Successful treatment of tetanus using the herbal medicine shakuyakukanzoto: a report of three cases

Shimono, Kenshin; Katsue, Tatsuji; Sato, Mitsuhito; Noguchi, Wataru; Yoshihara, Hideaki; Tsubouchi, Hirohito

doi:10.3918/jsicm.24_121

Cited by 4 publications

(4 citation statements)

References 4 publications

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“…There are only seven cases in which kampo medicines were used for the treatment of tetanus (Tables ,) . In all cases the patients survived, but pseudoaldosteronism occurred after the use of SKT in three of the cases.…”

Section: Discussionmentioning

confidence: 99%

Localized tetanus treated with kampo medicines

Nakae

Satoh

Okuyama

et al. 2018

Traditional & Kampo Medicine

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Case: A 73-year-old woman with a history of generalized tetanus and hypertension developed localized tetanus. Daisaikoto (DST) was used to control spasming of cervical muscles given the symptom of tenderness observed on both sides of her abdomen, kyokyo-kuman. All symptoms except for cheek discomfort were improved. On day 7, shakuyakukanzoto (SKT) was given to control the residual symptoms. Outcome: Residual symptoms improved after treatment with DST and SKT. Conclusion: DST can be used for the management of muscle spasms in localized tetanus, based on the oriental medical syndromes.

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Section: Discussionmentioning

confidence: 99%

Localized tetanus treated with kampo medicines

Nakae

Satoh

Okuyama

et al. 2018

Traditional & Kampo Medicine

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“…In four out of seven cases, pseudo-aldosteronism, such as hypokalaemia, slight oedema, or hypertension, occurred after SKT use and all symptoms improved after its discontinuation. The daily licorice dose and the duration of licorice treatment should be carefully determined [45].…”

Section: Treatment For Tetanus Using Both Western and Kampo Medicinementioning

confidence: 99%

“…Mechanical ventilation was performed for 50 days in one case. As for Kampo formula, SKT alone was used in all five cases [45][46][47]. Nevertheless, not only shakuyakukanzoto but also other Kampo formulas such as kakkonto and daijokito may be effective for tetanus.…”

Section: Treatment For Tetanus Using Both Western and Kampo Medicinementioning

confidence: 99%

Treatment for tetanus applying Kampo medicine: Administration of shakuyakukanzoto

Nakae

Irie

Satoh

et al. 2021

Traditional & Kampo Medicine

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Aim Severe tetanus can be fatal, even with the latest drug treatments and artificial respiration. Nevertheless, combining Western and Kampo medicine may be beneficial for tetanus treatment. Methods We summarise the benefits of applying Kampo medicine in tetanus, especially referring to using shakuyakukanzoto (SKT) from the aspect of controlling myospasms. SKT is a Kampo formula used for the treatment of pain associated with sudden myospasms. Results SKT, kakkonto, daisaikoto, and daijokito have been used to successfully treat patients with generalised convulsions caused by generalised tetanus, without the use of a muscle relaxant. However, hypokalaemia, oedema, and hypertension caused by pseudo‐aldosteronism, which may result from an adverse reaction to licorice, should be monitored when using SKT. Conclusion A large randomised controlled trial may be necessary to establish a treatment for tetanus using both Western and Kampo medicines.

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“…Shakuyakukanzoto (SKT) is one of Kampo medicines, and is clinically used for the treatment of pain associated with sudden myospasm widely. Recently, some studies showed that they are effective in treating muscle spasms caused by tetanus [12][13][14][15]. Especially, Nakae et al reported that the use of SKT reduced the dosage of propofol which was administered for the control of spastic convulsion in a tetanus patient [12].…”

Section: Introductionmentioning

confidence: 99%

Clinical Experience of Use of Kampo Medicine Shakuyakukanzoto for Muscle Spasms Caused by Tetanus

Oshima¹,

Sawada²,

Isshiki³

et al. 2023

Cureus

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Background Tetanus is an infectious disease caused by Clostridium tetani , which produces tetanospasmin. Intensive care using sedatives and muscle relaxants is required for the management of severe tetanus, however, long-term use of those medicines is associated with the occurrence of post-intensive care syndrome (PICS). Shakuyakukanzoto (SKT), which is clinically used for the treatment of pain associated with sudden myospasm widely, is one of Kampo medicines, and some studies showed that they are effective in treating muscle spasms caused by tetanus. The purpose of this study is to evaluate the usefulness of SKT in the management of tetanus patients from the viewpoint of the reduction of sedatives. Methods Patients who were diagnosed with tetanus and were treated in our hospital between January 2006 and December 2022 were included. Patients were divided into two groups, patients treated with SKT and those without SKT, and the background information and clinical courses, especially the reduction of sedatives, were compared between the two groups. Results There were five tetanus patients who were treated with SKT (SKT(+) group) and two tetanus patients without SKT (SKT(-) group), respectively. Intubation and mechanical ventilation were required for the management of generalized seizures in all seven patients, who were admitted to the intensive care unit (ICU). The administration of propofol could be discontinued after an average of 8.6 days (range: 3-22 days) from the initiation of SKT administration. The dosage of propofol was lower in patients who received SKT versus those who did not; midazolam and fentanyl exhibited a similar tendency. The mean durations of ICU and hospital stays for patients treated with or without SKT were almost equal (the mean durations of ICU stay in SKT(+) and SKT(-) groups were 22.6 and 24.0 days, and those of hospital stay in SKT(+) and SKT(-) groups were 35.2 and 36.0 days, respectively). All seven patients were discharged and transferred to another hospital for rehabilitation. Conclusions SKT may be useful in the management of myospasms in patients with tetanus. It may also prevent the occurrence of PICU in patients with tetanus who require intensive care by reducing the use of sedatives and analgesics.

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Successful treatment of tetanus using the herbal medicine shakuyakukanzoto: a report of three cases

Cited by 4 publications

References 4 publications

Localized tetanus treated with kampo medicines

Localized tetanus treated with kampo medicines

Treatment for tetanus applying Kampo medicine: Administration of shakuyakukanzoto

Clinical Experience of Use of Kampo Medicine Shakuyakukanzoto for Muscle Spasms Caused by Tetanus

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