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1.
Intern Med ; 57(12): 1733-1740, 2018 Jun 15.
Artigo em Inglês | MEDLINE | ID: mdl-29434136

RESUMO

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.


Assuntos
Doença Hepática Induzida por Substâncias e Drogas/etiologia , Medicamentos de Ervas Chinesas/efeitos adversos , Medicina Kampo/efeitos adversos , Scutellaria baicalensis , Idoso , Feminino , Humanos
2.
BMC Complement Altern Med ; 17(1): 547, 2017 Dec 21.
Artigo em Inglês | MEDLINE | ID: mdl-29268743

RESUMO

BACKGROUND: Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. METHODS: We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. RESULTS: Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was transiently harmed and required substantial treatment). CONCLUSIONS: There are many patient safety issues related to Kampo medicines. Patient safety awareness should be raised to prevent medication errors, especially administration errors, and adverse drug events in Kampo medicine.


Assuntos
Efeitos Colaterais e Reações Adversas Relacionados a Medicamentos/epidemiologia , Erros de Medicação/estatística & dados numéricos , Medicina Kampo/efeitos adversos , Segurança do Paciente/estatística & dados numéricos , Gestão de Riscos/estatística & dados numéricos , Pessoal de Saúde/estatística & dados numéricos , Hospitais Universitários , Humanos , Estudos Retrospectivos
3.
J Gastroenterol ; 52(3): 308-314, 2017 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-27220772

RESUMO

BACKGROUND: Mesenteric phlebosclerosis (MP) is a rare disease characterized by venous calcification extending from the colonic wall to the mesentery, with chronic ischemic changes from venous return impairment in the intestine. It is an idiopathic disease, but increasing attention has been paid to the potential involvement of herbal medicine, or Kampo, in its etiology. Until now, there were scattered case reports, but no large-scale studies have been conducted to unravel the clinical characteristics and etiology of the disease. METHODS: A nationwide survey was conducted using questionnaires to assess possible etiology (particularly the involvement of herbal medicine), clinical manifestations, disease course, and treatment of MP. RESULTS: Data from 222 patients were collected. Among the 169 patients (76.1 %), whose history of herbal medicine was obtained, 147 (87.0 %) used herbal medicines. The use of herbal medicines containing sanshishi (gardenia fruit, Gardenia jasminoides Ellis) was reported in 119 out of 147 patients (81.0 %). Therefore, the use of herbal medicine containing sanshishi was confirmed in 70.4 % of 169 patients whose history of herbal medicine was obtained. The duration of sanshishi use ranged from 3 to 51 years (mean 13.6 years). Patients who discontinued sanshishi showed a better outcome compared with those who continued it. CONCLUSIONS: The use of herbal medicine containing sanshishi is associated with the etiology of MP. Although it may not be the causative factor, it is necessary for gastroenterologists to be aware of the potential risk of herbal medicine containing sanshishi for the development of MP.


Assuntos
Medicamentos de Ervas Chinesas/efeitos adversos , Veias Mesentéricas/diagnóstico por imagem , Fitoterapia/efeitos adversos , Calcificação Vascular/induzido quimicamente , Adulto , Idoso , Idoso de 80 Anos ou mais , Uso de Medicamentos/estatística & dados numéricos , Feminino , Seguimentos , Gardenia , Inquéritos Epidemiológicos , Humanos , Japão/epidemiologia , Masculino , Medicina Kampo/efeitos adversos , Pessoa de Meia-Idade , Radiografia , Estudos Retrospectivos , Esclerose , Tomografia Computadorizada por Raios X , Calcificação Vascular/diagnóstico por imagem , Calcificação Vascular/epidemiologia
4.
Expert Rev Clin Pharmacol ; 9(9): 1225-33, 2016 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-27232545

RESUMO

INTRODUCTION: Medicinal plants, and formulations prepared from them, have been used in China and Japan for thousands of years. Nowadays, ancient formulations of Traditional Chinese and Kampo (Japanese) Medicines coexist with Western herbal medicines (HMs) and complement each other. HMs are used for the treatment of mild and chronic diseases, as an adjunct therapy, to improve wellbeing and delay aging, or as healthy (functional) foods. AREAS COVERED: This article, a third part in a series of reviews, is focusing on history, use and regulation of the traditional and modern HMs in Japan and China. Materials available from legislative and governmental websites, PubMed and news media were used. Expert commentary: HMs are heavily regulated in both countries, often in a similar manner as conventional pharmaceutical drugs. The majority of herbal formulations are sold as over-the-counter medications supplied with leaflets describing indications and appropriate dosages for patients of different ages. Medical practitioners prescribe herbal formulations that are tailored to the needs of particular patients. Both countries had problems with adverse drug reactions and toxicity of single herbs and herbal formulations that have been investigated by authorities, and some drugs have been removed from the market.


Assuntos
Fitoterapia/métodos , Preparações de Plantas/uso terapêutico , Plantas Medicinais/química , China , Medicamentos de Ervas Chinesas/administração & dosagem , Medicamentos de Ervas Chinesas/efeitos adversos , Medicamentos de Ervas Chinesas/uso terapêutico , Humanos , Japão , Medicina Tradicional Chinesa/efeitos adversos , Medicina Tradicional Chinesa/métodos , Medicina Kampo/efeitos adversos , Medicina Kampo/métodos , Fitoterapia/efeitos adversos , Preparações de Plantas/administração & dosagem , Preparações de Plantas/efeitos adversos
5.
Intern Med ; 55(6): 573-81, 2016.
Artigo em Inglês | MEDLINE | ID: mdl-26984071

RESUMO

OBJECTIVE: Mesenteric phlebosclerosis (MP) is a disease characterized by calcification of the mesenteric vein, which causes chronic mesenteric ischemia. Recently, the long-term intake of gardenia fruit ('Sanshishi' in Japanese) has been attracting attention as a possible cause. Usually, only advanced, severe MP cases get reported. However, we suspected that some latent cases of this disease may exist. We performed this study in order to determine the prediagnostic cases at our outpatient departments of herbal (Kampo) medicine, with particular attention paid to the initial changes, such as any slight color change of the colon, as shown in colonoscopy. METHODS: We recommend colonoscopy and computed tomography (CT) scans for patients with a long-term history of taking herbal medicines containing gardenia fruit. Clinical examinations were performed upon receiving patients' consent from December 2013 to November 2014. RESULTS: Of the 103 patients who took gardenia fruit long-term, 29 agreed to be checked for MP. 14 patients underwent colonoscopy. Four patients were confirmed to have MP due to the presence of fibrotic deposition of the colonic membrane on histological inspection. Twenty-one patients underwent abdominal CT screening. Characteristic calcification of the mesenteric vein was observed on CT scans in 2 patients. All 4 MP patients took Kampo formulas containing gardenia fruit for more than 6.8 years. The other patients did not develop MP, despite long-term gardenia fruit intake. CONCLUSION: We detected the latent and undiagnosed MP cases. All diagnoses were made while paying careful attention to any slight changes in colonoscopy and CT scans.


Assuntos
Arteriosclerose/patologia , Calcinose/patologia , Colo/patologia , Colonoscopia , Gardenia/toxicidade , Medicina Kampo/métodos , Veias Mesentéricas/patologia , Plantas Medicinais/efeitos adversos , Tomografia Computadorizada por Raios X , Adulto , Idoso , Arteriosclerose/induzido quimicamente , Calcinose/induzido quimicamente , Feminino , Humanos , Japão , Masculino , Medicina Kampo/efeitos adversos , Veias Mesentéricas/efeitos dos fármacos , Pessoa de Meia-Idade
6.
Rinsho Ketsueki ; 56(11): 2324-8, 2015 Nov.
Artigo em Japonês | MEDLINE | ID: mdl-26666719

RESUMO

A 56-year-old woman was referred to our department for detailed examination of anemia. She was diagnosed with pure red cell aplasia (PRCA) associated with severe reticulocytopenia based on blood testing and severe erythroblastopenia based on bone marrow aspiration. Blood tests revealed severe hypogammaglobulinemia, but monoclonal protein was not detected in either serum or urine by immunoelectrophoresis. Plasma cells were not increased in bone marrow aspirates or the biopsy specimen. Neither osteolytic lesions nor plasmacytoma was detected by computed tomography. We thus ruled out multiple myeloma. She had been treated with various Chinese herbal medicines prescribed at the referring hospital. We suspected PRCA induced by one of the Chinese herbal medicines and completely discontinued all of these herbal preparations. Hematologic testing revealed that the reticulocyte count and hemoglobin concentration began to recover on day 7 and the hemoglobin concentration and IgG levels had reached reference ranges on day 73 after discontinuation of the Chinese herbal medicines. We suspected Sanyaku (Dioscorea rhizome) or Bukuryou (Poria cocos) to have induced PRCA and hypogammaglobulinemia in this patient. To the best of our knowledge, this is the first report of PRCA and hypogammaglobulinemia induced by a Chinese herbal medicine. Clinicians must consider the possibility of drug-induced PRCA and hypogammaglobulinemia in patients taking Chinese herbal preparations.


Assuntos
Agamaglobulinemia/induzido quimicamente , Cocos/efeitos adversos , Dioscorea/efeitos adversos , Medicina Kampo/efeitos adversos , Poria/química , Aplasia Pura de Série Vermelha/induzido quimicamente , Rizoma/efeitos adversos , Biópsia , Feminino , Humanos , Pessoa de Meia-Idade , Aplasia Pura de Série Vermelha/patologia
7.
Biomed Res Int ; 2015: 797280, 2015.
Artigo em Inglês | MEDLINE | ID: mdl-26106615

RESUMO

It is well known that glucocorticoid receptor (GR) signaling regulates the hypothalamic-pituitary-adrenal (HPA) axis, and GR expression level is associated with HPA axis activity. Recent studies revealed that microRNA- (miR-) 18 and/or 124a are candidate negative regulators of GR in the brain. The Kampo medicine Yokukansan (YKS) can affect psychological symptoms such as depression and anxiety that are associated with stress responses. In this study, we evaluated the effect of YKS on miR-18 and 124a and GR levels in mice exposed to stress. We found that YKS pretreatment normalized elevated plasma corticosterone levels in stress-exposed mice. In addition, GR mRNA levels were downregulated in the brain following stress exposure. While miR-124a expression levels were not altered in the hypothalamus of stress-exposed mice, miR-18 levels decreased in the hypothalamus of YKS-pretreated mice after stress exposure. Finally, GR protein levels in the paraventricular nucleus (PVN) of the hypothalamus after stress exposure recovered in YKS-pretreated mice. Collectively, these data suggest that YKS normalizes GR protein levels by regulating miR-18 expression in the hypothalamus, thus normalizing HPA axis activity following stress exposure.


Assuntos
Medicamentos de Ervas Chinesas/administração & dosagem , Medicina Kampo/efeitos adversos , MicroRNAs/biossíntese , Estresse Psicológico/tratamento farmacológico , Animais , Corticosterona/sangue , Regulação da Expressão Gênica/efeitos dos fármacos , Glucocorticoides/metabolismo , Sistema Hipotálamo-Hipofisário/efeitos dos fármacos , Hipotálamo/efeitos dos fármacos , Hipotálamo/metabolismo , Camundongos , MicroRNAs/genética , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Sistema Hipófise-Suprarrenal/efeitos dos fármacos , Estresse Psicológico/fisiopatologia
8.
Gan To Kagaku Ryoho ; 42(13): 2414-7, 2015 Dec.
Artigo em Japonês | MEDLINE | ID: mdl-26809298

RESUMO

This study details the role of Kampo medicine in cancer therapy. Cancer normally cannot be cured only with Kampo medicine. Therefore, Kampo should be administered in combination with surgery, chemotherapy, or radiotherapy. In that context, Kampo is useful in team therapy for patients with cancer. One of the characteristics of Kampo medicine is that Kampo diagnosis does not target the disease, but the patient with the disease. Kampo diagnosis is called"pattern diagnosis". Many patients with cancer are diagnosed with a"deficiency pattern","cold pattern","qi deficiency pattern", or"blood deficiency pattern". Based on these diagnoses, hochuekkito or juzentaihoto are often used for patients with cancer. Many other Kampo formulae can be used for patients with cancer diagnosed with the"qi deficiency pattern"and/or"blood deficiency pattern". Kampo is not only considered an herbal therapy, but also acupuncture/moxibustion and Yojo (nourishing life). To implement these Kampo modalities comprehensively, team therapy is essential. In order to treat a patient with cancer, rather than the cancer itself, Kampo can be used effectively.


Assuntos
Medicina Kampo , Neoplasias/tratamento farmacológico , Terapia Combinada , Humanos , Medicina Kampo/efeitos adversos , Medicina Paliativa , Equipe de Assistência ao Paciente , Recidiva
9.
Drug Discov Ther ; 6(1): 1-8, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22460422

RESUMO

Gastrointestinal cancer is a great threat to human health in Japan. Conventional anticancer therapies including surgery, radiation, and chemotherapy are the main strategies and play important roles in curing this disease or extending the life of patients with these cancers. On the other hand, patients undergo great suffering induced by these treatments. Kampo, the Japanese traditional medicine, has been used in clinics to reduce side effects and to improve the quality of life of gastrointestinal cancer patients in Japan. In order to testify to the efficacy and safety of these Kampo medicines and to clarify the underlying mechanisms, a number of clinical and basic studies were implemented in the past several decades. These studies suggested the benefits of Kampo medicine as an adjuvant to conventional anti-cancer therapies in treating gastrointestinal cancer. Since the safety and efficacy as well as quality control of traditional medicine have long been focused worldwide, the development course of Kampo medicine may provide reference to other countries in the world.


Assuntos
Neoplasias Gastrointestinais/terapia , Medicina Kampo/métodos , Animais , Pesquisa Biomédica/métodos , Medicina Baseada em Evidências , Neoplasias Gastrointestinais/patologia , Humanos , Japão , Medicina Kampo/efeitos adversos , Medicina Kampo/normas , Controle de Qualidade , Qualidade de Vida
10.
Dermatol Online J ; 16(12): 13, 2010 Dec 15.
Artigo em Inglês | MEDLINE | ID: mdl-21199639

RESUMO

Herbal drugs are now widely used throughout the world. The general public tends to believe these agents to be safe because of their natural origin; thus, they are used frequently. However, the side effects of many of these potent chemicals may be significant. Several cases of fixed drug eruption (FDE) caused by herbal drugs have been reported. We herein report a case of FDE caused by kakkonto.


Assuntos
Erupção por Droga/etiologia , Medicamentos de Ervas Chinesas/efeitos adversos , Medicina Kampo/efeitos adversos , Paeonia/efeitos adversos , Fitoterapia/efeitos adversos , Adulto , Resfriado Comum/prevenção & controle , Medicamentos de Ervas Chinesas/administração & dosagem , Humanos , Masculino , Testes do Emplastro
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