Kan'o Tomomichi, Han Jing-Yan, Nakahara Kuniaki, Konno Shingo, Shibata Mayuko, Kitahara Takao, Soma Kazui
Department of Emergency and Critical Care Medicine Kitasato University Sagamihara Kanagawa Japan.
Department of Integration of Chinese and Western Medicine, School of Basic Medical Sciences Beijing University Beijing China.
Acute Med Surg. 2014 Mar 5;1(2):88-93. doi: 10.1002/ams2.24. eCollection 2014 Apr.
Yokukansan (a Japanese Kampo medicine) has been reported to be safe and useful in treating behavioral and psychological symptoms in dementia patients. This study aimed to investigate the effects of yokukansan on destructive and aggressive behaviors in patients after traumatic brain injury.
From April 2008 to July 2010, 189 patients who suffered traumatic brain injury were admitted to our tertiary emergency center. Of these, patients with destructive and aggressive behaviors were treated with neuroleptics. Seven patients (five men and two women) who could not be controlled by neuroleptics were given yokukansan (2.5 g powder) three times a day before meals. Main underlying conditions included brain contusion in three patients, acute subdural hematoma in two, and acute epidural hematoma in two. The following assessments were carried out at baseline and 1 and 2 weeks after initiation of treatment: the Glasgow Coma Scale for the assessment of disturbed consciousness after traumatic brain injury; Neuropsychiatric Inventory for the distress of medical staff; Mini-Mental State Examination for cognitive function; Barthel Index for activities of daily living; Vitality Index for motivation; presence of adverse effects and drug interactions.
After treatment with yokukansan, patients showed significant improvements in Glasgow Coma Scale ( = 0.001), Neuropsychiatric Inventory ( = 0.016), Mini-Mental State Examination ( = 0.029), Barthel Index ( = 0.043), and Vitality Index ( = 0.013). No adverse effects or drug interactions between yokukansan and Western medicines were observed.
Yokukansan improved the Glasgow Coma Scale, Neuropsychiatric Inventory, Mini-Mental State Examination, Barthel Index, and Vitality Index without any adverse effects or drug interactions with Western medicines in patients with destructive and aggressive behaviors after traumatic brain injury.
据报道， yokukansan（一种日本汉方药物）在治疗痴呆患者的行为和心理症状方面安全且有效。本研究旨在调查yokukansan对创伤性脑损伤患者的破坏性行为和攻击性行为的影响。
2008年4月至2010年7月，189例创伤性脑损伤患者入住我们的三级急诊中心。其中，有破坏性行为和攻击性行为的患者接受了抗精神病药物治疗。7例（5男2女）无法用抗精神病药物控制的患者，每天饭前服用3次yokukansan（2.5克粉末）。主要基础疾病包括3例脑挫伤、2例急性硬膜下血肿和2例急性硬膜外血肿。在基线以及治疗开始后1周和2周进行了以下评估：用于评估创伤性脑损伤后意识障碍的格拉斯哥昏迷量表；用于评估医护人员困扰的神经精神科问卷；用于评估认知功能的简易精神状态检查表；用于评估日常生活活动能力的巴氏指数；用于评估动机的活力指数；不良反应和药物相互作用的存在情况。
服用yokukansan治疗后，患者在格拉斯哥昏迷量表（P = 0.001）、神经精神科问卷（P = 0.016）、简易精神状态检查表（P = 0.029）、巴氏指数（P = 0.043）和活力指数（P = 0.013）方面有显著改善。未观察到yokukansan与西药之间的不良反应或药物相互作用。
yokukansan改善了创伤性脑损伤后有破坏性行为和攻击性行为患者的格拉斯哥昏迷量表、神经精神科问卷、简易精神状态检查表、巴氏指数和活力指数，且未产生任何不良反应，也未与西药发生药物相互作用。
