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Successful treatment of an older patient with COVID‐19 pneumonia using herbal medicine—especially saikanto 使用草药(特别是西关东)成功治疗1例老年COVID - 19肺炎患者
Pub Date : 2023-06-08 DOI: 10.1002/tkm2.1379
T. Utsunomiya, Den-ichiro Yamaoka, T. Asakawa, Yukio Mizumoto, Yasutsugu Takada
New antiviral drugs for COVID-19 have been launched with special approval. However, as there may be a shortage of drugs in the future, it may be difficult to provide appropriate medical intervention. Herein, we describe our experience of successfully treating COVID-19 pneumonia in an older patient using a Japanese herbal medicine without new antiviral drugs. A 94-year-old woman was diagnosed with COVID-19 and received home care. However, dyspnea appeared on day 4 of home treatment, so she visited the emergency department of our hospital. Her SpO2 then increased to 97% after oxygen delivery at a rate of 7 L/min via a mask. On physical examination, the patient presented with tachypnea (24 breaths per minute) and stable hemodynamics. Her blood pressure, heart rate, and body temperature were 104/65 mm Hg, 68 beats/min, and 37.5 C respectively. She had clear consciousness. Her height and body weight were 146 cm and 47 kg respectively. Laboratory test results are presented in Table 1. Computed tomography (CT) scan revealed infiltrates in the bilateral lower lungs with ground-glass signs. The qSOFA was one point and sepsis was not actively suspected, but the A-DROP was three points and the patient was indicated for hospitalization for severe pneumonia. Given her history of hypertension and stroke, she usually spent most of her time lying in bed, except for eating and defecating. Aspiration was not confirmed during home care. CT imaging showed mainly a groundglass appearance rather than an infiltrating shadow, so aspiration pneumonia was not actively suspected. Based on the course and CT imaging, typical bacterial pneumonia was not actively suspected and the use of antibiotics was withheld. Her respiration was stabilized with oxygen therapy; however, she was frail and old, and neither she nor her family wanted active treatment. As she could drink water, a Japanese herbal treatment for pneumonia was initiated. Her Kampo medical findings indicated that she had a deficiency. She complained of bitterness in her mouth and chest pain when coughing. Her pulse was weak
新冠病毒抗病毒药物已获特别批准上市。然而,由于将来可能出现药物短缺,可能难以提供适当的医疗干预。在此,我们描述了我们使用日本草药成功治疗老年患者COVID-19肺炎的经验,没有新的抗病毒药物。一名94岁的妇女被诊断出患有COVID-19并接受了家庭护理。然而,在家庭治疗的第4天出现呼吸困难,因此她来到了我院的急诊科。通过面罩以7l /min的速率给氧后,她的SpO2增加到97%。体格检查时,患者出现呼吸急促(每分钟24次呼吸),血流动力学稳定。她的血压、心率和体温分别为104/65 mm Hg、68次/分和37.5℃。她有清醒的意识。她的身高和体重分别为146厘米和47公斤。实验室测试结果见表1。计算机断层扫描显示双侧下肺浸润伴磨玻璃征。qSOFA为1分,未积极怀疑脓毒症,但A-DROP为3分,患者因严重肺炎需要住院治疗。考虑到她有高血压和中风病史,除了吃饭和排便,她通常大部分时间都躺在床上。在家庭护理期间未确认误吸。CT主要表现为磨砂样影,未见浸润影,不积极怀疑吸入性肺炎。根据病程及CT表现,未积极怀疑为典型细菌性肺炎,未给予抗生素治疗。氧疗稳定了她的呼吸;然而,她年老体弱,她和她的家人都不希望积极治疗。因为她可以喝水,所以开始使用日本草药治疗肺炎。她的康坡医学检查结果表明,她有缺陷。她说嘴里有苦味,咳嗽时胸痛。她的脉搏很微弱
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引用次数: 0
Severe adverse reactions caused by Kampo formulas from the viewpoint of cases relieved by the Adverse Drug Reaction Relief System in 2021 从2021年药品不良反应缓解制度所缓解的病例看汉方严重不良反应
Pub Date : 2023-06-03 DOI: 10.1002/tkm2.1378
Kazuo Yamada, Kensuke Usui, E. Suzuki
Although most adverse reactions to Kampo formulas are mild, there have been reports of serious adverse reactions, such as interstitial pneumonia caused by Shosaikoto [1] and mesenteric phlebosclerosis caused by Kampo preparations containing gardenia fruit (Gardeniae fructus) [2]. Although some previous reports [3, 4] on the incidence of adverse reactions to Kampo medicines are known, there are no reports on the actual number of patients with serious adverse reactions that resulted in hospitalization or death, excluding mild and moderate cases, in Japan. The ‘Adverse Drug Reaction Relief System’ aims to provide relief benefits for patients who experienced adverse drug reactions, required hospitalization, or died due to the adverse reaction [5]. Relief cases under the Adverse Drug Reaction Relief System are cases of severe adverse reactions to drugs. This study aimed to observe the recent trend of severe adverse reactions caused by Kampo formulas by examining the data on relief cases from the Adverse Drug Reaction Relief System, published on the website of the Pharmaceuticals andMedical Devices Agency (PMDA) in 2021 [6]. Data of 72 cases (24 males and 48 females), in which Kampo formulas were identified as the causative drug, out of the 1442 relief cases recorded in the 2021 Adverse Drug Reaction Relief System, available on the PMDA website, were examined [4]. The age range of the patients was from 20 to over 80 years old (20–29 years: 5 cases; 30–39 years: 5 cases; 40–49 years: 14 cases; 50–59 years: 14 cases; 60–69 years: 13 cases; 70–79 years: 15 cases; and ≥80 years: 6 cases). Adverse drug reactions caused by Kampo medicines included drug-induced liver injury (38 cases, 14 of which were in combination with modern medicines), interstitial pneumonia (32 cases, 9 of which were in combination with modern medicines), pseudo-aldosteronism or hypokalemia (four cases), generalized drug rash (three cases, all in combination with modern medicines), and one case of erythema multiforme type drug eruption (one case). In five cases, two Kampo prescriptions were combined. One case experienced two adverse reactions (drug-induced liver injury and generalized drug rash). The most common Kampo formula was saireito (18 cases), followed by saikokaryukotsuboreito (10 cases); bofutsushosan (six cases); seishinrenshiin, saikokeishikankyoto, and shin’iseihaito (four cases); shosaikotokakikyosekko and kakkonto (three cases); and nyoshinsan, shakuyakukanzoto, saibokuto, and hangeshashinto (two cases) (Table 1). Of these, five experienced adverse reactions to over-the-counter drugs (two cases of bofutsushosan), while one experienced an adverse reaction to a decoction. Kampo formulas causing drug-induced liver injury included saireito (eight cases); bofutsushosan (five cases); saikokaryukotsuboreito (three cases); shosaikotokakikyosekko (three cases); kakkonto, saikokeishikankyoto, shakuyakukanzoto, seishinrenshiin, and nyoshinsan (two cases); and nine other Kampo prescrip
虽然大多数对汉方的不良反应是轻微的,但也有严重不良反应的报道,如Shosaikoto引起的间质性肺炎[1]和含有栀子(栀子)的汉方制剂引起的肠系膜静脉硬化[2]。虽然以前有一些关于汉布药不良反应发生率的报道[3,4]是已知的,但在日本,除轻度和中度病例外,没有关于严重不良反应导致住院或死亡的患者实际人数的报道。“药物不良反应救济制度”旨在为发生药物不良反应、需要住院治疗或因不良反应死亡的患者提供救济福利[5]。药物不良反应救济制度下的救济案件是指对药物有严重不良反应的案件。本研究旨在通过查阅药品和医疗器械管理局(PMDA)网站于2021年发布的《药物不良反应缓解系统》(adverse Drug Reaction relief System)的缓解病例数据,观察汉方严重不良反应的近期趋势[6]。对PMDA网站上的《2021年药物不良反应缓解系统》记录的1442例缓解病例中的72例(男性24例,女性48例)的数据进行了分析[4]。其中,汉布方被确定为致病药物。患者年龄20 ~ 80岁以上(20 ~ 29岁5例;30 ~ 39岁:5例;40 ~ 49岁:14例;50 ~ 59岁:14例;60 ~ 69岁:13例;70 ~ 79岁:15例;≥80岁:6例)。汉布药引起的药物不良反应包括药物性肝损伤(38例,其中与现代药物联用14例)、间质性肺炎(32例,其中与现代药物联用9例)、假性醛固酮增多症或低钾血症(4例)、全身性药疹(3例,均与现代药物联用)、多形性红斑型药疹1例(1例)。在5个病例中,两种汉布处方被合并使用。1例出现两种不良反应(药物性肝损伤和全身性药物皮疹)。最常见的汉布方剂为saireito(18例),其次为saikokaryukotsuboreito(10例);Bofutsushosan(6例);清新人心、斋客石kankyoto、新生海东(4例);Shosaikotokakikyosekko和kakkonto(3例);和nyoshinsan, shakuyakukanzoto, saibokuto和hangeshashinto(2例)(表1)。其中,5例对非处方药有不良反应(2例为牛骨参),1例对煎剂有不良反应。引起药物性肝损伤的汉布方有八例;Bofutsushosan(5例);Saikokaryukotsuboreito(3例);Shosaikotokakikyosekko(3例);Kakkonto、saikokeishikankyoto、shakuyakukanzoto、seishinrenshiin、nyyoshinsan(2例);其他汉方9种(1例)(表1)。31例(81.6%)药物性肝损伤患者使用含黄芩的汉方。引起间质性肺炎的汉布方包括肺炎(9例);Saikokaryukotsuboreito(7例);Shin 'iseihaito(3例);西kokeishikankyoto(2例);其他11种汉方(1例)(表1)。29例(90.6%)间质性肺炎患者使用含沙参的汉方。有1例在服用shosaikoto时因间质性肺炎死亡。总之,汉宝方引起的最严重不良反应是药物性肝损伤和间质性肺炎。我们可以确认,在日本最常见的需要住院或葬礼的严重不良反应是药物性肝损伤和间质性肺炎,而这些不良反应大多是由于使用含有黄芪的汉方引起的。80%以上的患者发生了药物性肝损伤,90%以上的患者发生了含参的汉方引起的间质性肺炎。有报道称,这些不良反应是由黄芪过敏反应引起的[7]。尽管由于免疫过敏反应引起的不良反应即使是不含黄芪的汉布方也可能发生,但在使用含黄芪的汉布方时,应仔细监测这些严重不良反应。收稿日期:2023年2月7日修稿日期:2023年5月10日收稿日期:2023年5月21日
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引用次数: 0
Western medicine and Japanese Kampo medicine are in a complementary relationship — Stillness and movement are beautifully harmonized in Japanese Kampo medicine 西方医学和日本汉布医学是一种互补的关系——静止和运动在日本汉布医学中是和谐的
Pub Date : 2023-05-31 DOI: 10.1002/tkm2.1372
K. Tatsumi
This review is a general outline to have a proper understanding of Japanese Kampo medicine from my point of view.
这篇综述从我的角度对日本汉方医学有一个大致的认识。
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引用次数: 0
Progress and treatment of “long COVID” in non‐hospitalized patients: A single‐center retrospective cohort study 非住院患者“长冠状病毒”的进展和治疗:单中心回顾性队列研究
Pub Date : 2023-05-25 DOI: 10.1002/tkm2.1370
Rie Ono, Ryutaro Arita, S. Takayama, Takeshi Kanno, Akiko Kikuchi, Satoko Suzuki, Minoru Ohsawa, Natsumi Saito, Michiaki Abe, Ko Onodera, T. Akaishi, Y. Tadano, T. Ishii
“Long COVID” or “post‐COVID conditions” describes prolonged symptoms after the acute phase of coronavirus disease 2019 (COVID‐19). However, there is a paucity of published reports on its treatment.
“长COVID”或“后COVID状态”描述的是2019年冠状病毒病(COVID - 19)急性期后的长期症状。然而,关于其治疗的已发表报告很少。
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引用次数: 1
Symptoms associated with hematoma caused by radial artery injury successfully treated with jidabokuippo 吉达博基波成功治疗桡动脉损伤引起的血肿相关症状
Pub Date : 2023-05-23 DOI: 10.1002/tkm2.1374
H. Nakae, Yasuhito Irie
Dear Editor Jidabokuippo (JDI) is a herbal mixture used in Japan to alleviate contusion-induced swelling and pain caused by bruises and sprains. It has also been applied to various traumas and cellulitis [1]. There have been a few reports of JDI being applied for bleeding and pain after venipuncture; however, there are few reports on the symptoms after arterial puncture [2,3]. We encountered a case in which JDI was useful for subcutaneous hematoma, swelling, and pain due to catheterization-induced radial artery injury. A 59-yearold man with a history of hypertension, acute myocardial infarction, and chronic kidney disease, experienced chest tightness one week before admission. As the patient’s chest tightness increased, he was admitted for suspected exertional angina pectoris and underwent coronary angiography. A percutaneous coronary intervention (PCI) sheath was inserted through the left radial artery. The patient was administered 200 mg of oral aspirin and 12,000 units of intravenous heparin during the PCI procedure. Immediately after PCI sheath insertion, blunt pain in the forearm developed, and swelling was noted (The Numerical Rating Scale [NRS] was 3/10). After the PCI procedure, compression hemostasis was intensified because of increased swelling in the forearm. Ultrasonography did not reveal any obvious hemorrhagic areas. After the procedure, hemoglobin and hematocrit levels decreased from 15.2 g/dl to 11.9 g/dl and from 46.0% to 35.7%, respectively. Nonetheless, the patient’s vital signs were stable, and he was discharged one day after the procedure. The subcutaneous hemorrhage and swelling in the left upper limb increased, and the pain in the forearm worsened to 8/10 on the NRS. Dorsiflexion of the wrist joint and extension of the elbow joint were no longer possible because of pain and swelling. Therefore, 7.5 g/day of JDI (extract TJ-89, Tsumura & Co., Tokyo, Japan) was administered (Figure 1a). Four days after the procedure, JDI was discontinued because the swelling and pain were reduced (NRS 5/10) (Figure 1b). However, a
jidabokkippo (JDI)是一种日本草药混合物,用于缓解瘀伤和扭伤引起的挫伤引起的肿胀和疼痛。它也被应用于各种创伤和蜂窝织炎[1]。有一些报道称JDI用于静脉穿刺后出血和疼痛;然而,关于动脉穿刺后症状的报道很少[2,3]。我们遇到一个病例,JDI是有用的皮下血肿,肿胀和疼痛,由于导管诱导桡动脉损伤。59岁男性,有高血压、急性心肌梗死和慢性肾脏疾病病史,入院前一周胸闷。由于患者胸闷加重,他被怀疑是劳累性心绞痛并接受了冠状动脉造影。经皮冠状动脉介入治疗(PCI)鞘通过左桡动脉插入。患者在PCI手术期间给予200毫克口服阿司匹林和12000单位静脉肝素。PCI鞘插入后立即出现前臂钝性疼痛,并出现肿胀(数值评定量表[NRS]为3/10)。PCI手术后,由于前臂肿胀增加,压迫止血加强。超声检查未见明显出血区。手术后,血红蛋白和红细胞压积水平分别从15.2 g/dl降至11.9 g/dl,从46.0%降至35.7%。尽管如此,患者的生命体征稳定,并于手术后一天出院。左上肢皮下出血和肿胀加重,前臂疼痛加重,NRS评分为8/10。由于疼痛和肿胀,腕关节的背屈和肘关节的伸展不再可能。因此,给予7.5 g/天的JDI(提取物TJ-89, Tsumura & Co.,东京,日本)(图1a)。术后4天,由于肿胀和疼痛减轻,停用JDI (NRS 5/10)(图1b)。然而,一个
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引用次数: 0
Ulcer‐healing effects of jumihaidokuto extract in a mouse model of methicillin‐resistant Staphylococcus aureus causing skin infection 巨藻提取物对引起皮肤感染的耐甲氧西林金黄色葡萄球菌小鼠模型的溃疡愈合作用
Pub Date : 2023-05-09 DOI: 10.1002/tkm2.1371
M. Minami, T. Konishi, Masayo Taira, T. Makino
Methicillin‐resistant Staphylococcus aureus (MRSA) is a pathogenic bacterium that causes severe skin diseases with ulceration. Since MRSA are not susceptible to multiple antibiotics, novel therapeutic agents are desired. Jumihaidokuto, a combination of 10 crude drugs, is a Japanese traditional Kampo medicine that is used for the treatment of skin diseases. In this study, we investigated the effects of jumihaidokuto extract (JHT) on MRSA‐infected mice.
耐甲氧西林金黄色葡萄球菌(MRSA)是一种致病性细菌,可引起严重的皮肤溃疡。由于MRSA对多种抗生素不敏感,因此需要新的治疗药物。朱米海道是由10种药材混合而成的日本传统汉布药,用于治疗皮肤病。在这项研究中,我们研究了菊石提取物(JHT)对MRSA感染小鼠的作用。
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引用次数: 0
Uncovering the metabolomic effects of Kampo formulas using 1H‐NMR spectroscopy: A case study of goreisan 利用1H‐NMR光谱揭示汉布配方的代谢组学效应:以枸梨为例
Pub Date : 2023-04-14 DOI: 10.1002/tkm2.1369
S. Awale, M. Jo, Shiro Watanabe, N. Shibahara, Kinzo Matsumoto
The purpose of this study was to explore the effects of goreisan (GRS) on rats through the analysis of 1H‐NMR of urine samples, to assess the variations in metabolites affected by GRS, and to gain a new metabolomic understanding of the effects of Kampo medicine.
本研究旨在通过对大鼠尿液样本的1H‐NMR分析,探讨哥里散(GRS)对大鼠的影响,评估GRS对大鼠代谢物的影响,并对汉布药的作用有新的代谢组学认识。
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引用次数: 0
The effectiveness of goreisan, for gestational edema and amniotic fluid decrease 葛瑞森对妊娠期水肿和羊水减少的疗效
Pub Date : 2023-04-11 DOI: 10.1002/tkm2.1366
F. Makimoto
Ordinarily, a diuretic uniformly performs diuresis of body water and decreases it. When a diuretic is used for gestational edema, blood vessel dehydration and amniotic fluid are expected to decrease. This may be rather harmful for the gestational prognosis. Goreisan's mechanism of efficacy is different from that of ordinary diuretics. The results of treating gestational edema and amniotic fluid reduction with goreisan were studied. Whether goreisan is helpful for improving gestational prognosis was studied.
通常,利尿剂均匀地利尿和减少体内水分。当利尿剂用于妊娠水肿时,血管脱水和羊水预计会减少。这可能是相当有害的妊娠预后。高瑞散的作用机制不同于普通利尿剂。观察枸杞多糖治疗妊娠期水肿及羊水减少的效果。研究葛瑞森是否有助于改善妊娠预后。
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引用次数: 0
Conference report: Third annual young researcher forum of the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine 会议报告:日本传统医学医学和药学学会第三届年度青年研究人员论坛
Pub Date : 2023-04-01 DOI: 10.1002/tkm2.1362
Tetsuhiro Yoshino, T. Yokogawa, Kohsuke Nakamichi, Yoshiaki Manse, Hayato Yoshikawa, Hiroaki Sasaki, Hirokazu Ando, Souichi Nakashima
Four young researchers presented their studies in the field of traditional Japanese herbal medicine (Wakan‐yaku) at the third annual young researcher forum entitled “Respecting and Breaking Traditions,” held 1 week before the 2022 annual meeting of the Japan Society of Medical and Pharmaceutical Sciences for Traditional Medicine. Dr. Yokogawa presented her research focusing on the mechanism of the Ayurveda drug‐eluting string, Kshara Sutra, in treating anal fistulas, reporting on its effects on the anal tissue in an anal fistula rat model and its antibacterial activity against Escherichia coli and Staphylococcus aureus, the causative organisms of anal fistulas. Mr. Nakamichi presented his research focusing on the relationship between the efficacy of Kampo medicines with anti‐obesity effects and intestinal microbiota composition. His results partially revealed that bofutsushosan and boiogito affect lipid metabolism in mice and correlate with the intestinal microbiota composition. Dr. Manse reported the anti‐inflammatory activity of diterpenoid components in Enmei‐so (Isodonis Herba), revealing its novel inhibitory activity on nitric oxide released from activated macrophages and on inflammatory cytokines, and identified active components contributing to the inhibition and the mechanism of action. Mr. Yoshikawa reported the anticancer activity of small molecular compounds isolated from the medicinal plants, Valeriana fauriei and Hypericum erectum. His results suggest that five compounds may increase the sensitivity of human cervical carcinoma cells to adriamycin via HSP105 expression suppression. The event was conducted online, and included 78 participants. We intend to hold and improve this forum in 2023 and the future.
在2022年日本医学和药物科学学会传统医学年会召开前一周举行的第三届年度青年研究人员论坛上,四名年轻研究人员介绍了他们在日本传统草药(Wakan‐yaku)领域的研究。Yokogawa博士介绍了她的研究重点是阿育吠陀药物-洗液串,Kshara经,治疗肛瘘的机制,报告了它对肛瘘大鼠模型肛门组织的影响,以及它对大肠杆菌和金黄色葡萄球菌(肛瘘的病原体)的抗菌活性。Nakamichi先生介绍了他的研究重点是具有抗肥胖作用的汉布药物与肠道微生物群组成之间的关系。他的研究结果部分揭示了肉毒杆菌和生物素影响小鼠的脂质代谢,并与肠道微生物群组成相关。Manse博士报道了异东草中二萜成分的抗炎活性,揭示了其对活化巨噬细胞释放的一氧化氮和炎症细胞因子的新型抑制活性,并确定了抑制作用和作用机制的活性成分。Yoshikawa先生报告了从药用植物Valeriana fauriei和Hypericum erectum中分离出的小分子化合物的抗癌活性。他的研究结果表明,五种化合物可能通过抑制HSP105的表达来增加人宫颈癌细胞对阿霉素的敏感性。该活动是在线进行的,共有78名参与者。我们打算在2023年和未来举办并改进这个论坛。
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引用次数: 1
Suppressive effects of Bombycis Feces (bombyx feces) and Bombyx Batryticatus (stiff silkworm) extracts on blood glucose level elevation in disaccharides‐loaded rats 家蚕粪便和家蚕提取物对双糖负荷大鼠血糖水平升高的抑制作用
Pub Date : 2023-03-28 DOI: 10.1002/tkm2.1368
H. Matsuda, Akifumi Nagatomo, M. Hatakeyama, Yoshiaki Manse, M. Yoshikawa, T. Morikawa
Bombycis Feces (BF) and Bombyx Batryticatus (BB) are traditional medicines derived from silkworm. We investigated the suppressive effects of BF and BB extracts on elevated blood glucose levels in disaccharide‐loaded rats.
家蚕粪(BF)和家蚕粪(BB)是家蚕的传统药材。我们研究了BF和BB提取物对双糖负荷大鼠血糖水平升高的抑制作用。
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引用次数: 0
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Traditional & Kampo Medicine
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