Kampo (Japanese herbal) medicine for primary headache as an acute treatment –a retrospective investigation in Kesennuma City Hospital during 5 years-

Abstract

Kampo (Japanese herbal) medicine for primary headaches as an acute treatment has been empirically prescribed, but the evidence is insufficient. Therefore, we retrospectively investigated kampo medicine’s efficacy for primary headaches at 1 week and discussed how kampo medicine works for headaches, referring to previous articles. We prescribed, as needed, kakkonto (TJ-1) for 223 tension-type headaches, goshuyuto (TJ-31) for 93 migraines with or without aura and those with the menopausal disorder, goreisan (TJ-17) for 71 migraines with edema, dehydration (Sui-doku), or associated with weather conditions, and non-steroidal anti-inflammatory drugs (NSAIDs) for 162 primary headaches between 2015 and 2019 in Kesennuma City Hospital. As a total, 92.0% of the patients’ subjective symptoms improved after 1 week. The ratio of improvement was not significantly different between each kampo medicine and NSAIDs. The follow-up period is short as 1 week, and it is difficult to judge whether the improvement is due to medication, the placebo effect, or spontaneous remission. However, our results suggested that kampo medicine could be an alternative medication as an acute treatment for primary headaches, and our strategy would be applicable to the clinical practice of primary headaches. (187/250 words)

Questionnaire-Based Survey during COVID-19 Vaccination on the Prevalence of Elderly’s Migraine, Chronic Daily Headache, and Medication-Overuse Headache in One Japanese City—Itoigawa Hisui Study

“…However, 10 (41.70%) did not use acute medication. Only one (4.17%) individual used prophylactic medication of Japanese herbal kampo goreisan [ 18 , 30 , 31 ] ( Figure 2 ). Ten (41.70%) had hypertension, two (8.3%) had dyslipidemia, and the other two had back or knee pains ( Figure 3 ).…”

“…This could be due to the fact that lifestyle-related diseases are now being properly treated so that more people are taking antihypertensive drugs that also function as migraine prophylactics, and people are becoming more educated over time [ 41 ]. Another possibility is that Japanese herbal kampo medicines are commonly prescribed for the elderly in Japan and used as an acute alternative therapy for headache disorders [ 18 , 30 , 42 ], preventing the abuse of common analgesics. In addition, the fact that the elderly have more TTH [ 6 , 7 ] and often tolerate it until it improves without the use of acute medications may reduce the rate of MOH development.…”

The First Case Series From Japan of Primary Headache Patients Treated by Completely Online Telemedicine

“…The median HIT-6 scores before, one, and three months after treatment were 63 (58-64), 54 (53-62), and 52 (49-54), respectively. MHD before, one, and three months after treatment were 15 (9-28), 12 (3)(4)(5)(6)(7)(8)(9)(10)(11)(12)(13)(14)(15)(16)(17), and 2 (2-8), respectively. AMD before, one, and three months after treatment were 10 (3-13), 3 (1-8), and 2 (0-3), respectively.…”

“…Depending on the severity, we prescribed acute medications such as non-steroidal anti-inflammatory drugs, triptans, and lasmiditan, and novel 5-HT receptor agonists with high affinity and selectivity for the 5-HT 1F serotonin receptor. In addition, we also prescribed prophylactic medications, such as lomerizine, propranolol, valproic acid, amitriptyline, muscle relaxants, and Kampo medicine [16][17][18] (goreisan, goshuyuto, and yokukansan). The patients were referred to a nearby headache hospital if monoclonal calcitonin gene-related peptide antibodies were indicated as prophylactic medicine.…”

Japanese herbal Kampo medicine, Keishibukuryogan, for chronic subdural hematoma – Prospective observational study

“…In Japan, Japanese herbal kampo, goreisan (GRS), is often used postoperatively to prevent CSDH recurrence[ 3 , 5 ] and headache. [ 7 , 8 ] GRS mainly acts as an aquaporin-4 inhibitor, improving suidoku status from the kampo perspective. Suidoku status is defined as fluid disturbance such as edema, dehydration, and dislocation.…”