일본의 한방의료서비스 현황 조사연구

최보람,조여진,손창규,Choi, Bo-Ram,Jo, Yoe-Jin,Son, Chang-Gue 대한한방내과학회 2014 大韓韓方內科學會誌 Vol.35 No.3

Objectives: This study aimed to analyze the status of Kampo medicine services in Japan. Methods: We surveyed the literature or reports regarding health insurance, clinics for Kampo medicine, human resources and medical fees for Kampo medicine services. Results: The Japanese government abolished the system of the Oriental doctor in 1874, but Kampo medicine has been maintained and developed continuously. The national health insurance covers Kampo medicine services including acupuncture and moxibustion, and 674 products of 149 herbal drugs are now involved in items for health insurance. A total of 78 university medical schools or hospitals have Kampo clinics. As of 2012, 1,775 Kampo specialists, 100,881 acupuncturists and 99,118 moxibustion therapists provide Kampo medical services. Conclusions: Japan has a unique system of Kampo medicine which is much different from Korean medicine or traditional Chinese medicine. This study provides basic information about Kampo medicine, and can be useful to establish a globalization-strategy for Korean medicine for Japan.

Clinical studies of traditional Japanese herbal medicines (Kampo): Need for evidence by the modern scientific methodology

Ichiro Arai 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.3

Background: Japanese Kampo medicine is a traditional medicine with roots in ancient Chinese medicine. Because traditional physicians had been abolished in Japan, the present mainstream of Kampo treatment is that physicians who learned modern Western medicine prescribe Kampo extract products based on Western medical diagnosis. This situation is different from that in other east Asian countries, and the physicians require scientific clinical evidence. Methods: Clinical studies were searched from literature databases, clinical trial registry sites, and “Evidence Reports of Kampo Treatment (EKAT)” published by the Japan Society for Oriental Medicine. Results: At the approval of Kampo products, scientific clinical evidence was not required because they have a long-period experience as a decoction. However, in the 1990s, Kampo products became a subject for national reevaluation; double-blind and placebo-controlled clinical trials. At the time, a methodological foundation for conducting clinical assessments of Kampo medicines was established. From 2000 onwards, with the evidence-based medicine era, the field of Kampo medicine also saw many randomized controlled trials, and their evidence was collected and published as EKAT. In the 2010s, post-marketing clinical trials of Kampo products also had to be conducted in this environment due to the need for ethical and scientific assurance. Currently, there are numerous clinical trials of Kampo products being conducted with high-grade trial designs. Conclusion: The situation of Kampo clinical studies reflects the unique history and position of Kampo medical system and Kampo products in Japan.

Japanese government research grants for Kampo medicine: an overview of 10 years (1997–2017)

Min Kyung Hyun,Hong Yeoul Yoon,Tetsuhiro Yoshino,Min Jung Park 한국한의학연구원 2019 Integrative Medicine Research Vol.8 No.4

Background: Japan has its own traditional medicine called Kampo medicine, but it is relatively unknown compared to traditional Chinese medicine. Therefore, this study examined the current status of the research related to Kampo medicine supported by Japanese government research grants (JGRG). Methods: Three databases were searched on October 2019: National Institute of Public Health, Grant-in-Aid for Scientific Research and Japan Agency for Medical Research and Development. The search keywords were Kampo medicine, acupuncture, integrative medicine, oriental medicine, and traditional medicine. The final research that satisfied the inclusion criteria were selected and analyzed. Results: After a comprehensive search of the three databases and removing any duplication research, 2,246 JGRG (985 new proposals) that met the inclusion criteria were selected. The number and amount of JGRG on Kampo medicine have been increasing steadily. The basic research conducted by academic research institutes was mainstream, and the proportion of development research of new Kampo medical technology was low. Most research were non-clinical research and 21 % were clinical research. The largest research institute was the Toyama University and there were many non-clinical, cancer, and Juzentaihoto (Japanese herbal medicine) research. The Japanese government grants were funded relatively evenly without bias to specific fields or institutions. Conclusions: The Japanese government research grants from 1973 to 2017 indicate that research on Kampo medicine which barely had any interest previously, was revived in the 2000s. In particular, it increased sharply in the 2010s, and the research fields were relatively diverse.

일본에서의 한방의학(漢方醫學)에 대한 국비 지원 연구 동향과 그 함의

정창운,최창혁,조희근,송민영,백은혜 한방재활의학과학회 2018 한방재활의학과학회지 Vol.28 No.1

Objectives We analyzed the trends of government-funded research on Kampo medicine in Japan to provide advanced evidence to R&D support policy for Korean medicine, and to introduce new research fields and trends to the researchers. Methods We reviewed the researches on Kampo medicine through ‘research-er.jp’ and ‘KAKEN’ database which contain R&D status in Japan and scientific research funding project issued by the Japan Ministry of Education, Culture, Sports, Science and Technology. Results Since 1976, government-funded research on Kampo medicine has been continuously announced, and now 533 tasks have been completed or are in progress. The average duration of the study is 2.54 years, but it has been prolonged to 3.52 years in recent years. 4∼5 million yen was supported per project for laboratory research, and an average of 44,342 thousand yen was supported per project for specialized laboratory research and clinical research. Conclusions Despite the absence of systematically supporting departments, the researches on Kampo medicine in Japan were qualitatively superior since they focused on providing the scientific basis for clinical application. As competition in the world's traditional medicine market becomes more intense, it is necessary to improve the competitiveness of Korean medicine. Therefore, a keen interest in Korean medicine and active support from the government is needed. (J Korean Med Rehabil 2018;28(1):121-131)

근거 중심 Kampo medicine 임상진료지침의 현황

사사키 유이,황정운,김경한,박유리,심호종,박동선,전윤정,김지환,장보형,신용철,고성규,Sasaki, Yui,Huang, Ching Wen,Kim, Kyeong Han,Park, Yu Lee,Shim, Ho Jong,Park, Dong Sun,Jeon, Yoon Jeong,Kim, Ji-Hwan,Jang, Bo-Hyoung,Shin, Yong-Cheol,Ko, 대한예방한의학회 2016 대한예방한의학회지 Vol.20 No.1

Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

일본 의과대학에서의 전통의학 교육의 현황 조사연구

명예슬 ( Ye Seul Myeong ),안수연 ( Soo Yeon Ahn ),손창규 ( Chang Gue Son ) 경락경혈학회 2016 Korean Journal of Acupuncture Vol.33 No.1

Objectives : This study aimed to overview the current education status of a traditional medicine by medical schools in Japan. Methods : We surveyed the literatures regarding a traditional medicine education in Japan, and get the information via email-interview with an officer of medical schools in Japan as well as from their websites. Results : Japan`s education ministry presented the appropriateness of education for traditional medicine to medical students in 2001, and most of medical schools begun to set up the classes in Japan. We received the detail information of the traditional medicine education from 21 medical schools. Nineteen colleges(approximately 90%) of those have the regular classes for traditional medicine while two colleges don`t have the education program for the traditional medicine. Most of medical schools have single class for introduction of traditional medicine, and have average 16.2±8.8 hours during the 4th grade(61.9%). Conclusions : We presented the general feature of education for traditional medicine in Japan, and this result would be basic information for an establishment of a strategy regarding the enhancement of national competitiveness of traditional Korean medicine.

Effects of Furanocoumarins in Kampo Extract-Based Medicines on Rat Intestinal Absorption of CYP3A and P-glycoprotein Substrate Drugs In Vivo

Kazunori Iwanaga,Kaori Arimune,Makoto Miyazaki,Makio Shibano,Masahiko Taniguchi,Kimiye Baba,Masawo Kakemi 대한약학회 2012 Archives of Pharmacal Research Vol.35 No.6

While a great deal of information of drug-drug interactions is known, most concern Western drugs. Relatively little is known of the interactions between Western drugs and traditional drugs such as Kampo extract medicines (Japanese medicines modified from traditional Chinese medicines). This study investigated the effects of the marketed Kampo extract medicines, Senkyu-cha-cho-san and Sokei-kakketsu-to, on the intestinal absorption of CYP or P-glycoprotein (P-gp) in vivo. Midazolam, a CYP3A substrate drug, or talinolol, a P-gp substrate drug, was orally administered to rats with each of these Kampo extract medicines. Senkyu-cha-chosan or Sokei-kakketsu-to administered as a standard regimen did not obviously affect Cmax and area under the curve (AUC) of midazolam, although both Kampo extract medicines contained notopterol, a potent CYP3A4 inhibitor in vitro. The results implied a lack of potent drug–drug interactions between both Kampo extract medicines and CYP3A substrate drugs. Concomitant administration of each Kampo extract medicine unexpectedly showed the tendency to decrease Cmax and AUC of talinolol. Decreased intestinal absorption of talinolol might be caused, not by the inhibition of P-gp, but by the inhibition of organic anion transporting peptides by both Kampo extract medicines.

소아의 난치성 신증후군의 한약 치료에 대한 최신 임상연구 동향

장은하,민상연,김장현 대한한방소아과학회 2020 대한한방소아과학회지 Vol.34 No.3

Objectives: The purpose of this study is to analyze clinical studies on effectiveness of herbal medicine in refractory nephrotic syndrome (RNS). Methods: We searched the randomized controlled trials (RCTs) with herbal medicine treatment on RNS from the Pubmed, CNKI, OASIS, NDSL, J-stage, and CiNii. The demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Results: 11 RCT studies were selected and analyzed. The children in the control group were given western medicine therapy, and the treatment group was given herbal medicine along with the same western medicine of the control group. The most commonly used herbal medicines were the prescriptions to treat ‘Kidney Deficiency with Blood Stasis (腎虛兼瘀血)’ which composed of ‘Promoting blood circulation (化瘀)’, ‘Diuresis-inducing (利水)’, or ‘Heating Yang (溫陽)’ medicine based on ‘Replenishing Kidney or Spleen (補腎, 補脾)’ medicine. In the treatment group, proteinuria and serum lipid was significantly decreased, serum albumin was significantly increased, and total effective rate was significantly higher than the control group. Hypercoagulation and relapse rate was also significantly reduced. Adverse events were significantly lower in the treatment group. Conclusions: Herbal medicine treatment on pediatric RNS can be suggested as a new treatment for children who have less response to the conventional therapy. It can also supplement the limitations of the western medicine by reducing adverse events from the steroids and immuno-suppressive agents, and lower the relapse rate as well.

일본에서 발달장애아를 대상으로 Kampo치료 및 교육프로그램의 제공에 대한 연구동향

김미숙,고병섭 대한한방소아과학회 2019 대한한방소아과학회지 Vol.33 No.4

Objectives: This study reviewed the effects of a combined treatment with Kampo and Western medicine for Developmental disability in Japan, and the provision of education programs in clinical care. Methods: The search database includes J-STAGE. To narrow the search, the following key words were used: 'pervasive developmental disorders, Attention-Deficit/Hyperactivity Disorder, Learning Disorders or Learning Disabilities, Intellectual Disability, and Kampo'. The search was limited to the publication date from 2001 to 2019. Results: Japan analyzed five sections: The usage of the Kampo medicine ranges from 25.2% to 71.6%, and the Kampo medicine was highly used in large cities. 2. In Japan, the educational programs were provided for the caregiver and special educational programs were available for children with disabilities. 3. In Japan, there were 9 studies regarding developmental disability treating with herbal remedies. There were seven clinical trial reports, and two were published in a review or report form. 4. The results showed benefits of using Kampo for patients with lack of Yin in blood in treatment of developmental disorder. It is also important to control the liver qi and Yin in blood. 5. Seven papers reported no side effects or abnormal findings. They have reduced the use of antipsychotics. Conclusions: These review studies in regards to the combined treatment of Kampo and Western medicines can be helpful to improve long term side effects of the antipsychotics used in developmental disorders.

뇌혈관질환에 대한 오령산(五苓散) 치료의 일본 유용성 - 2011년 제20회 일본뇌신경외과한방의학회 학술대회 발표논문을 중심으로-

장인수,권승원,김경욱,Jang, In-soo,Kwon, Seung-won,Kim, Kying-wook 대한중풍순환신경학회 2011 대한중풍.순환신경학회지 Vol.12 No.1

Objectives : The purpose is to discuss the clinical applications of Orungsan(Goreisan: 五苓散) as an alternative management for increased intracranial pressure in the field of neurosurgery in Japan. Methods and Results : Attention has focused on Kampo medicine(traditional Japanese medicine) for some cerebral disease including chronic subdural hematoma(CSDH) and cerebral infarction in Japan. Orungsan and one of its classes, Sirungtang(Saireto: 柴苓湯) are well known their effects on brain edema. After some studies of Orungsan has the anti-edemic effects by the inhibition of aquaporin, this herbal medicine has been used widely in the neurosurgery field in Japan. It is high time to think about where we are and we go ahead for the progress and the integration in medicine. We have reviewed the studies using Orungsan or Sirungtang, that was reported at the 20th annual meeting of 'the Japan society for Kampo medicine and neurological surgery' was held on November 5, 2011 in Tokyo. Fifteen studies related with Orungsan or Sirungtang were reported among all 32 studies at the meeting. Orungsan in ten, and Sirungtang in five among 14 studies contained specific clinical case. In the aspects of disease, thirteen papers were related with SDH, including CSDH(11), SSDH(1), aneurism clipping for SDH prevention(1), and one was acute cerebral infarction and one was multiple metastatic brain tumor. In the report style, case control study was 7(mostly retrospective), and the case report was 8. Conclusions : Orungsan may be plausible to be an alternative method to reduce brain edema after SDH and other brain injury in the field of neurosurgery.