title: Efficacy of traditional Japanese herbal medicines-Keishikajutsubuto (TJ-18) and Bushi-matsu (TJ-3022)-against postherpetic neuralgia aggravated by self-reported cold stimulation: a case series.
abstract: OBJECTIVE
  It has been reported that postherpetic neuralgia (PHN) in patients over 60 years of age is aggravated under cold stimulation and is often difficult to treat. Keishikajutsubuto (TJ-18) and Bushi-matsu (TJ-3022) are traditional Japanese herbal medicines and have long been used to treat neuralgia and arthralgia, which are aggravated following cold stimulation. This study was designed to evaluate the effectiveness of combined TJ-18 and TJ-3022 therapy in cases of PHN aggravated by self-reported cold stimulation.
  
  
  METHODS
  Fifteen (15) PHN patients aged 60 years and over were examined. Patients were aware of the persistent pain despite other treatments; pain was generally aggravated following exposure to cold stimulation. First, TJ-18 (7.5 g/day) was administered to patients, and then TJ-3022 (1.0 g/day) was also administered and progressively increased by 0.5-1.0 g increments every 2-4 weeks, until stable improvement was achieved, which was rated using the visual analogue scale (VAS). Analgesic effects were evaluated using the VAS during each patient visit.
  
  
  METHODS
  Background variables, responses to treatment (time course of VAS rating, VAS improvement rate), the amount of additional TJ-3022 administered, and adverse reactions were analyzed.
  
  
  RESULTS
  Twelve (12) of the 15 patients completed the entire trial. Patient ages were 61-85 years, the male-to-female ratio was 4:8, and length of time after onset of herpes zoster was 2-92 months. In 3 patients, oral TJ-18 treatment was not possible due to hot flash or gastric discomfort. The VAS improvement rate for patients being orally administered both TJ-18 and TJ-3022 was 76.5±27.7% (mean±standard deviation). The additional TJ-3022 dose was 1.0-5.0 g/day. Twelve (12) patients have been treated without serious adverse reactions.
  
  
  CONCLUSIONS
  TJ-18 and TJ-3022 combination treatment is a promising means of treating intractable PHN, which has a self-reported tendency to aggravate pain under cold stimulation.
authors: Department of Kampo Medicine, Osaka University Graduate School of Medicine, Osaka, Japan. mihona@maia.eonet.ne.jp
authors: Miho
authors: M
authors: Nakanishi
authors: Junsuke
authors: J
authors: Arimitsu
authors: Mitsuru
authors: M
authors: Kageyama
authors: Shizue
authors: S
authors: Otsuka
authors: Takaya
authors: T
authors: Inoue
authors: Shinji
authors: S
authors: Nishida
authors: Hideki
authors: H
authors: Yoshikawa
authors: Yuki
authors: Y
authors: Kishida
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000700:Analgesics / Q000008:administration & dosage / Q000494:pharmacology / Q000627:therapeutic use*; D003080:Cold Temperature; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000494:pharmacology / Q000627:therapeutic use*; D005260:Female; D006562:Herpes Zoster; D006801:Humans; D007564:Japan; D019684:Magnoliopsida; D008297:Male; D020835:Medicine, Kampo; D008875:Middle Aged; D051474:Neuralgia, Postherpetic / Q000188:drug therapy* / Q000821:virology; D010147:Pain Measurement; D008517:Phytotherapy; D010946:Plants, Medicinal; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D004365:Drugs, Chinese Herbal; C477943:keishi-ka-jutsubu-to