Long-term administration of traditional kampo medicine shimotsuto, juzentaihoto and unseiin inhibits experimental thrombosis in mice

Traditional Chinese herbal medicines (Kampo) are used to improve flow characteristics of blood (Oketsu). We assumed that by preventing stagnation of blood, these medicines may be beneficial not only in venous but in arterial thrombotic conditions. The present study aimed to assess the antithrombotic effect of three Kampo, using well-established in vitro and animal models of thrombosis. Western-style highfat diet containing 1% Kampo (Shimotsuto, Juzentaihoto or Unseiin) was administered to C57BL/6 mice for 12 weeks. The effect on thrombus formation by laser irradiation of the carotid artery of mice was assessed. In addition the ex-vivo technique of shear-induced platelet reactivity measurement (haemostatometry) and the in vivo test of endothelial function (flowmediated vasodilation) were also used to assess the mechanism of antithrombotic effect. All three medicines have significantly inhibited arterial thrombus formation in mice. According to our studies, the mechanism of antithrombotic effect is based on the inhibition of shear-induced platelet reac- tivity and stimulation of endothelial function (Unseiin). It is assumed that the common ingredients Japanese Angelica Root, Cnidium Rhizome, Peony Root and Rehmannia Root could be responsible for the observed antithrombotic effect.

Improvement of decocting method for Kampo medicines using a microwave oven to extend its applications in clinical practice

Decoction of Kampo medicines plays an important role in clinical practice, especially in individualized treatment, while the inconvenience and a long time requirement of the decocting process are impediments to its widespread use in Japan. In this study, we improved the decocting method by using a microwave oven such as those found in most kitchens. To validate the feasibility and safety of this new method, we decocted kakkonto, which is the most widely used formula in clinical treatment in Japan, and keishikabushito, which contains toxic components using a microwave oven. Regarding the contents of 8 characteristic components in the kakkonto decoction and the contents of 6 toxic components in the keishikabushito decoction as indices, and with the extraction and detoxification effects equal to those of the conventional decocting method as targets, we optimized the decocting conditions with Response Surface Methods. With this new method, it took 35 min to obtain almost the same extraction effect for kakkonto as with the conventional decocting method, which takes 40 min;meanwhile, it took only 45 min to detoxify keishikabushito, which takes 60 min using the conventional decocting method. Decocting Kampo medicines with a microwave oven is feasible and as safe as the conventional decocting method. It is a convenient, safe, time-saving method, and may be applied widely in clinical practice. This innovation should allow more patients to benefit from decoction and the individualized treatment it offers.

Effects of Kampo medicine hangebyakujutsutemmato on persistent postural-perceptual dizziness:A retrospective pilot study

BACKGROUND Persistent postural-perceptual dizziness(PPPD)is a functional disorder,typically preceded by acute vestibular disorders.It is characterized by a shift in processing spatial orientation information,to favor visual over vestibular and somatosensory inputs,and a failure of higher cortical mechanisms.To date,no therapies for PPPD have been approved.Kampo medicine hangebyakujutsutemmato(HBT)has been reported to alleviate disturbances of equilibrium.We hypothesized that HBT would be a beneficial treatment for PPPD.AIM To examine the efficacy of HBT for the treatment of PPPD.METHODS Patients with PPPD were enrolled and divided into two groups:The HBT group(n=24)and the non-HBT group(n=14).The participants completed questionnaire surveys[Niigata PPPD questionnaire(NPQ),dizziness handicap inventory,hospital anxiety and depression scale(HADS),orthostatic dysregulation questionnaire,pittsburg sleep quality index(PSQI),and motion sickness scores]before and after HBT treatment.Additionally,to identify HBT responders,multivariate regression analysis was performed using the results of the ques-tionnaire surveys and equilibrium tests;including stabilometry,and caloric,vestibular evoked myogenic response,and head-up tilt tests.RESULTS Thirty-eight outpatients were included in this study,of which 14 patients(3 men,11 women;mean age,63.5±15.9 years)received treatment without HBT,and 24(1 man,23 women;mean age,58.2±18.7 years)received combination treatment with HBT.Following HBT treatment,NPQ scores decreased significantly(baseline 40.1±10.0 vs 2 mo 24.6±17.7,P<0.001).No statistically significant changes were observed in the NPQ scores in the non-HBT group(baseline 38.6±12.2 vs 2 mo 39.4±14.4,P=0.92).Multivariable regression analysis revealed that the results of stabilometry(P=0.02)and the caloric(P=0.03),and head-up tilt tests(P<0.001),HADS(P=0.003),and PSQI(P=0.01)were associated with HBT responsiveness in PPPD patients.CONCLUSION HBT may be an effective adjunct therapy for PPPD.Patients with autonomic dysfunction,unstable balance,semicircular canal paresis,anxiety,and poor sleep quality may be high responders to HBT.

Development and Future Trends of Traditional Kampo Medicine in Japan

Traditional Kampo medicine is based on traditional Chinese medicine,which spread to Japan via the Korean Peninsula in the 5th century.The practice of Kampo developed gradually under the influence of local Japanese culture and prospered until the Meiji Restoration.Kampo appeared in schools successively,such as the School of Later Developments,the School of Classic Methods,the School of Textual Research,and the Integrated School.However,the practice of Kampo gradually declined after the Meiji Restoration.Today,through the continuous efforts of knowledgeable Japanese Kampo practitioners,the practice of Kampo has entered a new era as an indispensable aspect of contemporary Japanese medicine.

Pharmacological characteristics of Kampo medicine as a mixture of constituents and ingredients

Herbal medicine in Japan is termed as Kampo medicine, which is derived from traditional Chinese medicine. Shakuyakukanzoto (Shao-Yao-Gan-Cao-Tang) as a kind of Kampo formulations is composed of just two components; Paeoniae Radix and Glycyrrhizae Radix, which produced marked relaxation of intestinal tract. Mokuboito (Mu-Fang-Ji-Tang) inhibited cardiac ionic channel currents, and as a mixture also produced great vasodilatation. Sinomenine (a main ingredient of Mokuboito) as a single compound also caused the vasodilatation, but decreased it along with ageing. Gypsum containing in Mokuboito and Chotosan (Diao-Teng-San) caused more marked effects, as compared with those without Gypsum. On the other hand, Rokumigan (Liu-Wei-Wan), Hachimijiogan (Ba-Wei-Di-Huang-Wan) and Goshajinkigan (Niu-Che-Shen-Qi-Wan) increase in order the number of contained ingredients. The formulations with more herbs (ingredients) produced much more effective actions on rat aorta, presumably due to compensation of the decline of pharmacological sensitivity with ageing. Thus, there are some important differences between single chemical drugs and mixture drugs with many ingredients. The effects of Kampo medicine (mixture) are never just a sum of each effect induced by a lot of ingredients. For elder persons, furthermore, Kampo medicine exerts more effective actions.

Modulation by anti-oketsu formulations in Kampo medicine of human arterial stiffness

目的:比较四种活血化瘀方对瘀血人群和非瘀血人群心血管功能的影响.方法:发射脉冲和反射脉冲形成桡动脉搏动波,其比值即反射波增强指数(AI)反映了动脉硬化的程度.根据瘀血证诊断评分标准把受试者分为瘀血组(n=76)和非瘀血组(n=37),均口服抗活血化瘀方(当归芍药散、加味逍遥散、桂枝茯苓丸或者桃核承气汤),之后连续60分钟监测AI、血压、心率和中心动脉压.结果:在服药后40-60分钟,瘀血组的AI降低6-18%,其中桃核承气汤组的AI降低18.3±3.1%(P<0.01,n=15).同时瘀血组中心动脉压也降低,其中桃核承气汤治疗组中心动脉血压降低9.1±2.0%(P<0.05,n=15),加味逍遥散组的中心动脉血压降低9.0±1.8%(P<0.05,n=23).所有处方对非瘀血组AI、血压、心率和中心动脉压没有显著影响.结论:活血化瘀方能改善瘀血人群的动脉硬化.

名古屋玄医与日本汉方医学之自立

名古屋玄医借医学复古对金元医学的非难首次打破了中国医学在日本的权威地位,之后更是提出医道规矩,试图使汉方医学区别于中国医学而自立。从历史的角度来看,日本医界的陈陈相因是他打破原有理论的原因,构建新的医学体系的动机更多是为了证明“和胜汉”说在医学领域的成立。从学术思潮传播的角度而言,玄医很大程度上受中国的错简重订派与温补学派的启发。玄医的医学反思,打破了汉方医学对中国医学的绝对依附,其思想也深刻参与构建了古方派的医学体系。

张景岳医学著述的传日、受容与变容

明代医家张景岳之代表作《类经》《景岳全书》《质疑录》等曾于江户时期先后多次传日,日人除抄刻《类经》《质疑录》原著外,还对《景岳全书》进行节选与重编。不同学者主要围绕张景岳关于阴阳五行、三焦、命门、伤寒以及经穴定位等方面的论述展开争鸣与考辨,日本医家对张景岳所创制的内、外、妇、儿各科方药与针灸疗法也多有择用。通过梳理张景岳医著的传日、受容与变容,可明晰其对日本医家所产生的影响。借日本医家之眼反观张景岳医学著述,也可促进其更好地应用于理论研究与临床工作。

室町时代以来日本汉方医家治疫验案探析

室町时代以来,日本汉方医学界相继形成了后世方派、古方派、折衷派等医学流派,各流派代表人物所留存的医案记录为中医药传日后应用于日本各类疫病辨治提供了切实依据。其中,后世方派曲直濑玄朔的医案反映了其分期治疗痘疮以及针对麻疹恢复期患者扶正托邪的治疗思路;古方派吉益南涯的医案体现了其治疗疫病善用峻剂驱逐瘀热之毒以及辨疫痢虚实而治的特点;折衷派浅田宗伯的医案则呈现出其博采仲景方及中日其他各家验方而井然有序的治疫经过。此外,北山友松子、古林见宜、野间玄琢等的医案也进一步展现了近世日本汉方医家将中医方剂灵活化裁应用于疫病治疗之中。

Prolapsed tongue papilloma cured by administration of the traditional Japanese(Kampo) herbal medicine, Keishibukuryogan-ka-yokuinin:A case report

Squamous papilloma is a benign mass lesion of the oral mucosa. For papillomas of the tongue, surgery is recommended owing to their malignant potential;however, certain complications may be associated with surgery. A traditional Japanese(Kampo) herbal medicine, Keishibukuryogan-ka-yokuinin(KBGY),has been used to treat viral warts and various skin diseases in Japan. Therefore, the effect of KBGY on papillomas is promising. A 49-year-old Japanese man presented with a wart on his tongue that was about3 months old. He smoked 5 cigarettes per day. He did not drink alcohol. He had no history of malignant illnesses. He was taking alprazolam for panic disorder. The patient was diagnosed with a suspected papilloma of the tongue at the Department of Otolaryngology and was advised to undergo an excision biopsy to exclude malignancy. However, he refused owing to the fear of an invasive procedure. After informed consent was obtained from the patient, KBGY was prescribed. Three months later, the wart on his tongue spontaneously prolapsed. The histopathological diagnosis was squamous papilloma. There was no indication of malignancy, and the patient discontinued Kampo treatment. He has had no recurrence in the past 3 years. KBGY is a combination of Keishibukuryogan and yokuinin(adlay seeds).Keishibukuryogan may be beneficial for skin or oral mucosal remodeling, and yokuinin may have antiviral properties. The present case report suggests the use of KBGY as an appropriate complementary therapy for squamous papilloma.

The Influence of Shanghanlun on Japanese Kampo Medicine

Shanghanlun is a classic work in traditional Chinese medicine(TCM),which systematically discusses diagnosis and treatment ideas based on syndrome differentiation and records a large number of highly practical prescriptions.When Shanghanlun was introduced into Japan along with the communication between China and Japan in the Sui and Tang Dynasties,it had a profound influence on the development of Kampo medicine in Japan.By sorting out the works related to Shanghanlun in the medical history literature of Kampo medicine before the Meiji Restoration,this paper discusses the relationship between Shanghanlun and the Koho school of Kampo medicine,as well as the influence of the thought“formula corresponding to pattern identification,”originating from the Koho school,on the development of modern Kampo medicine.The study of Shanghanlun by Kampo medicine nowadays not only attaches great importance to clinical practicality but also has theoretical discussions.It is expected that future medical exchanges between China and Japan will complement each other from the perspectives of both sides and promote the theoretical and clinical development of TCM.

Effect of Saikokeishito, a Kampo medicine, on hydrogen peroxide-induced premature senescence of normal human dermal fibroblasts

OBJECTIVE: Saikokeishito(TJ-10) is a Kampo(traditional Japanese herbal) medicine, clinically used for hundreds of years in East Asia. Among its various mechanisms elucidated so far, TJ-10 inhibits the production of transforming growth factor-β1(TGF-β1) and development of pancreatic fi brosis in vivo. Oxidative damage of normal human dermal fi broblasts(NHDFs) in the corium is a cause of human dermal senescence. Our aim was to determine whether TJ-10 protects NHDFs from premature senescence by hydrogen peroxide(H2O2). METHODS: Premature senescence was induced in NHDFs by 200 μmol/L H2O2 for 4 h. Cell viability and the expressions of p53, AMP-activated protein kinase α1(AMPKα1), AMPKα2, and 14-3-3 protein sigma(14-3-3 σ) were measured in NHDFs treated with TJ-10 for 48 h before exposure to H2O2 for 4 h. RESULTS: Cell viability after treatment with 200 μmol/L H2O2 for 4 h was similar(about 80%) to after pre-treatment with TJ-10. Ascorbic acid as a control did not protect NHDFs from damage by 200 μmol/L H2O2. Treatment with 200 μmol/L H2O2 tended to up-regulate p53 and to down-regulate SIRT1 and AMPKα1, but had no effect on AMPKα2 and 14-3-3 σ expression. Pretreatment with TJ-10 inhibited H2O2-induced up-regulation of p53 and enhanced AMPKα1 expression. CONCLUSION: It is suggested that Saikokeishito has a protective effect on oxidative stressinduced senescence of NHDFs.

Traditional Japanese Medicine,Kampo:Its History and Current Status

Traditional Japanese medicine,Kampo,is used by over 80%of medical doctors in Japan.Owing to its high quality and safety,Kampo has been integrated into modern medicine,and there are 345 randomized controlled trials using Kampo in Japan as of 2010.Although there are a number of articles in top journals about basic science research,we can find only small numbers of high-quality clinical evidence.Since undergraduate education on Kampo has been established,integrative approach with the balanced combination of modern medicine and Kampo is expected to generate good clinical evidence in the near future.

Standards of Reporting Kampo Products (STORK) in research articles

There had been no standardized rules for citing ethical Kampo products used in clinical trials in journal articles. Although the name of a Kampo manufacturer was described in 77.9% of research articles, the name and ratios of crude drug components of Kampo formulas were not described in 77.5% of these papers. Considering the importance of proper characterization of interventions in the Consolidated Standards of Reporting Trials(CONSORT) checklist, we hereby propose the use of the Standards of Reporting Kampo Products(STORK) website, http://mpdb.nibiohn.go.jp/stork, as a reference for Kampo products. This will provide an official source on the internet for verified information on individual Kampo formulations for citation purposes in clinical research articles.

日本汉方药保护措施研究

通过全面搜集、整理有关日本汉方药保护方面的各类文献,梳理日本汉方药发展脉络,深入研究日本对汉方药发展的各项保护措施,从简化汉方药注册审批流程、重视汉方药的研究开发、加强汉方药生产与质量管理、分类管理汉方药销售、完善汉方药的知识产权保护和管理制度、在制度上保证汉方医学教育、积极开展国际化合作研究7个维度逐一探讨日本对汉方药发展的促进与保护措施,汲取成功经验,为我国中医药高质量发展、保护发展研究成果等方面提供决策参考。

中西深斋《伤寒论辨正》注释特色探析

[目的]探析日本古方派医家中西深斋所著《伤寒论辨正》的注释特色,为研究《伤寒论》注释者提供参考。[方法]通过文献学分析方法,以《伤寒论辨正》全文所列条文及注释为研究对象,并结合其他相关书籍,对其注释特色进行归纳与总结。[结果]中西深斋文学功底深厚,在注释《伤寒论》时对比诸方用药之异,重视文法、点明紧要,厘定方剂古今剂量,直接训释、不重考证,且设以眉批补充余义。此书是一部注解详明,独具特色的《伤寒论》注释论著。[结论]中西深斋师从于古方派大家吉益东洞先生,专心研究古医方三十余年,所著《伤寒论辨正》条理疏畅,讨论明晰。现通过讨论其注释特色,以期为进一步研究《伤寒论》注释考证者提供较为详尽的参考,亦于现今临证治疗有所裨益。

汤本求真的学术思想探析

汤本求真是日本昭和初期著名的古方派医家,他的著作及学术思想不仅影响了日本医界,也对我国中医学现代化有一定的影响。本文基于对汤本求真著作的研究,依据国内外相关文献资料,概括总结了汤本求真的生平,分析探讨了汤本求真在西学中的医学背景下形成的学术思想,从病因、诊疗、治法、方药等方面予以阐述,希望能对我国中医药临床实践和传承发展带来借鉴与思考,并为研究汉方医提供可用资料。

中药与日本汉方药原植物的差异比较及原因分析

依据 2 0 0 0年版《中国药典》和第十四改《正日本药局方》收载植物类生药品种 ,列表比较了中药与日本汉方药原植物的差异 。

几种黄连解毒汤的HPLC指纹图谱研究

目的 :以HPLC指纹图谱区分不同工艺、不同原料制备的黄连解毒汤 (黄连、黄芩、黄柏、栀子 )制品及日本汉方黄连解毒汤制剂。方法 :HPLC法 ;采用C18V反相色谱柱 ,二元梯度洗脱 ,二极管阵列检测器 ,以芍药苷为内标作为相对标准。结果 :共有 15～ 16个特征峰为共有峰 ,但新工艺制品和醇提物出现 1个独特的特征峰 ,与其它制品不同。各不同工艺及原料制品的特征峰与内标峰的峰高比有显著性区别。结论 :试验结果稳定 ,重复性良好 。

我国中药占国际市场份额的测算及相关概念辨析

目的明确我国中药占国际市场的实际份额。方法通过查阅大量国内、外文献,对中药、植物药、汉方药和天然药物等概念进行界定;探究历来引用的我国中药占国际市场份额3%的来历,并就与中药出口相关的各种数据指标及概念进行辨析,对实际份额进行测算。结果与结论我国中药出口额占全球天然药物贸易额的7%,占全球天然药物销售额的3.2%,而我国中药贸易额占全球天然药物贸易额的9.4%。中药、植物药、汉方药及一些传统药物均属天然药物范畴,统计国际市场份额应以天然药物为准。