Effects of Goshajinkigan on Corneal Sensitivity, Superficial Punctate Keratopathy and Tear Secretion in Patients with Insulin-dependent Diabetes Mellitus

Abstract

Goshajinkigan (niu-che-shen-qi-wan in Chinese), a traditional herbal medicine, has been used in Japan to treat clinical symptoms of diabetic neuropathy. A double-masked study was performed to evaluate its effects on corneal sensitivity, superficial punctate keratopathy and tear production in patients with insulin-dependent diabetes mellitus. Fifty diabetic patients were randomized into two groups: Group A, in which 25 patients received goshajinkigan orally, 7.5 g/day for 3 months; Group B, in which 25 patients were orally administered placebo, 6.0 g/day for 3 months; and in Group C, 25 non-diabetic subjects were orally administered goshajinkigan, 7.5 g/day for 3 months. Corneal sensitivity was measured with an aesthesiometer. The area of superficial punctate keratopathy was expressed as a fluorescein staining score. Reflex tearing was determined with a Schirmer test without anesthesia goshajinkigan was analyzed by high-performance liquid chromatography. Corneal thresholds after treatment with goshajinkigan (2.03 g/mm2) in Group A were significantly lower than those before treatment (2.47 g/mm2). Those in Groups B and C did not change after treatment. Fluorescein staining scores after administration of Goshajinkigan (0.64) in Group A were significantly lower than those before treatment (1.32). Those in Groups B and C did not change after treatment. Schirmer test results after goshajinkigan administration (11.0 mm/5 min) in Group A were significantly higher than those before treatment (9.3 mm/5 min). Those in Groups B and C did not change after treatment. Hemoglobin A1c levels in Groups A, B,and C did not change after treatment. Several components in goshajinkigan were found on high performance liquid chromatography. In conclusion, goshajinkigan improved ocular surface disorders in patients with insulin-dependent diabetes mellitus.

Goshajinkigan oxaliplatin neurotoxicity evaluation (GONE): a phase 2, multicenter, randomized, double-blind, placebo-controlled trial of goshajinkigan to prevent oxaliplatin-induced neuropathy

“…In Japan, TJ-107 (goshajinkigan), a traditional Japanese medicine (Kampo) [ 12 ], has been frequently prescribed to alleviate symptoms of diabetic peripheral neuropathy such as numbness, cold sensation, and paresthesias/dysesthesias [ 13 – 15 ]. We hypothesized that TJ-107 might be effective against OPN and retrospectively investigated its use in a pilot study of 90 patients with advanced colorectal cancer undergoing FOLFOX therapy [ 16 ].…”

Long‐Term Effects of Goshajinkigan in Prevention of Diabetic Complications: A Randomized Open‐Labeled Clinical Trial

“…In an animal model of diabetes, goshajinkigan showed inhibition of weight gain, inhibitory effects on blood glucose, suppression of microalbuminuria [11], preventative effects on hypertriglyceridemia [12], inhibition of platelet aggregation [13], and elevation of the pain threshold [14, 15], all of which appeared to be effective in preventing further complications from diabetes. To date, however, no report has been published on the preventive effects of goshajinkigan for diabetic complications, with the exception of neuropathy and corneal disorders [16]. As such, a large study is needed for investigating whether kampo is effective in preventing the progression of diabetic complications.…”

The Kampo Medicine Goshajinkigan Prevents Neuropathy in Breast Cancer Patients Treated with Docetaxel

“…In Japan, B12 is the standard treatment for peripheral neuropathy (Kuwabara et al, 1999). Goshajinkigan (GJG) is a traditional Japanese medicine that is mainly used for the treatment of neurological symptoms including limb pain, cold sensation, and numbness in diabetic neuropathy (Nagaki et al, 2003;Uno et al, 2005). The incidence of docetaxel (DOC)-induced neuropathy (sensory/motor) is approximately 5% (Lee and Swain, 2006).…”