2.2 MEDICATIONS FOR AUTONOMIC NERVOOUS DISORDERS AND
RECONSTRUCTION OF AWAKENING-SLEEP RHYTHM
When there were orthostatic hypotension, prolonged QT interval, or
bradycardia with cardiomegaly or high brain natriuretic peptide, the
autonomic nervous disorder of circulatory organ was considered. And we
used a diuretic or Toki-Shakuyaku-San to reduce heart load. High blood
pressure was treated mainly by angiotensin II receptor blocker
(ARB).31 When pollakiuria was detected without the
storage of urine during night, we used Hachimi-Jio-Gan. The diuretics in
morning also contributed to construction of the urination rhythm. In the
case with arthralgia at the same time, we used Gosha-Jin-Ki-Gan. When
the need of improvement of gastrointestinal peristalsis was considered,
we treated lansoprazole in morning and tried to make the circadian
rhythm. Lansoprazole stabilizes the receptive relaxation of stomach in
morning.32 When we diagnosed loss of appetite, low
motivation, and muscle weakness of legs, so-called frail syndrome, we
used Ninjin-Yoei-To. When electroencephalogram (EEG) pointed out
fluctuating cognition, or the interview confirmed the change of the
cognitive function in the day or week, we chose Japanese Kampo Medicines
(JKMs), which contained Toki, Japanese Angelica Root, including
ligustilide, for the stabilization of awakening to reconstruct
awakening-sleep rhythm. When it was necessary to make the end of
activity towards night, we chose Japanese Kampo Medicines (JKMs)
containing Chotoko, Uncaria Hook, including rhynchophylline. In other
words, the Yokkan-San is a representative reconstructing the
awakening-sleep rhythm. With the combination of clonazepam, we made
experiences of the dream fewer and we performed a stabilization of the
sleep by nitrazepam.33,34