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Previous clinical trials have demonstrated the efficacy of yokukansan, a traditional Japanese medicine, for the treatment of behavioral and psychological symptoms of dementia (BPSD). However, less evidence is available for the treatment of BPSD with yokukansankachimpihange (YKSCH), which consists of yokukansan and two additional herbal ingredients. The present study was conducted to investigate the efficacy and safety of YKSCH for treating BPSD in patients with Alzheimer's disease (AD). We enrolled outpatients with mild-to-moderate AD who exhibited BPSD and obtained a Neuropsychiatric Inventory (NPI) score of >3 including subscale scores for "agitation", "anxiety", "irritability", and "sleep and night-time behavior change". A daily YKSCH dose of 7.5 g was administered for 12 weeks with concomitant administration of anti-dementia medication. BPSD was evaluated using the NPI at baseline and every 4 weeks during the intervention. We also examined apathy using the Japanese translation of the Apathy Scale, the short version of the Japanese version of the Zarit Caregiver Burden Interview, and the Modified Crichton Rating Scale for Predicting Activities of Daily Living. Cognitive dysfunction was evaluated using the Mini Mental State Examination and the AD Assessment Scale-Cognitive (Japanese version). Five participants were enrolled. The NPI total score tended to decrease between the baseline

Tokito is a Kampo formulation for treating chest and/or abdominal pain symptoms of individuals with deficiency pattern and cold pattern. Here, we report cases of chest symptoms except pain. Case 1 was an 81-yearold man who presented with chest tightness, and Case 2 was a 77-year-old man who presented with palpitation. Their symptoms improved remarkably and their physical strength got better after treatment with tokito. Tokito comprises ginseng and astragalus root, the same as the one used in hochuekkito, which is a well-known qitonifying formulation. It is suggested that tokito is effective as qi-tonifying formulation for a variety of chest symptoms in patients with deficiency pattern and cold pattern. tokito, chest and/or abdominal pain, palpitation, chest tightness, qi-tonifying formulation

It is not a few cases that present with fever and fatigability of an unknown cause. We report a case of fever and fatigability treated effectively with hangeshashinto. The case was 47 year-old woman who had been having fever and fatigability for three years. Sometimes she could not go to work because of this malaise. She was diagnosed with patterns of qi deficiency, upper body heat and lower body cold, qi stagnation and stagnant blood. We carefully considered shinkahiko (epigastric tightness and resistance).Hangeshashinto was prescribed, and her complaints improved remarkably. Hangeshashinto is a well-known Kampo formulation for treating disorders of digestion. But this suggested that hangeshasinto is effective for a variety of symptoms in patients with digestional disorders, who also have a shinkahiko condition.fever, fatigability, hangeshashinto, shinkahiko