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Baig MMFA, Wong LY, Wu H. Development of mRNA nano-vaccines for COVID-19 prevention and its biochemical interactions with various disease conditions and age groups. J Drug Target 2024; 32:21-32. [PMID: 38010097 DOI: 10.1080/1061186x.2023.2288996] [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: 06/24/2023] [Accepted: 11/18/2023] [Indexed: 11/29/2023]
Abstract
This review has focused on the development of mRNA nano-vaccine and the biochemical interactions of anti-COVID-19 mRNA vaccines with various disease conditions and age groups. It studied five major groups of individuals with different disease conditions and ages, including allergic background, infarction background, adolescent, and adult (youngsters), pregnant women, and elderly. All five groups had been reported to have background-related adverse effects. Allergic background individuals were observed to have higher chances of experiencing allergic reactions and even anaphylaxis. Individuals with an infarction background had a higher risk of vaccine-induced diseases, e.g. pneumonitis and interstitial lung diseases. Pregnant women were seen to suffer from obstetric and gynecological adverse effects after receiving vaccinations. However, interestingly, the elderly individuals (> 65 years old) had experienced milder and less frequent adverse effects compared to the adolescent (<19 and >9 years old) and young adulthood (19-39 years old), or middle adulthood (40-59 years old) age groups, while middle to late adolescent (14-17 years old) was the riskiest age group to vaccine-induced cardiovascular manifestations.
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Affiliation(s)
- Mirza Muhammad Faran Ashraf Baig
- Department of Chemistry and the Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Lok Yin Wong
- Department of Chemistry and the Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration, The Hong Kong University of Science and Technology, Hong Kong, China
| | - Hongkai Wu
- Department of Chemistry and the Hong Kong Branch of Chinese National Engineering Research Centre for Tissue Restoration, The Hong Kong University of Science and Technology, Hong Kong, China
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Bailly C. Efficacy and safety of the traditional herbal medication Chai-Ling-Tang (in China), Siryung-tang (in Republic of Korea) or Sairei-To (in Japan). JOURNAL OF ETHNOPHARMACOLOGY 2024; 319:117127. [PMID: 37683930 DOI: 10.1016/j.jep.2023.117127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2023] [Revised: 08/18/2023] [Accepted: 09/03/2023] [Indexed: 09/10/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE The herbal medicine designated Chai-Ling-Tang in China, Siryung-tang in South Korea, and Sairei-To (or Tsumura Saireito extract granules, TJ-114) in Japan is a complex polyherbal formulations with 12 plant components. It is used historically to treat Shaoyang syndrome, recorded in an ancient Chinese medical text "Treatise on Cold Damage Disorder" (Shanghan Lun). Chai-Ling-Tang formula combines two traditional Chinese herbal medicine prescriptions: Xiao-Chai-Hu-Tang and Wu-Ling-San (known as Sho-Saiko-To and Goreisan in Japan, and So Shi Ho Tang and Oreonsang in Korea, respectively). These traditional Chinese/Korean medicines and Kampo medicine have been used for more than 2000 years in East Asia, notably as regulators of body fluid homeostasis. AIM OF THE STUDY This study aims to evaluate clinical uses, pharmacological effects and unwanted effects of Sairei-To through a narrative literature survey. The main active phytoconstituents and their mechanism of actions are also collated based on the literature. METHODS Several databases including SciFinder and PubMed were searched in sourcing information using keywords corresponding to the medicinal treatment names and the corresponding plants and phytochemicals. Relevant textbooks, reviews, and digital documents (mostly in English) were consulted to collate all available scientific literature and to provide a complete science-based survey of the topic. RESULTS Sairei-To derives from ten plants and two fungi. The three major components are Bupleuri radix (Saiko), Pinelliae rhizoma (Hange), and Alismatis rhizoma (Takusha). The rest includes the species Scutellariae radix, Zizyphi fructus, Ginseng radix, Glycyrrhizae radix, Zingiberis rhizoma, Cinnamomi cortex, Atractylodis lanceae rhizoma, Poria sclerotium, and Polyporus sclerotium. The therapeutic uses of Sairei-To are very diversified, ranging from the treatment of autoimmune diseases, intestinal inflammatory disorders, edema, intestinal and kidney diseases, cancers, inflammatory skin pathologies, and other conditions such as reproductive failure. Sairei-To is considered as a safe and efficient medication, with potential rare unwanted side effects, notably lung injuries (pneumonitis essentially). Marked anti-inflammatory and immune-modulatory effects of Sairei-To have been reported, generally associated to the action of saponins (saikosaponins, glycyrrhizin), terpenoids (alisols) and flavonoids (baicalin, oroxylin A). CONCLUSION Sairei-To is commonly used to treat inflammatory diseases and appears efficient to decrease the side effects of corticosteroids. Its immune-regulatory action is well recognized and exploited to treat certain skin lesions and chemotherapy-related toxic effects. The activity of the Sairei-To product relies on the synergistic action of its individual ingredients. Further studies are warranted to quantify the synergy of action inherent to this interesting botanical medication.
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Affiliation(s)
- Christian Bailly
- OncoWitan, Consulting Scientific Office, Lille, Wasquehal, 59290, France; University of Lille, Faculty of Pharmacy, Institut de Chimie Pharmaceutique Albert Lespagnol (ICPAL), 3 rue du Professeur Laguesse, 59000, Lille, France; University of Lille, CNRS, Inserm, CHU Lille, UMR9020 - UMR1277 - Canther - Cancer Heterogeneity, Plasticity and Resistance to Therapies, 59000, Lille, France.
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Siwek M, Woroń J, Wrzosek A, Gupało J, Chrobak AA. Harder, better, faster, stronger? Retrospective chart review of adverse events of interactions between adaptogens and antidepressant drugs. Front Pharmacol 2023; 14:1271776. [PMID: 37829299 PMCID: PMC10565488 DOI: 10.3389/fphar.2023.1271776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 09/07/2023] [Indexed: 10/14/2023] Open
Abstract
Aim: We aimed to systematically evaluate the prevalence and clinical characteristics of adverse events associated with the adaptogens and antidepressant drug interactions in a retrospective chart review. Methodology: A total of 1,816 reports of adverse events were evaluated. Cases were included in the analysis if the pharmacoepidemiological analysis showed the presence of a high probability of a causal relationship between an adaptogen and antidepressant interaction and the occurrence of adverse events. The following data were extracted from the reports: age, sex, antidepressant, plant products containing adaptogens, other concomitant medications, and clinical consequences of the interactions and their possible mechanisms. Results: Adaptogens were involved in 9% of adverse events associated with the concomitant use of antidepressants and other preparations. We identified 30 reports in which side effects presented a causal relationship with the use of antidepressants and adaptogens. Here, we present the list of adaptogens with the corresponding antidepressants and the side effects caused by their interactions: Withania somnifera: reboxetine (testicle pain and ejaculatory dysfunctions), sertraline (severe diarrhea), escitalopram (myalgia, epigastric pain, nausea, vomiting, restless legs syndrome, and severe cough), and paroxetine (generalized myalgia, ophthalmalgia, and ocular hypertension); Eleutherococcus senticosus: duloxetine (upper gastrointestinal bleeding), paroxetine (epistaxis), sertraline (vaginal hemorrhage), and agomelatine (irritability, agitation, headache, and dizziness); Schisandra chinensis: bupropion (arthralgia and thrombocytopenia), amitriptyline (delirium), and fluoxetine (dysuria); Tribulus terrestris: citalopram (generalized pruritus), escitalopram (galactorrhea), and trazodone (psoriasis relapse); Coptis chinensis: mianserin (arrhythmias), mirtazapine (edema of lower limbs and myalgia), and fluoxetine (gynecomastia); Cimicifuga racemosa: mianserin (restless legs syndrome), paroxetine (gynecomastia and mastalgia), and venlafaxine (hyponatremia); Bacopa monnieri: agomelatine (back pain and hyperhidrosis) and moclobemide (myocardial infarction); Gynostemma pentaphyllum: duloxetine (back pain); Cordyceps sinensis: sertraline (upper gastrointestinal bleeding); Lepidium meyenii: mianserin (restless legs syndrome); and Scutellaria baicalensis: bupropion (seizures). Conclusion: Clinicians should monitor the adverse events associated with the concomitant use of adaptogens and antidepressant drugs in patients with mental disorders. Aggregation of side effects and pharmacokinetic interactions (inhibition of CYP and p-glycoprotein) between those medicines may result in clinically significant adverse events.
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Affiliation(s)
- Marcin Siwek
- Department of Affective Disorders, Chair of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
| | - Jarosław Woroń
- Department of Clinical Pharmacology, Chair of Pharmacology, Faculty of Medicine, Jagiellonian University Medical College, Kraków, Poland
- Department of Anesthesiology and Intensive Care, University Hospital in Cracow, Kraków, Poland
- University Center for Monitoring and Research on Adverse Drug Effects in Krakow, Kraków, Poland
| | - Anna Wrzosek
- Department of Anesthesiology and Intensive Care, University Hospital in Cracow, Kraków, Poland
- Department of Interdisciplinary Intensive Care, Jagiellonian University, Krakow, Poland
| | - Jarosław Gupało
- Pharma Consult, Pharmacotherapy Safety Team, Zakopane, Poland
| | - Adrian Andrzej Chrobak
- Department of Adult Psychiatry, Chair of Psychiatry, Jagiellonian University Medical College, Kraków, Poland
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Hirasawa N, Nakae H, Satoh K, Yoshida K, Okuyama M. Severe acute respiratory distress syndrome caused by Otsujito. Acute Med Surg 2023; 10:e874. [PMID: 37469375 PMCID: PMC10352571 DOI: 10.1002/ams2.874] [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: 01/15/2023] [Revised: 06/12/2023] [Accepted: 06/28/2023] [Indexed: 07/21/2023] Open
Abstract
Background Kampo prescriptions can cause drug-induced lung injury (DLI) and acute respiratory distress syndrome (ARDS). However, severe respiratory failure induced by Otsujito (OJT) is extremely rare. High-dose steroid pulse therapy is generally given to patients with severe DLI. Case Presentation A 63-year-old man with respiratory distress was admitted to our hospital. The patient was diagnosed with severe ARDS caused by OJT, which had been prescribed 4 weeks prior to admission. Thus, OJT was discontinued, and intensive care for ARDS, including ventilation and prone positioning, was implemented. His respiratory condition rapidly improved after treatment with an initial methylprednisolone dose (1.5 mg/kg/day). He was extubated on day 4 and discharged on day 16. The steroid dose was gradually reduced and discontinued by day 116. Conclusion A severe case of ARDS caused by OJT was successfully treated with low-dose steroids and specialized intensive care.
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Affiliation(s)
- Nobuhisa Hirasawa
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Hajime Nakae
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Kasumi Satoh
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Kenji Yoshida
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Manabu Okuyama
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
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Cheng YC, Wang YM, Lin YH, Cheng JY, Li SH, Huang YC, Tsai MY. Preventive effect and safety of Chinese herbal medicine for oral mucositis during radiotherapy in patients with head and neck cancer: Study protocol for a randomized trial. Contemp Clin Trials Commun 2022; 27:100912. [PMID: 35345874 PMCID: PMC8956911 DOI: 10.1016/j.conctc.2022.100912] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Revised: 03/02/2022] [Accepted: 03/15/2022] [Indexed: 12/30/2022] Open
Abstract
Background Oral mucositis (OM) is a common side effect of radiotherapy (RT) that can have severe implications in patients with head and neck cancer (HNC). Traditional Chinese medicine (TCM) formula is widely applied in treating OM, but little substantial evidence exists to clarify it effects. The study intends to determine whether the TCM-based prescription in treating HNC with RT can improve the OM when compared with RT alone. Methods A single-center, randomized, two-arm parallel-group, open-label controlled clinical trial will be conducted to determine whether the Zi-Yin-Liang-Ge-San (ZYLGS), which contains Rx. Scutellariae, Rx. Glycyrrhizae, Hb. Dendrobii, Rx. Ophiopogonis, and Hb. Menthae Haplocalycis, combined with RT can improve the incidence and severity of OM. Two hundred participants will randomly 1:1 to receive at least 6 weeks of RT plus ZYLGS powder or control. The primary outcome measures are onset, gradation of OM (Common Terminology Criteria for Adverse Events v5.0), and oral pain (visual analogue scale). The secondary outcome measures include nutritional status, the EORTC Quality of Life Core Questionnaire and head and neck module. The Patient-Reported Outcomes version of the Common Terminology Criteria for Adverse Events, serious adverse events, and blood and biochemical analysis will be recorded to evaluate the safety. Visits will be performed for each week during the RT treatment period and then 2 weeks in the follow-up period. Discussion The study's result will provide a high-level evidence for TCM-based formulation for HNC patients with RT on the effect of OM prevention and management.
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Affiliation(s)
- Yu-Chen Cheng
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Yu-Ming Wang
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Yun-Hsuan Lin
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Jen-Yu Cheng
- Department of Radiation Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Shau-Hsuan Li
- Department of Hematology-Oncology, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
| | - Yu-Chuen Huang
- Department of Medical Research, China Medical University Hospital and School of Chinese Medicine, China Medical University, Taichung, 41354, Taiwan
| | - Ming-Yen Tsai
- Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung, 83301, Taiwan
- Corresponding author Department of Chinese Medicine, Kaohsiung Chang Gung Memorial Hospital, No. 123 Dapi Rd, Niaosong Dist, Kaohsiung, 83301, Taiwan.
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Interstitial lung disease after receiving the mRNA-based COVID-19 vaccine tozinameran. Respir Med Case Rep 2022; 36:101618. [PMID: 35223425 PMCID: PMC8858430 DOI: 10.1016/j.rmcr.2022.101618] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 12/03/2022] Open
Abstract
Tozinameran, a messenger ribonucleic acid (mRNA)-based coronavirus disease 19 (COVID-19) vaccine, has a favorable safety profile and is highly efficacious in preventing COVID-19. Adverse reactions such as pain at the vaccination site, fever, malaise, headache, rash, and anaphylaxis have been commonly reported for mRNA-based COVID-19 vaccines. We report a case involving a 71-year-old Japanese woman who developed interstitial lung disease (ILD) after receiving an mRNA-based COVID-19 vaccine. We also review case reports of COVID-19 mRNA vaccine-associated ILD. Dyspnea or hypoxia that develops within 1–3 days after COVID-19 mRNA vaccination should be differentiated from ILD. Further studies to elucidate mechanisms and risk factors of rare adverse reactions such as ILD are warranted.
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Shii T, Kuroda M, Shamoto N, Mimaki Y. [An analysis of the ingredients in decoctions and extracts of Kampo medicines: Amounts of baicalin and baicalein in Kampo medicines containing Scutellariae Radix]. Nihon Ronen Igakkai Zasshi 2020; 57:72-80. [PMID: 32074563 DOI: 10.3143/geriatrics.57.72] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
AIM Kampo medicines containing Scutellariae Radix (the root of Scutellaria baicalensis Georgi; SR) sometimes cause serious adverse effects, including interstitial pneumonia and liver dysfunction. Baicalin (BL) is the major active component of SR and is presumed to be responsible for the adverse effects. We analyzed the amounts of BL in Kampo medicines to better understand how they can be used safely. METHODS We determined the amounts of BL in 28 Kampo decoctions containing SR (recommended daily dose: 1.5-4 g/day) and corresponding Kampo extract products by high-performance liquid chromatography. RESULTS The amounts of BL in the Kampo decoctions were 1.7-4.0-fold higher than those of the corresponding Kampo extract products. Inter-product variations in the amounts of BL in Shosaikoto, Otsujito, Daisaikoto, Saibokuto, Orengedokuto, and Saireito Kampo extracts from various companies were also examined. Significant differences in the amounts of BL were observed for Shosaikoto, Otsujito, Daisaikoto, and Saibokuto extract products (up to 2.6, 1.6, 1.5, and 1.3-fold differences, respectively), whereas no significant differences were observed for Orengedokuto and Saireito extract products. CONCLUSIONS Because the Kampo decoctions containing SR that we examined contained 1.7-4.0 times as much BL as the corresponding Kampo extract products, medical doctors and pharmacists should be aware that Kampo decoctions containing SR might cause more severe side effects than corresponding Kampo extract products. Furthermore, we recommend that the amounts of BL and its aglycone, baicalein (BA), in Kampo extract products be made known to practitioners and patients.
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Affiliation(s)
- Takashi Shii
- Department of Medicinal Pharmacognosy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences.,Department of Pharmacy, Kitasato University Hospital
| | - Minpei Kuroda
- Department of Medicinal Pharmacognosy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences
| | - Noriko Shamoto
- Department of Medicinal Pharmacognosy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences
| | - Yoshihiro Mimaki
- Department of Medicinal Pharmacognosy, School of Pharmacy, Tokyo University of Pharmacy and Life Sciences
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Mochizuki N, Ano S, Kikuchi N, Sakai C, Masuda M, Kondo Y, Ishii Y. Pneumonitis Due to Oren-gedoku-to (Coptis Detoxifying Decoction). Intern Med 2019; 58:3019-3023. [PMID: 31611510 PMCID: PMC6859392 DOI: 10.2169/internalmedicine.2586-18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2018] [Accepted: 04/18/2019] [Indexed: 11/19/2022] Open
Abstract
A 54-year-old man started to take oren-gedoku-to (coptis detoxifying decoction) because he was experiencing chronic hot flashes, night sweats and insomnia. He developed a high fever from the day of intake. At day 17, he stopped taking oren-gedoku-to because of malaise and chills, and he was admitted to our hospital. Drug-induced pneumonitis was suspected, and all drugs were stopped. Consequently, his symptoms, laboratory data and chest X-ray findings markedly improved. The results of a lymphocyte stimulation test were positive for oren-gedoku-to and one of its components, ougon (Baikal skullcap). Based on these findings, we diagnosed him with pneumonitis caused by ougon.
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Affiliation(s)
- Naoto Mochizuki
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Japan
| | - Satoshi Ano
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Japan
| | - Norihiro Kikuchi
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Japan
| | - Chio Sakai
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Japan
| | - Michiko Masuda
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Japan
| | - Yuzuru Kondo
- Department of Diagnostic Pathology, National Hospital Organization Kasumigaura Medical Center, Japan
| | - Yukio Ishii
- Department of Respiratory Medicine, National Hospital Organization Kasumigaura Medical Center, Japan
- Department of Respiratory Medicine, University of Tsukuba, Japan
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Adverse Events Associated with Ethical Kampo Formulations: Analysis of the Domestic Adverse-Event Data Reports of the Ministry of Health, Labor, and Welfare in Japan. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2019; 2019:1643804. [PMID: 31118950 PMCID: PMC6500660 DOI: 10.1155/2019/1643804] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/08/2019] [Accepted: 04/07/2019] [Indexed: 12/13/2022]
Abstract
Objectives Traditional Japanese Kampo medicines have been integrated into the Japanese national health-care system. In Japan, the Ministry of Health, Labor, and Welfare's website discloses adverse drug-event data that have been obtained from medical personnel reports investigated by the Pharmaceutical and Medical Devices Agency. Using these data, we investigated adverse events associated with ethical Kampo formulations. Methods Reports of adverse events associated with ethical Kampo formulations from the domestic adverse-event data were obtained from July 30, 2003, to March 31, 2018. Adverse events were then categorized, and the relationships between categories of adverse events and crude drugs were analyzed. Results There were 4,232 reported adverse events associated with ethical Kampo formulations. The numbers of events by category were as follows: events related to liver injury, 1,193; lung injury, 1,177; pseudoaldosteronism, 889; mesenteric phlebosclerosis, 223; drug eruption, 185; and others, 565. Among events related to both liver injury and lung injury, approximately 70% were suspected to be induced by Kampo formulations containing Scutellariae Radix. The pseudoaldosteronism-related events, which are induced by Glycyrrhizae Radix, included several events related to muscle injury, heart failure, and arrhythmia. Events related to mesenteric phlebosclerosis, believed to be induced by long-term use of Kampo formulas containing Gardeniae Fructus, increased remarkably during the study period. Among the events related to drug eruption, approximately 35% were suspected to be induced by Kampo formulations containing Ephedrae Herba. Conclusion Kampo medicines may cause various adverse events. The present results provide valuable information regarding adverse events associated with Kampo medicines from the viewpoint of patient safety.
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Shimada Y, Fujimoto M, Nogami T, Watari H, Kitahara H, Misawa H, Kimbara Y, Kita KI. Recurrent Drug-induced Liver Injury Caused by the Incidental Readministration of a Kampo Formula Containing Scutellariae Radix. Intern Med 2018; 57:1733-1740. [PMID: 29434136 PMCID: PMC6047989 DOI: 10.2169/internalmedicine.0275-17] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
A 67-year-old woman experiencing coughing visited a clinic and was prescribed drugs, including shosaikoto extract, for 4 days. She subsequently suffered from liver injury, but her condition improved after the discontinuation of all medications. Approximately 1 year later, she experienced fatigue, consulted another clinic, and received saikokeishikankyoto extract for 21 days. She subsequently suffered liver injury again. Both shosaikoto and saikokeishikankyoto contain Scutellariae Radix. This case is thought to be one of recurrent drug-induced liver injury caused by the incidental readministration of a Kampo formula containing Scutellariae Radix. An awareness of adverse drug events caused by Kampo formulas, especially those containing Scutellariae Radix, is essential.
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Affiliation(s)
- Yutaka Shimada
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Makoto Fujimoto
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Tatsuya Nogami
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Hidetoshi Watari
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Hideyuki Kitahara
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Hiroki Misawa
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Yoshiyuki Kimbara
- Department of Japanese Oriental Medicine, Graduate School of Medicine and Pharmaceutical Sciences, University of Toyama, Japan
| | - Kei-Ichiro Kita
- Department of General Medicine, Toyama University Hospital, University of Toyama, Japan
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Patient safety incident reports related to traditional Japanese Kampo medicines: medication errors and adverse drug events in a university hospital for a ten-year period. Altern Ther Health Med 2017; 17:547. [PMID: 29268743 PMCID: PMC5740942 DOI: 10.1186/s12906-017-2051-2] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 12/07/2017] [Indexed: 11/10/2022]
Abstract
BACKGROUND Kampo medicine is traditional Japanese medicine, which originated in ancient traditional Chinese medicine, but was introduced and developed uniquely in Japan. Today, Kampo medicines are integrated into the Japanese national health care system. Incident reporting systems are currently being widely used to collect information about patient safety incidents that occur in hospitals. However, no investigations have been conducted regarding patient safety incident reports related to Kampo medicines. The aim of this study was to survey and analyse incident reports related to Kampo medicines in a Japanese university hospital to improve future patient safety. METHODS We selected incident reports related to Kampo medicines filed in Toyama University Hospital from May 2007 to April 2017, and investigated them in terms of medication errors and adverse drug events. RESULTS Out of 21,324 total incident reports filed in the 10-year survey period, we discovered 108 Kampo medicine-related incident reports. However, five cases were redundantly reported; thus, the number of actual incidents was 103. Of those, 99 incidents were classified as medication errors (77 administration errors, 15 dispensing errors, and 7 prescribing errors), and four were adverse drug events, namely Kampo medicine-induced interstitial pneumonia. The Kampo medicine (crude drug) that was thought to induce interstitial pneumonia in all four cases was Scutellariae Radix, which is consistent with past reports. According to the incident severity classification system recommended by the National University Hospital Council of Japan, of the 99 medication errors, 10 incidents were classified as level 0 (an error occurred, but the patient was not affected) and 89 incidents were level 1 (an error occurred that affected the patient, but did not cause harm). Of the four adverse drug events, two incidents were classified as level 2 (patient was transiently harmed, but required no treatment), and two incidents were level 3b (patient was transiently harmed and required substantial treatment). CONCLUSIONS There are many patient safety issues related to Kampo medicines. Patient safety awareness should be raised to prevent medication errors, especially administration errors, and adverse drug events in Kampo medicine.
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Enioutina EY, Teng L, Fateeva TV, Brown JCS, Job KM, Bortnikova VV, Krepkova LV, Gubarev MI, Sherwin CMT. Phytotherapy as an alternative to conventional antimicrobials: combating microbial resistance. Expert Rev Clin Pharmacol 2017; 10:1203-1214. [PMID: 28836870 DOI: 10.1080/17512433.2017.1371591] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
INTRODUCTION In the modern antimicrobial era, the rapid spread of resistance to antibiotics and introduction of new and mutating viruses is a global concern. Combating antimicrobial resistant microbes (AMR) requires coordinated international efforts that incorporate new conventional antibiotic development as well as development of alternative drugs with antimicrobial activity, management of existing antimicrobials, and rapid detection of AMR pathogens. Areas covered: This manuscript discusses some conventional strategies to control microbial resistance. The main purpose of the manuscript is to present information on specific herbal medicines that may serve as good treatment alternatives to conventional antimicrobials for infections sensitive to conventional as well as resistant strains of microorganisms. Expert commentary: Identification of potential new antimicrobials is challenging; however, one source for potential structurally diverse and complex antimicrobials are natural products. Natural products may have advantages over other post-germ theory antimicrobials. Many antimicrobial herbal medicines possess simultaneous antibacterial, antifungal, antiprotozoal and/or antiviral properties. Herbal products have the potential to boost host resistance to infections, particularly in immunocompromised patients. Antimicrobial broad-spectrum activity in conjunction with immunostimulatory properties may help to prevent microbial resistance to herbal medicine. As part of the efforts to broaden use of herbal medicines to treat microbial infections, pre-clinical and clinical testing guidelines of these compounds as a whole should be implemented to ensure consistency in formulation, efficacy and safety.
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Affiliation(s)
- Elena Yu Enioutina
- a Division of Clinical Pharmacology, the Department of Pediatrics, School of Medicine , University of Utah , Salt Lake City , UT , USA.,b Department of Pathology, School of Medicine , University of Utah , Salt Lake City , UT , USA
| | - Lida Teng
- c Department of Drug Policy & Management (DPM), Graduate School of Pharmaceutical Sciences , The University of Tokyo , Tokyo , Japan
| | - Tatyana V Fateeva
- d Center of Medicine , All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR) , Moscow , Russia
| | - Jessica C S Brown
- b Department of Pathology, School of Medicine , University of Utah , Salt Lake City , UT , USA
| | - Kathleen M Job
- a Division of Clinical Pharmacology, the Department of Pediatrics, School of Medicine , University of Utah , Salt Lake City , UT , USA
| | - Valentina V Bortnikova
- d Center of Medicine , All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR) , Moscow , Russia
| | - Lubov V Krepkova
- d Center of Medicine , All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR) , Moscow , Russia
| | | | - Catherine M T Sherwin
- a Division of Clinical Pharmacology, the Department of Pediatrics, School of Medicine , University of Utah , Salt Lake City , UT , USA.,f Department of Pharmacology and Toxicology , University of Utah , Salt Lake City , UT , USA
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Japanese herbal medicine-induced pneumonitis: A review of 73 patients. Respir Investig 2017; 55:138-144. [PMID: 28274529 DOI: 10.1016/j.resinv.2016.11.007] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2016] [Revised: 10/24/2016] [Accepted: 11/24/2016] [Indexed: 11/21/2022]
Abstract
BACKGROUND The number of reports concerning Japanese herbal medicine (JHM)-induced pneumonitis has increased. However, comprehensive data are lacking in this regard, and the clinical characteristics of the disease remain unclear. METHODS A literature review was performed using PubMed and Ichushi-Web-the database of the Japan Medical Abstracts Society-to identify articles published between 1996 and 2015 describing patients with JHM-induced pneumonitis. The final cohort included 73 patients in 59 articles (7 in English; 52 in Japanese). RESULTS Among the various JHMs reported, sho-saiko-to was the most frequently used drug (26%), followed by sairei-to (16%), seishin-renshi-in (8%), and bofu-tsusyo-san (8%). These drugs commonly contain ougon (skullcap) and kanzo (liquorice). The mean age at pneumonitis diagnosis was 63.2 ± 15.5 years (range: 7-89 years). The male/female ratio was 44/29. Sixty-five patients (89%) developed pneumonitis within 3 months of beginning JHM treatment. Bilateral ground-glass attenuations on chest computed tomography, as well as lymphocytosis with a low CD4/CD8 T-cell ratio in bronchoalveolar lavage fluid, were common findings. Twenty-six patients (36%) recovered from the pneumonitis after simply discontinuing the causative JHM. However, the remainder required immunosuppressive therapy, and 13 patients (18%) received mechanical ventilation. Importantly, three patients (4%) did not survive, with two showing pathological diffuse alveolar damage upon autopsy. CONCLUSIONS Clinicians should be cautious regarding JHM-induced pneumonitis, particularly when using drugs/ingredients known to cause this complication, and during the early treatment period. Although most events are non-severe, critical cases should be recognized.
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Kato M, Sasaki S, Izumi H, Uekusa T, Tominaga S, Takahashi K. Development of diffuse alveolar damage after initiation of Nijutsuto. Respirol Case Rep 2016; 4:e00195. [PMID: 28031830 PMCID: PMC5167311 DOI: 10.1002/rcr2.195] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2016] [Revised: 09/13/2016] [Accepted: 09/21/2016] [Indexed: 11/23/2022] Open
Abstract
Chinese traditional medicine, Nijutsuto, is used to treat patients with frozen shoulder and osteoarthritis. Herbal medicine is often linked to the development of interstitial lung disease. An 83‐year‐old Japanese man with osteoarthritis who was on Nijutsuto was admitted to our hospital with dyspnoea and severe cough after 2 weeks from initiation of Nijutsuto. A chest computed tomography scan on admission showed diffuse ground glass opacity with traction bronchiectasis. Thus, he was diagnosed with Nijutsuto‐induced interstitial lung disease, and was treated with a high dose of methylprednisolone and cyclophosphamide. However, the patient died of respiratory failure 2 weeks after admission. The patient was definitively diagnosed with diffuse alveolar damage by pathological autopsy. Nijutsuto contains Radix Scutellariae, which is considered to be the cause of interstitial lung disease. Chinese traditional medicine containing both Radix Scutellariae and Licorice should be carefully used because of its potential role in the development of diffuse alveolar damage.
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Affiliation(s)
- Motoyasu Kato
- Department of Respiratory Medicine Juntendo University Urayasu Hospital Chiba Japan; Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Shinichi Sasaki
- Department of Respiratory Medicine Juntendo University Urayasu Hospital Chiba Japan; Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Hiroshi Izumi
- Department of Pathology Juntendo University Urayasu Hospital Chiba Japan
| | | | - Shigeru Tominaga
- Department of Respiratory Medicine Juntendo University Urayasu Hospital Chiba Japan; Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan
| | - Kazuhisa Takahashi
- Department of Respiratory Medicine Juntendo University Graduate School of Medicine Tokyo Japan
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Acute Hepatitis after Ingestion of a Preparation of Chinese Skullcap and Black Catechu for Joint Pain. Case Reports Hepatol 2016; 2016:4356749. [PMID: 27144042 PMCID: PMC4842037 DOI: 10.1155/2016/4356749] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2015] [Accepted: 03/21/2016] [Indexed: 12/13/2022] Open
Abstract
Many herbal preparations are routinely used and have been occasionally associated with a wide range of side effects, from mild to severe. Chinese skullcap and black catechu are herbal medications commonly used for their hepatoprotective and other properties. We report a case of acute toxic hepatitis associated with ingestion of Chinese skullcap and black catechu in one preparation for the alleviation of joint pain.
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Iida Y, Takano Y, Ishiwatari Y, Yoshida A, Shimizu T, Ito R, Hattori T, Takahashi N, Hashimoto S. Diffuse Alveolar Hemorrhage Associated with Makyo-kanseki-to Administration. Intern Med 2016; 55:3321-3323. [PMID: 27853076 PMCID: PMC5173501 DOI: 10.2169/internalmedicine.55.6986] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
We herein describe the first known case of diffuse alveolar hemorrhage (DAH) associated with the administration of Makyo-kanseki-to, a Chinese herbal drug. A 64-year-old man with bronchial asthma presented with persistent cough. Makyo-kanseki-to was prescribed as an adjunctive treatment for bronchial asthma. Immediately after drug ingestion, the patient expectorated bloody sputum. DAH was diagnosed based on the presence of bilateral ground-glass opacity which was identified on chest computed tomography and bloody bronchoalveolar lavage fluid. We diagnosed that the administration of Makyo-kanseki-to was the responsible medication because the hemorrhage developed immediately after drug ingestion and resolved after the cessation of such medication with no subsequent recurrence.
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Affiliation(s)
- Yuko Iida
- Division of Respiratory Medicine, Department of Internal Medicine, Nihon University School of Medicine, Japan
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Treatment of posttraumatic stress disorder using the traditional Japanese herbal medicine saikokeishikankyoto: a randomized, observer-blinded, controlled trial in survivors of the great East Japan earthquake and tsunami. EVIDENCE-BASED COMPLEMENTARY AND ALTERNATIVE MEDICINE 2014; 2014:683293. [PMID: 24790634 PMCID: PMC3982420 DOI: 10.1155/2014/683293] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 02/27/2014] [Indexed: 11/18/2022]
Abstract
The Great East Japan earthquake and tsunami caused immense damage over a wide area of eastern Japan. Hence, many survivors are at high risk for posttraumatic stress disorder (PTSD). This randomized, observer-blinded, controlled trial examined the efficacy and safety of the traditional Japanese herbal formula saikokeishikankyoto (SKK) in the treatment of PTSD among survivors of this disaster. Forty-three participants with an Impact of Event Scale-Revised (IES-R) score ≥ 25 were randomized into SKK (n = 21) and control (n = 22) groups. The primary endpoint was the change in IES-R scores from baseline till after 2 weeks of treatment. Intergroup statistical comparisons were performed. The magnitude of changes in total IES-R scores differed significantly between the two groups (P < 0.001). Post hoc analysis showed that the total IES-R score improved significantly in the SKK group from 49.6 ± 11.9 to 25.5 ± 17.0 (P < 0.001). Subscale scores improved significantly in the SKK group (avoidance, P = 0.003; hyperarousal, P < 0.001; intrusion, P < 0.001). Two-week treatment with SKK significantly improved IES-R scores among PTSD patients. This traditional medicine may be a valid choice for the treatment of psychological and physical symptoms in PTSD patients.
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Takaku S, Osono E, Kuribayashi H, Takaku C, Hirama N, Takahashi H. A case of migraine without aura that was successfully treated with an herbal medicine. J Altern Complement Med 2013; 19:970-2. [PMID: 23758551 DOI: 10.1089/acm.2013.0147] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE Migraine is a common neurologic condition characterized by the disabling effects it has on the patient. Despite recent progress in drug development, better pharmacotherapies against migraine are still needed. This report describes an herbal medicine that has a strong pain-relieving effect against migraine. PATIENT This case involved a 49-year-old woman with a 16-year history of headaches. Migraine without aura had been diagnosed at age 47 years. Despite taking antiepileptic drugs as prophylaxis, she had migraines almost three times a week, especially in the morning. As a result, 3 months before her visit to the study clinic she was prescribed sumatriptan, which she had to take for each attack. However, sumatriptan sometimes failed to work as a painkiller, and the patient did not want to continue taking it because she was worried about overuse. INTERVENTION AND OUTCOME According to traditional Japanese (Kampo) and Chinese herbal medicine, the patient was prescribed an oral sanno-shashin-to (Xie Xin Tang) extract formula to take at night to prevent her migraines. Soon after she started taking the formula, the intensity of her morning headaches markedly decreased, to the extent that triptans were no longer needed. Furthermore, her residual headaches quickly disappeared after the additional administration of the formula in the morning. CONCLUSIONS Sanno-shashin-to might have both prophylactic and therapeutic effects against migraine without aura. Although the underlying mechanism behind the effectiveness of this herbal medicine against migraine has not been fully elucidated, it is a possible option for the treatment of this type of headache.
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Affiliation(s)
- Shun Takaku
- 1 Division of Traditional Japanese Medicine, Nippon Medical School Hospital , Sendagi, Bunkyo-ku, Tokyo, Japan
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Jhun BW, Kim DM, Park JH, Jung H, Song L, Han J, Chung MP. A Case of Interstitial Pneumonitis with Acute Live Injury Caused by Herbal Medicine Made from Golden Thread. Tuberc Respir Dis (Seoul) 2011. [DOI: 10.4046/trd.2011.71.6.470] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Byung Woo Jhun
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Da Min Kim
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ji Hyeon Park
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Hyunae Jung
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Limhwa Song
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Joungho Han
- Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Man Pyo Chung
- Department of Internal Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Hiraya D, Kagohashi K, Satoh H. Pneumonitis due to an herbal medicine, Otsu-ji-to. Eur J Intern Med 2010; 21:244. [PMID: 20493432 DOI: 10.1016/j.ejim.2010.01.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2009] [Accepted: 01/07/2010] [Indexed: 11/22/2022]
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Kim SG, Kang GH, Kim JJ, Park H, Baek NN, Choi SB, Shin EA, Kim JS, Park IN, Jeung H, Hur JW, Lee SS, Lee HK, Kim JI, Lee YM, Lee HP, Yum HK, Choi SJ. A Case of Recurrent Pneumonitis Caused by Bojungikgitang(Bu-Zhong-Yi-Qi-Tang). Tuberc Respir Dis (Seoul) 2008. [DOI: 10.4046/trd.2008.65.5.416] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Seung Gu Kim
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Gun Hi Kang
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jun Jae Kim
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hyun Park
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Na Na Baek
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sang Bong Choi
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Eun Ah Shin
- Department of 2Pathology, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Joung Sook Kim
- Department of 3Radiology, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - I Nae Park
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hoon Jeung
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Jin Won Hur
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Sung Soon Lee
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hyun Kyung Lee
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Joo In Kim
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Young Min Lee
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Hyuk Pyo Lee
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Ho Kee Yum
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
| | - Soo Jeon Choi
- Department of 1Internal Medicine, Paik Hospital, Inje University College of Medicine, Seoul, Korea
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Iwasaki K, Kato S, Monma Y, Niu K, Ohrui T, Okitsu R, Higuchi S, Ozaki S, Kaneko N, Seki T, Nakayama K, Furukawa K, Fujii M, Arai H. A pilot study of banxia houpu tang, a traditional Chinese medicine, for reducing pneumonia risk in older adults with dementia. J Am Geriatr Soc 2007; 55:2035-40. [PMID: 17944889 DOI: 10.1111/j.1532-5415.2007.01448.x] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To evaluate whether the traditional Chinese herbal medicine banxia houpu tang (BHT, formula magnolia et pinelliae) prevents aspiration pneumonia and pneumonia-related mortality in elderly people. DESIGN A prospective, observer-blinded, randomized, controlled trial. SETTING Two long-term care hospitals for handicapped elderly patients in Japan from March 2005 to February 2006. PARTICIPANTS One hundred four elderly patients (31 men and 73 women; mean age+/-standard deviation 83.5+/-7.8) with dementia and cerebrovascular disease, Alzheimer's disease, or Parkinson's disease. INTERVENTION Ninety-five participants (mean age 84.0, M:F=28:67) were randomly assigned to the BHT treatment group (n=47) or the control group (n=48) and took BHT or placebo for 12 months. MEASUREMENTS The occurrence of pneumonia, mortality due to pneumonia, and the daily amount of self-feeding. RESULTS Complete data were available for analysis on 92 of the 95 subjects randomized. Four patients in the BHT group developed pneumonia, and one of them died as a result. Fourteen patients in the control group developed pneumonia, and six of them died as a result. There was a significant difference between the two groups in pneumonia onset (P=.008), and a tendency toward significance in pneumonia-related mortality (P=.05). The relative risk of pneumonia in the BHT group compared with the control group was 0.51 (95% confidence interval (CI)=0.27-0.84, P=.008) and that of death from pneumonia was 0.41 (95% CI=0.10-1.03, P=.06) according to the Cox proportional hazards model. No adverse events were observed from treatment with BHT. The BHT group was able to maintain self-feeding better than the control group (P=.006). CONCLUSION Treatment with BHT reduced the risk of pneumonia and pneumonia-related mortality in elderly patients with dementia.
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Affiliation(s)
- Koh Iwasaki
- Center for Asian Traditional Medicine, Graduate School of Medicine, Tohoku University, Sendai, Japan.
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Ishida K, Sato H. Kampo medicines as alternatives for treatment of migraine: Six case studies. Complement Ther Clin Pract 2006; 12:276-80. [PMID: 17030300 DOI: 10.1016/j.ctcp.2006.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Revised: 05/10/2006] [Accepted: 07/08/2006] [Indexed: 10/24/2022]
Abstract
Kampo is a well-recognized form of traditional medicine in Japan. This paper reports upon six cases of successful use of Kampo medicines, herbal medicine preparations, for the treatment of migraine. Most of the patients had been treated with conventional medicines, such as non-steroidal anti-inflammatory drugs or triptans, but were not satisfied with the outcomes of these conventional treatments with regard to their effectiveness or feelings of discomfort after administration. We administered two Kampo medicines, goshuyuto for prevention of migraine and senkyuchachosan as a painkiller. Both Kampo medicines worked successfully in the treatment of migraine and the patients were satisfied with their effects. Kampo medicine seems a favorable candidate for alternative therapy of migraine.
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Affiliation(s)
- Kazuyuki Ishida
- Department of Internal Medicine, Metropolitan Aoyama Hospital, 5-53-3 Jingumae, Shibuya-ku, Tokyo 150-0001, Japan.
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Hsu LM, Huang YS, Tsay SH, Chang FY, Lee SD. Acute hepatitis induced by Chinese hepatoprotective herb, xiao-chai-hu-tang. J Chin Med Assoc 2006; 69:86-8. [PMID: 16570576 DOI: 10.1016/s1726-4901(09)70119-4] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Xiao-chai-hu-tang (syo-saiko-to in Japanese) is a herbal remedy that has been widely used in China for treatment of respiratory, hepatobiliary, and gastrointestinal diseases, particularly among patients with chronic liver disease. However, its safety has recently been challenged. We, herein, report a Chinese patient with acute hepatitis induced by this herb. A 52-year-old woman presented with weakness, fatigue, and tea-colored urine after continual consumption of the decoction of xiao-chai-hu-tang for 1.5 months. Laboratory studies disclosed acute hepatitis even though all of the viral hepatitis markers were negative. Liver biopsy also revealed a picture of acute hepatocellular hepatitis. The symptoms improved after discontinuing the drug, and liver biochemical tests normalized 2 months later. The case report reminds us of the probable adverse drug reaction of herbs, even in some that are claimed to have hepatoprotective effects.
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Affiliation(s)
- Li-Ming Hsu
- Department of Medicine, Taipei Veterans General Hospital, National Yang-Ming University School of Medicine, Taiwan, ROC
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