<b>Inhibitory Effect of Shoseiryuto on Substance P and CGRP </b><b>Production in the Trigeminal Nerve </b> / 日本東洋医学雑誌

It has been reported that the effect of shoseiryuto, a traditional Japanese “Kampo” medicine, on allergic rhinitis depends on several mechanisms. Previously, we reported that shoseiryuto administered in an allergic rhinitis rat model, inhibited increases of substance P (SP) and calcitonin gene-related peptide (CGRP) in the nasal mucus, which in turn are involved in the exacerbation of rhinitis symptoms and allergic symptoms. In the present research, we looked into whether the secretion of SP and CGRP are directly inhibited by the administration of shoseiryuto.<br>Histamine solution 5µl (10 mg/ml) was instilled in both nostrils of healthy, male SD rats, thereby inducing allergic symptoms, and for the group to which shoseiryuto had been pre-administered, increase in the concentration of SP and CGRP in the nasal mucus was significantly inhibited. Moreover, upon investigating SP and CGRP production in the trigeminal ganglia by means of immunostaining, it was found to be similarly significantly inhibited. The above results indicate that shoseiryuto directly inhibits the secretion of SP and CGRP in the C-fibers of nasal mucosa.

<b>Analgesic and Anti-stress Effects of Yokukansan in Rats with Adjuvant Arthritis</b> / 日本東洋医学雑誌

Yokukansan (YKS), one of the traditional Japanese “Kampo” medicines, is a mixture of extract powders from seven kinds of medicinal herbs (<i>Atractylodis Lanceae Rhizoma, Hoelen, Cnidii Rhizoma, Uncariae Uncis Cum Ramulus, Angelicae Radix, Bupleuri Radix, and Glycyrrhizae Radix</i>). YKS has been administered to fragile habitus patients who show symptoms such as emotional irritability, neurosis and insomnia, and to infants who suffer from night crying and convulsions. In recent years, YKS has been reported to be effective against pain disorders such as headache and chronic pain, but the mechanism underlying these beneficial effects is still unclear. In this study, the effect of YKS on chronic inflammatory pain and stress caused by pain were investigated using rats with adjuvant arthritis.<br>Male Wistar rats were injected with complete Freund's adjuvant into the plantar surface of the right hindpaw, and then pain thresholds and stress markers were measured. The thermal pain threshold measured with the plantar test significantly decreased, and the level of salivary chromogranin A (CgA), which is used as a mental stress marker, was significantly increased in this model. The administration of YKS controlled the activation of spinal microglia involved in the expression of chronic pain, and significantly reduced a decrease in the pain threshold. Moreover, an increase in the level of salivary CgA was significantly inhibited. The authors concluded that YKS has effects in reducing chronic inflammatory pain and the stress caused by pain.

Influence of Chinese Herbal Medicine on Reactive Oxygen and Blood Fluidity in Rats / 日本東洋医学雑誌

Swelling and pain appear when blood flow is delayed in states of “<i>oketsu</i>.” Until now “<i>oketsu</i>” as a circulatory disturbance has been studied from profiles of vascular resistance characteristics and blood fluidity. Blood fluidity is influenced by blood cell function, plasma ingredients and reactive oxygen. In this study, we administered the various Chinese herbal medicines, tokishakuyakusan, saikokaryukotsuboreito, tokakujokito, keishibukuryogan and juzentaihoto to determine the effect of these medicines on “<i>oketsu</i>” by observing reactive oxygen dynamics and blood fluidity in rats.SPF male Wistar rats weighing 200 g were used. Each experimental group was given feed containing 3% extract of one Chinese herbal medicine for1week. Blood samples were mixed with heparin, EDTA-2K or sodium citrate to block coagulation. Blood fluidity was measured with a Micro Channel Array Flow Analyzer (MC-FAN). A PA-20 examined platelet aggregation by the reaction to ADP, which activates platelet aggregation. Reactive oxygen dynamics were measured with a Free Radical Elective Evaluator (FREE).As a result, anti-oxidative ability and blood fluidity increased in all Chinese herbal medicine-administered groups. Furthermore, an inverse correlation between the fluidity of erythrocyte suspensions and anti-oxidative ability was shown. We speculate that an anti-oxidative influence of Chinese herbal medicines affected erythroid deformability or stickiness. In addition, tokishakuyakusan, tokakujokito and keishibukuryogan decreased platelet aggregation ability.This study shows that “<i>oketsu</i>” improves blood properties and suggests that Chinese herbal medicine improves decrease in blood fluidity, the causes of conditions such as thrombosis or embolism.

Current of Traditional Medicine in Japan and Korea / 日本東洋医学雑誌

The Japan Society for Oriental Medicine, and The Korean Oriental Medical Society, organizations representing traditional medicine in both countries, concluded a convention of scientific exchange and held a formal signing ceremony on March 29, 2009. Taking this opportunity, the presidents of both societies gave commemorative lectures on behalf of their organizations.<br>1) Korean president Kim spoke of an original medical tradition differing from that in China, having existed before the time of Christ. He raised <I>yomogi</I> and garlic as examples of herbs not described in Shennong's <I>Classic of Materia Medica</I>. He told how traditional medicine exchange was already active between China, Korea and Japan, during China's Three Kingdoms period, and how after the <I>Treasured Mirror of Eastern Medicine</I> was published, traditional Korean medicine took root with the common people, and the concept of Four Constitution Medicine was created. Kim then spoke of how western medicine was introduced in 1876, and how a dual medical system has since developed in his country.<br>2) President Ishino told of how Kampo medicine originated from China, and how in particular, it was Japanized during the Edo period. He spoke of how its characteristic feature is a focus on “practice” rather than “theory”, which eliminates idealism, places more emphasis on positivism, and has led to the development of fukushin, or abdominal diagnosis. He explained the history of Kampo medicine in great detail, and spoke of how after the medical system was reformed in the Meiji era, Japanese medicine became western based. He then explained how after entering the Showa era, Kampo medicine was revived, and is now well-established and integrated with western medicine.

Why Kampo? Why Now? Why Me? / 日本東洋医学雑誌

The world has now rediscovered the value of traditional medicine. Much traditional medicine in South-East Asian countries originated from the medicines of ancient China, and developed independently within those individual countries. As a measure toward information exchange and communication among these countries, the World Health Organization's Western Pacific Regional Office (WHO-WPRO) has published its International Standard Terminologies (IST) for use globally. While domestically in Japan, Kampo is now taught as a regular subject in all medical schools. In this light, there is significant meaning to holding conference with the purpose of understanding the current status of Japanese Kampo around the world, and considering the best ways to disseminate Kampo information globally. The International Conference of Kampo Medicine (provisional title) has been held thus far a total of three times, to address the current status of Japanese Kampo, Japanese Kampo issues from global point of view, as well as the current status of traditional medicine in China and Korea also originating from the ancient Chinese medicine. The conference was entitled &lsquoWhy Kampo? Why Now? Why Me?—The reason why foreign medical doctors worldwide choose Japanese Kampo, and the situation or development of Kampo medicine in their own countries”, in which foreign doctors in Japan, medical students, and leading Kampo medical practitioners were invited to give lectures, which were followed by free discussions by all participants.

The Analysis of Kampo Medicines (Traditional Japanese Herbal Medicines) in our Kampo Clinic / 日本東洋医学雑誌

Kampo formulae are selected according to a patient's symptoms. In certain cases the decoctions are modified with additional herbs to provide a suitable treatment. Knowledge of herbs and formulae used clinically in Kampo medicine is essential; however there is a lack of knowledge on how extensively certain herbs are applied. We have analyzed our Kampo outpatient clinic prescriptions for September 2004. The 20 most frequently applied formulae accounted for 60% of all prescriptions. Also, we analyzed our patients' medical backgrounds in relation to the most frequently used 20 prescriptions in September 2004, and the distribution of our patients for each prescription. The distribution of patients for each prescription differed significantly from the distribution of all patients. As a last point, we looked at which herbs were most frequently added to prescriptions. The most frequently added herb was Astragali Radix, followed by Coicis Semen and Aconiti Tuber. We consider this to be significant information for Kampo physicians and pharmacists.

Successful Treatment of Panic Disorder with Ryukotsuto / 日本東洋医学雑誌

We encountered a patient with intractable panic disorder who responded extremely well to Ryukotsuto, a Kampo preparation. Beginning in March 2003, a 55-year-old female began to lose vigor and concentration, while developing palpitations and experiencing a rise in blood pressure (systolic pressure≥190mmHg) accompanied by sudden anxiety. When these symptoms became intense, she was brought to a hospital by ambulance. Although close examination revealed no abnormalities, on clinical diagnosis, however, autonomic imbalance was recognized. Despite treatment with antidepressants and minor tranquilizers, including selective serotonin reuptake inhibitors (SSRI), no improvement was observed. A series of medicinal Kampo preparations, prescribed one after another, also had no effect. For further treatment, she was referred to our hospital on July 22, 2005. At the first consultation, a diagnosis of panic disorder was made, according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV). Hon-Ton disease was suspected based on clinical findings, and Ryokeikansoto was prescribed as a decoction. However, no positive effects were observed after 1 week, while marked incompetence, forgetfulness, and depression were noted. Therefore, based on the results of a self-rating depression scale (SDS), a profile of mood states (POMS), and autonomic function tests, such as pupillary dynamics at the first consultation, panic disorder accompanied by extreme tension with depression was diagnosed. Consequently, her Kampo preparation was changed to Ryukotsuto. As a result, symptoms virtually disappeared and all western drugs were discontinued. Psychological tests, autonomic function tests, and her diagnostic scores for conditions of Ki, Ketsu, and Sui also improved. We conclude that Ryukotsuto may be an effective treatment for panic disorder accompanied by depression.

Kampo Therapy for Graves' Disease Associated with Psychological Disorders / 日本東洋医学雑誌

We report 2 patients with Graves' disease and psychological disorders. In these patients, treatment did not relieve psychological disorders despite normalization of thyroid function, but kampo therapy was effective. Patient 1 was a 24-year-old female. In 2000, she was diagnosed as having Graves' disease. Treatment with an antithyroid drug normalized thyroid function, but did not relieve psychological disorders such as irritation, anxiety, or despair. In February 2005, the patient consulted our hospital. Patient 2 was a 26-year-old female. After graduating from a high school, she developed Graves' disease. Treatment with an antithyroid drug was started. However, thyroid function was unstable ; mild hyperthyroidism and hypothyroidism repeatedly occurred. During this period, irritation, fatigue, malaise, and alopecia deteriorated, and she consulted our hospital in January 2005. In the two patients, keishikanzoryukotsuboreitogohangekobokuto was prescribed (the regimen was changed during follow-up in Patient 1), and their conditions markedly subsided after 16 and 9 weeks of administration, respectively, suggesting the usefulness of kampo therapy in the treatment of Graves' disease associated with psychological disorders.

Comparison between Constituents of the Extracts by Decoction of Adult and Child doses of Kampo Formulas / 日本東洋医学雑誌

For the dispensing of Kampo formulas, only an adult dose is described by conventional formulary. Therefore a child's dose is often prescribed by reducing instructions for the fraction-times of an adult dose. However, it is necessary to study whether the content of Kampo-extract pharmaceutical preparations at a child's dose, are similar to decoctions prepared by reducing the dose of crude drugs, and reducing the quantity of water by fraction-times. Therefore it was compared whether the constituents of a decoction liquid at an adult dose, were equal to those of a child's dose. In the decoction method of our clinic, adult doses are decocted with an initial 600mL quantity of water to half volume, as per the normal decoction method, whereas children's doses are reduced to 2/3 or 1/3 times that of adult dose, and decocted to half of the early-stage quantity of water that they are with adults. In the present study, three Kampo formulas which have been used frequently in our clinic and have different prescription weights i.e., Oren-gedoku-to (9g), Keishi-bukuryo-gan-ryo (20g), and Juzen-taiho-to (33g) were studied. When child and adult doses were compared, a difference was noted in pH, extraction rate and extracted constituents. Extraction rates for a child's dose of Oren-gedoku-to and Juzen-taiho-to were lower than that of an adult dose. Extraction rates of component gradients? ferulic acid in Oren-gedoku-to, pae-oniflorin in Keishi-bukuryo-gan-ryo, and paeoniflorin and liquiritin in Juzen-taiho-to? for a child's dose were lower than those of an adult dose. However, extraction rates of component gradients? albiflorin in Keishi-bukuryo-gan-ryo and albiflorin and trans-cinnamic acid in Juzen-taiho-to ? for a child's dose (quantity of 1/3 times) were higher than those of an adult dose. These results suggest that the content of a decoction, which was prepared by reducing an adult dose to the fraction-time of a child's dose, is not the same as reducing the amount of Kampo-extract pharmaceutical preparation to the fraction-time of a child's dose.

Risks in Dispensing Kampo Medicines and Their Prevention / 日本東洋医学雑誌

Recently, the number of physicians using Kampo (Japanese traditional herbal) medicines has been increasing in Japan, and it is becoming more common for pharmacists to dispense Kampo medicines. As Kampo medicines become more popular, in addition to extract formulae, the use of decocting formulae that are more suited to each patient's predisposition and symptoms has increased. Therefore, more pharmacists are dispensing such decocting formulae. However, dispensing decocting formulae can be a complicated task. The risk of dispensing errors is not small. In present paper, we examined preventive measures based on investigations of errors involving decocting formulae in our Kampo clinic. From 1990 to 1999, there were 54 cases in which errors were found after patients received their medicines, and 44 of these cases were dispensing errors. To prevent such errors, in addition to having the knowledge of Kampo medicine and medicinal herbs that is needed for dispensing decocting formulae, it is also necessary to understand the contents of the prescription. The most important preventive measures are to re-inspect the weight and contents of the prescription after preparing it, and to do a final inspection of the medicine contents with the patient. It is expected that this report will play a role in preventing dispensing errors of Kampo medicines by pharmacists.

A Case of Hepatitis and Interstitial Pneumonitis Induced by Hangeshashin-to and Shosaiko-to / 日本東洋医学雑誌

A 60-year-old male patient visited the Oriental Medicine Research Institute of the Kitasato on ***** because of abdominal discomfort. Hangeshashin-to was administered to him and the abdominal discomfort was relieved. He continued to take Hangeshashin-to from June to August 1997. He had chills, high fever, and fatigue from ********. He stopped Hangeshashin-to and took Shosaiko-to for five days because of liver dysfunction. He was admitted to our hospital on ********. Antibiotics and stronger neo-minophagen C were administered to him. A chest roentgenogram revealed a ground-glass shadow on the left upper lung, and Shosaiko-to was discontinued. The patient began to complain of dyspnea and had fine crackles on the chest. A chest roentgenogram and chest CT showed interstitial pneumonitis. Oral predonisolone therapy was started for hypoxemia and the patient improved. A drug lymphocytes stimulation test revealed that lymphocytes were stimulated by Shosaiko-to and its components, Saiko and Ogon. A chest roentgenogram just before ingesting Hangeshashin-to revealed the interstitial change of the lung. Taken all together, this patient suffered from druginduced hepatitis and pneumonitis as a result of ingesting Hangeshashin-to and Shosaiko-to.

Trial of a New Method of Intradermal Needle Insertion for Small Experimental Animals / 日本東洋医学雑誌

The authors' developed a new methods of preparing and inserting intradermal needles for small experimental animals.<br>To create the new type of needle, the tip of a filiform needle (0.14mm in diameter) was pinched into a wavy shape using mosquito forceps. A length of about 1.5mm of this wavy section was then cut off and used as an intradermal needle.<br>Designated areas of the mice were depilated, and the acupoints marked. For insertion, an injection needle (27 gauge) was used to penetrate directly beneath the marked point, starting from slightly above the marking. The wavy needle was then inserted into the tip of the injection needle and a filiform needle (0.18mm in diameter; adjusted length) used to push the wavy needle out, thereby inserting it into the intended point.<br>Using this method, insertion of the needles was easily carried out, and they stayed in places. This method therefore seems to be highly applicable for the insertion of intradermal needles in experimental animals.