Orengedoku-to augmentation in cases showing partial response to yokukan-san treatment: a case report and literature review of the evidence for use of these Kampo herbal formulae.
Orengedoku-to augmentation in cases showing partial response to yokukan-san treatment: a case report and literature review of the evidence for use of these Kampo herbal formulae.
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DOI：
10.2147/ndt.s38318
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发表时间：
2013
影响因子：
3.2
通讯作者：
Namiki T
中科院分区：
文献类型：
--
作者：
Okamoto H;Chino A;Hirasaki Y;Ueda K;Iyo M;Namiki T
Yokukan-san，日本传统草药（汉方）处方，最近越来越受到关注，因为越来越多的报道显示其在治疗各种传统药物难治性疾病以及痴呆症的行为和心理症状方面具有显着疗效。由于yokukan-san已经广泛地与传统医学相结合，当yokukan-san仅部分有效时，使用其他汉方处方进行增强治疗已成为必要。在本文中，我们报告了三个案例，其中添加orengedoku-to，另一个汉方公式，以yokukan-san显着有效。病例1是一名85岁的老年痴呆症患者，在过去2年中变得具有攻击性。三毫克阿立哌唑完全抑制了他的问题行为，但由于锥体外系症状而不得不停止。在第二个病例中，一名44岁的甲基苯丙胺诱导的精神病患者患有严重的迟发性肌张力障碍2年。没有任何传统的方法可以改善他的迟发性肌张力障碍。第三个病例是一名29岁的工程师，他经常无法抵抗攻击性冲动，被诊断为间歇性爆发性障碍。医生给他开了5毫克奥氮平，尽管剂量很低，但奥氮平并不能抑制他异常的愤怒，并导致嗜睡。Yokukan-san补充添加到患者的常规药物，并在所有情况下发挥了明确但部分的作用。在病例1中，将orengedoku-to添加到yokukan-san中在控制攻击性方面发挥了与阿立哌唑相同的疗效，在病例2中，迟发性肌张力障碍改善了80%，在病例3中，在控制患者的攻击性冲动方面完全有效。再加上实证证据表明，无论是yokukansan和orengedoku-to在减少易怒，冲动和侵略的有效性，这三个案例表明，orengedoku-to增强可以是一个有效的选择，在案件部分响应yokukan-san治疗。
Yokukan-san, a Japanese traditional herbal (Kampo) prescription, has recently gathered increasing attention due to accumulating reports showing its remarkable efficacy in treating a wide variety of diseases refractory to conventional medicine as well as the behavioral and psychological symptoms of dementia. As yokukan-san has become broadly integrated with conventional medicine, augmentation therapy with other Kampo prescriptions has become necessary when the yokukan-san has been only partially efficacious. In this paper, we report three cases in which the addition of orengedoku-to, another Kampo formula, to yokukan-san was remarkably effective. Case 1 was an 85-year-old man with Alzheimer-type dementia who had become aggressive during the past 2 years. Three milligrams of aripiprazole completely suppressed his problematic behaviors but had to be stopped because of extrapyramidal symptoms. In the second case, a 44-year-old man with methamphetamine-induced psychosis had suffered from serious tardive dystonia for 2 years. No conventional approach had improved his tardive dystonia. The third case was a 29-year-old engineer who often failed to resist aggressive impulses and was diagnosed with intermittent explosive disorder. He was prescribed 5 mg of olanzapine, which did not suppress his extraordinary anger and caused somnolence even though the dose was low. Yokukan-san was complementarily added to the patients’ regular medication and exerted a definitive but partial effect in all cases. The addition of orengedoku-to to yokukan-san exerted the same efficacy as aripiprazole in controlling aggressiveness in Case 1, improved the tardive dystonia by 80% in Case 2, and was completely effective in controlling the patient’s aggressive impulses in Case 3. Together with empirical evidence demonstrating the effectiveness of both yokukansan and orengedoku-to in reducing irritability, impulsivity, and aggression, these three cases suggest that orengedoku-to augmentation can be an effective option in cases that are partially responsive to yokukan-san treatment.