Herbal Mixture including Ganoderma Lucidum alleviate herpetic pain

1. Herbal Mixture includingGanoderma Lucidum alleviate herpetic pain Yuko Miyamae MD.,Ph.D (1) Yasuyo Hijikata MD.,Ph.D (2) (1) Miyamae Clinic (2) Toyodo Hijikata Clinic

2. Introduction Hijikata et al reported that WTMCGEPP(Wisteria floribunda , Trapa natans, Miristica agrans, Coix lachryma-jobi, cultivated Ganoderma lucidum, Elfuinga applanata, tissue-cultured Panax ginseng, and Punica granatum) decreased acute herpes zoster pain with or without conventional therapies (Ref 1). This time, we administered to patients with herpes-related pain and PHN. Ref 1. The American J.Chin.Med, Vol.33,No4,517-523

3. Subjects and Methods WTMCGEPP was added to conventional therapies to which patients did not respond sufficiently. A 78-year-old (yrs) female with acute shingles, a 54 yrs male with diabetic nephropathy under artificial dialysis, 85 yrs male and a 73 yrs male with herpes-related pain and two PHN patients (78 yrs female and 73 yrs male) are included. All of them described themselves according to the Visual Analogue Scale (VAS) .

4. Table 1 Action of WTMCGEPP Herbs (dry wt g/dose) actions Wisteria floribunda (0.38) Promote movement in channels and collaterals Remove pain Trapa natans (0.38) Invigorate digestive function Miristica agrans (0.38) Drain dampness Coix semen (0.75) Ganoderma lucidum (0.75) Tonify Qi Elfuinga applanata (0.38) Supply essence Panax ginseng (0.3) Provide energy which resists disease (tissue cultured) Punica granatum (0.38) Destroy pests Stabilize kidney to retain the essence

5. Case 1 Acute herpetic pain of right upper arm:78 –year-old female After swimming in a pool in January, the patient experienced the beginning of shingles with pain in the right upper arm and back.

6. Physiotherapies in need Aciclo-Div* Analgesic drug Vidarabine Oint Betamethasone Oint Antiviral Drug WTMCGEPP 80 70 60 50 VAS 40 30 20 NB Nerve Block(NB) 10 Nkcell Activity NB VASｘ10 0 2 1 6 18 8 10 12 27 11 15 4 20 9 17 Days of illness Fig1. Clinical course of acute herpes zoster of right upper arm of 78-year-female. (Aciclovir,Vitamin,Neurotropin) * X 10

7. Case 2 Herpes related pain of occipital herpes zoster:54-year-old male He developed a right occipital herpes zoster in November. He had been undertaking dialysis because of diabetic nephropathy.

8. TJ-7＋TJ-14 WTMCGEPP 80 60 Nkcell Activity anti-VZVabx0.1 VAS 40 Midnight Pain 20 VASｘ10 First SGB+Physiotherapy Consult 0 1 39 31 35 29 33 36 42 56 70 23 25 46 50 Days of illness 37 34 47 30 24 40 Fig2. Clinical course of herpes zoster of 54-year-male He is undergoing dialysis because of Diabetic Neropathy. x 10

9. Case 3 Herpes related pain of right facial herpes zoster:73-year-old male On November 5th he developed a right facial herpes zoster. He was hospitalized in a public hospital for 14days without any improvement

10. Kallidinogenase and Vitamin B1,6,12 100 80 WTMCGEPP 100 60 VAS 40 80 20 hospitalization VAS 60 0 56 68 43 21 86 1 36 40 Nkcell Activity 40 anti-VZVabx0.1 First 20 Consult SGB+Physiotherapy VASｘ10 0 40 47 42 49 53 68 44 51 55 86 Days of illness 52 56 41 43 45 Fig3. Clinical course of facial herpes zoster of 73-year-male. X 10

11. Case 4 Herpes related pain of left lower limb:85-year-old male He developed the shingle at 3 months after hospitalization because of pneumonia.. He was infected with VZV and HSV.

12. anti-HSVabx0.1 WTMCGEPP 100 80 anti-VZVabx0.1 60 VAS Nkcell Activity VASｘ10 40 Lower limb pain First 20 Consult VASｘ10 NB NB abdominal pain 0 29 99 135 -123 1 3 32 44 15 21 18 51 9 -96 Days since first consult Fig 4. Clinical course of lower limb herpes zoster (85-year-old male) x 10

13. Case 5 PHN of left leg herpes zoster:78-year-old female She had been suffering from PHN since 9 months ago at around VAS=8.

14. TJ-7 WTMCGEPP 80 70 anti-HSVabx0.1 80 60 60 50 VAS VAS Nkcell Activity 40 40 anti-VZVabx0.1 20 30 0 1 -261 24 50 27 20 First Consult Physiotherapy 10 VASｘ10 0 50 1 22 7 10 43 5 39 27 15 9 24 30 18 16 26 28 Days since first consult Fig 5. Clinical course of left leg herpes zoster of X10 + NB year-old-female(PHN) 78-

15. Case 6 Right femoral reginal PHN:74-year-old male Herpes zoster developed on the right femoral region with severe pain on the 3rd of Jan. Conventional therapies were undertaken to attain a VAS=3 on the 5th of February. He was able to lead his routine life with VAS=3 until September. On 10th of October, however, the pain appeared as cool temperatures arrived.

16. Keishikajyutsubuto Conventional therapy 100 Physiotherapy+etc 80 WTMCGEPP 60 VAS 40 First Consult 20 VASｘ10 0 220 97 22 76 24 34 9 1 53 121 -180 23 25 37 Days after first consult Fig 6. Clinical course of right femor herpes zoster of 74- X 10 year-old-male(PHN)

17. CONCLUSION When the conventional therapies did not work for acute herpetic pain, herpes-related pain and PHN, the addition of WTMCGEPP to conventional therapies reduced the herpetic pain. Now that there is no way to cure PHN, the addition of WTMCGEPP to conventional therapies can be a prominent method to prevent PHN. As WTMCGEPP increased the NK cell activity in many cases(Ref 1,2).we ‘d like to clarify how it concerns in VZV infection in future. Ref 2:Yasuhara et al.”Effect of herbal therapy on chronic herpes virus infections.”Alternative Therapies in Health and Medicine. Vol. 9, No.5, p 132-136, 2003.