Frailty and sarcopenia have recently gained considerable attention in terms of preventive care in Japan, which has an ever-increasing aging population. Sarcopenia is defined as atrophy of skeletal muscles caused by the age-related decrease in growth hormone/insulin-like growth factor and sex hormones. The Japanese Ministry of Health, Labor and Welfare reports that frailty can lead to impairment of both mental and physical functioning. Chronic diseases such as diabetes and dementia may underlie frailty. It is important to prevent progression of frailty and extend the healthy lifespan. In herbal medicine practice, including Japanese Kampo medicine, “Mibyo,” a presymptomatic state, has long been recognized and may be applicable to frailty. Kampo medicines may include several medicinal plants and are thought to have the potential to improve symptoms of frailty, such as loss of appetite and body weight, fatigue, and sarcopenia, as well as anxiety, depression, and cognitive decline. Ninjin'yoeito (Ren Shen Yang Ying Tang) is the most powerful Kampo medicine and has been widely applied to palliative care of cancer patients. This review includes recent anti-aging studies and describes the effects and mechanisms of Ninjin'yoeito (Ren Shen Yang Ying Tang) when used for frailty or to extend a healthy life expectancy.

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Background Kampo medicine was introduced into the core curriculum model of medical education in Japan in 2007, and has been taught at all 80 medical universities across the country. However, as there are differences in terms of content and between universities, Kampo medicine education needs to be standardized. Therefore, this study aimed to examine the effects of combining multiple strategies, including lectures, problem‐based learning (PBL), and simulator training for the development of a standardized educational curriculum for Kampo medicine. Methods We offered a lectures‐only class (Kampo strategy‐lectures [Ks‐L]), a class with lectures and decoction (Ks‐LD), a class with lectures, decoction, and PBL (Ks‐LDP), and a class with lectures, decoction, PBL, and simulator training (Ks‐LDPS). We analyzed the data from a 12‐item questionnaire conducted by the Faculty Development Committee of Kagoshima University Faculty of Medicine to evaluate the curriculum. Results Ks‐LDPS was rated significantly higher than the other modules in active learning, and overall satisfaction. Conclusions The results of this study suggest that combining multiple strategies rather than offering classes with lectures promoted a positive attitude to Kampo medicine and deep self‐learning among students, thereby improving the educational effects of Kampo medicine education.

Background The purpose of study was to develop an objective, valid, and reliable assessment method for Kampo medicine using an OSCE for the evaluation of clinical competence in Kampo medicine Methods We developed a blueprint followed by a list of 47 assessment items and three task scenarios related to clinical competence in Kampo medicine. An eight-member test committee checked the relevance and pass/fail criteria of the assessment items on a Likert scale. We calculated a content validity index and content validity ratio, and used the Angoff method to set the passing threshold. We trained a total of nine simulated patients with three assigned to each scenario. We conducted an OSCE for 11 candidates with varying medical abilities, and conducted three stations per person, and one evaluator in one room by direct observation evaluated. We used video recordings to test the inter-rater reliability of the three raters. We used the test results to verify the reliability of the evaluation scale. Results The inter-rater reliability (Cronbach’s α) was 0.92–1.00, intra-examinee reliability was 0.59–0.95, and the reliability of each task was 0.86, 0.89, and 0.86 for Scenarios 1, 2, and 3, respectively. Conclusions We developed a content-valid new OSCE assessment method for Kampo medicine and obtained high inter-rater and test reliabilities. Our findings suggest that this is one of the most reliable and valid evaluation methods for assessing clinical competence in Kampo medicine.

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