Clinical Practice Guidelines and Evidence for the Efficacy of Traditional Japanese Herbal Medicine (Kampo) in Treating Geriatric Patients

Abstract

Frailty is defined as a state of increased vulnerability to poor resolution of homeostasis following stress, which increases the risk of adverse outcomes such as falls, delirium, and disability in the elderly. Recently in Japan, clinical practice guidelines (CPG) have recommended kampo treatment. We conducted a search for reports on Japanese CPG and kampo medicine in the treatment of symptoms in the elderly. The search was performed using the databases PubMed, Ichushi Web, J-Stage, Japan Medical Publishers Association, Medical Information Network Distribution Service, and CPG containing kampo products in Japan; reports from January 1st, 2012 to October 31st, 2017 were reviewed. Over the past 5 years, nine CPGs have recommended kampo treatment based on the evidence for improvement in skin symptoms, cough, gastro-intestinal dysfunction, urinary dysfunction, and dementia. Treatments with kampo medicine are performed depending on the coexistence of manifestations based on the original kampo concept, i.e., cognitive dysfunction and dementia with sarcopenia showing urinary disorder. Each kampo formula includes multiple crude drugs that have several pharmacological functions; these drugs include alkaloids, glycosides, and polysaccharides. Thus, kampo formula has an effect on multiple organs and coordinates the relationship between the brain, endocrine system, immune system, and skeletal muscles. Kampo treatment can be considered as supporting holistic medicine in elderly individuals with frailty.

Paeonol, an Ingredient of Kamishoyosan, Reduces Intracellular Lipid Accumulation by Inhibiting Glucocorticoid Receptor Activity in 3T3-L1 Cells

“…Traditional Japanese herbal medicine (Kampo medicine) was originally based on traditional Chinese medicine but was adapted to Japanese culture [16,17]. Kamishoyosan (KSS, Chinese name: Jiaweixiaoyaosan, Korean name: Gamisoyosan) is a complex drug composed of 10 herbs.…”

Characteristics and course of patients treated with Kampo Medicine in the Department of General Medicine

“…A recent investigation reported that 92.7% Japanese family physicians have started to prescribe Kampo medicine (KM) . Considering the growing evidence on KM, several clinical practice guidelines (CPG) have listed KM as a treatment modality to address many conditions, disorders, and diseases, such as dementia, behavioral and psychological symptoms of dementia, prevention of aspiration pneumonia, gut disorders, and menstrual symptoms. Furthermore, several articles have reported the economic advantages of administering a Kampo prescription, including reduced hospitalizations and medical costs .…”

Therapeutic Benefit in Allergic Dermatitis Derived from the Inhibitory Effect of Byakkokaninjinto on the Migration of Plasmacytoid Dendritic Cells

“…Kampo formulas have been used according to individual situations. Many Kampo formulas target the immune system, and their therapeutic effects on immunological diseases have been demonstrated in clinical studies [ 11 , 12 ]. However, the precise mechanisms of Kampo formulas are not well understood.…”