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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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Ishizuka M, Shibuya N, Nagata H, Takagi K, Iwasaki Y, Hachiya H, Aoki T, Kubota K. Perioperative Administration of Traditional Japanese Herbal Medicine Daikenchuto Relieves Postoperative Ileus in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis. Anticancer Res 2017; 37:5967-5974. [PMID: 29061775 DOI: 10.21873/anticanres.12043] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2017] [Revised: 07/12/2017] [Accepted: 07/13/2017] [Indexed: 11/10/2022]
Abstract
AIM Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoing surgery for GI cancer. Therefore, the aim of this study was to investigate whether perioperative administration of DKT relieves PI in patients with GI cancer. PATIENTS AND METHODS We performed a comprehensive electronic search of the literature (Cochrane Library, PubMed, the Web of Science and ICHUSHI) up to December 2016 to identify studies that had shown the efficacy of perioperative DKT administration for relief of PI in patients with GI cancer. To integrate the individual effect of DKT, a meta-analysis was performed using random-effects models to calculate the risk ratio (RR) and 95% confidence interval (CI), and heterogeneity was analyzed using I2 statistics. RESULTS Seven studies involving a total of 1,134 patients who had undergone GI cancer surgery were included in this meta-analysis. Among 588 patients who received DKT perioperatively, 67 (11.4%) had PI, whereas among 546 patients who did not receive DKT perioperatively, 87 (15.9%) had PI. Perioperative administration of DKT significantly reduced the occurrence of PI (RR=0.58, 95% CI=0.35-0.97, p=0.04, I2=48%) in comparison to patients who did not receive DKT or received placebo. CONCLUSION The result of this meta-analysis suggests that perioperative administration of DKT relieves PI in patients undergoing surgery for GI cancer.
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Affiliation(s)
- Mitsuru Ishizuka
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Norisuke Shibuya
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hitoshi Nagata
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Kazutoshi Takagi
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Yoshimi Iwasaki
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Hiroyuki Hachiya
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Taku Aoki
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
| | - Keiichi Kubota
- Department of Gastroenterological Surgery, Dokkyo Medical University, Tochigi, Japan
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Nakae H, Saito Y, Okuyama M, Igarashi T. A case of tetanus treated with Kampo medicines such as Kakkonto and Shakuyakukanzoto. Acute Med Surg 2017; 4:217-220. [PMID: 29123865 PMCID: PMC5667273 DOI: 10.1002/ams2.254] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2016] [Accepted: 09/20/2016] [Indexed: 11/30/2022] Open
Abstract
Case A 74-year-old man developed tetanus 3 days after working with cow and poultry manure. Kakkonto and shakuyakukanzoto, traditional Japanese herbal medicines that are effective for the relief of pain primarily related to muscle contraction, were given to control the trismus and painful contracture of the neck. Generalized convulsions were controlled without the use of muscle relaxants. Outcome After 30 days, the patient was discharged from the hospital without any sequelae. Conclusion Kakkonto and shakuyakukanzoto may be useful for the control of muscle spasms resulting from generalized tetanus.
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Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Yuri Saito
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Manabu Okuyama
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
| | - Toshiko Igarashi
- Department of Emergency and Critical Care MedicineAkita University Graduate School of MedicineAkitaJapan
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Iwata N, Kainuma M, Kobayashi D, Kubota T, Sugawara N, Uchida A, Ozono S, Yamamuro Y, Furusyo N, Ueda K, Tahara E, Shimazoe T. The Relation between Hepatotoxicity and the Total Coumarin Intake from Traditional Japanese Medicines Containing Cinnamon Bark. Front Pharmacol 2016; 7:174. [PMID: 27378929 PMCID: PMC4913087 DOI: 10.3389/fphar.2016.00174] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Accepted: 06/03/2016] [Indexed: 12/20/2022] Open
Abstract
Cinnamon bark is commonly used in traditional Japanese herbal medicines (Kampo medicines). The coumarin contained in cinnamon is known to be hepatotoxic, and a tolerable daily intake (TDI) of 0.1 mg/kg/day, has been quantified and used in Europe to insure safety. Risk assessments for hepatotoxicity by the cinnamon contained in foods have been reported. However, no such assessment of cinnamon bark has been reported and the coumarin content of Kampo medicines derived from cinnamon bark is not yet known. To assess the risk for hepatotoxicity by Kampo medicines, we evaluated the daily coumarin intake of patients who were prescribed Kampo medicines and investigated the relation between hepatotoxicity and the coumarin intake. The clinical data of 129 outpatients (18 male and 111 female, median age 58 years) who had been prescribed keishibukuryogankayokuinin (TJ-125) between April 2008 and March 2013 was retrospectively investigated. Concurrent Kampo medicines and liver function were also surveyed. In addition to TJ-125, the patients took some of the other 32 Kampo preparations and 22 decoctions that include cinnamon bark. The coumarin content of these Kampo medicines was determined by high performance liquid chromatography (HPLC). TJ-125 had the highest daily content of coumarin (5.63 mg/day), calculated from the daily cinnamon bark dosage reported in the information leaflet inserted in each package of Kampo medicine. The coumarin content in 1g cinnamon bark decoction was 3.0 mg. The daily coumarin intake of the patients was 0.113 (0.049–0.541) mg/kg/day, with 98 patients (76.0%) exceeding the TDI. Twenty-three patients had an abnormal change in liver function test value, but no significant difference was found in the incidence of abnormal change between the group consuming less than the TDI value (6/31, 19.4%) and the group consuming equal to or greater than the TDI value (17/98, 17.3%). In addition, no abnormal change related to cinnamon bark was found for individual patients. This paper was done to assess the risk of hepatotoxicity by the coumarin contained in Kampo medicines and to clarify whether or not the Kampo preparations in general use that contain cinnamon bark may be safely used in clinical practice.
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Affiliation(s)
- Naohiro Iwata
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Mosaburo Kainuma
- Community Medicine Education Unit, Graduate School of Medical Sciences, Kyushu UniversityFukuoka, Japan; Department of General Internal Medicine, Kyushu University HospitalFukuoka, Japan
| | - Daisuke Kobayashi
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Toshio Kubota
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Naoko Sugawara
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Aiko Uchida
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Sahoko Ozono
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Yuki Yamamuro
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
| | - Norihiro Furusyo
- Department of General Internal Medicine, Kyushu University Hospital Fukuoka, Japan
| | - Koso Ueda
- Department of Pediatrics, Matsuyama Red Cross Hospital Matsuyama, Japan
| | - Eiichi Tahara
- Department of Japanese Oriental (Kampo) Medicine, Oriental Medical Center, Iizuka Hospital Iizuka, Japan
| | - Takao Shimazoe
- Department of Clinical Pharmacy and Pharmaceutical Care, Graduate School of Pharmaceutical Sciences, Kyushu University Fukuoka, Japan
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Kono T, Shimada M, Yamamoto M, Kaneko A, Oomiya Y, Kubota K, Kase Y, Lee K, Uezono Y. Complementary and synergistic therapeutic effects of compounds found in Kampo medicine: analysis of daikenchuto. Front Pharmacol 2015; 6:159. [PMID: 26300774 PMCID: PMC4523940 DOI: 10.3389/fphar.2015.00159] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2015] [Accepted: 07/17/2015] [Indexed: 01/17/2023] Open
Abstract
Herbal medicines have been used in Japan for more than 1500 years and traditional Japanese medicines (Kampo medicines) are now fully integrated into the modern healthcare system. In total, 148 Kampo formulae are officially approved as prescription drugs and covered by the national health insurance system in Japan. However, despite their long track record of clinical use, the multi-targeted, multi-component properties of Kampo medicines, which are fundamentally different from Western medicines, have made it difficult to create a suitable framework for conducting well-designed, large-scale clinical trials. In turn, this has led to misconceptions among western trained physicians concerning the paucity of scientific evidence for the beneficial effects of Kampo medicines. Fortunately, there has been a recent surge in scientifically robust data from basic and clinical studies for some of the Kampo medicines, e.g., daikenchuto (TU-100). Numerous basic and clinical studies on TU-100, including placebo-controlled double-blind studies for various gastrointestinal disorders, and absorption, distribution, metabolism and excretion (ADME) studies, have been conducted or are in the process of being conducted in both Japan and the USA. Clinical studies suggest that TU-100 is beneficial for postoperative complications, especially ileus and abdominal bloating. ADME and basic studies indicate that the effect of TU-100 is a composite of numerous actions mediated by multiple compounds supplied via multiple routes. In addition to known mechanisms of action via enteric/sensory nerve stimulation, novel mechanisms via the TRPA1 channel and two pore domain potassium channels have recently been elucidated. TU-100 compounds target these channels with and without absorption, both before and after metabolic activation by enteric flora, with different timings and possibly with synergism.
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Affiliation(s)
- Toru Kono
- Center for Clinical and Biomedical Research, Sapporo Higashi Tokushukai Hospital Sapporo, Hokkaido, Japan ; Pathophysiology and Therapeutics, Faculty of Pharmaceutical Sciences, Hokkaido University Sapporo, Japan ; Department of Surgery, Institute of Health Biosciences, Graduate School of Medicine, Tokushima University Tokushima, Japan
| | - Mitsuo Shimada
- Department of Surgery, Institute of Health Biosciences, Graduate School of Medicine, Tokushima University Tokushima, Japan
| | - Masahiro Yamamoto
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Atushi Kaneko
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Yuji Oomiya
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Kunitsugu Kubota
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Yoshio Kase
- Kampo Scientific Strategies Division, Tsumura Research Laboratories, Tsumura & CO. Ami, Japan
| | - Keiko Lee
- Kampo Scientific Strategies Division, International Pharmaceutical Development Department, Tsumura & CO. Tokyo, Japan
| | - Yasuhito Uezono
- Division of Cancer Pathophysiology, National Cancer Center Research Institute Tokyo, Japan
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Nakae H, Kusanagi M, Okuyama M, Igarashi T. Paralytic ileus induced by glyphosate intoxication successfully treated using Kampo medicine. Acute Med Surg 2014; 2:214-218. [PMID: 29123725 DOI: 10.1002/ams2.103] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2014] [Accepted: 10/24/2014] [Indexed: 12/24/2022] Open
Abstract
Case A 65-year-old woman ingested glyphosate-surfactant herbicide in an attempt to commit suicide. She experienced glyphosate intoxication associated with multiple organ failure and developed a paralytic ileus. Daijokito, a traditional Japanese Kampo medicine was given to the patient to improve constipation and psychological symptoms. Next, rikkunshito was given to increase her gastric motility. Finally, daikenchuto was given to improve overall digestive peristalsis. Outcome All abdominal symptoms ultimately improved after treatment with daikenchuto. Conclusion Kampo medicines may help improve abdominal symptoms associated with glyphosate intoxication in cases where modern medical treatment alone proves inadequate.
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Affiliation(s)
- Hajime Nakae
- Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan
| | - Misato Kusanagi
- Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan
| | - Manabu Okuyama
- Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan
| | - Toshiko Igarashi
- Department of Emergency and Critical Care Medicine Akita University Graduate School of Medicine Akita Japan
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