Viết tắt của phương thuốc kampo và thuật ngữ cơ bản trong y học kampo

TRỪU TƯỢNG Các tiêu chuẩn quốc tế về y học cổ truyền đặc biệt là Tổ chức Tiêu chuẩn hóa Ủy ban Kỹ thuật Quốc tế (ISO TC) 249 hiện đang được tranh luận. loại thuốc kampo của Nhật nào có lợi thế toàn cầu. Trong khi ngày càng có nhiều bằng chứng y tế về hiệu quả của các công thức chiết xuất kampo như daikenchuto và yokukansan, một vấn đề trong việc ghi lại bằng chứng này là làm thế nào để mô tả các công thức kampo bằng cách sử dụng ký hiệu tiếng Anh. Các nhà nghiên cứu hiện đang sử dụng các chữ viết tắt cho các công thức kampo, đã dẫn đến một số nhầm lẫn. Cũng cần có một hệ thống ký hiệu tiếng Anh để hỗ trợ tìm kiếm trên PubMed và các các công cụ tìm kiếm của các nhà nghiên cứu ở các quốc gia không sử dụng ký tự Trung Quốc. Do đó, chúng tôi đã phát triển một hệ thống ký hiệu tiếng Anh viết tắt cho các công thức kampo để hỗ trợ việc mở rộng toàn cầu của thuốc kampo. Đề xuất của chúng tôi hệ thống nhắm mục tiêu đến 298 công thức kampo, bao gồm cả công thức chiết xuất kampo không kê đơn, xuất hiện trong năm 2013 Sách Hướng dẫn Mới về Công thức Kampo Không Mô tả. Khi phát triển các từ viết tắt, chúng tôi đã khảo sát ký hiệu được sử dụng để thể hiện các công thức kampo trong các bài báo học thuật về nhận dạng kampo bằng công cụ tìm kiếm PubMed. Các ký hiệu khác nhau là được sử dụng trong tài liệu cho daikenchuto, là một công thức chiết xuất kampo điển hình, và số lượng bài báo nằm ở vị trí khác nhau theo cụm từ tìm kiếm, do đó chứng tỏ sự cần thiết phải tạo ra một hệ thống các từ viết tắt. Chúng tôi đã sử dụng bốn hướng dẫn tạo các chữ viết tắt: (i) các chữ viết tắt thường được chọn bằng cách chọn ba chữ cái có trong tên ký hiệu la tinh của công thức kampo; (ii) khi nhiều công thức kampo có cùng một chữ viết tắt, trước nó được trao cho công thức có nhiều lượt truy cập tìm kiếm nhất trên PubMed; (iii) khi nhiều công thức kampo có cùng viết tắt, chúng tôi chọn cái đã được sử dụng; và (iv) đối với công thức kampo có chứa các chất phụ gia thảo mộc, cấu trúc cơ bản của tên được duy trì và tên của chất phụ gia được viết tắt và thêm vào cuối. Dựa trên bốn nguyên tắc này, chúng tôi đã đệ trình hệ thống các từ viết tắt được đề xuất để thảo luận chung bởi Hiệp hội Y khoa và Dược phẩm cho WakanYaku và Hiệp hội Y học Phương Đông Nhật Bản (JSOM) vào tháng 8 năm 2014. Sau đó, chúng tôi đã tìm kiếm bình luận của công chúng về chương trình hệ thống được đặt ra vào tháng 10 năm 2014 và, sau khi nhận được nhiều đề xuất sửa đổi và chỉnh sửa, hệ thống viết tắt Các công thức của 298 kampo này đã được thành lập. Ủy ban Từ vựng của JSOM đã giám sát các thuật ngữ tiếng Nhật trong y học kampo kể từ năm 1969. Khoảng 300 thuật ngữ cơ bản đã được chọn để dịch sang tiếng Anh. 2014–2015. Các thuật ngữ này dựa trên các thuật ngữ trong Phân loại Bệnh tật Quốc tế (ICD) 11. Các thuật ngữ này đã được được dịch sang tiếng Anh và chờ xuất bản trong tương lai (dự kiến ​​cho năm 2018).

Article  in   Traditional & Kampo Medicine · September 2017

DOI: 10.1002/tkm2.1078

CITATIONS

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3 authors, including:

Some of the authors of this publication are also working on these related projects:

Abbreviation of kampo formulations and basic terminology in kampo medicine View project

Kampo Medicine in Iternational Classification of Traditional Medicine Project View project

Abbreviation of kampo formulations and basic terminology in kampo medicine

1 Department of Advanced Hybrid Medicine, Osaka University Graduate School of Medicine, Suita, Japan

2 Department of Clinical Kampo Medicine, Meiji Pharmaceutical University, Kiyose, Japan

3 Department of Japanese-Oriental (Kampo) Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan

ABSTRACT

International standards regarding traditional medicine – particularly the International Organization for cal Committee (ISO/TC) 249 – are currently being debated Kampo extract formulations of standardized quality are one area in

of kampo extract formulations such as daikenchuto and yokukansan, one issue in documenting this evidence is how to describe kampo formulations using English notation Researchers currently use abbreviations for kampo formulations, which has led to some confusion There is also a need for a system of English notation to facilitate searches on PubMed and other search engines by researchers in countries that do not use Chinese characters We have therefore developed a system of abbreviated English notation for kampo formulations in order to aid the global expansion of kampo medicine Our proposed system targets the 298 kampo formulations, including over-the-counter kampo extract formulations, which appear in the 2013 New Guidebook on Nonprescription Kampo Formulas When developing the abbreviations, we investigated the notation used to

used in the literature for daikenchuto, which is a typical kampo extract formulation, and the number of articles located differed according to the search term, thus demonstrating the need to create a system of abbreviations We used the following four guidelines in creating the abbreviations: (i) abbreviations are generally selected by choosing three letters contained in the romanized name/notation of the kampo formulation; (ii) when multiple kampo formulations have the same abbreviation, prior- ity is given to the formulation with the most search hits on PubMed; (iii) when multiple kampo formulations have the same abbreviation, we select the one already in use; and (iv) for kampo formulations containing herbal additives, the basic structure

of the name is maintained and the name of the additive is abbreviated and added to the end Based on these four guidelines,

we submitted the proposed system of abbreviations for joint discussion by the Medical and Pharmaceutical Society for Wakan-Yaku and the Japan Society for Oriental Medicine (JSOM) in August 2014 We then sought public comment on the pro- posed system in October 2014 and, after receiving various suggestions for revision and corrections, the system of abbrevia- tions for these 298 kampo formulations was established The Committee for Vocabulary in JSOM has been overseeing Japanese terminology in kampo medicine since 1969 Approximately 300 basic terms were selected for English translation in

translated into English and await future publication (planned for 2018).

KEY WORDS: abbreviation, Japanese traditional herbal medicine, kampo formulation, terminology

INTRODUCTION International standards for traditional medicine, such as International Organization for Standardization/Traditional Chinese Medicine (ISO/TC)249, are currently being dis- cussed in China and other nations [1] Within this context, the process of developing an international standard for Japan’s traditional medicine (known as kampo) has become

an important issue Kampo extract formulations have a dardized quality and this standardization represents one area

stan-in which Japanese kampo medicstan-ines have a global advantage There is now an accumulated body of clinical studies on

*Correspondence Keisuke Hagihara

†Abbreviation of Kampo Formulations Group: Toshiaki Makino, Hideyuki Nakata,

Hisanori Matsuoka, Junsuke Arimitsu, Keiko Ogawa, Hidetoshi Itakura.

‡Committee for Vocabulary in the Japan Society for Oriental Medicine: Yosuke

Amano, Michiho Ito, Kenji Kobayashi, Shoji Shinohara, Megumi Sumino, Masao

Togasaki, Toshihiro Togo, Yukiko Ueda, Koji Watanabe.

DOI:10.1002/tkm2.1078

Received 28 April 2017; revised 1 June 2017; accepted 21 June 2017

clarifying their previously unknown basic pharmacological

in English, however, is how to describe kampo formulations

using English notation.

The Japanese Society of Pharmacognosy has published

articles on a system of English notation for kampo

formula-tions and crude drug terminology [5,6], while the Japan

Society for Oriental Medicine (JSOM) released a system of

romanized notation in 2005 and a structural notation system

in 2011 [7,8] Researchers studying kampo medicine in

Japan, however, currently use their own arbitrary systems of

abbreviations to describe kampo formulations, which have

led to some confusion Given the current level of interest in

that do not typically use Chinese characters, there is need

for a system of abbreviated English notation to facilitate

searches on PubMed and other search engines A

standar-dized abbreviated English notation for kampo formulations

is also essential for preparing figures and tables in research

articles We have therefore developed a system of

abbrevi-ated English notation for kampo formulations to aid the

global expansion of Japanese kampo medicine.

With regard to the terminology in kampo medicine, JSOM

members who served on the Committee for Vocabulary

from 1969 started writing textbooks for terminology in

kampo medicine For persons who are not familiar with

Jap-anese terms of kampo medicine, the English version has

been under construction since 2014.

BACKGROUND TO DEVELOPMENT OF THE

ABBREVIATED ENGLISH NOTATION

Materials

We initially targeted the 210 formulations described in the

2011 Revised Guidebook on Nonprescription Kampo

Formu-las, together with 18 over-the-counter (OTC) formulations

[9], and developed a system of abbreviations for 144 Kampo

extract formulations selected from these 228 formulations.

Due to the considerable level of interest shown in our

pro-posed system, we subsequently expanded its scope to

encom-pass the 298 kampo formulations, including OTC kampo

extract formulations, which appear in the 2013 New

Guide-book on Nonprescription Kampo Formulas [10].

Development process

In developing this system, we prepared abbreviated notation

for 144 Kampo extract formulations based on discussions

with various relevant individuals led by Osaka University’s

Department of Kampo Medicine (endowed chair) in May

sought the opinions of scientists as part of the ‘Research

Pro-gram to Establish a Globally Relevant and Scientifically Valid

funded by the Ministry of Health, Labour and Welfare at Chiba University Based on the feedback obtained regarding our research, we held a second meeting in March 2014 and developed a system of abbreviated notation for a total of

298 kampo formulations We submitted our proposed tem of abbreviations for joint discussions by the Medical and Pharmaceutical Society for Wakan-Yaku and the Japan Society for Oriental Medicine in August 2014, and sought public comment in October 2014 Based on the various sug-

abbreviation system.

DEVELOPMENT OF THE ABBREVIATION SYSTEM

Review of current usage of abbreviations

We studied a number of articles using common abbreviations and various notations used to describe typical Kampo extract formulations such as daikenchuto, rikkunshito, hangesha- shinto and keishibukuryogan As shown in Table 1, daikench- uto is expressed in various ways, for example using the 2005 Romanized Notation, the 2011 Structural Notation, the prod-

number of articles located by database searching differed depending on the search term As shown in Table 1, rikkun- shito, hangeshashinto, and keishibukuryogan have also been expressed in various ways, and therefore the number of articles located again differed according to the search term, thus reiter- ating the need for standardized abbreviations The number of articles in Table 1 was current as of 2 December 2016.

Methodology for developing the abbreviationsThe following three criteria were used to create the abbrevia- tions: (i) scientific name of the plant used to make the crude drug; (ii) name of the kampo formulation translated into English based on the meaning of the kampo Japanese name; and (iii) romanized notation.

For criterion 1, based on the scientific name of the plant used to make the crude drug, the plant name for kamishoyo- san is Angelica Bupleurum gardenia We then investigated the use of the abbreviation ABGM based on the listing of crude drugs, but we decided not to use this method due to a number of issues, such as the inherent difficulty in under- standing the structure of the kampo formulation, deciding

on how to select representative crude drugs, the similarities

of crude drug structures, and deciding on how to deal with the presence of many additives Issues regarding the use of criterion 2 included the question of who should decide on the translated English name of a kampo formulation The immense amount of effort required to develop the system based on this method was deemed to be unrealistic, so this method was not adopted Finally, criterion 3, the romanized and structural notations, was consistent with the Japanese

Pharmacopoeia and offered the potential for expansion, so

this method was selected.

Guidelines for establishing the abbreviated notation for

Kampo formulations

1 Abbreviations are generally selected by choosing three

letters contained in the romanized name/notation of

the Kampo formulation.

2 When multiple Kampo formulations have the same

abbreviation, priority is given to the one providing the

most search hits on PubMed.

3 When multiple Kampo formulations have the same

abbreviation, we select the one already in use.

4 For Kampo formulations containing herbal additives,

the basic structure of the name is maintained and the

name of the additive is abbreviated and added to

the end.

To demonstrate a typical abbreviation created using these

guidelines, the example of juzentaihoto is shown Three

let-ters are selected from the romanized name ‘juzentaihoto’, in

this case JTT The abbreviation generally consists of three

letters, but in the case of tokishigyakukagoshuyushokyoto,

which is very long when transliterated into English, the

(Table 2).

As shown in Table 2, daikenchuto and daiokanzoto are

examples of guideline 2, which gives priority to the kampo

formulation name that appears most frequently in PubMed

searches When adhering to guideline 1, the same tion DKT is obtained for both formulations, but daikenchuto

abbrevia-is clearly used more often in the literature and therefore the abbreviation DKT is assigned to this formulation while DKZT is assigned to daiokanzoto.

As shown in Table 2, kakkonto and kamikihito are ples of guideline 3, which gives priority to an abbreviation that is already in use Kakkonto would customarily be abbreviated as KKT, but a search of the literature showed that it is actually abbreviated as KT while kamikihito is abbreviated as KKT, therefore KKT is assigned to the latter formulation.

exam-As shown in Table 2, KST (keishito) is an example of an abbreviation for numerous kampo formulations containing various herbal additives, wherein the abbreviated basic structure KST is maintained based on guideline 4 The abbreviations for the additive-containing formulations are constructed by simply adding abbreviations for the herbal additives to KST The list of abbreviations for the

298 Kampo formulations created using the guidelines is shown in Table 3.

JSOM KAMPO MEDICINE TERMINOLOGY Recently China and other countries have started stan- dardizing East Asian traditional medicine in various fields.

Table 1 | Pubmed results as of 2 December 2016

Because kampo and Korean medicine, like modern

tradi-tional Chinese medicine (TCM), have developed medical

systems derived from ancient Chinese medicine, it is often

thought that these medical systems are almost identical.

Kampo medicine, however, is different from TCM in many

respects [11] and, indeed, differs more from TCM than

Korean medicine.

For example, to reach a diagnosis in kampo medicine,

abdominal examination is commonly performed, but this

is not the case in TCM or Korean medicine In addition,

these different medical systems have different ways of

thinking about their medicines Kampo medical doctors

think about formulae as a single unit, and it is rare for

them to change the composition of a formula or the

quan-tity of crude drugs recommended by a classical text book

(e.g Shang Han Lun) In contrast, TCM doctors coordinate

their prescriptions by taking into consideration the effect

of each of the crude drugs included Furthermore, kampo medical theory was simplified to make it easy to apply in clinical use, and is different from TCM theory in many respects.

Terminology in kampo is also different from that in TCM Terms in kampo began to differentiate from those

in Chinese medicine once the Koho school, which rily used the formulae in the Shen Han Lun textbook), rose to prevalence across Japan in the middle of the Edo era (18th century); and in the revival period of kampo medicine in the early 20th century, differentiation of the terms used in kampo medicine increased greatly There- fore, JSOM, which was established in 1950, recognized that

prima-a sepprima-arprima-ate prima-and originprima-al vocprima-abulprima-ary text for kprima-ampo cine terms was necessary in Japan To date, JSOM has

medi-Guideline 1 Three letters based on romanized notation

Romanized notation Structural notation Abbreviated notation

Tokishigyakukaoshuyushokyoto

Toki-shigyaku-ka-goshuyu-shokyo-to

TSGST

Guideline 2 Priority based on no search hits

Romanized notation No search hits Candidate

abbreviatednotation

Final abbreviatednotation

Guideline 3 Priority based on notation already being used

abbreviatednotation

No search hits

in PubMed

Final abbreviatednotation

KT 1†

KT

Guideline 4 Basic structure maintained with additives

Romanized notation Structural notation Abbreviated

Table 3 | Abbreviated notation for kampo formulations

Letters Romanized notation Structural notation Chinese characters Abbreviated notation

附子理中湯(附子人参湯)

BRT

Bukuryoingohangekobokuto Bukuyo-In-go-Hange-koboku-To 茯苓飲合半夏厚朴湯 BRIHK

(continued overleaf )

Letters Romanized notation Structural notation Chinese characters Abbreviated notation

八味地黄丸(八味丸)

Hontonto (kinkiyouryaku) Honton-To (kinkiyouryaku) 奔豚湯(金匱要略) HTK

KSCT

Keishibukurogan(ryo)kayokuinin Keishi-bukuryo-Gan-ka-yokuinin 桂枝茯苓丸(料)加薏苡仁 KBGY

Keishinieppiittokajutsuto Keishi-ni-eppi-it-To-ka-jutsu-To 桂枝二越婢一湯加朮湯 KNEIJ

(continued overleaf )

Letters Romanized notation Structural notation Chinese characters Abbreviated notation

Kyukichoketsuindaiichikagen Kyu-ki-choketsu-In-daiichi-kagen 芎帰調血飲第一加減 KCIDI

Reitakutsukitokashin’i Reitaku-tsuki-To-ka-shin’i 麗択通気湯加辛夷 RTTS

Table 3 (continued)

Letters Romanized notation Structural notation Chinese characters Abbreviated notation

Letters Romanized notation Structural notation Chinese characters Abbreviated notation

Yokukansankachimpihange Yokukan-San-ka-chimpi-hange 抑肝散加陳皮半夏 YKSCH

Yokukansankashakuyakuoren Yokukan-San-ka-shakuyaku-oren 抑肝散加芍薬黄連 YKSSO

Table 4 | Japanese and English terms for Kampo medicine

Japanese term(Chinese characters) Japanese pronunciation English term

Intermediate location

(continued overleaf )