Effect of Goreisan, a traditional Japanese Kampo medicine, on postoperative nausea and vomiting in gynecological patients

Efficacy of Goreisan in Preventing Transurethral Resection Syndrome in Transurethral Resection of the Prostate: A Randomized-Controlled Study

Objectives: Nonconductive irrigation fluids used during transurethral resection (TUR) of the prostate can cause fluid overload and dilutional hyponatremia. TUR syndrome is generally defined as serum sodium at or below 125 mmol/L with cardiovascular and neurologic symptoms. The aim of this study was to evaluate the effects of Goreisan, a traditional Japanese Kampo medicine, on serum sodium levels and the occurrence of TUR syndrome in patients undergoing TUR of the prostate. Design: This was a randomized-controlled trial. Settings/Location: This trial was conducted at the Osaka Medical College Hospital and Keneikai Sanko Hospital. Subjects: Fifty patients scheduled for TUR of the prostate were included. Interventions: Patients in the Goreisan group (n = 23) received 2.5 g Goreisan orally on the night before surgery and on the morning of surgery. The control group (n = 27) did not receive Goreisan. Surgical procedures, perioperative management, and patient monitoring were otherwise the same in both groups. Outcome Measures: The primary outcome was occurrence of TUR syndrome. The secondary outcome was serum sodium level. Results: Serum sodium remained above 125 mmol/L in all patients, so none of the patients met the criteria for TUR syndrome. However, the Goreisan group had significantly higher intraoperative sodium levels (p < 0.001) and significantly higher intraoperative (p = 0.008) and postoperative (p = 0.02) hemoglobin levels than the control group. Conclusions: These findings indicate that preoperative Goreisan administration can help maintain serum sodium levels in patients undergoing TUR of the prostate.

Oreongsan, an herbal medicine prescription developed as a new alternative treatment in patients with chronic subdural hematoma: a narrative review

An herbal medicine prescription, Oreongsan (ORS), which is composed of Polyporus, Alismatis Rhizoma, Atractylodis Rhizoma, Poria (Hoelen), and Cinnamomi Cortex Spissus, has been used as treatment in patients with various symptoms such as thirst, diminished urination, edema, hangover, and diarrhea. ORS is the representative prescription of the ’inducing diuresis’ (isu) effect, which traditionally means the effect of controlling the water balance. Advancement of modern science has enabled the determination of the action mechanism of herbal medicine complexes. As a result, ORS has been used in the treatment of patients with chronic subdural hematoma (CSDH), representing a novel indication. ORS inhibits the upregulation of aquaporin-4, which is involved in the development of brain edema in the central nervous system. Both aquaporin-1 and aquaporin-4 are expressed in the outer membrane of the CSDH; through its effect as aquaporin-4 inhibitor, ORS prevents the inflow of fluid into the hematoma, thereby preventing the development and recurrence of hematoma. In this study, we reviewed the relationship between the inducing diuresis effect of ORS and aquaporin, conservative treatment approach in patients with CSDH, and the prevention of recurrence in patients undergoing combined burr hole surgery and treatment with ORS.