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Tsunokawa Y, Tsukada M, Inoue T, Tamaoka M, Mugita T, Chuluunbat O, Maeda Y, Fukagai T, Ogawa Y, Sunagawa M. Analgesic Effect of the Kampo Formula Yokukansan via the Suppression of Substance P in an Experimental Rat Model of Hunner-Type Interstitial Cystitis. Cureus 2024; 16:e52238. [PMID: 38352105 PMCID: PMC10862183 DOI: 10.7759/cureus.52238] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/13/2024] [Indexed: 02/16/2024] Open
Abstract
INTRODUCTION Yokukansan (YKS), a Kampo formula used in traditional Japanese medicine, has an analgesic effect, and is used for various pain disorders. This study investigated its analgesic effects on Hunner-type interstitial cystitis (HIC) and its mechanism of action in animal models. Methods: Rats with toll-like receptor-7 agonist (loxoribine)-induced HIC were used. Eight-week-old female Wistar rats were divided into three groups: control, HIC, and HIC-administered YKS (YKS + HIC). Bladder pain was assessed based on escape behavior using the von Frey test. Three days after HIC induction, the bladder and spinal cord were excised, and the expression of substance P (SP) was examined. Results: The pain threshold decreased significantly in the HIC group compared to that in the control group, but this decrease was suppressed by further YKS administration. The expression of SP in the bladder wall and spinal cord increased significantly in the HIC group compared to that in the control group; however, this increase was suppressed by YKS administration. CONCLUSION SP is involved in the onset of bladder pain via neurokinin 1 receptors in bladder tissue. YKS may be useful for managing HIC-induced pain, and the suppression of SP secretion is one of its mechanisms of action.
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Affiliation(s)
- Yoshiki Tsunokawa
- Department of Physiology, Showa University Graduate School of Medicine, Tokyo, JPN
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | - Mana Tsukada
- Research Administration Center, Showa University, Tokyo, JPN
- Department of Physiology, Showa University Graduate School of Medicine, Tokyo, JPN
| | - Tatsuki Inoue
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | - Masashi Tamaoka
- Department of Physiology, Showa University Graduate School of Medicine, Tokyo, JPN
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | - Toshiki Mugita
- Department of Physiology, Showa University Graduate School of Medicine, Tokyo, JPN
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | | | - Yoshiko Maeda
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | - Takashi Fukagai
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | - Yoshio Ogawa
- Department of Urology, Showa University School of Medicine, Tokyo, JPN
| | - Masataka Sunagawa
- Department of Physiology, Showa University Graduate School of Medicine, Tokyo, JPN
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Ishida T, Kawada K, Morisawa S, Jobu K, Morita Y, Miyamura M. Risk Factors for Pseudoaldosteronism with Yokukansan Use: Analysis Using the Japanese Adverse Drug Report (JADER) Database. Biol Pharm Bull 2021; 43:1570-1576. [PMID: 32999167 DOI: 10.1248/bpb.b20-00424] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Yokukansan is a Kampo formula that is commonly used by the elderly because it is expected to improve peripheral symptoms of dementia and delirium. However, side effects from its use are frequently reported in the elderly. In particular, pseudoaldosteronism caused by the licorice contained in yokukansan leads to hypertension, hypokalemia, and muscle weakness, which may result in death. This study aimed to identify the risk factors of pseudoaldosteronism with yokukansan use. Using cases reported in the Japanese Adverse Drug Report (JADER) database, the reporting odds ratio (ROR) was calculated and compared to assess the risk of pseudoaldosteronism for each licorice-containing Kampo formula. We also analyzed the risk factors for pseudoaldosteronism in patients taking yokukansan. Yokukansan (ROR 2.4, 95% confidence interval (CI) 1.9-2.8; p < 0.001) had a higher risk of pseudoaldosteronism than that of other licorice-containing Kampo formulas. Furthermore, the results of a logistic regression analysis in patients taking yokukansan showed that the licorice dose (OR 1.5, 95% CI 1.2-2.0; p < 0.01), older age (<70 years, OR 5.9, 95% CI 1.8-20; p < 0.01), dementia (OR 2.8, 95% CI 1.6-4.9; p < 0.001), low body weight (<50 kg, OR 2.2, 95% CI 1.1-3.5; p = 0.034) were risk factors for pseudoaldosteronism, Although not significant, treatment with loop diuretics (OR 1.8, 95% CI 0.98-3.5; p = 0.059) tended to increase the risk of pseudoaldosteronism. In summary, patients must understand the risk factors when considering taking yokukansan and reduce the licorice dose they consume.
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Affiliation(s)
| | - Kei Kawada
- Department of Pharmacy, Kochi Medical School Hospital.,Department of Biomedical Science, Kochi Medical Graduate School
| | - Shumpei Morisawa
- Department of Pharmacy, Kochi Medical School Hospital.,Department of Biomedical Science, Kochi Medical Graduate School
| | - Kohei Jobu
- Department of Pharmacy, Kochi Medical School Hospital
| | - Yasuyo Morita
- Department of Pharmacy, Kochi Medical School Hospital
| | - Mitsuhiko Miyamura
- Department of Pharmacy, Kochi Medical School Hospital.,Department of Biomedical Science, Kochi Medical Graduate School
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Sunagawa M, Yamaguchi K, Tsukada M, Ebihara N, Ikemoto H, Hisamitsu T. Kampo (Traditional Japanese Herbal) Formulae for Treatment of Stomatitis and Oral Mucositis. Medicines (Basel) 2018; 5:medicines5040130. [PMID: 30544681 PMCID: PMC6313652 DOI: 10.3390/medicines5040130] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2018] [Revised: 11/27/2018] [Accepted: 11/29/2018] [Indexed: 01/08/2023]
Abstract
Stomatitis is occasionally multiple, recurrent, and refractory. Currently, mucositis induced by chemotherapy and radiation therapy in patients with cancer has become a significant clinical problem. Effective treatments have not been established and the treatment of numerous cases remains a challenge for physicians. Traditional Japanese herbal medicines termed Kampo formulae (i.e., Hangeshashinto, Orengedokuto, Inchinkoto, Orento, Byakkokaninjinto, Juzentaihoto, Hochuekkito, and Shosaikoto) are used for treating various types of stomatitis and mucositis. Its use has been based on the Kampo medical theories—empirical rules established over thousands of years. However, recently, clinical and basic research studies investigating these formulae have been conducted to obtain scientific evidence. Clinical studies investigating efficacies of Shosaikoto and Orento for the treatment of cryptogenic stomatitis and acute aphthous stomatitis and those investigating the effects of Hangeshashinto, Orengedokuto, and Juzentaihoto on chemotherapy- or radiotherapy-induced mucositis have been conducted. The Kampo formulae comprise several crude drugs, whose mechanisms of action are gradually being clarified. Most of these drugs that are used for the treatment of stomatitis possess anti-inflammatory, analgesic, and antioxidative properties. In this review, we introduce the clinical applications and summarize the available evidence on the Kampo formulae for the treatment of stomatitis and oral mucositis.
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Affiliation(s)
- Masataka Sunagawa
- Department of physiology, School of medicine, Showa University, Tokyo 142-8555, Japan.
| | - Kojiro Yamaguchi
- Department of physiology, School of medicine, Showa University, Tokyo 142-8555, Japan.
| | - Mana Tsukada
- Department of physiology, School of medicine, Showa University, Tokyo 142-8555, Japan.
| | - Nachi Ebihara
- Department of physiology, School of medicine, Showa University, Tokyo 142-8555, Japan.
| | - Hideshi Ikemoto
- Department of physiology, School of medicine, Showa University, Tokyo 142-8555, Japan.
| | - Tadashi Hisamitsu
- Department of physiology, School of medicine, Showa University, Tokyo 142-8555, Japan.
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Arai YC, Shimo K, Inoue M, Sakurai H, Ohmichi Y, Matsubara T, Nishihara M, Kawai T, Ikemoto T, Inoue S. Integration of a Kampo medicine, Nijutsuto, and Western medical treatment in the treatment of long-term frozen shoulder refractory to Western medical treatment: a case series. J Evid Based Complementary Altern Med 2015; 20:157-61. [PMID: 25613331 DOI: 10.1177/2156587214568346] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
OBJECTIVE Frozen shoulder is a common disorder in general orthopedic practice, characterized by spontaneous onset of pain in the shoulder and accompanied by limitation of glenohumeral movement. Treatments for frozen shoulder include shoulder exercise, manual therapy, corticosteroid injection, manipulation under anesthesia, and arthroscopic capsular release. Several patients suffer from some degree of pain and range of motion limitation for up to 10 years even when these treatments are applied. Kampo, a traditional Japanese herbal medicine based on traditional Chinese herbal medicine, has been used for the treatment of pain in Japan. Nijutsuto has been a Kampo formula used to effectively treat frozen shoulder. METHODS Thirteen patients suffering from long-term frozen shoulder refractory to Western medical treatment were administered Nijututo. RESULTS Almost all patients experienced sound pain relief after Nijutsuto admnistration. There were no severe side effects reported. CONCLUSION Nijutsuto combined with an exercise program improved pain intensity in 13 patients with long-term frozen shoulder.
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