KAIM
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INTERNATIONAL INSTITUTE OF HEALTH AND HUMAN SERVICES,
BERKELEY
Volume 10, Number 4 ･ Winter 2015

Editorial

The Past, Present and Future of Kampo Extract Preparations in Japan
Akihiro Soma

Integrating Kampo and Evidence-Based Medicine (4) – Type 3 Case
The Effects of Kampo Medicine against the Side Effects of Anticancer Drugs
Hiromichi Yasui

Japanese Acupuncture - Current Research

Japanese Traditional Medicine Text (18) – Acupuncture and Moxibustion Therapy for Rheumatoid Arthritis andConnective Tissue Disease
Daichi Kasuya

Clinical Report 1 (Acupuncture)

Acupuncture Treatment for Irritable Bowel Syndrome (IBS-D): A Case Report
Hiroshi Kondo

Clinical Report 2 (Kampo Medicine)

Case Studies from Ehime Prefectural Central Hospital (3)– From the Rural Bedside to the Global Podium –Genki Shimizu, Hiroshi Kakuto, Den-ichiro Yamaoka

Conference Report

A Letter from the 10th International Association of Gerontology and Geriatrics (IAGG)
Kazunari Ozaki, Takehiko Numata, Shin Takayama, Tsu-Hung Huang, Kazuki Yoshizawa, Kenki Miyazawa,
Yasushi Takeya, Yoshio Nakamura, and Koh Iwasaki

ISSN:1559-033X

College Logos
We believe it is necessary to create a new way of thinking
for the total understanding of "Life, Survival, and Health".
We decided to coin the world "Lifence" to express this.
Lifence means the combination of life sceince and medicine
as well as other disciplines such as health science, psychology,
ethics, etc.
Our college logos symbolizes the above.
The ripple effect represents the ocean and the birth of life.
The rainbow colored sphere represents a safe environment
and a barrier to protect us from negative influences.
The picture by Leonardo da Vinch represents a balanced
body and health.
Completing our logos is a ring which represents the unity ofspace fulfilling the total meanings of lifence.

―

The Journal of
Kampo, Acupuncture andIntegrative Medicine(KAIM)
Research on Theory, Practice and Integration

Volume 10, Number 4 ･ Winter 2015

EXECUTIVE EDITOR

Shuji Goto
Chairman, GOTO College ofMedical Arts & Sciences

TA B L E O F C O N T E N T S

Tokyo, JapanASSOCIATE EDITORS
Shuichi Katai

1 Editorial
The Past, Present and Future of Kampo Extract Preparations in Japan
Akihiro Soma

Ibaraki-ken, Japan

Hiromichi Yasui
Tokyo, JapanEDITORIAL STAFF

Akihiro Souma
Hiromi Sasaki
Hiroshi Tsukayama
Hitoshi Yamashita
Junko Okubo
Kazunari Ozaki
Kengo Nakata
Masayuki Kashima
Naoya Ono
Noboru Mitsuhata
Sayaka Toda
Takao Namiki
Toshiaki Makino
Toshihiro Togo

2 Integrating Kampo and Evidence-Based Medicine (4) – Type 3 Case
The Effects of Kampo Medicine against the Side Effects of Anticancer Drugs
Hiromichi Yasui
8 Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (18) – Acupuncture and Moxibustion Therapy forRheumatoid Arthritis and Connective Tissue Diseases
Daichi Kasuya

14 Clinical Report 1 (Acupuncture)
Acupuncture Treatment for Irritable Bowel Syndrome (IBS-D): A Case Report
Hiroshi Kondo

PUBLISHER

Shuji Goto
International Institute of Health andHuman Services, Berkeley
2550 Shattuck Avenue, Berkeley
California 94704-2724, U.S.A.

19 Clinical Report 2 (Kampo Medicine)
Case Studies from Ehime Prefectural Central Hospital (3)– From the Rural Bedside to the Global Podium –Genki Shimizu, Hiroshi Kakuto, Den-ichiro Yamaoka

21 Conference Report
A Letter from the 10th International Association of Gerontology and Geriatrics (IAGG)– Asia/Oceania Regional Congress in Chiang Mai, Thailand
Kazunari Ozaki, Takehiko Numata, Shin Takayama, Tsu-Hung Huang, Kazuki Yoshizawa,
Kenki Miyazawa, Yasushi Takeya, Yoshio Nakamura, and Koh Iwasaki

MISSIONTo disseminate peer-reviewed information on the use of acupuncture and herbs, and integration with western
medicine, based on research from an international perspective; thereby stimulating further research, applicationof documented therapeutic measures; and facilitating dialogue among health care practitioners worldwide.

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)KOTARO PHARMACEUTICAL introduced in 1957 the world's first Kampo extract
preparations on the market. Later, in 1967, six of our preparations could be covered in Japanfor the first time by the health insurance and after 1976 more than 100 of our preparations
were used in hospitals and clinics. Now it is half a century since we put our Kampo extract
preparations on the market and believe, we made a major contribution to this industry.
In the future we intend to continue working in accordance with our company motto: "Still better
Kampo for still more people" and provide pharmaceutical products of still higher quality.

Origin of the company's name
The company was named "KOTARO" by its
founder Taro Ueda with reference to his birthplace. Close to the ancient city of Nara. Kotaro
is the name of an enormous sheer cliff, 700 m
wide and about 200 m high. Mr. Ueda felt anaffection rising to the heavens for this cliff andthus made it the company's name.

KOTARO PHARMACEUTICAL CO., LTD.
5-23 Nakatsu 2-Chome, Kita-ku, Osaka 531-0071, JAPANURL: http://www.kotaro.co.jp

Volume 10, Number 4 | Winter 2015

Editorial
The Past, Present and Future of Kampo Extract Preparations in Japan
Kampo extract preparations typically known throughout the world today are produced by crude herbs —originally for traditional formulations of decoction, pill and powder— decocting in water, extracting theiractive ingredients, then adding an excipient. This technology was developed in Japan.
Kampo extract preparations have been developed and subject to clinical tests by Dr. Takeshi Itakura from asearly as the first half of the 1940s. Dr. Itakura’s research was thereafter suspended, but in 1950, Dr. Takeshi
Watanabe completed the original form of today’s extract preparations, and in the mid-1950s, a number ofpharmaceutical companies commercialized them and began selling them in pharmacies. Extract preparations
were first widely available over-the-counter (OTC) before they were approved as ethical drugs in 1976.
This development allowed physicians to handle Kampo medicine in a convenient manner—inprescription units—at medical facilities covered by health insurance which Kampo medicine were previously
irrelevant. Extract preparations were originally recognized as an alternative to decoctions, but their market
steadily expanded thereafter owing to their convenience, such that they have come to be used widely in the
medical field in place of decoctions.
There are 148 types of extract preparations in Japan. One of their salient characteristics is that they areeach made according to a fixed formula prescription. Extract preparations are rigidly regulated by the Ministryof Health, Labour and Welfare, from their raw ingredients to production process. They ensure high quality as
meeting an advanced Kampo GMP that pharmaceutical manufacturers voluntarily establish in addition to
general GMP. Owing to this, it has become possible to conduct diverse clinical trials, and in fact, a number ofcase series and RCT have emerged today, and are expected to increase even more hereafter.
The second characteristic is that approximately half of all prescriptions are sourced on the Shokanron (ShanHang Lun) and Kinkiyoryaku (Jin Gui Yao Lue). These classic preparations, from which Kampo medicine wasderived, started being used frequently in Japan from around 300 years ago, and have provided a richaccumulation of experience to practitioners. Their extremely sophisticated content, high clinical value, andwide scope of applications have greatly contributed to popularizing extract preparations in Japan.
The indications of Kampo extract preparations were widely studied along with the development ofmodern medicine, and they came to be used for the treatment of a diversity of diseases beyond comparison
with those in ancient China. The study of their side effects has also advanced, and sufficient knowledge of
their safety has spread. Although the market is extremely small, worth merely around 140 billion yen, Kampo
extract preparations play an extremely large role in supporting Japanese medical and healthcare field. Theirneeds will undoubtedly continue to grow in the future.

Akihiro Soma
Editorial Staff of the Journal of KAIM

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

1

Volume 10, Number 4 | Winter 2015

Integrating Kampo and Evidence-Based
Medicine (4) – Type 3 Case
The Effects of Kampo Medicine against the Side Effects ofAnticancer Drugs
Hiromichi Yasui
Japan Institute of TCM Researchand other such treatments that are used to treat
cancer.
Below, I shall discuss how Kampo medicine isused against the side effects of anticancer drugs inroutine clinical practice, through examples.
1. A Certain Episode

Introduction

Prof. Yoshiharu Motoo (Department of Medical

In this series, I define four types of use of Kampo

Oncology, Kanazawa Medical University) provides

medicine in daily clinical practices within Japan’s

front-line treatments to cancer patients. He is a close

unified medical system, and discuss the diseases

friend of mine who also actively engages in the study

that fall under each of these types, by givingof Kampo medicine, in an effort to constantly provide

relevant case examples. In the previous issue of thisthe best treatment to his patients by combining thejournal, I introduced four episodes, and explained

two.

that they fall under the four types of use of Kampo

Dr. Motoo has treated many cancer patients tomedicine in daily clinical practices. Let me recountdate, and has presented many papers. I have heard

them below.

many stories of his experiences, but I found theType 1: Kampo treatment is better than standard

following case particularly interesting.
A man in his late fifties received surgery formodern medical treatment
Type 2: The effects of standard modern medicaltransverse colon cancer in March 20XX. He was attreatment and Kampo treatment are both

StageⅢb. Since the five-year survival rate ofstrengthened when the two are used inStageⅢb transverse colon cancer is approximately

combination

60.1%, his prognosis was not good. Therefore, theType 3: The side effects of standard modern
medical treatment can be mitigated in
combination with Kampo treatment
Type 4: Circumstances prevent the application ofstandard modern medical treatment, but
treatment is neededcases, in which Kampo treatment is used in
combination with standard modern medicine to
the

side

regimenadministeredaseffectsofthelatter.

Representative of these are cases in which Kampo
medicine is used to mitigate the side effects ofanticancer drugs that are commonly used against
cancer. No data exists that shows that Kampo
medicine could treat cancer per se, but manystudies provide proof that it has the effect of
mitigating the side effects of operative treatment,

decidedpostoperative

tobeadjuvant

regimen that combines folinic acid (Leucovorin), 5FU, and oxaliplatin.
The side effects of FOLFOX treatment are diverse.
thatemergeimmediately

after

administration of the treatment include peripheral
neuropathy such as numbness and pain in the hands,
feet

and

mouth;

myelosuppression;digestive

symptoms such as nausea, vomiting, and loss ofappetite; diarrhea and other lower digestive tract
disorders; stomatitis; and taste disorders. Several
weeks later, skin and nail discoloration, hand-footsyndrome, hair loss, and other symptoms begin toappear. Frequently, these side effects require a
reduction in drug dose or a suspension of drug
administration.

anticancer drug treatment, radiation treatment,

2

waschemotherapy. This mFOLFOX6 is a chemotherapy

Effects

In this article, we shall take a look at Type 3

mitigate

mFOLFOX6The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 10, Number 4 | Winter 2015

In response to this situation, Dr. Motoo prescribed
9.0 g/day of ninjin’yoeito extract for ethical use(Tsumura & Co., Ltd., Tokyo, Japan) from the firstcycle of chemotherapy, to mitigate peripheral
neuropathy and hematotoxicity among the side
effects. As a result, mFOLFOX6 dose did not need tobe reduced to the end, and the postoperative
adjuvant chemotherapy was successfully completed
after administering the planned 12 cycles. The
cumulative dose of oxaliplatin was 1,020 mg/m2, but
no accumulative peripheral neuropathy appeared.
Only acute peripheral neuropathy was noted, but it
was up to grade 1, and disappeared at an early stage.
At a performance status (PS) of 0, the patient wasthereafter able to complete his treatment while
engaging in regular work duties.
In this case, neither the physician nor the patient
was optimistic of the prognosis, as the patient had
Stage Ⅲb transverse colon cancer and was at highrisk of recurrence. However, what was immediately
necessary was to mitigate the side effects of
mFOLFOX6 treatment and successfully complete

the postoperative adjuvant chemotherapy to prevent
recurrence.
In particular, peripheral neuropathy that occurs
as a side effect of oxaliplatin was a burden for thepatient, to the point that treatment is sometimes
interrupted for this reason. Therefore, the fact that
this particular patient’s condition progressed in an
extremely mild manner probably lightened his spirit.
Generally, when the cumulative dose of oxaliplatin
exceeds 500 mg/m2, grade 2 peripheral neuropathy issaid to occur at a rate of 30%, but this patient’s dose
had exceeded 1,000 mg/m2. The administration ofninjin’yoeito helped maintain his PS at a good level
and would probably lead to his good prognosis
thereafter.
Dr. Motoo provides this type of treatment to many
patients within his daily clinical practice. The
Kampo medicine that was used here wasninjin’yoeito, chosen based on Dr. Motoo’s long yearsof clinical experience.
Dr. Motoo has published many papers on the
adjunctive use of Kampo medicine to standard
cancer treatment, from which we daily benefit1).

Reference: Peripheral neuropathy caused by Oxaliplatin (product name: L-Plat®)

De Gramont A, et al: Leucovorin and fluorouracil with or without oxaliplatin as first-line treatment inadvanced colorectal cancer. J Clin Oncol 18: 2938-2947, 2000
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

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Volume 10, Number 4 | Winter 2015

2. General Malaise, Loss of Appetite, Poor Mood, etc.

on the seventh day, but in the saireito group, BUN

during Cancer Chemotherapy

did not exceed the normal level of 20 mg/dL neither

All anticancer drugs accompany side effects toon the third nor seventh days. Furthermore, in thesome extent. It is said that hochuekkito is effective

control group, Cisplatin administration brought

against these side effects2) 3), and general clinicians

about a decrease in Ccr (creatinine clearance) and an

widely administer this prescription to patients who

increase in NAG (N-acetyl-β-D-glucosaminidase),

are

is

but such fluctuations were significantly controlled inanother prescription that is used frequently for thethe saireito group. From this result, Dr. Okimoto etsame purpose. Its effects against leukopenia andal. suggest that saireito mitigates Cisplatin renal

thrombopenia and controlling metastasis have beendamage6).

undergoing

chemotherapy.

juzentaihoto

verified in animal experiments4).
In

Japan,

hochuekkito,

Another study examines the effect of juzentaihoto

juzentaihoto,andagainstmyelosuppression

causedbytheninjin’yoeito are commonly prescribed to increaseadministration of Carboplatin. Dr. Jiro Okimoto et al.

bodyinvestigatedstrengthandimproveappetites

duringCarbotinmyelosuppressionbychemotherapy against cancer, but there are specificexamining 70 lung cancer patients who were not

Kampo prescriptions for each type of symptom.

administered juzentaihoto in the first cycle but wereadministered 7.5 g/day of juzentaihoto extract

3. Utilization of Kampo Medicine to Mitigate the(Tsumura Pharma, Ltd., Tokyo, Japan) for 21 days

Side Effects of Anticancer Drugs

from the day before being administered Carboplatin

1) Effects of Kampo medicine against the side effects

in the second cycle. As a result, Hb decreased by 3.1of Cisplatin and Carboplatin

g/dL on the average when comparing the levels

In Dr. Motoo’s case, ninjin’yoeito was used tobefore and after Carboplatin administration in theoxaliplatin.

first round, but decreased by only 1.4 g/dL on the

Goshajinkigan has also been reported to be effective

average in the second round, indicating that theby Shindo et al5).

decrease of Hb was significantly controlled. The

mitigate

the

side

effectsofandlowest values of leucocytes and neutrophils werecarboplatin (CBDCA) display a strong antitumor effect,

2,230/μL and 740/μL on the average, respectively, inbut their side effects are also strong, and difficulties

the first round, and 2,960/μL and 1,220/μL on theare often experienced in counteracting them. A number

average in the second round, indicating that theof studies regarding this are introduced below.

decrease

Platinumcompounds

cisplatin(CDDP)

The first is a study of saireito against kidneydamage when administering Cisplatin.

inleucocytes

andneutrophils

weresignificantly controlled. The lowest value of platelets
decreased by 5.7×104/μL on the average in the first

Dr. Jiro Okimoto et al. investigated renal damage

round, but decreased by a mere 9.0×104/μL on theafter administering Cisplatin through two groups of

average in the second round, indicating that thelung cancer patients: 10 patients in the saireito

decreasegroup were given 9g/day of saireito extract (Tsumura

controlled7).

Pharma, Ltd., Tokyo, Japan) for 15 days beginning

2) Kampo medicine against the side effects ofon the day before administering Cisplatin, and 16

fluoropyrimidine drugs

inplatelets

was

also

significantly

patients in the control group were not given saireito.

Fluoropyrimidine drugs are antimetabolites. The

As a result, the control group saw an increase inmost representative is Fluorouracil (5-FU), from

BUN such that average BUN was 26.5 mg/dL on thewhich a number of drugs have been developed as

third day of Cisplatin administration and 25.4 mg/dL

prodrugs. Its side effects occur in the mucous

4

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

Volume 10, Number 4 | Winter 2015

membrane of the alimentary canal and bone marrow,motivation, fatigue and malaise were observed in thewhere cellular proliferation potential is high. As aninjin’yoeito group9).

result, digestive symptoms such as loss of appetite,3) Kampo medicine against the side effects ofgeneral malaise, diarrhea, nausea, vomiting and

Irinotecan

stomatitis appear, in addition to myelosuppression

Irinotecan(CPT-11)isasemisyntheticof

symptoms such as leukopenia. Hair loss and hand-Camptothecin with a wide antitumor spectrum. In

and-foot syndrome may also appear.

addition to single administration, it is frequently

A number of clinical studies are introduced below.

used in combination with other drugs, such as in

Dr. Takuya Yamada conducted a randomized

FOLFIRI (Folinic acid + 5-U + Irinotecan) treatment.

controlled trial (RCT) on 94 postoperative gastric

Its side effects include leukopenia, diarrhea, andcancergeneral malaise.

patients

byprescribing

an

oral

administration of 5-FU to all patients and dividing

Among these side effects, it has become possible

them into a group that was also given juzentaihoto

to improve leukopenia by administering a humanin combination and a group that was not. No

granulocyte colony-stimulating factor (G-CSF). Withdifference in five-year survival rate was observed

regard to diarrhea and general malaise, theamong all patients and patients in Stages I and Ⅱ,

combined use of Kampo medicine has been found to

but among patients in Stages Ⅲ and Ⅳ , medianbe effective to a certain extent.
Hangeshashinto is used particularly for delayed
diarrhea. Dr. Kiyoshi Mori et al. performed astandard treatment against progressive non-small
cell lung cancer by combining the use of Cisplatin
and Irinotecan. Particularly to prevent delayed
diarrhea caused by Irinotecan, he administered 7.5
g/day of hangeshashinto extract (Tsumura Pharma,
Ltd., Tokyo, Japan) and evaluated its clinical efficacy
through an RCT. Of the 41 patients who were able tobe evaluated, there were 18 patients in thehangeshashinto administration group and 23
patients in the non-administration group.
Improvements in diarrhea were evaluated from
Grades 0 to 4. In the first round of treatment, asignificant improvement in diarrhea grade wasobserved in the administration group compared to
the non-administration group (P = 0.044), and theincidence rate of diarrhea Grade 3 and above wassignificantly low (P = 0.018)10) 11).
4) Kampo medicine against the side effects of taxane
drugs
Paclitaxel and Docetaxel are taxane anticancer
drugs. Paclitaxel was discovered from the bark of
Taxus brevifolia, and is used singly or in combination
with another anticancer drug. Among the side effectsof taxane anticancer drugs, digestive symptoms such

survival time was 35.1 months for the combined
administration group and 14.3 months for the noncombined administration group. Five-year survival
rate was 25% for the combined administration groupand 0% for the non-combined administration group.
This showed that life expectancy was significantly
extended in the combined administration group8).
Dr. Tsuyoshi Ohara et al. conducted an RCT on a
total of 178 patients who were prescribed Tegafur for
gastric cancer, colorectal cancer, breast cancer, orother types of cancer, by dividing them into ahochuekkito combined administration group, aninjin’yoeito combined administration group (as willbediscussed

later),

andaTegafursingleadministration group. As a result, significant
improvements
symptoms,

were

observedinobjective

symptoms

andsubjective
generalsymptoms in groups administered with Kampo
medicine in comparison with the control group (nonadministration group). The side effects of Tegafur
were observed in all groups, but they were not of aserious level in the Kampo administration group.
Additionally, an improvement in appetite wasobservedinthehochuekkito

group,

andimprovements in nausea, vomiting, bowel movement,

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

5

Volume 10, Number 4 | Winter 2015as nausea and vomiting are rare, but leukopenia andother myelosuppression occur at a high rate, andhair loss is inevitable. With Paclitaxel, peripheral
neuropathy such as numbness at the tips of hands
and feet, as well as muscle pain and joint pain also
appear at a high rate (35.7%).
There are a number of reports that say
goshajinkigan and shakuyakukanzoto are effectivein mitigating peripheral neuropathy, muscle pain
and joint pain caused by Paclitaxel.
Dr. Takao Hidaka et al. examined the clinicalefficacy of shakuyakukanzoto against muscle pain in
20 serous ovarian cancer patients who began
receivingcombination
chemotherapy
using
Paclitaxel and Carboplatin but who displayed
muscle pain of Grade 2 (degree of pain that requires
several doses of analgesic) or higher even after using
NSAIDs in the first round of treatment (average age:
59.8+/-7.7; 36 – 73 years of age). In the second round,the patients were given 7.5 g/day (3 times a day) of
shakuyakukanzoto extract (Tsumura Pharma, Ltd.,Tokyo, Japan) for 7 days from the first day in
combination with NSAIDs. He then evaluated its
analgesic effect using an independently developed
five-stage pain evaluation system, and compared thepain scale value of each round with the index value.
As a result, by using shakuyakukanzoto, the degreeof the progressing muscle pain significantly
decreased (P = 0.015), and its duration became
significantly shorter (P < 0.01)12).
Above, we have seen a number of cases in which
Kampo medicine was able to mitigate the side effects
of anticancer drugs that are used against malignant
tumors. They are but a few examples. In actual
clinical practice, much larger numbers of Kampo
medicine are used in response to diverse situations.
They shall be taken up little by little in this series.

2)

Tai, Kiyoshi et al. “Effects of Hochuekkito in Preventing
the Side Effects of Chemotherapy against Lung Cancer.”

Biotherapy 6: 624-627, 1992.
3)

Fushiki, Hiroshi et al. “Effectiveness of Hochuekkito in
Mitigating the Side Effects of Anticancer Drugs.” Recent

Progress of Kampo Medicine in Obstetrics andGynecology 7: 72-75, 2000.
4)

Saiki I：A Kampo medicine "Juzen-taiho-to"-preventionof malignant progression and metastasis of tumor cells
and the mechanism of action. Bio Pharm Bull, 23：677688, 2000

5)

Shindo, Yoshiaki et al. “Study of the Effects of
Goshajinkigan in Mitigating Peripheral Neuropathy
Related to Oxaliplatin.” Japanese Journal of Cancer andChemotherapy 35: 863-865, 2008.
6)

Okimoto, Jiro et al. “Effects of Tsumura Saireito against
Cisplatin (CDDP) Renal Damage.” Diagnosis andTreatment 79: 1497-1501, 1991.
7)

Okimoto, Jiro et al. “Effects of Tsumura Juzentaihoto
against Myelosuppression caused by Anticancer Drugs.”

Diagnosis and Treatment 81: 2040-2043, 1993.
8)

Yamada, Takuya. “Randomized Controlled Trial on the
Combined Effects of 5-FU Oral Preparation andJuzentaihoto (TJ-48) against Stomach Cancer.” Prog

Med 24: 2746-2747, 2004.
9)

Ohara, Takeshi et al. “Study of the Effectiveness of
Hochuekkito and Ninjinyoeito Combined with Tegafur.”Japanese Pharmacology & Therapeutics 21: 4423-4434,
1993.
10) Mori, Kiyoshi et al. “Study of the Effectiveness ofHangeshashinto against Diarrhea Accompanying theUse of Cisplatin and Irinotecan hydrochloride for
Progressive Non-Small Cell Lung Cancer.” Japanese

Journal of Cancer and Chemotherapy 25: 1159-1163,
1998.
11) Mori K. et al.: A phase I study of irinotecan andinfusional

cisplatinwithrecombinanthuman

granulocyte colony-stimulating factor support in the

References

treatment of advanced non-small cell lung cancer. Eur J

1)Cancer 33: 503-505, 1997.

Motoo, Yoshiharu. “Chapter Ⅲ Kampo Treatment in
the Acute-care Ward and during Chronic Care: 11.

12) Hidaka, Takao, et al. “The Effects of Shakuyakukanzoto

Cancer Care and Kampo.” Takahiko Ono, ed. Let’s UseagainstKampo Medicine, 107-112, Kobundo, Tokyo, 2015.

Administration.” Recent Progress of Kampo Medicine in

MusclePain

CausedbyObstetrics and Gynecology 17: 79-83, 2000.
6

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

Paclitaxel

Volume 10, Number 4 | Winter 2015

The four types and their characteristics

Diseases subject to treatment
by Kampo medicine

Type 1Treatment is effective
by Kampo treatment
alone

Type 2Treatment effect isincreased in combination
with standard Western
medical treatment

Type 3The side effects of Western
medical treatment are
mitigated when combinedwith Kampo treatment

Type 4Situations whereWestsern medicine
cannot be appliled[List of prescriptions]ninjin’yoeito 人参養栄湯hochuekkito 補中益気湯
juzentaihoto 十全大補湯saireito 柴苓湯hangeshashinto 半夏瀉心湯goshajinkigan 牛車腎気丸
shakuyakukanzoto 芍薬甘草湯

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

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Volume 10, Number 4 | Winter 2015

Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (18) – Acupunctureand Moxibustion Therapy for Rheumatoid Arthritis andConnective Tissue Diseases
Daichi Kasuya(AS), antiphospholipid antibody syndrome, andFelty’s syndrome. Osteoarthrosis and fibromyalgia
were excluded from the definition of connective
tissue diseases. The results were then analyzed withregard to four items: (1) Conditions of subjectpatients (disease activity and functional disorders),(2) method of acupuncture and moxibustion therapy,

A. Introduction
Chronic inflammatory diseases as represented by(3) evaluation method, and (4) effects.

rheumatoid arthritis (RA) have conventionally been
considered

indicationsofacupuncture

and

2. Results

moxibustion therapy. According to a national basic

The search through the Igaku Chuo Zasshi

health survey, approximately 80% of RA patients

database yielded the following results: 54 references

make regular visits to a masseur, acupuncture clinic

on RA, 5 on SjS, 3 on SSc, 2 on SLE, 2 on BD, 2 onor judo therapy clinic in addition to a medical

PM/DM, 1 on AS, one on MCTD and one on

institution. Even in today’s society where clinicalpremature RA. RA accounted for more than 80% ofpractice guidelines are centered on pharmacologicalall connective tissue diseases. The search of overseas

treatment, patients with diverse complaints makereferences in MEDLINE yielded the following

visits to such abovementioned clinics seeking

results: 42 references on RAs, 3 on AS, 3 on SSc, 2 on

acupuncture and moxibustion therapy. This section

SjS, 2 on SLE, and 1 on BD. Again, many results

will thus discuss the roles and possibilities oftended to be acquired for RA. Based on these results,

acupuncture

andintroducing

summaries

therapybyRA and other connective tissue diseases will bereferences,anddiscussed separately below.

moxibustionofparticularly clinical studies, on the effectiveness andpresent status of acupuncture and moxibustion

B. Present Status of Acupuncture and Moxibustion

therapy with regard to rheumatoid arthritis andTherapy for RA

connective tissue diseases.
1. Case reports and accumulation of cases in Japan● RA Conditions (disease activity and functional

1. Collecting references
The Igaku Chuo Zasshi web database of thedisorders)Japan Medical Abstracts Society (1983-2009) was

Only 32 among the 54 references contained

used to collect all relevant Japanese references,

information about RA conditions. Of these 32, 30

excluding conference minutes. Western references

deal with cases showing relatively stable disease

were

specifying

activity, and 29 deal with cases in which patients are“randomized controlled trial” and “clinical trial” asable to take care of themselves even while

the research design. The search terms that wereexperiencing pain from a class 2 or 3 functional

useddisorder.

collected

included

using

the

PubMedfollowing:andacupuncture,

This

shows

that

acupunctureandmoxibustion, rheumatoid arthritis (RA), systemic

moxibustion therapy is mostly performed when RA

lupus erythematosus (SLE), polymyositis (PM),activity and the patient’s overall condition aredermatomyositis (DM), systemic sclerosis (SSc),

relatively stable, and that the therapy tends to bemixed connective tissue disease (MCTD), Behçet’s

applied to mild rather than severe cases of functional

disease (BD), vasculitis syndrome, Still’s disease,

disorder.

Sjogren’s syndrome (SjS), ankylosing spondylitis

8

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

Volume 10, Number 4 | Winter 2015

● Methods of acupuncture and moxibustion therapy

followed by mitigation of functional disorder (26The methods of treating RA by acupuncture andreferences), improvement of QOL (9 references),

following:

improvement of general conditions (1 reference), theapplication of acupuncture and moxibustion tovalue of acupuncture and moxibustion therapy as

tenderness and induration of the affected joint or thecomplementary medicine (1 reference), and thewholeeffectivenessoftherapy

combination

moxibustion

therapybodytreatment(13

includedreferences);(emphasisonthemodernmodernmedicalphysiology,inacupuncture

and

with

moxibustion

pharmacologicalpathology, and anatomical science) (12 references);

treatment (1 reference). The main effects ofclassic treatment (emphasis on proof of meridians) (8acupuncture and moxibustion therapy for RA mostly

references); traditional Chinese medicine treatment

tend toward the relief of joint pains and mitigation(emphasis on traditional causes and proof) (5of functional disorder, including improvement ofreferences);

ADL.

moxibustion

only

(4

references);ryoudoraku medicine (3 references); the Nagano

As shown above, clinical reports on RA cases inmethod (2 references); and others (5 references). In

Japan can be summarized as follows. (a) Subjects arethese ways, the results showed that RA is treated bypatients whose RA activity or functional disorder isa wide variety of schools, as there are no

relatively stable. (b) There are diverse methods

acupuncture points or treatment method specific to(concepts) of acupuncture and moxibustion therapy,

RA, and revealed the uniqueness of acupuncture andbut their goal is pain relief and functional

moxibustion therapy.

improvement. (c) There is no specific acupuncture● Evaluation method

point for RA. (d) Immediate and cumulative effects

Effectiveness was measured by the following

are recognized, based on evaluations by patients. (e)evaluation methods (with some overlapping): visual

Some of the known effects are pain relief, functional

analogue

scale

(VAS)

(22

practitioner’sownmethodreferences);rheumatoidreferences);theimprovement and QOL improvement. (f) There is noevaluation(11

mention of the corrective effects on autoimmune

andabnormalities or anti-inflammatory actions.

ofactivityindex

improvement criteria of the American College of

These clinical reports also pose the following

Rheumatology (ACR Core Data Set) (7 references);

issues. (a) Many do not provide information on the

Arthritis Impact Measurement Scales version 2

medical condition (extent of disease activity or(AIMS-2)functional

(RA

QOL

assessment

method)(6

disorder)ofRA

patients.

(b)

No

references); face scale (4 references); pain scale (4observations are made regarding the effects of drugs

references);(1even if they are administered in combination. (c) RA

reference). Conventionally, evaluations by patients

symptoms come and go, but only three references

themselves, such as by using VAS, were theprovide information of cases in which acupuncture

mainstream, but in recent years, a number ofand moxibustion therapy was continued for morereferences has appeared that utilize the ACR Core

than a year, where the same situation would

Data Set, which serves as a global “gold standard” bynormally warrant a long-term follow-up of more thanalso

a year in other treatment areas. (d) Pain relief andandincluding

no

blood

evaluation

andconducted

biochemical

blood

examination data, and RA QOL assessments.

functional improvement were acknowledged from● Effects

the results of this study, but pain relief alone cannot

As to the effects based on the above-mentioned

be said to control the bone destruction action uniqueofto RA. (e) No shared understanding has beenreferences referred to pain relief (42 references),achieved on what type of indicator should be used if

evaluation

methods,

thelargestnumber

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

9Volume 10, Number 4 | Winter 2015

anti-inflammatory actions and corrective effects on

At the same time, however, there are differences in

autoimmune abnormalities were to be presented inopinion regarding the evaluation of RA reviews.

a clinical study.

Reports that evaluate the use of acupuncture and2. Comparative tests in Japan and overseas (Table

moxibustion therapy for RA as ineffective or16) 1-3)

undeterminable gave problems in research design orComparative tests by PubMed show that many

number of cases as their reason for not being able toreports recognize the effectiveness of diverse

make a judgment. Those that evaluate it as effective

acupuncture and moxibustion treatment methods,

say that it is more effective than sham treatment,

ranging

fromelectric

acupuncture

and

ear

acupuncture to moxibustion and systemic therapy,
compared to using drugs alone or sham treatment(sham

acupuncture).

Furthermore,theyacknowledge the effects of pain relief, functionalthat effectiveness is increased in combination withpharmacologicaltreatment

treatments,

that

and

and

other

long-termsuchtreatmentiseffective.

improvement and QOL improvement, using such
evaluation methods as VAS, ROM, blood tests and

C. Present Status of Acupuncture and Moxibustion

the ACR Core Data Set.

Therapy on Collective Tissue Diseases Other thanThe “randomized comparative test of facilities

RA

that provide acupuncture and moxibustion therapy
for rheumatoid arthritis,” which was conducted by

1. Case reports and accumulation of cases in Japan

this writer over a period of three years with funding

There are few reports compared to those on RA,

from the Health Labor Sciences Research Grant, also

indicating

recognized that the combination of pharmacologicaltherapy is not frequently applied to collective tissue

treatment

moxibustion

diseases in reality. However, reports that do exist

therapy led to an improvement of pain and ADL andacknowledge the improvement of pain, Raynaud’s

increased the QOL of rheumatoid patients comparedphenomenon and functional disorder when current

to pharmacological treatment alone4). Thus, it istreatment is combined with acupuncture andthought that by properly assessing the conditions

moxibustion(degree of RA activity and functional disorder) of RA

symptoms. They utilize thermography and a blood

patients and administering treatment that isflow meter to evaluate Raynaud’s phenomenon inappropriate

toacupuncture

and

with

acupuncture

each

and

stage

of

moxibustion

that

acupuncture

therapyagainstandmoxibustion

disease-specificthedisease,SSc, SLE and MCTD, use saliva production as antherapy

could

indicator for dry symptoms in SjS, and examine

adequately address the diverse symptoms of RA.

immunological tests and changes in antinuclear
antibodies for SSc, SLE and BD.

Table 16: Evaluation of RA reviews
Ineffective/Undeterminable

Effective

10- Ernst E: Rheumatol, 2006(2)- Casimiro L: Cochrane Database Syst Rev,
2005(4)- Berman BM: Rheum Dis CLin North Am,
2004(1)- Soeken KL: Clin J Pain, 2004(1)- Gaus W: Arzneimittel Forsc Hung, 1995(1)- Zijlstra FJ: Mediators Inflamm, 2003(2)- Linde K: BMC Complement Altern Med,-> - It is difficult to judge, due to problems in research
design and number of cases.

-> - It is more effective than Sham treatment.
- Effectiveness is increased in combination withpharmacological treatment and other suchtreatments.

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

Volume 10, Number 4 | Winter 2015

The above suggests that the mitigation ofand moxibustion therapy. However, its effects can be

symptoms specific to connective tissue diseases

roughlyclassified

into

four

categories—(1)could be expected to improve QOL. However, as with

mitigation of joint pain and other such pain; (2)reports on RA, there are no reports that mention thefunctional improvement, including improvement ofcorrective effects on autoimmune abnormalities or

the range of joint motion and ADL; and (3)anti-inflammatory actions, and acupuncture andmaintenance of favorable general conditions throughmoxibustion therapy is regarded merely as a type of

improvement of stiff shoulders, lower back pain, andsymptomatic treatment.

poor circulation. This suggests the possibility ofacupuncture and moxibustion therapy contributing
to QOL improvement among patients of RA and2. Comparative tests (Table 17)5)
As with RA, reports show that acupuncture andmoxibustion therapy is effective compared to shamtreatment,

or

more

of conditions, such as the degree of disease activity

combination with pharmacological treatment thanor functional disorder, or of evaluation methods.

such

in

Therefore, it is hereafter necessary to establish a

combination with exercise therapy. They thus

research design by assessing patients’ conditions

indicate that mitigating symptoms specific toand examining the expected effects of combining

connective tissue diseases could improve QOL.

existing

However, compared to RA, there are few papers on

acupuncture and moxibustion therapy using a

respective diseases, and the accumulation of EBM is

standard evaluation method. It is thought thatsought in the future.

cooperation with medical institutions and joint

administered

when

used

However, many reports lack any specific mention

intreatment

effective

connective tissue diseases6).

alone,

orpharmacologicaltreatments

withTable 17 Reports on connective tissue diseases other than RA
AuthorAnkylosing
spondylitis

Patients

Jia J, et al: J Tradit Chin Med,2006
Bai WJ, et al: Zhongguo Zhen
Jiu, 200630

Systemicscleroderma
Systemic lupus
erythematosus

Maeda M: J Dermatol Sci, 1998

11

Kung YY: Am J Chin Med, 2006

24

Behçet’s disease

Yu P, et al: J Tradit Chin Med,
2003

46

60

Treatment/site

Evaluation

Moxibustion
RCT
Acupucture
RCT

CRP, ESRVAS Chopart
VAS
Exercise therapy

Electric acupuncture
CCT
Moxibustion
RCT meridian, sanyin jiao
Acupucture
RCT

Endothelin 1

EffectImmunologicaltests

More effective thancontrol
Effective whencombined with
exercise therapy
Vasodilating action isobserved
More effective thancontrol

Antinuclear
antibodyMore effective thancontrol

D. Effects and Possibilities of Acupuncture andstudies with medical specialists are indispensable

Moxibustion Therapy on RA and Connective Tissue

toward this end.

Diseases

Additionally, most RCT and review reports

As RA and connective tissue diseases are a large

contain information on comparisons with placebosgroup of diseases, it is hardly possible to make aand results of examinations of effects when used insweeping generalization of the effects of acupuncture

combination with pharmacological treatment. While

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

11

Volume 10, Number 4 | Winter 2015

a small number of papers show the effectiveness ofthe theory of cytokine (TNFα, IL-10, INF) control byacupuncture and moxibustion in relieving pain,

the interaction of neuropeptides and β-endorphins.

improving functional disorders and maintaining

The majority of animal experiments looks at

favorable general conditions for QOL improvement,

acute effects obtained from one stimulus, so it isthere were also papers that claim no significant

necessary to hereafter examine the effect ofdifference, and there were systematic reviews thatsustainable stimuli on the immune system, but they

make many critical comments about research design,

suggest the possibility that pain relief and functional

evaluation and other such methodologies. At present,

improvement,

there

are

few

clinicalreports

about

anti-

inflammatory actions and corrective effects on
autoimmune abnormalities (Table 18).

which

are

clinicaleffectsoninflammatory diseases, are results of the antiinflammatory actions of acupuncture andTable 18 Current state and possibilities of acupuncture and moxibustion for connective tissue
Treatment• Meridians must be selected in accordance with the symptoms of each(1) Stimulus site

disease(2) Piercing depth• Unknown(3) Treatment frequency• Frequency cannot be determined, but the longer the treatment period,
the more manifest the effect becomes.

(4) Treatment method• Greater effects can be expected in combination with a drug.
• Long-term treatment tends to produce greater effects.
• There is the possibility that moxibustion is effective.

Future issues• Establishment of a research design that also takes into consideration anti-inflammatory actions andcorrective effects on immunological abnormalities• Examination of outcomes that take into consideration such conditions as disease activity and functional
disorders

Meanwhile, in basic studies based on animal
experiments (Table 19), some reports were foundthatsuggestanti-inflammatory

Based on the results of basic research also inTheclinical disciplines, future reports are awaited thatmechanism is explained by a number of theories,

deal with how to evaluate and intervene with chronic

includinginflammatory autoimmune diseases, which are athetheorythat

actions.

moxibustion stimulus.

acupunctureandmoxibustion (mainly moxibustion) stimulus on
adjuvant arthritis controls arthritis through a T-cellandneutrophil-mediatedmechanism;

theimmunediscussed

above,

acupunctureandmoxibustion therapy may be effective against pain
and functional disorders of RA and connective tissue

regulation by neuropeptides such as α-melanocyte

diseases, but as there is lack of strong evidence, it isstimulating hormones that are secreted by thenecessary

pituitary

research that also includes an examination of its

the

of

As

functiongland;

theoryimmunologicalcondition of connective tissue diseases.

theoryofindirectimmunosuppression via sympathetic nerves; and12

toconduct

evidence-based

anti-inflammatory actions in the future.

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

clinicalVolume 10, Number 4 | Winter 2015

Table 19 Basic research on acupuncture and moxibustion stimuli
Reports of basic studies that suggest anti-inflammatory effects
Matsukuma et al
J Jpn Soc Balneol Climatol Phys Med, 2005 (3)Rat with adjuvant arthritis
Moxibustion on stomach meridians(9 times in 4 weeks)

The increase of T cells (CD4+T) was
controlled.
The number of neutrophils decreased.
Anti-inflammatory effects were observed.

Fang JQ, et al.
In Vivo, 1998 (12)Rat with arthritis
Moxibustion on stomach meridians(15 times in 30 days)

The increase of anti-type II collagenantibodies was controlled.
Anti-inflammatory actions were observed.

REVIEW
Azumaya et al.
Zensin Journal, 2006 (5)Examination of 94 references
It is a fact that acupuncture and moxibustion stimulus directly and indirectly affects
immunological parameters of the immune system, but universality and reproducibility areissues to be addressed in the future.

・Control of inflammatory cytokines by neuropeptides such as α-melanocyte stimulating hormones
・Immune cell adjustment by increased production of glucocorticoid by the adrenal gland・Indirect immune function regulation by somatic reflection of the immune system via sympathetic nerves
・Control of cytokines (TNF-α, IL-10, INF) by the interaction of neuropeptides and β-endorphins

References
1) Kasuya, Daichi, et al.: multi─center randomized
controlled trial of acupuncture and moxibustion forrheumatoid arthritis. The Journal of the JapaneseSociety of Balneology, Climatology and Physical
Medicine 68 (4): 193-202, 2005
2) Ernst E.: Acupuncture and electro-acupuncture forthe treatment of rheumatoid arthritis. Nat Clin
Pract Rheumatol 2 (2): 74─ 80, 2006
3) Casimiro L., Barnsley L., Brosseau L. et al.:Acupuncture and electro-acupuncture for thetreatment of rheumatoid arthritis. Cochrane
Database Syst Rev Oct 19; (4) CD003788, 2005

4) Yamamoto, Kazuhiko, et al.: Study on randomized
comparison tests of acupuncture and moxibustion therapy
for rheumatoid arthritis. Report funded by the Health
Labour Sciences Research Grant (comprehensive researchon aging and health), 2000-2002.
5) Ernst E.: Complementary and alternative medicine
for pain management in rheumatic disease. Curr
Opin Rheumatol 14 (1): 58─ 62, 2002
6) Kasuya, Daichi, Taguchi, Reina, Omata, Hiroshi, etal.: The role and present status of acupuncture andmoxibustion therapy for chronic pain. Chronic Pain
26 (1): 57-74, 2007.

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

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Volume 10, Number 4 | Winter 2015

Clinical Report 1 (Acupuncture)
Acupuncture Treatment for Irritable Bowel Syndrome(IBS-D): A Case Report
Hiroshi Kondo
Course of Acupuncture and Moxibustion,
Department of Health, Faculty of Health Science,
Tsukuba University of Techonology

Summary
This

case

study

reportintroduceshowacupuncture treatment on an IBS-D patient led to an
improvement in stool form and health-related QOL.
Case: 75-year-old man.
Chief complaint: Diarrhea. The patient has been
experiencing frequent symptoms of diarrhea since
early in life, but the symptoms worsened from arounda year ago, so he visited the hospital, where he wasdiagnosed with irritable bowel syndrome (IBS). Hiscondition improved temporarily by taking an internal
medicine, but because continuous use of the medicine
causedconstipation

andnausea,theinternal

medicine was discontinued, and his doctor referred
him to acupuncture treatment. As a subjective
symptom, the patient mostly passes watery stool andloose stool on rare occasions. He defecates three tofour times a day. He has discomfort in his abdominal
region, and tends to accumulate gas. His diarrhea
symptoms intensify when he consumes irritating
foods such as chocolate, spicy foods, and alcohol. The
progress of treatment was evaluated using a stool
diary that contains a record of the patient’s daily
bowel movements, and also by SF-36.
Result: The patient’s stool mostly changed fromwatery to loose stool from around two weeks ofreceiving acupuncture treatment. In the third weekof treatment, he produced regular stool once. In theeighth week, the frequency of watery stool decreased
and that of loose stool increased. The patient’s SF-36
subscale score increased in the tenth week oftreatment compared to his initial visit before
treatment.
Observation: With IBS, it is reported that
improving QOL is extremely important, even if no14

significant change is observed in stool form. Judging
from the result of the above case example, it isthought that acupuncture treatment is effective inachieving a slight improvement in stool form andimproving health-related QOL in IBS-D patients.
Keywords: Acupuncture, irritable bowel syndrome,
diarrhea-predominant, SF-36, QOL
1. Introduction
Irritable bowel syndrome (IBS) is a functional
disease that is accompanied by bowel movement
disturbance and discomfort or pain in the abdominal
region, and causes a marked decline in QOL. It
occurs commonly, and is prevalent at a rate of around
15% among the general population in developed
countries1) 2). Acupuncture treatment is renderedwith the aim of regulating bowel movement andmitigating the various physical symptoms of bowel
movement disturbance3). In recent years, theeffectiveness of acupuncture treatment has beenreported in a number of clinical studies4) 5), but they
do not discuss its effects according to the subtype ofstool forms. Based on the understanding thatreporting on the clinical results of acupuncture
treatment by subtype would benefit clinical studiesof acupuncture treatment, this paper introduces acase example in which acupuncture treatment was
shown to be effective against diarrhea-predominant
IBS.
2. Case example
1) Case example: 75-year-old man (height 165cm;
weight 49kg; BMI 18.0; slender)
2) Chief complaint: Diarrhea
3) History of present illness:Thepatient

has

beenexperiencing

frequent

symptoms of diarrhea since early in life, with thesymptoms often intensifying during summer.
X-31 years: A constant intake of alcohol and spicy
foods aggravated the patient’s diarrhea symptoms to
the point that he developed a hemorrhoid, so heconsulted a local doctor, who diagnosed him withThe Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

Volume 10, Number 4 | Winter 2015

anal fistula. The patient was prescribed an ointment,

whenever he defecates. He also experiences aand the symptoms abated, but thereafter, he

prolapsed hemorrhoid sometimes when he urinates.

suffered diarrhea whenever he ate irritating foods,

For this reason, when he has an urge to defecate, heand tended to experience a prolapsed hemorrhoid

frequently rushes to the bathroom with his hand on

when he strained.

his anus. He also prolapses when engaging in

X-4 years: The diarrhea symptoms worsened, so

standing work for a long time or when walking.

the patient received a colon fiberscope inspection at(2) Objective findings: In a palpation examination,aorganic

strong muscle tone was found in the abdominal

disturbance was found. The patient had been taking

rectus muscle. There were chills in the feet.

an antiflatulent when his diarrhea symptoms

Tenderness was found from the patient’s chest to theworsened, but stopped taking it when he began toerector spinae muscle. The tenderness is felt moreexperience stomach pain.

strongly on the left side. There is no left-right

local

proctology

hospital,butnoX-1 year: The diarrhea symptoms worsened, so thedifference in the dorsal artery of the patient’s feetpatient consulted a hospital, where he was diagnosed

and posterior tibial artery, and both are normal.

with irritable bowel syndrome. He was prescribed7) Evaluation method:

Irribow tablet, albumin tannate, and Coronel, and the

The patient was asked to keep a stool diary andsymptoms abated. However, continued use of theserecord stool forms and daily bowel movements. SF-

drugs caused constipation and nausea, so the patient

36 was also used for a comprehensive evaluation of

stopped taking them after six months.

health-related Quality of Life (QOL). It is composed
prolapsedof 36 items in 8 subscales, namely physicalhemorrhoid worsened with an excessive intake offunctioning (PF), role-physical (RP), body pain (BP),chocolate, so the patient visited our Center for

general health (GH), vitality (VT), social functioning

Integrative Medicine. He was prescribed Kampo(SF), role-emotional (RE), and mental health (MH)6).

medicine (Tsumura No. 3 Otsujiyu and Tsumura No.

The higher the scores of each subscale means the

32 Ninjinto) and Bio-Three powder, but stopped

better the patient’s condition. The evaluation was

taking them because they made him feel poorly. At

performed at the patient’s initial visit, and five andthe request of the Kampo doctor, he agreed to receive

ten weeks after commencement of treatment.

acupuncture treatment.

8) Acupuncture treatment:

X:

The

patient’s

diarrheaand4) History of past illnesses: None in particular

The following treatment was provided at an5) Social history:

interval of once a week, with the aim of mitigating

The patient has engaged in bicycle sales for a longthe patient’s diarrhea symptoms and prolapsed

time. Even after retiring, people in his neighborhood

hemorrhoid and maintaining his health.

sometimes come to see him to have their bicycles

Needleretention(length40mm;

diameterrepaired.

0.16mm; stainless steel needles) for 10 minutes on6) Present symptoms:

Zhongwan (CV12), Qihai (CV6), Tianshu (ST25),(1) Subjective symptoms: The patient defecates three

Dadu (SP2), Shangqiu (SP5), Sanyinjiao (SP6),

to four times a day, but his stool is mostly watery andTaichong (LR3), Dachangshu (BL25), Shenshu

sometimes loose. He has discomfort in his abdominal(BL23), Weishu (BL21), and Sanjiaoshu (BL22)

region, and tends to accumulate gas. His diarrhea

3 bulb moxa on Sanyinjiao (SP6), 7 heat transmitting

symptoms intensify when he consumes irritatingmoxa on Baihui

foods such as chocolate, spicy foods, and alcohol. He
alwaysexperiencesaprolapsed

hemorrhoid

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

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Volume 10, Number 4 | Winter 2015

3. Result1) Stool form
From around two weeks after commencement ofacupuncture treatment, the patient’s stool mostly
changed from watery to loose stool. He also produced
regular stool once in the third week of treatment.
However, from the fourth week, watery stool
reappeared frequently. In the eighth week, the waterystool decreased, and the patient mostly passed loosestool. His urination frequency also decreased.

2) Health-related QOL
At the time of his initial visit, all eight of thepatient’s subscale scores fell below the Japanesestandard. In the fifth week, MH increased by 5
points. In the tenth week, all subscale scores
increased, and an improvement in QOL was seen
(Figure 2). It is noteworthy that the scores for RP, SF,
RE and MH surpassed the Japanese standard.

Figure 1 shows weekly average defecation and urination frequencies based on a record of daily

Figure 2 shows the scores of the eight subscales of SF-36. An improvement was observed in the 10th

16

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

Volume 10, Number 4 | Winter 2015

4. Observations

chronic illness can receive acupuncture treatment on

1) IBS pathology and this case example

a continuous basis.

Based on the Rome III diagnostic criteria, IBS is

In this case example, acupuncture treatment

classified as a disease in which abdominal pain or

increased the rate at which the patient’s stool form

discomfort in the abdominal region occurs for morechanged from watery to loose stool. His urination

than three days in a month within the latest threefrequency also decreased, but he hardly produced

months, and accompanies at least two of theregular stool. At the same time, however, the eight

following three conditions: the abdominal pain or

subscales

discomfort in the abdominal region (1) is mitigatedacupuncture treatment’s contribution to improving

by defecation, (2) is brought on by a change in

QOL. Furthermore, the acupuncture treatment

defecation frequency, or (3) is brought on by a change

produced no adverse events. Matsumoto et al.11)

in stool form (appearance). IBS is furthermore

report that in acupuncture treatment against IBS,

classified into four subtypes using the Bristol Stool

improving QOL is essential, even if no significant

Form Scale: (1) constipation-predominant IBS (IBS-change is observed in stool form. From the result ofC), (2) diarrhea-predominant IBS (IBS-D), (3) mixed

the case example, it is thought that providing

IBS (IBS-M), and (4) unsubtyped IBS (IBS-U)7) 8).

acupuncture treatment is effective in achieving a

The IBS case example introduced here is classified

slight improvement in stool form and improving

as IBS-D, as the patient’s stool is mostly watery stool.

health-related QOL in IBS-D patients.

of

SF-36

all

increased,

indicating

IBS

In recent years, there have been a number ofabdominal

clinical studies4) that show the effectiveness of

discomfort and bowel movement disturbance falls

acupuncture treatment in improving QOL among

into a negative cycle by a dysesthesia in the digestive

IBS

tract, dyskinesia or psychological disorder such asmechanism of the effect of acupuncture. However, atdepression and anxiety, via gut-brain interaction9) 10).

the same time, systematic reviews conclude that

Additionally, IBS undermines QOL2). In the casethere are no rational grounds for supporting the use

example introduced here, SF-36 evaluation revealedof acupuncture treatment to treat the symptoms ofa decrease in QOL.

irritable bowel syndrome14). As most clinical studies

2) Treatments for IBS and acupuncture treatmentthat have been conducted to date have been small in

Diarrhea-predominant IBS is commonly treatedscale, it is necessary to hereafter examine theusing a serotonin 5-HT3 receptor antagonist. As side

effectiveness of acupuncture by conducting a large-

effects, it sometimes causes thirst, nausea in somescale clinical study and performing an analysis

instances, vomiting and constipation. In the caseaccording to severity, subtype, and other such factors.

Generally,
accompanying

thepathophysiology

abdominal

pain,

of

patients

and

basic

studies12),13)

on

the

example as well, symptoms of side effects appeared,
and the internal medication was stopped. There arealso patients who refuse Western medical drug

5. Conclusion
Acupuncture treatment applied to a diarrhea-

treatment because of the symptoms that appear

predominantIBS

patient

led

to

a

slightother than their chief complaint. Meanwhile,

improvement in stool form and an improvement in

acupuncture and moxibustion treatment have few

health-related QOL.

side effects, and imposes minimum burden on thepatient’s body. For this reason, patients with a
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

17

Volume 10, Number 4 | Winter 20158)

References
1)

2)

3)

4)

Jones R, Lydeard S.: Irritable bowel syndromeIIIin the general population. BMJ. 1992; 304: 87-

Gastrointes-tinal Disorders, 3rd ed. Kyowa

90.

Planning, 2008, Tokyo 302-18.

Gralnek IM, Hays RD, Kilbourne A, Naliboff B,

Functional

Michael C.: Management of the Irritable Bowel

10) Sasaki D, Fukushi T, Sato K.: Irritable Bowel

Gastroenterology. 2000; 119: 654-60.

Syndrome among the Elderly. Clinical Research.

Iwa M, Yano T.: “3. Irritable Bowel Syndrome.”

2006: 64(8); 1516-20

In Illustrated Acupuncture and Moxibustion—11) Matsumoto J,Ishizaki N, Ono K, et al.: Two Case

Guide to Acupuncture and Moxibustion
Treatment Techniques I, Chapter 10, Section 3

Examples in which Acupuncture Treatment was

Digestive Tract and Metabolism Illnesses, 1stamong the Elderly. Japanese Acupuncture andedition. (Tokyo: Bunkodo, 2012), 815-21.

Moxibustion. 2007; 57(4): 501-8.

Schneider A, Enck P, Streitberger K, et al.:treatmentinirritablebowel

Effective against Irritable Bowel Syndrome12) Weng ZJ, Wu LY, Zhou CL, et al.: Effect ofelectroacupuncture on P2X3 receptor regulation

syndrome. Gut. 2006; 55(5): 649-54.

in the peripheral and central nervous systems of

Lembo AJ, Conboy L, Kelley JM, et al.: A

rats with visceral pain caused by irritable bowel

treatment trial of acupuncture in IBS patients.

syndrome. Purinergic Signal. 2015; 11(3): 321-9.
13) Ma XP, Hong J, An CP, et al.: Acupuncture-

Fukuhara S, Suzukamo Y.: Manual of SF-36v2

moxibustioninJapanese

syndrome:howversion,InstituteforHealth

2004.

18

The

Syndrome on Health-Related Quality of Life.

Outcomes & Process Evaluation research. Kyoto,
7)

version)

Syndrome. Gastroenterology. 2001; 120: 652-68.

Am J Gastroenterol. 2009; 104(6): 1489-97.
6)

9)(Japanese

Mayer E.: The Impact of Irritable Bowel

Acupuncture
5)

Fukutsuchi S, Hongo M, Matsueda A K.: ROME

treating

irritable

does

work?

it

bowel

World

J

Gastroenterol. 2014; 20(20): 6044-54.
14) Manheimer E, Cheng K, Wieland LS, et al.:Longstreth GF, Thompson WG, Chey WD, et al.:Acupuncture for treatment of irritable bowel

Functional bowel disorders. Gastroenterology.

syndrome. Cochrane Database Syst Rev. 2012;

2006; 130: 1480-91.

5: CD005111.

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

Volume 10, Number 4 | Winter 2015

Clinical Report 2 (Kampo Medicine)
Case Studies from Ehime Prefectural Central Hospital (3)– From the Rural Bedside to the Global Podium –Genki Shimizu, Hiroshi Kakuto, Den-ichiro Yamaoka
The Internal Departement of East Asian Traditional
Medicine of Ehime Prefectural Central Hospital

Type 3 Cases
The side effects of Western medical treatment isalleviated when combined with Kampo treatment[Case 9 (Dr. Shimizu’s case)]
Effective administration of Bofutsushosan for
medication

overuseheadache

(MOH)

and

premenstrual edema in a 28-year-old woman[Chief complaint]
Headache, edema[History of present illness]
The patient began to take loxoprofen sodium
hydrate for menstrual pain from around the age of
20. About two years ago, she began to develop aheadache when the weather was poor. In the
beginning, her condition improved with loxoprofen
sodium hydrate, but the frequency of her headache
gradually increased, such that she began toexperience daily headaches. Loxoprofen sodium
hydrate no longer worked, so she began to takediclofenac sodium when the pain was intense.
Since

a

year

ago,

the

patient

has

beenexperiencing a condition in which her eyes become
swollen, she cannot wear her ring, and she feels
fatigue due to edema in her legs during the period
from ovulation to the third day of menstruation. A
local doctor prescribed Goreisan extract andTokishakuyakusan extract, but neither had any
effect. The patient was also prescribed furosemide
at times when her edema flared up. Furosemide
was effective in the beginning, but because it
gradually lost its effectiveness, she was prescribed
increased amounts. Still, no satisfactory progress
was seen, so the patient visited our department.

[Life history]
Occupation: Care worker; Smoking: 15 × 13 years;
Drinking: Around twice a week
[Oral medicine]
Diclofenac sodium, furosemide, brotizolam[Physical health]The patient has a tendency for her hands andlower body below her hip to become cold. She has
difficulty starting urination. As she experiences nobowel movement for two, three days, she takes alaxative. She does not have a weak stomach. Herlegs swell from the date of ovulation to the firstday of menstruation.
[Present symptoms]
Height 162cm; weight 53kg; BMI 20.2
Dark red around the eyes. Tongue: slight whitecoating, some teeth marks. No varicosis.
Pulse: Between floating and sunken, rather rapid.
Abdominal symptoms: No chest side painfulness.
No epigastric discomfort or resistance. Pulsation of
abdominal aorta. Splashing sound in epigastricregion.
Resistance and sharp tenderness in left iliac
region. Lower abdominal resistance and fullness.
[Progress]
The patient was prescribed 7.5g of Bofutsushosan
extract. By her return visit two weeks later, herheadache had completely disappeared. She still
had some edema before and after ovulation, but it
had mitigated compared to before. She was able toopen her eyes, and her sleep improved. She notedthat her urine had become yellow.
[Observations]This was a case in which a tendency to develop
edema and headaches occurred as a side effect ofthe prolonged use of medicine as standard
treatment, but a diuretic was not effective.
Bofutsushosan comprises 18 different drugs. Its
crude drug ingredients reveal a combination ofsuch acrid-warm herbs relieving superficies as
Mao(ephedra),(Saposhnikovia(schizonepeta);

Shoga(ginger),

Bofu

divaricate),andKeigaithe

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

cold-pungent

diaphoresis

19Volume 10, Number 4 | Winter 201520

Hakkai (peppermint); Rengyo (forsythia fruit); theIn the above case, the problem involved headaches

heat dissipating drug Sekko (gypsum); in addition toand premenstrual edema caused by the overuse ofSanshishi (gardenia fruit), Ogon (Baikal skullcap),

NSAIDs. The patient was not obese, but she had

Daio (rhubarb), Bosho (mirabilite), and Kasseki

constipation and poor urination, and reacted(talc). It can be said to be a front-rear double solution

poorly to medicine. These symptoms suggested a

medicine for exterior cold and interior heat and for

decline in metabolic and excretory functions

exterior heat. From a different perspective, it cancaused by indigestion. Therefore, instead ofalso be said to be a medicine for edema caused byprescribing simple ingredient drugs such asheat pattern, as Mao, Sekko, Kasseki, Byakujutsu,

Goreisan and Tokishakuyakusan, the patient was

Hakka and Bofu induce diuresis to alleviate edema.

successfully prescribed Bofutsushosan, which has

Furthermore, the addition of laxatives such as Daiothe effect of dissipating heat, inducing diuresis,

and Bosho helps remove interior heat, and is thus

purging the bowel, and providing front-rear double

suited to people who tend to develop indigestion.

solution.

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

Volume 10, Number 4 | Winter 2015

Conference Report
A Letter from the 10th International Association ofGerontology and Geriatrics (IAGG)– Asia/Oceania Regional Congress in Chiang Mai, Thailand

include “geriatrics” in the name, and the IAG became

Kazunari Ozaki*1), Takehiko Numata2), Shin
Takayama2),
Tse-Hung
Huang3),
Kazuki
Yoshizawa4), Kenki Miyazawa1), Yasushi
Takeya5)1), Yoshio Nakamura1), and Koh
Iwasaki6)

highest levels of accomplishment in gerontological1)

gerontological interests. The IAGG chases these

Department of Geriatric Medicine, Itami City Hospital,
Itami, Hyogo, Japan
2) Department of Education and Support for Community
Medicine, Tohoku University Hospital, Sendai, Japan.
3) Department of Chinese Medicine, Chang Gung Memorial
Hospital, Keelung and Graduate Institute of Clinical
Medical Sciences, Chang Gung University, Taoyuan,
Taiwan4) Shonan-Kamakura General Hospital Kanagawa Japan
5) Department of Geriatric and General Medicine, Osaka
University Graduate School of Medicine, Suita, Japan
6) Center for Traditional Asian Medicine and Home
Healthcare, Southern Tohoku General Hospital,
Iwanuma, Japan* Corresponding author: Kazunari OZAKI
Department of Geriatric Medicine, Itami City Hospital:
1-100 Koyaike, Itami, Hyogo, JAPAN

CongressandGeriatrics)

Association
wasoforiginallyestablished in Belgium in 1950. The purpose is toimprove the quality of life (QOL) of elderly people allover the world by sharing study results on health,welfare,andmedicalscience.

The

First

International Congress of Gerontology was held in
Liège, Belgium, where it gathered 113 gerontologists
from 14 countries, in July 1950. The Association’s
name,

which

was

originallywith other international, inter-governmental andnon-governmental organizations in the promotion ofactivities with a view of improving the highest QOL
and well-being of human beings as they experience“aging”. The last 65 years has seen the IAGG develop
from a relatively small organization to a majorinternational community represented today in 64
different countries, with a combined membership ofover 45,100 people (1).
The 10th IAGG Asia/Oceania Regional Congress
took place in Chiang Mai, Thailand, at theInternational Convention and Exhibition Centre
Commemorating His Majesty’s 7th Cycle Birthday
Anniversary from October 19 – 22, 2015. It was
hosted by Thai Society of Gerontology and GeriatricSurgeons

1. IAGG and the 10th IAGG Asia/Oceania Regional

Gerontology

research and training worldwide, and to interact

Physicians of Thailand, the Royal College of Dental

Asian medicine, Kampo medicine, elderly(International

2005. The assignment of the IAGG is to promote theCommission (Thailand), the Royal College ofGerontology and Geriatrics (IAGG), Traditional

IAGG

Geriatrics (IAGG) for the 18th World Congress in

Medicine. Co-hosted by National Older Person

Key words: International Association ofThe

the International Association of Gerontology and

known

as

the

International Association of Gerontological Societies(IAGS), was changed in the same year to theInternational Association of Gerontology (IAG). In
2004, the IAG’s Council of Directors decided toofThailand,

and

Help

Age

International East Asia and the Pacific. It was
supportedbyThe

ThailandConvention

andExhibition Bureau (TCEB), and Thai Airways
International (2). The congress and the anniversary
activities were rich and diversified in contents.
Theme of the congress was “Healthy Aging Beyond
Frontiers” (3). Sub-themes of the congress were as
follows: “Clinical Medicine”, “Health Promotion for
Active Aging”, “Biological Science”, “Molecular
Biology as Possible Enhancers for Healthy Ageingand Longevity, Social & Behavioral Science”, “Activeand Dignified Ageing”, “Social Research & Planning
Scientific”,

and“SocialResearchandPolicyResponse for Ageing beyond Frontiers”. Speakers
were government officials and administrators of
medicine and welfare and scholars of teaching and

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

21

Volume 10, Number 4 | Winter 2015

research institutes from all over the world. The

presentation

conference was attended by more than 1100

Disasters”.

on“Older

Personsin

Naturalresearchers and physicians from all over the world

At “Stroke and Parkinson’s Disease” section, Dr.

(4) – primarily from Asia/Oceania – who exchanged

Piu Chan, Xuanwu Hospital of Capital Medical

opinions and presented studies on diverse geriatric

University in China, has introduced on “Update in

medical research fields, of which 7 speakers for

Parkinson’s Disease”, Dr. Maw Pin TAN, University

Plenary Lecture and 64 invited speakers, with 540

of Malaya in Malaysia, has made a lecture on “Fear-sessions of oral presentations and 128 sessions of

Of-Falling in Stroke and Parkinson’s disease”, andsymposiums.

Dr. Siti Setiati, Universitas Indonesia in Indonesia,
has made a presentation on “Stroke Prevention inOlder People”.

2. Highlights of the Conference
At “Falls and Musculoskeletal Medicine” section,
Dr. James.K.H. Luk, Fung Yiu King Hospital in

3. The submitted symposium of “Traditional AsianHong Kong, has made a presentation on “FallMedicine for Geriatrics”

Prevention in Older People – What We Know andHere we will focus on the reports of the submitted

What We Do Not”, Dr. Edward Leung, Hong Kong

symposium of “Traditional Asian Medicine for

Association of Gerontology in Hong Kong, has

Geriatrics” only because of shortage of space. Dr. Kohintroduced on “Advances in Management of Hip

Iwasaki prepared the symposium and was the

Fractures in Older People”, Dr. Atsushi Harada,chairperson.

National Center for Geriatrics & Gerontology in

Dr. Tse-Hung Huang (Department of Chinese

Japan, has made a lecture on “Osteoporosis andMedicine, Chang Gung Memorial Hospital, Keelung

Sarcopenia”, and Dr. Ding-Cheng (Derrick) Chan,and Graduate Institute of Clinical Medical Sciences,

National Taiwan University Hospital Chu-Tung

Chang Gung University, Taoyuan, Taiwan and

Branch in Taiwan, has made a presentation on

Graduate Institute of Integration of Traditional“Osteoporosis Services in Taiwan”.

Chinese Medicine with Western Nursing, College ofAt “Mental Health” section, Dr. Leon Flicker, The

Nursing, National Taipei University of Nursing andUniversity of Western Australia in Australia, has

Health Sciences, Taipei, Taiwan) has introduced

introduced on “Diagnosis in Dementia”, Dr. Feng-"The application of traditional health exercises to

Hwa Lu, National Cheng Kung University in Taiwan,

improve the quality of life in old age". Dr. Huang andhas made a lecture on “Diagnosis of Anxiety andhis colleague’s findings show that Tai-Chi-Chuan

Depression in Older People”, and Dr. Mark Chan,

alleviated anxiety and decreased the risks for

Tan Tock Seng Hospital in Singapore, has made a

cardiovascular disease including blood pressure,presentation on “Update on Delirium”.

Anxiety Index: The Beck Anxiety Inventory, Body

At “Frailty and Metabolic Disorders” section, Dr.

Mass Index and Waist Circumference. He has shared

Bernard Kong, Pamela Youde Nethersole Eastern

the way of thinking and the methods of prevention

Hospitalon

and treatment of chronic musculoskeletal conditions“Prognosis and Management of Hypoglycemia inwith traditional health exercises, which is an

Elderly”, Dr. Philip Poi, University of Malaya inappropriate program to improve the QOL.

in

Hong

Kong,

has

introduced

Malaysia, has made a lecture on “Long Term

Dr. Takehiro Numata (Department of Education

Outcomes for Fallers Attending the ER”, and Dr.

and Support for Community Medicine, Tohoku

Shelley de la Vega, University of the Philippines

University Hospital, Sendai, Japan) has introduced

College of Medicine in Philippines, has made a"A Randomized Controlled Trial using Kampo

22

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

Volume 10, Number 4 | Winter 2015

Medicine Daikenchuto on Functional Constipationcolleagues investigated the efficacy and safety of

Suitai-score had strong positive correlation to E/Ea.
They suggested that Kampo-scores especially Suitaiscore and Qi-deficiency-score, can be used to define

daikenchuto (大建中湯<JP>, Major Middle-Strengthening

clinical assessment of frailty in hemodialysis

Decoction) in patients suffering constipation as aoutpatients with chronic heart failure.

in Poststroke Patients ". Dr. Numata and hiscomplication of cerebrovascular disease: Thirty-four

Dr. Koh Iwasaki (Center for Traditional Asianthe

Medicine and Home Healthcare, Southern Tohoku

daikenchuto or control group; both groups received

General Hospital, Iwanuma, Japan) has introduced

conventionalthe“Systemic Review and Providing Guideline ofdaikenchuto group were also administered 15 gramsof daikenchuto over 4-week. The Constipation

Traditional Asian Medicine for Elderly”. Dr. Iwasaki

scoring system (CSS) was recorded before and afterand Support for Regional Medicine, Department of

a 4-week observation period, and the Gas volume

Kampo Medicine, Tohoku University Hospital,score (GVS) was calculated using simple abdominal

Sendai, Japan) investigated whether the Grading ofradiograph of supine position. The CSS score

Recommendations Assessment, Development andimproved significantly in the daikenchuto group

Evaluation (GRADE) system is available to evaluate

compared to control: daikenchuto administration

Traditional Medicine or not, and presented theirimproved constipation of poststroke patients. The

trial in updating the guideline of Japan Geriatrics

GVS

the

Society treated Traditional Chinese Medicines. The

daikenchuto group compared to the control:
daikenchuto administration reduced intestinal gas

guideline of Traditional Asian Medicine (TAM) forvolume.

listed as “Screening Tool to Alert doctors to Right

subjects

were

was

randomly
constipation

also

allocatedtherapy,significantly

into
but

reducedinand Prof. Shin Takayama (Department of Educationelderly was established and 5 herbal recipes were

Dr. Kazunari Ozaki (Department of GeriatricTreatment (START)” while recipes containing 5

Medicine, Itami City Hospital, Itami, Hyogo, Japan)

herbs were listed as “Screening Tool of Older

has introduced "Noninvasive Evaluation of Frailty in

Person’s Prescriptions (STOPP)”.

Elderly Persons with Heart Failure: The correlation

Dr. Koh Iwasaki has also introduced Prof. Shinbetween Kampo-scores and “The timed ‘Up and Go’

Takayama’s work, “The role of Kampo medicine in an

Test”

with

aging society: experience with Kampo treatment

echocardiography". The timed “Up and Go” Test

after a natural disaster”. Prof. Takayama and his(TUG, Podsiadlo1991) is a widely used performance-colleague’s findings show that Kampo medicine hasbased measure of functional mobility in community-

been helping some of the tsunami/ earthquake

dwelling older adults. Dr. Ozaki and his colleagues

survivors.

andcardiovascularscoresstudied 40 outpatients at the hemodyalysis unit withsimultaneous

Kampo-scoresandechocardiographical indices with echocardiography
and the TUG. They measured and compared Kampo
scores and echo-cardiographical indices and the
TUG by linear regression. According to their study,some of the Kampo-scores (Suitai-score (or water
stagnation score) and Qi (vital energy)-deficiencyscore) had high positive correlation to the TUG. E/Ea
(E/e’) had high positive correlation to the TUG.

4. Concluding remarks and about the upcoming
congresses.
All the participants including those attendee who
were at the submitted symposium of “Traditional
Asian Medicine for Geriatrics”, agreed that the
symposium was an international academic event ofGerontology and Geriatrics with high level andstandard. Traditional Asian Medicine including
Kampo medicine would be helpful for Gerontology
and Geriatrics. The researchers and physicians of

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

23

Volume 10, Number 4 | Winter 2015

the Traditional Asian Medicine have obligation to
improve the quality of life (QOL) of elderly people allover the world by sharing study results on health,welfare, and medical science. The submitted
symposium this time was the first trial to treat
Traditional Asian medicines in IAGG. One of theparticipants commented that trials of this kindshould be held also in future.
The Gerontological Society of America (GSA) will
be hosting IAGG’s 21st World Congress in San
Francisco, USA (July 23-27, 2017) (5). The theme ofthis future conference will be “Global Ageing and
Health: Bridging Science, Policy, and Practice”. Inview of GSA’s long experience in organizing key
events and of the city’s important congress facilities,
IAGG 2017 will be sure not to dissatisfy.

References1

http://iaggchiangmai2015.com/overview/about-iagg/[the last date of access Nov. 21, 2015]24

http://www.kampo-s.jp/magazine2/252/index3.htm[the last date of access Nov. 21, 2015]

http://iaggchiangmai2015.com/overview/iagg-

5

IAGG Newsletter (Vol.20-8) - IAGG Congress 2015;

asia-oceania-2015/

http://iaggchiangmai2015.com/wp-[the last date of access Nov. 21, 2015]

content/uploads/2014/05/IAGG-Newsletter-Vol.20-8.pdf

3

The 10th International Association of Gerontology[the last date of access Nov. 21,2015]

and Geriatrics - Asia/Oceania 2015 Congress, Final
Program,

19-22

October,

2015(Chiang

Mai,

Thailand), 1-130, 2015.

24

The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)Make the most of Kampo in modern medicine

Foundation: 1905
A century of tradition ――――We are a manufacturer consistently controlling the entire process fromthe import of crude herbs to the manufacture of Kampo extracts and assuch have contributed to the development of Japanese Kampo.
We sincerely hope to continue in the future with our contribution tomodern medicine through "Kampo".

OHSUGI Pharmaceutical Co., Ltd.

1-1-2 Tennojicho, Minami, Abeno-Ku, Osaka, Japan
Phone: +81-6-6693-3301

The crude drugs like many other creatures on earth areraised by bountiful NATURE.
Humankind earns as well grace from Mother Natureand is blessed as a member of natural world.
PROFILE of

TOCHIMOTO

Since Tochimoto was appointed as aJapan-China friendship trading firm in
1963, we have expanded our businessoverseas, mainly with China.
We import a variety of quality-controlled
natural resources from all over the world
for maintaining wellness.

TOCHIMOTO TENKAIDO CO., LTD.
3-21 Suehiro-cho, Kita-ku, Osaka 530-0053, JAPANwww.tochimoto.co.jp