RESUMEN
We administered daisaikoto to 13 patients with traumatic cervical syndrome and observed complete responses in the following 2 patients. Patient 1 was a 40-year male. He was in the xiaoyang stage, and showed high abdominal tension and marked chest oppression. These findings were indications for daisaikoto. Patient 2 was a female in her 50 s. She was in the xiaoyang stage, showed moderate abdominal tension and chest oppression, and was aware of chest tension and constipation. Evaluation using the VAS in the 13 patients showed a complete response in 3 patients, partial response in 6, minor response in 1 and no response in 3. To clarify indications for daisaikoto in this disease, findings of Japanese Oriental Medicine in the 13 patients were evaluated. Of 9 patients with high abdominal tension, 8 showed partial or complete responses. Of 4 patients with moderate abdominal tension, a complete response, partial response, and no response were observed in 1, 1, and 2, respectively. In addition, objective abdominal coldness was present in both patients with moderate abdominal tension who showed no response but not in the patient showing a complete response.We confirmed the importance of therapy based on oriental medical syndromes when daisaikoto is used for traumatic cervical syndrome. However, patients with moderate abdominal tension without abdominal coldness can be differentiated from others for this therapy.
RESUMEN
We report a case of 87-year-old female with somatoform autonomic dysfunction whose complaint of oppression ranging from the left chest to the epigastrium was successfully treated with shimbuto, in whom neither antidepressants nor anxiolytic drugs had been effective. Since weak abdominal power, bilateral kyokyokuman and pulsation in the upper navel region were observed, saikokeishikankyoto was initiated, but satisfactory effect was not obtained. Thus, we re-estimated her conditions and judged as the stage of Shao yin based on symptoms such as bedridden tendency, coldness of the limbs and indigestible diarrhea, although a weak and surface pulse was noted. Shimbuto was then administered, and various symptoms including chest oppression were improved rapidly and dramatically. We speculated that her chest oppression might occur due to kiutsu (depression of ki) secondary to suitai (accumulation of sui) rather than kigyaku (regurgitation of ki), and that the improvement of suitai by shimbuto might result in the disappearance of kiutsu. Although shimbuto is not popularly used for the treatment of somatoform disorder having chest symptoms, our case suggests that there should be a certain case in which shimbuto is so effective. Also it is suggested that shimbuto might be applicable even when deep pulse or excessive strain of abdominal muscles is not necessarily observed.