Volume 11, Number 4 | Winter 2016

Clinical Report 2 (Kampo Medicine)
Case of Effective Administration of Saikanto for Left
Chest Pain
Keiko Ogawa-Ochiai
Kanazawa University Hospital

Main complaint: Left chest hurts every time thepatient coughed
Past history: 38 year old HELLP syndrome after
giving birth to child
Current clinical history: The patient contractedin

September,XXXXyear.

Antibiotics were prescribed for fever, coughing, andyellow sputum. Fever subsided, but coughing
continued. Two weeks after becoming ill, sharp painin the left chest after coughing and Pressure pain on
the axillary line of the 10th thoracic vertebra wereexperienced. Symptoms intensified with breathing,
bodymovement,administered,andcoughing,

NSAID

was

theanalgesiceffectwasbutinsufficient. A chest fixing band was put on but
breathing became difficult, so the band was not worncontinuously.

A

tramadol-acetaminophen

combination was administered and the patient could
finally sleep. However, when this drug wasadministered during the day, dizziness, nausea, andfatigue made it difficult to work.
Findings at the initial visit:

Pulse: 72/min.

satO2 98％
Pulse: Right: Slightly floating and string-like,slightly soft pressed, thin and rough pulse
String-like, pressed, rough pulse Slightlyandstring-like,slightly

soft,pressed, thin and rough pulse
Left: Slightly floating, slightly string-like,pressed, thin and rough String-like, pressed,rough pulse

Slightly floating and string-like, soft, pressed, thin and rough pulse
Tongue: Swollen, teeth marks, and white coated
16

under

theheart

Discomfort when pressed in exhalation Tightened
rectus abdominis, right-dominant side chest pain.
Clinical course:Saikanto was administered for chest pain andbecame 5/10 in numerical rating scale (NRS)
immediately after administration, and frequency ofcoughed-up sputum and coughing also decreased.
Sensation of dyspnea disappeared the next day. Two
combination

wasnotneeded,

andsufficient

analgesic effect could be achieved by NSAID alone.
Three days later, NSAID was also no longer required.
Discussion
Saikanto used here is a combination of shosaikoto
and shokankyoto. It is a traditional prescription firstmentioned in 12th Century Chinese literature.
Although not well known in China today, it isfeatured as a Kampo medicine in Japan, inheriting
the experience of skilled doctors from 100 years past.
Indications include bronchitis and pleurisy, and it issometimes used for chest pain with unclear cause.
In this case, rib injury occurred due to coughing
caused by bronchitis. The impression was thatadministration of saikanto was effective not only in
reducing pain as it decreased coughing, but also waseffective on the pain itself.

166cm, 52kg

Blood pressure: 110/74mmHg

floating

harddays after administration, tramadol-acetaminophenFamily history: Nothing in particularbronchitis

Slightlycoughed-up sputum, pain experienced by the patient

Case: 43 year old woman

acute

Abdomen:Pain experienced by this patient was strong andthe usual NSAID did not have effect, but could
finally be controlled by tramadol-acetaminophen
combination. However, by administration of thislatest and superior medicine, pain experienced by
the patient could be reduced, but side effects such asdizziness, nausea, and fatigue appeared, making herwork difficult.
Saikanto was prescrived to reduce coughing andcoughed-up sputum in hopes that the patient could
return to a normal life. The trial was successful, andthe patient could return to the work site within

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

Volume 11, Number 4 | Winter 2016

several days. This prescription was effective to not
only reducing coughing and coughed-up sputum, butalso to pain itself.
When reviewing this case from the viewpoint of“Yasui Classification of the Indications for Kampo
treatment,” the successful combination of NSAID
and saikanto satisfies Type 4, by improving thecondition of “difficulty in daily life due to the adverse
effects of tramadol-acetaminophen combination,” aswell as Type 2.

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

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