Goreisan

Goreisan is a traditional herbal formula in Japanese Kampo medicine. It is primarily used for the treatment of hemorrhoids. The formula is a combination of several herbal ingredients, including Japanese catnip (Nepeta tenuifolia), gardenia fruit (Gardenia jasminoides), and atractylodes rhizome (Atractylodes lancea).

In Kampo medicine, Goreisan is believed to have anti-inflammatory, analgesic, and hemostatic properties. It is often prescribed to alleviate symptoms associated with hemorrhoids, such as pain, itching, swelling, and bleeding. The specific mechanisms by which Goreisan works are not fully understood, but it is thought to help reduce inflammation, improve blood circulation, and promote tissue healing.

Goreisan is typically available in various forms, including granules, powders, or pills, and the dosage and administration instructions may vary depending on the manufacturer and the individual patient's condition. As with any herbal remedy or medication, it is essential to consult with a qualified healthcare professional, preferably a practitioner experienced in Kampo medicine, to determine the appropriate usage and dosage for your specific situation.

It's important to note that while Kampo medicine, including Goreisan, has a long history of use in Japan, its effectiveness and safety should be evaluated on an individual basis.

Goreisan is used to treat a chronic subdural hematoma. Yokukansan and Keishikaryukotsuboreito are useful for alleviating the behavioral and psychological symptoms of dementia. Keishikajyutsubuto and Shinbuto are used to treat numbness and pain associated with peripheral neuropathy. Hangeshashinto has successfully attempted to treat intractable hiccoughs. It is advisable to use an extract of stable quality in accordance with the rule of thumb described in the classics. However, awareness of side effects, such as pseudo-aldosteronism caused by licorice, is important ¹⁾

Goreisan for chronic subdural hematoma

1: Nakao J, Marushima A, Fujita K, Fujimori H, Mashiko R, Kamezaki T, Sato N, Shibata Y, Takano S, Ishikawa E. Conservative Treatment of Chronic Subdural Hematoma with Gorei-san. Neurol Med Chir (Tokyo). 2022 Oct 25. doi: 10.2176/jns- nmc.2022-0229. Epub ahead of print. PMID: 36288975.

2: Katsuki M, Kawamura S, Koh A. Japanese herbal <i>Kampo</i> medicine, Keishibukuryogan, for chronic subdural hematoma - Prospective observational study. Surg Neurol Int. 2022 Jul 15;13:307. doi: 10.25259/SNI_455_2022. PMID: 35928329; PMCID: PMC9345083.

3: Katsuki M, Kashiwagi K, Kawamura S, Koh A. Spontaneous Intracranial Hypotension Manifesting Orthostatic Headache Worsened by Playing the Saxophone and Treated by Japanese Herbal Kampo Medicine Goreisan. Cureus. 2022 May 27;14(5):e25393. doi: 10.7759/cureus.25393. PMID: 35774649; PMCID: PMC9236673.

4: Katsuki M, Kashiwagi K, Kawamura S, Koh A. The Efficacy of Japanese Herbal Kampo Medicine as an Acute and Prophylactic Medication to Treat Chronic Daily Headache and Medication Overuse Headache:-Single Arm Retrospective Study. Cureus. 2022 May 27;14(5):e25419. doi: 10.7759/cureus.25419. PMID: 35769688; PMCID: PMC9233981.

5: Lee HK, Jin C, Kwon S, Jang BH, Jeon JP, Lee YS, Yang SB, Jung WS, Moon SK, Cho KH. Treatment of nausea and vomiting associated with cerebellar infarction using the traditional herbal medicines banhabaekchulcheonma-tang and oryeong- san: Two case reports (CARE-complaint). Explore (NY). 2021 Dec 1:S1550-8307(21)00246-9. doi: 10.1016/j.explore.2021.11.011. Epub ahead of print. PMID: 34911662.

6: Katsuki M, Kawamura S, Kashiwagi K, Koh A. Medication Overuse Headache Successfully Treated by Three Types of Japanese Herbal Kampo Medicine. Cureus. 2021 Jul 31;13(7):e16800. doi: 10.7759/cureus.16800. PMID: 34513406; PMCID: PMC8405851.

7: Wang X, Song J, He Q, You C. Pharmacological Treatment in the Management of Chronic Subdural Hematoma. Front Aging Neurosci. 2021 Jul 1;13:684501. doi: 10.3389/fnagi.2021.684501. PMID: 34276343; PMCID: PMC8280518.

8: Fujisawa N, Oya S, Yoshida S, Tsuchiya T, Nakamura T, Indo M, Matsui T. A Prospective Randomized Study on the Preventive Effect of Japanese Herbal Kampo Medicine Goreisan for Recurrence of Chronic Subdural Hematoma. Neurol Med Chir (Tokyo). 2021 Jan 15;61(1):12-20. doi: 10.2176/nmc.oa.2020-0287. Epub 2020 Nov 19. PMID: 33208583; PMCID: PMC7812313.

9: Shimizu S, Mochizuki T, Kuroda H, Nemoto M, Kumabe T. [Lymphorrhea at the Site of Repeated Fascia Lata Harvesting:A Case Report]. No Shinkei Geka. 2020 Jul;48(7):621-625. Japanese. doi: 10.11477/mf.1436204241. PMID: 32694232.

10: Harada Y, Yoshida K, Nojiri S, Kurihara Y, Kobayashi H, Arai H. Identification of chronic subdural hematoma types most responsive to Goreisan, Kampo medicine: A retrospective study. J Clin Neurosci. 2020 Aug;78:198-202. doi: 10.1016/j.jocn.2020.04.063. Epub 2020 Apr 23. PMID: 32336630.

11: Yamada T, Natori Y. Prospective Study on the Efficacy of Orally Administered Tranexamic Acid and Goreisan for the Prevention of Recurrence After Chronic Subdural Hematoma Burr Hole Surgery. World Neurosurg. 2020 Feb;134:e549-e553. doi: 10.1016/j.wneu.2019.10.134. Epub 2019 Oct 31. PMID: 31678452.

12: Kawase T, Bishnoi I, Tanaka R, Dash C, Kato Y, Yamada Y. Study of Incidence and Factors: Risk and Preventive, of Chronic Subdural Hematoma/hygroma in Clipped Patients of Unruptured Intracranial Aneurysms - An Institutional Experience. Asian J Neurosurg. 2018 Jul-Sep;13(3):707-713. doi: 10.4103/ajns.AJNS_355_16. PMID: 30283532; PMCID: PMC6159057.

13: Goto S, Kato K, Yamamoto T, Shimato S, Ohshima T, Nishizawa T. Effectiveness of Goreisan in Preventing Recurrence of Chronic Subdural Hematoma. Asian J Neurosurg. 2018 Apr-Jun;13(2):370-374. doi: 10.4103/ajns.AJNS_174_16. PMID: 29682036; PMCID: PMC5898107.

14: Katayama K, Matsuda N, Kakuta K, Naraoka M, Takemura A, Hasegawa S, Akasaka K, Shimamura N, Itoh K, Asano K, Konno H, Ohkuma H. The Effect of Goreisan on the Prevention of Chronic Subdural Hematoma Recurrence: Multi-Center Randomized Controlled Study. J Neurotrauma. 2018 Jul 1;35(13):1537-1542. doi: 10.1089/neu.2017.5407. PMID: 29444611.

15: Okamura A, Kawamoto Y, Sakoda E, Murakami T, Hara T. Evaluation of recurrence factors and Gorei-san administration for chronic subdural hematoma after percutaneous subdural tapping. Hiroshima J Med Sci. 2013 Dec;62(4):77-82. PMID: 24597210.

16: Wakabayashi Y, Yamashita M, Asano T, Yamada A, Kenai H, Kondoh Y, Hori Y, Nagatomi H. [Effect of Gorei-san with tranexamic acid for preventing recurrence of chronic subdural hematoma]. No Shinkei Geka. 2012 Nov;40(11):967-71. Japanese. PMID: 23100384.

17: Miyagami M, Kagawa Y. [Effectiveness of Kampo medicine Gorei-San for chronic subdural hematoma]. No Shinkei Geka. 2009 Aug;37(8):765-70. Japanese. PMID: 19663334.