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Mitsui S, Tanaka Y, Nishikubo M, Doi T, Tane S, Hokka D, Imai T, Maniwa Y. Ninjin'yoeito improves respiratory symptoms after lung cancer surgery: a prospective randomized study. Surg Today 2024:10.1007/s00595-024-02977-w. [PMID: 39718597 DOI: 10.1007/s00595-024-02977-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2024] [Accepted: 10/06/2024] [Indexed: 12/25/2024]
Abstract
PURPOSE This study evaluated the efficacy of ninjin'yoeito for alleviating postoperative symptoms after lung cancer surgery. METHODS Overall, 140 patients who underwent lobectomy were randomized into a conventional treatment group and a ninjin'yoeito group. The primary endpoint was change in the Cancer Fatigue Scale (CFS) score from baseline and the secondary endpoints were the Cancer Dyspnea Scale (CDS) scores, the Kihon Checklist, and respiratory function. RESULTS The mean change in the CFS score 8 weeks postoperatively was - 5.56 in the ninjin'yoeito group and - 5.53 in the conventional treatment group (P = 0.425), but this outcome did not meet the primary endpoint. Changes in the mean CDS scores 8 weeks postoperatively were - 5.60 and - 3.38 in the ninjin'yoeito and conventional groups, respectively, with a difference of - 1.95 (P = 0.049). The changes in the mean vital capacity 8 weeks postoperatively were - 340.5 mL in the ninjin'yoeito group and - 473.5 mL in the conventional treatment group, with a difference of + 135.1 mL (P = 0.041). The ninjin'yoeito group had a significantly lower proportion of patients with malnutrition 16 weeks postoperatively than the conventional treatment group (P = 0.040). CONCLUSION The results of this study show that ninjin'yoeito is effective for alleviating respiratory symptoms and improving malnutrition after lung cancer surgery.
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Affiliation(s)
- Suguru Mitsui
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Yugo Tanaka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan.
| | - Megumi Nishikubo
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takefumi Doi
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Shinya Tane
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Daisuke Hokka
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
| | - Takumi Imai
- Clinical and Translational Research Center, Kobe University Hospital, Hyogo, Japan
| | - Yoshimasa Maniwa
- Division of Thoracic Surgery, Kobe University Graduate School of Medicine, 7-5-2 Kusunoki-cho, Chuou-ku, Kobe, Hyogo, 650-0017, Japan
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Choi Y, Shin HK. Adverse events associated with herbal medicine products reported in the Korea Adverse Event Reporting System from 2012 to 2021. Front Pharmacol 2024; 15:1378208. [PMID: 39498343 PMCID: PMC11532164 DOI: 10.3389/fphar.2024.1378208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Accepted: 10/10/2024] [Indexed: 11/07/2024] Open
Abstract
Introduction Systematic collection of diverse adverse events during herbal medicine administration is crucial. The Korea Adverse Event Reporting System (KAERS) compiles spontaneously reported adverse event data for medicinal products including herbal medicines. This study focused on extracting and analyzing adverse event data specifically related to herbal medicine products from the KAERS database. Methods Individual case safety reports (ICSRs) encompassing 84 types of herbal medicine products, identified by item codes from 2012 to 2021, were extracted from the KAERS database. Descriptive statistics were employed to analyze the characteristics of the extracted reports, and adverse event information was systematically categorized and analyzed based on the MedDRA System Organ Class and preferred term classification. Results In total, 1,054 ICSRs were extracted, with some documenting multiple adverse events in a single ICSR, resulting in 1,629 extracted adverse events. When categorized by the MedDRA System Organ Class, gastrointestinal disorders were the most prevalent (28.7%), followed by skin and subcutaneous tissue disorders (20.1%). Based on the preferred terms, the most frequently reported adverse events were diarrhea (5.8%), urticaria (5.3%), pruritus (4.7%), rash (4.4%), and abdominal discomfort (4.2%). The most frequently reported herbal medicines were Bangpungtongseong-san (297 cases), Kyeongok-go (144 cases), and Eunkyo-san (108 cases). Conclusion Spontaneously reported adverse events associated with herbal medicine products were systematically documented using the KAERS database. This study, which focused on voluntarily reported adverse reactions, underscores the need for additional research to estimate the incidence rate of adverse events and assess causality.
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Ando S, Azuma K, Futami S, Mori K, Hirose Y, Shirasaka T, Minami S. Organizing Pneumonia With Diffuse Alveolar Hemorrhage Induced by the Kampo Medicine Choreito. J Med Cases 2024; 15:120-125. [PMID: 38993806 PMCID: PMC11236336 DOI: 10.14740/jmc4222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 06/05/2024] [Indexed: 07/13/2024] Open
Abstract
Kampo medicine, a traditional Japanese herbal medicine, is covered by the Japanese National Health Insurance and prescribed for various purposes. While relatively safe with few adverse effects, it may potentially cause severe adverse effects, such as lung injury. Herein, we describe the case of a 61-year-old Japanese woman with choreito-induced lung injury that manifested as organizing pneumonia (OP) with diffuse alveolar hemorrhage (DAH). She was referred to our department due to multiple abnormal opacities detected on annual chest radiography. Chest computed tomography (CT) revealed multiple nodules in bilateral lungs. Bloody bronchoalveolar lavage fluid was obtained from the left lingular lobe, appearing nearly normal, while a transbronchial lung biopsy from a subpleural nodule in the left lower lobe was pathologically consistent with OP. The drug lymphocyte stimulation test result was positive for choreito, which the patient had regularly consumed for 6 - 7 months to treat hematuria. Consequently, a diagnosis of choreito-induced OP and DAH was made. Owing to the discontinuation of choreito alone and without the introduction of systemic steroid therapy, the multiple nodules shrank and eventually disappeared on follow-up chest CT. Regardless of the type of crude drug used in Kampo medicine, clinicians must always be careful for potential lung injury, which may present as OP with DAH.
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Affiliation(s)
- Seijitsu Ando
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka, Japan
| | - Koji Azuma
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka, Japan
| | - Shinji Futami
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka, Japan
| | - Kiyosi Mori
- Central Laboratory and Surgical Pathology, NHO Osaka National Hospital, Osaka, Japan
| | - Yumiko Hirose
- Central Laboratory and Surgical Pathology, NHO Osaka National Hospital, Osaka, Japan
| | | | - Seigo Minami
- Department of Respiratory Medicine, NHO Osaka National Hospital, Osaka, Japan
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Oura K, Tanaka M, Matsumoto K, Satake R, Inoue M, Yoshida Y, Wakabayashi W, Hasegawa S, Iwata M, Suzuki T, Maezawa M, Nakao S, Liao J, Iguchi K, Nakamura M. Analysis of drug-induced interstitial lung disease caused by herbal medicine using the Japanese Adverse Drug Event Report database. BMC Complement Med Ther 2024; 24:121. [PMID: 38486172 PMCID: PMC10938654 DOI: 10.1186/s12906-024-04428-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 03/06/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND Drug-induced interstitial lung disease (DIILD) is a severe adverse event leading to morbidity and mortality. This study evaluated the adverse event indicators of DIILD and time-to-onset profiles following the daily intake of herbal drugs (Scutellariae radix ["ogon" in Japanese], Bupleuri radix ["saiko" in Japanese], and Pinelliae tuber ["hange" in Japanese]) using the Japanese Adverse Drug Event Report database. DIILD was defined in accordance with the Medical Dictionary for Regulatory Activities. METHODS The Japanese Adverse Drug Event Report database contained 830,079 reports published between April 2004 and April 2023. The association between herbal medicines and DILLD was evaluated using the pharmacovigilance index as the reporting odds ratio (ROR), logistic regression models, propensity score-matching techniques, and Weibull shape parameters. RESULTS The adjusted RORs using multivariate logistic regression models for Scutellariae radix (daily intake), Pinelliae tuber (daily intake), sex (male), age (≥ 60 years), Scutellariae radix (daily intake)*age (≥ 60 years), and Scutellariae radix (daily intake)* Pinelliae tuber (daily intake) were 1.47 (1.36 - 1.59), 1.05 (1.01 - 1.10), 1.45 (1.34 - 1.57), 1.92 (1.74 - 2.11), 3.35 (3.12 - 3.60), and 1.49 (1.46 - 1.53), respectively. DIILD onset profiles were evaluated using the Weibull shape parameter. A logistic plot of daily intake and onset of DIILD was drawn. ROR signals were detected in 32 of 54 herbal medicines, including Scutellariae radix, Bupleuri radix, and Pinelliae tuber. The median duration (days) (interquartile range) to DIILD onset was 36.0 (27.0-63.0) for Saikokaryukotsuboreito, 35.0 (21.0-55.0) for Saireito, and 31.0 (13.5-67.5) for Shosaikoto. The Weibull shape parameter beta (95% confidence interval) values for Saikokaryukotsuboreito, Saireito, and Shosaikoto were 1.36 (1.08-1.67), 1.36 (1.20-1.52), and 1.31 (0.98-1.68), respectively. CONCLUSIONS DIILD demonstrated a dose-dependent to crude drugs. Clinicians should strive for the early detection of DIILD and avoid the inadvertent administration of herbal medicines.
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Affiliation(s)
- Keita Oura
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Mizuki Tanaka
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Kiyoka Matsumoto
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Riko Satake
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Misaki Inoue
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Yu Yoshida
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Wataru Wakabayashi
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Shiori Hasegawa
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Kaneichi Pharmaceutical, Company, Limited, Osaka, Japan
| | - Mari Iwata
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Kifune Pharmacy, Gifu, Japan
| | - Takaaki Suzuki
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Gifu Prefectural Government, Gifu, Japan
| | - Mika Maezawa
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
| | - Satoshi Nakao
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan
- Department of Pharmacy, Kyushu University Hospital, Fukuoka, Japan
| | - Jun Liao
- Department of Information Science and Information System, China Pharmaceutical University, Nanjing, China
| | - Kazuhiro Iguchi
- Laboratory of Community Pharmacy, Gifu Pharmaceutical University, Gifu, Japan
| | - Mitsuhiro Nakamura
- Laboratory of Drug Informatics, Gifu Pharmaceutical University, 1-25-4, Daigaku-Nishi, Gifu, 501-1196, Japan.
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Nishiwaki R, Inoue Y, Sugao M, Sugimasa N, Hamaguchi T, Noji M, Takeuchi K, Ito Y, Kato T, Yasuma T, D'Alessandoro-Gabazza CN, Gabazza EC, Imoto I. Hangeshashinto-Associated Mesenteric Phlebosclerosis and Highly Atypical Adenoma Requiring Laparoscopic Right Hemicolectomy. Diagnostics (Basel) 2024; 14:565. [PMID: 38473037 DOI: 10.3390/diagnostics14050565] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/25/2024] [Accepted: 03/03/2024] [Indexed: 03/14/2024] Open
Abstract
Mesenteric phlebosclerosis is a rare ischemic colonic disorder caused by impaired venous drainage. Its prevalence is higher in East Asia, where herbal medicine is widely used. Treatment remains controversial. A 76-year-old woman who had taken Hangeshashinto, an herbal medicine, for 11 years was admitted for endoscopic treatment of high-grade dysplasia in the ascending colon. She had diarrhea and mesenteric phlebosclerosis diagnosed by abdominal computed tomography at age 71. At age 75, small polyps were detected in the ascending colon. A subsequent study revealed an increase in polyp size to 15 mm. Endoscopic mucosal resection failed to remove the lesion. A biopsy showed high-grade dysplasia with possible colon cancer risk. Conservative therapy did not improve mesenteric phlebosclerosis-related diarrhea; therefore, a laparoscopic right hemicolectomy was performed. Intraoperatively, the cecum was adherent to the abdominal wall and the right ovary. The specimen showed high-grade dysplasia in the mucosa and severe submucosal fibrosis. No metastasis was observed. This case shows the link between mesenteric phlebosclerosis and high-grade dysplasia in the ascending colon. Endoscopic mucosal resection was unsuccessful in removing the tumor. Endoscopic submucosal dissection was an alternative, but its safety in mesenteric phlebosclerosis-affected colonic segments remains uncertain. A laparoscopic right hemicolectomy was performed.
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Affiliation(s)
- Ryo Nishiwaki
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
- Department of Immunology, Mie University Faculty and Graduate School of Medicine, Tsu 514-8507, Japan
| | - Yasuhiro Inoue
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Masataka Sugao
- Department of Internal Medicine, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Natsuko Sugimasa
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Tetsuya Hamaguchi
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Midori Noji
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Kenji Takeuchi
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Yoshiyuki Ito
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Toshio Kato
- Department of Surgery, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
| | - Taro Yasuma
- Department of Immunology, Mie University Faculty and Graduate School of Medicine, Tsu 514-8507, Japan
| | | | - Esteban C Gabazza
- Department of Immunology, Mie University Faculty and Graduate School of Medicine, Tsu 514-8507, Japan
| | - Ichiro Imoto
- Digestive Endoscopy Center, Doshinkai Tohyama Hospital, Tsu 514-0043, Japan
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Uneda K, Kawai Y, Kaneko A, Kayo T, Akiba S, Ishigami T, Yoshida-Komiya H, Suzuki M, Mitsuma T. Analysis of clinical factors associated with Kampo formula-induced pseudoaldosteronism based on self-reported information from the Japanese Adverse Drug Event Report database. PLoS One 2024; 19:e0296450. [PMID: 38165850 PMCID: PMC10760746 DOI: 10.1371/journal.pone.0296450] [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: 08/14/2023] [Accepted: 12/10/2023] [Indexed: 01/04/2024] Open
Abstract
Drug-induced pseudoaldosteronism is a typical adverse effect of Kampo formulas. Previous research described the potential risks of Kampo formula-linked pseudoaldosteronism. However, few studies assessed the risk factors using a real-world database and a data-mining approach. Using the Japanese Adverse Drug Event Report database, we extracted pseudoaldosteronism reports for 148 Kampo formulas covered by Japanese national health insurance. Adverse events were decided according to the preferred terminology of the Medical Dictionary for Regulatory Activities/Japanese version 25.1. We calculated reporting odds ratio (RORs) and identified Kampo formulas as suspected causes of pseudoaldosteronism. Moreover, we evaluated clinical factors associated with Kampo formula-induced pseudoaldosteronism via logistic regression. From April 2004 to November 2022, 6334 adverse events related to the Kampo formulas were reported. We selected 2471 reports containing complete clinical data, including 210 reports on pseudoaldosteronism. In the pseudoaldosteronism group, 69.0% of patients were female, and 85.2% were ≥70 years old. The formulas most commonly associated with pseudoaldosteronism were Shakuyakukanzoto, Yokukansan, and Ryokeijutsukanto (ROR [95% confidence interval {CI}] = 18.3 [13.0-25.9], 8.1 [5.4-12.0], and 5.5 [1.4-21.9], respectively). Logistic analysis identified female sex (odds ratio [OR] [95% CI] = 1.7 [1.2-2.6]; P = 0.006), older age (≥70, 5.0 [3.2-7.8]; P < 0.001), low body weight (<50 kg, 2.2 [1.5-3.2]; P < 0.001), diuretics usage (2.1 [1.3-4.8]; P = 0.004), hypertension (1.6 [1.1-2.4]; P = 0.014), and dementia (7.0 [4.2-11.6]; P < 0.001) as pseudoaldosteronism-related factors. Additionally, the daily Glycyrrhiza dose (OR = 2.1 [1.9-2.3]; P < 0.001) and duration of administration (>14 days, OR = 2.8 [1.7-4.5]; P < 0.001) were associated with adverse events. We did not observe an interaction between aging and hypertension. Careful follow-up is warranted during long-term Glycyrrhiza-containing Kampo formula use in patients with multiple clinical factors for pseudoaldosteronism.
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Affiliation(s)
- Kazushi Uneda
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Aizuwakamatsu, Japan
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Yuki Kawai
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | - Akira Kaneko
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Aizuwakamatsu, Japan
| | - Takumi Kayo
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Aizuwakamatsu, Japan
| | - Shuichiro Akiba
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Aizuwakamatsu, Japan
| | - Tomoaki Ishigami
- Department of Medical Science and Cardiorenal Medicine, Yokohama City University Graduate School of Medicine, Yokohama, Japan
| | | | - Masao Suzuki
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Aizuwakamatsu, Japan
| | - Tadamichi Mitsuma
- Department of Kampo Medicine, Aizu Medical Center, Fukushima Medical University, Fukushima, Aizuwakamatsu, Japan
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Björnsson HK, Björnsson ES. Review of human risk factors for idiosyncratic drug-induced liver injury: latest advances and future goals. Expert Opin Drug Metab Toxicol 2023; 19:969-977. [PMID: 37997265 DOI: 10.1080/17425255.2023.2288260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 11/22/2023] [Indexed: 11/25/2023]
Abstract
INTRODUCTION Idiosyncratic drug-induced liver injury (DILI) is a common cause of acute liver injury and can lead to death from acute liver failure or require liver transplantation. Although the total burden of liver injury is high, the frequency of DILI caused by specific agents is often low. As the liver injury is by per definition idiosyncratic, the prediction of which patients will develop liver injury from specific drugs is currently a very difficult challenge. AREAS COVERED The current paper highlights the most important studies on prediction of DILI published in 2019-2023, including studies on genetic, metabolomic, and demographic risk factors, concomitant medication, and the role of comorbid liver diseases. Risk stratification using demographic, metabolomic, and multigenetic risk factors is discussed. EXPERT OPINION Great advances have been made in identifying genetic risk factors for DILI. Combining these risk factors with demographic information and other biomarkers into multigenetic risk models might become highly useful in risk stratifying patients exposed to DILI. However, a more detailed mapping of genetic risk factors is needed. Results of these studies need to be validated in the selected ethnic groups before applicability and cost-effectiveness can be determined.
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Affiliation(s)
- Helgi Kristinn Björnsson
- Department of Internal Medicine, Division of Gastroenterology and Hepatology, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Einar Stefan Björnsson
- Division of Gastroenterology and Hepatology, Landspitali - The National University Hospital of Iceland, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
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Ko MM, Jeong MK, Choi CM, Lee SH, Chun J, Yi JM, Jang H, Lee SY. Safety and Efficacy of Bojungikki-Tang in Advanced NSCLC Patients Receiving Treatment with Immune Checkpoint Inhibitors: Protocol for a Multicenter, Double-Blind, Randomized, Placebo-Controlled Pilot Trial. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4507. [PMID: 36901517 PMCID: PMC10002386 DOI: 10.3390/ijerph20054507] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 02/20/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
Cancer immunotherapy with immune checkpoint inhibitors (ICIs) is a major treatment option for several types of cancer, including non-small cell lung cancer (NSCLC). The proposed study aims to investigate the safety and efficacy of Bojungikki-tang (BJIKT) therapy (an herbal medicine) in patients with advanced NSCLC treated with ICIs. This multicenter, randomized, placebo-controlled pilot study will be performed at three academic hospitals. Thirty patients with advanced NSCLC, undergoing atezolizumab monotherapy as second- and subsequent-line treatment, will be recruited and randomly assigned to either BJIKT treatment (atezolizumab + BJIKT) or placebo (atezolizumab + placebo). The primary and secondary outcomes are the incidence of adverse events (AEs), including immune- related AEs (irAEs) and non-immune-related AEs (non-irAEs); and early termination rate, withdrawal period, symptom improvement of fatigue, and skeletal muscle loss, respectively. The exploratory outcomes are patient objective response rate and immune profile. This is an ongoing trial. Recruitment started on 25 March 2022 and is expected to be completed by 30 June 2023. This study will provide basic evidence for the safety profiles, including irAEs, of herbal medicine in patients with advanced NSCLC treated with ICIs.
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Affiliation(s)
- Mi Mi Ko
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Mi-Kyung Jeong
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Chang Min Choi
- Department of Pulmonary and Critical Care Medicine, Asan Medical Center, College of Medicine, University of Ulsan, Seoul 05505, Republic of Korea
| | - Seung Hyeun Lee
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul 02447, Republic of Korea
| | - Jaemoo Chun
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Jin-Mu Yi
- KM Convergence Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Ho Jang
- KM Data Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Sung Yong Lee
- Division of Pulmonary, Allergy, and Critical Care Medicine, Department of Internal Medicine, Korea University Guro Hospital, Korea University College of Medicine, Seoul 08308, Republic of Korea
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Nakamura R, Arakawa N, Tanaka Y, Uchiyama N, Sekine A, Mashimo Y, Tsuji K, Kagawa T, Sato K, Watanabe M, Aiso M, Hiasa Y, Takei Y, Ohira H, Ayada M, Tsukagoshi E, Maekawa K, Tohkin M, Saito Y, Takikawa H. Significant association between HLA-B*35:01 and onset of drug-induced liver injury caused by Kampo medicines in Japanese patients. Hepatol Res 2022; 53:440-449. [PMID: 36583370 DOI: 10.1111/hepr.13874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/05/2022] [Accepted: 12/24/2022] [Indexed: 12/31/2022]
Abstract
AIM Drug-induced liver injury (DILI) is a severe and life-threatening immune-mediated adverse effect, occurring rarely among treated patients. We examined genomic biomarkers in the Japanese population that predict the onset of DILI after using a certain class of drugs, such as Kampo products (Japanese traditional medicines). METHODS A total of 287 patients diagnosed as DILI by hepatology specialists were recruited after written informed consent was obtained. A genome-wide association analysis and human leukocyte antigen (HLA) typing in four digits were performed. RESULTS We found a significant association (p = 9.41 × 10-10 ) of rs146644517 (G > A) with Kampo product-related DILI. As this polymorphism is located in the HLA region, we evaluated the association of HLA types and found that 12 (63.2%) of 19 Kampo-DILI patients contained HLA-B*35:01, whereas only 15.2% were positive for this HLA among healthy volunteers. The odds ratio was 9.56 (95% confidence interval 3.75-24.46; p = 2.98 × 10-6 , corrected p = 4.17 × 10-5 ), and it increased to 13.55 compared with the DILI patients not exposed to Kampo products. The individual crude drug components in the Kampo products, including Scutellaria root (ougon in Japanese), rhubarb (daiou), Gardenia fruit (sanshishi), and Glycyrrhiza (kanzou), were significantly associated with HLA-B*35:01. CONCLUSIONS HLA-B*35:01 is a genetic risk factor and a potential predictive biomarker for Kampo-induced DILI in the Japanese population.
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Affiliation(s)
- Ryosuke Nakamura
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Noriaki Arakawa
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Yoichi Tanaka
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Nahoko Uchiyama
- Division of Pharmacognosy, Phytochemistry and Narcotics, National Institute of Health Sciences, Kawasaki, Japan
| | - Akihiro Sekine
- Department of Infection and Host Defense, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Yoichi Mashimo
- Department of Public Health, Chiba University Graduate School of Medicine, Chiba, Japan
| | - Keiji Tsuji
- Department of Gastroenterology, Hiroshima Red Cross Hospital and Atomic Survivors Hospital, Hiroshima, Japan
| | - Tatehiro Kagawa
- Division of Gastroenterology, Department of Internal Medicine, Tokai University School of Medicine, Isehara, Japan
| | - Ken Sato
- Department of Gastroenterology and Hepatology, Gunma University Graduate School of Medicine, Maebashi, Japan
| | - Masaaki Watanabe
- Department of Gastroenterology, Kitasato University Medical Center, Kitamoto, Japan
| | - Mitsuhiko Aiso
- Department of Medicine, Higashisaitama National Hospital, Hasuda, Japan
| | - Yoichi Hiasa
- Department of Gastroenterology and Metabology, Ehime University Graduate School of Medicine, Toon, Japan
| | | | - Hiromasa Ohira
- Department of Gastroenterology, Fukushima Medical University, Fukushima, Japan
| | - Minoru Ayada
- Department of Internal Medicine, Kakegawa Higashi Hospital, Kakegawa, Japan
| | - Eri Tsukagoshi
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Keiko Maekawa
- Faculty of Pharmaceutical Sciences, Doshisha Women's College of Liberal Arts, Kyotanabe, Japan
| | - Masahiro Tohkin
- Graduate School of Pharmaceutical Sciences, Nagoya City University, Nagoya, Japan
| | - Yoshiro Saito
- Division of Medicinal Safety Science, National Institute of Health Sciences, Kawasaki, Japan
| | - Hajime Takikawa
- Faculty of Medical Technology, Teikyo University, Tokyo, Japan
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10
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Makinouchi R, Machida S, Matsui K, Shibagaki Y, Imai N. Severe hypokalemia in the emergency department: A retrospective, single‐center study. Health Sci Rep 2022; 5:e594. [PMID: 35509383 PMCID: PMC9059213 DOI: 10.1002/hsr2.594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 03/23/2022] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
Background and Aims Hypokalemia is one of the most common problems in the emergency department (ED). Severe hypokalemia, defined as a serum potassium level ≤2.5 mEq/L, is a relatively uncommon electrolyte disorder, and few studies have reported its prevalence, etiology, symptoms, and management in the ED. Therefore, we aimed to investigate them in this study. Methods This retrospective single‐center study included adult patients whose serum potassium levels were measured in the ED between 2012 and 2019. Data including age, sex, serum potassium levels, and serum creatinine levels were collected from the electronic medical records. Results The serum potassium levels of 21,616 adult patients were measured. The median age of these patients was 73 years (range: 57–83 years), and 38% were men. The prevalence of severe hypokalemia was 0.4%. The most common symptom of symptomatic severe hypokalemia was weakness (p = 0.001). Malnutrition, use of Japanese herbal medicine, and use of diuretics were the main causes of severe hypokalemia. Sixty‐one patients (70%) underwent electrocardiography. Fifty‐nine patients (68%) received treatment for severe hypokalemia within one day of the visit. Conclusion The management of severe hypokalemia in the ED may be suboptimal. Emergency physicians should be vigilant to avoid missing hypokalemia.
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Affiliation(s)
- Ryuichirou Makinouchi
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital Yokohama Kanagawa Japan
| | - Shinji Machida
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital Yokohama Kanagawa Japan
| | - Katsuomi Matsui
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital Yokohama Kanagawa Japan
| | - Yugo Shibagaki
- Division of Nephrology and Hypertension St. Marianna University School of Medicine Kawasaki Kanagawa Japan
| | - Naohiko Imai
- Division of Nephrology and Hypertension, St. Marianna University School of Medicine Yokohama City Seibu Hospital Yokohama Kanagawa Japan
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11
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Ishida T, Kawada K, Jobu K, Kawazoe T, Tamura N, Miyamura M. Analysis of Drug-Induced Liver Injury from Bofutsushosan Administration Using Japanese Adverse Drug Event Report (JADER) Database. Biol Pharm Bull 2022; 45:460-466. [DOI: 10.1248/bpb.b21-00887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Affiliation(s)
| | - Kei Kawada
- Department of Pharmacy, Kochi Medical School Hospital
| | - Kohei Jobu
- Department of Pharmacy, Kochi Medical School Hospital
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12
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Abstract
This review summarizes the adverse effects of Kampo medicines. These adverse effects in terms of immunoallergic reactions include interstitial pneumonia, liver injury, allergic cystitis, and drug eruption. Many cases of interstitial pneumonia, liver injury, and allergic cystitis associated with Kampo formulas have been reported to be caused by formulas containing Scutellariae Radix (Scutellaria root, ogon). The known adverse effects linked to overdose of Kampo formulas include pseudoaldosteronism [caused by Glycyrrhizae Radix (licorice, kanzo)], sympathomimetic symptoms [caused by Ephedrae Herba (ephedra, mao)], aconite poisoning [caused by Aconiti Tuber (processed aconite root, bushi and uzu)], and diarrhea [caused by Rhei Rhizoma (rhubarb, daio)]. In recent years, mesenteric phlebosclerosis caused by the long-term administration of Gardeniae Fructus (gardenia fruit, sanshishi) has also been reported. It is necessary to consider these potential adverse effects when prescribing Kampo medicines in clinical practice.
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Affiliation(s)
- Yutaka Shimada
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
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13
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Wang J, Shao J, Lu H, Wang B, Chen J. Idiopathic mesenteric phlebosclerosis: one case report and systematic literature review of 240 cases. Am J Transl Res 2021; 13:13156-13166. [PMID: 34956536 PMCID: PMC8661183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Accepted: 08/18/2021] [Indexed: 06/14/2023]
Abstract
AIM This research is both a case study and a systematic literature review. Our goal was to learn more about the pathophysiology, clinical features, and therapy options for idiopathic mesenteric phlebosclerosis (IMP). METHODS A case of IMP was treated by surgery in our department. Combined with the data of 240 cases of IMP retrieved from PubMed and Wanfang Data, we conducted a systematic review of this less well-known disease. RESULTS These 240 cases of IMP mainly occurred in East Asia. Among the patients, 78.7% of them had a history of herbal medicine consumption; 15.2% had no obvious symptoms and their diagnosis was confirmed through characteristic CT findings and colonoscopic manifestations; 58.4% were cured by conservative treatment; 41.6% had severe symptoms and underwent surgical treatment. Additionally, more patients treated with surgical treatment had lesions involving the cecum (59/82 vs. 53/115, P=0.0003) and sigmoid colon (20/82 vs. 10/115, P=0.0025) compared with those treated conservatively. CONCLUSION The occurrence of IMP is associated with the long-term consumption of herbal medicines. Early diagnosis of IMP could be determined by CT and colonoscopy and conservative or surgical treatment was chosen based on of the severity of the condition (e.g., the involved bowel segment).
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Affiliation(s)
- Jialiang Wang
- Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200336, China
| | - Jun Shao
- Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200336, China
| | - Helei Lu
- Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200336, China
| | - Bingyi Wang
- Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200336, China
| | - Ji Chen
- Department of General Surgery, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai 200336, China
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14
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Ota K, Yokoyama H, Fujii K, Nakamura E, Oka M, Ota K, Sano Y, Takasu A. Severe hypokalemia due to Kampo medicine (Shakuyakukanzoto): A report of two cases. J Herb Med 2021. [DOI: 10.1016/j.hermed.2021.100467] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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15
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Kawahara T, Yamaguchi M, Onitsuka C, Kimura T, Homma T, Sagara H. Utility of Basophil Activation Test in a Case of Daisaikoto- and Yokukansan-induced Lung Injury. Intern Med 2021; 60:1573-1576. [PMID: 33361680 PMCID: PMC8188028 DOI: 10.2169/internalmedicine.6296-20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 10/29/2020] [Indexed: 11/24/2022] Open
Abstract
Drug-induced lung injury is defined as a respiratory disorder. The usefulness of the basophil activation test (BAT) for drug allergy-related cases was recently reported. The patient was an 82-year-old woman who had been taking Daisaikoto and Yokukansan (herbal medicines) 3 months before developing dry cough. She was admitted to our hospital with an initial diagnosis of pneumonia with elevated serum LDH, KL-6, and IgE. Chest CT showed bilateral ground-glass opacities. Her bronchoalveolar lavage fluid showed increased eosinophils. Finally, a BAT was positive for both medications. Based on the findings, the patient was diagnosed with Daisaikoto- and Yokukansan-induced lung injury. The current case suggests that the BAT may be useful for the diagnosis of drug-induced lung injury.
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Affiliation(s)
- Tomoko Kawahara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Munehiro Yamaguchi
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Chisato Onitsuka
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Tomoyuki Kimura
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Tetsuya Homma
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
| | - Hironori Sagara
- Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University School of Medicine, Japan
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16
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Komagamine J, Kaminaga M, Omori T, Tatsumi S. The use of Kampo medications that may cause heart failure in hospitalized acute heart failure patients in a Japanese hospital. J Gen Fam Med 2021; 22:141-147. [PMID: 33977010 PMCID: PMC8090841 DOI: 10.1002/jgf2.411] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Revised: 11/17/2020] [Accepted: 11/23/2020] [Indexed: 12/04/2022] Open
Abstract
BACKGROUND The use of Kampo medications (Japanese traditional herbal medications) is common in Japan. However, some Kampo medications may cause heart failure. Given that the incidence of heart failure has increased in past decades, investigating the prevalence of the use of Kampo medications that may cause heart failure in patients with acute heart failure is important. METHOD A retrospective cross-sectional study was conducted. All 437 consecutive hospitalized patients with acute heart failure from April 2017 to October 2019 were included. The primary outcome was the use of Kampo medications, including ephedra, licorice, aconite, or ginseng, which were defined as those that may cause heart failure. The causality between these medications and the index of acute heart failure was determined by clinical pharmacists based on the Naranjo criteria. RESULTS The mean patient age was 81.1 years old, and 199 (54.5%) were women. Kampo medications that may cause heart failure were used in 30 patients (6.9%), and in four of these patients, acute heart failure was judged to be caused by Kampo medications. In the multivariable analysis, the number of non-Kampo medications used regularly (OR 1.13) and female sex (OR 2.23) were the only independent predictive factors for the use of Kampo medications that may cause heart failure. CONCLUSIONS A substantial proportion of acute heart failure patients in Japanese hospitals use Kampo medications that may cause heart failure. Further study is warranted to investigate the causal link between the incidence of acute heart failure and the use of these herbal medications.
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Affiliation(s)
- Junpei Komagamine
- Department of Internal Medicine National Hospital Organization Tochigi Medical Center Utsunomiya Japan
| | - Miho Kaminaga
- Department of Pharmacy National Hospital Organization Tochigi Medical Center Utsunomiya Japan
| | - Toshikazu Omori
- Department of Pharmacy National Hospital Organization Tochigi Medical Center Utsunomiya Japan
| | - Shinpei Tatsumi
- Department of Pharmacy National Hospital Organization Tochigi Medical Center Utsunomiya Japan
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17
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Kusutani N, Nishida M, Sowa-Osako J, Maekawa N, Fukai K. Acute generalized exanthematous pustulosis induced by pseudoephedrine in a combination tablet with fexofenadine. Int J Dermatol 2021; 60:e286-e288. [PMID: 33559159 DOI: 10.1111/ijd.15431] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2020] [Revised: 12/31/2020] [Accepted: 01/11/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Nao Kusutani
- Department of Dermatology, Osaka City General Hospital, Osaka, Japan
| | - Marina Nishida
- Department of Dermatology, Osaka City General Hospital, Osaka, Japan
| | - Junko Sowa-Osako
- Department of Dermatology, Osaka City University Graduate School of Medicine, Osaka, Japan
| | - Naoki Maekawa
- Department of Dermatology, Osaka City General Hospital, Osaka, Japan
| | - Kazuyoshi Fukai
- Department of Dermatology, Osaka City General Hospital, Osaka, Japan
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18
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Taira K, Fujiwara K, Fukuhara T, Koyama S, Takeuchi H. The effect of Hangeshashinto on Oral Mucositis Caused by Induction Chemotherapy in Patients with Head and Neck Cancer. Yonago Acta Med 2020; 63:183-187. [PMID: 32884437 DOI: 10.33160/yam.2020.08.007] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 07/06/2020] [Indexed: 01/09/2023]
Abstract
Background Oral mucositis (OM) is a side effect of chemotherapy in head and neck cancer. Severe OM often has a large impact on quality of life. Therefore, the treatment of OM during chemotherapy is very important. It was recently reported that Hangeshashinto (TJ-14), a Japanese traditional medicine (Kampo), is effective for OM caused by fluorinated pyrimidine-based agents used in colon cancer. We investigated the efficacy of TJ-14 for OM. Methods We enrolled patients with head and neck cancer who were treated with induction chemotherapy between September 2014 and March 2016. In this double-blind trial, patients were randomly assigned to the TJ-14 group or placebo group. Patients were instructed to dissolve 2.5 g of TJ-14 or placebo in 100 ml of drinking water, rinse their mouths with the solution for 30 s and then spit it out. They were not allowed to eat anything for 30 minutes before or after using the mouthwash. Results The incidence of ≥ grade 2 OM was 37.5% (three patients) in the TJ-14 group and 50.0% (four patients) in the placebo group, with no significant difference between the two groups. The mean day of onset was 9.7 in the TJ-14 group and 6.7 in the placebo group. The mean duration of ≥ grade 2 OM was 1.3 days in the TJ-14 group and 3.7 days in the placebo group. Thus TJ-14 significantly reduced the duration of ≥ grade 2 OM. Conclusion Treatment of OM with TJ-14 was associated with a statistically significant reduction in the duration of ≥ grade 2 OM compared to placebo. Gargling with TJ-14 is a safe and effective method of administering the drug to patients with head and neck cancer.
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Affiliation(s)
- Kenkichiro Taira
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Kazunori Fujiwara
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Takahiro Fukuhara
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Satoshi Koyama
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
| | - Hiromi Takeuchi
- Division of Otolaryngology, Head and Neck Surgery, Department of Sensory and Motor Organs, School of Medicine, Faculty of Medicine, Tottori University, Yonago 683-8504, Japan
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19
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Gray PE, Belessis Y. The use of Traditional Chinese Medicines to treat SARS-CoV-2 may cause more harm than good. Pharmacol Res 2020; 156:104776. [PMID: 32251726 PMCID: PMC7129235 DOI: 10.1016/j.phrs.2020.104776] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2020] [Revised: 03/13/2020] [Accepted: 03/23/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Paul E Gray
- Dept. of Immunology and Infectious Diseases, Sydney Children's Hospital, Sydney, Australia; School of Women's and Children's Health, University of New South Wales, Sydney, Australia.
| | - Yvonne Belessis
- School of Women's and Children's Health, University of New South Wales, Sydney, Australia; Dept. of Respiratory Medicine, Sydney Children's Hospital, Sydney, Australia
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20
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Abstract
Kampo, a branch of traditional Japanese herbal medicine, has been the backbone of Japanese medicine for more than 1500 years. The health insurance system in Japan allows patients to access both Western and Kampo medical care at the same time in the same medical institution. Kampo has been used for the treatment of not only acute but also chronic pain in Japan. In this review, we will elaborate on the short history of Kampo, its basic concepts, and use for the treatment of pain.
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