweat, and that based on which part of the body sweats occurred we might understand pathophysiology of night sweat. The night sweat by Warm-heat, which is different from the one by Wind-cold, was considered to be caused with deficiency of Yin.Thus we conclude that the theories of night sweat developed over time, based on Chinese medical classics.

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