Ninjin'yoeito for symptoms of frailty: Successful treatment of three cases

Kimura, Yoko; Ito, Takashi

doi:10.1002/tkm2.1206

Cited by 4 publications

(4 citation statements)

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“…Table 4 presents the list of clinical studies and Table 5 presents the list of case reports of NYT according to the search strategy. Five randomized clinical trials (RCT) [59][60][61][62][63], four observational studies [64][65][66][67], and 12 case reports were searched [68][69][70][71][72][73][74][75][76][77][78][79][80]. Herein, we summarize the findings of clinical studies on NYT.…”

Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

“…Morinaga et al reported a case with hip fracture and sarcopenia whose appetite loss, nutritional status, body weight, and muscle mass improved by NYT [71]. Kimura et al reported three cases whose general fatigue was improved by NYT [72]. Hirai et al also reported a case whose body weight, muscle mass, frailty score, COPD score, and anxiety and depression score were improved by NYT [73].…”

Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

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Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Takayama,

Michihara,

Kimura

et al. 2023

Traditional & Kampo Medicine

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BackgroundThe source of ninjin'yoeito (NYT) is considered the ‘Formulary of Bureau of Taiping People's Welfare Pharmacy’, written around 1241–52 AD. NYT is used to treat patients with chronic fatigue, malaise with qi deficiency, and exhaustion of all five parenchymatous viscera with difficulty in recovering.Key FindingsNYT formula consists of 12 crude drugs. NYT extract for medical use is covered by the National Health Insurance system of Japan for convalescence after recovery from diseases, fatigue and malaise, anorexia, perspiration during sleep, cold limbs, and anemia. Studies have shown clinical effects of NYT: treatment of anemia, cancer treatment support, frailty, cognitive dysfunction, apathy, fatigue/malaise, anorexia, and lung diseases. Preclinical studies support clinical studies; activating ghrelin‐neuropeptide Y pathway‐mediated appetite‐enhancing effects, inhibiting muscle volume loss through the Akt/mTOR pathway‐mediated hyperphosphorylation of 4E‐BP1 and FoxO1‐mediated Atrogin‐1, suppressing the hypothalamic–pituitary–adrenal axis by downregulating the sympathetic‐adrenal‐medullary axis and GABA neurons for improving sociability, promoting recovery from skeletal muscle atrophy through the activation of PGC‐1α, hematopoiesis‐promoting effects, and increasing the number of immune cells in immunocompromised models. The incidence of adverse events of NYT was reported as 3.09 or 2.03%. The most significant adverse effects of NYT are gastrointestinal disorders.ConclusionRecently, NYT has been widely used to treat several symptoms and conditions under the National Health Insurance System of Japan. Clinical studies showed the efficacy of NYT to treat anemia, frailty, cognitive dysfunction, anorexia, apathy, and fatigue/malaise, as well as for long‐term cancer treatment support. The pharmacological mechanisms supporting its effects are also being reported.

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Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

Section: Clinical Results and Applications From Clinical Trials And C...mentioning

confidence: 99%

Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Takayama,

Michihara,

Kimura

et al. 2023

Traditional & Kampo Medicine

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“…Further, the hochuekkito group tended to have an increase in body weight and serum albumin levels compared with their respective values in the control group ( 13 ). Ninjinyoeito, which is another hozai for such as frailty ( 33 ), has also been used for NTM-PD. Nogami et al reported the efficacy of ninjinyoeito in a patient with NTM-PD due to Mycobacterium fortuitum , who did not improve despite receiving guideline-based therapy for 2 years ( 34 ).…”

Section: Discussionmentioning

confidence: 99%

Case Report: Kampo Medicine for Non-tuberculous Mycobacterium Pulmonary Disease

et al. 2021

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Background: While the number of pulmonary tuberculosis cases has decreased, increase in non-tuberculous mycobacterium pulmonary disease (NTM-PD) is a global problem. Guideline-based therapy for NTM-PD sometimes causes complications that prevent treatment completion, and there are many cases of relapse even if the treatment can be completed. In addition to antibacterial treatment, care of host risk factors, such as aging, lean physique and immunosuppressive state, is also very important for the management of NTM-PD. In Japan, Kampo medicine, a traditional Japanese herbal formulation, used alone or in combination with standard multidrug therapy for NTM-PD, has been found to be effective for such cases.Case Presentation: A 77-year-old lean woman had been diagnosed with Mycobacterium intracellulare pulmonary infection 6 years earlier, and had received the standard multidrug treatment 5 years later at a former hospital due to worsening of her symptoms of cough, breathlessness and hemoptysis. However, the treatment was discontinued within a year due to the development of adverse events. She refused the guideline-based antibacterial treatment, and asked for Kampo medicine instead. Bukuryoshigyakuto was subsequently prescribed, which led to cough and sputum, especially hemosputum, being well controlled. With 3 years of Kampo medicine treatment, she gained weight and her hemosputum disappeared. High-resolution computed tomography images showed improvement in her lung condition, and her sputum smear culture was negative for acid-fast bacillus.Conclusion: Various kinds of Kampo medicines have been used empirically for NTM-PD in Japan. A literature review from 1992 to 2020 showed that hozais, in particular, seem to be key drugs for the treatment of host NTM-PD risk factors. Kampo medicines can contribute to comprehensive treatment for NTM-PD management that does not rely solely on antibacterial drugs.

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“…To date, clinical studies on the use of ninjin'yoeito have demonstrated efficacy in patients with lung cancer ( 11 ), pulmonary non-tuberculous mycobacteriosis ( 14 ), pharyngeal vascular malformation ( 15 ), anemia associated with chronic hepatitis C ( 16 ), chronic inflammation and poor QOL due to hemodialysis ( 17 ), depression associated with Alzheimer-type dementia (when used in combination with donepezil) ( 18 ), and frailty ( 19 – 22 ). Rikkunshito is a formulation comprising eight crude drugs, five of which are also included in ninjin'yoeito: ginseng, Atractylodes rhizome, Poria sclerotium, C. unshiu peel, and Glycyrrhiza .…”

Section: Discussionmentioning

confidence: 99%

Good Rehabilitation Outcomes and Improved Nutritional Status After Treatment With the Japanese Herbal Medicine Ninjin'yoeito in an Elderly Patient With Hip Fracture and Sarcopenia: A Case Report

Morinaga

Nakamura²,

Hattanmaru³

et al. 2020

Front. Nutr.

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We report a case involving a 92-year-old man who successfully received treatment with ninjin'yoeito, a Japanese herbal medicine, during the rehabilitation phase after hip fracture surgery. The patient was diagnosed with a left femoral neck fracture and underwent surgery. Two weeks after surgery, he was admitted to a rehabilitation hospital. At that time, his height, weight, body fat percentage, muscle mass, and Functional Independence Measure (FIM) score were 167 cm, 61 kg, 34.1%, 38.2 kg, and 49, respectively. For 1 month after surgery (i.e., 2 weeks after admission to the rehabilitation facility), he received rikkunshito, a traditional Japanese herbal medicine also known as Kampo medicine, for appetite loss and underwent rehabilitation. However, his appetite loss showed no improvement, and rikkunshito (7.5 g/d) was replaced with ninjin'yoeito (7.5 g/d). Two months later, although the patient's body weight and body fat percentage decreased to 56.5 kg and 21.1%, respectively, his muscle mass increased to 38.9 kg. Nutritional status evaluation indicated an improvement in the level of proteins such as transferrin, prealbumin, and retinol-binding protein, which reflected an increase in food intake. The FIM score improved from 49 to 105. No side effects were observed. The findings from this case suggest that ninjin'yoeito, which includes Astragalus root and Schisandra fruit, may be an effective treatment option for sarcopenia or frailty with appetite loss and impaired activities of daily living in aged patients.

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Ninjin'yoeito for symptoms of frailty: Successful treatment of three cases

Cited by 4 publications

References 10 publications

Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Review of frequently used Kampo prescriptions: Part 4, Ninjin'yoeito

Case Report: Kampo Medicine for Non-tuberculous Mycobacterium Pulmonary Disease

Good Rehabilitation Outcomes and Improved Nutritional Status After Treatment With the Japanese Herbal Medicine Ninjin'yoeito in an Elderly Patient With Hip Fracture and Sarcopenia: A Case Report

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