An ankle sprain with long-term swelling and pain successfully treated with the traditional Japanese herbal medicine Jidabokuippo: A case report

Application of Traditional Japanese Drug Jidabokuippo in a Modern Society

Background: Jidabokuippo (JDI) (治打撲一方) has been used in Japan to alleviate contusion-induced swelling and pain since medieval times.

Method: This review investigated the effects of JDI on various symptoms in patients with trauma or static blood^[TM1]. The PubMed and Igaku Chuo Zasshi databases were searched until 24 December 2021. We summarize the benefits of applying JDI to inflammatory conditions, including bruises.

Results: JDI has been used to resolve blood ^[TM1] stasis, regulate qi in trauma patients, and treat inflammatory swelling and pain caused by rheumatoid arthritis and cellulitis. As the adverse event rate associated with JDI is low (1.3%), JDI is considered a safe drug.

Conclusion: JDI can be used to resolve blood^[TM1] stasis in trauma patients without adverse events associated with nonsteroidal anti-inflammatory drugs.

Antithrombin Effect of Jidabokuippo and Identification of Active Compounds

Static blood (Oketsu) is a blood disorder of Kampo medicine. Many natural medicines have been used to cure static blood, and these drugs are called blood stasis-resolving formula. Some of these were reported to inhibit blood coagulation. Jidabokuippo (JDI), one of the blood stasis-resolving formulas, has been used to treat bruises and sprains. In this study, we evaluated the antithrombin activity of JDI and its active compounds using thrombin and an artificial substrate. Bioassay-guided isolation was performed for JDI, and the active compounds were identified using spectral data (NMR spectroscopy and mass spectrometry) by comparison with reported data. JDI depressed thrombin activity in a dose-dependent manner, ranging from 0.125 to 1 mg/mL. Chrysophanol-1- O-β-D-glucoside (1) and chrysophanol-8- O-β-D-glucoside (2) were obtained from JDI and showed thrombin inhibitory activity. This study provided the first report of the antithrombin effect of JDI and the isolation from it of two active compounds (1 and 2). These findings might contribute to the understanding of the mechanism of static blood and blood stasis-resolving formula.