Abstract
Frailty is defined as a state of increased vulnerability to poor resolution of homeostasis following stress, which increases the risk of adverse outcomes such as falls, delirium, and disability in the elderly. Recently in Japan, clinical practice guidelines (CPG) have recommended kampo treatment. We conducted a search for reports on Japanese CPG and kampo medicine in the treatment of symptoms in the elderly. The search was performed using the databases PubMed, Ichushi Web, J-Stage, Japan Medical Publishers Association, Medical Information Network Distribution Service, and CPG containing kampo products in Japan; reports from January 1st, 2012 to October 31st, 2017 were reviewed. Over the past 5 years, nine CPGs have recommended kampo treatment based on the evidence for improvement in skin symptoms, cough, gastro-intestinal dysfunction, urinary dysfunction, and dementia. Treatments with kampo medicine are performed depending on the coexistence of manifestations based on the original kampo concept, i.e., cognitive dysfunction and dementia with sarcopenia showing urinary disorder. Each kampo formula includes multiple crude drugs that have several pharmacological functions; these drugs include alkaloids, glycosides, and polysaccharides. Thus, kampo formula has an effect on multiple organs and coordinates the relationship between the brain, endocrine system, immune system, and skeletal muscles. Kampo treatment can be considered as supporting holistic medicine in elderly individuals with frailty.
Highlights
Frailty is defined as a state of increased vulnerability to poor resolution of homeostasis following stress, which increases the risk of adverse outcomes such as falls, delirium, and disability in the elderly [1,2,3]
Evidence based on clinical studies has grown in the past two decades; and recently, in Japan, clinical practice guidelines (CPG) for symptoms in the elderly gave some recommendations for use of kampo medicine
Over the past 5 years, the following eligible nine CPGs have given some recommendations for kampo treatment based on the evidence for skin symptoms, allergy, cough, gastro-intestinal dysfunction, urinary dysfunction, and dementia: Clinical Practice Guideline for the Pruritus cutaneus universalis [8], Practical Guideline for the Management of Allergic Rhinitis in Japan [9], The Japanese Respiratory Society guidelines for management of cough [10], Evidence-based Clinical Practice Guidelines for Gastro Esophageal Reflux Disease (GERD) [11], Evidence-based Clinical Practice Guidelines for Functional Dyspepsia [12], Evidence-based Clinical Practice Guidelines for Irritable Bowel Syndrome [13], Evidence-based clinical practice guidelines for chronic constipation [14], Clinical guidelines for overactive bladder syndrome [15], and Practice Guideline for Dementia [16]
Summary
Frailty is defined as a state of increased vulnerability to poor resolution of homeostasis following stress, which increases the risk of adverse outcomes such as falls, delirium, and disability in the elderly [1,2,3]. Frailty involves disorders in multiple inter-related physiological systems, including the brain, the endocrine system, the immune system, and the skeletal muscle, resulting in weight loss, exhaustion, low energy expenditure, slow gait. Traditional Japanese medicine (kampo) has been applied for the treatment of comorbid symptoms or disorder for the past 1500 years. Kampo medicine has an effect on multiple organs and coordinates the relationship between the brain, endocrine system, immune system, skeletal muscles, and the patients’ emotional condition. We believe that concomitant use with western medicine and kampo medicine can contribute to management of patients with frailty. Evidence based on clinical studies has grown in the past two decades; and recently, in Japan, clinical practice guidelines (CPG) for symptoms in the elderly gave some recommendations for use of kampo medicine
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