Zeitschrift für Phytotherapie 2017; 38(06): 260-265
DOI: 10.1055/s-0043-121598
Forschung
© Georg Thieme Verlag KG Stuttgart · New York

Kampō in der Gastroenterologie

Praktikable Konzepte für die integrative Therapie von Beschwerden des Gastrointestinaltraktes mit traditioneller japanischer Phytotherapie
Tobias Ahrens
Further Information

Publication History

Publication Date:
19 January 2018 (online)

Zusammenfassung

Die Kampō-Medizin ist eine mehr als 1000 Jahre alte Form der japanischen Phytotherapie, die auf pragmatische Art die Erkenntnisse der wissenschaftlich fundierten Medizin mit traditionellen Konzepten wie der Bauchdeckendiagnostik verbindet. Kampō ist heute fest im japanischen Gesundheitssystem verankert und wird von ca. 83,5 % der praktizierenden Ärzte dort genutzt, wobei die meisten Anwender Kampō-Rezepturen ausgehend von wissenschaftlichen Wirksamkeitsbelegen bzw. ICD-Diagnosen verschreiben. Grundlage dafür ist eine überschaubare Anzahl standardisierter Rezepturen, die überwiegend als Trockenextrakt in Granulatform eingenommen werden.

Anwendungsmöglichkeiten bestehen für eine Vielzahl von akuten und chronischen Beschwerden, wobei neben der Studienlage die Konstitution und das individuelle Beschwerdemuster des Patienten eine wichtige Rolle für die Auswahl der passenden Rezeptur spielen. Rikkunshi tō, hange shashin tō und keishi ka shakuyaku tō sind drei Kampō-Rezepturen, für deren Anwendung es bei dyspeptischen Beschwerden, der Reduktion Irinotecan-vermittelter Diarrhöen und dem Reizdarmsyndrom vom Diarrhö-Typ vielversprechende wissenschaftliche Wirksamkeitsbelege gibt. Nachdem Herr Kutcha bereits 2014 in der Zeitschrift für Phytotherapie sehr umfassend die Geschichte der Kampō-Medizin dargestellt hat, möchte ich nur kurz auf allgemeine Aspekte wie die historische Entwicklung eingehen und die spezifischen Anwendungsmodalitäten und therapeutischen Möglichkeiten bei gastrointestinalen Erkrankungen in den Vordergrund stellen.

Summary

Kampō medicine for gastrointestinal disorders

For more than a thousand years, Kampō medicine has stood out as a profound version of Japanese herbal medicine. It combines the knowledge of evidence-based medicine with traditional concepts like the abdominal diagnosis also called fukushin. Nowadays Kampō is deeply rooted in the Japanese health care system; around 83.5 % of the Japanese doctors prescribe Kampō on a daily basis. Interestingly, most of the practitioners use Kampō from a modern evidence-based point of view. This acceptance within the Japanese medical society is due to the relatively small number of standardized formulas, the possibility of taking Kampō as a water soluble granular and the evidence of a considerable number of indications.

Kampō medicine can be used for a variety of acute and chronic diseases whereby the individual constitution of the patient and clinical evidence guide the practitioner during the selection of the right formula. Rikkunshi tō, hange shashin tō und keishi ka shakuyaku tō are three Kampō prescriptions that are widely known for their effect in the case of dyspepsia, the reduction of diarrhea caused by Irinotecan and irritable bowel syndrome of the diarrhea type. Several articles concerning the background of Kampō were written by K. Kutcha in this journal (2014). This current article focuses on the usage of Kampō in treating gastrointestinal disorders.

 
  • Literatur

  • 1 Otsuka K. Kampo: Geschichte, Theorie und Praxis der chinesisch-japanischen traditionellen Medizin. Tsumura Juntendo; Tokyo: 1976
  • 2 Kuchta K. Traditionelle Japanische Medizin – Kampo. Teil 1. Z Phytother 2014; 35: 79-84
  • 3 Reißenweber-Hewel H. Japanese Kampo medicine. Pharmakon 2014; 2: 127-134
  • 4 Terasawa K. Evidence-based reconstruction of Kampo medicine: Part I – Is Kampo CAM?. Evid Based Complement Alternat Med 2004; 1: 11-16
  • 5 Katayama K, Yoshino T, Munakata K. et al Prescription of kampo drugs in the Japanese health care insurance program. Evid Based Complement Alternat Med 2013; 2013: 576973
  • 6 Watanabe K, Matsuura K, Gao P. et al Traditional Japanese Kampo medicine: clinical research between modernity and traditional medicine – the state of research and methodological suggestions for the future. Evid Based Complement Alternat Med 2011; 2011: 513842
  • 7 Motoo Y, Seki T, Tsutani K. Traditional Japanese medicine, Kampo: Its history and current status. Chin J Integr Med 2011; 17: 85-87
  • 8 Moschik EC, Mercado C, Yoshino T. et al Usage and attitudes of physicians in Japan concerning traditional Japanese medicine (Kampo medicine): A descriptive evaluation of a representative questionnaire-based survey. Evid Based Complement Alternat Med 2012; 2012: 139818
  • 9 Reißenweber H, Schäfer S. Japanische Phytotherapie (Kampo) – Klinische Relevanz und Qualitätssicherung in der Modernen Medizin. Rietbrock N, Hrsg Phytopharmaka VI. Forschung und klinische Anwendung. 2000. Darmstadt: Steinkopff: Heidelberg: Springer; 271-277
  • 10 Yu F, Takahashi T, Moriya J. et al Traditional Chinese medicine and Kampo: a review from the distant past for the future. J Int Med Res 2006; 34: 231-239
  • 11 Eberhard U. Leitfaden Kampo-Medizin: Japanische Phytotherapie. 2003. Elsevier, Urban & Fischer; München:
  • 12 [Anonymous]. Evidence reports of Kampo treatment 2010: 345 randomized controlled trials. The Japan Society for Oriental Medicine: Tokyo, 2010
  • 13 Tominaga K, Arakawa T. Kampo medicines for gastrointestinal tract disorders: a review of basic science and clinical evidence and their future application. J Gastroenterol 2013; 48: 452-462
  • 14 Tominaga K, Kido T, Ochi M. et al The traditional Japanese medicine Rikkunshito promotes gastric emptying via the antagonistic action of the 5-HT (3) receptor pathway in rats. Evid Based Complement Alternat Med 2011; 2011: 248481
  • 15 Suzuki H, Matsuzaki J, Fukushima Y. et al. Rikkunshito study group. Randomized clinical trial: rikkunshito in the treatment of functional dyspepsia – a multicenter, double-blind, randomized, placebo-controlled study. Neurogastroenterol Motil 2014; 26: 950-961
  • 16 Hayakawa T, Arakawa T, Kase Y. et al Liu-Jun-Zi-Tang, a kampo medicine, promotes adaptive relaxation in isolated guinea pig stomachs. Drugs Exp Clin Res 1999; 25: 211-218
  • 17 Kido T, Nakai Y, Kase Y. et al Effects of rikkunshi-to, a traditional Japanese medicine, on the delay of gastric emptying induced by N(G)-nitro-L-arginine. J Pharmacol Sci 2005; 98: 161-167
  • 18 Naito T, Itoh H, Yasunaga F, Takeyama M. Rikkunshi-to raises levels of somatostatin and gastrin in human plasma. Biol Pharm Bull 2001; 24: 841-843
  • 19 Matsumura T, Arai M, Yonemitsu Y. et al The traditional Japanese medicine Rikkunshito increases the plasma level of ghrelin in humans and mice. J Gastroenterol 2010; 45: 300-307
  • 20 Gunji S, Ueda S, Yoshida M. et al Effects of rikkunshito, a kampo medicine, on quality of life after proximal gastrectomy. J Surg Res 2013; 185: 575-580
  • 21 Oka T, Okumi H, Nishida S. et al JOPM-EBM Working Team. Effects of Kampo on functional gastrointestinal disorders. Biopsychosoc Med 2014; 8: 5
  • 22 Iizuka N, Hamamoto Y. Constipation and herbal medicine. Front Pharmacol 2015; 6: 73
  • 23 Takagi K, Harada M. [Pharmacological studies on herb paeony root. II. Anti-inflammatory effect, inhibitory effect on gastric juice secretion, preventive effect on stress ulcer, antidiuretic effect of paeoniflorin and combined effects with licorice component Fm 100]. Yakugaku Zasshi 1969; 89: 887-892
  • 24 Maeda T, Shinozuka K, Baba K. et al Effect of shakuyaku-kanzoh-toh, a prescription composed of shakuyaku (Paeoniae radix) and kanzoh (Glycyrrhizae radix) on guinea pig ileum. J Pharmacobiodyn 1983; 6: 153-160
  • 25 Mao QQ, Ip SP, Xian YF. et al Anti-depressant-like effect of peony: a mini-review. Pharm Biol 2012; 50: 72-77
  • 26 Ai M, Yamaguchi T, Odaka T. et al Objective assessment of the antispasmodic effect of shakuyaku-kanzo-to (TJ-68), a Chinese herbal medicine, on the colonic wall by direct spraying during colonoscopy. World J Gastroenterol 2006; 12: 760-764
  • 27 Sasaki D, Uehara A, Hiwatashi N. Clinical efficacy of keishikashakuyakuto in patients with irritable bowel syndrome: a multicenter collaborative randomized controlled study. Rinsho to Kenkyu (Jpn J Clin Exp Med) 1998; 75: 1136-1152
  • 28 Mizuno S, Nagata K, Yoshida K. et al Kabinsei cho shoukougun ni taisuru keishikashakuyakuto ekisu no chiryo kouka - mepenzolate bromide tono hikaku shiken [in Japanese]. Shindan to Chiryo 1985; (08) 1143-1152
  • 29 Simren M, Barbara G, Flint HJ. et al. Rome Foundation Committee. Intestinal microbiota in functional bowel disorders: a Rome foundation report. Gut 2013; 62: 159-176
  • 30 Jalanka-Tuovinen J, Salojarvi J, Salonen A. et al Faecal microbiota composition and host-microbe cross-talk following gastroenteritis and in postinfectious irritable bowel syndrome. Gut 2014; 63: 1737-1745
  • 31 Imazu Y, Tsuiji K, Toda T. et al Juzentaihoto reduces post-partial hepatectomy hyperammonemia by stabilizing intestinal microbiota. J Traditional Med 2006; 23: 208-215
  • 32 Takashima K, Munakata K, Tsuiji K. et al Kampo medicines induce formula-dependent changes in the intestinal flora of mice. J Traditional Med 2012; 29: 179-185
  • 33 Mori K, Kondo T, Kamiyama Y. et al Preventive effect of Kampo medicine (Hangeshashin-to) against irinotecan-induced diarrhea in advanced non-small-cell lung cancer. Cancer Chemother Pharmacol 2003; 51: 403-406
  • 34 Kase Y, Hayakawa T, Takeda S. et al Pharmacological studies on antidiarrheal effects of Hange-shashin-to. Biol Pharm Bull 1996; 19: 1367-1370
  • 35 Kase Y, Hayakawa T, Aburada M. et al Preventive effects of Hange-shashin-to on irinotecan hydrochloride-caused diarrhea and its relevance to the colonic prostaglandin E2 and water absorption in the rat. Jpn J Pharmacol 1997; 75: 407-713