Department of Psychiatry, Tokyo Women's Medical University, Tokyo, Japan; Japan Somnology Center, Neuropsychiatric Research Institute, Tokyo, Japan.
Department of Somnology, Tokyo Medical University, Tokyo, Japan; Department of Life Sciences and Bio-informatics, Division of Biomedical Laboratory Sciences, Graduate School of Health Sciences, Tokyo Medical and Dental University, Tokyo, Japan; Department of Clinical Laboratory Science, Faculty of Medical Technology, Teikyo University.
J Clin Sleep Med. 2019 Aug 15;15(8):1173-1178. doi: 10.5664/jcsm.7816.
The herbal medicine Yokukansan (YKS; Yi-Gan San in Chinese) is reported to be effective for treating rapid eye movement sleep behavior disorder (RBD). However, the effectiveness and safety of YKS treatment have not been confirmed in a large sample. Thus, we retrospectively analyzed the outcomes of YKS treatment on patients with RBD using clinical records.
Treatment outcomes were evaluated using the Clinical Global Impression of Illness Severity (CGI-S) and Improvement (CGI-I) scales. Patients with scores of 1 (very much improved) and 2 (much improved) on the CGI-I were classified as responders. After excluding patients with very mild RBD symptoms and those without detailed clinical information, 36 patients with idiopathic RBD including 17 receiving YKS monotherapy and 19 receiving YKS add-on therapy in addition to other medication were analyzed.
The patients' mean age [standard deviation, SD] was 69.3 [6.8] years, and the mean duration of RBD morbidity [SD] was 5.7 [3.5] years at the start of YKS treatment. Importantly, 12 of 17 patients (70.6%) receiving YKS monotherapy were responders. However, among patients receiving YKS add-on therapy, the proportion of responders was substantially lower (4 of 19 patients; 21.1%). No adverse events were reported, other than mild gastric distress in one case.
Considering the effectiveness of YKS and the low likelihood of adverse events, YKS should be considered as a potential treatment for patients with RBD.
Matsui K, Sasai-Sakuma T, Ishigooka J, Nishimura K, Inoue Y. Effect of yokukansan for the treatment of idiopathic rapid eye movement sleep behavior disorder: a retrospective analysis of consecutive patients. J Clin Sleep Med. 2019;15(8):1173-1178.
据报道，草药和汉方药（YKS；在中文中为一甘三）对治疗快速眼动睡眠行为障碍（RBD）有效。然而，YKS 治疗的有效性和安全性尚未在大样本中得到证实。因此，我们使用临床记录回顾性分析了 YKS 治疗 RBD 患者的结果。
使用疾病严重程度临床总体印象量表（CGI-S）和改善量表（CGI-I）评估治疗效果。CGI-I 得分为 1（明显改善）和 2（改善很多）的患者被归类为应答者。排除 RBD 症状非常轻微的患者和无详细临床信息的患者后，分析了 36 例特发性 RBD 患者，其中 17 例接受 YKS 单药治疗，19 例除其他药物外还接受 YKS 附加治疗。
患者的平均年龄[标准差，SD]为 69.3[6.8]岁，开始接受 YKS 治疗时 RBD 发病的平均病程[SD]为 5.7[3.5]年。重要的是，17 例接受 YKS 单药治疗的患者中有 12 例（70.6%）为应答者。然而，接受 YKS 附加治疗的患者中，应答者的比例明显较低（19 例中有 4 例；21.1%）。除 1 例出现轻度胃部不适外，未报告其他不良反应。
鉴于 YKS 的有效性和不良反应发生的可能性较低，YKS 应被视为 RBD 患者的一种潜在治疗选择。
Matsui K, Sasai-Sakuma T, Ishigooka J, Nishimura K, Inoue Y. Yokukansan 治疗特发性快速眼动睡眠行为障碍的效果：连续患者的回顾性分析。J Clin Sleep Med. 2019;15(8):1173-1178.
