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Recent applications of Kampo treatment for neurological diseases 汉布治疗神经系统疾病的最新应用
Pub Date : 2023-01-04 DOI: 10.1002/tkm2.1356
S. Muramatsu, Mayumi Tamada, Yoshinao Harada, M. Raimura, Seungwon Kwon
Although various new drugs have been developed for neurological diseases, many diseases have no effective treatment or only inadequate efficacy. Here we introduce some examples of effective Kampo treatment.
虽然针对神经系统疾病开发了各种新药,但许多疾病没有有效的治疗或疗效不足。这里我们介绍一些有效的汉布治疗的例子。
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引用次数: 0
Yokukansankachimpihange therapy fortified with bisoprolol and lifestyle changes in a patient intolerant to antihypertensive agents 对降压药不耐受的患者联合比索洛尔强化yokukansankachimihange治疗和生活方式改变
Pub Date : 2022-12-02 DOI: 10.1002/tkm2.1354
D. Katayose
Modern medicine's technological advancements recognize the contributions of traditional and complementary medicine. Combining Kampo medicine, antihypertensive agents, and lifestyle changes can be an effective, holistic treatment approach for patients with hypertension, frequently accompanied by impaired mental health and quality of life. This case concerns a patient with hypertension who demonstrated poor lifestyle habits, mental stress, and intolerance to antihypertensive agents. The patient was treated with yokukansankachimpihange therapy fortified with bisoprolol and lifestyle changes including dietary modifications, sleep hygiene, and exercise (including street dance).
现代医学的技术进步承认了传统医学和补充医学的贡献。对于经常伴有精神健康和生活质量受损的高血压患者,将汉布药、降压药和改变生活方式相结合是一种有效的整体治疗方法。本病例涉及一位高血压患者,他表现出不良的生活习惯、精神压力和对抗高血压药物的不耐受。患者接受比索洛尔强化的yokukansankachimpihange治疗,并改变生活方式,包括改变饮食、睡眠卫生和锻炼(包括街舞)。
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引用次数: 1
Efficacy of Kampo medicine in respiratory diseases “1st International Symposium on Kampo Medicine” “第一届汉布医学国际研讨会”
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1341
K. Tatsumi, H. Sagara, Tomoko Suzuki, T. Sekiya
To the Editor The integration of Western and Kampo medicine is a characteristic and massive advantage of medical care in Japan. Kampo medicine complements the parts which Western medicine cannot deal with and sometimes contributes to the primary treatment. More than 90% of Japanese clinicians prescribe Kampomedicines daily, including for respiratory diseases. Kampo medicine treats not only symptoms such as cough or sputum but also the disease itself. Furthermore, Kampo medicines called “hozai” support the patients with the disease themselves by immunomodulating effects or improving frailty. Western and Kampo medicine are in a different position from a treatment perspective. In this session, the unique remedy perspective for chronic obstructive pulmonary disease (COPD) and non-tuberculous mycobacterial (NTM) pulmonary disease that Kampo treatment has, is introduced. Recently the basic science regarding the mechanisms of Kampo medicines has progressed, and the mechanical approach for seihaito is briefly described with original data. Through these topics, we will discuss the efficacy of Kampo medicine for respiratory diseases. The first presentation is “Stillness and Movement are Beautifully Harmonized in Japanese Kampo Medicine.” Japanese Kampo medicine complementarily fills in gaps of Western medicine based on coexisting with the latter. Understanding of Japanese Kampo medicine from both a Western and Kampo medical perspective is therefore required. What is the basis of medical care? The answer is how to capture the signals emitted by the living body. In Western medicine, diagnosis naming the disease is required for medical therapy to acquire a medical insurance reimbursement. In contrast, in Japanese Kampo medicine a pathophysiological diagnosis is required for Kampo therapy. Western medicine is the science of disease, while Japanese Kampo medicine is the science of indication. In other words, Western medicine is searching to find a drug that works, while Japanese Kampo medicine is pursuing how to make medicine work. Japanese Kampo medicine originally comes from classic Chinese medicine. This framework was introduced to Japan around the 5th–6th centuries, and since then, based on the heritage of past experience, and by repeating verification again and again and making progress in the search of new developments, Japanese Kampo medicine has continued to develop. Japanese Kampo medicine has become established by combining a perspective of modern Western medicine and looking for what appropriate therapy is in accordance with the Kampo medical syndromes [1, 2]. Japanese Kampo medicine is a harmonious medical practice. The second presentation is “Clinical Application and Consideration of Ninjin’yoeito for Frailty of COPD Patients.” From a clinical perspective, chronic obstructive pulmonary disease (COPD) is characterized by gradual chronic cough, phlegm, and/or dyspnea on exertion, often combined with malnutrition and reductions in muscle mass. COPD pr
西方医学与汉方医学相结合是日本医疗保健的一大特色和巨大优势。汉布医学补充了西医无法治疗的部分,有时有助于初级治疗。超过90%的日本临床医生每天都会开kampomedicine,包括呼吸道疾病。汉布药不仅治疗咳嗽或痰等症状,还治疗疾病本身。此外,被称为“hozai”的汉布药物通过免疫调节作用或改善虚弱来支持患有这种疾病的患者。从治疗的角度来看,西药和汉布药处于不同的位置。在本次会议上,介绍了Kampo治疗所具有的慢性阻塞性肺病(COPD)和非结核分枝杆菌肺病(NTM)的独特治疗视角。近年来,关于汉方药物作用机制的基础科学研究取得了进展,本文用原始资料对西海陀的力学方法作了简要介绍。通过这些主题,我们将讨论汉布药对呼吸系统疾病的疗效。第一个演讲是“静止与运动在日本汉布医学中和谐和谐”。日本汉方医学在与西医共存的基础上,补充填补了西医的空白。因此,需要从西方和汉方医学的角度来理解日本的汉方医学。医疗保健的基础是什么?答案是如何捕捉活体发出的信号。在西医中,需要诊断出疾病,才能进行医疗治疗,以获得医疗保险报销。相反,在日本汉布医学中,汉布疗法需要病理生理诊断。西医是疾病的科学,而日本汉方医学是指征的科学。换句话说,西方医学正在寻找一种有效的药物,而日本的汉方医学正在追求如何使药物起作用。日本汉方医学起源于中国古典医学。这一框架大约在5 - 6世纪被引入日本,从那时起,基于过去经验的遗产,通过一次又一次的反复验证,并在寻找新的发展中取得进展,日本汉布医学继续发展。日本汉方医学是结合现代西方医学的观点,根据汉方医学证候寻找合适的治疗方法而建立起来的[1,2]。日本汉方医学是一种和谐的医学实践。第二场报告是“ninin’yoeito治疗COPD患者虚弱的临床应用与思考”。从临床角度来看,慢性阻塞性肺疾病(COPD)的特征是运动时逐渐出现慢性咳嗽、痰多和/或呼吸困难,常伴有营养不良和肌肉量减少。慢性阻塞性肺病具有高发病率和高死亡率,是日本国内外需要进一步临床研究的疾病之一。最近,自从虚弱作为COPD的一种症状被引入以来,虚弱和COPD的共存在老年患者中被认为是非常普遍的。由于两种功能衰退的进展表明相似性,因此提出了一种共同的机制。忍者是一种草药,用于治疗虚弱的症状,包括力量下降和/或疲劳;一项慢性阻塞性肺病的临床试验也有报道。我们检查了ninin 'yoeito对虚弱和/或易感的COPD患者的影响,尽管他们接受了既定的门诊治疗bbb。这是一项随机对照试验,主要终点是反映虚弱状况的基本检查表。次要终点包括食欲、生活质量和心理症状。给药后显示出对虚弱的改善效果,COPD评估测试评分显示严重程度加重、食欲不振、焦虑和/或抑郁有统计学显著差异。本研究证明了ninin 'yoeito在虚弱和/或虚弱前期COPD患者中的多重作用。第三个报告是“NTM肺部疾病(NTM- pd)的汉布医学”。非结核分枝杆菌(NTM)患者的增加已成为一个全球性问题。虽然NTM-PD的标准联合治疗,如大环内酯类抗生素、利福平、乙胺丁醇、阿米卡星或链霉素通常是标准的,但这些药物的并发症阻碍了治疗的完成。许多复发的病例也被确认。NTM-PD的管理在全球范围内被认为是:收到:2022年5月23日修订:2022年7月6日接受:2022年7月15日
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引用次数: 0
Kampo treatment for functional dyspepsia: focusing on rikkunshito “1st International Symposium on Kampo Medicine” 汉布治疗功能性消化不良:以立昆士托为中心“第一届汉布医学国际研讨会”
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1344
M. Arai, Hiroshi Takeda, Hidekazu Suzuki, Jae-Woo Park, T. Oikawa
To the editor, The title of this gastrointestinal session is “Kampo treatment for functional dyspepsia: Focusing on rikkunshito,” and the discussion will focus on rikkunshito. Rikkunshito is very famous as a Kampo formula that improves gastrointestinal dysfunction. In Japan, not only Kampo doctors but also doctors who practice western medicine frequently use it in daily clinical practice. Rikkunshito is one of the Kampo formulas with the most fully elucidated mechanism of action, and research on rikkunshito related to the appetite-promoting hormone ghrelin is actively discussed at international conferences every year. Furthermore, in clinical practice, rikkunshito is not just an alternative medicine drug, but the subject of an international consensus clinical guideline for the upcoming revision of the Rome criteria dealing with the treatment of functional gastrointestinal disorders (FGIDs). In this way, rikkunshito has become remarkably popular internationally in recent years. Therefore, the purpose of this symposium is to give practitioners and researchers an updated understanding of rikkunshito and to suggest the best treatment for functional dyspepsia (FD). In this symposium, the current and future state of Kampo treatment of FD centered on rikkunshito will be explained and discussed from four points of view: clinical, basic, international, and evidencebased medicine from global authorities in each field. The first presentation is “Treatment strategies for functional dyspepsia in Kampo medicine.” In Kampo treatment for FD, it is important to find out if there is epigastric pain, as in western medicine. For postprandial distress syndrome without epigastric pain, rikkunshito and hangeshashinto are the main formulas clinically. Novices may first use rikkunshito according to the disease name. Secondly, if you have some knowledge about Kampo medicine, differentiating between excess and deficiency patterns in patients increases treatment efficiency. However, when the patient’s constitution is medium and the judgment is difficult, the chief complaints should be noted as the basis for selection of the prescription. Rikkunshito should be chosen for the chief complaint of loss of appetite, and hangeshashinto for that of epigastric discomfort. Furthermore, it may be better to consider the patient’s age. In general, rikkunshito is often adopted for treatment in the elderly because they tend to present the deficiency pattern. As other clinical differential formulas, hangekobokuto is frequently used for stress-induced FD accompanied by obstructive discomfort in the throat and chest, and anxiety and depression. The prescription used for the treatment of epigastric pain syndrome (EPS) differs depending on whether the pain is spastic or non-spastic. Saikokeishito is the first-line drug for treating EPS with spastic pain, while anchusan is prescribed for EPS with non-spastic pain. The second presentation is “Current knowledge about the pharmacological and molec
致编辑,本次胃肠道会议的标题是“功能性消化不良的汉布治疗:聚焦于立病”,讨论将集中在立病上。立昆士汤是一种非常有名的康布配方,可以改善胃肠功能障碍。在日本,不仅是汉方医生,西医医生在日常临床中也经常使用汉方。立坤泻是目前已知作用机制最充分的汉方之一,每年国际会议都在积极讨论与促食欲激素胃饥饿素有关的立坤泻。此外,在临床实践中,rikkunshito不仅是一种替代药物,而且是即将修订的功能性胃肠疾病(fgid)治疗罗马标准的国际共识临床指南的主题。通过这种方式,立功诗近年来在国际上非常受欢迎。因此,本次研讨会的目的是让从业者和研究人员对立病有一个最新的认识,并建议功能性消化不良(FD)的最佳治疗方法。在本次研讨会上,将从临床、基础、国际和循证医学四个方面解释和讨论以立病为中心的FD的康布治疗的现状和未来状况。第一个报告是“汉布医学功能性消化不良的治疗策略”。在汉布治疗FD时,重要的是要发现是否有上腹部疼痛,就像西医一样。对无胃脘痛的餐后窘迫综合征,临床上以利昆士汤、悬散汤为主。新手可根据疾病名称先使用立病之道。其次,如果你有一些关于汉布医学的知识,区分病人的虚实模式可以提高治疗效率。但当患者体质中等,判断困难时,应注意主诉,作为选方的依据。对食欲不振的主诉应选用立昆茶,对上腹不适的主诉应选用悬沙茶。此外,考虑患者的年龄可能会更好。一般来说,立健食经常被用于老年人的治疗,因为他们往往表现出不足的模式。与其他临床辨证方一样,hangekobokuto常用于应激性FD伴咽喉、胸部梗阻性不适、焦虑、抑郁。治疗胃脘痛综合征(EPS)的处方根据疼痛是痉挛性还是非痉挛性而不同。Saikokeishito是治疗痉挛性疼痛的EPS的一线药物,而anchusan是治疗非痉挛性疼痛的EPS的处方药。第二个报告是“关于利坤之作用的药理学和分子基础的最新知识”。虽然利坤泻被广泛用于治疗上消化道症状,但其分子机制尚不清楚。在2008年,我们报道了rikkunshito能够通过拮抗5 -羟色胺2b/2c受体刺激胃饥饿素的分泌。后来,我们披露了另一个有趣的发现,即利坤茶通过激活下丘脑sirtuin 1的活性来延长小鼠的健康寿命,而下丘脑sirtuin 1的活性取决于胃饥饿素系统。Ghrelin是Kojima等人在1999年发现的一种多肽激素,是生长激素促分泌受体的内源性配体,但不久之后,人们发现Ghrelin具有更广泛的功能:调节食物摄入、肥胖和葡萄糖代谢。它还能刺激肠道蠕动和胃酸分泌。最近的证据有力地表明,胃饥饿素作为一种“生存激素”,保护身体免受极端的营养和心理压力。因此,立健茶可能通过激活胃饥饿素信号来增强自我防御系统,这表明它可能不仅对胃肠道功能障碍有效,而且对包括消耗性疾病和神经精神疾病在内的各种疾病都有效。在这里,我将回顾目前的知识有关的药理学和分子基础的利坤士多效作用。第三个报告是“立健食在功能性消化不良治疗中的国际地位”。罗马标准是fgid的国际共识临床指南,于2016年修订,收到:2022年5月20日修订:2022年7月12日接受:2022年7月13日
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引用次数: 0
History of Kampo medicine “1st International Symposium on Kampo Medicine” “第一届国际汉布医学研讨会”
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1345
Tatsuhiko Suzuki, Xiang Jingjing, Cheng Gaoya, Mathias Vigouroux
To The Editor In the history of Kampo medicine, the characteristics of medicine during the Edo period that had a strong influence on modern Kampo medicine are analyzed, and the purpose is to capture international exchanges of Kampo medicine. The first presentation describes the medicine of Dosan Manase in the Azuchi-Momoyama period, who established a foundation for the Gosei school in the Edo period. Presentations 2 and 3 we show how the back-to-the ancient thought and the evidential scholarship influenced by China developed into the Japanese style among the Koho and Koshogaku schools. Presentation 4 analyses how acupuncture and moxibustion were introduced to early modern Europe focusing on the transmission of medical images related to the acupuncture channels theory. The first presentation is “Medicine of Dosan Manase: The Founder of Gosei School”. Dosan Manase was a representative physician of the Azuchi-Momoyama period. He was born in Kyoto and grew up as a monk. Early in his career, he went to study at the Ashikaga school. When he was enrolled at this school, he became a disciple of Sanki Tashiro, a court physician of Koga-Kubo. Under Sanki, Dosan became acquainted with the latest medical literature and acquired his clinical skills, especially Satsusho-benchi as the system to examine the patient’s condition and determine the treatment accordingly without using fixed prescriptions. Because it does not refer to existing prescriptions, the medical practice system of Satsusho-benchi needs an organized theory of medicinal efficacy. Dosan had taken over Satsusho-benchi and medical theory from Sanki. The characteristics of Sanki’s practice differed from Chinese medicine by being accompanied by Buddhist thought. After Sanki’s death, Dosan returned to Kyoto and studied more medical literature. Dosan referred to his own medicine as Li Dongyuan and Zhu Danxi medical school. He wrote many medical books such as Keiteki-shu and instructed many pupils in his private school, which was called Keiteki-an, but neither included Buddhism as an element of medicine. In the Edo period, Manase’s school became the mainstream of the Gosei school. The second presentation is “Knowledge Transfer and Innovations in Primordialist Thought: New Reflections on the Koho School in the Edo Period”. In the middle of the Edo period, the Koho school rose to prominence under the influence of transferred medical knowledge from the Ming and Qing Dynasties, and criticized the medicine of the Gosei school which flourished in the Early Edo period. The Koho school advocated the revival of the primordial medical sources, including the Shang Han Lun (Treatise on Exogenous Febrile Disease), and criticized the “warming and tonifying method” as well as the theory of “yin/ yang and five elements” of the Gosei school. However, close investigation of the Koho works by the four eminent physicians Konzan Goto, Shuan Kagawa, Toyo Yamawaki, and Todo Yoshimasu reveals that the socalled “retrogression”
在汉布医学史上,分析了江户时期对现代汉布医学有较大影响的医学特点,目的是捕捉汉布医学的国际交流。第一份报告描述了安一桃山时代的道山真濑的医学,他为江户时代的合成学派奠定了基础。演示2和演示3展示了受中国影响的回归古代思想和实证学术是如何在Koho和Koshogaku学派中发展成日本风格的。Presentation 4分析了针灸是如何传入近代早期欧洲的,重点介绍了与针灸经络理论相关的医学图像的传播。第一个演讲是“Dosan Manase的医学:合成学派的创始人”。道山真濑是安一桃山时代的代表医师。他出生在京都,成长为一名僧人。在他的职业生涯早期,他去了足利学校学习。在这所学校入学后,他成为古贺久保御医田代山木的弟子。在Sanki的指导下,Dosan熟悉了最新的医学文献,并掌握了他的临床技能,特别是Satsusho-benchi,因为它可以在不使用固定处方的情况下检查病人的病情并确定相应的治疗方法。因为它不参考现有的处方,所以Satsusho-benchi的医疗实践体系需要一个有组织的疗效理论。道山从山木那里继承了Satsusho-benchi和医学理论。三医的实践特点与中医不同,它有佛教思想的陪伴。山木死后,道山回到京都,学习更多的医学文献。多山把自己的医术称为李东元和朱丹熙的医术。他写了许多医学书籍,如《Keiteki-shu》,并在他的私立学校Keiteki-an中指导了许多学生,但都没有将佛教作为医学的元素。江户时代,真濑派成为合成派的主流。第二场演讲是“原始主义思想中的知识转移和创新:对江户时代Koho学派的新反思”。江户中期,在明清医学知识传入的影响下,Koho学派逐渐兴起,并对江户前期盛行的化生医学进行了批判。Koho学派主张恢复原始医学资源,包括《商寒论》,批评“温补法”和合成学派的“阴阳五行”理论。然而,仔细研究后藤健山、香川顺、山崎丰雄、吉正丰等四位著名医学家的古医著作,就会发现,所谓的“回归”或“回归本源”实际上既包括对日本医学在中国传统基础上的实际继承,也包括对日本医学的创新。此外,后来的Koho学派医生的思想和他们与合成学派的争论逐渐演变为对宋元明清中医的批评。我们可能会认为,这些发展导致日本在江户时代后期熟悉了中医,尽管人们普遍认为,Koho学派促进了回归古代医学思想。第三个报告是“18 -19世纪日本循证医学学派的出现和发展,特别以泷家族为例”。证据学术是一种基于证据分析和批评的经典参考文献研究的语言学方法。它在清朝中期达到顶峰,并通过书籍传入日本。江户时代晚期,以医学循证学派的形成为标志,医学循证学派的学者将清代循证学派的方法应用于医学经典的研究,并取得了后来被带回中国并受到高度重视的成就。在这次演讲中,演讲者将重点介绍Taki家族,他们的成员被认为是学校的代表。收稿日期:2022年5月23日修稿日期:2022年7月5日录用日期:2022年7月27日
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引用次数: 0
A case of coronavirus disease 2019 in a pregnant woman successfully treated with shoseiryuto: A telephone consultation 用shoseiryuto成功治疗的2019年冠状病毒病孕妇一例:电话咨询
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1350
Hidenori Tanaka, H. Miura, Y. Terada, H. Nakae
Dear Editor The number of coronavirus disease2019 (COVID-19) cases in Japan has reached 21 million and is rising; the COVID-19 epidemic is continuing with exacerbations and remissions. The surge in COVID-19 cases will put a strain on hospitals across the country; we estimate that approximately 0.5% of all infections may occur during pregnancy. All infection during late pregnancy increases the probability of preterm delivery and may cause severe illness [1]. Oral drugs, like molnupiravir, cannot be prescribed because of their teratogenic potential [2], and drugs reducing the disease severity in pregnant women are limited. Kampo medicines are effective, relatively inexpensive, and safe for incident viral infections, but only a few cases of Kampo medicines used to treat pregnant women have been reported [3]. We experienced a case of COVID-19 with persistent symptoms, including cough in a pregnant woman. A primiparous woman developed COVID-19 at 30 weeks and one day of gestation and opted for home care. Her, cohabiting husband and two-year-old son had COVID-19 ten and six days respectively before her illness set in. Because of persistent cough and phlegm that disturbed her sleep at night, she made a request for a telephone consultation from our clinic through the Akita City Public Health Center. We prescribed shoseiryuto (SST) (a Tsumura medical extract), 7.5 g/d for fivevdays. After treatment, her cough and sputum were alleviated almost fully (Table 1), and management of her remaining condition was transferred to the hospital at which she was scheduled for delivery. We referred to the manuals of acute contagious diseases, Shanghanlun [4] and Jin Gui Yao Lue [5], written in China in the third century, to select the best Kampo medicine for our patient. SST is used in the early yang stage of the medium pattern to treat wheezing, cough, dyspnea, and nasal symptoms. Jin Gui Yao Lue [5] mentions “Cough rises up and you cannot lie on your back to breathe.” In that case, the patient could not lie down owing to persistent coughing, and the doctor suggested SST treatment. This is congruent with the present case of “persistent cough and phlegm during the night and inability to sleep.” Moreover, the Shanghanlun [4] mentions, “In case of cold damage (acute contagious diseases such as COVID-19 in the present case), and if the exterior has not healed, there is water qi below the heart, dry retching, heat effusion and cough, possibly thirst or diarrhea or dysphagia, inhibited urination and lesser abdominal fullness, or panting, then use SST.” We believed this can be applied to the present case owing to “the symptoms of fever, cough, phlegm, and runny nose that persisted even on the fifth day after disease onset, and the distended stomach.” Based on these manuals — Shanghanlun and Jin Gui Yao Lue — the patient was prescribed SST. The patient experienced no adverse events including side effects. However, additional studies on pregnant women treated with SST are neces
日本2019冠状病毒病(COVID-19)病例数已达到2100万例,并且还在上升;COVID-19疫情仍在继续,时而加剧,时而缓解。COVID-19病例的激增将给全国各地的医院带来压力;我们估计大约0.5%的感染可能发生在怀孕期间。妊娠后期的所有感染都会增加早产的可能性,并可能导致严重疾病[1]。口服药物,如molnupiravir,由于其致畸潜力而不能开处方[2],并且降低孕妇疾病严重程度的药物有限。汉布药对偶发性病毒感染是有效的、相对便宜的和安全的,但是只有少数案例报道了汉布药用于治疗孕妇[3]。我们遇到了一例持续症状的COVID-19病例,包括一名孕妇的咳嗽。一名初产妇在妊娠30周零一天时患上COVID-19,并选择了家庭护理。在她发病前10天和6天,她的同居丈夫和2岁的儿子分别感染了COVID-19。由于持续的咳嗽和痰,她在晚上打扰了睡眠,她通过秋田市公共卫生中心向我们的诊所提出了电话咨询的要求。我们处方shoseiryuto (SST)(一种Tsumura医学提取物),7.5 g/d,连续5天。治疗后,她的咳嗽和痰几乎完全减轻(表1),并将她的剩余情况转移到她计划分娩的医院进行管理。我们参考了三世纪中国的急性传染病手册《上汉论》[4]和《金贵要略》[5],为我们的病人选择了最好的汉布药。SST用于中证阳初证,用于治疗喘息、咳嗽、呼吸困难和鼻部症状。《金桂要略》[5]提到“咳嗽起,不能仰卧呼吸”。在该病例中,患者因持续咳嗽无法躺下,医生建议SST治疗。这与本例的“夜间持续咳嗽、痰多,无法入睡”是一致的。此外,《尚汉论》[4]提到,“如遇冷损(本例为COVID-19等急性传染病),如果外部未愈合,心下有水气,干干,热溢咳嗽,可能口渴或腹泻或吞咽困难,小便抑制,腹胀较小,或喘气,则使用SST。”我们认为这可以适用于本病例,因为“发烧、咳嗽、痰多、流鼻涕的症状在发病后第五天仍持续存在,并且胃胀。”根据《伤寒论》和《金桂要略》,给患者开了SST。患者未发生包括副作用在内的不良事件。然而,对接受SST治疗的孕妇进行进一步的研究是必要的。最后,我们目前正在进行一项包括本病例在内的孕妇COVID-19病例使用SST的研究,该研究已获得秋田医学会伦理委员会(No. 44, 2022.8.15)的批准,并将很快报告研究结果。
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引用次数: 0
Kampo medicine in modern cardiology “1st International Symposium on Kampo Medicine” 现代心脏病学中的汉布医学“第一届汉布医学国际研讨会”
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1347
T. Ishigami, Hidenori Ito, Y. Nakada, Kazushi Uneda
To the editor, In the field of modern medicine, the requirements and necessity of evidence-based medicine (EBM) are increasingly demanded. Cardiovascular medicine in Japan is no exception. To answer various clinical questions, we need to perform carefully planned clinical trials at a huge expense of various medical resources. These trials are providing statistically validated medical procedures including medical devices and usage medicines for clinical guidelines. To the contrary, various procedures provided by Kampo Medicine are not sufficiently validated by EBM. Traditionally, orally described clinical chips, called “Kuketsu”, for individual subjects are used and applied to treat and cure the patients. Such individual approaches are the strength and characteristics of Kampo treatments in modern medicine, including in cardiology. In the current symposium, we are going to share our experiences of the effectiveness and utility of Kampo medicine in subjects with cardiovascular symptoms and discuss potential applications of Kampo medicine in geriatric cardiology. In the conclusions, we suggest that effective modernization of Kampo medicine in cardiology will be promising to create future integrated medicine with sophisticated combinations of both Kampo and western medicine. The first presentation is “Nutritional Solution Aided by Kampo Medicine in Cardiology.” Currently, malnutrition, frailty, and sarcopenia are becoming major clinical concerns for elderly patients in Japan. In cardiology, these ultimately result in a severe, life-threatening condition, “cardiac cachexia,” which is poorly understood and has no effective medical solutions. Not only physically unhealthy conditions, but also psycho-sociological insufficiencies are causing these health problems that are characteristic for the elderly. Both medical and nursing burdens are growing and ruin social, medical, and individual resources which in Japan are called “Year 2025 Problems,” inducing the medical reconstruction of the community. In this symposium, we are going to propose solutions for geriatric cardiology aided by Kampo medicine in Japan. These might include rehabilitation and multidisciplinary collaboration, both aided by Kampo medicine. In Kampo medicine senescence is seen as the gradual processes of imperceptibly losing vitality, which is called congenital “Qi” in ICD-11, accompanied by impairment of digestive function, which is called “Hi-I-kyo” and is a major source of acquired “Qi” in humans [1]. In Kampo medicine, we have various solutions for treating these conditions such as rikkunshito, hochyuekkito, ninjinyoeito, and so on [2]. These solutions should be beneficial in cardiac malnutrition and might be used in modern medical procedures to settle unresolved conditions such as malnutrition, frailty, sarcopenia and ultimately cardiac cachexia aided by Kampo medicine. The second presentation is “Practice in Cardiology by Kampo Medicine in Japan.” According to the Japanese Society o
在现代医学领域,对循证医学(EBM)的要求和必要性越来越高。日本的心血管医学也不例外。为了回答各种临床问题,我们需要在各种医疗资源的巨大代价下进行精心策划的临床试验。这些试验为临床指南提供了经过统计验证的医疗程序,包括医疗设备和使用药物。相反,Kampo医学提供的各种程序没有得到EBM的充分验证。传统上,口头描述的临床芯片,称为“Kuketsu”,用于个体受试者,并用于治疗和治愈患者。这种个性化的方法是现代医学,包括心脏病学中汉布疗法的优势和特点。在本次研讨会上,我们将分享我们在心血管症状患者中使用汉布药物的有效性和实用性的经验,并讨论汉布药物在老年心脏病学中的潜在应用。在结论中,我们建议在心脏病学中有效地实现汉布医学的现代化,将有希望创造未来的汉布和西医结合的综合医学。第一个报告是“在心脏病学中由汉布医学辅助的营养液”。目前,营养不良、虚弱和肌肉减少症正在成为日本老年患者的主要临床问题。在心脏病学中,这些最终会导致一种严重的、危及生命的疾病,即“心脏恶病质”,人们对这种疾病知之甚少,也没有有效的医学解决方案。造成这些老年人特有的健康问题的原因不仅是身体上的不健康状况,而且还有心理和社会方面的不足。医疗和护理负担都在增加,破坏了社会、医疗和个人资源,这在日本被称为“2025年问题”,引发了社区医疗重建。在这次研讨会上,我们将在日本汉布医学的帮助下提出老年心脏病的解决方案。这些可能包括康复和多学科合作,这两者都得到了汉布医学的帮助。在汉布医学中,衰老被看作是在不知不觉中失去活力的渐进过程,在ICD-11中被称为先天性“气”,伴随着消化功能的损害,被称为“Hi-I-kyo”,是人类获得性“气”的主要来源[1]。在汉布医学中,我们有各种各样的方法来治疗这些疾病,比如“立术”、“合术”、“忍术”等等[2]。这些解决方案应该对心脏营养不良有益,并可能在现代医疗程序中使用,以解决诸如营养不良、虚弱、肌肉减少和最终心脏恶病质等未解决的问题。第二个演讲是"日本汉布医学在心脏病学上的实践"根据日本高血压学会高血压管理指南,日本估计有4300万人患有高血压[3],高血压正逐渐成为地方性疾病。根据日本所有心脏和血管疾病登记处的数据,2012年约有21万名患者出现心力衰竭,2016年约有26万人患上心力衰竭,自2012年以来每年约增加1万人[4]。在老龄化社会中,心血管疾病的发展进一步加快。西医是治疗心血管疾病的主要形式,因为有大量证据支持其有效性,而汉布医学在临床实践中并不常见。然而,在某些西医标准治疗无法取得满意效果的情况下,例如心脏神经症,一些汉方药物的配方似乎有效。据报道,日本90%的医生都有开过汉方药的经验,这表明汉方药在日本现代医学中占有重要地位。因此,在心血管疾病的医疗实践中获得有关汉布药的证据是至关重要的。在这次研讨会上,我将介绍一些心血管疾病患者的病例报告,以帮助理解证据的构建。第三个报告是“汉布医学,改善患者症状,优于常规心脏病学实践。”与胸部有关或局限于胸部的症状常常使我们感到焦虑。众所周知,应该先用西医彻底诊断和治疗。收稿日期:2022年5月20日修订日期:2022年7月21日接受日期:2022年7月27日
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引用次数: 0
Only Kampo medicine can cure these symptoms in the field of obstetrics and gynecology “1st international symposium on Kampo medicine” 只有汉布医学才能治愈妇产科领域的这些症状"第一届国际汉布医学研讨会"
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1338
T. Kita, T. Sano, F. Makimoto, Y. Isohama
To the Editor There are many cases that only Kampo medicine can cure in the fields of obstetrics and gynecology. In the case of Kampo medicine, a prescription is chosen according to the psychological status and character of the patient. If an appropriate Kampo medicine is prescribed, it provides good psychological stability without reducing the activity level. These facts have been elucidated by the relation between the Kampo medical diagnosis and psychological test results. Heart failure carries a high risk in the field of obstetrics even if they were mild degree. The symptoms are signs of heart failure such as difficult breathing and a serious edema. Mokuboito has a remarkable effect on patients suffering from heart failure and pre-menstrual syndrome with asthma. Gestational edema and amniotic fluid decrease are the results of a maldistribution of water in the body. Kampo medicine optimizes the amount of body water, and also reallocates the water appropriately. Thus, Kampo medicine keeps the amniotic fluid volume at an appropriate level and improves the prognosis of the pregnancy. Regular diuretics influence the active transport of electrolytes across the cell membrane. Kampo medicine controls the number of floodgates (such as aquaporin) in the cell membrane. Thus, no electrolyte disorders occur. The mechanism by which Kampo medicine activates the water metabolism can be explained by the action of aquaporin. The first presentation is “The Relation between the Psychological Test and the Kampo Medical Diagnosis.” Brain changes as a result of stress can affect the autonomic, endocrine, and immune systems as well as have a significant impact on mental function and state of mind. Therefore, Kampo medicine diagnoses and treats stress conditions based on the concept of the unity of mind and body. The empirical expectation that it can improve mental symptoms concomitantly with physical symptoms is a characteristic of Kampo medicine. This presentation will focus on our study to clarify the psychological aspects of Kampo medical diagnoses using several questionnaires and the 16PF personality test in patients who had been successfully treated with three kinds of Kampo medicines (i.e., kamishoyosan, saikokaryukotuboreito and yokukansankachinpihange). In Kampo medical diagnosis, it is very important to collect as much information as possible about the physical aspects, such as physical complaints, pulse, tongue, and abdominal findings. However, our study using psychological tests suggests that in Kampo treatment of stress-related diseases, focusing on psychological rather than physical aspects may lead to more accurate diagnosis and appropriate treatment. It was also suggested that when capturing the psychological aspects of Kampo medical diagnosis, it is important to consider not only mental states such as anxiety and depression, but also personality traits. The second presentation is “Efficacy of Mokuboito in the Fields of Obstetrics and Gynecology.” Moku
在妇产科领域,有许多只有汉布药才能治愈的病例。就汉布医学而言,处方是根据病人的心理状态和性格来选择的。如果服用适当的汉布药,可以在不降低活动水平的情况下提供良好的心理稳定。这些事实已通过汉布医学诊断与心理测试结果之间的关系得到阐明。心衰在产科领域具有很高的危险性,即使是轻度心衰。这些症状是心脏衰竭的征兆,如呼吸困难和严重水肿。Mokuboito对患有心力衰竭和经前综合症的哮喘患者有显著效果。妊娠期水肿和羊水减少是体内水分分布不均的结果。汉布药优化体内水分,并适当地重新分配水分。因此,汉布药使羊水量保持在适当的水平,改善妊娠预后。常规利尿剂影响电解质在细胞膜上的主动运输。汉布药控制细胞膜中闸门(如水通道蛋白)的数量。因此,不会发生电解质紊乱。汉布药激活水代谢的机制可以用水通道蛋白的作用来解释。第一个报告是“心理测验与汉布医学诊断的关系”。压力导致的大脑变化会影响自主神经系统、内分泌系统和免疫系统,也会对精神功能和精神状态产生重大影响。因此,汉布医学基于身心统一的观念来诊断和治疗应激状态。经验期望它能改善伴随身体症状的精神症状,这是汉布医学的一个特点。本报告将重点介绍我们的研究,以阐明汉布医学诊断的心理方面,使用几份问卷和16PF人格测试,对已经成功治疗过三种汉布药物(即kamishoyosan, saikokaryukotuboreito和yokukansankachinpihange)的患者进行诊断。在汉布医疗诊断中,收集尽可能多的关于身体方面的信息是非常重要的,如身体不适、脉搏、舌头和腹部的发现。然而,我们使用心理测试的研究表明,在汉布治疗压力相关疾病时,关注心理而不是身体方面可能会导致更准确的诊断和适当的治疗。还有人建议,在捕捉汉布医学诊断的心理方面时,重要的是不仅要考虑焦虑和抑郁等精神状态,还要考虑人格特征。第二个报告是“Mokuboito在妇产科领域的功效”。Mokuboito是汉布药,被列入《健约雅库》,它对呼吸窘迫和水肿有效。呼吸窘迫和水肿是心力衰竭的症状,即使是轻度的。这些必须小心处理,以免恶化预后。Mokuboito用于16例呼吸窘迫和水肿的孕妇。她们的年龄在23至37岁之间,怀孕27至39周。在7 ~ 14天内评估效果。完全缓解4例,部分缓解8例,无效4例。对于这些症状,mokuboito是有效的。在孕妇水肿抱怨呼吸问题,应积极使用mokuboito。经前综合症(PMS)的主要原因是水分潴留。因此,tokishakuyakusan和类似的公式对经前症候群很有用。特别是Mokuboito对经前症候群哮喘患者有显著的效果。第三个报告是“葛瑞珊治疗妊娠期水肿和羊水减少的疗效”。高瑞散对治疗妊娠水肿有效。在治疗水肿过程中,黄芩具有利尿作用。在水肿改善后,葛丽珊不表现出强制利尿的效果。这些影响是通过检查准妈妈体重的变化来确定的。收稿日期:2022年5月18日修稿日期:2022年6月28日收稿日期:2022年7月6日
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引用次数: 0
Kampo medicine in modern medicine “1st International Symposium on Kampo Medicine” 现代医学中的汉布医学“第一届汉布医学国际研讨会”
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1346
Masamitsu Nakajima, M. Fujimoto, H. Goto, Ming-Jen Chuang
To the editor The first presentation is ‘The features of Kampo medicine in modern medicine’. Kampo, traditional Japanese medicine, has unique features, such as an emphasis on abdominal examination for diagnosis. In Japan, the same physician can practice both modern Western medicine and traditional medicine. Furthermore, Kampo decoctions and extract preparations that have been developed over time are widely used in Japan. Kampo medicine is covered by Japanese health insurance in the same way as Western medicine, and most physicians practice a combination the two types of medicine. In addition, attempts are being made to document the traditional medical diagnostic system, disseminate evidence, and consider medical safety through research on adverse reactions such as herbal-medicine-induced pneumonitis. During undergraduate study, Kampo medical education is included in the core curriculum not only in medical school but also in pharmacy and nursing schools. After graduation from medical school, a system of medical specialization in Kampo medicine can be accessed through various standards and examinations. In acupuncture and moxibustion treatment, both acupuncturists, as independent professionals, and physicians work side by side. In this symposium, I would like to discuss the role of Kampo medicine in modern medicine. The second presentation is ‘Abdominal diagnosis as a hallmark of Kampo medicine in modern medicine’. In principle, the patient should be placed in supine position with the legs extended, as opposed to abdominal examination in Western medicine, which is performed with the knees bent. This is because, in abdominal examination in Western medicine, it is necessary to relax the abdominal wall to examine the intra-abdominal organs, whereas in Kampo medicine, the abdominal wall is examined to determine how the intra-abdominal organs are situated and physical abnormalities are manifested in the abdomen, on the basis of its tension, characteristics, and tenderness. This presentation will demonstrate the clinical significance of typical Kampo medicine abdominal diagnosis findings, such as abdominal strength, abdominal fullness, epigastric stuffiness and resistance, fullness and discomfort in the chest and hypochondrium, abdominal muscle tension, splashing sound in epigastric region, palpitation in the supraumbilical region, weakness of the lower abdominal region, and paraumbilical tenderness and resistance. The third presentation is ‘Kampo extracts frequently used in Japan and their clinical studies’. In Japan, the number of specialists in Kampo medicine is few, andmanyKampo extracts are prescribed by doctors who are not specialists in Kampo medicine. In many of these cases, doctors prescribe Kampo extracts not on the basis of Kampo diagnosis but on evidence reported by clinical studies. One of the tasks of the Evidence-Based Medicine (EBM) Committee of the Japan Society for Oriental Medicine is making evidence reports on randomized controlled tr
致编辑第一个报告是“现代医学中的汉布医学特征”。日本传统医学汉方有其独特的特点,比如强调腹部检查进行诊断。在日本,同一位医生可以同时使用现代西医和传统医学。此外,随着时间的推移,汉布煎剂和提取制剂在日本被广泛使用。日本医疗保险以与西医相同的方式涵盖了汉方医学,大多数医生将两种医学结合起来使用。此外,正在尝试记录传统医学诊断系统,传播证据,并通过对诸如草药引起的肺炎等不良反应的研究来考虑医疗安全。在本科学习期间,汉布医学教育不仅被纳入医学院的核心课程,而且被纳入药学和护理学校的核心课程。从医学院毕业后,可以通过各种标准和考试进入汉布医学专业体系。在针灸治疗中,作为独立专业人员的针灸师和内科医生并肩工作。在这次研讨会上,我想讨论一下汉布医学在现代医学中的作用。第二个报告是“现代医学中作为汉布医学标志的腹部诊断”。原则上,病人应仰卧位,双腿伸直,而西医的腹部检查是屈膝进行的。这是因为,在西医的腹部检查中,需要放松腹壁来检查腹内器官,而在汉布医学中,检查腹壁是根据腹壁的张力、特征和触痛来确定腹内器官的位置和腹部的物理异常表现。本报告将展示典型的坎坡医学腹部诊断表现的临床意义,如腹部力量,腹部充盈,上腹部充盈和阻力,胸部和肋部充盈和不适,腹肌紧张,上腹部飞溅声,脐上区心悸,下腹部无力,脐旁压痛和阻力。第三个报告是“日本常用的汉布提取物及其临床研究”。在日本,研究汉布医学的专家很少,而且很多汉布提取物都是由不是汉布医学专家的医生开的。在许多这样的情况下,医生开出的康普提取物不是根据康普诊断,而是根据临床研究报告的证据。日本东方医学学会循证医学委员会(EBM)的任务之一是对Kampomedicines的随机对照试验进行证据报告。我是EBMcommittee的一员,一直在做证据报告。我查看了从1990年到2020年发表的证据报告的数量,并研究了调查了哪些疾病和配方。在结果中,我发现了大量关于胃肠道、呼吸系统和泌尿生殖系统疾病的报告;癌症;还有神经系统。关于公式,我发现了大量关于daikenchuto, rikkunsito, shosaikoto, shakuyakukanzoto和goshajinkigan的报道。根据当时的趋势和需要,关于特定疾病和配方的报告数量在这一时期有所不同。因此,临床使用的配方一直在变化。有了这些信息,根据证据的数量选择公式就变得司空见惯了。第四场演讲是“台湾中医与汉方医学的差异及汉方医学的实用性”。传统医学起源于中国古代,在漫长的历史进程中传播到东亚和东南亚,每个地区都进一步发展了自己独特的医学。汉方药(日本传统医药)起源于古代中国,并以一种特别独特的方式发展到日本。台湾的中医是以《黄帝内经》的内容为理论基础发展起来的临床医学,采用辨证论治的方法,着重讨论阴阳、五行学说、经络学说、六经辨证等理论进行治疗。另一方面,Kampo开发了一种配方方法。收稿日期:2022年5月25日修订日期:2022年7月27日收稿日期:2022年7月27日
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引用次数: 0
Two cases of functional abdominal bloating successfully treated with hangekobokuto 应用韩氏胃保汤治疗功能性腹胀2例
Pub Date : 2022-12-01 DOI: 10.1002/tkm2.1342
T. Oikawa, Y. Yakazu, Kazuhiro Hirasawa, Y. Yamaguchi, Yoshimi Harada
To the editor, Functional abdominal bloating is a clinical entity which is characterized by intractable and uncomfortable abdominal fullness due to aerophagia with bowel gas retention. Recently, we experienced two cases of functional abdominal bloating with complaints of abdominal fullness or flatulence; the symptoms were successfully treated with the Kampo medicine hangekobokuto (HKT). Case 1 was a 73-years-old male whose complaint was abdominal fullness since 10 years. His abdominal fullness occurred around 10 a.m. every morning, sometimes accompanied with belching. Abdominal fullness is sometimes also accompanied by a need to defecate, and he passed normal stool mixed with a huge amount of bowel gas, which dispersed by flatulence. He had a past history of diabetes mellitus, angina and hypertension. On tongue diagnosis, he showed light-red tongue with slight white fur. His pulse diagnosis was deep and somewhat weak. His abdominal diagnosis showed slightly weak abdominal strength accompanied by lower abdominal weakness. After taking HKT ethical granule, his abdominal fullness almost disappeared the following day. After that, he was not disturbed any more by abdominal fullness and other gas symptoms. Case 2 was a 48-years-old male whose complaint was a frequent urgency to defecate since three months. His abdominal discomfort and rumbling of the intestine, and the frequent need to defecate, occurred from evening to nighttime. He usually passed bowel gas only, but sometimes had normal stool mixed with bowel gas, which dispersed by flatulence. He had a past history of surgery for thymic tumor and somatoform disorder as well as adaptation disorder. On tongue diagnosis, he showed light-red tongue with moderate white fur. His pulse diagnosis was deep, and abdominal diagnosis showed moderate abdominal strength accompanied with tympanic sound, suggestive of abdominal gas retention. After taking HKT ethical granule, the rumbling of his intestines improved after four weeks. After eight weeks, all his symptoms related to bowel gas had disappeared. Various treatments including medical and mental therapy are now applied as therapeutic options for functional abdominal bloating, but no effective standard therapy has yet been reported [1]. From this standpoint, Kampo medicine can be a new option for medical treatment, because it is easy to use in Japanese medical practice. HKT consists of Pinelliae Tuber, Hoelen, Magnoliae Cortex, Perillae Herba and Zingiberis Rhizoma. HKT is frequently used to treat neurosis or globus, but is also applied for gastrointestinal diseases. Previously, we reported that HKT reduced bowel gas volume and improved gastrointestinal symptoms, along with improving the gastric emptying rate in patients with functional dyspepsia [2, 3]. The reduction of bowel gas seems to be due to the suppression of aerophagia, which might be a characteristic mechanism of action for HKT. Moreover, the anxiolytic effect of the crude drugs included in HKT has
功能性腹胀是一种临床症状,其特征是由于食气并肠气潴留引起的难治性和不舒服的腹部充盈。最近,我们经历了两例功能性腹胀与腹部充盈或胀气的投诉;用汉布药hangekobokuto (HKT)成功地治疗了症状。病例1为男性,73岁,主诉腹胀10年。他每天早上10点左右出现腹胀,有时伴有打嗝。腹胀有时还伴有排便的需要,他排出的大便中夹杂着大量的肠气,这些气体因胀气而分散。既往有糖尿病、心绞痛、高血压病史。舌诊,舌呈淡红色,毛微白。他的脉搏微弱而深。他的腹部诊断显示腹部力量轻微虚弱,并伴有下腹部无力。服用HKT伦理颗粒后,第二天腹部充盈几乎消失。此后,他不再受到腹部充盈和其他气体症状的困扰。病例2为48岁男性,主诉为3个月来频繁急便。他腹部不适,肠鸣,频繁需要排便,从晚上到晚上发生。他通常只排便肠气,但有时正常大便混有肠气,并因胀气而分散。既往有胸腺肿瘤、躯体形式障碍及适应障碍手术史。舌诊,舌呈浅红色,毛呈中度白色。他的脉搏诊断深,腹部诊断显示腹部力量适中,伴有鼓室音,提示腹部气体潴留。在服用HKT伦理颗粒后,他的肠道隆隆声在四周后有所改善。八周后,他所有与肠气有关的症状都消失了。目前,包括药物和心理治疗在内的各种治疗方法被用作功能性腹胀的治疗选择,但尚未有有效的标准治疗方法被报道。从这个角度来看,汉方医学可以成为一种新的医疗选择,因为它易于在日本医疗实践中使用。HKT由半夏块茎、雪莲、木兰皮、紫苏和姜黄组成。HKT常用于治疗神经症或球形疾病,但也用于胃肠道疾病。此前,我们报道了HKT可减少肠气量,改善胃肠症状,同时提高功能性消化不良患者的胃排空率[2,3]。肠道气体的减少似乎是由于抑制气噬作用,这可能是HKT的一个特征性作用机制。此外,HKT中所含的生药在动物模型中也有抗焦虑作用的报道[4,5],应考虑其在腹部减气中的相关作用机制。病人主诉因食气而腹部充盈并不罕见。因此,需要一种有效的治疗这种令人烦恼的症状的模式,在一般做法,包括坎布诊所。HKT是治疗功能性腹胀的一种强有力且可行的选择。
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引用次数: 1
期刊
Traditional & Kampo Medicine
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