Jump to comment:

• Re: Herbal medicine (Gan Mai Da Zao decoction) for depression: a systematic review protocol
  Nozomu Kawashima
  Published on: 5 September 2014

• Published on: 5 September 2014

  Re: Herbal medicine (Gan Mai Da Zao decoction) for depression: a systematic review protocol

  • Nozomu Kawashima, Researcher

  This is a very interesting research proposal to evaluate a formula originated from Chinese traditional medicine, Gan Mai Da Zao (GMDZ) decoction. The protocol for a systematic review is generally well written; however, there are several points that need to be addressed from the standpoint of Japanese traditional Kampo medicine, which incorporated the Gan Mai Da Zao decoction as kambakutaisoto.

  Kampo medicine ori...

  Show More

  This is a very interesting research proposal to evaluate a formula originated from Chinese traditional medicine, Gan Mai Da Zao (GMDZ) decoction. The protocol for a systematic review is generally well written; however, there are several points that need to be addressed from the standpoint of Japanese traditional Kampo medicine, which incorporated the Gan Mai Da Zao decoction as kambakutaisoto.

  Kampo medicine originated from ancient Chinese traditional medicine, but developed distinctively [1]. Kampo medicine was the orthodox medicine in Japan until the 19th century when modern Western medicine took over. Nevertheless, some Kampo formulae are still officially registered in the Japanese Pharmacopoeia [2]. Since 1967, Kampo formulae have been covered by National Health Insurance, and currently 148 Kampo formulae are approved for ethical use [3]. Although Kampo extracts are crude drugs derived from plants, animals, and minerals, their quality is strictly controlled in accordance with the Japanese Pharmacopoeia by quantitative analysis of marker components using high-performance liquid chromatography.

  Unlike China and Korea, traditional medicine in Japan is used in a Western-style medical system, and is prescribed by medical doctors, educated in Western medicine [3], who are required to have a basic knowledge of Kampo formulae. Reflecting the needs for establishing evidence-based medicine in Kampo, the Japan Society for Oriental Medicine has run a project from 2001 to gather comprehensive data on the randomized controlled trials (RCTs) of Kampo formulae in Japan, and to compile structured abstracts with critical appraisal. This report is published annually as Evidence Reports of Kampo Treatment (EKAT) in Japanese and English.[4] In the current version EKAT 2013, 402 RCTs of Kampo formulae are included.

  The first point to be addressed is that the systematic review protocol developed by Dr. Jun et al. lacks searches of articles written in Japanese; thus, it may result in a biased review. The authors are encouraged to search in Japanese database, Ichushi [5], although no RCTs of kambakutaisoto (Japanese name for GMDZ decoction) seem to be reported in EKAT 2013. Secondary, the authors mention that they include forms of GMDZ such as extracts, tablets, capsules, pills, powders or injections. However, unlike Japanese Kampo extracts, the quality and ingredients of the formulae such as tablets, capsules, or crude powders are not strictly controlled, especially in the older articles, which may result in a bias. Thirdly, although the authors are planning to search the Kampo formula by kambakutaisoto or kam baku tai soto, older articles seem to use the word kanbaku-taiso-to to express the formula, and this word should be included in the search. The structured notation of kambakutaisoto is not quite correct; it should be Kambaku-taiso-To.

  1. Matsumoto M, Inoue K, Kajii E. Integrating traditional medicine in Japan: the case of Kampo medicines. Complement Ther Med 1999;7(4):254-5 2. Kawashima N, Deveaux TE, Yoshida N, et al. Choreito, a formula from Japanese traditional medicine (Kampo medicine), for massive hemorrhagic cystitis and clot retention in a pediatric patient with refractory acute lymphoblastic leukemia. Phytomedicine 2012;19(12):1143-6. 3. Motoo Y, Arai I, Tsutani K. Use of Kampo diagnosis in randomized controlled trials of kampo products in Japan: a systematic review. PLoS One 2014;9(8):e104422. 4. Task Force for Evidence Reports/Clinical Practice Guidelines (ER/CPG- TF) Special Committee for Evidence-based Medicine (EBM), The Japan Society for Oriental Medicine (JSOM). Evidence Reports of Kampo Treatment (EKAT) Appendix 2012. Retrieved September 4, 2014, from http://www.jsom.or.jp/medical/ebm/ere/pdf/EKATE_Appendix_2012.pdf. 5. Tomizawa Y. Ichushi, Japanese medical bibliography. Kyobu Geka 2010;63(7):585-9, in Japanese

  Conflict of Interest:

  None declared

  Show Less

  Conflict of Interest:
  None declared.

  • Back to top