Japanese government research grants for Kampo medicine: aAn overview of 10 years (1997-2017)

Similar but Different Three Major Traditional Medicines in East Asia: A Bibliometric Analysis

OBJECTIVE

Traditional medicine (TM) has played a key role in the health care system of East Asian countries, including China, Japan and South Korea. This bibliometric study analyzes the recent research status of these three TMs, including traditional Chinese medicine (TCM), traditional Korean medicine (TKM), and Kampo medicine (KM).

METHODS

Research topics of studies published for recent 10 years (2014 to 2023), through a search on MEDLINE via PubMed, was analyzed. Medical Subject Headings were used to distinguish between the three TMs researches. Bibliographic information was analyzed through VOSViewer version. Total 10,151 documents were included: TCM studies (n=9,630); TKM studies (n=256); and KM studies (n=295).

RESULTS

Comparing the three co-occurrence analysis maps, TCM studies generally overwhelm the quantitative scale of TKM and KM studies. In the trend of the latest research of TCM, not only corona virus disease 2019 (COVID-19), but also clinical research topics such as gastrointestinal microbiome and diabetes mellitus have emerged, with in silico research approaches being actively applied. In the case of TKM, obesity and cooperative treatment with Western medicine are gaining attention. In KM, COVID-19 and Scutellaria baicalensis were recent research focuses. Unique features that distinguished from the other two TM research trends included 'gut microbiota', 'diabetes mellitus', 'clinical trials', 'disease models', and 'quality control' in the TCM map; 'prospective studies', 'cell line, tumor', and 'panax' in the TKM map; and 'aged, 80 and over', 'retrospective studies', 'glycyrrhiza', 'panax', and 'paeonia' in the KM map. Also, some quantitative and qualitative differences were found in author co-operation maps in each TM.

CONCLUSIONS

This analysis revealed that there were clear quantitative and qualitative differences among TCM, TKM, and KM. Although these medicines have a common root, they may have become distinct due to factors such as the size of research funds, cultural differences, and the medical licensing system.

Trends in Kampo Medicine Usage as Supportive Care During Anticancer Drug Treatment in Japanese Patients: A Nationwide Cohort Analysis from Fiscal Years 2015 to 2021

The adverse effects of anticancer drugs significantly impact the quality of life of patients undergoing chemotherapy, necessitating evidence-based supportive therapies. In Japan, Kampo medicines, traditional Japanese herbal therapies used for relief of various symptoms, have been widely used as complementary and alternative treatments for cancer, despite limited evidence regarding their efficacy and safety. Thus, we investigated the actual use of Kampo medicines as supportive care in patients undergoing anticancer drug treatment and evaluated the trends in prescription according to year. We analyzed 89,141 cancer drug therapy cases registered in the Japan Medical Data Center database between April 2014 and July 2022, excluding those with a history of Kampo medicine prescriptions before the first prescription of antineoplastic drugs. We assessed the trends in prescription according to sex, age group (<50, 50-74, and ≥75 years), and cancer type subgroup using the Cochran-Armitage trend test. Approximately 23.7% of patients were prescribed Kampo medicines during anticancer drug treatment. Since 2014, a decrease in the prescription of Kampo medicines during anticancer treatment has been observed regardless of sex, age, or cancer type. These findings suggest that recent negative reports on the efficacy and safety of Kampo medicines in cancer care may have influenced this trend.

Animal-and mineral-based medicines in Gansu-Ningxia-inner Mongolia region, P.R. China: a cross-cultural ethnobiological assessment

Introduction: Traditional animal- and mineral-based medicines are widely used in the Gansu-Ningxia-Inner Mongolia junction zone, a region with diverse ethnic groups and cultures. This study aims to document, conserve, and explore the potential of these medicines for further research and sustainable development of ethnic medicine. Methods: We interviewed 56 informants from different ethnic backgrounds and analyzed their responses quantitatively. Additionally, a comparative analysis with adjacent regions was conducted, providing invaluable contextual insights. Results: The study unveiled a diverse array of traditional medicines in the Gansu-Ningxia-Inner Mongolia junction zone. A total of 47 animal-based medicines were identified, ranging from insects and scorpios to distinctive animal organs. Of notable significance was Moschus, emerging as a pivotal traditional Chinese medicine resource. In parallel, 12 mineral-based medicines were cataloged, procured both locally and from "pharmacies". Female informants, frequently local herbal practitioners, demonstrated broader knowledge of medicines. The analysis of 13 villages revealed varying perceptions of medicine importance, underscoring the wealth of traditional knowledge. Specific medicines, such as Feng-Mi and Xie-Zi, were widely used and valued in local healthcare practices for their cultural and medicinal benefits. Conclusion: This study provides a comprehensive overview of traditional animal- and mineral-based medicines in the Gansu-Ningxia-Inner Mongolia junction zone. It highlights the need for preserving and applying these practices in a sustainable manner. It also lays a solid foundation for future research on ethnic medicine, which can contribute to the holistic wellbeing of local communities.

Translation and validation of the Chinese version of the Japan Frailty Scale

Purpose

Frailty is a difficult-to-measure condition that is susceptible to adverse outcomes. The Japan Frailty Scale (JFS) is a tool for assessing frailty status in older adults. This study aimed to translate and culturally adapt the JFS into a Chinese version (JFS-C).

Materials and methods

The study included 160 older adults as participants. Internal consistency was assessed using Cronbach's alpha, and test-retest reliability was conducted using the intraclass correlation coefficient (ICC). Convergent validity was evaluated by assessing the correlation between JFS-C and the Barthel Index, the Frail scale, and the 36-item Short-Form Health Survey (SF-36). Criterion validity was assessed by comparing JFS-C scores with the Frail scale.

Results

JFS-C demonstrated adequate internal consistency (Cronbach's alphas = 0.711) and excellent test-retest reliability over a 7 to 10-day interval (ICC = 0.949). Correlation analysis showed a strong positive correlation between JFS-C and the Frail scale (r = 0.786, p < 0.001), a moderate negative correlation with the Barthel Index (r = -0.598, p < 0.001), and moderate correlations with various subscales of SF-36 (r = -0.574 to -0.661). However, no significant correlations were found between JFS-C and SF-36 mental health (r = -0.363, p < 0.001) or role emotional (r = -0.350, p < 0.001). Based on the reference standard of the Frail scale phenotype (score ≥ 2), the cutoff value for JFS-C was determined to be 3.

Conclusion

JFS-C demonstrates good reliability and validity in assessing frailty among the older population in China.

Intron retention is a stress response in sensor genes and is restored by Japanese herbal medicines: A basis for future clinical applications

Intron retention (IR) is a regulatory mechanism that can retard protein production by acting at the level of mRNA processing. We recently demonstrated that IR occurs at the pre-symptomatic state during the aging process of a mouse model of aging, providing a promising biomarker for that state, and can be restored to the normal state by juzentaihoto (JTT), a Japanese herbal medicine (Kampo) (Okada et al. 2021). Here we characterized the genes that accumulate retained introns, examined the biological significance of increased IR in these genes for the host, and determined whether drugs other than JTT can have this effect. By analyzing RNA-sequencing data generated from the hippocampus of the 19-week-old SAMP8 mouse, a model for studying age-related depression and Alzheimer's disease, we showed that genes with increased IR are generally involved in multiple metabolic pathways and have pivotal roles in sensing homeostasis. We thus propose that IR is a stress response and works to fine-tune the expression of many downstream target genes, leading to lower levels of their translation under stress conditions. Interestingly, Kampo medicines, as well as other organic compounds, restored splicing of a specific set of retained introns in these sensor genes in accordance with the physiological recovery conditions of the host, which corresponds with the recovery of transcripts represented by differentially expressed genes. Thus, analysis of IR genes may have broad applicability in evaluating the pre-symptomatic state based on the extent of IR of selective sensor genes, opening a promising early diagnosis of any diseases and a strategy for evaluating efficacies of several drugs based on the extent of IR restoration of these sensor genes.

Relationship Between Conventional Medicine Chapters in ICD-10 and Kampo Pattern Diagnosis: A Cross-Sectional Study

Objectives: The newest revision to the International Classification of Diseases, the 11^th edition (ICD-11) includes disease classifications from East Asian medicine, including traditional Japanese medicine (Kampo medicine). These disease classifications allow for comparisons between disease classifications from conventional medicine and Kampo medicine.

Design/Location/Subjects/Interventions: This is an exploratory, cross-sectional study exploring the relationship between conventional medicine diagnoses and Kampo medicine diagnoses at a large Kampo clinic in Japan. Patients were seen from October 1st, 2014 to June 30th, 2019 and were 20 years of age or older.

Outcome measures: Patients presented with one or more conventional medicine ICD-10 codes into the clinic and were given one descriptor from the ICD-11 within the heat-cold module, excess-deficiency module, and an optional body constituents module. The distribution of these Kampo medicine codes was examined in relation to conventional medicine chapters.

Results: 1,209 patients were included in our final analysis. Patient number, ages, sex ratio, and BMI varied within conventional medicine ICD-10 chapters and Kampo medicine descriptor codes. Certain conventional medicine chapters are related to specific Kampo medicine descriptor codes, such as chapter IV (endocrine, nutritional, and metabolic diseases) with excess, heat, and kidney qi deficiency.

Conclusion: The advent of the ICD-11 allows for systematic, standardized comparisons between Kampo medicine, and contemporary medicine. In this exploratory study, our findings support the independence of Kampo medicine pattern descriptors with ICD-10 conventional medicine chapters. Code overrepresentations in relation to conventional medicine diseases and by age and sex should be an area of future investigation to best understand how to synergize and improve patient care.