Saikokeishikankyoto extract alleviates muscle atrophy in KKAy mice.

Sarcopenic obesity is associated with increased visceral fat and decreased muscle mass, resulting in decreased insulin sensitivity, increased production of inflammatory cytokines, and oxidative stress. In this study, we first evaluated the effects of herbal medicines on the transcriptional activity of the Sirtuin 1 (sirt1) promoter in vitro as an indicator of their therapeutic effect. Our data suggested that hot water Saikokeishikankyoto (SKK) extracts increased sirt1 transcriptional activity in vitro, identifying it as a candidate therapeutic for evaluation in the KKAy type 2 diabetic obesity mouse model. These in vivo evaluations revealed that SKK treatment increased the wet weight and muscle fiber content in cross sections of the gastrocnemius muscle (GA) and restored motor function in these animals. In addition, SKK treatment reduced tumor necrosis factor-α (TNFα) expression in the sera and suppressed Atrogin1 and MuRF1 transcription in the GA samples. This treatment also increased sirt1 expression in these tissues. These results suggest that SKK inhibits skeletal muscle atrophy and improves motor function in KKAy mice by suppressing inflammation. In actual clinical practice, SKK is expected to inhibit muscle atrophy and improve motor dysfunction in sarcopenic obesity.

A Case of Refractory Recurrent Genital Herpes Successfully Treated with Juzentaihoto and Saikokeishikankyoto / 日本東洋医学雑誌

A 40-year-old woman had suffered from genital herpes twice a year since approximately age 25 years. A year and a half before her first visit to our department, the frequency of her genital herpes had increased from 2 to 5 times a month. Continuous suppressive antiviral medication had not worked, and the patient was referred to our department. We discontinued the anti-herpes medication, and started treatment with Kampo (Japanese herbal) medicine. Initially, the patient’s symptoms did not improve with tokishigyakukagoshuyushokyoto for coldness of the hands and feet or hochuekkito for general fatigue. Then, on the basis of her symptoms of irritability, nightmares, dry skin and hair loss, we changed her prescription to juzentaihoto before meals and saikokeishikankyoto after meals. The frequency of genital herpes thereafter gradually decreased, and finally no further recurrences of herpes were observed as long as the patient was taking these two medicines. This result showed that some patients with recurrent genital herpes who fail to respond to antiviral therapy could be managed with Kampo medicine alone.

Two Cases of Vulvodynia and Insomnia Relieved by Japanese Herbal Medicine Including Saiko / 日本東洋医学雑誌

Vulvodynia is defined as vulvar pain of at least three months duration without a clearly identifiable cause. Currently, there are few established treatments. We report two cases of vulvodynia treated successfully with relief of insomnia, using Japanese herbal medicine including saiko. Case 1: A 29-year-old female had been in a poor physical condition for two years. Initially, she had vulvar itching, which gradually became vulvar pain. At the first consultation, she complained of not only vulvar pain but also insomnia and feeling cold. Additional symptoms included severe fatigue, constipation, frustration, stiff shoulder, and heart palpitations. There were no abnormal findings in the genital region. We began treating the insomnia and coldness using saikokeishikankyoto. By the time of the second consultation two weeks later, her insomnia and coldness completely resolved, vulvar pain disappeared, and other symptoms improved. Case 2: A 46-year-old female experienced vulvar pain two months before the first visit to the hospital. The pain increased gradually and she awakened every 30 minutes in the night with severe vulvar pain. However, there were no abnormal findings in the genital region. We used saikokaryukotsuboreito, an antidepressant and a sleeping pill. Her insomnia improved gradually, and vulvodynia resolved two weeks after the improvement of the insomnia. These results suggest that saiko is effective on vulvodynia with insomnia.

Recurrent Drug-induced Liver Injury Caused by the Incidental Readministration of a Kampo Formula Containing Scutellariae Radix.

A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.

<b>Proposal of New Method for Abdominal Diagnosis in a Standing Position</b> / 日本東洋医学雑誌

The abdominal diagnosis plays an essential role in Japanese Kampo medicine. Moreover, this diagnostic method is a characteristic practice in Kampo medicine. The conventional method of abdominal diagnosis is performed with the patient in a supine position. However, the author has found that several patients have presented with tenderness of the epigastrium or hypochondrium in a standing position, which was not detected in a conventional supine position. This paper is intended to announce the significance of a new method of abdominal diagnosis named “Ritsuishin”. In this paper, the author describes the utility of this method via a case of saikokeishikankyoto and of hontonto (Chugoho).

<b>Four Cases of Menopausal Symptoms with Respiratory Complaints </b><b>Effectively Treated with Saikokeishikankyoto </b> / 日本東洋医学雑誌

We describe four cases of menopausal symptoms with respiratory complaints successfully treated with saikokeishikankyoto. Case 1 was a 49-year-old female who became easily tired and often caught colds, as well as suffered from cough, hot flushes and insomnia. Case 2 was a 47-year-old female who became easily fatigued and irritated, and suffered from dry cough. Case 3 was a 51-year-old female, who became easily exhausted and suffered from nasal congestion and swelling of the gums. Case 4 was a 53-year-old female, who suffered from sensations of coldness and hot flushes, insomnia, sore throat and dry cough. Although saikokeishikankyoto has been classically applied for diverse symptoms, respiratory signs are associated with the most preferable outcome. Saikokeishikankyoto could be a suitable herbal medicine for menopausal patients with a weak constitution, who present with respiratory symptoms caused by coldness, <i>qi </i>deficiency and <i>qi </i>stagnation.

Atopic Dermatitis as a Psychosomatic Disorder / 日本東洋医学雑誌

As mental stress has a great impact on the symptoms of atopic dermatitis, we administered Qi-related prescriptions to 6 patients with atopic dermatitis. Not only were mental and autonomic imbalances, but also skin conditions were improved in all six. We examined changes in palmoplantar sweating and a self-rating depression scale to evaluate the effectiveness of the Qi-related prescriptions. The Qi-related prescriptions were used in combination with standard treatments as follows : keishikaryukotsuboreito in Case 1, shigyakusan in Cases 2 and 3, yokukansankachimpihange and keishikaryukotsuboreito in Case 4, shigyakusan and keishikaryukotsuboreito in Case 5, and saikokeisikankyoto in Case 6. It appears to be important to treat Qi-disorders, along with skin disorders, in patients with atopic dermatitis.