Isobe T, J Altern Complement Integr Med 2023, 9: 369

DOI: 10.24966/ACIM-7562/100369

HSOA Journal of
Alternative, Complementary & Integrative Medicine
Research Article

Effectiveness of Kampo Extract po treatment should refer to the results of the current study when
choosing a second prescription if the Kampo formula they prescribed
was initially ineffective. Furthermore, determining Kampo extracts
Formulations in Traditional based on the results of the current study is useful and convenient for
medical personnel who are too busy to learn Kampo medicine and
Japanese Herbal Medicine for patients who are too busy to make a decoction daily.
Keywords: Herbal medicine; Kampo medicine; Oriental medicine;
Tetsuya Isobe* Traditional medicine
International Oriental Medical Center, Kamishidami, Moriyama, Nagoya,
Aichi, Japan
Introduction
Traditional Chinese medicine, which includes herbal medicine
Abstract
and acupuncture, originated in ancient China and has gradually spread
Traditional Japanese herbal medicine, known as Kampo medi- to neighboring countries. Since trade and cultural exchange between
cine, has unique diagnostic methods. In Kampo medicine, herbal for- Japan and China ceased around 1600, traditional medicine has devel-
mulations have been prescribed since the Edo period based on the
oped uniquely over time in each country. As a result of these develop-
experience of eminent Japanese practitioners, including the great
masters. An instant preparation called the Kampo extract formula is
ments, traditional Japanese herbal medicine, known as Kampo medi-
often used in Japan. cine, has unique diagnostic methods [1]. In Kampo medicine, herbal
formulations have been prescribed since the Edo period based on the
This study included 8,494 women who were seen as outpatients experience of eminent Japanese practitioners, including the great
at our Women’s Clinic for Traditional Herbal Medicine from May 2011
masters. An instant preparation called the Kampo extract formula is
to April 2022. A total of 11,933 cases of herbal formulations were
prescribed in this study population.
often used in Japan. In contrast, in traditional Chinese herbal medi-
cine, the patient’s condition is diagnosed based on traditional Chinese
A suitable Kampo extract formula was selected based on the logic known as dialectic, and Chinese herbs are prescribed based on
Kampo medicine diagnosis, and patients were treated with Kampo the same logic. The integration of the merits of modern medicine has
extracts from Tsumura. The initial prescription of Kampo extracts
been attempted in recent years.
was a standard dose for 1 month, and its effectiveness was deter-
mined by asking patients about their level of satisfaction after taking The traditional way of taking herbal formulations is, in principle,
the extract. Patients whose level of satisfaction was at least 60% to decoct a day’s supply of crude drugs of natural origin (denoted
were deemed responders, and the percentage of responders was
here simply as crude drugs) and to drink the supernatant of that de-
defined as the effective rate of the formulation. The average level
of satisfaction among responders was defined as the efficacy of the
coction during the day. A decoction is made by putting a daily dose
formulation. of the desired herbal formulation of crude drugs in 600-800 ml of
water and heating it for 30-40 minutes until it is reduced to half its
The effectiveness of the Kampo formula was determined in 50 original volume. The quality of crude drugs varies depending on their
or more patients. The effective rate (%) and efficacy are written in
origin, even if they are the same type. Decoction is time-consuming
parentheses immediately after the name of each formula used. As
a representative formula, if a patient complained of “fatigue” and
and crude drugs have a short shelf life, but decoction has an advantage
“being physically drained,” then Hochu-ekki-to (effective rate 88.6%, since an optimal herbal formulation can be made for each patient by
efficacy 90.4) was prescribed first. If a patient had “fatigue,” “anxiety increasing or decreasing the amount of each crude drug in accordance
or depression/insomnia” and “listlessness,” then Kami-kihi-to (effec- with the patient’s physique, constitution, and resistance. In contrast,
tive rate 85.6%, efficacy 86.7) was prescribed first. The effectiveness an instant preparation called a Kampo extract formula (denoted here
was obtained for 40 symptoms in all. simply as a Kampo extract) is often used in Japan. The amount of
This study identified the most frequently used Kampo formulas a crude drug cannot be changed in accordance with the individual
based on symptoms. Medical personnel seeking to incorporate Kam- patient, but a Kampo extract is extremely convenient because it is
portable and does not involve the time and effort of decoction. Kampo
*Corresponding author: Tetsuya Isobe, International Oriental Medical Center, extracts were first developed by Dr. Shiro Hosono in Kyoto in 1950 or
Kamishidami, Moriyama, Nagoya, Aichi, Japan, E-mail: iso12-7@blue.ocn.ne.jp so. A Kampo extract is a powder made by decocting a large amount of
a crude drug comprising each herbal formulation, concentrating and
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Tradi-
tional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.
drying it, and mixing it with excipients [2]. Several companies cur-
rently manufacture them and a total of 148 herbal formulations that
Received: July 03, 2023; Accepted: July 12, 2023; Published: July 19, 2023 are covered by health insurance in Japan. Tsumura & Co. currently
manufactures and sells the largest number of products, most of which
Copyright: © 2023 Isobe T. This is an open-access article distributed under the
terms of the Creative Commons Attribution License, which permits unrestricted
are sold in 3 equal portions at a standard daily dose of 7.5 g for adults.
use, distribution, and reproduction in any medium, provided the original author Tsumura Kampo extracts are packaged in laminated aluminum foil
and source are credited. and can be stored at room temperature for 3-5 years. Over the past few
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

• Page 2 of 8 •

years, the clinical effectiveness of various types of Kampo extracts composition of crude drugs is thought to change when the crude drugs
has been reported [3-38], and several effective herbal formulations are that comprise multiple Kampo formula are mixed, resulting in differ-
listed by symptom in existing books of herbal formulations. However, ent efficacy from that of each initial formulation. This is presumed to
the effectiveness of each herbal formulation for each symptom has reduce efficacy from its original level before mixing. The standard
not been determined. The current study compiled data on 12 years of dosage of a Kampo extract in traditional Japanese herbal medicine
experience with Kampo prescriptions at the same facility and it tallied is 3 packets (7.5 g in most instances) per day, which is the minimum
the efficacy and effective rate of each effective Kampo formulation dosage required for it to be effective. Forgetting to take the extract
by symptom. is more likely to reduce the efficacy of treatment than mixing it with
food, so patients were allowed to take the extract after meals in this
Subjects and Methods study. When the daily dosage was increased to 4 packets, 2 packets
were prescribed in the morning and 2 in the evening. Patients were al-
A suitable Kampo extract formula was selected based on the
lowed to take up to 2 packets at a time regardless of whether they took
Kampo medicine diagnosis, and patients were treated with Kampo
a combination of an odd or even number of packets, unless they were
extracts from Tsumura. The Kampo formula used have been indicated
taking a special Kampo formulation. Most herbal formulations tend to
with their number from Tsumura (e.g., Kakkon-to TJ1). This study
be tasteless, so patients were allowed to take them with their preferred
compiled data from 11 years of experience with Kampo formula pre-
flavored beverage but not with water. In the 12 years covered by this
scribed by the current author at the same facility, and it tallied the
study, the author has never experienced any decrease in effectiveness
efficacy and effective rate of each effective herbal formulation ac-
due to changes in beverages or taking formulations after meals.
cording to symptoms. Subjects were 8,494 women who were seen
as outpatients by this facility’s women’s clinic for traditional herbal Patient data were strictly managed at the facility with patients in-
medicine from May 2011 to April 2022 and who took herbal formula- dicated by their initials so that individuals could not be identified.
tions prescribed in 11,933 cases. The initial prescription of an herbal Verbal informed consent was obtained from the patients prior to con-
formulation was, in principle, a standard dose (3 packets of a Tsumu- ducting this study. This study began once it was approved by the eth-
ra extract per day for adults) for 1 month, and its effectiveness was ical review board of this facility. There are no conflicts of interests in
determined by asking patients about their level of satisfaction after this study.
taking the herbal formulation [39,40]. If a patient desired increased
effectiveness after taking the initial dose, the dose was increased to Results
4 packets per day as needed, and the patients were asked about its
The effectiveness of Kampo formula taken by 50 or more patients
effectiveness again after taking that dose for 1 month. When increased
are shown in table 1. For each of the formulas shown in Table 1,
effectiveness was requested, up to 6 packets per day were similarly
patients were divided into responders and non-responders, and the
prescribed again. If a patient reported that the initial dose was inef-
average number of packets given to each group and the results of a
fective and the patient was switched to a different Kampo formula
t-test between the two groups are shown in Table 2. For each formu-
or if the same patient presented with different symptoms at differ-
la, a t-test was performed to compare the age of patients in the two
ent times, then each instance was treated as a separate case. Patients
groups. There were no significant differences in age for any of the
whose level of satisfaction with an herbal formulation prescribed for
formulations, so the average age of the patients in the two groups is
the same symptoms was 60% or higher were deemed to be respond-
shown in table 2. Kampo formula used is described in Japanese style.
ers, and the percentage of responders was defined as the effective rate
of the formulation. The rationale for this definition is that patients Symptom or con- Effective rate
were randomly selected to ask about their level of satisfaction once Kampo formulation Efficacy
dition (%)
they finished taking the formulation, and at the same time, they rated
(1) Physical fatigue Hochu-ekki-to(TJ41) 88.6 (373/421) 90.4
their distressing symptoms on a 6-point scale (① disappeared, ②
(2) Mental fatigue Kami-kihi-to(TJ137) 85.6 (285/333) 86.7
mostly disappeared, ③ considerably alleviated, ④ alleviated, ⑤
slightly alleviated, and ⑥ signs of alleviation seemed to appear). The Tokaku-joki-to(TJ61) 84.5 (49/58) 80.3
(3) Premenstrual
relationship between rated alleviation of symptoms and the level of Kami-shoyo-san(TJ24) 84.3 (316/375) 77.6
irritability
satisfaction was examined, and results revealed a close correlation Yoku-kan-san(TJ54) 76.8 (76/99) 75.7
between alleviation of symptoms rated as ①-② and a level of sat-
(4) Premenstrual
isfaction of 90-100%, alleviation of symptoms rated as ②-③ and deppresion
Hange-koboku-to(TJ16) 77.4 (41/53) 81.7
a level of satisfaction of 80-90%, alleviation of symptoms rated as
(5) Premenstrual
③-④ and a level of satisfaction of 70-80%, alleviation of symptoms lethargy
Gorei-san(TJ17) 86.2 (150/174) 85.6
rated as ④-⑤ and a level of satisfaction of 60-70%, alleviation of
Goshuyu-to(TJ31) 78.9 (123/156) 82.3
symptoms rated as ⑤-⑥ and a level of satisfaction of 50-60% (44).
(6) Migrain
The average level of satisfaction among responders was defined as the Senkyu-cha-
74.1 (43/58) 81.5
cho-san(TJ124)
efficacy of the formulation. When multiple types of Kampo formula
were prescribed at the same time, different formula were instructed (7) Dull headache
Hange-byakujutsu-tem-
86.9 (313/360) 86.4
ma-to(TJ37)
to take them at least 30 minutes apart in order to avoid mixing of
the constituent crude drugs in the stomach. The rationale for this is deteriolate in rain,
Gorei-san(TJ17) 83.1 (54/65) 85.6
premense
that each Kampo formula consists of a specific combination of crude
drugs that produces a particular effect. The reason why a particular (8) Dizziness
Hange-byakujutsu-tem-
84.2 (213/253) 87.7
ma-to(TJ37)
composition of crude drugs is effective in treating a particular condi-
tion has yet to be scientifically elucidated, but that approach has been Feeling of floating Gorei-san(TJ17) 75.8 (69/91) 85.2
arrived at based on longstanding human wisdom and experience. The
J Altern Complement Integr Med ISSN: 2470-7562, Open Access Journal Volume 9 • Issue 5 • 100369
DOI:10.24966/ACIM-7562/100369
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

• Page 3 of 8 •

Ryo-kei-jutsu-kan- Gosha-jinki-gan(TJ107) 78.4 (40/51) 79.9

74.2 (132/178) 87.7
to(TJ39) (33) Low back pain
Hachimi-jio-gan(TJ7) 72.4 (71/98) 86.1
Saikoka-ryukot-
(9) Vertigo 63.1 (41/65) 84.6
su-borei-to(TJ12) (34) Acne Sei-jo-bofu-to(TJ58) 66.7 (66/99) 77.8
Toki-shakuyaku-
(10) Hot flash 75.2 (221/294) 81.1 (35) Eczema &
san(TJ23) Oren-gedoku-to(TJ15) 72.5 (66/91) 77.1
Hives
Keis-
Climacteric disorder 72.9 (180/247) 81.8 Unsei-in(TJ57) 66.0 (33/50) 76.5
hi-bukuryo-gan(TJ25)
(36) Atopic dertitis
Kami-shoyo-san(TJ24) 71.1( 91/128) 79.6 Keigai-rengyo-to(TJ50) 57.7 (30/52) 75.3

(11) Generalized Kami-shoyo-san(TJ24) 82.7 (110/133) 79.9

Shimbu-to(TJ30) 75.6 (65/86) 80.7 (37) Irritability
coldness
Yoku-kan-san(TJ54) 72.5 (95/131) 75
Hachimi-jio-gan(TJ7) 67.5 (79/117) 79.7
(12) Coldness of Hange-koboku-to(TJ16) 89.9 (205/228) 84.3
(38) Anxiety &
lower body Ryo-kyo-jutsu-kan-
42.9 (33/77) 79.2 Depression
to(TJ118) Kami-kihi-to(TJ137) 84.6 (302/357) 86.1

(13) Coldness of Toki-shigyaku-ka-

69.2 (155/224) 77 (39) Nervousness Hange-koboku-to(TJ16) 85.2 (69/81) 83
extremities goshuyu-shokyo-to(TJ38)
Overstrained Sha-kanzo-to(TJ64) 84.0 (79/94) 86.2
Bofu-tsusho-san(TJ62) 95.4 (83/87) 79.1
(14) Proven consti- Saikoka-ryukot-
Tokaku-joki-to(TJ61) 90.5 (153/169) 79 Panic attack 77.1 (54/70) 83.1
pation su-borei-to(TJ12)

Choi-joki-to(TJ74) 79.7 (102/128) 75 (40) Emotional

Nyoshin-san(TJ67) 87.5 (49/56) 81
instability
(15) False proof
Juncho-to(TJ51) 70.2 (59/84) 77.6
constipation Table 1: Efficacy and effective rate of Kampo formulas taken by 50 or
more patients.
(16) Difficulty
Sansonin-to(TJ103) 84.5 (131/155) 85.8
falling asleep

(17) Shallow sleep Kami-kihi-to(TJ137) 80.2 (162/202) 86.3 Dosed number of

Mean
packs
(18) Abdominal Kampo formulation P(t-test)
Dai-kenchu-to(TJ100) 84.6 (77/91) 86.2 N o n re -
bloating age Responder
sponder
(19) Stodginess Rikkunshi-to(TJ43) 81.7 (98/120) 84.5
(1) Hochu-ekki-to(TJ41) 45.9 3.3 3.1 0.009
(20) Stomachache Anchu-san(TJ5) 78.0 (39/50) 90.9
(2) Kami-kihi-to(TJ137) 46.8 3.7 3.3 0.000048
(21) Diarrhea Ninjin-to(TJ32) 81.5 (66/81) 84.3
Tokaku-joki-to(TJ61) 37.5 2.4 2.1 0.57
(22) Menorrhagia Kyuki-kyogai-to(TJ77) 90.0 (45/50) 77.4
(3) Kami-shoyo-san(TJ24) 37.7 3.6 3.3 0.0011
Shakuyaku-kanzo-
(23) Leg cramps 97.8 (90/92) 96.2
to(TJ68) Yoku-kan-san(TJ54) 37.9 3.4 3.3 0.6

(24) Dripping nose Sho-seiryu-to(TJ19) 86.0 (178/207) 78.1 Hange-koboku-

(4) 35.6 3.5 3.3 0.2
to(TJ16)
Gorei-san(TJ17) 73.6 (78/106) 86.2
(25) Generalized (5) Gorei-san(TJ17) 39.3 3.4 3.3 0.49
edema
Sairei-to(TJ114) 65.1 (54/83) 81.6
Goshuyu-to(TJ31) 43.3 3.5 3.2 0.0015
(26) Edema of lower (6)
Boi-ogi-to(TJ20) 76.9 (80/104) 84.9 Senkyu-cha-
body 44.2 3.7 3.1 0.00009
cho-san(TJ124)

(27) Stiff shoulder Kakkon-to(TJ1) 74.6 (141/189) 74.9 Hange-byakujut-

41.8 3.7 3.3 0.00009
su-temma-to(TJ37)
(7)
(28) Sore throat Kikyo-to(TJ138) 92.8 (90/97) 98.6
Gorei-san(TJ17) 42.4 3.3 3.4 0.69
(29) Frequent
Hachimi-jio-gan(TJ7) 72.9 (62/85) 79.7 Hange-byakujut-
urination 43.7 3.7 3.3 0.0025
su-temma-to(TJ37)
Tokaku-joki-to(TJ61) 84.9 (45/53) 76.4
(8) Gorei-san(TJ17) 41.3 3.4 3.1 0.039
Toki-shakuyaku-
84.9 (73/86) 75.4 Ryo-kei-jutsu-kan-
san(TJ23) 44.5 3.4 3.3 0.2
(30) Menstrual to(TJ39)
crump Toki-kencyu-to(TJ123) 73.8 (127/172) 74.7 Saikoka-ryukot-
(9) 45.8 3.4 3.2 0.3
su-borei-to(TJ12)
Keis- Toki-shakuyaku-
60.2(68/113) 74.6 50.1 3.5 3.2 0.00003
hi-bukuryo-gan(TJ25) san(TJ23)

(10) Keis-
(31) Dry cough Bakumondo-to(TJ29) 91.4 (53/58) 87.5 51.5 3.6 3.1 0.0000003
hi-bukuryo-gan(TJ25)

(32) Kneel pain Gosha-jinki-gan(TJ107) 79.2 (42/53) 86.5 Kami-shoyo-san(TJ24) 50.5 3.5 3.3 0.32

J Altern Complement Integr Med ISSN: 2470-7562, Open Access Journal Volume 9 • Issue 5 • 100369
DOI:10.24966/ACIM-7562/100369
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

• Page 4 of 8 •

(11) Shimbu-to(TJ30) 44.1 3.6 3.1 0.0004 Hange-koboku-

44.4 3.8 3.2 0.000002
to(TJ16)
(38)
Hachimi-jio-gan(TJ7) 47.9 3.4 3.1 0.007
Kami-kihi-to(TJ137) 46.7 3.6 3.2 0.000013
(12)
Ryo-kyo-jutsu-kan-
43.4 3.6 3.2 0.0016 Hange-koboku-
to(TJ118) 44.4 3.7 3 0.00032
to(TJ16)
Toki-shigyaku-ka-
(13) goshuyu-shokyo- 41.6 3.5 3.2 0.0013 (39) Sha-kanzo-to(TJ64) 48.2 3.3 3.1 0.1
to(TJ38)
Saikoka-ryukot-
44.6 3.8 3.1 0.00046
Bofu-tsusho-san(TJ62) 46.1 3.3 3.1 0.6 su-borei-to(TJ12)

(14) Tokaku-joki-to(TJ61) 39.7 2.2 1.9 0.37 (40) Nyoshin-san(TJ67) 37.8 3.7 3.1 0.012

Choi-joki-to(TJ74) 41.8 2.5 2.5 0.8

Table 2: Mean age and Average dosed number of packs in each responder
or non-responder.
(15) Juncho-to(TJ51) 46.3 3.1 2.6 0.0003

(16) Sansonin-to(TJ103) 48.7 4.1 3.7 0.017

The results as shown in Table1 were obtained based on the fol-
lowing diagnosis. The effective rate (%) and efficacy are written in
(17) Kami-kihi-to(TJ137) 47.9 3.7 3.5 0.08 parentheses immediately after the name of each formula used. Both
(18) Dai-kenchu-to(TJ100) 42.1 5.1 5.1 0.97 (1) and (2) are prescriptions for fatigue, but (1) is for physical fatigue
and (2) is for mental fatigue. Mental fatigue causes listlessness and
(19) Rikkunshi-to(TJ43) 42.9 3.3 3.2 0.8
disturbance of sound sleep along with malaise, and anxiety over stress
(20) Anchu-san(TJ5) 41.5 3.1 3 0.3 due to mental fatigue causes a depressed mood. When mental fatigue
becomes chronic, amnesia also develops. Therefore, if a patient com-
(21) Ninjin-to(TJ32) 39.6 3.2 3.1 0.6
plained of “fatigue” and “physically drained,” then Hochu-ekki-to
(22) Kyuki-kyogai-to(TJ77) 43.5 3.3 3 0.0035 (effective rate 88.6%, efficacy 90.4) was prescribed first. If a patient
Shakuyaku-kanzo- had “fatigue”, “anxiety or depression/insomnia” and “felt listless,”
(23) 59.9 1.7 1.3 0.4
to(TJ68) then Kami-kihi-to (85.6%, 86.7) was prescribed first. In reality, phys-
(24) Sho-seiryu-to(TJ19) 41.5 4.3 4 0.28
ical fatigue and mental fatigue are presumably both present in many
instances, but the prescription is determined by which form of fatigue
Gorei-san(TJ17) 42.2 3.3 3.3 0.7 is more evident. (3), (4), and (5) are prescriptions for premenstrual
(25)
Sairei-to(TJ114) 44.8 3.2 3 0.07 syndrome and are categorized by principal symptoms they treat. (3)
is a prescription for irritability of premenstrual syndrome, and To-
(26) Boi-ogi-to(TJ20) 44.2 3.6 3.3 0.1
kaku-joki-to (84.5%, 80.3) is the first prescription for patients with
(27) Kakkon-to(TJ1) 44.9 4.8 3.9 0.00043 constipation. The first prescription for patients without constipation is
Kami-shoyo-san (84.3%, 77.6) and the second prescription is Yoku-
(28) Kikyo-to(TJ138) 52.2 3 3 0.009
kan-san (76.8%, 75.7). Hange-koboku-to (77.4%, 81.7) was used
(29) Hachimi-jio-gan(TJ7) 55.5 3.5 3.1 0.0098 as the first prescription for Premenstrual depression (4). Gorei-san
Tokaku-joki-to(TJ61) 36.1 2.2 0.9 7.7E-07
(86.2%, 85.6) was used as the first prescription for Premenstrual leth-
argy (5). (6) and (7) are prescriptions for headaches, which are divid-
Toki-shakuyaku-
32.8 3.7 3.1 0.0012 ed into headaches that occur on or before rainy days or 10 days prior
san(TJ23)
(30) to menstruation (dull headaches) and headaches that are unrelated to
Toki-kencyu-to(TJ123) 31.3 3.6 3.2 0.0011 rainy days or that occur prior to menstruation (migraines). Goshuyu-
Keis- to (78.9%, 82.3) was used as the first prescription for migraines (6)
34.7 3.7 3.1 0.0000005
hi-bukuryo-gan(TJ25) and Senkyu-chacho-san (74.1%, 81.5) was used as the second pre-
(31) Bakumondo-to(TJ29) 46.9 3.2 3.1 0.5 scription. Hange-byakujutsu-temma-to (86.9%, 86.4) was used as the
first prescription for dull headaches (7), and Gorei-san (83.1%, 85.6)
Gosha-jin-
(32)
ki-gan(TJ107)
65.2 3.8 3.4 0.15 was used as the second prescription. (8) and (9) are prescriptions for
dizziness. Hange-byakujutsu-temma-to (84.2%, 87.7) was used as the
Gosha-jin-
57 3.4 3.2 0.2 first prescription for lightheadedness, which was described as “feeling
ki-gan(TJ107)
(33) of floating” or for a more severe feeling of dizziness, Ryo-kei jutsu-
Hachimi-jio-gan(TJ7) 50.5 3.3 3.2 0.1 kan-to (74.2%, 87.7) was used as the second prescription, and Gorei-
(34) Sei-jo-bofu-to(TJ58) 31.1 3.5 3.2 0.016
san (75.8%, 85.2) was used as the third prescription. Saikoka-ryukot-
su-borei-to (63.1%, 84.6) was the first prescription for vertigo. (10)
(35) Oren-gedoku-to(TJ15) 43.4 3.3 3.2 0.9 is a prescription for hot flashes, which are the principal symptom of
what is known as climacteric syndrome. If the patient had yet to reach
Unsei-in(TJ57) 37.2 3.6 3.4 0.3
menopause, Toki-shakuyaku-san (75.2%, 81.1) was the first prescrip-
(36)
Keigai-rengyo-
34.9 3.4 3.1 0.1 tion, Keishi-bukuryo-gan (72.9%, 81.8) was the first prescription for
to(TJ50)
coldness in the lower extremities, and Kami-shoyo-san (71.1%, 79.6)
Kami-shoyo-san(TJ24) 42.9 3.6 3.1 0.00057 was the first prescription for constant irritability. (11), (12), and (13)
(37)
are herbal formulations to treat coldness. Shimbu-to (75.6%, 80.7)
Yoku-kan-san(TJ54) 42.2 3.4 3.1 0.013
was the first prescription for generalized coldness, Hachimi-jio-gan

J Altern Complement Integr Med ISSN: 2470-7562, Open Access Journal Volume 9 • Issue 5 • 100369
DOI:10.24966/ACIM-7562/100369
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

• Page 5 of 8 •

(67.5%, 79.7) was the first prescription for coldness in the lower body, mainly anxiety, and Sha-kanzo-to (84.0%, 86.2) was the first prescrip-
Ryo-kyo-jutsu-kan-to (42.9%, 79.2) was used as the second prescrip- tion for palpitations. Saikoka-ryukotsu-borei-to (77.1%, 83.1) was
tion, and Toki-shigyaku-ka-goshuyu-shokyo-to (69.2%, 77.0) was the first prescription for excessive sensibility and overstrain. (40) is a
the first prescription for coldness in the extremities. (14) and (15) prescription for emotionally unstable patients with varying irritabil-
are prescriptions for constipation. If the patient had not defecated for ity and depression and emotional incontinence. Nyoshinsan (87.5%,
several days, the severity of proven constipation was considered. To- 81.0) was the first prescription. It is an herbal formulation that can
kaku-joki-to (90.5%, 79.0) was prescribed when the patient had not also be used to treat postpartum neurosis.
defecated for about one week, and Choi-joki-to (79.7%, 75.0) was
prescribed for constipation lasting about 3 days. If the patient had Responders were given more doses of formulations than non-re-
false proof constipation and the patient also wished to lose weight, sponders as shown in Table 1. If a patient showed no signs of im-
Bofu-tsusho-san (95.4%, 79.1) was prescribed. Juncho-to (70.2%, provement after taking 3 doses per day for 1month, further improve-
77.6) was the first prescription for “constipation due to a hypo-func- ment should not be expected even if the doses are increased. If, in
tioning condition.” (16) and (17) are prescriptions for insomnia. San- contrast, a patient showed signs of improvement but effectiveness
sonin-to (84.5%, 85.8) was prescribed for “difficult falling asleep,” was only partial, further improvement could be expected if the doses
and Kami-kihi-to (80.2%, 86.3) was prescribed for nocturnal sleep are increased up to 6 doses per day. For formulations with significant
arousal, dreaming and other symptoms of shallow sleep. Dai-ken- differences in the doses given, an average of 4 doses per day (2 doses
chu-to (84.6%, 86.2) was used as the first prescription for abdominal for Tokaku-joki-to, 3 doses for Choi-joki-to, and 6 doses for Daiken-
bloating (18). Rikkunshi-to (81.7%, 84.5) was used as the first pre- chuto) is considered necessary. Shakuyaku-kanzo-to is intended for
scription for stodginess (19). Anchu-san (78.0%, 90.9) was used as temporary use in case of muscle cramps and requires 2 packets per
the first prescription for stomachache (20). Ninjin-to (81.5%, 84.3) dose. Kakkon-to for neck/shoulder stiffness and Shousei-ryu-to for
was used as the first prescription for diarrhea (21). Kyuki-kyogai-to pollinosis (nasal discharge) require 2 packets per dose in most pa-
(90.0%, 77.4) was used as the first prescription for menorrhagia (22). tients.
Shakuyaku-kanzo-to (97.8%, 96.2) was used as the first prescription Many of the patients with menstruation-related symptoms such as
for leg cramps (23). Sho-seiryu-to (86.0%, 78.1) was used as the PMS, menstrual cramps, or acne or atopic dermatitis were in their
first prescription for dripping nose (24). (25) and (26) are prescrip- 30s, those with climacteric disturbances such as hot flashes, muscle
tions for edema. Gorei-san (73.6%, 86.2) was prescribed for acute cramps, frequent urination, and lower back pain were in their 50s,
generalized edema, and Sairei-to (65.1%, 81.6) was prescribed for those with knee pain were in their 60s, and those with other symptoms
chronic edema. Boi-ogi-to (76.9%, 84.9) was prescribed for edema of were in their 40s.
lower body. Kakkon-to (74.6%, 74.9) was used as the first prescrip-
tion for stiff shoulder (27). Kikyo-to (92.8%, 98.6) was used as the Discussion
first prescription for sore throat (28). Hachimi-jio-gan (72.9%, 79.7)
Matching between formulas and symptoms was attempted based
was used as the first prescription for frequent urination (29). (30) is
on the results of Kampo treatment data obtained over the past 12
a prescription for menstrual cramps. If a patient was constipated and
years. Hange-byakujutsu-temma-to was the first prescription for diz-
ultrasound revealed endometriosis, Tokaku-joki-to (84.9%, 76.4) was
ziness in (8), Ryo-kei jutsu-kan-to was the second prescription, and
used as the first prescription. If the patient with endometriosis was
Gorei-san was the third prescription. However, the efficacy of Gorei-
not constipated, Keishi-bukuryo-gun (60.2%, 74.6) was used as the
San (75.8%) was higher than that of Ryo-kei jutsu-kan-to (74.2%), so
first prescription. Toki-kencyu-to (73.8%, 74.7) was used as the first
Gorei-San should be the second prescription and Ryo-kei jutsu-kan-to
prescription for patients without endometriosis, and Toki-shakuyaku-
should be the third prescription. Ryo-kyo-jutsu-kan-to was used as
san (84.9%, 75.4) was used as the second prescription. Bakumondo-to
the second prescription for coldness in the lower body in (12), but
(91.4%, 87.5) was used as the first prescription for dry cough (31).
its effective rate was low (42.9%). Therefore, Keishi-bukuryo-gan,
Gosha-jinki-gan (79.2%, 86.5) was used as the first prescription for
which had a higher effective rate (82.6%, 19/23) despite being given
kneel pain (32). (33) is a prescription for lower back pain. Hachimi-
to fewer patients, should be the second prescription. In the future,
jio-gan (72.4%, 86.1) was used as the first prescription for lower back
Keishi-bukuryo-gan should be used as the second prescription for
pain, and Gosha-jinki-san (78.4%, 79.9) was used as the second pre-
coldness in the lower extremities, and if the compiled data indicate
scription. Sei-jo-bofu-to (66.7%, 77.8) was used as the first prescrip-
that its effective rate exceeds 67.5%, then Keishi-bukuryo-gan should
tion for acne (34). Oren-gedoku-to (72.5%, 77.1) was used as the first
overtake Hachimi-jio-gan as the first prescription. The first prescrip-
prescription for eczema & hives (35). (36) is a prescription for atopic
tion for menstrual cramps without endometriosis (30) was Toki-ken-
dermatitis. Unsei-in (66.0%, 76.5) was used as the first prescription
cyu-to with an effective rate of 73.8%, and the second prescription
for atopic dermatitis, and Keigai-rengyo-to (57.7%, 75.3) was used
was Toki-shakuyaku-san with an effective rate of 84.9%. However, a
as the second prescription. (37) is Kampo formula for irritability, and
comparison of their effective rate indicates that the first prescription
Yoku-kan-san (72.5%, 75.0) was prescribed for patients who were
and the second prescription should be swapped. The first prescription
usually irritable regardless of menstruation, and Kami-shoyo-san
for lower back pain (33) was Hachimi-jio-gan with an effective rate
(82.7%, 79.9) was prescribed for patients who were irritable prior to
of 72.4% and the second prescription was Gosha-jinkii-gan with an
menstruation. (38) is a prescription for patients complaining of anx-
effective rate of 78.4%, but this effective rate indicates that the prece-
iety and presenting with a depressed mood. However, the first pre-
dence of these two formulations should also be switched. As a result,
scription for patients who felt a plum stone-like obstruction of the
Hachimi-jio-gan could be the first prescription for both lower back
throat was Hange-koboku-to (89.9%, 84.3). The first prescription for
pain and knee pain.
patients with listlessness and insomnia was Kami-kihi-to (84.6%,
86.1). (39) is a prescription for nervousness, overstrained, or panic The following observations can be made when looking at for-
attacks. Hange-koboku-to (85.2%, 83.0) was the first prescription for mulations given to fewer than 50 patients. The effective rate of

J Altern Complement Integr Med ISSN: 2470-7562, Open Access Journal Volume 9 • Issue 5 • 100369
DOI:10.24966/ACIM-7562/100369
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

• Page 6 of 8 •

Kami-shoyo-san in treating irritability of premenstrual syndrome was its efficacy was around 70%. The effective rate with which Unsei-in
84.3% (316/375), its effective rate in treating depression was 68.8% and Keigai-rengyo-to treated atopic dermatitis was lower than 70%,
(11/16), and its effective rate in treating malaise/lethargy was 94.4% and their efficacy was around 70%. The effective rate with which Ka-
(17/18), so this single formulation may be able to alleviate all 3 symp- kkon-to treated neck/shoulder stiffness (27) was 74.5% and its effica-
toms at the same time. Similarly, the effective rate of Toki-shakuyaku- cy was 74.8%. These results indicate that coldness, skin conditions,
san in treating generalized coldness was 87.5% (7/8), its effective rate
and neck/shoulder stiffness are not amenable to Kampo treatment.
in treating coldness in the lower extremities was 68.8% (11/16), and
its effective rate in treating coldness in the extremities was 72.0% A look at a list of effective Kampo formulas by symptom in spe-
(18/25), so this formulation may be a panacea for the alleviation of cialized books on herbal formulations did not reveal which formu-
coldness. The effective rate with which Hange-byakujutsu-temma-to lations are most frequently used, but the current retrospective study
treated dull headaches aggravated by rainy days and prior to menstru- over 12 years has revealed the frequency of use of these formulations.
ation was 86.9% (313/360), and the effective rate with which it treated Of course, the most effective Kampo formula for each patient does
lightheadedness-dizziness was 84.2% (213/253), so this formulation not necessarily coincide with the frequency of use, but it can be used
may alleviate both dull headaches and lightheadedness. The effec- as a reference for selecting prescriptions in the future. To fully master
tive rate with which Gorei-San treated heaviness in the stomach was the Kampo diagnosis of traditional Japanese herbal medicine, vol-
100% (9/9), its effective rate in treating nausea was 93.3% (14/15), umes written by the great masters need to be read, and to fully mas-
and its effective rate in treating diarrhea was 87.5% (14/16), so Gorei- ter the dialectics of traditional Chinese medicine, this difficult theory
San may be useful for a wide range of gastrointestinal disorders. The needs to be understood. Books on both traditional Japanese herbal
hope is to examine these findings in a larger number of patients in
medicine and traditional Chinese medicine are written in Chinese
the future.
characters; consequently, mastering these practices is even more dif-
The following strengths and weaknesses of traditional Japanese ficult for medical personnel in countries that do not use Chinese char-
herbal medicine were identified as a result of comprehensively ex- acters. Therefore, medical personnel seeking to incorporate Kampo
amining the efficacy and effective rate of each Kampo formula. The treatment can refer to the results of the current study when choosing
efficacy with which Kikyo-to treated a sore throat (28) was 92.8% and a second prescription if the Kampo formula they initially prescribed
its effective rate was 98.6%, and the efficacy with which Shakuyaku- was ineffective. Furthermore, determining Kampo extracts based on
kanzo-to treated leg muscle cramps (23) was 97.8% and its effective the results of the current study is useful and convenient for medical
rate was 96.2%. This indicates that a sore throat and muscle cramps personnel who are too busy to learn Kampo medicine and for patients
are easily cured to Kampo treatment. Kikyo-to and Shakuyaku-kan-
who are too busy to make a decoction daily. In the future, the aim
zo-to are effective in 5-10 minutes since Kikyo-to consists of 2 crude
is to increase the number of patients to improve the effectiveness of
drugs, Kikyo and Kanzo, and Shakuyaku-kanzo consists of 2 crude
drugs, Shakuyaku and Kanzo. The efficacy with which Hochu-ekki-to Kampo treatment based on Kampo diagnosis and to obtain modern
treated physical fatigue (1) was 88.6% (373/421) and its effective rate scientific evidence [41]. In Japan, specialized education on Kampo
was 90.4%, and the efficacy with which Kami-kihi-to treated mental treatment is provided to medical students at specific medical colleges
fatigue (2) was 85.6% (285/333) and its effective rate was 86.7%, so [42], with the intent of spreading Kampo medicine worldwide for in-
fatigue is a symptom that can be easily alleviated by Kampo treat- tegration with modern medicine [41, 43,44].
ment, and physical fatigue is more easily alleviated than mental fa-
tigue. The efficacy with which Sansonin-to treated difficulty falling Conclusion
asleep (16) was 84.5% (131/155) and its effective rate was 85.8%,
This study identified the most frequently used Kampo formu-
and the efficacy with which Kami-kihi-to treated disturbance of sound
las based on symptoms. Medical personnel seeking to incorporate
sleep (17) was 80.2% (162/202) and its effective rate was 86.3%.
Kampo treatment can refer to the results of the current study when
The efficacy and effective rate of both formulations exceeded 80%,
choosing a second prescription if the Kampo formula they initially
indicating that insomnia is a symptom that can be easily alleviated
prescribed was ineffective. Furthermore, determining Kampo extracts
by Kampo treatment. The efficacy with which Goshuyu-to and Sen-
based on the results of the current study is useful and convenient for
kyu-chacho-San treated migraines (6) exceeded 80% and the efficacy
medical personnel who are too busy to learn Kampo medicine and for
and effective rate with which Hange-byakujutsu-temma-to and Gorei-
patients who are too busy to make a decoction daily.
san treated dull headaches (7) on rainy days or prior to menstruation
both exceeded 80%, indicating that headaches are amenable to Kam- References
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J Altern Complement Integr Med ISSN: 2470-7562, Open Access Journal Volume 9 • Issue 5 • 100369
DOI:10.24966/ACIM-7562/100369
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

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J Altern Complement Integr Med ISSN: 2470-7562, Open Access Journal Volume 9 • Issue 5 • 100369
DOI:10.24966/ACIM-7562/100369
Citation: Isobe T (2023) Effectiveness of Kampo Extract Formulations in Traditional Japanese Herbal Medicine. J Altern Complement Integr Med 9: 369.

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Journal Of Psychiatry Depression & Anxiety | ISSN: 2573-0150 
Journal Of Clinical Studies & Medical Case Reports | ISSN: 2378-8801 
Journal Of Pulmonary Medicine & Respiratory Research | ISSN: 2573-0177 
Journal Of Community Medicine & Public Health Care | ISSN: 2381-1978 
Journal Of Reproductive Medicine Gynaecology & Obstetrics | ISSN: 2574-2574 
Journal Of Cytology & Tissue Biology | ISSN: 2378-9107 
Journal Of Stem Cells Research Development & Therapy | ISSN: 2381-2060 
Journal Of Dairy Research & Technology | ISSN: 2688-9315 
Journal Of Surgery Current Trends & Innovations | ISSN: 2578-7284 
Journal Of Dentistry Oral Health & Cosmesis | ISSN: 2473-6783 
Journal Of Toxicology Current Research | ISSN: 2639-3735 
Journal Of Diabetes & Metabolic Disorders | ISSN: 2381-201X 
Journal Of Translational Science And Research
Journal Of Emergency Medicine Trauma & Surgical Care | ISSN: 2378-8798 

Journal Of Environmental Science Current Research | ISSN: 2643-5020  Journal Of Vaccines Research & Vaccination | ISSN: 2573-0193 

Journal Of Food Science & Nutrition | ISSN: 2470-1076  Journal Of Virology & Antivirals

Journal Of Forensic Legal & Investigative Sciences | ISSN: 2473-733X  Sports Medicine And Injury Care Journal | ISSN: 2689-8829 

Journal Of Gastroenterology & Hepatology Research | ISSN: 2574-2566 Trends In Anatomy & Physiology | ISSN: 2640-7752 

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