The review of innovative integration of Kampo medicine and Western medicine as personalized medicine at the first multidisciplinary pain center in Japan

Abstract

BackgroundThe Japanese medical system is unique because it is the only country in the world where Western medicine and traditional Japanese medicine including Kampo medicine, traditional Japanese herbal medicine, are used in our daily clinical practice. Pain is essentially an interactive psychophysiological behavior pattern. Thus, an interdisciplinary approach is often recommended in providing appropriate therapeutic care for the patients suffering from chronic and intractable pain. In addition, we have been prescribing Kampo medicines in combination with Western medicines as personalized medicine in order to treat patients with chronic pain at our pain center. The aim of our study was to conduct a survey on the current use and the effect of Kampo medicines in our multidisciplinary pain center.MethodsRetrospective analysis was performed on 221 out of 487 patients suffering from chronic pain.ResultsThe most frequent medical complaints for which Kampo medicines were prescribed were lower back/lower limb pain, neck/upper limb pain, various facial pains, headache/migraine, whiplash-associated disorder, and frozen shoulder. Kampo medicines were prescribed based on patient-centered Kampo diagnosis. Moreover, several Kampo medicines generally for the management of psychological symptoms were prescribed for about 70% of the patients. Pain improvement in the patients was categorized as follows: 26.3% with marked improvement, 12.7% with moderate improvement, 38.9% with some improvement, and 19.9% with no improvement.ConclusionsTwo thirds of the chronic pain patients with the use of Kampo medicines combined with Western medicine experienced further pain improvements.

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

“…In the absence of an organic disease, KM can successfully balance qi‐blood‐fluid and/or heat‐cold condition, which is conceptually different from Western medical practices. Arai et al reported that Kampo prescription to manage psychological symptoms such as yokukansan, kamishoyosan, and kososan was used for psychopathological patients suffering from chronic pain in a multidisciplinary pain center . For example, yokukansan can influence several neurotransmitters and receptors such as serotonergic and glutamate receptors, which can provide a significant degree of control over the entire body.…”

Integration of a Kampo Medicine, Nijutsuto, and Western Medical Treatment in the Treatment of Long-term Frozen Shoulder Refractory to Western Medical Treatment

“…7,8 Nijutsuto is a Kampo formula used to effectively treat frozen shoulder. [8][9][10] We have prescribed Nijutsuto for almost all patients with frozen shoulder refractory to Western medical treatment in our clinical daily practice.…”

“…7,8 Nijutsuto (ingredients: white and blue atractylodes, hoelen, citrus, arisaema, cyperus, scute, clematis, chianghuo, pinellia, liquorice, ginger) has been a Kampo formula used to effectively treat frozen shoulder. [8][9][10] We report here that Nijutsuto combined with a 20-minute exercise program improved pain intensity and shoulder function in 13 patients with frozen shoulder refractory to Western medical treatment.…”

Kampo for the Treatment of Pain in Japan: A Review

“…The Japanese government had long recognized Kampo, even as Kampo herbs were categorized as drugs separate from Western synthetic drugs. It took several more years for Kampo medicine to receive official attention around 1970 [1][2][3]. The time-tested herbal remedies of Kampo had regained the attention of the public at last.…”