Juzen-taiho-to (Shi-Quan-Da-Bu-Tang): Scientific Evaluation and Clinical Applications

237 Pages·2005·32.235 MB·English

by  Haruki Yamada, Ikuo Saiki

Traditional Herbal Medicines for Modern Times
Juzen-taiho-to
(Shi-Quan-Da-Bu-Tang)
Scientific Evaluation and
Clinical Applications
Edited by
Haruki Yamada
Ikuo Saiki
Boca Raton London New York Singapore
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Preface
As medical science has progressed, the profile of illness has changed greatly: disease related to
aging and inappropriate lifestyles is increasing. Because it is difficult to cure patients with these
diseases using only modern medicines, Kampo (Japanese herbal) medicine, which tends to regulate
homeostasis, has an increasing role in medical practice in Japan.
Although Kampo medicine originated from Chinese medicine, it was modified and established
as Kampo medicines in the 17th century in Japan. Japanese traditional medicine mainly involves
Japanese herbal medicine, so-called Kampo medicine, and acupuncture. Modern medicines are
used in an analytical way and tend to have a specific action against target molecules, whereas
Kampo medicines have a holistic action and appear able to regulate the whole body system.
Because of their holistic actions, Kampo medicines are suitable for the treatment of several diseases
of the elderly, such as chronic diseases, multiorgan diseases, malaise, decreasing physical strength,
senile dementia, and osteoporosis. Kampo medicines have also been thought to function as
preventive medicine. Because Kampo medicine has been used for the treatment of a wide range
of diseases with many reports of clinical effectiveness, it now plays a very important part in
modern-day therapy in Japan.
The number of higher plant species on Earth is about 250,000, and it is estimated that 35,000 to
70,000 species have, at one time or another, been used in some cultures for medical purposes (Chen Ken,
WHO Regional Office for the Western Pacific, 2002). Herbal medicines, traditionally used in Asia,
have gained popularity globally. In the U.S., where the boom spread from Europe, people show great
interest in complementary/alternative medicine, using various herbal medicine preparations as dietary
supplements. Also in the U.S., huge research budgets are being spent at the National Institutes of
Health (NIH) for scientific research into the safety and efficacy of these medicines.
The World Health Organization (WHO) published its traditional medicines strategy 2002–2005:
objectives, components, and expected outcomes. It incorporates four objectives relating to policy:
safety, efficacy and quality, access, and national use. In Australia, Europe, and the U.S., comple-
mentary and alternative medicine is increasingly used in conjunction with allopathic medicine,
particularly for treating and managing chronic diseases. Concern about the adverse effects of
chemical medicines, a desire for more personalized health care, and greater public access to health
information fuel this increased use (Traditional Medicine—Growing Needs and Potential, WHO,
Geneva, 2002).
Kampo medicines have traditionally been used as the “formulation,” and now 148 kinds of
Kampo formulations are allowed to be covered by the national health insurance system in Japan,
starting in 1976, and 210 kinds of formulations have been recognized as useful formulations by
the Ministry of Health, Labour and Welfare of Japan. Among such formulations, Juzen-taiho-to
(Shi-Quan-Da-Bu-Tang in Chinese) is an important formulation derived from ten component herbs.
It has been administered traditionally to patients with anemia, anorexia, or a debilitated general
condition caused by surgery, chronic disease, or childbirth. Juzen-taiho-to has been widely studied
in nonclinical and clinical research.
Although Kampo medicines have a long clinical experience to support their efficacies and
safety, the efficacy of Kampo medicines requires the clarification of the mechanism of action and
active ingredients in nonclinical studies and objective clinical evaluations as an evidence-based
medicine. Because Kampo medicines contain many active ingredients due to the several component
herbs, clarification of such combination effects and standardization are also very important in order
to understand the mechanism of action and to supply quality-controlled materials. Attempted with
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Juzen-taiho-to, these studies supply very useful examples of research methodologies and new ideas
for the study not only of Kampo medicines but also of other natural source medicines.
In this book, we give a general introduction to Kampo medicine; studies of the taxonomy,
cultivation, quality assurance, chemical constituents, and pharmacological actions of plant raw
materials as the component herbs are described, followed by the therapeutic indications and tradi-
tional uses of Juzen-taiho-to. Recent progress in pharmacological studies of Juzen-taiho-to and the
elucidation of its active ingredients, its important antitumor and antimetastatic properties, and its
clinical use are described and discussed. Its toxicology and side effects, together with the use of
Juzen-taiho-to and the other related formulations, are described by contributors who are experts
involved in the study of Kampo medicines in general.
The editors believe that the scientific approaches described in this volume will be applicable
to other herbal medicines and could provide a new strategy for the development of new medicines
in the 21st century.
I wish to thank Dr. Shinyu Nunome for his helpful assistance in editing this book and for
confirming the names of the plant raw materials given in the chapters.
Finally, I offer heartfelt thanks to Dr. Roland Hardman for his critical reading and valuable
advice in the editorial process.
Haruki Yamada, Ph.D.
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Editors
Haruki Yamada is the director of and a professor at the Kitasato Institute for Life Sciences and
dean of the Graduate School of Infection Control Sciences, Kitasato University, Japan. He is also
the executive director for research at the Oriental Medicine Research Center and the director of
the WHO Collaborating Center for Traditional Medicine at the Kitasato Institute. He received the
Li-Fu Academic Award for Chinese Medicine in 1999. He is well known in the fields of bioactive
polysaccharides and the scientific elucidation of Kampo medicines.
Ikuo Saiki is a professor in the Department of Pathogenic Biochemistry, Institute of Natural
Medicine, Toyama Medical and Pharmaceutical University. He has investigated the control of cancer
invasion and metastasis and immunological diseases by various treatments, including Kampo
medicines and their molecular mechanism of action. In 1990, he received the Incitement Award of
the Japanese Cancer Association.
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Contributors
Shigeru Abe Teruhiko Matsumiya
Institute of Medical Mycology Department of Pharmacology
Teikyo University Tokyo Medical University
Tokyo, Japan Tokyo, Japan
Toshihiko Hanawa Tsukasa Matsumoto
Oriental Medicine Research Center Kitasato Institute for Life Sciences
The Kitasato Institute Kitasato University and Oriental Medicine
Tokyo, Japan Research Center
Tokyo, Japan
Hiroko Hisha
First Department of Pathology Shinyu Nunome
Kansai Medical University Kitasato Institute for Life Sciences
Osaka, Japan Kitasato University and Oriental Medicine
Research Center
Osamu T. Iijima Tokyo, Japan
Department of Pharmacology
Tokyo Medical University Takashi Okamoto
Tokyo, Japan Kanagawa Cancer Center
Yokohama, Japan
Susumu Ikehara
First Department of Pathology Ikuo Saiki
Kansai Medical University Department of Pathogenic Biochemistry
Osaka, Japan Institute of Natural Medicine, Toyama Medical
and Pharmaceutical University
Hiroaki Kiyohara Toyama, Japan
Kitasato Institute for Life Sciences
Kitasato University and Oriental Medicine Kiyoshi Sugiyama
Research Center Department of Clinical Pharmacokinetics
Tokyo, Japan Hoshi University
Tokyo, Japan
Katsuko Komatsu
Research Institute for WAKAN-YAKU Hiroshi Takeda
Toyama Medical and Pharmaceutical Department of Pharmacology
University Toyko Medical University
Toyama, Japan Toyko, Japan
Yasuhiro Komatsu Tadahiro Takeda
Department of Serology Kyoritsu College of Pharmacy
Kanazawa Medical University Tokyo, Japan
Ishikawa, Japan
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Shigeru Tansho Hideyo Yamaguchi
Department of Microbiology and Immunology Institute of Medical Mycology
Teikyo University School of Medicine Teikyo University
Tokyo, Japan Tokyo, Japan
Kazuo Tarao Nobuo Yamaguchi
Kanagawa Cancer Center Department of Serology
Yokohama, Japan Kanazawa Medical University
Ishikawa, Japan
Haruki Yamada
Kitasato Institute for Life Sciences
Kitasato University and Oriental Medicine
Research Center
Tokyo, Japan
Toshihiko Yanagisawa
Medical Evaluation Research Laboratory
Tsumura & Co.
Ibaraki, Japan
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Contents
Chapter 1 Introduction: What Is Kampo Medicine?
Haruki Yamada
Chapter 2 Crude Drugs of Juzen-taiho-to
Shinyu Nunome, Hiroaki Kiyohara, Katsuko Komatsu, and Tadahiro Takeda
Chapter 3 Therapeutic Indications of Juzen-taiho-to
in Modern Therapy
Toshihiko Hanawa
Chapter 4 Immunological Properties of Juzen-taiho-to
Tsukasa Matsumoto and Haruki Yamada
Chapter 5 Hemopoiesis-Stimulatory Effects of Juzen-taiho-to
Hiroko Hisha and Susumu Ikehara
Chapter 6 Preventive Effects of Juzen-taiho-to on Infectious Diseases
Shigeru Abe, Nobuo Yamaguchi, Shigeru Tansho, and Hideyo Yamaguchi
Chapter 7 The Search for Active Ingredients of Juzen-taiho-to
Hiroaki Kiyohara and Haruki Yamada
Chapter 8 Effects of Juzen-taiho-to on Carcinogenesis, Tumor Progression,
and Metastasis In Vivo
Ikuo Saiki
Chapter 9 Juzen-taiho-to in Combination with Chemotherapy
and Radiotherapy
Kiyoshi Sugiyama
Chapter 10 Antitumor Effects in Combination with Chemotherapy
Kazuo Tarao and Takashi Okamoto
Chapter 11 Toxicology and Side Effects of Juzen-taiho-to
Osamu T. Iijima, Toshihiko Yanagisawa, Hiroshi Takeda,
and Teruhiko Matsumiya
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Chapter 12 Formulations Related to Juzen-taiho-to: Hochu-ekki-to
and Ninjin-yoei-to
Yasuhiro Komatsu
Appendix 1 Component Herbs of Juzen-taiho-to (Shi-Quan-Da-Bu-Tang in Chinese)
Appendix 2 Composition of Kampo Formulas
Appendix 3 Chinese and Japanese Herbs in Kampo Medicines
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1 Introduction: What Is
Kampo Medicine?
Haruki Yamada
Chinese traditional herbal medicine was introduced into Japan from China between the 5th and
6th centuries and was established as a medical system in the 7th century. It was developed as
Kampo (Japanese herbal) medicine with some modifications. When Japan opened its door to
Western countries in the middle of the 19th century, the Japanese government refused to give
medical doctors a license unless they had a license for Western medicine. As a result, the use of
Kampo medicine declined at this stage.
Despite such an unfavorable period, Kampo medicine continued to thrive through the efforts
of a few medical leaders who recognized its benefits. With the progress of modern science and
technology, modern medicine has greatly improved; however, some chronic disorders of an endog-
enous nature surfaced during the second half of the 20th century. Furthermore, pressing medical
problems such as nonspecific, constitutional, or psychosomatic diseases have also increased. Dis-
illusion with modern medicine has on occasion been brought about by the severe adverse effects
of synthetic compounds and environmental pollution. Against these social backgrounds, use of
Kampo medicines in Japan emerged as an alternative. Consequently, Kampo medicine now plays
an important role in medical treatment in Japan.
Kampo medicines benefit patients with a disease that affects physical functions and thus prevents
mobility and ease of operation. They help those who have responded poorly to modern medical treatment
because of its side effects or who have improved on clinical examination, yet remained ill. Similarly, those
who are normal on clinical examination, but remain affected; those who are expected to show an improve-
ment of the constitution or have a tendency toward psychosomatic disorders; the aged; or those who have
decreased physical strength have seen benefits. Kampo medicines are often used for the treatment of:
• Hepatitis
• Menopausal disorders such as autonomic-nervous and hormonal manifestations
• Autonomic imbalances
• Bronchial asthma
• Cold syndrome
• Digestive disorders
• Atopy
• Dermatitis
• Eczema
• Hypersensitivity to low temperatures
• Allergic rhinitis
• Complaints of general malaise
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