“The Kampo Future Vision Study Group responsible for health and medical care of people” was established in 2016 with the aim of discussions to resolve various problems related to Kampo, and issued six proposals as important items. Among these proposals, the emphasized themes that are directly linked to clinical practice are “Kampo as a supportive treatment for cancer” and “Kampo as a countermeasure against frailty in the elderly.” The Japan Society of Oriental Medicine decided on a policy to be involved in these themes and established the Proposal-Discussing Committee (later absorbed into the Policy Advisory Committee). At first, the committee asked experts to present the research status of Kampo medicine as supportive care for cancer and as countermeasures against frailty. The committee, then, decided to lead clinical research by itself on frailty treatment with Kampo medicine. In such clinical research, evaluation criteria for judging therapeutic effects are necessary. Therefore, the existing well-defined diagnostic criteria were combined to create a Kampo frailty score. This article explains the Kampo frailty score, citing the supporting literature.

We present a case of painful trigeminal neuropathy that was successfully treated with hangebyakujutsutenmato (HBT) extract, a traditional Japanese medicine. A 76-year-old woman experienced severe left facial pain caused by a large basilar artery aneurysm compressing the brainstem. Administration of gabapentin (GPT) reduced facial pain slightly. However, attempts to increase the GPT dose aggravated dizziness and gait disorder. GPT combined with HBT relieved both facial pain and dizziness, enabling dose reduction of GPT. The classical text “Hiiron,” the original literature on HBT, recommends this medicine for headaches and/or dizziness secondary to gastrointestinal dysfunction caused by inappropriate treatment. Many different medicines can cause dizziness, and HBT may be useful for the treatment of this side effect.

A patient with intractable glossalgia was successfully treated with a combination of three Kampo medicines : orengedokuto, bukuryoin, and kososan extracts. Then, 3 more patients with glossalgia were administered similar treatment based on the experience of the first case. The clinical features of these four patients and the efficacy of the combination Kampo treatment are reported herein.
A 61-year-old man with a 3-year history of glossalgia had been treated with psychopharmaceuticals for 4 months at another hospital, without any relief from symptoms. Upon referral to this Kampo clinic, the patient was treated with goreisan extract, daisaikoto extract, or other Kampo medicines, but these medicines were not effective. The prescription was then changed to a combination of orengedokuto, nichinto, and kososan extracts, which ameliorated the glossalgia symptoms almost by half. Furthermore, the glossalgia improved completely after the nichinto extract in the Kampo combination was replaced with bukuryoin extract.
After successful treatment of the first patient, three other patients were treated with the same Kampo combination. Two patients showed improvement within 2 weeks, but the combination treatment was ineffective in the other patient, whose symptoms finally improved with a zinc supplementation from Polaprezinc. The clinical features of the patients with good outcome were generally characterized by a combination of symptoms such as glossalgia, tendency toward depression, and digestive symptoms.
The combination treatment was prescribed as a substitute for seinetsugeutsuto decoction, and it was effective in three of the four patients with glossalgia. These results indicate that the combination treatment could be a candidate medicine to treat glossalgia.

Sleep-related leg cramp (SRLC) is a sleep disorder characterized by disturbance of sleep because of painful leg cramps. In this report, we studied the efficacy of goshajinkigan (GJG) in the treatment of SRLC. From among the outpatients at our Kampo clinic, we selected SRLC patients who were treated with GJG and investigated their distinctive features. Seven patients (5 men and 2 women), with a mean age of 72.1 years met the inclusion criteria. In addition to SRLC, 4 patients experienced cramps following exercises such as walking, swimming, and mountain trekking ; further, one of these 4 patients complained of cramps even in the upper extremities. Among the 7 patients, 3 were successfully treated for SRLC by GJG. GJG was effective in patients who showed symptoms of the Kidney yang-ki deficiency without gastrointestinal dysfunction. On the other hand, GJG was not so effective in the patient without the Kidney yang-ki deficiency, the patients with gastrointestinal dysfunction, and the patient with cramps in the arms. In conclusion, our findings suggest that GJG is effective in the treatment of SRLC patients with the Kidney yang-ki deficiency without both gastrointestinal dysfunction and cramps in the upper extremities.

[Purpose] In Kampo medicine, blood deficiency is considered to cause systemic symptoms such as insomnia and dizziness, in addition to skin-related symptoms such as xeroderma. Diagnosis of blood deficiency does not appear to be definitive since it is based on subjective judgment. To resolve this problem, we have attempted to establish an objective method for diagnosing blood deficiency by measuring skin moisture.[Methods] Using a skin moisture meter, we measured the skin moisture (at the neck, forearm, and abdomen) of 80 women during their first examination at our clinic. The patients were also classified according to their blood deficiency scores.[Results] A statistically significant difference was observed between patients with blood deficiency and those without blood deficiency with regard to the skin moisture at the neck and forearm. The coefficient of correlation between the skin moisture of the neck and the blood deficiency score was -0.41.The results of statistical analysis performed using a type1quantification method revealed high values even for some conditions not associated with the skin, such as hypomenorrhea and excessive strain of the abdominal muscles, in addition to high values for skin-associated conditions. And in pre-post-treatment comparisons, improvements in blood deficiency scores generally matched transitions in keratinous moisture.[Discussion] Due to the absence of a high correlation between skin moisture and the blood deficiency score, it is unlikely that skin moisture can be used instead of the blood deficiency score as a parameter for the accurate diagnosis of blood deficiency.[Conclusion] Although skin moisture levels may be an indicator of blood deficiency, further studies are required before this parameter can be applied in clinical diagnosis.
deficiency ; In Blood ; Integumentary system ; Neck ; Diagnosis

[Purpose] We studied the pathophysiology of hot flush and cold feet.[Methods] By using an infrared thermometer, we measured the surface temperature of 98 female patients. We classified the patients into 4 groups : Group A patients without hot flushes or cold feet ; Group B patients with hot flushes but without cold feet ; Group C, patients without hot flushes but with cold feet ; and Group D patients with both hot flushes and cold feet. We measured the surface temperature of their tongues, upper abdomen, lower abdomen, and soles.[Results] The tongue temperature in Group B was significantly higher than that in Group A. The difference in the temperatures between the tongue and upper abdomen in Group B was also significantly greater than that in group A. Groups C and D, on the other hand, showed similar surface temperatures. Then, we examined the relationship between tongue temperatures, and the difference in the temperatures between the tongue and sole (Diff T-S) by using a correlation coefficient test : a significant correlation (r=0.77) was observed in Group C but not in Group D. Next, the patients in Group D were divided into 3 subgroups on the basis of their Diff T-S ; we found that these subgroups were characterized by the constitutionally ordinary symptoms (COS) of “yin and yang” and “deficiency and excess.”[Discussion] The occurrence of hot flush with cold feet was shown to depend on the slope of the body temperature, which was influenced by COS.[Conclusion] The occurrence of hot flush is associated with COS.
Hot flushes ; Feet, unit of measurement ; Tongue ; Group D ; Group B rank

Two brothers with nocturnal enuresis, aged 8 and 7 years, were brought to our clinic. They had had nocturnal enuresis since early childhood, necessitating the use of disposable diapers every night. Their past histories were unremarkable, and a family history revealed that their father had experienced the same disorder until he was 12 years of age. On physical examination, we noted hypertonic abdominal muscles and high sensitivity to tickling in the 8-year-old boy, and no remarkable finding in the 7-year-old boy. Initially, the elder brother was treated with saikokeishito extract ; the younger brother, with kakkonto extract. Because these extracts were ineffective, rokumigan extract was later added. The combination therapies cured the nocturnal enuresis in both the children. The fact that these patients were brothers and that their father had the same disorder as a child indicates that the cause of nocturnal enuresis observed in the parent and the siblings might be related to “kidney qi deficiency”.
Enuresis ; Brother, NOS ; Therapeutic procedure ; success ; Night time

We evaluated the clinical effects of acupuncture/moxibustion therapy in 7 patients with vertigo that was uncontrollable with western medicine. The observation period was 6-15 months. The 7 patients consisted of 1 male and 6 females aged 29-73 years (mean, 44.7 years). More than 4 courses or more of acupuncture/moxibustion treatment (acupuncture + warm moxibustion) were performed in each patient, and the effects were evaluated based on the results of a daily living disability questionnaire before and after treatment. In practice, these effects were classified into 4 grades (cure, improvement, no change, aggravation). Cure was observed in1patient, improvement in 5 patients, and no change in1patient, indicating this therapy was effective in 85% of the patients. None of the patients showed aggravation of their condition. In addition, no adverse effects were observed.Our results suggest that acupuncture/moxibustion therapy has certain effects on intractable vertigo. Therefore, in patients with vertigo who do not respond to western medical care, such as the administration of anti-vertigo drugs, a beneficial effect of acupuncture/moxibustion as a complementary therapy can be expected.
Acupuncture ; Therapeutic procedure ; Vertigo ; Patients ; Effective

Purpose : Cold sensation of the limbs is a common complaint for which patients seek treatment with Kampo medicine. However, some patients complain of coldness of the limbs despite maintaining normal skin temperature. We studied this condition and its association with ki (energy), ketsu (blood), and sui (body fluids) by measuring surface body temperatures.Methods : Using an infrared thermometer, we measured the surface body temperature of 98 female patients during their first examinations at our clinic. We classified the patients according to the season of their examination and the presence of the abnormalities of ki, ketsu, and sui ; subsequently, we statistically analyzed these findings.Results : No statistical difference was observed in the surface body temperature of the patients with complaints of coldness (Pw/C), and those without such complaints (Pw/oC). However, under particular conditions, the surface body temperature of Pw/C was observed to be higher than that of Pw/oC. In the presence of “ki deficiency” and “sui accumulation,” the surface body temperatures were lower than in the absence of the ki and sui abnormalities, respectively. In contrast, the surface body temperature was higher in patients with the “oketsu (blood stasis) syndrome” than in those without the “oketsu syndrome”.Discussion : Although the dissociation between the subjective cold sensation and actual skin temperature is present only in limited conditions, the presence of this dissociation indicates that factors other than the surface body temperature such as the abnormalities of ki, ketsu, and sui may also determine cold sensation.Conclusion : It is important to treat Pw/C by taking into account their state of coldness and the abnormalities of ki, ketsu, and sui. Measuring surface body temperature using an infrared thermometer appears to be an effective method for analyzing cold sensation of the limbs.
Body Temperature ; seconds ; teratologic ; g <3> ; Measurin

Rehabilitation and exercise are occasionally restricted by intractable pain to an extent greater than that estimated due to physical dysfunction. Here, we report three patients with intractable pain in whom Kampo medicine was highly effective, in cases where common treatments such as the administration of non-steroidal anti-inflammatory drugs and nerve blockade proved ineffective. Sokeikakketsuto extract was prescribed for three patients with different conditions: intermittent claudication of cauda equina due to lumbar spondylolisthesis, posttraumatic chronic psychogenic pain, and complex regional pain syndrome type 1 that occurred after cerebral infarction. Sokeikakketsuto extract alleviated severe pain and therefore facilitated rehabilitation and exercise in all three of these cases. From the viewpoint of Kampo medicine, we hypothesized that all three cases shared some common etiology of blood abnormalities, although conventional medical diagnosis differed for each. We suggest that treatment with Sokeikakketsuto extract corrected the blood abnormalities, thereby resulting in the successful treatment of intractable pain in these patients.