Kampo Formula Research Articles

Kampo Formula Prescribed Frequently from the Historically

Kampo Formula Prescribed Frequently from the Historically

UP-1.198: Efficacy of Sansoninto, A Kampo Formula, for Nocturia Refractory to Previous Treatments Modalities in Elderly Patients

UP-1.198: Efficacy of Sansoninto, A Kampo Formula, for Nocturia Refractory to Previous Treatments Modalities in Elderly Patients

Unkeito, a traditional Kampo formula, exhibits a selective estrogen receptor modulator-like activity - prevention of osteoporosis in ovariectomized mice.

Unkeito, a traditional Kampo formula, exhibits a selective estrogen receptor modulator-like activity - prevention of osteoporosis in ovariectomized mice.

Complete Recovery from Tension-Type Headache Through Kampo Medicine

We administered Kampo medicine for tension-type headache with extremely effective results. The objective is to demonstrate the effect of Kampo medicine. The case was 13 year-old-girl who had been suffering from headaches from the age of 11 years. As general and neurologic examinations (blood tests, urine analysis, head computed tomography, and electroencephalography) showed no abnormal findings, we diagnosed her as suffering from tension-type headache. Accompanying signs and symptoms included fatigue, shoulder stiffness, and a lot of stress in a private supplementary school and from ballet lessons. Kampo medicine was chosen to address the necessity for a comprehensive treatment. We prescribed saikokaryukotsuboreito, with clear positive effect. Although headaches re-appeared when she later forgot to take the formula, the symptom disappeared by taking it again. Treatment was discontinued after 11 months, and the headache has not recurred for 3 years. Kampo medicine was able to improve her overall symptom pattern, as Kampo formulas are selected not only by paying attention to the primary symptom (in this case headache) but also by checking the other characteristics (additional symptoms, constitution, etc). This case showed that Kampo treatment is an effective therapeutic option for tension-type headaches accompanied by various other symptoms.

Simple and Rapid Determination of Cypermethrin and Fenvalerate Residues in Kampo Products by Gas Chromatography-Mass Spectrometry with Negative Chemical Ionization

In Japan, crude drugs that are used as ingredients of kampo formulae are mainly imported from China. In China, cypermethrin and fenvalerate, which are pyrethroid pesticides, are detected frequently in food exported to Japan. In fact, cypermethrin and fenvalerate have been detected in crude drugs distributed in Japan. There is concern that cypermethrin and fenvalerate will move from crude drugs to kampo products. Cypermethrin and fenvalerate in kampo products are controlled by a self-imposed residual pesticide limit set by the Japan Kampo Medicine Manufacturers Association. Several methods to analyze cypermethrin and fenvalerate in kampo products have been reported, but they are time-consuming, require expensive column clean-up, and use large amounts of organic solvents. In this study, a simple, rapid, and inexpensive sample preparation method was developed to determine cypermethrin and fenvalerate levels in kampo products by gas chromatography (GC)-mass spectrometry (MS) with negative chemical ionization (NCI). Twenty-two samples of kampo products were analyzed according to the proposed method. No samples were contaminated by cypermethrin and fenvalerate levels greater than the detection limit.

Kampo-medicine Affects Influenza-Specific Interferon (IFN)-.GAMMA. Production by Human Peripherala blood Mononuclear Cells

Aim: Kampo, Sino Japanese traditional medicine has been employed for the treatment of upper respiratory infections, including influenza-like symptoms, for more than 2000 years. Interestingly, recent clinical studies have revealed the possible effectiveness of Kampo medicines to improve influenza-like symptoms. However, the mechanisms by which Kampo-medicine affects acquired immune systems against influenza infection have not been well understood. In the present study, we examined the ex vivo immune response of peripheral blood mononuclear cells (PBMCs) from healthy subjects against influenza antigens using ELISPOT assay, as well as viral replications. Materials and methods: Peripheral blood samples were obtained from 6 healthy voluneers after obtaining informed consents. PBMCs were stimulated with influenza-HA antigen for 48 hours in the presence or absence of Kakkon-to, Mao-to, Syoseiryu-to, and Keishi-toin. IFN-γ production was evaluated by ELISPOT assay. Viability of PBMCs was determined by measuring formazan formation. Viral replication was estimated with hemmaglutination assay with influenza-sensitive MDCK cells. Results: Influenza-HA antigen-specific IFN-γ production was down-regulated by treatment with Kakkon-to, Mao-to, Syoseiryu-to, and Keishi-to. Treatment with Syoseiryu-to alone inhibited cell viability. PBMCs viability was reduced by influenza-HA antigen stimulation in the presence of Kampo-medicine. The four Kampo formulae employed in the present study showed no remarkable effects on influenza virus replication in MDCK cells. Conclusion: Four Kampo-medicines that are frequently employed to treat upper respiratory infections have minimal or adverse effects on influenza-specific immune responses and viral replications. The therapeutic effects of Kampo-medicines might be with a consequence of their anti-inflammatory effects.

Clinical efficacy of Kampo medicine (Japanese traditional herbal medicine) in the treatment of primary dysmenorrhea

We intended to evaluate the clinical efficacy of Kampo medicine, a Japanese traditional herbal medicine, for primary dysmenorrhea which was prescribed according to the Kampo diagnosis, with classification of its severity. A retrospective evaluation of Kampo treatment in 176 subjects with dysmenorrhea during the previous 12 years was performed. In order to minimize the subjective discretion of the severity of symptoms, classification of the severity level of abdominal pain during menstruation was applied by considering the requirement for non-steroidal anti-inflammatory drugs (NSAIDs) and disturbance of daily activities. The following severity levels were used: no abdominal pain (level 0), abdominal pain with no requirement of NSAIDs (level 1), abdominal pain with no daily activity disturbances with use of NSAIDs (level 2), and painful menstruation which required absenteeism even with use of NSAIDs (level 3). Severity levels before and after Kampo treatment were defined in 108 subjects. Distribution of the severity levels in 108 subjects was significantly changed by Kampo treatment; the numbers of cases in levels 0, 1, 2, and 3 changed from 0 (0%), 0 (0%), 47 (43.5%), and 61 (56.5%) to 5 (4.6%), 42 (38.9%), 51 (47.2%), and 10 (9.3%), respectively. (P<0.0001) There were 25 kinds of Kampo formulae prescribed in effective cases. Kampo medicine prescribed according to Kampo diagnosis reduced the severity of primary dysmenorrhea and is therefore suggested to be beneficial in improving quality of life.

Message from the chief editor

It is my great honor to announce to the members of the Japan Society of Pharmacognosy and to the readers of this journal that I have been nominated as Chief Editor of the Journal of Natural Medicines to succeed Dr. Tadahiro Takeda from April 2008. I, along with the new editorial board and the staff members of the editorial office of the journal in the Center for Academic Publications Japan and in Springer Japan, will make every effort to improve the quality of the journal. For this purpose, we would like to ask you to contribute your excellent papers dealing with naturally occurring medicines and related foods and cosmetics, including identification and structure elucidation of natural products, biosynthesis, biotechnology, and the clinical application of herbs, natural products, and Kampo formulas to both humans and animals. The Journal of Natural Medicines has been indexed by Chemical Abstracts. In addition, the Institute for Scientific Information (ISI/Thomson Scientific) has recently started including our journal in the Science Citation Index Expanded and the Journal of Citation Reports/Science Edition. Therefore, it is expected that the Impact Factor of the Journal of Natural Medicines calculated by ISI will be published from June 2009. Of the papers published in each volume of the Journal of Natural Medicines, approximately three will be chosen by members of the Selection Committee for honors as Excellent Papers. From volume 60 (2006), two papers concerning an opioid agonistic alkaloid [1] and the pharmacology of a Kampo formula [2] were given awards. Selection of Excellent Papers from volume 61 is currently in progress, and the results will be announced soon. We are looking forward to receiving your very best research articles. In closing, the editors and I would again like to thank our authors, reviewers, and readers for their interest, suggestions, and support. Please be assured that we always welcome your comments and suggestions for improving the quality of the Journal of Natural Medicines.

Evidence-Based Efficacy of Kampo Formulas in a Model of Non Alcoholic Fatty Liver

Data on the efficacy of herbal compounds are often burdened by the lack of appropriate controls or a limited statistical power. Treatments to prevent the progression of non alcoholic fatty liver disease (NAFLD) to steatohepatitis (NASH) remain unsatisfactory. A total of 56 rabbits were arrayed into 7 groups fed with standard rabbit chow (SRC), SRC with 1% cholesterol, or each of the five experimental treatments (Kampo formulas 1% keishibukuryogan [KBG], 1% orengedokuto [OGT], and 1% shosaikoto [SST]; vitamin E [VE]; or pioglitazone [PG]) in a 1% cholesterol SRC. We analyzed changes after 12 weeks in plasma and liver lipid profiles, glucose metabolism, adipocytokines, oxidative stress, and liver fibrosis. Data demonstrated that all five treatments were associated with significant amelioration of lipid profiles, oxidative stress, and liver fibrosis compared to no supplementation. KBG was superior to VE and PG in the reduction of liver total cholesterol (P < 0.01) and lipid peroxidase levels (P < 0.05), urinary 8-hydroxy-2'-deoxyguanosine (P < 0.05), hepatic alpha-smooth muscle actin positive areas (P < 0.01) and activated stellate cells (P < 0.01). In conclusion, there was a statistically significant benefit of Kampo formulas (KBG in particular) on a dietary model of NAFLD/NASH. Future studies need to be directed at the mechanisms in the treatment of NASH.

Effect of Keishibukuryogan on Silent Brain Infarction over 3 Years

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.

Keishibukuryogan (Gui-Zhi-Fu-Ling-Wan), a Kampo formula decreases the disease activity and the level of serum thymus and activation-regulated chemokine (TARC) in patients with atopic dermatitis

Keishibukuryogan (Gui-Zhi-Fu-Ling-Wan), a Kampo formula decreases the disease activity and the level of serum thymus and activation-regulated chemokine (TARC) in patients with atopic dermatitis

Scutellariae Radix enhances but Scutellariae Radix-containing Kampo formulas, Orengedokuto and San'oshashinto, prevent intestinal bleeding associated with indomethacin-induced enteropathy in mice

Scutellariae Radix enhances but Scutellariae Radix-containing Kampo formulas, Orengedokuto and San'oshashinto, prevent intestinal bleeding associated with indomethacin-induced enteropathy in mice

E.04.03 The impact of publicly-funded vs. industry-funded AD trials on clinical practice

In our previous study, the daily administration of chotosan (CTS), a Kampo formula consisting of Uncaria and other 10 different crude drugs, ameliorated cognitive deficits in several animal models of dementia including type 2 diabetic db/db mice in a similar manner to tacrine, an acetylcholinesterase inhibitor. The present study investigated the metabonomics of CTS in db/db mice, a type 2 diabetes model, and m/m mice, a non-diabetes control strain, to identify the exogenous and endogenous chemicals susceptible to the administration of CTS using high performance liquid chromatography equipped with an orbitrap hybrid Fourier transform mass spectrometer. The results obtained revealed that the systemic administration of CTS for 20 days led to the distribution of Uncalia plant-derived alkaloids such as rhynchophylline, hirsuteine, and corynoxeine in the plasma and brains of db/db and m/m mice and induced alterations in four major metabolic pathways; i.e., (1) purine, (2) tryptophan, (3) cysteine and methionine, (4) glycerophospholipids in db/db mice. Moreover, glycerophosphocholine (GPC) levels in the plasma and brain were significantly higher in CTS-treated db/db mice than in vehicle-treated control animals. The results of the in vitro experiment using organotypic hippocampal slice cultures demonstrated that GPC (10–30 μM), as well as tacrine, protected hippocampal cells from N-methyl-d-aspartate-induced excitotoxicity in a manner that was reversible with the muscarinic receptor antagonist scopolamine, whereas GPC had no effect on the activity of acetylcholinesterase in vitro. Our results demonstrated that some CTS constituents with neuropharmacological activity were distributed in the plasma and brain tissue following the systemic administration of CTS and may subsequently have affected some metabolic pathways including glycerophospholipid metabolism and cognitive function in db/db mice. Moreover, the present metabonomic analysis suggested that GPC is a putative endogenous chemical that may be involved in the tacrine-like actions of CTS in the present diabetic animal model.

The efficacy of the Kampo (Japanese herbal medicine) formulas on the cardiac autonomic balance

Kampo medicine is a Japanese herbal medicine and is widely used as a treatment for various diseases. However, the mechanisms of action of the individual Kampo formulas have not been well elucidated. It is suggested that Kampo formulas relieve the symptoms of various diseases by modulating the autonomic balance. The aim of this study is to verify this hypothesis by focusing on the cardiac autonomic balance.

Low level of quality of life in patients with mental and behavioral disorders wanting complementary and alternative (kampo) therapy

To compare the quality of life (QOL) in patients with and without mental and behavioral disorders wanting to receive kampo, a type of complementary and alternative medicine (CAM), we investigated the QOL of patients using the World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). Seven hundred and twenty-nine outpatients with various diseases or disorders wanting to receive kampo therapy were recruited in the study. Two hundred and ninety-four patients (F-group) had mental or behavioral disorders. For these 729 patients, QOL was rated on the WHOQOL-BREF Japanese version. The average WHOQOL-BREF score of F-group (2.93 +/- .54) was significantly lower than that of controls (3.23 +/- .53). Especially, the average WHOQOL-BREF score of the 135 patients who had already been treated with modern medicines and wanted to be treated with kampo formulas to augment modern medicines (2.77 +/- .55) was significantly lower than that of other patients. QOL in patients with mental and behavioral disorders wanting to be treated with kampo who had already been treated with modern medicines was lower than that in patients with general medical conditions or with mental or behavioral disorders not treated with modern medicine.

和漢診療科病棟の入院患者に対する医薬品情報の提供と服薬指導を目的とした漢方薬データベースの作成とその評価

To improve the drug information service and standardize pharmaceutical care for inpatients of the Department of Japanese Oriental Medicine, Toyama University Hospital, we created a Kampo (Oriental) medicine database and used it in the preparation of medication instruction sheets. The database was configured on a Power Mac G4 (Apple Computer, Inc. ; Cupertino, CA, USA) personal computer operating on Mac OS 10.4 using FileMaker Pro 6 database software. The database comprised 5 interlinked files-patient registration file, constituent crude drug registration file, Kampo formula registration file, and a file for the making and storing of instruction sheets. Information on 239 crude drugs and 560 Kampo formulae obtained from our “Hospital Manual for Japanese Oriental Medicine” was recorded in the database. Further, color photographs of the plants from which the herbal medicines were derived and other natural medicines were included in the instruction sheets to give patients a better understanding of Kampo pharmacotherapy. The database has made it easy to prepare personalized instruction sheets, which can be done by only entering the patient's ID and the Kampo formulae prescribed or crude drug name. In addition, the medication instructions for each inpatient and the indication(s) of prescribed Kampo formulae have been recorded in the database for later use in the management of inpatient histories and to provide utilization statistics for Kampo medicines.When a questionnaire survey of inpatients of the Department of Japanese Oriental Medicine was carried out to evaluate the usefulness of the medication instruction sheets prepared using the database, it was found that they gave patients a better understanding of Kampo pharmacotherapy and made them more interested in it. In conclusion, our database system will help improve the drug information service and quality of pharmaceutical care for inpatients treated with Kampo formulae prepared from crude drugs.

Chotosan, a Kampo Formula, Ameliorates Chronic Cerebral Hypoperfusion-Induced Deficits in Object Recognition Behaviors and Central Cholinergic Systems in Mice

We previously demonstrated that the Kampo formula chotosan (CTS) ameliorated spatial cognitive impairment via central cholinergic systems in a chronic cerebral hypoperfusion (P2VO) mouse model. In this study, the object discrimination tasks were used to determine if the ameliorative effects of CTS on P2VO-induced cognitive deficits are a characteristic pharmacological profile of this formula, with the aim of clarifying the mechanisms by which CTS enhances central cholinergic function in P2VO mice. The cholinesterase inhibitor tacrine (THA) and Kampo formula saikokeishito (SKT) were used as controls. P2VO impaired object discrimination performance in the object recognition, location, and context tests. Daily administration of CTS (750 mg/kg, p.o.) and THA (2.5 mg/kg, i.p.) improved the object discrimination deficits, whereas SKT (750 mg/kg, p.o.) did not. In ex vivo assays, tacrine but not CTS or SKT inhibited cortical cholinesterase activity. P2VO reduced the mRNA expression of m3 and m5 muscarinic receptors and choline acetyltransferase but not that of other muscarinic receptor subtypes in the cerebral cortex. Daily administration of CTS and THA but not SKT reversed these expression changes. These results suggest that CTS and THA improve P2VO-induced cognitive impairment by normalizing the deficit of central cholinergic systems and that the beneficial effect on P2VO-induced cognitive deficits is a distinctive pharmacological characteristic of CTS.

Effects of Keishibukuryogan on Vascular Function in Adjuvant-Induced Arthritis Rats

It is known that rheumatoid arthritis (RA) accelerates atherosclerosis. Further, the soluble form of vascular adhesion molecule-1 (VCAM-1) is known as a predictive marker of atherosclerosis in RA patients. We reported that keishibukuryogan, one of the Kampo formulas, improved articular symptoms and decreased soluble VCAM-1 in patients with RA. In adjuvant-induced arthritis (AIA) rats, an animal model of RA, it is known that endothelial function is injured by inflammation. So, we investigated the effect of keishibukuryogan on endothelial function in AIA rats. Lewis rats were divided into control, AIA control, and AIA with keishibukuryogan groups. The AIA with keishibukuryogan group was fed 3% keishibukuryogan contained in normal chow. On day 25 after injection of Mycobacterium butyricum, endothelium-dependent relaxation by acetylcholine in the AIA control group was suppressed, but it was improved in the AIA with keishibukuryogan group. The contractions by xanthine/xanthine oxidase in both AIA rats increased, but that in keishibukuryogan decreased compared to the AIA control group. Plasma levels of lipid peroxide increased in the AIA control group, but keishibukuryogan decreased these levels. Plasma levels of nitric oxide (NO) increased in both AIA groups. The expressions of endothelial NO synthase, inducible NO synthase and VCAM-1 of thoracic aorta were investigated by western blotting. These expressions increased in the AIA control group, but were restricted in the AIA with keishibukuryogan group. We considered that keishibukuryogan protected the endothelial function of AIA rats mainly by its anti-oxidative effect.

Quality of Life in Patients Treated with Kampo Medicine: A Complementary Alternative to Modern Medicine

Kampo (Japanese traditional herbal medicine) is widely used as a complementary medicine for improving the quality of life (QOL) of patients in Japan. We investigated the efficacy of kampo therapy in improving QOL of patients with various diseases and disorders, using the World Health Organization Quality of Life Brief Scale (WHOQOL-BREF). One hundred and sixty-seven outpatients with various diseases or disorders wishing to receive kampo therapy and who had already been treated with modern medicines were recruited into the study. Patients were offered kampo formulas and modern medicines for 3 months. Scores of WHOQOL-BREF and Clinical Global Impression (CGI) Global Improvement scale, and adverse events. Eleven patients were "very much improved," 46 were "much improved," 59 were "minimally improved," 42 showed "no change," 7 were "minimally worse," and one was "much worse" in the CGI Global Improvement scale. The mean WHOQOL-BREF score improved significantly from 3.05 +/- 0.54 at baseline to 3.14 +/- 0.53 after 3 months (p = 0.002). Patients presenting with various diseases and disorders were successfully treated with kampo therapy. Our results suggest that kampo therapy as a complementary medicine may improve the QOL of patients with various diseases and disorders.

The efficacy of goshuyuto, a typical Kampo (Japanese herbal medicine) formula, in preventing episodes of headache

ABSTRACTObjective: The purpose of this clinical trial was to assess the efficacy of goshuyuto, a typical Kampo formula, in preventing episodes of headache in chronic headache patients.Research design and methods: Because the treatment target of a Kampo formula is decided on a basis different to that of Western medicine, we first selected patients belonging to a subgroup that responded to goshuyuto before conducting the usual randomized controlled trial. During stage 1, the subjects were instructed to orally consume goshuyuto for 4 weeks. Only those subjects judged as responders advanced to stage 2, during which a double-blind, randomized, placebo-controlled study was conducted. The subjects consumed the same dose of goshuyuto or placebo for 12 weeks.Results: Of the 91 subjects enrolled in stage 1, 60 were judged as responders. Of these, 53 advanced to stage 2; 28 were assigned to the goshuyuto group and 25 to the placebo group. The decrease in the number of days on which headache episodes occurred was greater in the goshuyuto group than in the placebo group (2.6 ± 3.7 vs. 0.3 ± 4.0 days, p = 0.034); no difference was observed with regard to the reduction in the frequency of consuming reliever medications (2.2 ± 4.0 vs. 1.4 ± 8.2, p = 0.672). Improvement in the associated symptoms was observed in more than 50% of the subjects in the goshuyuto group.Conclusion: Goshuyuto is useful in preventing episodes of headache in chronic headache patients. Responder-limited design is a candidate for evaluating Kampo medicine.