Use Of Kampo Medicine Research Articles

The Use of Japanese Traditional (Kampo) Medicines Before and During Pregnancy in Japan: The Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study.

Japanese traditional (Kampo) medicines are often used for pregnant women in Japan. However, no comprehensive studies have been conducted regarding the self-reported use of these medicines during pregnancy. This study investigated the use of Kampo medicines during pregnancy in Japan using the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study). Questionnaires were distributed to pregnant women participating in the TMM BirThree Cohort Study (July 2013 to March 2017) at approximately 12 weeks (early pregnancy) and 26 weeks (middle pregnancy). We analysed Kampo medicines use over three periods: (1) 12 months before pregnancy diagnosis, (2) the period between pregnancy diagnosis and around Week 12 of pregnancy and (3) from around Week 12 of pregnancy. In total, 19 220 women were included in the analysis. The proportions using prescribed Kampo medicines were 4.1% before pregnancy diagnosis, 4.5% from diagnosis to Week 12% and 4.5% after Week 12 of pregnancy. The most frequently prescribed Kampo medicines were tokishakuyakusan (1.0%) before pregnancy diagnosis, shoseiryuto (1.3%) from diagnosis to Week 12 and shoseiryuto (1.5%) Post-week 12. Sixty of the pregnant women used Kampo medicines containing crude drugs, which should be administered cautiously during pregnancy. The proportion of Kampo medicines use before and during pregnancy was 4%-5%. Some pregnant women used Kampo medicines containing crude drugs that should be administered cautiously during pregnancy. Further research is required to determine the safety of Kampo medicines during pregnancy.

Efficacy of Glycicumarin and Isoliquiritigenin in Suppressing Colonic Peristalsis in Both an Animal Model and a Clinical Trial.

Patients with diarrhea-predominant irritable bowel syndrome (IBS-D) show excessive peristalsis, and antispasmodic agents may be useful therapeutic agents. There are few reports on the use of Kampo medicines for the treatment of IBS-D. Shakuyakukanzoto (SKT) is a Kampo medicine that is effective against abdominal pain. We examined the relationship between SKT and intestinal peristalsis in an animal model and a prospective study. In the animal model, SKT and its components were administered from the serosal side of the colon and colonic peristalsis was evaluated using intraluminal pressure and spatiotemporal mapping before and after the administration of SKT and its components. In this clinical trial, we used abdominal ultrasonography (US) to obtain long-axis images of the sigmoid colon of 11 patients. The frequency of intestinal peristalsis was measured using US in five patients with SKT and six patients without medication after the ingestion of a test meal. The primary outcome was the frequency of peristalsis. The Clinical Trial Registry Website (Trial No. UMIN-CTR; UMIN000051547). In the animal model, peony did not suppress peristalsis frequency, but SKT (p = 0.005) and glycyrrhiza (p = 0.001) significantly suppressed peristalsis frequency compared with saline and peony. Among the glycyrrhiza components, glycycoumarin and isoliquiritigenin suppressed the peristalsis frequency compared to dimethyl sulfoxide (control) (p = 0.001, 0.01, respectively). In a clinical trial, peristalsis was significantly suppressed after oral administration in patients taking SKT (p = 0.03). Administration of SKT was found to inhibit colonic peristalsis, with glycicumarin and isoliquiritigenin being particularly relevant among its components.

Risk of Major Congenital Malformations Associated with the Use of Japanese Traditional (Kampo) Medicine Containing Ephedra During the First Trimester of Pregnancy.

Japanese traditional (Kampo) medicines containing ephedra may be used to treat colds during pregnancy. There are reports that ephedrine, a component of ephedra, has a risk of teratogenicity; however, the evidence remains equivocal. This study aimed to evaluate the risk of major congenital malformations (MCMs) associated with exposure to Kampo medicines containing ephedra during the first trimester of pregnancy using the Tohoku Medical Megabank Project Birth and Three-Generation Cohort Study (TMM BirThree Cohort Study). To 23,730 mother-infant pairs who participated in the TMM BirThree Cohort Study from July 2013 to March 2017, questionnaires in early and middle pregnancy were distributed approximately at weeks 12 and 26 of pregnancy, respectively. Infants' risk of MCMs in women who used Kampo medicines containing ephedra or acetaminophen during the first trimester was assessed, and the odds ratios (ORs) were estimated with unadjusted and adjusted analyses. Among 20,879 women, acetaminophen and Kampo medicines containing ephedra were used in 665 (3.19%) and 376 (1.80%) women, respectively, in the first trimester. Among the infants born to the mothers who used acetaminophen or Kampo medicine containing ephedra during the first trimester, 11 (1.65%) and 8 (2.13%), respectively, had overall MCMs. OR of overall MCMs was higher in women who used Kampo medicines containing ephedra than in those who used acetaminophen in the first trimester (adjusted OR, 1.45; 95% confidence interval (CIs), 0.57-3.71); however, the difference was not statistically significant. In this study, there was no statistically significant association between the use of Kampo medicines containing ephedra during the first trimester of pregnancy and the risk of MCMs. Although some point estimates of ORs exceeded 1.00, the absolute magnitude of any increased risks would be low.

Effects of ku‐oketsu and seinetsu Kampo medicines on rosacea‐like skin symptoms induced by steroid in mice

AbstractAimRosacea is a chronic inflammatory skin disease characterized by consistent erythema, papules, pustules, telangiectasias, and recurrent hot flashes, mainly on the cheeks, nose, and forehead. Many palliative treatment options are available for this condition; currently, no radical treatment option is available. However, improvement has been observed in some cases after the use of Kampo medicine. In this study, we aimed to analyze the effects of Jumi‐Haidokuto (JHT) and a mixture of Keishi‐Bukuryo‐gan‐ka‐Yokuinin (KBY) and JHT on steroid‐induced rosacea in mice.MethodsClobetasol propionate ointment was applied to the mice for 10 days and then the mice were provided food mixed with JHT and JHT + KBY for 28 days. Subsequently, the average velocity of capillary flow, area of the purpura, histopathologic features, and fecal metabolome were investigated.ResultsRecovery of the capillary flow velocity, reduction in the area of purpura, and restoration of the epidermal features were observed in JHT‐ and JHT + KBY‐fed mice. The improvement in circulatory disturbances observed after JHT and JHT + KBY administration might have contributed to the reduction in telangiectasias and erythema. Recovery of the skin barrier system by both Kampo medicine might be the key factor of ameliorating rosacea‐like symptoms.

Kampo Medicines Used in Psychiatry

Compared to psychotropic drugs, the clinical use of Kampo medicines (Japanese herbal medicines) is unclear because of the difficulty in accumulating scientific evidence for various reasons. This study reviews Kampo medicines frequently prescribed in psychiatry and the principles of disorders of qi, blood, and fluid for their use, which are considered particularly important in this field. Kampo medicines are one of the preferred treatment modalities for patients with mental disorders in Japan, and we hope that these will become a treatment option for patients refractory to psychotropic drugs.

The importance and requirement of evidence‐based medicine to expand the use of Kampo medicine

AbstractBackgroundCancer treatment is one of the major projects in the world due to the highest number of deaths. In recent years, chemotherapy, surgical treatment, radiation and immune checkpoint therapy have been used for the treatment of cancer patients. In association with these treatments, the number of cancer survivors has also increased. On the other hand, the number of patients suffering from side effects of cancer treatment is increasing, and the importance of cancer supportive care is being emphasized.Japanese Herbal MedicineJapanese herbal medicine, Kampo, has been developed since it was imported from China. Kampo medicine is effectively used in Japan to relieve several symptoms that Western medicine cannot address. However, evidence‐based medicine is essential for the expansion of the use of Kampo in the clinical field.Needs of Evidence‐Based Medical ResearchOwing to the development of liquid chromatography mass spectrometry (LC/MS) and a variety of molecular biology tools, we are now able to examine profiles of particular effective ingredients included in Kampo medicines. We now are investigating the effects of Kampo medicine on ameliorating adverse effects by searching and analyzing targets for Kampo medicine in cancer patients. In light of this point, properties of hangeshashinto and rikkunshito, two representatives of Kampo medicine, are shown based on their established scientific evidence.ConclusionIn the present study, we show the importance and requirement of evidence‐based medicine to expand the use of Kampo medicine.

Toward the sustainable use of Kampo medicines “1st International Symposium on Kampo Medicine”

Traditional & Kampo MedicineVolume 9, Issue 2 p. 128-129 LETTER TO THE EDITOR Toward the sustainable use of Kampo medicines “1st International Symposium on Kampo Medicine” Yohei Sasaki, Yohei Sasaki orcid.org/0000-0003-4743-4298 Division of Pharmaceutical Sciences, Kanazawa University, Kanazawa, Ishikawa, JapanSearch for more papers by this authorKatsuko Komatsu, Katsuko Komatsu Institute of Natural Medicine, University of Toyama, Toyama, JapanSearch for more papers by this authorShigeki Hayashi, Shigeki Hayashi Hokkaido Division, Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, Nayoro, Hokkaido, JapanSearch for more papers by this authorEiichi Kodaira, Eiichi Kodaira School of Pharmacy, Kitasato University, Tokyo, JapanSearch for more papers by this authorShengli Wei, Shengli Wei Beijing University of Chinese Medicine, Beijing, ChinaSearch for more papers by this authorNoriaki Kawano, Noriaki Kawano Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, Tsukuba, Ibaraki, JapanSearch for more papers by this authorKayo Yoshimatsu, Corresponding Author Kayo Yoshimatsu yoshimat@nibiohn.go.jp Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, Tsukuba, Ibaraki, Japan Correspondence Kayo Yoshimatsu, Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan. Email: yoshimat@nibiohn.go.jpSearch for more papers by this author Yohei Sasaki, Yohei Sasaki orcid.org/0000-0003-4743-4298 Division of Pharmaceutical Sciences, Kanazawa University, Kanazawa, Ishikawa, JapanSearch for more papers by this authorKatsuko Komatsu, Katsuko Komatsu Institute of Natural Medicine, University of Toyama, Toyama, JapanSearch for more papers by this authorShigeki Hayashi, Shigeki Hayashi Hokkaido Division, Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, Nayoro, Hokkaido, JapanSearch for more papers by this authorEiichi Kodaira, Eiichi Kodaira School of Pharmacy, Kitasato University, Tokyo, JapanSearch for more papers by this authorShengli Wei, Shengli Wei Beijing University of Chinese Medicine, Beijing, ChinaSearch for more papers by this authorNoriaki Kawano, Noriaki Kawano Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, Tsukuba, Ibaraki, JapanSearch for more papers by this authorKayo Yoshimatsu, Corresponding Author Kayo Yoshimatsu yoshimat@nibiohn.go.jp Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, Tsukuba, Ibaraki, Japan Correspondence Kayo Yoshimatsu, Research Center for Medicinal Plant Resources, National Institutes of Biomedical Innovation, Health and Nutrition, 1-2 Hachimandai, Tsukuba, Ibaraki 305-0843, Japan. Email: yoshimat@nibiohn.go.jpSearch for more papers by this author First published: 11 August 2022 https://doi.org/10.1002/tkm2.1328Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume9, Issue2August 2022Pages 128-129 RelatedInformation

Prescription of Kampo Formulations for Pre-natal and Post-partum Women in Japan: Data From an Administrative Health Database.

Introduction: Traditional Japanese (Kampo) medicines are often prescribed for women in Japan before, during, and after pregnancy. However, detailed information on the actual frequency of use and safety of Kampo preparations during pregnancy is lacking.Aim: To investigate the frequency of prescription of Kampo medicines for pregnant women in Japan.Methods: Information on Kampo medicines prescribed during outpatient care and hospitalization of selected mothers from January 2005 to August 2016 were extracted from the Japan Medical Data Center (Tokyo, Japan), which is a large claims database.Results: Of the 33,941 subscribers identified from the database, 16,294 (48%) received at least one prescription of a Kampo medicine. Kakkonto was the formula most prescribed during the study period, followed by shoseiryuto and tokishakuyakusan. In the 180 days before pregnancy, the most prescribed medicine was tokishakuyakusan, followed by kakkonto and shoseiryuto. Shoseiryuto, tokishakuyakusan, and kakkonnto were the formulae most prescribed during pregnancy. The most prescribed medicines during the 180 days postpartum were kakkonto, shoseiryuto, and saireito.Conclusions: Information in the Japanese insurance system shows that Kampo medicines are often prescribed during pregnancy. Most of these prescriptions are generally used for the treatment of common cold. Tokishakuyakusan in particular is usually used in the treatment of various symptoms of pregnancy. Further research is needed to clarify the relationship between the use of Kampo medicines during pregnancy and adverse events in infants in Japan.

Kampo Medicine Treatment for Advanced Pancreatic Cancer: A Case Series

Aims: The present report aims to investigate the use of Kampo medicine for advanced pancreatic cancer patients in order to prolong survival.Methods: We retrospectively reviewed medical records of patients with pancreatic cancer who presented to our Shimizu Clinic from 2000 to 2020. Patients who survived at least twice as long as the initial prognostic estimate were selected and their treatment was reviewed. The Kampo formula and crude drugs were selected according to the Kampo diagnosis and treatment strategy, which included qi and blood supplementation; qi, blood and water smoothing; and inflammation (termed “heat”) and cancer suppression.Results: Ten patients aged 45–80 years (six males and four females) with stage IV advanced cancer were selected. All patients received hozai, which is a tonic formula, of juzentaihoto (JTT) or hochuekkito (HET) decoction. Anti-cancer crude drugs were included in the decoctions of nine patients. At the first visit, the estimated life expectancy for all patients was no more than 1 year; however, treatment with Western and Kampo medicine led to a relatively long survival period of over 2 years. Three patients were still living at the time of this writing, more than 2, 6, and 14 years after treatment initiation.Conclusion: Our results suggest that Kampo medicine may be useful for disease control and supportive care for patients with advanced pancreatic cancer.

The Use of Kampo Medicine for Acne: An Approach According to Five Exacerbating Factors

Although the pathogenesis of acne has been elucidated, many patients do not notice improvement with standard treatments alone. Acne is a multifactorial disease, and although there are different aggravating factors such as diet, external stimuli, and stress that varies among individuals, the correct approach to tackling these factors has likely not been considered. Hence, we recommend using Kampo, a traditional Japanese medicine. Kampo examines a patient physically and mentally through unique concepts such as qi, blood, and fluid, and treats using Kampo medicines. With Kampo, both the illness and other aspects such as the general health and well being of the patient are examined and treated. We believe that if Kampo is employed in identifying and treating the aggravating factors of acne of each patient, both the overall therapeutic effect and patients’ motivation for treatment will be improved. This paper classifies the aggravating factors of acne into five categories, decreased barrier function of the skin, excessive secretion of sebum, exacerbation before menstruation, gastrointestinal symptoms, and stress, and introduces effective Kampo medicines in each case.

Kampo Medicine for Various Aging-Related Symptoms: A Review of Geriatric Syndrome.

With the continued growth of the aging population in Japan, geriatric syndrome (GS), which is associated with aging-related symptoms, has become a social problem. GS is caused by physiological and pathological aging and may manifest various symptoms. Physicians use multidisciplinary approaches to provide treatment for individual GS symptoms. Kampo medicine, a Japanese traditional medicine that uses multiple pharmacologically active substances, is useful for many syndromes, conditions, disorders, and diseases associated with GS. Evidence of the effectiveness of Kampo medicine for GS has accumulated in recent years. The effects of Kampo treatment for symptoms related to functional decline of the cardiovascular, respiratory, and digestive systems, cognitive impairment and related disorders, pain and other sensory issues, among others, support the use of Kampo medicine for the management of GS. The role of Kampo medicine for GS is summarized in this review.

Perspectives on the Use of Ninjin'yoeito in Modern Medicine: A Review of Randomized Controlled Trials.

Background Ninjin'yoeito (NYT), a traditional Japanese (Kampo) medicine that originates from China, has been used to treat qi and blood deficiency based on its original concept. Kampo medicine has been widely used to treat many conditions and disorders combined with western medicine or Kampo medicine alone in modern situation. Aims We reviewed randomized controlled trials (RCTs) of NYT and discussed various standpoints regarding its use in modern situation. Methods We searched PubMed, Cochrane Library, and Evidence Reports of Kampo Treatment (EKAT) for articles written in English, and Ichushi, J-Stage, and EKAT for those written in Japanese. Articles published before January 1, 2019, were retrieved using the keywords “ninjinyoeito” and “ninjin'yoeito,” and RCTs were selected from these extracted articles. Result Of 734 articles, 13 were RCTs, 46 were non-RCTs or studies of other designs, 15 were case reports, and 36 were experimental studies using NYT. NYT was evaluated for its use as a treatment for cancer and related conditions, refractory blood diseases and conditions, and otorhinolaryngologic symptom in 13 RCTs. Based on the use of Kampo medicine in modern situation called as Yasui's classification, 10 of 13 RCTs were categorized as “the side effects of Western medicinal treatment are mitigated when combined with Kampo treatment” and the remaining 3 were categorized as “treatment effect of Kampo medicine is increased in combination with standard Western medicinal treatment.” Conclusion. Several studies demonstrated the efficacy of NYT in refractory diseases and other conditions, and the accompanied side effects of treatment with western medicine.

Kampo medicine resolves a case of polypharmacy with improvement sustained for 10 years

ABSTRACTCaseAn 81‐year‐old man who had many symptoms, including body pain, was receiving 13 different drugs. We used kampo medicine to improve his symptoms and to reduce the number of drugs he received.OutcomeKeishikajutsubuto (KSTJB) was given to the patient, and gradually the number of drugs he received was reduced. All symptoms were improved with only two drugs, KSTJB and epinastine, and the patient's condition has been improved for more than 10 years.ConclusionBy introducing kampo medicine, we were able to reduce the patient's daily regimen from 13 to 2 medications. A pharmaceutical cost estimate indicated savings of approximately ¥1m over the past 10 years. Thus, use of kampo medicine can resolve polypharmacy and potentially reduce pharmaceutical costs.

A case of mesenteric phlebosclerosis induced by long-term use of Kampo medicine

A case of mesenteric phlebosclerosis induced by long-term use of Kampo medicine

Impact of the use of Kampo medicine in patients with esophageal cancer during chemotherapy:a clinical trial for oral hygiene and oral condition.

The aim of this study was to investigate the impact of the use of two Kampo medicines on oral mucositis, tongue coating bacteria, and gingiva condition in patients with esophageal cancer undergoing chemotherapy. Twenty-three esophageal cancer patients who receive chemotherapy at Tokushima University Hospital, were included. The participants, who received professional oral healthcare, were randomly divided into three groups:7 subjects received Daiokanzoto sherbets, 7 subjects received Hangeshashinto sherbets, and 9 subjects received nothing (control). The numbers of total bacteria and specific periodontopathogenic bacteria in tongue coating were determined in addition to clinical parameters. No difference on the onset of oral mucositis was found among the three groups. However, tongue coating index, gingival index (GI), plaque index, the number of total bacteria, Fusobacterium nucleatum and Campylobacter rectus were decreased during chemotherapy. More specifically, GI as well as the number of F. nucleatum and C. rectus were decreased significantly in the Daiokanzoto group when compared to the control group (psize 8 < 0.05). No such differences were observed for the group receiving Hangeshashinto. This clinical trial showed that Daiokanzoto might be effective in attenuating gingival inflammation and reducing the levels of periodontopathogenic bacteria in patients with esophageal cancer. J. Med. Invest. 65:184-190, August, 2018.

Interactions between crude drug extracts used in Japanese traditional Kampo medicines and organic anion-transporting polypeptide 2B1

Ethnopharmacological relevanceThe use of herbal medicines has become popular worldwide, and the information on drug interactions between herbal medicines and chemical drugs is needed. Aim of the studyWe screened the inhibitory effects of crude drugs used in Kampo medicines used in Japan on organic anion-transporting polypeptide (OATP) 2B1 to predict potential interactions between Kampo medicines and chemical drugs used together. Materials and methodsWe chose 98 kinds of crude drugs frequently used as ingredients of Kampo formulations in Japan and prepared their boiling water extracts. We then screened their inhibitory effects on OATP2B1 by measuring the uptake of estrone 3-sulphate (E3S) by HEK293 cells stably expressing OATP2B1. ResultsAt the concentration of 100µg/ml, the extracts prepared from 12 kinds of crude drugs, Scuteralliae Radix, Arecae Semen, Aurantii Fructus Immaturus, Perillae Herba, Panacis Japonici Rhizoma, Moutan Cortex, Polygalae Radix, Rhei Rhizoma, Cannabis Fructus, Chrysanthemi Flos, Eriobotryae Folium, and Querci Cortex, suppressed the function of OATP2B1 by less than 20%. The extract of bofutsushosan, a representative Kampo formulation, inhibited OATP2B1 function with sufficient levels to suppress absorption of OATP2B1 substrates in clinics. We further evaluated the inhibitory effects of several ingredients containing Rhei Rhizoma, Perillae Herba, and Moutan Cortex on OATP2B1. ConclusionsBecause of crude drugs used in Kampo medicines might suppress absorption of OATP2B1 substrates, these results may contribute to the safe and effective use of Kampo medicine in clinics.A list of abbreviations: EC, (−)-epicatechin; ECG, epicatechin gallate; EGC, epigallocatechin; EGCG, Epigallocatechin gallate; FBS, fetal bovine serum; grapefruit juice; HEK293, Human embryonic kidney; IC50, The half inhibitory concentration; OATP, organic anion-transporting polypeptide; β-PGG, penta-O-galloyl-β-D-glucose; t.i.d, 3 times a day

Education Program of Kampo-medicine for Undergraduates in Preparation for Clinical Setting

Kampo-medicine has become popular in Japanese medical practice combined with western medicine. For example, Daikenchu-To for intestinal obstruction after surgical operation, Shakuyakukanzo-To and Goshajinki-Gan for anti-cancer agents-induced neuropathy, and Yokkan-San for behavioral psychological symptoms of dementia are alternatively used in addition to conventional treatments in Japan. However, combined use of Kampo-medicine and western medicine may cause unexpected adverse events including undesirable drug-drug interactions because Kampo-medicine was not originally developed to be used with western medicine. Although adverse effects of Kampo-medicine are rare compared with those of western medicine, severe events such as liver dysfunction and interstitial pneumonia have been reported in increasing trends. Medical staff including pharmacists, therefore, should be aware of the onset of adverse events before the patients' symptoms become severe. Several adverse effects are caused by chemical constituents such as glycyrrhizin in licorice for pseudoaldosteronism and geniposide in Gardeniae fructus for mesenteric phlebosclerosis. To understand the adverse effects of Kampo-medicine, pharmacists should learn trends in current medication as well as pharmacology and toxicology of the chemical constituents in pharmacognosy. These issues should also be addressed in educational materials for students of clinical pharmacy and pharmacy practice.

Use of Kampo Medicine in University Hospital

Purpose:Massage therapy has been shown to be efficacious in the postoperative setting and is routinely offered in our institution. The purpose of this study was to explore whether massage therapy combined with meditation would be more effective than massage therapy alone in women recovering from autologous tissue reconstruction after mastectomy for breast cancer. Methods: Forty women who had undergone mastectomies for breast cancer and were scheduled to undergo reconstruction using autologous tissue were randomized to either massage therapy for 20minutes on postoperative days 13 (Group1) or massage therapy (20minutes) combined with meditation (an additional 15minutes) on postoperative days 1-3 (Group 2). Type of meditation used included paced breathing with a DVD for 15minutes prior to massage and positive imagery during massage. Outcome measures: Visual Analog Scales for stress, anxiety, relaxation, insomnia, alertness, fatigue, tension, pain, mood, and energy level (scores 0-10) prior to and after intervention on postoperative days 1-3 and at 3 weeks follow-up. Results: Of 40 accrued patients, 19 in each group finished the study. The mean age for all patients was 47.7+8.4 years with a range from 30 to 63. Preintervention and postinterventionmean total VAS scores assessed during days 1-3 improved significantly in both groups (p<0.001). However there was no significant difference in improvement between the 2 groups at day 1-3 post op and at 3 weeks follow-up. Satisfaction with the intervention measured on postoperative day 3 was high (very satisfied + satisfied 84% Group1; 89% in Group2) but not significantly different between the 2 groups (p= 0.63). Conclusion: In this pilot study the addition of meditation to already available massage therapy for the postoperative care of breast cancer patients undergoing autologous tissue reconstruction after mastectomy did not appear to add any measurable benefit. Contact: Dietlind Wahner-Roedler, wahnerroedler. dietlind@mayo.edu

"Ninjinto" (Ginseng Decoction), a Traditional Japanese Herbal Medicine, Improves Gastrointestinal Symptoms and Immune Competence in Patients with Chronic Intestinal Failure.

Background. Treating functional gastrointestinal disorders is extremely difficult. We herein report the effect of the oral administration of Ninjinto (NJT, ginseng decoction), a traditional Japanese Kampo medicine, on chronic intestinal failure. Patients and Methods. Seven patients with chronic intestinal failure treated with NJT were evaluated in this study. The primary diseases included chronic intestinal pseudoobstruction (CIPO: n = 4), short bowel syndrome (SBS: n = 2), and intestinal atresia (n = 1). All patients orally received NJT extract granules at a dose of 0.3 g/kg BW per day. The treatment outcomes were then assessed according to the patients' symptoms and consecutive abdominal X-ray findings. Results. The targeted symptoms were abdominal distension in four patients, diarrhea in three patients, and frequent hospitalization due to infections in two patients. An improvement in the symptoms was observed in six of the seven patients, whereas one patient with SBS did not show any improvement. An improvement in an abdominal roentgenogram was observed in the four patients with remarkably dilated bowel loops due to CIPO. Conclusions. NJT may be effective in controlling functional gastrointestinal disorders associated with chronic intestinal failure. The use of Kampo medicine in the field of pediatric surgery may help to improve the quality of life in children suffering from such conditions.

A New Strategy Using Rikkunshito to Treat Anorexia and Gastrointestinal Dysfunction.

Because the clinical condition of gastrointestinal dysfunction, including functional dyspepsia, involves tangled combinations of pathologies, there are some cases of insufficient curative efficacy. Thus, traditional herbal medicines (Kampo medicines) uniquely developed in Japan are thought to contribute to medical treatment for upper gastrointestinal symptoms. Rikkunshito is a Kampo medicine often used to treat dyspeptic symptoms. Over the past few years, several studies have investigated the efficacy of rikkunshito for dysmotility, for example, upper abdominal complaints, in animals and humans. Rikkunshito ameliorated the decrease in gastric motility and anorexia in cisplatin-treated rats, stress-loaded mice, and selective serotonin reuptake inhibitor-treated rats by enhancing plasma ghrelin levels via serotonin2B/2C receptor antagonism. In addition, rikkunshito ameliorated the decrease in food intake in aged mice and stress-loaded decreased gastric motility via enhanced ghrelin receptor signaling. Several clinical studies revealed that rikkunshito was effective in ameliorating upper gastrointestinal symptoms, including dyspepsia, epigastric pain, and postprandial fullness. In this review, we discuss these studies and propose additional evidence-based research that may promote the clinical use of Kampo medicines, particularly rikkunshito, for treating anorexia and gastrointestinal dysfunction.