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Matsumoto H, Matsumoto A, Miyata S, Tomogane Y, Minami H, Masuda A, Yamaura I, Yoshida Y, Hirata Y. The Effect of Japanese Herbal Medicines (Kampo) Goreisan and Saireito on the Prevention of Recurrent Chronic Subdural Hematoma: A Prospective Randomized Study. Neurosurgery 2024; 94:80-89. [PMID: 37638721 DOI: 10.1227/neu.0000000000002649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 06/22/2023] [Indexed: 08/29/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Chronic subdural hematoma (CSDH) sometimes recurs after surgical treatment and requires reoperation. In Japan, Japanese herbal medicines (Kampo), such as Goreisan and Saireito, have been used as adjunctive therapies to prevent the recurrence of CSDH. However, no prospective randomized study has proven the efficacy of Kampo medicine in all patients. To investigate whether Goreisan and Saireito reduce the postoperative recurrence of CSDH in a prospective randomized study. METHODS Between April 2017 and July 2019, a total of 118 patients who underwent initial burr hole surgery for CSDH were randomly assigned to the following 3 groups: (1) Goreisan for 3 months (Group G), (2) Saireito for 3 months (Group S), and (3) no medication (Group N). The primary end point was symptomatic recurrence within 3 months postoperatively, and the secondary end point was complications associated with the administration of Kampo medicine. RESULTS Among 118 patients, 114 (Group N, n = 39; Group G, n = 37; and Group S, n = 38) were included in our analysis. In this study, byakujutsu (containing Atractylodes rhizome ) Goreisan and Saireito were used, unlike other prospective randomized studies in which sojutsu (containing Atractylodes lancea rhizome) Goreisan was used. The overall recurrence rate was 11.4% (13/114: 10 for Group N, 2 for Group G, and 1 for Group S). The recurrence rate of Group G was significantly lower than that of Group N (5.4% vs 25.6%; P = .043). The recurrence rate of Group S was also significantly lower than that of Group N (2.6% vs 25.6%; P = .02). No patients developed complications associated with the administration of Kampo medicine. CONCLUSION This is the first study to show that Kampo medicine reduced the recurrence rate of CSDH in an overall population. This study demonstrated that byakujutsu Goreisan and Saireito may have favorable effects, unlike other studies, because byakujutsu has stronger anti-inflammatory activity than sojutsu.
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Affiliation(s)
- Hiroaki Matsumoto
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Atsushi Matsumoto
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Shiro Miyata
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Yusuke Tomogane
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Hiroaki Minami
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Atsushi Masuda
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Ikuya Yamaura
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Yasuhisa Yoshida
- Department of Neurosurgery, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
| | - Yutaka Hirata
- Department of Neurology, Cerebrovascular Research Institute, Eisyokai Yoshida Hospital, Kobe , Hyogo , Japan
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Takayama S, Ishii T. Kampo medicine bukuryoingohangekobokuto and ninjin'yoeitoyoeito as supportive care for management of anorexia and tightness of the esophagus in advanced esophageal cancer: A case report. Explore (NY) 2023; 19:256-259. [PMID: 35232681 DOI: 10.1016/j.explore.2022.02.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2022] [Revised: 02/05/2022] [Accepted: 02/14/2022] [Indexed: 12/20/2022]
Affiliation(s)
- Shin Takayama
- Department of Education and Support for Regional Medicine (General and Kampo medicine), Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
| | - Tadashi Ishii
- Department of Education and Support for Regional Medicine (General and Kampo medicine), Tohoku University Hospital, 1-1, Seiryo-machi, Aoba-ku, Sendai, Miyagi 980-8574, Japan.
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Takayama S, Arita R, Ishii T. Case Report: Prolonged Anorexia With Nausea Caused by Immune Checkpoint Inhibitors for Malignant Melanoma Treated Using Kampo Medicines Bukuryoingohangekobokuto and Ninjin’yoeito. Front Pharmacol 2022; 13:870823. [PMID: 35496285 PMCID: PMC9039612 DOI: 10.3389/fphar.2022.870823] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2022] [Accepted: 03/18/2022] [Indexed: 12/24/2022] Open
Abstract
Immune checkpoint inhibitors (ICIs) are indicated for several cancers, including malignant melanoma. Anorexia and nausea resulting in malnutrition are side effects of ICIs. In such cases, conventional drugs are used for symptom relief, but the symptoms may persist. We report a case of advanced malignant melanoma with prolonged anorexia and nausea, which occurred after nivolumab administration, and was successfully treated using Kampo medicines. A 75-year-old man with nasal bleeding visited our hospital. A nasal scope revealed an obstructive tumor in the left nasal concha. Tissue biopsy showed malignant melanoma, and computed tomography showed metastasis to the liver and bone. Thus, the patient was diagnosed with stage IV malignant melanoma. He received radiotherapy (30 Gy) and nivolumab with ipilimumab four times, followed by nivolumab administration alone. During the administration of nivolumab, he complained of severe anorexia and nausea, with a numeric rating scale (no symptoms, 0; severe symptoms, 10) score of 10. He could not consume food because of these symptoms, even after nivolumab administration was discontinued. His blood pressure was 92/59 mmHg, his performance status (PS; no fatigue, 0; bedridden or disabled, 4) was 4, and his body weight gradually decreased from 60 to 39 kg in a month. The patient showed malnutrition and dehydration and experienced anxiety and depression. Nivolumab was terminated, and conventional symptomatic drugs were prescribed, but the symptoms persisted. We then prescribed 9.0 g/day of ninjin’yoeito (TJ-108, Tsumura and Co.) to allow recovery from anorexia and subsequently added bukuryoingohangekobokuto (TJ-116, Tsumura and Co.) to treat the persistent nausea. After treatment with these two Kampo medicines, the patient’s appetite gradually recovered. Along with the recovery of nutritional status, his PS improved to 0, his anxiety and depressive state improved, and his body weight increased to 60 kg. The patient remained in good condition without cancer recurrence. The patient’s clinical course shows the usefulness of Kampo medicine as supportive care for symptom relief and maintenance of nutritional and mental status during cancer treatment.
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Shimizu M, Takayama S, Kikuchi A, Arita R, Ono R, Ishizawa K, Ishii T. Kampo Medicine Treatment for Advanced Pancreatic Cancer: A Case Series. Front Nutr 2021; 8:702812. [PMID: 34458306 PMCID: PMC8387656 DOI: 10.3389/fnut.2021.702812] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 07/13/2021] [Indexed: 11/13/2022] Open
Abstract
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.
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Affiliation(s)
- Masayuki Shimizu
- Shimizu Clinic, Sendai, Japan.,Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan
| | - Shin Takayama
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Akiko Kikuchi
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Ryutaro Arita
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Rie Ono
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Kota Ishizawa
- Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan
| | - Tadashi Ishii
- Department of Kampo Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan
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Takayama S, Arita R, Ono R, Saito N, Suzuki S, Kikuchi A, Ohsawa M, Tadano Y, Akaishi T, Tanaka J, Kanno T, Abe M, Onodera K, Ishii T. Treatment of COVID-19-Related Olfactory Disorder Promoted by Kakkontokasenkyushin'i: A Case Series. TOHOKU J EXP MED 2021; 254:71-80. [PMID: 34108344 DOI: 10.1620/tjem.254.71] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Olfactory disorders are one of the characteristic symptoms of the coronavirus disease of 2019 (COVID-19), which causes infection and inflammation of the upper and lower respiratory tract. To our knowledge, there are no treatments for COVID-19-related olfactory disorder. Here, we report five olfactory disorder cases in COVID-19, treated using the Japanese traditional (Kampo) medicine, kakkontokasenkyushin'i. We treated five patients with mild COVID-19 at an isolation facility using Kampo medicine, depending on their symptoms. Patients with the olfactory disorder presented with a blocked nose, nasal discharge or taste impairment. Physical examination using Kampo medicine showed similar findings, such as a red tongue with red spots and sublingual vein congestion, which presented as blood stasis and inflammation; thus, we prescribed the Kampo medicine, kakkontokasenkyushin'i. After administration, the numeric rating scale scores of the smell impairment improved within 3 days from 9 to 3 in case 1, from 10 to 0 in case 2, from 9 to 0 in case 3, from 5 to 0 in case 4, and from 9 to 0 within 5 days in case 5. Following the treatment, other common cold symptoms were also alleviated. Kakkontokasenkyushin'i can be used for treating nasal congestion, rhinitis, and inflammation in the nasal mucosa. The olfactory disorder in COVID-19 has been reportedly associated with inflammation and congestion, especially in the olfactory bulb and olfactory cleft. Kakkontokasenkyushin'i may be one of the treatment alternatives for the olfactory disorder with rhinitis in patients with COVID-19.
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Affiliation(s)
- Shin Takayama
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine
| | - Ryutaro Arita
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Rie Ono
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Natsumi Saito
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Satoko Suzuki
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Akiko Kikuchi
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine
| | - Minoru Ohsawa
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine
| | - Yasunori Tadano
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Tetsuya Akaishi
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Junichi Tanaka
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Takeshi Kanno
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Michiaki Abe
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Ko Onodera
- Department of Education and Support for Regional Medicine, Tohoku University Hospital
| | - Tadashi Ishii
- Department of Kampo Medicine, Tohoku University Hospital.,Department of Education and Support for Regional Medicine, Tohoku University Hospital.,Department of Kampo and Integrative Medicine, Tohoku University Graduate School of Medicine
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