Studies on the psychosomatic functioning of Ill-health according to Eastern and Western medicine 7. Psychoimmuno-endocrinological changes induced by Kampo medication and Relaxation Training

Studies on the psychosomatic functioning of Ill-health according to Eastern and Western medicine 7. Psychoimmuno-endocrinological changes induced by Kampo medication and Relaxation Training

Masashi Takeichi

Abstract: Using the anxiety-affinitive constitution index (AACI) that we created, we measured the degree of the anxiety-affinitive constitution as an equivalent of ill-health for the study of psychoimmuno-endrocrinological changes induced by Kampo medication and relaxation training (RT). With 20 sixth-year Saga Medical School students (average age: 24.8 [+ or -] 1.4) as the subjects, we obtained three results: (1) relaxation training produced lowered STAI trait and state anxiety scores and tended to transform the respiratory pattern from thoracic to abdominal; (2) Kampo medication generated lowered GHQ-30 total scores and lowered the depression factor scores for its symptom components; and (3) Kampo medication for overcoming blood stagnation induced lowered NK cell activity, whereas Kampo medication for providing a tonic effect on vital energy and enriching blood brought about elevated NK cell activity and blood cortisol concentration. These results strongly suggest that while Kampo medication alleviated psychological distress as demonstrated by lowered GHQ-30 scores, RT improved the respiratory pattern, as demonstrated by increased abdominal dominance. The utmost attention must be paid to the prolonged administration of drugs for overcoming blood stagnation because of their possible immunosuppressive action.

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Ill-health refers to the broad area ranging between health and illness, and is the area in which the normal factors and the abnormal factors compete in a gradual continuous progression toward illness (Ishikawa, 1998). The study of the abnormal factors related to ill-health from several perspectives will supply new kinds of preventive medicine for lifestyle illnesses and stress-related diseases.

Until now, ill-health “is defined as it emerges in such ordinary symptoms as insomnia, fatigue, headaches, and tightness of the shoulders, and laboratory findings are within standard values” (Tanaka, 1998). Therefore, it has been impossible to objectively evaluate the real condition of ill-health.

Thus, we used Oriental psychosomatic medicine to attain quantitative and qualitative diagnoses for the morbid condition of ill-health. Therefore, we created an anxiety-affinitive constitution index. We so far have reported on the significance of our research from the perspective of preventive medicine (Takeichi et al., 1999; Takeichi and Sato, 1999; Takeichi and Sato, 2000). The subjects for our research were medical students who are often subjects for stress research, because first, they are members of the academic environment, and, second, they can be expected to be under pressure at any given time due to their constant schedule of exams and papers, and clinical training (Locke and Colligan, 1986).

In this report, we examine the changes in ill-health resulting from Kampo medication and relaxation training (RT) from a psychoimmuno-endocrinological perspective, with particular reference to the anxiety-affinitive constitution index.

Methods

Subjects

The control group for the research in this report was comprised of 104 fifth-year medical students in clinical training at the Saga Medical School from whom informed consent regarding the research was obtained. The subject group was comprised of 20 sixth-year medical students who joined the four-week elective course in Oriental psychosomatic medicine. Informed consent regarding the research also was obtained from the members of this group.

Procedures

The objective of our research was to examine the effect of Kampo medication and RT on psychosomatic function. The selection of Kampo medication relied on the practice of diagnosis and treatment of unbalanced qi, blood, and body fluid based on the relationship of a U-shaped distribution pattern between 30 items of the General Health Questionnaire (GHQ-30) and the normalized red value of the sublingual vein (Takeichi et al., 1999). The RT followed a method of muscle relaxation, based on E. Jacobson’s method of progressive muscle relaxation, revised by J. Wolpe and simplified by us (Takeichi and Sato, 1999). This required about 18 minutes to perform.

Various examinations were performed to determine the effect. These included psychological examinations, physiological examinations (fractal and non-fractal dimension analyses), orthodontic examinations, tongue diagnosis from the perspective of Oriental and contemporary medicine, and measurements of natural killer (NK) cell activity ([sup.51]C free method; normal range: 18-40%) (Abo et al., 1981) and the cortisol values in blood (RIA solid phase method, normal range: 4.0-18.3 [micro]g/dl) (Ruder et al., 1972).

For both the control and the subject groups, the State-Trait Anxiety Inventory (STAI) trait anxiety was used as the dependent variable and various physical functions as the independent variable in the creation of an anxiety-affinitive constitution index (AACI) using a multiple regression analysis (Takeichi et al., in press). AACI was calculated as: -62.9 + 72.9 x the thoracic-abdominal respiratory movement ratio (TARMR, a fractal dimension value of the thoracic respiratory curve / fractal dimension value of the abdominal respiratory curve) + 22.5 x the fractal dimension value of the horizontal movement in the left eyeball + 2.4 x the indentation of the tongue (present (1) or absent (0)). Then, the psychosomatic functions of the subject group were measured three times–first, before use and application of Kampo medication and RT, second, one week after the use of Kampo medication, and third, one week after the application of RT.

For statistical processing, an analysis of variance (ANOVA) was used for a comparative verification of three groups. The Wilcoxon signed-rank test was used for a comparative verification of two groups. The significant level was set at 5% or less for both.

Results

A Comparison of the Health Condition of the Control Group and the Subject Group Based on a Two-dimensional Coordinate Display (Simple Regression Analysis)

The average value of the AACI for the control group was 42.8 [+ or -] SD 4.5. AACI values in the control group were widely distributed over a range of 55.0 at their maximum to 30.0 at their minimum. A significant correlation was found between the AACI value and trait anxiety score (r = 0.449, p < 0.0001). This identified the presence of the anxiety-affinitive constitution (ill-health, thoracic dominant breathing) indicated by high AACI values and STAI trait anxiety scores (right half of upper section of Figure 1).

[FIGURE 1 OMITTED]

In the subject group, in contrast, all but 3 of the AACI values of the 20 sixth-year Saga Medical School students in the elective course were distributed within the range of the average value [+ or -] SD for the control group. No correlation was identified between the AACI value and the STAI trait anxiety score (r = -0.023, p = 0.9221). This implied that most members of the subject group were in relatively good health (lower section of Figure 1).

The Effect of Kampo Medication and RT

Using the AACI, the TARMR, the STAI trait and state anxiety scores, the GHQ-30 total score, NK cell activity, and the blood cortisol concentration of the 20 medical students in the subject group, in Table 1 we show the average [+ or -] SD and the results of a three group verification using a variance analysis using ANOVA before use of the Kampo medication and RT, after the use of Kampo medication, and after the application of RT.

As was also shown in Figure 1, the health condition of the 20 students in the subject group was relatively good. Therefore, we had few expectations for changes through the use and application of Kampo medication and RT. We did, however, confirm the following four distinctive findings.

1. Findings Regarding the Tranformation of Respiratory Pattern from Thoracic-dominance to Abdominal Dominance, and Changes in the STAI Trait Anxiety Scores Associated with This Transformation

As was shown in Table 1, the TARMR changed from 1.024 [+ or -] 0.032 to 1.007 [+ or -] 0.059 before the application of RT to after the application of RT (Post hoc test, p = 0.0854). As a result, we confirmed it can be said that thoracic-dominant respiration changes in the direction of abdominal-dominant respiration. There was not a significant change but a tendency. There was no significant difference before and after the use of Kampo medication.

2. Findings Regarding STAI State Anxiety Scores

In regard to the therapeutic effect for STAI state anxiety using Kampo medication and RT, we did not find a significant difference before and after the use of Kampo medication, but the STAI state anxiety scores changed from 39.05 [+ or -] 1.16 to 32.86 [+ or -] 2.34 before and after the application of RT. There was a significant decline in the period from before the application of RT to after the application of RT (Post hoc test, p = 0.0143).

3. Findings Regarding the GHQ-30 Total Score (30 items of the Japanese version of the General Health Questionnaire) and the Depression Factors (percentage response) in its Symptom Components

The GHQ-30 is useful for both the screening of non-psychotic, non-organic psychiatric disturbances using the cut-off point of its total score (Sato et al., 1993) and the quantification and qualification of symptom components using an analysis of the factors. Table 2 shows the depression factors in the symptom components of the GHQ-30. Figure 2 shows the AACI and GHQ-30 total scores (upper section of the figure) of the control group. It also shows the distribution of the two-dimensional coordinates for the AACI and the depression factor of symptom components of the GHQ-30. (This is shown by the percentage response of the subject group to the items of the depression components of GHQ-30 in Table 2.) A simple regression analysis of the AACI and GHQ-30 total scores showed a weak but significant correlation (r = 0.307, p = 0.0015). On the other hand, a simple regression analysis of the AACI and the depression factor of the symptom components of GHQ-30 showed a greater correlation (r = 0.617, p = 0.0001).

[FIGURE 2 OMITTED]

Figure 3 shows the changes in the GHQ-30 scores before and after the use of Kampo medication. As already has been shown in Figure 1, the medical students (average age: 24.8 [+ or -] 1.4, upper section of the Figure 3) in the subject group were in relatively good health.

[FIGURE 3 OMITTED]

Therefore, there was only a declining tendency for the GHQ-30 scores in the statistical examination using the Wilcoxon signed-rank test (from 4.7 [+ or -] 3.9 to 2.8 [+ or -] 4.3, p = 0.0684). No significant difference was observed for the depression factor of the symptom components of GHQ-30 (from 29.3 [+ or -] 23.4% to 22.9 [+ or -] 23.5%, p = 0.4432) (Goldberg et al., 1991).

In contrast, there was a clear decline for both GHQ-30 total scores (from 15.9 [+ or -] 8.9 to 10.1 [+ or -] 6.6, p = 0.0052) and the depression factor of symptom components of GHQ-30 (from 49.8 [+ or -] 30.1% to 34.0 [+ or -] 20.1%, p = 0.0330) for the 19 psychiatric outpatients at the Saga Medical School Hospital (Average age 54.4 [+ or -] 9.9 years, lower section of Figure 3). This strongly suggests that Kampo medication is effective for stress-related psychological distress.

4. Changes in NK cell activity and blood cortisol concentration resulting from Kampo medication in 11 medical students of the subject group

Of the 11 members of the subject group, as noted in Table 1, for whom the NK cell activity and blood cortisol concentration could be measured, no significant difference could be found in the F and P values for ANOVA before and after the use of Kampo medication and after the application of RT.

In consideration of immunology research according to traditional Chinese medicine (Liu et al., 1993) which holds that there is immunoactive or immunosupressive Chinese materia medica as shown in Table 3, the following procedures were conducted for the 11 members of the subject group for whom the NK cell activity and the blood cortisol concentration were measured. First, Kampo medication was selected in accordance with the results of the diagnostic chart for an imbalance of qi, blood, and body fluid based on the results of the GHQ-30, which we have reported on (Takeichi et al., 1999). Second, one of the 11 members that was administered Tsumura Hange-Kouboku-to extract granules for ethical use was excluded because there was neither immunoactive nor immunosuppressive Chinese materia medica in the composition of the drug. Third, the remaining 10 members were classified into two groups according to the composition of Kampo medication. One was the Kampo medication group for overcoming blood stagnation (7.5 grams per day of Tsumura Keishibukuryou-gan extract granules for ethical use), and the other was the Kampo medication group for providing a tonic effect for vital energy and enriching blood. (Three members were administered 7.5 grams per day of Tsumura Shikunshi-to extract granules for ethical use and two members were administered 7.5 grams per day of Tsumura Shimotsu-to extract granules for ethical use.)

Following this, the changes in the NK cell activity and the blood cortisol concentration were reexamined. In the group that received Kampo medication for overcoming blood stagnation, there was a tendency for the suppression of NK cell activity (p = 0.1380), while in the group that received Kampo medication for providing a tonic effect for vital energy and enriching blood, there was a tendency for the activation of NK cell activity (p = 0.1380).

As for the effects on blood cortisol concentration, there were no marked changes in the group that received Kampo medication for overcoming blood stagnation, while the group that received Kampo medication for providing a tonic effect for vital energy and enriching blood showed an increase (p = 0.0679) (Table 4).

Both Rikkunshi-to and Hochu-ekki-to are classified as Kampo medication for providing a tonic effect for vital energy (Takayama, 1992). The increase of cortisol is generally said to be related to stress and immunosuppression. The administration of Rikkunshi-to and Hochu-ekki-to to people with low levels of cortisol raises the amount of cortisol. It is clear that the administration of Kampo medication changes cortisol in a direction approaching a normal range (Oka et al., 1993). The increase in blood cortisol concentration observed in members who received Kampo medication for providing a tonic effect for vital energy and enriching blood (the three members of the subject group who were administered Shikunshi-to and the two members who were administered Shimotsu-to) is strongly suggested to have been a change corresponding to those described in these previous reports.

Discussion

Table 5 shows the therapeutic effect on the subject group following the use and application of Kampo medication and RT. These results regarding the psychoimmuno-endrocrinological effect of an approach toward ill-health grounded in Oriental medicine enabled the deduction of the significance of preventive treatment for ill-health and the final treatment for the present illness (Takeichi and Sato, 1999), and the precautions when using the Kampo medication for overcoming blood stagnation.

The Significance of Preventive Treatment for Ill-health and the Final Treatment for the Present Illness

Honda (1997) believes there are two kinds of illnesses: Illness that leads to death and illness that moves in a favorable direction. He believes that the latter illness, i.e., ill-health is an “illness on the road to health,” or a “good illness that is beneficial.” He claims that on the one hand, the relationship between treatment and ill-health is a preliminary stage relationship. He has said that ill-health is the manifestation of another illness to prevent the patient from being stricken by a more serious hidden illness. Its efficacy comes from serving to treat the severe illness. He also has said that there is a latter stage relationship, in which ill-health frequently is manifested when an illness is improving through treatment. He says this is a bridge between health and the present illness, and that the patient’s condition could develop in either direction.

Reading Honda’s term “ill-health” as the “anxiety-affinitive constitution” as presented by the authors in this research will facilitate the understanding of the significance of preventive treatment for ill health and the final treatment for the present illness.

The Effect of Kampo Medication for Overcoming Blood Stagnation on NK Cell Activity

Figure 4 shows the relationship between the AACI and NK cell activity through the display of the coordinates in two dimensions for the control group. A simple regression analysis reveals no correlation between AACI and NK cell activity (r = 0.128, p = 0.2417).

[FIGURE 4 OMITTED]

It is generally accepted that NK cell activity is lowered as anxiety increases. However, the Kampo medication for overcoming blood stagnation is likely to further lower NK cell activity. A distinction must be made between an acute anxiety response that promotes a compensatory increase in immune function and a chronic anxiety response that actually lowers immune function.

Figure 4 also shows that there is a tendency for thoracic respiration to be associated with increased NK cell activity. If this is true, it suggests that the unfavorable thoracic respiration has the potential to promote immune function in a compensatory way. We forecast that AACI and NK cell activity would have an inverse correlation, but the results were not as we expected. When considering NK cell activity, however, we think a distinction must be made between a compensatory increase due to acute anxiety that resembles the promotion of immune function and chronic anxiety that suggests a tree lowering of immune function.

Summary of Issues in This Research

We have been conducting research into ill-health from the perspective of Oriental psychosomatic medicine. In this process, we have confirmed that the anxiety-affinitive constitution characterized by an imbalance in qi, blood, and body fluid formed an equivalent to ill health, and found that the psychosomatic characteristics of this constitution existed in high trait anxiety and thoracic dominant respiration. In addition, we developed a formula for the anxiety-affinitive constitution index using multiple regression analysis.

In connection with this anxiety-affinitive constitution index, we used a treatment approach comprised of the application of Kampo medication and RT for the 20 members of the subject group. We studied how the members of the subject group improved through the observation of psychoimmuno-endrocrinological changes using an approach based on Oriental psychosomatic medicine.

The health of the 20 medical students in the subject group was relatively good. Therefore, we had few expectations for improvement through the use and application of Kampo medication and RT. We did, however, make the following four findings: (1) thoracicdominant respiration changes in the direction of abdominal-dominant respiration, and there is a decrease in the STAI trait anxiety scores associated with this change, (2) a decline in state anxiety is brought about by RT, (3) Kampo medication had little effect on GHQ-30 total scores and on scores of the depression component of the GHQ-30 (stress-related psychological distress); and (4) Kampo medication for overcoming blood stagnation tended to suppress NK cell activity, whereas Kampo medication for promoting a tonic effect on vital energy and enriching blood brought about elevated NK cell activity and blood cortisol concentration. It is generally believed that an increase in cortisol suppresses immune function. For immunological function and cortisol to increase together cannot be explained by general theory. As has already been pointed out, there must be a distinction between acute and chronic anxiety reactions.

These results again confirmed our previous report (Takeichi and Sato, 1999) regarding the significance of the preventive treatment for the anxiety-affinitive constitution that forms the equivalent of ill-health or disorganized illness (wei bin) and the final treatment of the lifestyle illness. They also strongly suggest a possible link to preventive medicine in the 21st century.

Table 1. Therapeutic Effects Induced Kampo Medication

and RT in the Subject Group (N = 20)

Pre-Treatment

AACI 44.08 [+ or -] 2.59

TARMR * 1.024 [+ or -] 0.032

STAI trait anxiety score 41.16 [+ or -] 1.19

STAI state anxiety score 39.05 [+ or -] 1.16

GHQ-30 total score 4.65 [+ or -] 3.92

NK cell activity ** 46.46 [+ or -] 15.97

Serum cortisol

concentration ** 15.46 [+ or -] 4.73

After the use

of Kampo

medication

AACI 43.86 [+ or -] 3.59

TARMR * 1.019 [+ or -] 0.036

STAI trait anxiety score 39.63 [+ or -] 1.52

STAI state anxiety score 36.53 [+ or -] 1.62

GHQ-30 total score 2.60 [+ or -] 2.72

NK cell activity ** 47.18 [+ or -] 20.91

Serum cortisol

concentration ** 16.86 [+ or -] 4.31

After the RT

AACI 43.29 [+ or -] 4.82

TARMR * 1.007 [+ or -] 0.059

STAI trait anxiety score 36.93 [+ or -] 2.37

STAI state anxiety score 32.86 [+ or -] 2.34

GHQ-30 total score 2.75 [+ or -] 4.27

NK cell activity ** 46.00 [+ or -] 19.17

Serum cortisol

concentration ** 16.70 [+ or -] 5.01

F value p value

AACI 0.201 0.8186

TARMR * 0.731 0.4865

STAI trait anxiety score 1.551 0.2224

STAI state anxiety score 3.228 0.0482

GHQ-30 total score 1.897 0.1628

NK cell activity ** 0.008 0.9920

Serum cortisol

concentration ** 0.284 0.755

* TARMR > 1: thoracic (rib) dominant respiration, TARMR = 1:

thoracic/abdominal balance of breathing

TARMR<1: abdominal (diaphragmatic) dominant respiration

** N=11

Table 2. The Depression Component of GHQ-30 (Goidberg et al, 1991)

Authors (date) Description

Chan and Chan (1983) depression

Chan (1985)

(Chinese) depression

(English) depression

D’Arcy (1982) depression/anhedonia

D’Arcy and Siddique (1984) depression

Cleary et al. (1982) depression

Goldberg et al. (1976) depression and anxiety

Shek (1987) depression

Burvill and Knuiman (1981) suicidal ideation

Authors (date) Items

Chan and Chan (1983) 24, 25, 29

Chan (1985)

(Chinese) 24, 25

(English) 20, 23, 25, 26

D’Arcy (1982) 20, 23, 24, 25, 26, 29

D’Arcy and Siddique (1984) 24, 25, 26, 29, 30

Cleary et al. (1982) 23, 24, 25, 26, 28, 29

Goldberg et al. (1976) 19, 20, 23, 24, 25, 27, 29

Shek (1987) 23, 24, 25, 26, 29

Burvill and Knuiman (1981) 25, 29

Table 3. Immunoactive or Immunosuppressive Chinese Materia Medica

(Liu Zheng Cai et al., 1993)

I. Immunoactive Chinese materia medica

1. Chinese materia medica for invigorating vital energy

Radix Astragali seu Hedysari / Radix Ginseng ** / Ganoderma

Lucidum seu Japonicum / Radix Codonopsis Pilosule / Rhizoma

Atractyloids Macrocephalae ** / Poria * **/ Semen Coicis /

Fructus Ziziphi Jujubae **

2. Chinese materia medica for tonifying blood

Radix Angelicae Sinensis *** / Caulis Spatholobi / Colla Corii

Asini / Radix Phemaniae Praeparata *** / Radix Paeoniae Alba ***

/ Fructus Mori

3. Chinese materia medica for invigorating yang

Herba Epimedii / Semen Cuscutae / Herba Cistanches / Herba

Cynomorii / Radix Morindae Officinalis / Fructus Psoraleae /

Rhizoma Curculiginis / Placenta Hominis / Cortex Cinnamoni

4. Chinese materia medica for invigorating yin

Ophiopogonis Tuber / Radix Scrophulariae / Herba Dendrobii /

Fructus Lycii / Fructus Corni / Fructus Ligustri Lucidi /

Rhizoma Polygonati / Cordyceps / Ramulus Taxilli

5. Miscellaneous

Polypurus Umbellatus / Hebra Hedyotis Diffusae / Radix

Scutellariae / RizomaCoptidis / Rhizoma Ligustici Chuanxiong ***

/ Flos Carthami / Radix Salviae Miltiorrhizae

II. Immunosuppressive Chinese materia medica

1. Chinese materia medica for dispelling wind-evil and wetness-evil

Periostracum Cicadae / Fructus Xanthii / Radix Bupleuri / Herba

Ephedrae / Pamulus Cinnamoni * / Herba Asari / Herba

Schizonepetae / Radix Ledebouriellae / Rhizoma Alismatis / Radix

Stephaniae Tetrandrae / Fructus Amomi / Radix Gentianae

Macrophyllae

2. Chinese materia medica for clearing away heat and toxic

materials

Hebra Hedyotis Diffusae / Hebra Andrographitis / Folium Isatidis

/ Flos Lonicerae / Hebra Taraxaci / Hebra Houttuyniae / Radix

Gentianae / Radix Scutellariae / Rhizoma Coptidis / Cortex

Phellodendri / Radix et Rhizoma Rhei

3. Chinese materia medica for activating blood circulation to

dissipate blood stasis

Radix Salviae Miltiorrhizae / Radix Paeoniae Rubra * / Cortex

Moutan Rodicis * / Rhizoma Ligustici Chuanxiong / Semen Persicae

* / Flos Carthami / Rhizoma Sparganii Olibanum / Myrrha

Note: Mark * shows Chinese materia medica composing Tsumura

Keishi-bukuryo-gan extract granules for ethical use.

Mark ** shows Chinese materia medica composing Tsumura Shikunshi-to

extract granules for ethical use.

Mark *** shows Chinese materia medica composing Tsumura Shimotsu-to

extract granules for ethical use.

EFFECTS OF KAMPO MEDICINE AND RELAXATION TRAINING

Table 4. The Change of NK Cell Activity and Blood Cortisol

Concentration Induced by Kampo Medication in the Subject Group

(N=11) (Wilcoxon sign-rank test)

Pre-Treatment

I. The Kampo medication group for

overcoming blood stasis

1. NK cell activity ([sup.51]C free method,

normal range: 18-40%) 44.70 [+ or -] 15.67

2. Blood cortisol concentration (RIA

solid phase method, normal range:

4.0-18.3 [micro]g/dl) 17.42 [+ or -] 3.52

II. The Kampo medication group for providing

a tonic effect for vital energy and enriching

blood (Shikunshi-to N=3, Shimotsu-to N=2)

1. NK cell activity ([sup.51]C free method,

normal range: 18-40%) 42.20 [+ or -] 15.96

2. Blood cortisol concentration (RIA solid

phase method, normal range:

4.0-18.3 [micro]g/dl) 12.28 [+ or -] 5.28

After the use of

Kampo medication

I. The Kampo medication group for

overcoming blood stasis

1. NK cell activity (SIC free method,

normal range: 18-40%) 39.80 [+ or -] 18.47

2. Blood cortisol concentration (RIA

solid phase method, normal range:

4.0-18.3 [micro]g/dl) 18.44 [+ or -] 4.38

II. The Kampo medication group for providing

a tonic effect for vital energy and enriching

blood (Shikunshi-to N=3, Shimotsu-to N=2)

1. NK cell activity ([sup.51]C free method,

normal range: 18-40%) 51.40 [+ or -] 24.48

2. Blood cortisol concentration (RIA solid

phase method, normal range:

4.0-18.3 [micro]g/dl) 16.22 [+ or -] 4.26

p value

I. The Kampo medication group for

overcoming blood stasis

1. NK cell activity (SIC free method,

normal range: 18-40%) 0.1380

2. Blood cortisol concentration (RIA

solid phase method, normal range:

4.0-18.3 [micro]g/dl) 0.6858

II. The Kampo medication group for providing

a tonic effect for vital energy and enriching

blood (Shikunshi-to N=3, Shimotsu-to N=2)

1. NK cell activity ([sup.51]C free method,

normal range: 18-40%) 0.1380

2. Blood cortisol concentration (RIA solid

phase method, normal range:

4.0-18.3 [micro]g/dl) 0.0679

Table 5. Summary of Therapeutic Effect Induced by Kampo Medication

and RT in the Subject Group (N=20)

Objetive findings Subjective findings

Treatment TARMR STAI trait STAI state GHQ-30 total

anxiety anxiety score

Kampo no change no change no change a trend of

medication reduction

RT 1 > 1 a trend of reduction possible

[right reduction reduction

arrow] = 1

Treatment Depression

component of

GHQ-30

Kampo a trend of

medication reduction

RT possible

reduction

The Kampo medication for overcoming blood stagnation has a possible

potential for suppressing NK cell activity. The causion may be required

when prescribing it to those with lowered NK cell activity, and in

particular in the long-term prescription of the medication to those

with abdominal-dominant breathing.

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(19.) Takeichi, M. and T. Sato. The significance of modern medicine toward ill-health according to Eastern and Western medicine. J. Tokyo Mibyo Assoc. 4: 40-43, 1998. (in Japanese)

Masashi Takeichi * and Takeshi Sato

Department of Psychiatry, Saga Medical School, 5-1-1 Nabeshima, Saga 849-8501, Japan.

* Corresponding author

(Accepted for publication August 7, 2000)

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