Psoriasis vulgaris is a chronic intractable disease characterized by systemic demarcated erythema and rashes with silvery-white scales. Tumor necrosis factor (TNF) α inhibitors, one of the biological agents, are new therapeutic options for psoriasis vulgaris. However, the number of cases of paradoxical reactions has been increasing in psoriasis patients treated with TNF α inhibitors. Here, we show a successful case indicating the efficacy of Kampo formulas for treating an infliximab-associated paradoxical reaction. The patient was an 83-year-old man. He was diagnosed with psoriasis vulgaris at the age of 69. While receiving infliximab injection and topical steroids, he presented and was admitted to our hospital after painful erythema appeared on his trunk and limbs. He was diagnosed with a paradoxical reaction related to infliximab. We identified the patient’s painful edematous erythema and systemic coldness. Therefore, we stopped infliximab and started to administer eppikajutsubutokadaio. His erythema and other symptoms gradually improved, and he was discharged on the 11th day of hospitalization. Eppikajutsubutokadaio has potential efficacy for psoriasis vulgaris with TNF α inhibitor-associated paradoxical reaction.

Psoriasis vulgaris is a chronic disease in which demarcated erythema and rashes with silvery-white scales occur at various sites, and it is sometimes intractable. We report that Kampo medicines are effective in the treatment of psoriasis vulgaris. An 83-year-old woman suffered from erythema with pruritus and strong redness on the trunk and upper limbs and she visited the dermatology department. She was diagnosed with psoriasis vulgaris and started treatment with betamethasone ointment. However, her symptoms did not improved, and she requested Kampo medicine treatment. After the administration of maorenshoshakushozuto, erythema gradually improved. Maorenshoshakushozuto is effective for the dermatological diseases with pruritus and strong redness like psoriasis vulgaris.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we performed a special program focusing on education in Kampo medicine, “Pre-graduation and post-graduation education in Kampo medicine for the next generation.” As a part of this project, we constructed the “Common Kampo test” based on the “Standard lectures on Kampo” as a web-based test using Moodle, and then the test was conducted in the form of a web test with 163 participants. The commentary of the “Common Kampo test” was live-streamed and was viewed by many participants, including students, educators and academics from all over Japan. In this paper, we report on the series covering the construction of the web system, creation of questions, answer results, and commentary on answers. With the recent popularization of tablet devices and smartphones, this web-based test system has the potential to become a scientifically based and optimal learning system not only for students but also for medical professionals such as doctors, pharmacists, and nurses.

Team-based learning (TBL) is an educational method developed to cultivate the ability to solve problems by learning and applying knowledge on one's own, as well as the ability to make decisions, take responsibility, and collaborate by working on issues in small groups. TBL in Kampo medicine was held as a special program : active learning at the 71st Annual Meeting of the Japan Society for Oriental Medicine. A total of 57 students participated in the TBL session. The theme of the session was the common cold with the theory of yin and yang. According to the results of a questionnaire survey, the students answered that they were able to understand the flow of diagnosis in Kampo medicine, which was the goal of the course. As a bridge from classroom lectures to clinical practice, TBL in Kampo medicine was considered to be useful in Kampo medical education.

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.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program, “Pre-graduation and post-graduation Kampo medical education for the next generation,” focusing on Kampo medical education. We summarize and report a mock lecture on standard Kampo medicine conducted jointly with the Japan Council for Kampo Medical Education (JCKME) for the purpose of faculty development. The lecture contents were based on the “Basic Curriculum for Pre-Graduate Education in Kampo Medicine 2016” established by the JCKME, and the common model slides prepared by the JCKME were used. The lectures were pre-recorded for 240 minutes on the “History of Kampo medicine,” “basic theory of Kampo medicine,” “physical examination of Kampo medicine,” “composition and effects of typical Kampo medicines, effects and side effects of typical herbal medicines,” “usefulness of Kampo and clinical cases that were effective,” and “overview of acupuncture and moxibustion treatment,” and were delivered from seven days before to seven days after the annual meeting. This was the first nationwide educational activity for the general meeting of the society. These lectures were viewed 1,017 times nationwide, by medical students, educators, and members of the society.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine held in August 2021, we conducted a special program focusing on Kampo medicine education, “Pre-graduation post-graduation Kampo medicine education for the next generation.” The following is a summary report on the practical training in Kampo medicine at each educational facility where the project was conducted. We recorded videos with explanations of topics in advance : “Four examinations,” “Decoction and crude drugs,” and “Acupuncture and moxibustion.” The report on the hands-on training in Kampo medicine was viewed 501 times by medical students, educators, and the society members across the country. This initiative was the first nationwide educational activity of the society.

At the 71st Annual Meeting of the Japan Society for Oriental Medicine in August 2021, we conducted a special program focusing on education in Kampo medicine, “Pre-graduate and post-graduate Kampo medicine education for the next generation.” As part of this project, we directed a symposium on the model core curriculum (core curriculum) in medicine, dentistry, pharmacy and nursing. The core curriculum in these fields includes Kampo education. Each institution shall promote education in accordance with the core curriculum, considering the characteristics of the field and the circumstances of the educational institution. We introduced the core curriculum in each field, and summarized and reported the current status of Kampo education in the field, points to note and suggestions for multidisciplinary cooperation, issues related to clinical practice and lack of educators, and future prospects.

Ninety percent of the crude drugs consumed in Japan depend on imports. Recently, the Japanese government has been promoting the domestic production of crude drugs. We investigated the history and current situation of the cultivation of medicinal plants and the production of crude drugs in the Tohoku region, where the 71st annual meeting of the Japan Society for Oriental Medicine was held in August 2021. In the Tohoku region, the cultivation of medicinal plants expanded after the Kyoho era of the Edo period. Several medicinal plants in this region have been successfully cultivated and distributed as local specialty products and are being preserved (e.g., Panax ginseng in Aizu, Carthamus tinctorius in Dewa). In some other areas, cultivation has just begun. In each cultivation area, a contractual relationship was established in which local governments, cultivation experts, farmers, Kampo-related associations, and pharmaceutical companies collaborated to continue and expand the cultivation business. To generate revenue, they have been trying to find sales channels not only for crude drugs but also for foods, cosmetics, textiles, and processed products. Although many issues remain to be solved in the distribution of medicinal plants as the source of crude drugs, this survey clarified the ingenuity of medicinal plant cultivation in various areas of the Tohoku region. The results of the investigation are available as videos on the website for members of the Japan Society for Oriental Medicine.

[Objective] We report a successfully treated case by a combined therapy of acupuncture and Kampo medicine for a patient with lower limb pain associated with Guillain-Barre syndrome (GBS).[Case] The patient was a 74-year-old man whose chief complaints were severe lower limb pain, gait difficulty, and hyposthenia. Clinical history: In late September in X year, the patient had a cold infection. On October 14, he became aware of weakness in his lower limbs on both sides, difficulty in walking, and severe pain in his lower limbs. He visited our hospital's general internal medicine department and was diagnosed with GBS. The patient was hospitalized and started to receive intravenous immunoglobulin therapy for GBS. Since pain in the lower limbs continued after treatment, he received analgesics, which was not effective. Therefore, acupuncture treatment was started on October 30 aiming to alleviate lower limb pain. Evaluation: Pain and burning sensation were evaluated using a numerical rating scale (NRS), and Hughes' function grade scale (FG) as an objective evaluation. [Acupuncture treatment] The acupuncture treatment was based on Chinese medicine. The basic combination of meridian points for treatment of the case were LR3 (Taichong), LI4 (Hegu), KI6 (Zhaohai), KI3 (Taixi), ST36 (Zusanli), PC6 (Neiguan), and SI8 (Xiaohai). The patient received acupuncture treatments once a day for 12 weeks.[Progress] The first evaluation of the patient's pain in his lower limbs on both sides was 10 points in NRS and 4 units in FG. Pain was alleviated immediately after acupuncture treatment was started, and a significant improvement in pain was observed by the seventh acupuncture treatment. However, the　patient started to complain of burning sensation on his soles. Therefore, the combined use of Kampo medicine (Choutousan, Rokumijiougan) were introduced in addition to the acupuncture treatment, and his burning sensation disappeared. Since then, rehabilitation was enhanced, and after three months from the start of acupuncture treatment, he was discharged since the FG was improved to 2 units. [Discussion] Lower limb pain and burning sensation in this case were considered to be neuropathic pain associated with GBS, and conventional analgesics were only temporarily effective. In contrast, the combined use of acupuncture and Kampo medicine alleviated the pain and burning sensation, and ADL was improved. Acupuncture and Kampo medicine were effective for lower limb pain and burning sensation from GBS.