A symposium on pattern identification (PI) was held at the Korea Institute of Oriental Medicine (KIOM) on October 2, 2013, in Daejeon, South Korea. This symposium was convened to provide information on the current research in PI as well as suggest future research directions. The participants discussed the nature of PI, possible research questions, strategies and future international collaborations in pattern research. With eight presentations and an extensive panel discussion, the symposium allowed participants to discuss research methods in traditional medicine for PI. One speaker presented the topic, 'Clinical pattern differentiation and contemporary research in PI.' Two speakers presented current trends in research on blood stasis while the remaining five other delegates discussed the research methods and future directions of PI research. The participants engaged in in-depth discussions regarding the nature of PI, potential research questions, strategies and future international collaborations in pattern research.
Humans ; Internationality ; Medicine, Chinese Traditional ; Research ; trends ; Syndrome

Blood stasis syndrome is one of the pathological concepts of Oriental traditional medicine. In Oriental traditional medicine, blood is thought of as not only blood but also as a living component of the body. In fact, blood stasis syndrome is related to not just circulation disorders but dermatological and gynecological and other diseases. In Japan, the concept of blood stasis syndrome is based on the past literature, for instance, Synopsis of Golden Chamber (Jin Kui Yao Lue), etc. There are many signs of this syndrome, such as a dry mouth, fullness of the abdomen and rough skin. However, the levels of importance of these signs had been unclear. Therefore, in order to determine the levels of seriousness, a scoring system of blood stasis syndrome was made based on multivariate analysis by Dr. Terasawa (Terasawa's Blood Stasis Score). Using the scoring system, we have studied blood stasis syndrome mainly related to blood circulation using modern techniques of analysis. From the results, we found that patients with blood stasis syndrome showed hemorheological abnormalities, and an improvement in these abnormalities was shown after administration of removing-blood stasis formulae. Furthermore, we have studied blood stasis syndrome from the point of view of molecular biology. We searched for the specific protein expression in blood stasis syndrome by proteomic analysis, and found no specific protein expression. However, there may be a possibility of developing a diagnostic algorithm for blood stasis by construction of a decision tree. During the past few years, as one of the molecular biological factors affecting blood stasis syndrome, we have been studying hypoxia inducible factor, which is located in the upstream of many genes. Above all, blood stasis syndrome is more than just circulatory deficit but encompasses the pathological concept of constant multilateral change in the living body.
Algorithms ; Coronary Disease ; diagnosis ; genetics ; Diagnosis, Differential ; Hemorheology ; Humans ; Japan ; Medicine, East Asian Traditional ; methods ; Molecular Biology ; methods ; Vascular Diseases ; diagnosis ; genetics

We experienced two cases of postherpetic neuralgia (PHN) improved with Kampo medicines that include uzu (i.e. uzu-zai).The pain from PHN was improved via the administration of an uzu-zai in these 2 cases, worsened by its discontinuation, and improved again by its re-introduction.Case 1 : A 76-year-old male suffering from PHN of the right L 2-3 area was administered uzukeishito and obtained pain reduction. After 12 months, his prescription was changed from uzukeishito to keishikaryoju-tsubuto. Then, after only 2 days his pain worsened again. Uzukeishito treatment was re-instated, and he again obtained pain reduction. Case 2 : An 82-year-old male suffering from PHN of the right C 4-5 area was given uzuto and obtained pain relief. After 3 months his prescription was changed from uzuto to keishikajutsubuto. Then, after only1week his pain worsened again. Uzuto was then re-introduced, and pain reduction was achieved again. These two cases led to two suggestions. First, that the uzu-zais were very effective against the PHN pain. Second, that this effect of an uzu-zai against PHN pain might be a symptomatic rather than a radical treatment.These two cases highlight the fact that the use of an uzu-zai was instrumental in reducing PHN-associated pain, but further studies will be needed to determine a dosage protocol, including when and at what pace uzu-zais might be reduced/discontinued.

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.

We report 5 patients with polymyalgia rheumatica (PMR) successfully treated with Kampo medicines. In total, we investigated 10 patients with PMR, including the 5 patients here treated in our department. Results showed that Kampo medicine was effective in 6 cases. One of the 6 refused steroid drug administration, and tapering dosage steroid was difficult in the other 5 patients due to myalgia or inflammation. Except for one case, C-reactive protein in most of the effective cases was below 3.0 mg/dl. On the other hand, the non-effective cases had severe inflammation levels and needed steroid therapy. The effective cases were treated with sokeikakketsuto, tokakujokito, keishibukuryogan, choyotokasyakuyaku, yokuibushihaishosan and tokishakuyakusan, which have the effect of improving oketsu states. Thus, it was considered that Kampo medicine has the potential for treatments in PMR patients who have difficulty tapering steroid dosage and mild inflammation. Moreover, this suggests Kampo medicines that improve oketsu state are useful for PMR treatment.

Thalamic pain is known as intractable central pain caused by thalamic bleeding and infarction. Although some physical and surgical therapies have been tried, there is no established method for its improvement. We attempted the treatment of 6 cases of thalamic pain, and 4 of them showed improvements in their symptoms. Our patients were aged 27-70 years, 4 men and 2 women. Their diagnoses were 3 cases of right thalamic bleedings, 1case of left thalamic bleeding, and 2 cases of right thalamic infarctions. The periods from onset to consulting our department were from6months to 12 years. In the 4 cases whose symptoms improved, the symptoms had almost disappeared or were decreased by at least 40%. These improved cases used formulas containing uzu or bushi. Yokukansankachimpihange was effective for two cases with mental disturbances. One case showing major improvement was treated by only the formula against oketsu. The cases whose symptoms had continued for a long time were more intractable, with the symptoms remaining to some degree in spite of their decreasing tendency. Finally, in intractable cases, their symptoms remained fixed and they had severe paralysis.

Medicine, Kampo ; Pulmonary evaluation ; Therapeutic procedure ; Geriatrics

Recently, QOL has become an important consideration when giving medical treatment. The development of treatments for urinary incontinence, a condition which greatly affects QOL, however, has been late in coming, because there are few critical symptoms. We experienced three cases of urinary incontinence successfully treated with ryokyojutsukanto. Case 1 was a 63-year-old woman. She had developed stress urinary incontinence (SUI) from about 30 years of age. As she came to be aware of lumbago and numbness of legs, she sought Kampo treatment. Tokishakuyakusangoninjinto was ineffective, but her all symptoms were improved with ryokyojutsukanto. Case 2 was a 46-year-old woman. She had become aware of incontinence after delivery of her first child (at 27 years of age), and she received Kampo treatment for lumbago and her incontinence. Tokishakuyakusankabushi was slightly effective for her lumbago, but ineffective for her incontinence. These symptoms were improved after a change to ryokyojutsukanto. Case 3 was a 70-year-old woman. She developed a bladder/bowel disturbance, and mixed urinary incontinence (MUI) caused by conus syndrome with a compression fracture of Th12 vertebral body. With ryokyojutsukanto, her fecal incontinence disappeared, and her lumbago and urinary incontinence showed a tendency toward improvement.
Urinary Incontinence ; Low Back Pain ; symptoms <1> ; Human Females ; therapeutic aspects

Recently, the number of athletes who receive acupuncture therapy is increasing. However, most of these athletes receive acupuncture therapy with single-acupuncture and/or electro-acupuncture to a local point, or a trigger point. We experienced two water polo athletes who were improved using acupuncture and moxibustion therapy with “zuisho” therapy. Case 1 was 16 year old man. He became aware of pain in his right thumb after training, which continued with extended training time, a numbness in his left hand appeared more, and he received acupuncture and moxibustion therapy. These symptoms disappeared immediately with acupuncture and moxibustion therapy using the standard traditional methods, such as contact needling to a yuan point, and in situ acupuncture to a back shu point, etc. Case 2 was 17 year old man. He received acupuncture and moxibustion therapy for lumbago and stiffness of the neck. These symptoms disappeared immediately after acupuncture and moxibustion therapy using the standard traditional methods such as contact needling to a yuan point, and inserting needles into a back shu point, an extra meridian, etc. In these two cases, symptoms were improved with “zuisho” therapy, and both could continue with longer and more strenuous training. This suggests that acupuncture and moxibustion therapy using the standard traditional methods are useful for athletes.
Acupuncture ; Therapeutic procedure ; symptoms <1> ; Training ; Water

The purpose of this study was to evaluate the effect of keishibukuryogan (KB) against the cognitive symptoms associated with silent brain infarction in a prospective cohort study. The subjects were 93 patients with silent brain infarcts who visited the Department of Japanese Oriental Medicine, University of Toyama, and its allied hospitals. They consisted of 24 males and 69 females, mean age (± S.E.) 70.0±0.8.Group SK (n=51) consisted of patients who used KB extract for more than6months per year. Group SC (n=42) consisted of patients who did not use Kampo formulas. The NS group (n=44) consisted of elderly subjects who had no silent brain infarction, 21 males and 23 females, with a mean age (± S.E.) of 70.7±0.7 years. Among the three groups, the revised version of Hasegawa's dementia scale, apathy scale and self-rating depression scale were compared between the study start and after three years. In the SK and SC groups, these scores, and the subjective symptom levels (head heaviness, headache, dizziness or vertigo, stiff shoulder) were also studied. The results showed that the self-rating depression scales at study start for the SK and SC groups were significantly higher compared to the NS group. In spite of the scores for the NS group increasing after three years, the SK group scores were significantly decreased compared to the SC and NS groups. KB was effective against head heaviness, which often complicates silent brain infarction. In the above mentioned, KB was effective in treating cognitive disorders and subjective symptoms related to silent brain infarction.
Infarction ; Brain ; seconds ; Ions ; symptoms <1>