Volume 3, Number 3 | Fall 2008

Kampo Medicine - Current Research
Effect of Kakkontokasenkyushin’i on Sinobronchial
Syndrome

findings such as CRP levels and pulmonary
functions improved. As a result, improvements wereobtained in cough, phlegm, breathing difficulty,

Hiromichi Yasui
Japan Institute of TCM Researchnasal congestion, nasal discharge, and postnasal
drip. With reduced dosing of the combination drug,
the overall effect was “marked improved” in 4

Sinobronchial syndrome (SBS) is pathologicalpatients, “moderately improved” in 8 and “slightly

changes combined with upper respiratory tract

improved” in 7. In the markedly improved patientschronic

diffusewith DPB, who used Erythromycin concomitantly,panbronchiolitis (DPB) and bronchiectasis. There

improvements were also clearly manifested in theare various views of the etiology, which, however

symptoms of the upper respiratory tract and x-ray

has not clearly verified. It is conceivable that someCT images of the lung fields. For 7 patients withdecreased immune function and the ability toErythromycin-refractory sinobronchial syndrome,

defend against upper respiratory infections maykakkontokasenkyushin'i was additionally used,exist. Advanced respiratory inflammation causes

resulting in improvements in not only the symptoms

progressionof sinusitis but also respiratory symptoms, andsinusitis,

oflower

respiratory

bronchiectasis

andchronic

respiratory impairment. There is Kartagener’srespiratory functions.

syndrome, which is a special type of clinicalcondition that involves not only sinusitis but alsochronic cough, sputum and shortness of breath. It is

Report by Kato, et al.
Kato, et al. administered the extract, as a

generally treated with a long-term administration of

combined

Erythromycin in small doses (macrolide therapy).

(7.5g/day) for a period of 12 months to the patients

The use of macrolide therapy shows excellent

with symptoms of sinusitis that had not shown

prognoses and reduces severe cases to a few.

improvements with Erythromycin 400-600mg/day

However, some patients do not respond to this typefor 6-12 months (diffuse panbronchiolitis in 3of therapy and quite a number of these patientspatients and chronic bronchitis in 4: male 5, female

desire Kampo use. There are case reports for such2) and observed changes in subjective findings

cases as follows:(nasal congestion, nasal discharge, postnasal drip,

medicine,ofkakkontokasenkyushin’iand smell disorder) and in objective findings (theReport by Egashiraamount of postnasal drip, swelling of the nasal

Egashira, et al. administered a combination
treatmenttosinobronchialand characteristics of nasal secretion). The results

syndrome refractory to conventional treatments

indicated improvements in the subjective symptoms

usingofof nasal congestion, nasal discharge, postnasal drip,

kakkontokasenkyushin’i (average age 57.8, upperand smell disorder, and in the objective symptoms ofrespiratory tract empema, lower respiratory tractswelling of the nasal mucous membrane, thechronic bronchitis -13 patients, bronchiectasis-2,

amount of nasal discharge, and characteristics ofand diffuse panbronchiolitis - 5).

nasal discharge, and the amount of postnasal drip.

the20patients

withmucous membrane, the amount of nasal discharge,

extract(7.5g/day)

In terms of the symptoms of the respiratory tract,
Coughing was reduced in many of the patients.

the degree of breathing difficulty and the amount ofFirstly, nasal discharge and nasal congestion

sputum improved on the Hugh-Jones scale withmarkedly ameliorated and subsequently symptoms

significantly elevated PaO2 levels and significantlyof the lower respiratory tract as well as laboratory

lowered PaCO2 levels. Pulmonary function tests

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

7

Volume 3, Number 3 | Fall 2008

indicated a significant increase in FEV 1.0% with aU.S. and Europe. As the disease is most likely to besignificant decrease in %RV. Blood tests showed

complicated by sinusitis, Kampo is a promising

significant decreases in cold agglutinin titer andtherapy.
There are several formulae that are used for thisserum levels of soluble ICAM-1 and a significant

disease and one of the most effective formulae isincrease in NK-cell activity.

kakkontokasenkyushin’i.
Report by Nakamura, et al.
Theyorallyadministered

Clarithromycin,

Mequitazine, and kakkontokasenkyushin’i to the 9References
1) Yousuke Egashira, Masahito Ushijima: Effects ofa Combination Treatment of the Sinobronchialpatients with a diagnosis of sinobronchial syndrome,Syndrome

which had not had attained complete remission withnasal douching. And changes in symptoms wereal.: Clinical Effects of a Long-term Combined
Treatment of Sinobronchial Syndrome with
Erythromycinassessed by scoring. As a result, improvements wereAs a whole, symptoms ameliorated, although the3)

HiroshiNakamura,

Yoshifusa

Aizawa:Combination

Discussion

andpresumption that this formula, if used, for thecondition that purulent nasal discharge caused bysinus inflammation flows down to the lower
respiratory tract, which thereby becomes inflamed,
could suppress the inflammation of the paranasal
sinuses, leading to relief of the lower respiratory
above

successfullysubstantiated this presumption.
Moreover, on the basis of a similar concept,
studies on keigairengyoto and shin’iseihaito havebeen conducted, and these formulae are known as
being effective.
Diffuse panbronchiolitis mostly accompanied bysinobronchial syndrome is a disease that has often
been reported in Japan whereas a fewer cases in the8Effects

Treatmen

Medicine 19(8) 1999

The frequent use for sinusitis is based on thestudies

Takashiofkakkontokasenkyushin’i.

used for symptoms of acute and chronic sinusitis.

Thekakkontokasenkyushin’i.
Nakamura,ofLow-dose

Sinobronchial

Syndrome with Clarithromycin, Mequitazine,

Japan in relatively recent years, has often been

symptoms.

andKokyu, 17(8):919-926, 1998

degree of amelioration differs depending on patients.

Kakkontokasenkyushin’i, a formula developed inErosive2) Shiro Kato, Izumi Konoshiro, Noboru Ohnuma, etusing questionnaire sheets and the answers werewas also shown in the scoring assessment (p,0.01).

ParticularKampo and Immunoallergy, 4:33-41, 1990

observed once every two weeks for three months

shown in all patients, and a significant improvement

inPanbronchiolitis with kakkontokasenkyushin’i.

the medication for more than six months ofErythromycin and ontological procedures including(SBS),The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Progressin