Volume 4, Number 4 | Winter 2009

Kampo Dermatology – Clinical Studies
Urticaria/Hives (8)Fumino Ninomiya
Aoki Clinic

Case 1: Urticaria, oversensitivity
Male of 51 years old
Current medical history: Urticaria had been
persistent for 15 years. The patient hadreceived treatment of various kinds but no cure
was attained.
Present conditions: Edemas and erythmas

Treatment and course
Inchingoreisan 5.0g, keigairengyoto 6.0g, andLoratadine 1 tablet were administered for 14 dys.
Formulations were changed to shigyakusan
5.0g and tsudosan 5.0g. Claritin 1 tablet wascontinued. The medication was maintained.
One year later, the conditions became mostlyimproved.
Sweat test
Before treatment

Sweat

Chronic urticaria (more commonly known ashives) is unexpectedly one of intractable disorders
in our every day life. Many cases of acuteurticaria have known causes so that it can easily
be cured. In many cases, urticaria appearing
repeatedly for a long period has an unknown
cause. The skin condition of urticaria can often beimproved by Kampo medicines selected based on
the overall condition.
Urticaria is a raised, bumpy red wheal thatappears anywhere on the body. The wheals can be
the size of a grain of rice enlarging in a map-likeform. Generally, acute urticaria will fade withinseveral hours whereas chronic urticaria will lastmore than a month, sometimes persist severalyears to more than 10 years.
Causes are certain foods, drugs, focal infection,and the direct physical stimulation of the skin.
Urticaria, however, is often caused byIgE-mediated allergies. For chronic urticaria, nodefinite cause can be identified.
Urticaria often causes red erythmas andelevated patches (wheals) – it is basically due to theabnormality of water damp. Therefore, to treat thissho, medicines to induce diuresis and medicines toclear heat are appropriately combined.
Basic two prescriptions are inchingoreisan andeppikajutsuto. And adjustments will bedetermined depending on whether or not there issweat, cold sensation, or blood stasis.

covering the entire body with intense itching.
Pigmentation
andmoistness
coexisted.
Dermographism (＋＋). Highly irritable due tooversensitivity. Had difficulty falling asleep
and getting up in the morning. Cold feet (＋＋),
constipation (＋), and lose stool.
Feeling thirsty (＋). Blood pressure 128/80
Abdominal sho: Tension of abdominal rectus
muscles on both sides, a bloated feeling in thechest and hypochondriac region, andtenderness in the lower abdomen.
Examination findings: Table 1 (attached)

Right
hand
Left
hand
Right
hand
Left
hand

After
treatment

Beforestressapplication

After
stressapplication

Beforestressapplication

After
stressapplication

37.9

40.8

26.1

32.6

38.544.1

26.6

37.5

39.5

45.8

35.2

49.0

34.5

40.6

37.9

36.9

* Sweat test is a simple test that shows the levels ofstress felt by the patient. The patient is requested tosubtract 7 from 100, and to keep subtracting fromthe result. And then, the volume of palmar sweating
is measured. The table indicates that patient’s
stress levels are dropping.

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

19

Volume 4, Number 4 | Winter 2009

Before treatment

Before treatment

After treatment

Before treatment

After treatment

Case 1: Examination findings<Biochemistry>

Before treatment

After treatment

Total protein

6.6g/dl

6.6g/dl

UA91mg/dl

8.1mg/dl

TC

227mg/dl

180mg/dl

TG

183mg/dl

65mg/dl

CPK (peripheral blood)

236

178

<Hematological value>

Before treatment

After treatment

Erythrocytes

538×10/ul

479×l0/ul

Leukocytes

9.3↑

9.0↑

Lymphocytes

16.1%

21.0%

Neutrophils

69.8%

71.9%

Acidocytes

7.4%

1.7%

IgG 830mg/dl

20IgA 87 mg/dl↓

IgE 244 Cedar (＋＋＋)↑The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)