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Review
. 2021 Dec 14:14:705023.
doi: 10.3389/fnmol.2021.705023. eCollection 2021.

Kampo Formulae for the Treatment of Neuropathic Pain ∼ Especially the Mechanism of Action of Yokukansan ∼

Masataka Sunagawa  1 , Yasunori Takayama  1 , Mami Kato  1 , Midori Tanaka  1   2 , Seiya Fukuoka  1   3 , Takayuki Okumo  1 , Mana Tsukada  1 , Kojiro Yamaguchi  1
Affiliations
Review

Kampo Formulae for the Treatment of Neuropathic Pain ∼ Especially the Mechanism of Action of Yokukansan ∼

Masataka Sunagawa et al. Front Mol Neurosci. .

Abstract

Kampo medicine has been practiced as traditional medicine (TM) in Japan. Kampo medicine uses Kampo formulae that are composed of multiple crude drugs to make Kampo formulae. In Japan, Kampo formulae are commonly used instead of or combined with Western medicines. If drug therapy that follows the guidelines for neuropathic pain does not work or cannot be taken due to side effects, various Kampo formulae are considered as the next line of treatment. Since Kampo formulae are composed of two or more kinds of natural crude drugs, and their extracts contain many ingredients with pharmacological effects, one Kampo formula usually has multiple effects. Therefore, when selecting a formula, we consider symptoms other than pain. This review outlines the Kampo formulae that are frequently used for pain treatment and their crude drugs and the basic usage of each component. In recent years, Yokukansan (YKS) has become one of the most used Kampo formulae for pain treatment with an increasing body of baseline research available. We outline the known and possible mechanisms by which YKS exerts its pharmacologic benefits as an example of Kampo formulae's potency and holistic healing properties.

Keywords: Kampo formula; Kampo medicine; Yokukansan; analgesic effect; neuropathic pain.

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Conflict of interest statement

MS received a research grant from Tsumura & Co. (Tokyo, Japan). The remaining authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

FIGURE 1
FIGURE 1
Mechanisms of action of Yokukansan for neuropathic pain. Several different mechanisms of action may act on neurotransmission in the spinal dorsal horn. (1) Attenuation of excessive glutamate release from presynaptic neurons. (2) Promotion of the uptake of glutamate into astrocytes. (3) Antagonistic effect on the glutamate receptor, N-methyl-D-aspartate (NMDA) receptor. (4) Agonistic effect on the GABAA receptor. (5) Inhibition of the activation of glia cells (microglia and astrocyte). (6) Agonistic effect on the serotonin 5-HT1A receptor. YKS, Yokukansan; AMPA, α-amino-3-hydroxy-5-methyl-4-isoxazolepropionic acid receptor.
See this image and copyright information in PMC

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