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INTERNATIONAL INSTITUTE OF HEALTH AND HUMAN SERVICES,
BERKELEY
Volume 8, Number 4 ･ Winter 2013

Editorial

The Present State of Acupuncture and Moxibustion Education in Japan
Noboru Mitsuhata

Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (10) – Gynecology
Yoji Shimizu

Kampo Medicine - Current Research

Kampo Treatment for Allergic Rhinitis and Hay Fever
Hiromichi Yasui

Clinical Report 1 (Acupuncture)

A Clinical Report of Anterior Cruciate Ligament Injury Treating with Acupuncture and Physical Training for Collegiate Women’s
Lacrosse Player
Akihito Uehara, Akinori Kihira, Yasuhisa Kaneko and Eiji Furuya

Clinical Report 2 (Kampo Medicine)Case: Autistic Spectrum Disorder, 5-year-old Boy
Hideaki Yamaguchi

Report from Association

A cynical hermit’s record of “The Six Prefectural Joint Congress (Rokken-goudou-kyouiku-kouenkai) of the Japan Society for Oriental
Medicine (On February 24, 2013), Kansai branch, in Japan”
Kazunari Ozaki

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 8, Number 4 ･ Winter 2013

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 Present State of Acupuncturist and Moxibustionist Education in Japan
Noboru Mitsuhata

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 Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (10) – Gynecology
Yoji Shimizu

8 Kampo Medicine - Current Research
Kampo Treatment for Allergic Rhinitis and Hay Fever
Hiromici Yasui

13 Clinical Report 1 (Acupuncture)
A Clinical Report of Anterior Cruciate Ligament Injury Treating with Acupuncture andPhysical Training for Collegiate Women’s Lacrosse Player
Akihito Uehara, Akinori Kihira, Yasuhisa Kaneko and Eiji Furuya

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: Autistic Spectrum Disorder, 5-year-old Boy
Hideaki Yamaguchi

21 Report from Association
A cynical hermit’s record of “The Six Prefectural Joint Congress (Rokken-goudou-kyouikukouenkai) of the Japan Society for Oriental Medicine (On February 24, 2013), Kansai
branch, in Japan”
Kazunari Ozaki

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 8, Number 4 | Winter 2013

Editorial
The Present State of Acupuncturist and Moxibustionist Education in JapanThe mainstay of education for acupuncturists/moxibustionists in Japan are three-year vocational colleges.
There are 11 universities, but as many as 90 vocational colleges (as of April 2013). Acupuncturist/moxibustionist
education is also implemented in educational facilities for visually disabled people in each prefecture. The
number of people who take the national examination for the practice of acupuncture and moxibustion is on an
increasing trend, such that in fiscal 2012, there were 5,015 applicants for the national exam for acupuncturists and4,996 applicants for the national exam for moxibustionists, corresponding to approximately double the numbers
ten years ago (fiscal 2002: 2,645 applicants for the acupuncturist exam, 2,613 applicants for the moxibustionistexam).
People who wish to become a practitioner of acupuncture or moxibustion in Japan must go to a university
or vocational college that provides training for acupuncturists/moxibustionists, acquire a prescribed number ofunits that include technical education, and pass a national examination. The national exam, however, is a test ofknowledge level only, and technical skills are in part left up to the discretion of each training facility. For thisreason, practitioners of acupuncture and moxibustion may achieve a uniform level of knowledge, but theirtechnical level is not uniform at present.
Given this social background, movements for enhancing the quality of acupuncturist/moxibustionist education
have begun to emerge. One is a movement initiated by the Japan College Association of Oriental Medicine, which
is an association dedicated to cultivating practitioners of acupuncture and moxibustion. With the objective of having
students achieve a uniform technical skills level before graduating, it adopted a technical evaluation system forstudents of all member schools in fiscal 2009. The system aimed to allow teachers to evaluate students in otherschools based on a unified evaluation criteria, as a first attempt of its kind in the field of acupuncturist andmoxibustionist education. The problem, however, was that only 46 (including 2 universities), and roughly half, of
90 vocational colleges that provide acupuncturist/moxibustionist education were members of the Association. This
prevented the uniformization of the technical level of all national exam applicants.
On the other hand, enhanced education has become available to those who have acquired qualification topractice acupuncture and moxibustion. Postgraduate training was previously provided only by clinics that
recruited them, but institutions affiliated with university hospitals and educational institutions such as vocational
colleges that provide acupuncturist/moxibustionist education, have also begun to establish a framework foroffering postgraduate training in acupuncture and moxibustion. Furthermore, the Acupuncture-moxibustion
Promotion Organization for the People Japan (AcuPOPJ) is presently preparing to offer postgraduate clinicaltraining for acupuncturists/moxibustionists (slated for full-scale implementation from fiscal 2014).
Before acupuncturists/moxibustionists became a national qualification, a skills test was also held as part of
the qualifying examination, but along with the transition to a national qualification, the skills test was abolished.
It is now twenty years since acupuncturists/moxibustionists have become a national qualification. Perhaps it istime to review not only the examination, but also the system of acupuncturist/moxibustionist education itself,with the aim of achieving a uniformity of both knowledge and technical levels.

Noboru Mitsuhata
Goto College of Medical Arts and Sciences
Advanced Course in Clinical Pedagogy
Tokyo Eisei Gakuen College

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

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Volume 8, Number 4 | Winter 2013

Japanese Acupuncture - Current Research
Japanese Traditional Medicine Text (10) – Gynecology

1) Systematic review
Yang H et al.1) reported that among the reviews of

Yoji Shimizu

acupuncture research on primary dysmenorrhea,

Department of Acupuncture and Moxibustion

most of the reported research (32 published reports)

Chuwa Professional Training College of Medical Care

had been ranked at a low level. Relevant research
included 18 studies comparing analgesics andacupuncture.

1. Introduction

Acupuncture

was

found

to

be

Here we introduce studies on the effects ofsignificantly effective. However, it was reported that

acupuncture treatment for gynecological disorders.

9 of these studies did not show significant

The main subjects’ dysmenorrhea, menstrual cycle

effectiveness. These reports focused on traditional

abnormalities, infertility, and menopause are subject

Chinese medicine, pain medication, psychotherapy

mainly. We found that most of the studies fromwith placebo acupuncture used as the control group.

abroad were high level, evidence based research2) Randomized Controlled Trials

based on RCTs (randomized controlled trials), andHelms JM et al reported the results of RCTs. The

however, Japanese studies were primarily casesubjects for these trials included 43 womenstudies with essentially no RCTs presented. One

complaining

similarity between foreign research and that fromrandomly assigned to an acupuncture group, placebo

Japan is that, compared to reports on acupuncture,acupuncture group and a standard control group.

is the relative dearth of research on moxibustion. A

Results following a pre-determined course oflarge number of the studies from abroad are based

treatment were compared between the groups.

on traditional Chinese medicine (traditional Chinese

Improvement rates (that is, reports of reduced pain)

medicine TCM) theory as a standard treatment. In

within the acupuncture group were the highest. It

contrast, the various reports from Japan are based

was also reported that the frequency of analgesic

on the classical theories from Classical Text andtreatment decreased the most within acupuncture

TCM, such as the somatic ─ visceral reflex. Because

group.

ofdysmenorrhea.

Subjects

wererecent Acupuncture research examines therapeutic

Also, Caroline A. et al. investigated 92 women

effects on the endocrine system, it is becoming morewith primary dysmenorrhea. The acupuncture

important worldwide. In the future, I hope thattreatment group and the placebo acupuncture

beyond TCM, clinical research based on classicaltreatment control group were compared. Following

theory and texts contributes to Japan's own research

the treatment series, the acupuncture treatment

development.

group tended to have fewer days of menstrual pain

Now we will proceed with our discussion ofcompared to the control group. Three months after
the treatment series, compared to the placebo

research on Infertility [6.Obstetrics].

acupuncture group, the acupuncture treatment
2. The current state of Clinical Research Abroadgroup had significantly fewer days of menstrual pain.

a) Dysmenorrhea

Additionally, the required amount of additional

Many RCTs on Acupuncture treatment for

analgesics was also significantly reduced among thedysmenorrhea have been performed, these trials

acupuncture treatment subjects. However, it wasoften involve a study of women with primary

reported that6 months following the trials, thedysmenorrhea.

effects of the acupuncture treatments were no longer

Additionally,

there

have

numerous “systematic reviews” published.

2

been

reported by the subjects.

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

Volume 8, Number 4 | Winter 2013c) Menopauseb) Irregular MenstruationareAmong the research on the effects of acupuncture

manifold including but not limited to anovulation

treatment for gynecological diseases, studies on

various disorders associated with the corpus luteum.

menopause have been particularly frequent. There

Clinical studies on menstrual cycle abnormalities

are numerous symptoms associated with Menopause,

are often intricately related to infertility research.

but many of the RCTs are conducted to verify theClinical studies on polycystic ovary syndrome

effect of acupuncture treatment for hot flashes.

(PCOS) have been carried out in efforts to clarify the1) Randomized Controlled Trials

The

causesofirregular

menstruation

Cohen SM et al. used 18 women who complained

causes of irregular menstruation.

of hot flashes. The subjects were randomly divided

1) Systematic Review
Lim CE et al.2) reviewed acupuncture research on

into

two

groups.

The

first

group

received

PCOS. They found that acupuncture treatment for

acupuncture treatments using points appropriate for

PCOS patients led to increased blood flow to themenopausal symptoms and the second groupovaries, reduced in the number of ovarian cysts andreceived

overall size of the ovaries, and, seemed to influence

general strength and vitality. For the acupuncture

blood sugar levels and insulin sensitivity by reducing

treatment trial group, comparing the frequency andcirculating blood insulin levels.

intensity of the hot flashes prior to the treatment

2) Randomized Controlled Trials

series it was reported that, during and following theacupuncture

treatments

designed forStener and Victorin E et al. 3) recruited 20 women

treatments, hot flash frequency and intensity waswith PCOS and divided them into three trial groups:

significantly reduced. Similarly, for the general

the electro-acupuncture stimulation (EA) group, thestrength and vitality trial group, hot flashes were

exercise group and the no treatment group. Many ofsignificantly reduced following the treatments.

the common features of PCOS, such as central

Further, both groups reported significantly improved

obesity, hyper-insulinemia and obstructive sleep

sleep following the treatments.

chronic

Borud EK et al.4) investigated the effects ofthatacupuncture treatment combined with education

sympathetic—excitation may be involved in theabout self-care compared to only education about

pathogenesis of this condition. PCOS patients are

self-care in 267 menopausal women. The trial groups

known to have accelerated sympathetic nerve

were randomly selected and following the treatment

activity within muscle. Stener and Victorin reported

series hot flash frequency and intensity werethat the exercise and EA groups experienced

compared. It was reported that the acupuncture

inhibition of this phenomenon of the muscle

treatment group had significantly reduced hot flash

sympathetic nerve activity.

frequency and intensity. However, at the 6 and 12

3) Comparative Clinical Research比month follow-up sessions, there were no significant

apnea(OSA),

sympathetic

are

over

associatedactivity,withsuggesting

Stener and Victorin E et al. recruited a group ofdifferences between the groups.

24 PCOS women with non-ovulatory menstrual

Also, in recent years there have been numerous ofcycles or oligomenorrhea. Their reported results forreported studies examining the effect of acupuncture

the women who underwent EA, ovulatory cycles

treatment for menopausal symptoms caused by theincreased significantly. EA pretreatment averageside effects of hormone therapy in breast cancer

was 0.15 compared to a treatment and post-

patients in recent years.

treatment average of 0.66.

Walker EM et al. randomly assigned 50 breast
cancer patients with depression to acupuncture

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

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Volume 8, Number 4 | Winter 2013

treatments or venlafaxine (anti-depressant) protocol.

retention method acupuncture treatment. The

Comparing results, both groups reported significant

researchers used a visual analogue scale (VAS) withimprovements in hot flashes, depression and otherboth trial groups and reported that both groups felt

QOL indexes. However, it was reported that thetheiracupuncturegroup`sthat

immediately following the treatments but that there

acupuncture

was

the

were no significant differences between the groups.

reports

more

indicated

effective

than

lower

abdominal

pain

was

relieved

b. Case Studies

pharmaceutical alternative.

Yamashita et al., reported their results from a
3. Currents Status and Prospects for Clinicalcomparativecase

review

of

7

women

with

Research in Japandysmenorrhea. With each passing week of their cycle,a) Dysmenorrhea

these women tended to have lower dysmenorrhea

1) Research on Dysmenorrhea

symptom scores. Significantly lower discomfort

Clinical studies from Japan on Dysmenorrhea

scores were reported prior to the treatments andfocus mainly on painful menstruation and various

during the second and third weeks of their cycles.

pain symptoms experienced during menstruation.

Treatment results for the seven subjects included

There are fewer reports on the cause of the pain and

one remarkably effective case, 3 significantly

other symptom sequela or on classification ofeffective cases. The remaining 3 subjects did not findcommontheprimaryor

secondarysymptoms.

treatments

effective.

Notably,significant

Comparative studies on study design, case series

decreases were observed in lethargy and lower

and case reports make up the majority of publishedabdominal pain. It was reported that, in all 7

literature.

subjects, symptoms that had previously interfereda. Comparative Clinical Researchwith life style enjoyment and daily activities

Yoshimoto et al.5), conducted research on 51
women with dysmenorrhea (painful menstruation).

improved.
c. Case Reports

They established a treatment a treatment free

Taguchi et al., 6) investigated the effects of tackperiod prior to and following the determinedneedles on Sp6 in 2 patients with functional

treatment series. They reported the results of theirdysmenorrhea. After 2 weeks of treatment, subject 1

examination on the effect of embedded needles atreported a Menstrual Disorders Index of 96.5 but

Sp6 on menstrual pain. During the treatment period,

after 6 and 10 weeks of treatment her Menstrual

pain

pain

Disorders index had decreased to 49 and then 40.

improved in about half of the participants. The

VAS scores and amounts of medications decreased

amount of medication taken by the subjects also

until the 6th week but were then found to be

decreased significantly.

increasing again following the 10th week. The second

assessments

showedthesubject`s

Tanaka et al. divided 22 women subjects withsubjects started treatment with a Menstrual

dysmenorrhea into 2 groups. The first group received

Disorders Index of 59. Her score was 49.5 after one

acupuncture that included retention method withmonth of treatment and 21.5 after 5 months. Bothdispersing stimulation. The second group received

her VAS scores and necessary amount of pain

retention method acupuncture without dispersing

relievers also decreased over the course of thestimulation. The treatment protocol began with 2

treatment series.

weeks of treatment, followed by a week without

Among the case reports of acupuncture treatment

treatment. After menstruation had continued fromfor organic dysmenorrhea, Yamashita et al, reported

between 1-3 days, the subjects received a 10 minuteon the results of acupuncture treatment for a 29-

4

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

Volume 8, Number 4 | Winter 2013whose

phases of 4 days. Additionally, after one year of

symptoms resulted from bilateral chocolate ovariantreatment, 5 subjects were confirmed to have high-cysts.

temperature phases as well.

year-old

woman

with

Following

dysmenorrhea

a seriesof 42

acupuncture

treatments, it was reported that her Menstrual

Further, 33 adult women were asked to measure

Disorders Index had decreased from 37 to 23 and she

their basal temperature for 3 months. Six subjects

reported that her menstrual pain was “no longer

were found to have normal basal body temperatureinterfering with her daily activities” and haschanges and regular menstruation, they made up

improved to a level that “no longer bothered her”.

the control group. The trial group was made up of 72) Prospects for Future Research

women who were not found to have normal basal

Among gynecologic clinical studies in Japan, I

body temperature fluctuations throughout theirsuspect the number of reports on dysmenorrhea iscycle. After conducting a 75 g glucose tolerance test,

relatively large. Pain symptoms, such as menstrual

both groups were compared. Blood glucose levels andpains associated with dysmenorrhea, are suitable forblood insulin levels were significantly higher in the

short-term observation and represent the main

abnormal group. Blood glucose was abnormally highreason for the prevalence of such studies. In theat 30, 60, and 120 minute intervals. Abnormally highfuture, reports of studies designed with follow-up

blood insulin levels were confirmed at 120 minutes.

periods and appropriate control groups would add

For the abnormal trial group, ear acupuncture,significantly to the value of this research. Also

needling at Sp6 combined with infra-red light wasstandardized classification of the cause of symptoms,

continued for one year. Blood sugar and insulin

such as primary of secondary would also be desirable.

levels prior to and following the treatment series
were compared and found to be significantly reducedb) Irregular Menstruation

at 30- and 120-minute intervals following the1) Research on Irregular Menstruation

treatment series. It was reported, following theStudies of menstrual cycle abnormalities make up

course of treatment, that the menstrual cycle

the majority of reported cases and comparative

duration (number of days) was reduced and the highstudies. Research often focuses on amenorrhea andtemperature phase was significantly lengthened.

disorders associated with ovulation. Most research

Taguchi et al. investigated 16 women complaining

aims to clarify evaluation methods and observationsof irregular menstruation by comparing a no-

of

the

treatment period followed by electro-acupuncture

menstrual cycle. Specifically, many research reports

group following a pre-determined protocol. Results

include easily obtainable data comparing of the time

showed that 6 subjects improved, 5 had no change

course of basal body temperature and menstrualand 2 became worse following the treatments. Fivecycle dates.

of the subjects became bi-phasic following thea. Comparative Clinical Research

protocol. The author reported that there was no

physicalchangesexperienced

during

Shimizu et al.7, 8), targeting six women who weresignificant change in the cycle duration or basal bodysuspected of anovulatory cycle disease by tracking

temperature (taken at the eardrum).

their basal body temperature. They observed

b. Case Study Reports

changes in basal body temperature following Stick

Shimizu et al. reported on a 23 year old diagnosed

andElectro-with hypothalamic amenorrhea. She had seen no

combined with

infra-redchange following a course of Kaumann Therapy andirradiation. They reported that, after 6 months offertility drugs. These researchers treated her withtreatment, 2 subjects experienced high-temperature

EA (Electro acupuncture). After 45 days her period

Moxa

treatments

acupuncture

at

on

Sp6

the

feet

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

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Volume 8, Number 4 | Winter 2013

started and after 8 menstrual cycles a highreplacement therapy for menopausal symptoms andtemperature phase was confirmed. E2 values werealso complained of retractable shoulder pain. The

taken prior to the treatment series (14th day of her

first group (23 women) received acupuncture

cycle, 57.2pg/ml) and again after 19 weeks oftreatments, the second group (24 women) received atreatment (day 17 of her cycle, 278.9pg/ ml). Samples

muscle relaxant. Results were obtained by interview

were taken while the basal body temperature was inand responses were divided into a 4-tier evaluation

its low temperature phase. The subjects also

scheme. The researchers found that the acupuncturereported that her facial skin was less dry and thegroup reported significantly improved symptoms

edema she had experienced on her lower legs wascompared with the muscle relaxant treatment group.

much improved.

b. Case Study Reviews
Miki et al. attempted to differentiate between

2) Prospects for Future Research
menstrual

psychogenic and autonomic complaints among 150

abnormalities tend to also have or develop infertility.

menopausal women with indefinite complaints. They

Because treatment periods for these types ofused a CMI survey and autonomic function testing

patients tend to be protracted and patients may nottofeel the results of the treatments, it has been difficult

Acupuncture was performed at appropriate neck,to attract new patients to participate in these types

shoulder and/ or upper back, with retention method.

of treatments.

Moxibustion was performed at the low abdomen, low

Clinically,

many

women

with

betterclarifythesedifficultcomplaints.

Studies using the basal body temperature as anback and around the sacrum. Five small cones were

evaluation method are very common. Basal bodyburned on each of the chosen points. The researchers

temperature is a simple and effective objective

found that more than 72% of the patients responded

evaluation method to determine whether or not thepositively

woman`s cycle is bi-phasic, but cannot be relied on toautonomic symptoms had improved.

confirm the presence or absence of ovulation.

c. Case Report

to

the

treatments,

reportingtheir

In the future, studies should be carried out within

Sawada et al. performed two case reports. Thea relatively short period of time and it is necessary

first case involves the case of a 48 year-old post-

to carry out verification using objective evaluation

menopausal woman who received acupuncture

methods, such as ultrasound and blood tests intreatments at a pace of twice in a two week intervalcollaboration with medical institutions.

for 6 months. Her Kupperman index decreased, but
her hot flashes and her blood hormone levels
remained unchanged. Following these results shec) Menopause
Research on menopause in Japan, as well as

started hormone replacement therapy. The second

abroad, can be divided into reporting that focuses oncase focused on a 47 year-old woman who complained

one symptom of menopause and reporting thatof urinary incontinence following a left ovariectomy.

evaluates patients with menopausal symptoms as a

It was recommended that she perform pelvic floor

whole using an index table. Most research designs

exercises at home and receive acupuncture two times

include comparative studies of case reports orevery two weeks. Quantitative urinary incontinence

systematic review of a series of specific cases.

tests were used to evaluate her progress and

1) Research Studies on Menopause

suggested that a great degree of improvement had

a. Comparative Researchoccurred.

Yaegashi et al.9) divided their treatment subjects
into two groups. All subjects were on hormone

6

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

Volume 8, Number 4 | Winter 2013

2) Prospects for Future Research

References

Compared to research on menopause from abroad,1) Yang H, Liu CZ, Chen X, et al.: Systematic review

the number of Japanese reports are relatively few.

of clinical trials of acupuncture-related therapies

It cannot be said that many symptoms ofmenopause are necessarily specific because they are
often

the

resultofotherhiddenunderlying

for primary dysmenorrhea. Acta Obstet Gynecol
Scand 87 (11): 1114─1122, 2008
2) Lim

CE,

Wong

WS:

Current

evidenceof

conditions such as conditions arising from poor

acupuncture on polycystic ovarian syndrome.

circulation that might include chilliness, aches andGynecol Endocrinol 26 (6): 473─478, 2010

pains etc. And then there are the usual complaints

3) Stener ─ Victorin E, Jedel E, Janson PO, et al.:of hot flashes and stiff shoulders. It is difficult to

Low ─ frequency electroacupuncture and physicalclassify Menopause as a gynecological disorder.

exercise decrease high muscle sympathetic nerve

Since menopause can reduce the QOL of menopausal

activity in polycystic ovary syndrome. Am J

women over a long period of time, it may be

Physiol Regul Integr Comp Physiol 297 (2):beneficial to maintain on-going follow-up and review

R387─395, 2009of treatments and patient changes.

4) Borud EK, Alraek T, White A, et al.: The
Acupuncture on Hot Flushes Among Menopausal
Women (ACUFLASH) study, a randomized
controlled trial. Menopause 16 (3): 484─493, 20095) Professor Yoshimoto, Reina Taguchi, Kenji Imaiet al.: An Investigation of the Effects of PressTack Needle Acupuncture on Menstrual Pain.
Journal of the National Society of Japanese
Acupuncture 59 (4) 406─415, 2009.
6) Rena Taguchi, Professor Yoshimoto, Hiroshi
Kitakoji: Two Case Studies on the Effects of
Acupuncturefor

Functional

Dysmenorrhea.

Adolescence 24 (2): 400─406, 2006
7) Yoji Shimizu: Acupuncture for infertility--mainly
anovulatory cycles ─. Modern Acupuncture andMoxibustion 9 (1): 71─75, 20098) Yoji Shimizu, Kuniaki Niwa Kuniaki, Kazumi
Nakazawa et al.: Effect of Acupuncture on the
Menstrual Cycle and Sugar Metabolism in Women
with Anovulatory Cycles. The Journal of Japanese
Association of Physical Medicine, Balneology andClimatology 73 (3): 202─211, 20109) Minoru

Yaegashi,FujinoTakashi,

Masashi

Nishitani: Acupuncture and Moxibustion for
Menopausal

Disorders.

ObstetricalandGynecological Treatment 76: 802─807, 1998

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

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Volume 8, Number 4 | Winter 2013

Kampo Medicine - Current Research
Kampo Treatment for Allergic Rhinitis and Hay Fever
Hiromichi Yasui
Japan Institute of TCM Research

general improvement, with 12.0% showing marked
improvement, 32.6% moderate improvement, and39.1% slight improvement, resulting in a usefulnessof 46.2%3).
Furuuchi et al. also conducted a study using

shoseiryuto against year-round allergic rhinitis.

IntroductionMore than 20% of Japan’s entire population are

Rate of efficacy was 45.0%, and reached as high as

said to be affected by allergic rhinitis, with the

77.5% when including “somewhat effective” cases.

numbers further increasing yearly.

When looking at overall improvement by degree ofStandard treatment includes drug therapy using

severity, rate of efficacy was 56% among severe cases

anti-allergenic drugs (oral medicine, nasal drops, eyeand 38.9% among mild cases. It was thus reported

drops, etc.), phylactic remedy (antigen avoidance)that shoseiryuto is highly effective particularly

using

among severe cases4).

gogglesandmasks,

hyposensitization

treatment, and surgical remedy. Most of theseThrough these studies, it has been found thattreatments work well and control the relevant

shoseiryuto is highly effective against roughly 45%

symptoms through the hay fever season withof year-round allergic rhinitis cases, and extremely

continuous use. However, they are ineffective ateffective against another 12%.

times, or produce a strong side effect, and are not

Therefore, it is not an exaggeration to say thatexactly without problems. Kampo drugs, on the

shoseiryuto is the foremost selected drug against

other hand, have the power to fill in voids thatallergic rhinitis and hay fever. A typical case isWestern medical treatment cannot address, andpresented below.

offer many advantages, such as imposing minimumA

47-year-old

woman

suffered

hay

fever

physical damage even with prolonged use. In thesymptoms every spring since ten years ago. In

1970s when allergic rhinitis and hay fever began toaddition to typical symptoms such as sneezing,garner attention, kakkonto and shoseiryuto were
known to be effective. Thereafter, however, thesymptoms have become complex, such that it has
become increasingly difficult to treat the diseases

runny nose and nasal congestion, she also developed
eye irritation. She preferred Kampo, because thedrugs she used previously made her sleepy and
impeded her daily life. She took a shoseiryuto extract

with just a few varieties of Kampo prescriptions.

and soon experienced a mitigation of her symptoms.

Shoseiryuto – Prescription most frequently used for

As the prescription was effective for three to fourwind-cold type allergic rhinitis

Shoseiryuto has been used most frequently
against allergic rhinitis since emergence of thedisease. Many cases have been reported and studies
are being actively pursued.
Accordingtoadouble-blind

randomized

controlled trial conducted by Baba et al. using

shoseiryuto for year-round nasal allergy, the groupthat was prescribed shoseiryuto displayed
significant improvement compared to the placebogroup. They achieved a solid result in terms of
8hours, she took it three times a day. By early May,
her symptoms had disappeared, and she stopped
taking the prescription.
On January 22 of the following year, the patient’s
hay fever symptoms reappeared, so she once again
took shoseiryuto like she did before, this time for twomonths. The patient continues to develop hay fever
every spring, and comes to the hospital every year toreceive a prescription for shoseiryuto. She would
take Olopatadine Hydrochloride on an as-neededbasis when her symptoms were severe, but for many

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

Volume 8, Number 4 | Winter 2013

years until today, her short-term use of shoseiryuto

Symptoms may also vary according to type ofallows her to live each day comfortably without thepollen. Cedar pollen is dispersed into the air in

discomfort of any symptoms.

February and March, hinoki cypress pollen in April,

In this way, shoseiryuto is effective for many
patients, but subsequent studies have begun toreveal that each patient’s condition of allergic
rhinitis is diverse even from the Kampo perspective.
Disease patterns and recent changes in allergic

pollen from orchard grass and other gramineous
plants from May to early summer, and pollen fromhogweed and other asteracea plants in autumn.
Furthermore, the same patient may display different
symptoms for cedar and cypress pollen.
Dr. Imanaka came across patients who showed
symptoms of the wind-cold type of rhinitis but whose

rhinitis
In Chinese medicine, allergic rhinitis is classified

nasal mucosa was red and swollen or whose ocular

into wind-cold type, wind-heat type, and weakness

mucous membrane became red. He judged that a

type.

wind-cold pathogen invaded the body from outside

In the wind-cold type, a wind-cold pathogen

even though the patient had inner heat, and the(pathogen with cold properties) invades the body

patient experienced a mixture of cold and heat. Thus,

from outside. In the wind-heat type, a wind-heat

he added gokoto to shoseiryuto, and observed apathogen (pathogen with properties of heat) invades

dramatic efficacy. He named the prescription

the body from outside. In the weakness type, there is
not enough healthy qi to protect the body against
pathogens from outside.
In Japan, shoseiryuto, kakkontokasenkyushin’iand senkyuchachosan are used for the wind-cold
type of rhinitis. eppikajutsuto and shin’iseihaito areused for the wind-heat type of rhinitis, andhochuekkito and maobushisaishinto are used for the
weakness type of rhinitis.
In recent years, however, the symptoms of allergic
rhinitis have changed somewhat from the Kampo
perspective. This has to do with changes in thelifestyle environment (including foods and drinks) ofmodern people.
Even when clear snivel flows, as in the wind-cold
type of rhinitis, if the patient wants something cold
to drink, has a red tongue, or inner heat, the heatmust also be cooled down at the same time.
This is related to the season, to a certain degree.
In February, the outside environment is cold, so r is

koryuto by taking the “ko” (meaning tiger) fromgokoto and the “ryu” (meaning dragon) fromshoseiryuto.
Dr. Imanaka introduced the following patient towhich koryuto was effective.
A 58-year-old man suffered hay fever every springfor 25 years. He experienced severe symptoms ofrunny nose, nasal congestion and eye irritation, but
as he was a golf coach, he spent a lot of his time
outdoors. He somehow dealt with his symptoms bytaking Fexofenadine Hydrochloride that causes lessdrowsiness than other antihistamines, and also byusing antihistamine eyedrops and steroid nasal
drops, but he would still develop hay fever every year
from February to early May. 2009 was a year of masspollen dispersal, but thanks to the combined use of

shoseiryuto and gokoto from March 11, he was able
to spend the hay fever season comfortably without
taking Fexofenadine Hydrochloride 5).

effective, but when the outside environment becomes

Dr. Imanaka says that in most cases, hewarmer in March and April, some people experience

prescribes shoseiryuto for hay fever around February,stronger inner heat, along with the rise in ambientand adds gokoto around March when inner heattemperature.

occurs. Contrarily, if there is a patient who has the
The Journal of Kampo, Acupuncture and Integrative Medicine (KAIM)

9Volume 8, Number 4 | Winter 2013

wind-cold type of rhinitis but cannot be treatedadequately

withshoseiryuto,

he

adds

maobushisaishinto.

patients who do not benefit from such drugs means
different conditions must be assumed.
Allergic rhinitis mostly occurs in spring andActually, there is a certain characteristic to theautumn, as a result of a wind-cold pathogen or wind-

abovementioned prescriptions.

heat pathogen invading the body. These are called

shoseiryuto, gokoto, kakkontokasenkyushin’i,eppikajutsuto, and maobushisaishinto all contain
Ephedrae Rhizoma. Ephedrine, the major ingredientof Ephedrae Rhizoma, was found to be contained inEphedrae Rhizoma by a Japanese pharmacologist“outer winds.”

named Nagayoshi Nagai.

Drs. Ebe and Haimoto.

On the other hand, “inner winds” are pathogens
that occur inside the body. The mechanism by whichallergic rhinitis is caused by “inner winds” has been
simultaneously discovered and clinically applied by

In subsequent studies by various other people, it

They thought that inner heat is originally

was found that ephedrine has a sympathomimetic

generated by yin deficiency, and when it rises andeffect similar to adrenaline.

becomes an inner wind, excess water around the

For this reason, it can be said that Kampo drugs

chest rises and suddenly produces snivel. Theirsuch as shoseiryuto that contain Ephedrae Rhizomaprescriptions differ, but they share the same concept.

is effective against allergic rhinitis by the action ofephedrine. Needless to say, these drugs are not madeof a single ingredient, but exerts an effect by thesynergy of many other drugs.
Nevertheless, when looking at short-term efficacy,
Kampo drugs that contain Ephedrae Rhizoma begin
to work after about twenty minutes of taking it,
continues to be effective for about three hours, andDr. Ebe’s prescription6)

Menthae Herba 6 / Chrysanthemi Flos 15 /Rehmanniae Radix 15 / Paeoniae Radix 15 /Haematitum 15 / Fossilia Ossis Mastodi &Ostreae Testa 15 each / Gypsum Fibrosum 30 /Fritillariae Bulbus 10 / Kasseki 15 /Glycyrrhizae Radix 6
Dr. Haitani’s prescription7)

thereafter gradually declines in efficacy, in mostRehmanniae

cases. For this reason, it is frequently necessary to

Rhizoma 15 / Paeoniae Radix Rubra 15 /consider the timing of taking the drug. In some cases,

Glehniae Radix cum Rhizoma 10 /Ophiopogonis Radix 10 / Cnidii Rhizoma 10 /Menthae Herba 3 / Glycyrrhizae Radix 5 /Gypsum Fibrosum 20

another dose needs to be taken at night. From thelong-term perspective, there have been cases wheregeneral symptoms had improved unawares.

Radix

7

/

Anemarrhenae* Note: Most antihistamine drugs do not contain ephedrine,

These prescriptions cannot be substituted with

but in recent years, a new product (product name: Dillegra)

extracts, but jiinkokato+senkyuchachosan comes

has appeared, which adds ephedrine to fexofenadineclose. What must be noted here, however, is thathydrochloride (product name: Allegra). When taking this

there are cases where yin deficiency may haveproduct in combination with a Kampo drug, it is necessary tooccurred from taking an antihistamine continuously.

pay attention to the concentration of ephedrine.

In this case, the above prescription should be used

A new type, discovered just recently
The use of ephedra agents such as shoseiryuto iseffective for only up to approximately 45% of patientsand no more. The fact that there are around 30% of

10by reducing the amount of antihistamine as much as
possible.
Within this type of rhinitis, there have beenreports of cases where the patient was dramatically
cured by taking a bakumondoto8).

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

Volume 8, Number 4 | Winter 2013

The

Prevention

efficacy

rateofmaoto+eppikajutsuto

In the case of year-round allergic rhinitis, it isprescribed to severe cases (7 patients) was 72%. In

necessary to make up for the lack of qi, also forthe case where shoseiryuto+gokoto were used inprevention.

hochuekkito

commonly

used

and

with

the

rikkunshito

arecombination to strengthen the anti-inflammatory

additionofaction of Ephedrae Rhizoma and Gypsum Fibrosum

maobushisaishinto.

(16 patients), efficacy rate was 87% and exhibited an

Even if it is seasonal, the above prescription

even better result. Of these patients, there wereshould be prophylactically administered so thenone who needed to use an oral steroid, and only one

symptoms do not appear.

patient who complained of a heavy stomach feeling

Spring hay fever should be treated from autumn

as a side effect.

or winter. hochuekkito should be mainly considered.

Based on the above result, Dr. Imanaka et al. said

Dr. Iwao Yamamoto administered hochuekkito alongthat Western and Kampo drugs could be used inwith tokishakuyakusan as a prophylactic9).

combination as an attempt to increase efficacy.

Other prescriptions for health improvement

It should be noted that even if nasal symptoms areinclude saikokeishito and keigairengyoto. Somealleviated by Kampo treatment, allergy test values

signs for using keigairengyoto are whether the

hardly change, and IgE RAST and IgE RIST values

patient has a sinus problem or heat symptoms that

also show hardly any changes. However, there is noaccompany tonsil inflammation. People who develop

data on the results of long-term administration.

hay fever symptoms from around January should beWith regard to the combined use of Kampo drugs

administered tokishigyakukagoshuyushokyoto fromwith other standard treatment, there have been no

before they develop the symptoms. In some cases, thereports so far that any inconveniences have occurred.

hay fever season ends without their experiencing
References

any symptoms.
Combined use with Western drugs
Kampo medicines are completely a different typeof drug from antihistamines. There is no problem incombining their uses, in most cases. If the patient’s
symptoms are severe and cannot be effectively
mitigated using Kampo alone, using a drug that goes
well with Kampo is recommended. The same applies
for eyedrops and nasal drops.

1) Committee for Preparation of Nasal Allergy
Treatment Guidelines: Nasal Allergy Treatment

Guidelines —Year-round Rhinitis and Hay
Fever— (2016 edition), Life Science, 2015 (inJapanese).
2) Committee for Preparation of Nasal Allergy
Treatment Guidelines: Nasal Allergy Treatment

Guidelines —Year-round Rhinitis and Hay
Fever— (2016 digest edition), 2015 (in Japanese).

There is a study on the combined use of Kampo

3) Baba S, Takasaka T, Inamura N, et al.: “Efficacy ofand Western drugs, by Dr. Imanaka, who developed

shoseiryuto against Year-round Nasal Allergy —shoseeiryuto+gokoto as mentioned above, along with

Double-blindDrs. Mine and Yamazaki10).

Practica Oto-Rhino-Laryngologica 88 (3) 389-405,

According to the study, the efficacy rate ofRandomized

Controlled

Trial—,”

1995 (in Japanese).

shoseiryuto administered as the foremost selected

4) Furuuchi et al.: “Study of the Clinical Efficacy of

drug against allergic rhinitis (20 patients) was 45%.
The efficacy rate of eppikajutsuto (24 patients) was

shoseiryuto against Year-round Allergic Rhinitis,”
Allergy in Practice 7: 502-513, 1987 (in64% and even better.

Japanese).

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

11

Volume 8, Number 4 | Winter 20135) Imanaka M: “Memorable Cases <1> Tsumura
Medical Today,” Radio NIKKEI, Jan. 5, 2011
broadcast (in Japanese).
6) Ebe Y: “Spring Hay Fever Caused by Yin
Deficiency,” Clinical Journal of Traditional

Chinese Medicine Vol. 29, No. 1, 50-55, 2008 (inJapanese).
7) Haimoto H: “Jibiinkoto for Allergic Rhinitis
Cause by Yin Deficiency,” Φυτο, Vol. 8 No. 2, 410, 2006.
8) Otsuka, Keisetsu, Domei Yakazu, and Totaro
Shimizu: Kampo shinryo iten (dictionary of

Kampo medicine, 247-248, Nanzando, 1964 (inJapanese).
9) Bando S: Practice of Kampo Therapy Based on

Disease Names, Medical Yukon, 2002 (inJapanese)10) Imanaka M, Mine H, Yamazaki T: “Clinical
Efficacy of Kampo Combination Therapy against
Cedar Pollen Allergy,” Kampo Medicine, Vol., 60,
No. 6, 611-616, 2009 (in Japanese).

12

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

Volume 8, Number 4 | Winter 2013

Clinical Report 1 (Acupuncture)
A Clinical Report of Anterior Cruciate Ligament Injury
Treating with Acupuncture and Physical Training forCollegiate Women’s Lacrosse Player

an MRI scan and was diagnosed with ACL
damage. In July, she underwent reconstructive
surgery by semitendinosus tendon graft (STG),
and thereafter received training at the same

Akihito Uehara, Akinori Kihira, Yasuhisa Kaneko

hospital to recover her motor function. In

and Eiji Furuya

November, her attending doctor gave her

Kuretake College Oriental Medicine Clinical Laboratory

permission to engage in light exercise. A test of
knee extension force in December showed astrength of 73.2kg in the right leg and 45.8kg in[Introduction]
Women’s lacrosse in Japan is a sport where two
teams of 12 members each compete for points byshooting a ball into the opponent’s goal on a field 110m
long and 60m wide, in two 25-minute halves. A total of
8,698 female lacrosse athletes were registered with theJapan Lacrosse Association in fiscal 2013. The sport
requires a variety of movements, such as running,dashing, cutting, and jumping. Injuries to the leg, andparticularly to the ankles and knees, have beenreported as the most common injuries sustained while
playing lacrosse (1, 2).
Below is a report of a case where a lacrosse
athlete who sustained an injury to her knee anterior
cruciate ligament (ACL) while playing lacrosse
received training (TR) and acupuncture treatment(AT) at Kuretake College Oriental Medicine ClinicalLaboratory (KOMCL) with the cooperation of an
orthopedic surgeon in private practice and a surgeon
at a general hospital, and made a successful return

her left leg. The weight bearing index (WBI) was
1.52 for the right leg and 0.95 for her left leg.
4. Training

andacupuncture

treatment:Thepatient’s first treatment session at KOMCL wason December 16.
(1) Chief complaint at the time of the firsttreatment session: Feeling of apprehension
about returning to the sport(2) Subjective

information:The

patient

experienced no pain from activities of dailyliving, but there was irregular pain when she
engaged in weight training, jogging, andother such light exercises in which she
applied her own weight. She also felt pain on
the front and inner sides of her knee during
light knee extension resistance training. She
was told by her doctor that she should aim to
return to the sport in February 2012.
However, she felt strong apprehension atto the sport.

returning to the sport after only the[Patient’s information]

presently undergoing.

functional

1. Patient: 19-year-old female university student,height 154cm, weight 47kg
2. Treatment status: In May 2011 while playing ina lacrosse match, the patient heard a rupturesound and felt intense pain in her left knee when
she tried to cut in front of the opposing team’s
defense player from the left to right, and fell.
Immediately after the injury, she could not walk,due to the pain and a feeling of weakness.
3. Diagnosis and treatment: The patient first saw
an orthopedic surgeon in private practice, andwas referred to a general hospital, where she had

recoverytraining

shewas(3) Objective information: Acute inflammation(–). Limitation in range of motion of the knee
joint (–). Manual muscle testing (MMT) forleft knee joint extension showed a strength of
4 on the right and 5 on the left. Stress test of
the ligament around the knee (–). McMurray
Test (–). Claudication (–). Left knee flexural
failure and minor pain when walking down
the stairs (+).
(4) Assessment: The patient made good progress
after the surgery, and her obstacles in dailyliving were almost completely eliminated.

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

13

Volume 8, Number 4 | Winter 2013

However, when she did a side step, a[Method]deviation in the center of gravity of her upper(1) TR: Leg motions that were necessary for the

body to the sides of her base of support andsport were categorized into running motions,knee-in were observed, and knee-in was alsoside steps, and cross-over steps and quick turns,

observed when she did a cross-over step.

and resistance TR was implemented with the

These were attributed to the low WBI of hergoal of acquiring stability in the frontal, lateral,left leg, which suggested a lack of absoluteand horizontal directions of each movement andmuscle strength that is demanded by theincreasing muscle strength. With the side steps

sport, and a low ability in performing theand cross-over steps, the patient performed the

movements of the sport due to a long absence

movements in front of a mirror and also

from practice. Thus, these two items wererecorded them on video, so she could correct her

considered to be behind the patient’s feelingmovements by herself. She was instructed toof apprehension of returning to the sport.

engage in repeated TR at home. Table 1 shows(5) Treatment policy: The short-term goal was

the objectives, activities, and assessment of her“to improve the lack of muscle strength andmotor function” that was behind the patient’s(2) AT: Acupuncture was applied mainly to the

feeling of apprehension, and the long-termlower back and leg using acupuncture needles

goal was “to increase performance after
returning to the sport and prevent re-injury.”
Fig. 1 shows an image of the treatment policy.
It was decided that KOMCL would provide
training (TR) for strengthening muscle
strength and posture control, which forms
the basis of athletic rehabilitation (AR), in
addition to acupuncture treatment (AT) for
relieving muscle fatigue generated by the TR.
Thelearning

of

sport

motions

wasapproached through AR performed in the
training field.

Performance

14

TR.

50mm long and 0.18mm in diameter. The major
acupoints that were used were the Shenshu(BL23), Dachangshu (BL25), Huantiao (GB30),
Yinmen (BL37), Chengji (BL56), Futu (ST32),
Liangqiu (ST34), and Xuehai (SP10). The effectof acupuncture was examined by quantifying
the degree of the symptoms using a visual
analog scale (VAS) and comparing them before
and after the treatment. For significancetesting, significance level was set to 5% or lessin a t-test. Fig. 2 shows the flow of training andacupuncture treatment.
(3)
AR: AR was implemented
once to two times a week by
Treatment policy
accompanying
thepatient’s
Improved
performance
Improved
practice. The movements of her
Training
physical strength
Prevention
knee joint when cutting in andof re-injury
changing directions were recorded
Functional recovery
on video, and the patient was
immediately shown the video.
Conditioning
Problems in movement werebroken down into frontal, lateral,and horizontal elements, and TR
Muscle fatigue relief,
Acupuncture
guidance was given to correct the
Pain alleviation
movement. The patient’s conditionTime
was reported to her attending
Fig. 1: Treatment policy

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

Volume 8, Number 4 | Winter 2013

surgeon by uploading the video to YouTube andmaking it accessible only by the surgeon. At thehospital, the surgeon assessed the patient’s
condition and provided guidance at a frequency of
about one to two times a month (once in threemonths after she returned to the sport).

Fig. 3 shows a timeline of the patient’s medical
treatment.

TR,

AT

and

AR

were

each

implemented by respective personnel, with the
AR instructor assigned as the head of the teamand placed in charge of sharing information
with the doctor.

Table 1: Training objectives, activities and assessment

2

Objectivea. Practice of basic running motions andimprovement of muscle strengtha. Same as above3b. Practice of basic lateral travel (side step)
motions and improvement of muscle strengtha. Same as above

1b. Same as above

4c. Practice of basic turnaround (cross-overstep) motionsa – c. The load of each motion is increased, tosimulate motions of the sport that
accompany quick turns* Training (1st to 4th sessions)
Resistance training was performed in
front of a mirror. The patient engaged insimple movements with a certain load,and problems were pointed out so she
could perform repeat exercises at homeand school.
The stability of frontal, lateral andhorizontal movements were evaluatedvisually, and by video recording.
* Acupuncture treatment (4th to 14th
sessions)
Using 0.50mm No. 18 needles,
stimulation was applied to the lower
back and leg to a depth of around 10mm.
To examine the immediate effect ofacupuncture treatment, the patient was
asked the intensity of her chiefcomplaint before and after treatmentusing a Visual Analog Scale (VAS), andthe results was evaluated by a t-test(p<0.05).

Main activity
Squat
3 sets of 5Squat
3 sets of 10
Side step
3 sets of 5Squat
3 sets of 10
Side step
3 sets of 10
Cross-over step
3 sets of 5
Jumping motions thathave been performed
above in each activity
3 sets of 5

Assessment
The lower back flexes noticeably whensquatting.
The lower back flexes somewhat whensquatting.
The upper body center of mass deviates
to the sides of the base of support.
There is hardly any flexing of the lower
back when squatting.
The upper body center of mass is
contained within the base of support.
No clear instability is seen.
The emergence of instability isremarkably small despite the increasein load.

Flow of treatment at KOMCL
Medicalinterview

Assessment andguidance in thepractice field

Measurement oftreatment effectTreatment

Manualexamination

Establishment ofa treatment plan

Informed
consent

Fig. 2: Flow and content of treatment

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

15

Volume 8, Number 4 | Winter 2013

February2012

December 2011

May 2011

KOMCL- Muscle strengthening andmotor learning- Acupuncture treatment- “Performanceenhancement andrecurrence prevention”
was established as thegoal after returning to
the sport.

Practice field

Retired fromsport

- Surgery- Medical rehabilitation- Reporting of regulartreatment sessions andassessments to KOMCL- WBI measured on
February 3, 2012 was 1.49
for the right side, 1.25 forthe left side, so theattending doctor gave thepatient permission to
return to the sport.
- Removal of the bolt in
November 2012

Return tosport

Hospital

October 2012

- Athletic rehabilitation(motion confirmation,
training guidance)- Taping and other suchtreatment- Videotaping of motions
during practice andverification by the doctor
via YouTube- Up-down conditioning
guidance

Fig. 3: Timeline from surgery to retirement from the sport[Result](1) TR: Training was conducted a total of four times
until February 2012. In the fourth TR, an
improvement was confirmed in the patient’s sidestep motion. Similarly, an improvement was also
seen in quick turns in lateral jumping
movements.
(2) AT: The first treatment was applied immediately
after the fourth training session. Thereafter, it
was applied at a frequency of one to two times amonth, to alleviate pain and other complaints,
and to relieve fatigue. The treatment was applied
14 times in all, from the first treatment to
October 2012 when the patient retired fromcollegiate sports. According to the VAS, theaverage level of the patient’s chief complaint was
40.6±21.6mm
beforetreatment
and26.2±15.8mm after treatment, and showed asignificant drop after treatment (p<0.01). Table 2
shows the VAS values before and after eachtreatment in regard to the chief complaint.
(3) AR: AR was conducted seven times until
February 2012. An improvement was confirmedin the knee-in condition when changing
directions. The WBI measured at the hospital in
the same month was 1.49 for the right leg and1.25 for the left, so the attending doctor gave thepatient permission to return to the sport. The
patient experienced no re-injury until she retired
from collegiate sports in October, and was able toplay in all student league matches.
Table 2: Complaints at the time of acupuncture treatment
and VAS values before and after treatment
Numberoftreatment
sessions
1
2
3
4
5
6
7

8
9
10
11
12
13

14

(Unit: mm)
VAS value VAS value(before(aftertreatment)
treatment)

Complaint

Lower back pain
Heaviness in lower backLower back pain
Fatigue in the leg
Pain on inner side of right knee
Whole body fatigue
Conditioning
Conditioning
Pain on the outer side of the rightfootPain on the front of the right hip joint
Lower back pain
Pain on the outer side of the rightfootWhole body fatigue
Leg fatigue
Leg fatigue
Pain on the bottom of the right footPain on the outer side of the rightknee
Pain on the bottom of the right footLeg fatigue
Pain on the outer side of the rightknee
Pain on the front of the right hip joint
Pain on the outer side of the right
thigh
Pain on the bottom of the right foot

15
49
38
28
63
13
0
0
30
20
25

21
25
35
23
45
5
0
0
20
11
14

21

11

64
47
57
61
50

34
15
19
45
40

62
60
55

55
37
41

70
59

49
35

47

23

Average
SD

40.6
21.6

26.2
15.8

Note: “Conditioning” is used when there is no pain or other such physical findings,
and treatment is applied for the purpose of maintaining and enhancing health

16

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

Volume 8, Number 4 | Winter 2013

institution, and generally must strive to return to[Observations]
KOMCL was established within Kuretake College

their sport after engaging only in self conditioning.

in November 2007, with the mandate to engage inToday, the development of social networks and cloudthe clinical practice, research, and education ofstorage systems allows information about theacupuncture. It has provided acupuncture treatment

movements of an athlete in the field to be shared

to members of women’s collegiate lacrosse teams

with concerned parties who are not present on-site.

since its establishment, and has treated a total ofThus, it can be said that taking advantage of

1,547 lacrosse players from April 2008 to Marchtechnology to achieve smooth sharing of information

2014.

with medical institutions was a large factor in

Acupuncture is widely used for conditioning by
sports athletes, but at KOMCL, importance is placed

mitigating the patient’s feeling of apprehension andallowing her to return to the sport.

not only on treatment by acupuncture, but also on

The patient had received acupuncture treatment

engaging athletes to perform active TR. This is

only once in the past, and had a strong resistancebecause it is believed that strengthening physicalagainst AT from the beginning of TR. Therefore, only

strength through TR relatively lowers the exercise

TR was conducted on the first to third treatment

intensity of the sport, and helps prevent injury. On

sessions, and AT was implemented only after she

the other hand, the accumulation of fatigue from

actually felt the effects of the TR and fostered acontinued TR and sport activities is believed tofeeling of trust in the personnel in charge of AT. It

heighten the risk of injury, so relieving fatigue is also

appears that the patient’s realization that receiving

an important issue. With regard to this point,

AT to actively relieve the fatigue from the TR would

previous studies suggest that AT is effective incontribute to realizing her goal, prompted her torelieving muscle fatigue and controlling the delayed

receive AT and undergo regular treatment even after

onset of muscle soreness (3, 4, 5).

completion of her TR program. Many young people

This was a successful case in which various

tend to have a feeling of resistance to AT, but tocombinedstrengthen their willingness to receive AT, it is

toward achieving the patient’s goal after undergoing

important to share patients’ goals and deepen their

ACL reconstructive surgery, with the result that theunderstanding that AT is effective in achieving thosepatient’s lack of muscle strength and motor functions

goals.

treatment

methods

wereeffectively

were improved, performance was enhanced, and reinjury was prevented. The reason why the goal was
ultimately able to be achieved was because thepatient’s information was shared between the
medicalinstitution

andpractice

field

from

immediately after the injury, and the medical
institution, KOMCL, and practice field were eachable to make an input in their respective capacities
based on an accurate understanding of the patient’s
condition. In Japan, many amateur sports lack anadequate medical support system, so most athletes
who undergo surgery for ACL damage have few
opportunities to receive specialized treatment otherthan functional recovery training at a medical[Conclusion]
1. In order for us acupuncturists to help athletes
who have sustained injury to return to theirsport in the amateur sports world, which lacks
an adequate medical support system, it isimportant to share information among medical
institutions, acupuncture clinics, and the sport
field, and take measures to ensure that medical
cooperation can be continued.
2. In order for injured athletes to return to their sport,
acupuncture treatment and other such passive
treatment could be more effective when combinedwith exercise therapy and other active therapy.

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

17

Volume 8, Number 4 | Winter 2013

Reference
1. Dick R Lincoln AE, Agel J,Carter EA, MarshallSW, Hinton RY: Descriptive epidemiology ofcollegiate women’s lacrosse injuries:National
Collegiate

Athletic

Association

InjurySurveillance System, 1988-1989 through 20032004. J Athl Train, 42: 262-269, 2007
2. Sanomura

M,

Hosokawa

Y,

NakamuraC,

Fukubayashi T.: Collegiate women’s lacrosse
injuries:a 2-year prospective surveillance study.

Jpn J Phys Fitness Sports Med, 62 (5): 399-411,
2013
3. Kaneko Y, Furuya E, Sakamoto A: The Effect ofPress Tack Needle Treatment on Muscle Sorenessafter Triathlon Race:Placebo-controlled Study. J

JSAM, 56 (2): 158-165, 2006
4. Furuya E, Kaneko Y, Uehara A, Uehara I,
Soejima K, Sakamoto A: Effect of the Press Tack
Needle on Recovery from Muscle Fatigue by
Randomized Controlled Trial:sham controlled
study. J JSAM, 59 (4): 375-383, 2009
5. Furuya E, Kaneko Y, Uehara A, Sakamoto A:
Effectiveness of acupuncture in the control oflower back pain of sailors at the National Sports
Festival of Japan. J JSAM, 62 (1): 63-69, 201218

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

Volume 8, Number 4 | Winter 2013

Clinical Report 2 (Kampo Medicine)
Autistic Spectrum Disorder, 5-year-old Boy

Hideaki Yamaguchi
Tosei General Hospital[Chief complaint]
Self-injury behavior, insomnia[History of present illness]
The patient was diagnosed with childhood
disintegrative disorder (CDD) at two and a halfyears of age, and went to a preschool in a
specialized facility. He visited a medical
institution around once every six months. He
knew only a few words and one two-word phrase,and exhibited a marked delay in language
development. He appeared nervous and restless,and panicked at subtle changes on a daily basis.
In a state of panic, he would hit his mother, anddisplay self-injury behavior by hitting his own faceand banging his head against the wall, whilecrying. He had trouble falling asleep, and suffereda sleep disorder, such as being able to sleep only
lightly. On his first outpatient visit, he tended toavert his eyes, and restlessly wandered about
crying and looking troubled.
[Diagnosis/Treatment]
Heart fire and liver fire, emotional weakness
yokukansankachinpihange extract
Tsumuragranules 5g twice a day
Tsumura kanbakutaisoto extract granules 2.5g
before sleep(The patient proactively took the aboveprescription mixed in cocoa.)[Progress]
The prescription had an effect from the day it was
taken, such that two weeks later, the patient’s
sleep stabilized, and his panic and self-injury
behavior subsided dramatically.
Two months later, practice and preparation for aschool sports day caused the patient’s panic toincrease, so 5g of kanbakutaisoto wasadministered twice a day to alleviate thesymptoms. According to the patient’s mother, theprescription seemed to have an overall effect ofalleviating the symptoms from a level of 10 to 3,
and QOL in the home improved significantly.
Ten months later, the patient entered primaryschool (special needs class), and has adapted to his
school schedule.
In recent years, emotional and psychologicalconditions are increasing among children.
Development disorders, in particular, aretranscending the bounds of medicine and are
becoming a social issue. Pharmacotherapy is one
means of treatment, but there are extremely few
psychotropic drugs that could be used on children.
Some Kampo drugs have a psychotropic effect, andhave been used mainly on adults. They may not be
strongly effective, but they are considered moresuitable to children than psychotropic drugs, as
they have little side effects. However, emotional
and psychological conditions among children aremodern phenomena, so the application of suchdrugs to children has yet to be established. I havethus referred to Chinese traditional medicine andcategorized Kampo drugs that could be used totreat the mind-state of children as follows.
Categorization of state of mind based on
traditional medicine, and applicable prescriptions
Category 1 (mainly emotional weakness, heart
blood deficiency, lack of courage)
Characterized by a worrying temperament, fear,
lack of confidence, insecurity, sense of pathos,etc.
Negative emotions such as depression,
insecurity and fear mainly persist.
Prescription: kanbakutaisoto, kamikihito,
keishikaryukotsuboreito, etc.
Category 2 (mainly liver depression qi stagnation)

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

19

Volume 8, Number 4 | Winter 2013

Characterized by a sense of melancholy,
insecurity, anxiety, hysteria, etc.
Physical stress is strong, and mood swings tend
to occur readily.
Prescription: shigyakusan, saikokaryukotsuboreito,
saibokuto, etc.
Category 3 (mainly excessive heart fire, flaring ofliver fire, gallbladder stagnation with
disturbance from phlegm)
Characterized by anxiety, short temper,
restlessness, irritation, etc.
Excitatory symptoms mainly persist.
Prescription: yokukansan, yokukansankachinpihange,
daisaikotokyodaio, orengedokuto, etc.
In this case, panic symptoms of autism standout, but strong anxiety related to low feelings ofself-esteem was thought to be behind those
symptoms, so kanbakutaisoto for Category 1 andyokukansankachinpihange for Category 3 wereprescribed simultaneously. As a result, thepatient’s symptoms were alleviated, and QOL of
his family also improved significantly.

20

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

Volume 8, Number 4 | Winter 2013

Report from Association
A cynical hermit’s record of “The Six Prefectural Joint
Congress (Rokken-goudou-kyouiku-kouenkai) of the Japan
Society for Oriental Medicine (On February 24, 2013),
Kansai branch, in Japan”
Kazunari Ozaki*1)2)3)4)5)
1)
2)
3)
4)
5)

Department of Geriatric Medicine, Itami City Hospital,
Itami, Hyogo, Japan
Department of Clinical Gene Therapy, Osaka University
Graduate School of Medicine, Suita, Osaka, Japan
Division of General Medicine and Hypertension, Osaka
University Hospital, Suita, Osaka, Japan
Department of Japanese-Oriental (Kampo) Medicine,
Kobe Century Memorial Hospital, Kobe, Japan
Nishimoto Clinic, Nishinomiya, Hyogo, Japan

Kanto Ko-Shin-Etsu, Tokai, Hokuriku, Kansai,
Chugoku-Shikoku, and Kyushu offices.
The Congress this time started by the opening
remarks of Dr. Shogo Yamamoto, “Chairperson of

Wakayama sectional meeting, Kansai branch office,Japan Society for Oriental Medicine" and then thefollowing presentations had been given according to"Formula comments and differentiation of formula My administration classification with introductionsof a rare case, a complete response case, and so on".
As the themes: Presentation of "On kuoketsuzai
medicine ( 駆 瘀 血 剤 , combinations of agents fordispellingbloodstasis),especiallyon

The Six Prefectural Joint Congress (Rokken-

keishibukuryogan ( 桂 枝 茯 苓 丸 , Cassia Twig andgoudou-kyouiku-kouenkai) of the Japan Society for

Tuckahoe Pill) " by Prof. Takahisa Ushiroyama,

Oriental Medicine, Kansai branch was held in Osaka

Health Science Clinic, Osaka Medical Collage;

University Nakanoshima Center on February 24,

presentation of "On goreisan (五苓散, Poria Powder

2013. In the following, I will make the summary ofwith Five Herbs) as agents for removing dampness"this congress in public.

by Dr. Takashi Mine, Mine clinic; "On saikozai

First, I will show the summary of the Six

medicine ( 柴 胡 剤 , combinations of the agents

Prefectural Joint Congress. The Six Prefecturalcontaining mainly saiko (柴胡, Bupleurum root, orJoint Congress is one of the Science Council of the

Bupleuri, Radix (1)) and ogon (黄芩, Scutellaria root,

Kampo

traditionallyor Scutellariae Baicalensis Radix ( 2 )), which werepracticed in Japan, based on ancient Chinese

used in interior-fever conformations (such as half-

medicine) and is hosted by each prefectural sectionalsurface/half-interior conformations)), especially on

meeting of six prefectures, namely, Osaka, Kyoto,saikokeishito (柴胡桂枝湯, Bupleurum and Cassia

Hyogo, Nara, Wakayama, Shiga prefectures in Kinki

Twig Decoction) by Prof. Kazuo Mitani, Mitani(Kansai) prefectures which belong to the Japanfamily clinic; and "Explanation of crude drugs: On

Society for Oriental Medicine Kansai branch office.

sojutsu ( 蒼 朮 , Atractyloides Rhizoma ( 3 )) andIn addition, the Japan Society for Oriental Medicine

byakujutsu ( 白 朮 , Atractyloides Macrocephalae

is an academic society with the purpose for

Rhizoma (4))" by Prof. Toshiaki Makino, Laboratory

contributing to advancement and popularization ofoforiental medicine, scholarly activities, and culture

Pharmaceutical Sciences, Nagoya City University.

through the presentation of the study on oriental

There were many newsy lectures and also many

medicine (including Kampo medicine, acupuncture

questions and answers. In the following, I will show

and moxibustion, and so on). It is also the one of thethe main points as to the contents of these

subcommittee members of the academic society inpresentations.

medicine(the

medicine

Pharmacognosy,

Graduate

Schoolofthe Japanese Association of Medical Sciences. It has

As for "On kuoketsuzai medicine ( 駆 瘀 血 剤 ,eight branches offices, namely, Hokkaido, Tohoku,

combinations of agents for dispelling blood-stasis),
especially on keishibukuryogan (桂枝茯苓丸, Cassia

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

21

Volume 8, Number 4 | Winter 2013

Twig and Tuckahoe Pill)" by Prof. Ushiroyama,"Shokanron (傷寒論, Discussion of Cold Damage, orquoted "Jin Kui Yao Lue, or Essentials from theShang Han Lun)" published in the Later Han

Golden Cabinet, an original text of keishibukuryogan"(Eastern Han) Dynasty (25AD–220AD). Originally,

which was an indispensable Kampo item among thegoreisan is the medicine for a cold damage, namely,

medicalheacute febrile illnesses, and it is frequently used toemphasized that keishibukuryogan was a therapeutic

acute infective gastroenteritis in particular at theagent for an intra-abdominal mass (choko) that

present day. The characteristics of the treatment

associates with pregnancy, threatened abortion or

targets of goreisan are thirst, difficulty in excretion

threatened premature labor. In other words, it wasof urine, such vomiting so-called as "suigyaku (水逆,shown that the main therapeutic object of thiswatery vomiting)" or vomiting immediately afterprescription was the treatment for the blood stasis. On

eatingthe other hand, Prof. Ushiroyama quoted the

distribution of the water and improves water"Formulary and Mnemonics from 'No Mistake'metabolism when disturbance in water metabolism

Pharmacy (5) (Futsugo-yakushitsu-hokan-kuketsu)"

exists in the body. The diuretics of the contemporary

by Sohaku Asada; and Prof. Ushiroyama showed

medicine forcibly excrete urine even if there isthat the keyword, pregnancy, did not appear in thedehydration; however, goreisan makes it difficult toarticle of keishibukuryogan, showed the explanation

excrete urine when there is dehydration. This actionof the secret oral teachings of Sohaku Asada, andhas been proved by the experiment of Prof. Shinichi

showed that the actual dosing of keishibukuryogan

Tashiro et al. As for the other indications of thewas not only given to women, but also to men. Prof.

goreisan, it is effective for many symptoms caused by

Ushiroyama understands that the reason why

the atmospheric pressure change. For example,

keishibukuryogan is classified in the combinations of

uneven distribution of moisture occurs before it rains

agents for dispelling blood-stasis lies in theand then headache and dizziness occur. Goreisan"Formulary and Mnemonics from 'No Mistake'will produce improvement of them at that time. Also,

Pharmacy". Prof. Ushiroyama presented that we

it is effective when we have dizziness and ringing in

could not only expect the role of keishibukuryogan as

our ears by the atmospheric pressure change in thethe blood stasis-dispelling formulas, but also the

airplane. It is also effective in prevention of the

improvement

climactericmountain sickness. In addition, it is effective whencomplaints including depressive tendency, mild

body fluid volume is excessive. For example, theedema, and so on because it could circulate "qi" orgoreisan can achieve a complete response when avital energy and remove dampness due to thepatient feels dull in the body due to having swelling

containing of keishi ( 桂 枝 , Cassia Twig orby nausea and vomiting in mother during the

Cinnamomi, Ramulus ( 6 )) and bukuryo ( 茯 苓 ,pregnancy or by a hangover. The action mechanism

Tuckahoe, or Poriae (7)).

of goreisan had been unknown for a long time, but intreatments

of

for

many

women

kinds

and

of

then

or

drinking.

Goreisancures

unevenDr. Hisashi Mine emphasized in his lecture, "Onlate years a water channel called as aquaporin has

goreisan (五苓散, Poria Powder with Five Herbs) as

been discovered, and there is a report that goreisan

agents for removing dampness" that among manyshows drug efficacy by acting on the aquaporin.

Kampo extract products, "goreisan" can show the

Therefore, the application of it spreads more.

highest effectivity immediately after its dosing

Goreisan is applied to cerebral edema and to thealthough it is the formula described in theabsorption of chronic subdural haematoma and has

22

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

Volume 8, Number 4 | Winter 2013

produced good results. There is an idea of phlegm-

theory of five circuits and six qi) (ibid. p.77) diseases

rheum (痰飲 , Tan-Yin) in the traditional Chinese

and also the accumulation of pathogen in chest (結胸medicine. This is the disease in which a pathological証 ). This accumulation of pathogen in chest

substanceiscorresponds to pleurisy and asthma bronchial by theaccumulated in the body and then causes aname of diseases of the contemporary medicine. The

pathological reaction. Both of the phlegm and rheum"Discussion of Cold Damage" says that the exhale ofare pathological water; however, phlegm means a

the pathogenic qi of the exterior syndrome issticky liquid with high viscosity while rheum means

considered as the first choice in the greater yangno-sticky liquid like water. It is the latter liquid thatdisease and that after having sweat, a purgative

goreisan is chiefly effective on. Goreisan cannot

formula will be given. It is described that theremove the sticky sputum. Anyway, goreisan is theaccumulation of pathogen in chest will develop, if aprescription that we can use for whatever kinds ofpurgative formula is given before having sweat. As

case, if there is uneven distribution called as rheum

for the symptoms of the accumulation of pathogen incaused by abnormality in water metabolism in thechest, “resistance and distention at epigastric region

body. Therefore, it is necessary for us to improve thewill develop and then pain will develop”.

dysfunction of these viscera and bowels together

Mitani quoted the "Formulary and Mnemonics fromwhen we think about radical treatment. Dr. Mine

'No Mistake' Pharmacy (Futsugo-yakushitsu-hokan-

lectured that we could perform more effective

kuketsu)" by Sohaku Asada and then emphasized thattreatment when treating the symptoms of thesaikokeishito was not a simple "medicine for cold". Also,

disease by goreisan and treating the cause of thehe presented that the "saikokeishitokadaio (柴胡桂枝湯disease by adjusting the functional balances among

加 大 黄 , Bupleurum and Cinnamon Twig Decoction

five viscera and six organs.

plus Rhizoma Rhei)" was more efficient for menstrual

so-calledasphlegm-rheumProf.

As for “On saikozai medicine ( 柴 胡 剤 ,disorders (Traditionally called as chinomichi-sho

combinations of the agents containing mainly saiko(literally meaning blood-way symptom). He also

(柴胡, Bupleurum root) and ogon (黄芩, Scutellariaemphasized that it was upper abdominal muscle

especially on saikokeishito (柴胡桂枝湯,strain ( 心 下 支 結 ) that a type of patients whom

Bupleurum and Cassia Twig Decoction)”, Prof.

"saikokeishito" tended to exert better effect on had

Kazuo

the

such abdominal pattern as. Therefore, we should"Shokanron (Discussion of Cold Damage, or Shang

have understood the clinical condition of the upper

Han Lun)" that “When in cold damage [that has

abdominal muscle strain as to the type of patients

lasted for] six or seven days, [there is] heat effusion,

whom "saikokeishito" tend to work better on.

root)),

Mitanishowedthesentenceinmild aversion to cold, vexing pain of the limb joints,

As for the "Explanation of crude drugs: On sojutsu

mild retching, propping bind below the heart, and(蒼朮, Atractyloides Rhizoma) and byakujutsu (白朮,exterior pattern is still present, Bupleurum andAtractyloides

Cinnamon Twig Decoction governs” (8). Prof. Mitani

Toshiaki Makino explained the difference between

also showed that the "saikokeishito" is indicated forthem in the scientific standpoints during his lecture.

the patients who have the combination diseases ofAt first, he showed that some of the plant species

greater yang (太陽, Tai-Yang (referring to cold qi inwhich belong to the same Atractylodes genus in

the theory of five circuits and six qi) (9) and lesser

Asteraceae family in Japan and the China wereyang (少陽, Shan-Yang (referring to fire qi in thecalled in the similar crude drug names for the

Macrocephalae

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

Rhizoma)",

Prof.

23

Volume 8, Number 4 | Winter 2013

original

crude(Atractyloides

drug

plantsRhizoma)

and

of
the

the

sojutsu

byakujutsu

had "hot, bitter, warm; having those effects of drying
damp

and

strengthening

digestivefunction,(Atractyloides Macrocephalae Rhizoma). He said

removing pathogenic wind-dampness, improvingthat this brought much troubled condition. In othereyesight" in the second version of the Dictionary ofwords,

the

Traditional Chinese Medicine (Zhong Yao Da Zi Dian,

byakujutsu (Atractyloides Macrocephalae Rhizoma)

中薬大辞典)" compiled by the Nanjing University ofis defined as a rhizome of “okera (Atractylodes

Traditional Chinese Medicine. He described thejaponica Koidzumi ex Kitamura ( 和 白 朮 )) orabove-mentioned

oobanaokera (A. macrocephala Koidzumi (or A.

obtained for clinicians in each Chinese Dynasty to

ovata De Candolle)) in Compositae”, while theactually use the sojutsu (Atractyloides Rhizoma) andsojutsu (Atractyloides Rhizoma) is defined as atherhizome of "hosobaokera (A. lancea De Candolle (古Rhizoma), and he then presented the following

立 蒼 朮 ), or A. chinensis Koidzumi ( 津 蒼 朮 ), or

problem.

intheJapanesecrossbred of them"
Chinesepharmacopeia,(10). On the other hand, in the( 中 国 薬 典 ),byakujutsu

effectiveness(Atractyloides

had

been

Macrocephalae

The problem is: The clinicians of those days had

thedifferentiated the effectiveness of drugs between the

Atractyloides Macrocephalae Rhizoma (Bai Zhu, 白sojutsu (Atractyloides Rhizoma) and the byakujutsu

朮(白术)) is defined as a rhizome of "A. macrocephala(Atractyloides Macrocephalae Rhizoma), and what

Koidzumi", while the Atractyloides Rhizoma (Cangkinds of the rhizome of any Atractylodes genus plantZhu, 蒼朮(苍术)) is defined as a rhizome of "A. lancea

species were used? The effectiveness of drugs in theor A. chinensis". Therefore, A. japonica has not been

above-mentioned second version of the Dictionary ofused in China. Also, Prof. Makino showed that theTraditional Chinese Medicine has been being

rhizome of A. japonica which is called as Chinese

determined from the past China to current China.

white atractylodes rhizome (唐白朮) in Japan has the

Therefore, he pointed out that there was possibility

distribution name of "Guan Cang Zhu (关苍术(関蒼that the effectiveness of "Japanese byakujutsu朮))" in China and thus it was regarded as one type

(Atractyloides Macrocephalae Rhizoma) may haveof the sojutsu (Atractyloides Rhizoma). As for the

been unknown", because the Atractylodes genus

effectiveness of drugs in the traditional medicine,

plant species which was equivalent to JapaneseProf. Makino then cited that the byakujutsu

byakujutsu (Atractyloides Macrocephalae Rhizoma)(Atractyloides

wasseemed to have no evidence to be used as theclassified into the herbs that tonify the spleen-qi,

Atractyloides Macrocephalae Rhizoma (Bai Zhu, 白while the sojutsu (Atractyloides Rhizoma) was朮 ( 白 术 )) in China". In the meanwhile, he alsoclassified into the (aromatic) herbs that transform

pointed out that there was no guarantee for thedampness in the traditional Chinese medicine. And

clinicians of those days to use the crude drug which

he also showed that the byakujutsu (Atractyloides

was identified correctly and that the different

Macrocephalae Rhizoma) had "bitter, sweet, warm;

effectivenesshaving those effects of strengthening digestive

understood as to whether it was fact or not. In thisfunction and replenishing qi, drying damp andregards, however, Todo Yoshimasu's “Yakucho (Oninducing diuresis, stopping sweating, and anti-

the efficacy of medicines, Yao Zheng, 薬徴)” written

abortion", while the sojutsu (Atractyloides Rhizoma)

in the 18th century in Japan described Atractylodes

24

Pharmacopoeia

drug

Macrocephalae

Rhizoma)between

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

them

could

not

been

Volume 8, Number 4 | Winter 2013( 朮 , Jutsu, Zhu) as having "removing action of

As stated above, there were many active

dampness first and then pain relief action secondly"

questions and answers from researchers, clinicians,

and as "removing action of the sojutsu (Atractyloides

physicians, pharmacists, and so on who participatedbyakujutsu

in the congress for the four lecturers. It was only held

(Atractyloides Macrocephalae Rhizoma)", if thefor one day, but it was considered that there werename of Atractylodes (Jutsu) was used when the

many projects and also it seemed that both the

Rhizoma)exceeded

that

of

the

difference

betweenthesojutsu(Atractyloides

beginners and learners and experts could be

Rhizoma)andbyakujutsu(Atractyloides

satisfied with the congress. Please refer to the

Macrocephalae Rhizoma) were not classified. This

homepage(11) of the Six Prefectural Joint Congress ofaccords with the written order of the effectiveness of

the Japan Society for Oriental Medicine for thethe drug, drying damp, in "the second version of thedetails.

theDictionary of Traditional Chinese Medicine" andIn the next year, this congress is going to be heldwith the fact that sojutsu (Atractyloides Rhizoma) isin the Medical Science Information Center, Osakaclassified into the (aromatic) herbs that transform

City University School of Medicine on Sunday,

dampness group in the major category of the Chinese

February 16, 2014 ( 12 ). It is expected that those

medicine.

thepresentations having richer contents and more

identification methods of an original crude drug

active questions and answers are expected thanplant might be not too much different between Japan

those in the congress this time.

and China.

References

Therefore,hesuggestedthat

According to the Preparation Guide, California

ration.pdf (California Acupuncture Board 444 N 3rd

Acupuncture Licensing Examination, February 2011: p.25.

Street, Suite 260 Sacramento, CA 95811) [the last

http://www.acupuncture.ca.gov/students/exam_prepa

date of access Nov30, 2013]

ration.pdf (California Acupuncture Board 444 N 3rd

5

Street, Suite 260 Sacramento, CA 95811) [the last

Medicine: Formulas & Strategies (2nd Edition).

date of access Nov30, 2013]

Seattle, Eastland Press, 2009. P.946.

1

2

According to the Preparation Guide, California

6

Translated by Bensky, D., et al. : Chinese Herbal

According to the Preparation Guide, California

Acupuncture Licensing Examination, February 2011: p.27.

Acupuncture Licensing Examination, February 2011: p.26.

http://www.acupuncture.ca.gov/students/exam_prepa

http://www.acupuncture.ca.gov/students/exam_prepa

ration.pdf (California Acupuncture Board 444 N 3rd

ration.pdf (California Acupuncture Board 444 N 3rd

Street, Suite 260 Sacramento, CA 95811) [the lastStreet, Suite 260 Sacramento, CA 95811) [the lastdate of access Nov30, 2013]

date of access Nov30, 2013]3

According to the Preparation Guide, California

7

According to the Preparation Guide, California

Acupuncture Licensing Examination, February 2011: p.25.

Acupuncture Licensing Examination, February 2011: p.26.

http://www.acupuncture.ca.gov/students/exam_prepa

http://www.acupuncture.ca.gov/students/exam_prepa

ration.pdf (California Acupuncture Board 444 N 3rd

ration.pdf (California Acupuncture Board 444 N 3rd

Street, Suite 260 Sacramento, CA 95811) [the lastStreet, Suite 260 Sacramento, CA 95811) [the lastdate of access Nov30, 2013]

date of access Nov30, 2013]4

According to the Preparation Guide, California

Acupuncture Licensing Examination, February 2011: p.24.

8

http://www.acupuncture.ca.gov/students/exam_prepa

Mitchell, Feng Ye, and Nigel Wiseman. Shang Han Lun:

Zhong-Jing Zhang. Edited and translated by Craig

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

25

Volume 8, Number 4 | Winter 2013

Chinese Medicine – Clinical Pharmacognosy). Ishiyaku
On Cold Damage, Translation and Commentaries.
Paradigm Publications, Brookline, MA, USA. 1999. p429.
9

WHO Library Cataloguing in Publication Data. WHO

Pub,Inc (医歯薬出版), Tokyo, Japan. 2009. pp303-305.
11

Homepage of the Six Prefectural Joint Congress of

the

Japan

Societyfor

Oriental

Medicine.

International Standard Terminologies on Traditional

http://homepage3.nifty.com/kansaikanpou/H24%20Ro

Medicine in the Western Pacific Region. 2007: p.77.

kken3.pdf [the last date of access Nov30, 2013]

http://www.wpro.who.int/publications/docs/WHOIST_26
JUNE_FINAL.pdf) [the last date of access Nov30, 2013]

12ofHomepage of the Three Prefectural Joint Congress
the

Japan

Societyfor

Oriental

Medicine.

Edited by Toshiaki Makino ( 牧 野 利 明 ). Kampo-

http://homepage3.nifty.com/kansaikanpou/25%20san

Chuigaku Koza-Rinshoshoyakugakuhen (漢方・中医学

kengoudou.pdf [the last date of access Nov30, 2013]10

講座 臨床生薬学編, Invitation to Clinical Traditional

26

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

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Our mission is simply to help our clients grow their globalizing businessand gain profits by providing high quality translation deliverables andadded values with our unconventional and creative ideas. Our highly
competent and experienced staff and our qualified freelance translators
together provide the best solution to satisfy our clients’ expectation in areaof Information Technology, Financial market, Medical & Pharmaceuticalmarket, Automobile, Legal, Patents, etc.
Our language pairs cover more than 50 languages for our clients.

Consultation Services
We offer the focused consulting services that meet the need of each clientcompany for their business development in the borderless markets.
Our clients vary in size and field, and are offered with various consultation
proposals. We search the issues and the opportunities that confront ourclients, and provide the best support in developing business systems thatgenerate the profit to our clients. We further extend our consulting
services in various markets as we started in Asian countries.

Global Tech Communications, Inc.
Nakano SUNPLAZA 9F
4-1-1 Nakano, Nakano-ku, Tokyo 164-8512, JAPANTEL: +813-5942-3038 FAX: +813-5942-3601
URL: www.globaltech.jp

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