proposed this method to be categorised as serum pharmacology and serum
pharmacochemistry.
As a kampo medicine contains many active ingredients, several combina-
tion effects are involved in their action. These combination effects can be
classified as follows.
Pharmacological effects
These effects may include synergistic, additive and antagonistic actions, new
pharmacological activity and reduction of adverse reaction.
Pharmaceutical effects
These effects affect modulations of taste and pH, absorption, enhancement
of extraction and interaction among constituents.
Sometimes the decocted extract of the original prescription shows much
higher effect than that of the mixture of extracts prepared individually from
the respective component herbs at the designated similar ratio. Combina-
tions of the component herbs in kampo medicines may also influence the
content of active principles when decocted.
Combination effect of kampo medicines
If only one component herb is replaced in a formulation, the clinical applica-
tion may be greatly changed. Maoto,Makyokansekito andMakoyokkanto
are similar kampo formulations consisting of four component herbs. Three
of the herbs (Ephedrae herba,Ameniacae semen andGlycyrrhizae radix) are
common to both formulations but their indications for use are quite
different (Table 8.4).
Maoto,Makyokansekito andMakyoyokkantohave all been used for the
treatment of influenza, asthma and rheumatoid conditions, respectively.
However Maotois indicated where the patient has no sweating, high fever,
muscle and joint pains, whereas Makyokansekitois indicated where there is
natural sweating, cough and asthma. Makyoyokkanto is indicated where
there are muscle and joint pains. Another Kampo formula, Shosaikoto-
gokeishikashakuyakusan (TJ-960) has been studied for the effect of its
component herbs on treating epilepsy induced by pentylenetetrazole injec-
tion in EI mice. TJ-960 shows very potent inhibitory activity of epilepsy. It
consists of 10 component herbs, but when just one of component herbs was
omitted from the original formulation, its activity became negligible.^15
The foregoing examples show that a combination of several active
principles in the component herbs of a kampo formulation is important for
a kampo formulation to be effective.
Examples of studies on specific formulae
Three kampo formulae are introduced as examples of current pharmaco-
logical studies of kampo medicines.
238 | Traditional medicine