Shosaiko-to and other Kampo (Japanese herbal) medicines: a review of their immunomodulatory activities

The use of alternative medicine, including consumption of herbal products and dietary supplements, has been increasing substantially both in the United States and in Western Europe. One area that is garnering increased attention is the use of Oriental Medicine including Kampo, or Japanese herbal medicine. Herein, we review representative examples of research available on the most common use of Kampo medicinals, namely to improve the immune response. We also provide an extensive background on the history of Kampo. There are more than 210 different Kampo formulae used in Japan and most uses of Kampo are to modulate the immune response, i.e. to improve immunity. We have extracted data on seven common Kampo medicinals, and the data are reviewed with respect to in vitro and in vivo activities for both humans and experimental animals; the ingredients as well as the problems with classification of these materials are presented. Research suggests that Kampo herbals are biologically active and may have therapeutic potential. While it is believed that Kampo medicines have few side effects, there is a paucity of data on their toxicity as well as a relative lack of knowledge of the bioactive constituents and potential drug interactions of these agents.     

Challenge tests and kampo medicines: case report and review of the literature

In order to diagnose Kampo medicine-induced liver injury, a challenge test using the suspected medicine is the most reliable method of assessing the relationship between Kampo medication and liver injury. However, such a challenge test may cause severe liver injury. We examined the clinical features and safety of challenge tests conducted by a physician in a case of Kampo medicine-induced liver injury that we encountered as well as in the previous literature (six cases) in Japan. In all cases except two, one-third of the daily dose was given a few times for the challenge test (challenge dose was not described in two cases). The reaction induced by the challenge peaked 1-3 days after challenge. Mild eosinophilia (6%) was observed in two cases. All liver injuries induced by challenge cleared within 2 weeks, and neither severe nor fatal liver injury was observed. In conclusion, a challenge with a small dose of Kampo medicine conducted in our case and in the previous literature induced mild and reversible liver injury. The safety and availability of challenge with a small dose of Kampo medicine should be further examined in a larger population with Kampo medicine-induced liver injury.     

Mechanisms of action of Sri Lankan herbal medicines used in the treatment of diabetes: A review

Natural plant-based remedies for diabetes mellitus have been proven to be safe and effective alternatives to Western medications, and details about more than 400 plants are available in the literature. Sri Lanka is a tropical country which is blessed with many natural plant products that can be utilized for the treatment of diabetes. But the knowledge of these plant-derived remedies, especially their doses, mechanism of action and toxicity has not been extensively researched. Therefore, this review focuses on documenting the plant-based remedies that the Sri Lankan Aurvedic physicians use and the extent of research that has been carried out on each of these plant-based remedies.     

Oral herbal medicines marketed in Brazil for the treatment of osteoarthritis: A systematic review and meta‐analysis

Herbal medications are commonly used to manage symptoms associated with osteoarthritis (OA). This systematic review evaluated the effectiveness and safety of oral medications used in Brazil for the treatment of OA. Randomized clinical trials involving adults with OA treated by a herbal medicine or a control group were eligible. The primary outcomes measured were pain, physical function, swelling, stiffness and quality of life; and the secondary outcomes were adverse events, activity limitations and treatment satisfaction. Sixteen studies were included (n = 1,741 patients) in the systematic review and nine studies in the meta‐analysis, representing 6 of the 13 herbal medicines studied: Boswellia serrata (n = 2), Curcuma longa (n = 3), Harpagophytum procumbens (n = 1), Salix daphnoides (n = 3), Uncaria guianensis (n = 2) and Zingiber officinale (n = 5). B. serrata was more effective than both placebo and valdecoxib for improvement of pain and physical function. No difference was observed for H. procumbens, C. longa and U. guianensis compared with control. Z. officinale showed improvement of pain over placebo. The evidence was insufficient to support the effective and safe use of these herbal medicines, because the quality of evidence of studies was low. This study guides managers of the Brazilian public health system and prescribers in decision‐making regarding the use of these herbal medicines for OA. Copyright © 2017 John Wiley & Sons, Ltd.     

Misuse of randomization: a review of Chinese randomized trials of herbal medicines for chronic hepatitis B

The quality of randomization of Chinese randomized trials on herbal medicines for hepatitis B was assessed. Search strategy and inclusion criteria were based on the published protocol. One hundred and seventy-six randomized clinical trials (RCTs) involving 20,452 patients with chronic hepatitis B virus (HBV) infection were identified that tested Chinese medicinal herbs. They were published in 49 Chinese journals. Only 10% (18/176) of the studies reported the method by which they randomized patients. Only two reported allocation concealment and were considered as adequate. Twenty percent (30/150) of the studies were imbalanced at the 0.05 level of probability for the two treatments and 13.3% (20/150) imbalanced at the 0.01 level in the randomization. It is suggested that there may exist misunderstanding of the concept and the misuse of randomization based on the review.     

羊膜在眼科的应用

作者综述了羊膜的解剖和生理特点以及制备、保存和在眼科的应用及其局限性等，为羊膜更广泛地应用于眼科临床提供了参考。     

Traditional herbal medicine as adjunctive therapy for colorectal cancer:a scoping review

Background:A variety of therapy options are available for colorectal cancer,ranging from traditional medicine to complementary and alternative medicine.There is a growing body of evidence supporting the efficacy of complementary and alternative medicine.Therefore,the main aim of this study is to conduct a scoping evaluation of traditional and herbal medicine’s effectiveness as an additional therapy for colorectal cancer patients in clinical settings.Methods:A systematic search was conducted for all articles pertaining to clinical trials related to traditional herbal medicine(THM)with or without other treatments,such as chemotherapy,placebos,or other types of treatment,published from 2010 to November 13,2020,using four search engines,namely Medline,Web of Science,Cochrane Library,and Scopus.Results:The number of colorectal cancer patients in five trials ranged from 89 to 565 people.The THMs stated in these studies were catalpol(Rehmannia glutinosa extract),the traditional Japanese medicine Daikenchuto(mixture of herbal extracts)and Goshajinkigan,Chinese patent herbal medicine Aidi injection,and the traditional Chinese medicine Simo decoction.Positive results were reported in term of reduction of colorectal cancer tumour marker(by catalpol),improvement of gastrointestinal function following gastrointestinal surgery(by Daikenchuto and Simo decoction),better disease control rate and quality of life score(by combination of Aidi injection and chemotherapy),and a decrease in the incidence of oxaliplatin-induced peripheral neurotoxicity(Goshajinkigan).Conclusion:All studies demonstrated fewer adverse effects found in THM intervention groups,however,evidence pointing to THMs’favourable effects on colorectal cancer patients is still required.Therefore,researchers and clinicians are encouraged to perform more research in this area so that more evidence of THM’s efficacy and safety in clinical settings can be obtained.     

The efficacy of herbal medicine (kampo) in reducing the adverse effects of IFN-beta in chronic hepatitis C

The purpose of this study was to determine if the adverse effects of interferon (IFN) in hepatitis C patients could be reduced by treatment with Japanese Oriental (Kampo) medicine. Twelve patients with chronic hepatitis C were treated with a combination of IFN-beta and either Mao-to or Dai-seiryu-to (groups A and B), and 16 patients were treated with IFN-beta alone (group C). Mao-to was administered to eight patients and Dai-seiryu-to was administered to four in groups A and B, respectively. Adverse effects were evaluated by clinical and laboratory examinations. The severity of symptoms was daily self-classified into four categories (1: none, 2: very slight, 3: moderate, and 4: serious), using a questionnaire consisting of 29 items. Scores of symptom such as discomfort and fever in group A, and discomfort, general malaise, paresthesia and arthralgia in group B were significantly lower than those in group C (p < 0.05). In all patients, HCV-RNA was negative at the end of the treatment, and serum alanine aminotransferase (ALT) levels had normalized transiently in all group A and B patients with genotype 1b by 2 weeks after cessation of IFN treatment. This study indicates that Kampo medicines are useful for reducing the adverse effects accompanying IFN treatment in patients with chronic hepatitis C without reducing the antiviral effects.     

Traditional medicines of plant origin used for the treatment of inflammatory disorders in Pakistan:A review

OBJECTIVE:To pool data on ethnobotanical medicine for the treatment of inflammatory disorders in Pakistan.METHODS:We reviewed 237 research publications based on data from the six provinces in Pakistan(Punjab = 85,Khyber Pakhtunkhwa = 65,Sindh =15,Balochistan = 8,Gilgit Baltistan = 22,Azad Jammu and Kashmir = 42) published until June 2015 in various journals.This was achieved using seven online databases:Science Direct,Google,Google Scholar,Pub Med,Wiley Online Library,SpringerLink,and MEDLINE.Data were analyzed from different perspectives.RESULTS:People from Pakistan made use of 371 plant species belonging to 263 genera and 99 families for the treatment of inflammatory disorders.Plants from the Asteraceae family were used most often.Herbs were the dominant growth form.Leaves were the plant parts used most often.Decoctions were the main preparation method.Nine plant species were used most frequently in thedwellers of most regions of Pakistan.A total of 111 plants were shown experimentally to have neither anti-arthritic nor anti-inflammatory activities,and148 plant species were threatened.Eighty-four species had commercial importance.Twelve plant species were imported,and 25 plant species were exported,from Pakistan.CONCLUSION:This review provides baseline data for plant species in Pakistan that have potential anti-inflammatory/anti-arthritic activities.     

Building a bridge between ecology and Chinese herbal medicines

正The modernization of traditional Chinese medicine(TCM) industry not only needs inheritance and development of the theory of TCM, but also requires application modern science and technology of related fields(Liu, 2016). Plant distribution is closely related to regional climate, because climate determines the type and quantity of vegetation. Taking advantage of the geographic and     

Active ingredients of traditional Japanese (kampo) medicine,inchinkoto, in murine concanavalin A-induced hepatitis

Aim of the study

The traditional Japanese (kampo) medicine inchinkoto (ICKT) is used in Eastern Asia as a choleretic and hepatoprotective agent. Previously, we reported that ICKT ameliorates murine concanavalin A (con A)-induced hepatitis via suppression of interferon (IFN)-γ and interleukin (IL)-12 production. In the present study, we investigated the active ingredients of ICKT.

Materials and methods

ICKT and extracts of its component herbs were fractionated, and their effects on liver injury and cytokine production in vivo (biochemical markers of liver injury and cytokine levels in serum) and in vitro (cytokine and nitrite production in the cultures of splenocytes and peritoneal macrophages).

Results

Decoctions of component herbs, Artemisiae Capillari Spica (Artemisia capillaris Thunberg: ‘Inchinko’ in Japanese), Gardeniae Fructus (Gardenia jasminoides Ellis: ‘Sanshishi’) and Rhei Rhizoma (Rheum palmatum Linné: ‘Daio’) were administered orally. Inchinko and Sanshishi decreased serum transaminases and IFN-γ concentrations. Examination of fractions of component herbs suggested that capillarisin, a component of Inchinko, has potent hepatoprotective activity in vivo. In in vitro studies, capillarisin and genipin, an intestinal metabolite of geniposide that is contained in Sanshishi, were examined. IFN-γ production was significantly suppressed by capillarisin and genipin in con A-stimulated splenocyte culture. Genipin also suppressed IL-1β, IL-6, and IL-12p70 synthesis. Capillarisin and genipin decreased nitrite release from IFN-γ-stimulated macrophages.

Conclusions

These results suggested that both Inchinko and Sanshishi may contribute to the protective effects of ICKT against con A hepatitis. Capillarisin was found to be potently hepatoprotective, and genipin may also contribute, especially via modulation of cytokine production.     

Pregnancy and herbal medicines: An unnecessary risk for women's health—A narrative review

The indiscriminate use of herbal medicines to prevent or to heal diseases or even the use for questionable purposes such as weight loss has received both interest and scrutiny from the scientific community and general public alike. An increasing number of women put their own and the unborn child's health at risk due to a lack of knowledge about the phytochemical properties and adequate use of herbal medicine (phytomedicines or herbal supplements) and lack of communication with their healthcare provider. The purpose of this narrative review was to summarize the use of herbal medicines during pregnancy and their potential toxic effects to highlight the importance of caution when prescribing herbal medicines or supplements for women, because, in addition to suffering interactions and a great amount of information obtained in preclinical predictive studies, assessment of nephrotoxicity, neurotoxicity, hepatotoxicity, genotoxicity, and teratogenicity of traditional medicinal herbs still remains scarce in the clinical setting.     

Efficacy of the kampo medicine xiong-gui-tiao-xue-yin (kyuki-chouketsu-in), a traditional herbal medicine, in the treatment of maternity blues syndrome in the postpartum period

This study was to evaluate the clinical efficacy of Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in), a Japanese traditional herbal medicine, in stabilizing postpartum psychological state. We enrolled 268 women who had a normal delivery in Osaka Medical College Hospital or its affiliated clinics and randomly assigned them to the following two groups: a group of 134 women who received Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) at a dose of 6.0 g/day and another group of 134 women without Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) (control group). We observed 2.06-fold and 1.67-fold higher incidences of depressive mood and nervousness, respectively, after delivery in the control group than in the Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) group. Within 3 weeks of postpartum, there was a significant difference in the incidences of maternity blues between the Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) group (15.7%; 21/134) and the control group (32.1%; 43/134) (p = 0.0195). No adverse effects were observed in this study. The results of this study demonstrate the beneficial clinical effects of Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) in stabilizing psychological state in the postpartum period. Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in) can be expected to improve the mental health of women in the postpartum period and prevent maternity blues.     

论日本汉方医学的衰退及复兴

中国医学是从公元5世纪通过朝鲜半岛传人日本.自此以后,经历了很多年代,日本人通过孜孜不倦地努力形成了适合自己的医学.17世纪,为了区分从荷兰传来的"兰方"医学,就将当时已成为主流的医学称为"汉方".虽然1874年公布医事制度以后,一段时期日本汉方从医学、医疗的正面舞台消失了,但后来经过诸多前人的努力,日本汉方医学再一次在现代医学中体现出它的必要性,人们追求并希望形成一个西洋医学和日本汉方医学相融合的新综合医疗体系.     

In vitro anti-Helicobacter pylori action of 30 Chinese herbal medicines used to treat ulcer diseases

Infection by Helicobacter pylori has been ascertained to be an important etiologic impetus leading usually to chronic active gastritis and gastric ulcer with growing incidences worldwide. Utilizing as the test pathogen a standard and five clinic strains of Helicobacter pylori, the antibacterial action was assessed in vitro with ethanol extracts of 30 Chinese herbal medicines which have been frequently prescribed since ancient times for treating gastritis-like disorders. Among the 30 tested materials, the ethanol extracts of Abrus cantoniensis (Fabaceae), Saussurea lappa (Asteraceae) and Eugenia caryophyllata (Myrtaceae) were strongly inhibitory to all test strains (MICs: approximately 40 microg/ml), and Hippophae rhamnoides (Elaeagnaceae), Fritillaria thunbergii (Liliaceae), Magnolia officinalis and Schisandra chinensis (Magnoliaceae), Corydalis yanhusuo (Papaveraceae), Citrus reticulata (Rutaceae), Bupleurum chinense and Ligusticum chuanxiong (Apiaceae) substantially active with MICs close to 60.0 microg/ml. As to antibacterial actions of the aqueous extracts of the same drugs, those derived from Cassia obtusifolia (Fabaceae), Fritillaria thunbergii and Eugenia caryophyllata were remarkably inhibitory against all the six Helicobacter pylori strains (MICs: approximately 60 microg/ml). The work compared almost quantitatively the magnitude of the anti-Helicobacter pylori actions of the 30 most prescribed gastritis-treating Chinese herbal drugs, and located as well some source plants where potent anti-Helicobacter pylori phytochemicals could be characterized.     

Folk herbal medicines used in birth control and sexual diseases by tribals of southern Rajasthan, India

An ethnobotanical survey of tribal area of southern Rajasthan was carried out during the year 2001-2002 for ethnosexicological herbal medicines. The information on ethnosexicological herbs is based on the exhaustive interview with local medicine-men and -women, birth attendants and other knowledgeable persons who prescribe their own herbal preparation to check birth control, including abortion at initial stages, preventing conception or by making either member of the couple sterile and to cure various sexual diseases like leucorrhoea, gonorrhoea, menorrhagia, to regularize menses and syphilis in both the sexes. During ethnobotanical survey, 53 plants belonging to 33 families have been reported from the study area, which are used to cure sexual diseases, and for family planning. A list of plant species along with their local name, habit, flowering and fruiting period, plant part/s used and the mode of administration to cure the sexual diseases are given.