00 Cover 1730

In the case of Rikkunshito, a low-dose preparation was used as a placebo
control because of difficulty in developing control granules.
In a separate double-blind, controlled study for re-evaluation, Chotosan
(Siao-Tang-San)was also shown to have a beneficial clinical effect in the
treatment of vascular dementia.^26
Although kampo medicines have a long clinical experience, they also need
an objective clinical evaluation as evidence-based medicine (EBM). However,
kampo medicines have traditionally been used according to the disturbed
pathophysiological conditions of the patient (so-calledshoclinically), so clin-
ical study of kampo medicines needs to consider the concept ofsho.^27 In clin-
ical trials, objects should be chosen depending on the status ofsho, e.g. the
trial can be limited to patients showing a hypofunctioning condition. The
design of the trial is very important for clinical study of kampo medicine.
Kampo medicines have to consider two judgements in EBM: one is the
most reliable scientific proof and the other is the specific clinical situation

Japanese kampo medicine | 245

Shakuyakukanzoto

Maintenance of contractility against muscle clamping model

Shimotsuto

Anti-stress effect

Reversal effect of scopolamine-induced impairment in the radical maze performance

Delay of the development of the infarction and rarefaction following chronic ischaemia of the brain

Anti-metastatic activity

Saibokuto

Suppression of experimental allergic reactions

Suppression and antagonistic actions on release and production of chemical mediators

Suppression of decrease of b-receptor

Suppression of decrease of glucocorticoid receptor

Suppression of induction of IgE Fcereceptor II in lymphocytes from asthma patient

Improvement of tracheal mucociliary tract

Ninjinyoeito

Immunomodulating activity (suppression of decrease of NK activity in spleen cells)

Improvement of passive avoidance behaviour in hyoscine administered mouse

Saireito

Diuretic activity

Anti-inflammatory activity (increase of blood ACTH level, increase of corticosterone secretion from

adrenal gland)

Table 8.5Continued

5HT, 5-hydroxytryptamine (serotonin); ACTH, adrenocorticotrophic hormone; ChAT, choline

acetyltransferase; FSH, follicle-stimulating hormone; hCG, human chorionic gonadotrophin; Ig,

immunoglobulin; IL, interleukin; LH, luteinising hormone; NGF, nerve growth factor; NKT, natural killer/T

cells; PAF, platelet-activating factor; PG, prostaglandin; SHR-SP, stroke-prone spontaneously hypertensive

rats; Th, T-helper cell.