Hinoshita Fumihiko, Ogura Yosuke, Suzuki Yoshio, Hara Shigeko, Yamada Akira, Tanaka Naoko, Yamashita Akira, Marumo Fumiaki
Department of Internal Medicine, International Medical Center of Japan, Tokyo.
Am J Chin Med. 2003;31(3):445-53. doi: 10.1142/S0192415X03001144.
Muscle cramps are one of the most common complications of hemodialysis (HD), and often are a source of great pain in spite of various clinical measures. The traditional herbal medicine, shao-yao-gan-cao-tang (Japanese name: Shakuyaku-kanzo-to), consists of equal amounts of paeony and licorice roots, and has been used in Japan and China for muscle pain or skeletal muscle tremors. To determine whether this medicine is able to prevent frequent and unendurable muscle cramps in patients undergoing HD, Shakuyaku-kanzo-to at 6 g per day was prospectively administered for 4 weeks to five patients on HD who were suffering from frequent muscle cramps. The frequency and severity of cramping before and after the treatment treatment were carefully observed and compared. Skeletal muscle cramps completely disappeared in two of the treated patients after the start of oral administration of Shakuyaku-kanzo-to. Moreover, the frequency of cramping was significantly decreased in two of the remaining three patients after persistent administration. The severity of muscle cramps was also decreased by this treatment in the responsive patients. No serious side effects were detected during the treatment period. The inhibitory effect of Shakuyaku-kanzo-to on muscle contraction was also experimentally examined by using phrenic nerve-diaphragm preparations from male Wistar rats. Differences between the twitch responses were determined when the diaphragms and the nerves were stimulated in the presence and absence of the extract of Shakuyaku-kanzo-to. The results demonstrated that extracts of paeony and licorice roots inhibit contraction of skeletal muscles in rats. Taken together, we suggest that administration of Shakuyaku-kanzo-to is a safe, effective treatment for preventing muscle cramps in patients undergoing HD.
肌肉痉挛是血液透析（HD）最常见的并发症之一，尽管采取了各种临床措施，它往往仍是巨大疼痛的来源。传统草药芍药甘草汤（日语名称：芍药甘草汤）由等量的芍药根和甘草根组成，在日本和中国已被用于治疗肌肉疼痛或骨骼肌震颤。为了确定这种药物是否能够预防接受HD治疗的患者频繁出现且难以忍受的肌肉痉挛，对5名患有频繁肌肉痉挛的HD患者前瞻性地给予每日6克芍药甘草汤，持续4周。仔细观察并比较治疗前后痉挛的频率和严重程度。在开始口服芍药甘草汤后，两名接受治疗的患者的骨骼肌痉挛完全消失。此外，在持续给药后，其余三名患者中的两名痉挛频率显著降低。这种治疗方法也使有反应的患者的肌肉痉挛严重程度降低。在治疗期间未检测到严重的副作用。还通过使用雄性Wistar大鼠的膈神经-膈肌制备物，对芍药甘草汤对肌肉收缩的抑制作用进行了实验研究。在有和没有芍药甘草汤提取物的情况下刺激膈肌和神经时，确定抽搐反应之间的差异。结果表明，芍药根和甘草根的提取物可抑制大鼠骨骼肌的收缩。综上所述，我们认为给予芍药甘草汤是预防接受HD治疗的患者肌肉痉挛的一种安全、有效的治疗方法。
