Volume 7, Number 4 | Winter 2012

Clinical Report 2 (Kampo Medicine)
Maobushisaishinto for Non-dipper Hypertension

Narihiro Fujii
Tokando Medical Clinic

Other symptoms:

Sensitivity

tocold(–),

Sensation of warmth (–)
Present illness:
Height: 169cm; Weight: 72kg; BMI: 25.2
Anemia (–); Edema (–)

Case

69-year-old male

Chief complaint

Non-dipper hypertension

regular

Past medical history

not particular

Stethoscopy and tapping found no particular

Family history

Hypertension (-);

abnormality

Father: prostrate cancer;

Good complexion, light pink tongue with a light,

Mother: gastric cancer

dry coating

Smoking: 10 cigarettes/day

Pulse: On the right, inch-bar-cubit is stable anduntil 2008, thereafter quit.

slightly string-like; on the left, inch-bar is stable

Drinking: Occasionallyand slightly string-like, and cubit is slightly

Social history

History of present illness:

Blood pressure: 130/70mmHg; Pulse: 55/min,sunken.

The patient visited our clinic on 5/25/XXXX after

Abdominal examination: Ventral horn – moderate;

experiencing occasional staggering. He had a blood

Abdominal pressure 3/5; Epigastric fullness (–);

pressure of 185/110mmHg in his right arm andChest side painfulness (left and right 1+);

175/100mmHg in his left. He underwent a complete

Splashing sound in epigastric region (–);

medicalPalpitation (–); Weakness (+)

checkupeveryyear,

but

was

neverquestioned about blood pressure. He weighs 69kg,
marking an increase of 2kg from the previous year.

Blood biochemical examination: No particular
problem

He underwent an endocrine examination but noProgress: The noctural rise in blood pressure wasparticular problem was detected. He was prescribedseen as poor prognosis, so Maobushisaishinto 5g

an oral medication of valsaltan(80)1T, and was told

was administered on 7/6 to improve nighttime

to record his blood pressure at home. As a result, hisblood pressure.

nighttime blood pressure was found to be high,No subjective complaint from the patient

indicating non-dipper hypertension. In winter, hishimself. A re-examination on 8/6 showed noweight increased to 72kg, his blood pressurechange in the rise and drop in blood pressure,increased at home, and his systolic blood pressure

but blood pressure pattern changed from a non-measured 150-160mmHg. His antihypertensive drug

dipper to a dipper pattern (Fig. 1).

was thus switched to valsaltan + trichlorotiazide

Flow of the defense qi

MD1Tab on 12/24. With a blood pressure of 115 –Physiological condition: The defense qi is produced

135/90-70mmHg, he continued to display non-dipper

from the hydration shell in the lienogastric artery,

hypertension. He continued the oral administration,and flows through the entire body. It flows aroundand returned to the clinic on 7/6/XXXX+1.

the Yang parts of the body during the daytime andAppetite:

Ordinaryaround the Yin parts during the nighttime (Fig. 2),

Bowel movement:

Once a day; no change

and flows through the entire body 50 times in a day.

Bladder movement: 6 – 8 times, once during theThat is, it flows through the Yang parts 25 times

nightduring the daytime and through the Yin parts 25

Goodtimes during the nighttime. It then flows throughSleep:

the five organs.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 7, Number 4 | Winter 2012

Fig. 1: Non-dipper hypertension changed to dipper hypertension by administering
Maobushisaishinto

Fig. 2: Flow of the Defense Qi – 1 of 2Fig. 2: Flowof the Defense Qi – 1 of 2MorningLiverHands & feetFootshaoyin

Kidney &bladder

Middle yang Lateyang Early yangNight

Daytime: Surface of bodyLungs &large
intestines

Nighttime: Inside ofbody
Cited from Mechanism of the Yellow
Emperor's Inner Classic

Fig. 3: Flow of the Defense Qi – 2 of 224

At dawn, the defense qi finishes circulating throughthe Yin parts and is discharged through the eyes asYang qi. This makes people open their eyes and wakeup.
This Yang qi flows along the bladder meridian tothe little toes.
The Yang qi that separates from the outside of theeyes flows along the small intestine meridian to thelittle fingers. From the outside of the eyes, it mightalso flow along the gall bladder meridian to the fourth
toe, then up along the triple energizer meridian to thetips of the fingers.
The Yang qi that is discharged from thepreauricular area flows along the stomach meridian
down to the toes. The Yang qi that is discharged fromthe parotid flows along the large intestine meridian tothe fingers.
Of the above, the Yang qi that reaches the feet flows
from the soles to the kidney meridian channel at themedial malleolus. From here, it flows along thekidney meridian to the kidneys, and from the kidneys
to the heart, lungs, liver, spleen, and kidney, where it
completes its round of the Yin part and once again
flows out through the eyes and around the Yang parts.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 7, Number 4 | Winter 2012Conclusion
Highbloodpressureduringthenighttime

improved with maobushisaishinto. The exteriordefense qi pattern cannot be evaluated subjectively,
but there are clearly symptoms that can be improved
with maobushisaishinto. If maobushisaishinto could
improve the exterior defense qi pattern, it could also
be used for other diseases.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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