Yoshino, Tetsuhiro



School of Medicine, Joint Research Laboratory for precision Kampo pattern diagnosis (Shinanomachi)


Project Senior Assistant Professor (Non-tenured)/Project Assistant Professor (Non-tenured)/Project Lecturer (Non-tenured)

E-mail Address

E-mail address

Academic Background 【 Display / hide

  • 2002.04

    Keio University, School of Medicine

    Japan, University, Graduated

Academic Degrees 【 Display / hide

  • 博士(医学), Keio University, Dissertation, 2016.07

    The Difference between the Two Representative Kampo Formulas for Treating Dysmenorrhea: An Observational Study

Licenses and Qualifications 【 Display / hide

  • 日本内科学会総合内科専門医

  • 日本内科学会認定医

  • 普通自動車運転免許, 2003.02

  • 医師免許, 2008.04

  • 日本漢方生薬ソムリエ, 2014.08

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Research Areas 【 Display / hide

  • General internal medicine (including psychosomatic medicine)


Papers 【 Display / hide

  • Differences in demographics and complementary and alternative medicine use between patients attending integrative kampo versus biomedical clinics in Japan

    Melby M., Yoshino T., Tonob D., Horiba Y., Watanabe K.

    Complementary Therapies in Medicine (Complementary Therapies in Medicine)  46   202 - 209 2019.10

    ISSN  09652299

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    © 2019 Elsevier Ltd Objectives: Growing interest in integrative medicine motivates examination of who seeks integrative care, and why. By examining differences in demographics and complementary and alternative medicine (CAM) use between patients recruited from Japanese Kampo (traditional herbal medicine) versus biomedical clinics, this study aimed to identify whether integrative medicine options might attract different patients. Design and setting: In this cross-sectional, observational study we administered the International Complementary and Alternative Medicine-Questionnaire (I-CAM-Q) to 209 patients recruited from four hospital clinics. Demographics, use of different types of CAM (self-help CAM, CAM practitioners, CAM products), and motivations were compared between Kampo and Non-Kampo patients and by gender. Factors influencing attendance at the Kampo clinic and CAM use were identified using logistic regression. Results: While some demographic characteristics, CAM provider and total CAM use differed between Kampo and non-Kampo patients, self-help CAM use did not. Motivations (for acute, long-term, health maintenance, or other reasons) differed between Kampo and non-Kampo clinic patients for going to non-Kampo physicians (P = 0.02) and Kampo physicians (P = 0.1). Logistic regression results for ‘any CAM’ use showed odds ratio of 0.32 (95%CI 0.15-0.67) for self-rated health, and 1.60 (95%CI 1.10–2.32) for Macarthur subjective social status scale. Attendance at the Kampo clinic showed odds ratios of 1.50 (95%CI 1.11–2.02) for education and 0.56 (95%CI 0.39-0.80) for employment status. Conclusions: Better understanding of factors such as motivation, self-rated health, and socioeconomic conditions that influence patients’ CAM use and integrative clinic attendance may enable more effective targeting of populations and integration of CAM into biomedical settings.

  • Classification of patients with cold sensation by a review of systems database: A single-centre observational study

    Yoshino T., Katayama K., Yamaguchi R., Imoto S., Miyano S., Mima H., Watanabe K.

    Complementary Therapies in Medicine (Complementary Therapies in Medicine)  45   7 - 13 2019.08

    ISSN  09652299

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    © 2019 Elsevier Ltd Objectives: In Kampo medicine, a traditional medicine pattern(TM1) refers to the complete clinical presentation of the patient at a given moment in time. Candidate herbal formulas are chosen for a chief complaint, and an appropriate formula is determined on the basis of the pattern(TM1) diagnosis. In this study, we demonstrated the importance of accompanying symptoms in diagnosing traditional medicine patterns(TM1). Design: Single centre observational study. Setting: We analysed data from 524 new patients with a hypersensitivity to cold sensation as their primary diagnosis (mean age 51.6 ± 17.8 years; female ratio 82.1%) who visited the Keio University Hospital Kampo Clinic between 2008 and 2013. Main outcome measures: Accompanying symptoms were recorded on the browser-based e-questionnaire system, which contained 128 items. The Japan Society for Oriental Medicine's board certified Kampo specialists diagnosed the traditional medicine patterns(TM1). Results: When participants were classified according to the origin of their cold sensation, there were no differences in their traditional medicine patterns. In contrast, when patients were classified based on the number of accompanying symptoms, a significant difference in the patterns was identified. An increasing number of accompanying symptoms was associated with more frequent qi stagnation and blood stasis pattern(TM1). Patients with a qi stagnation pattern had higher rates of depression and insomnia. In contrast, patients with a blood stasis pattern(TM1), had higher rates of acne, body stiffness, and menstrual abnormality. Conclusions: Qi stagnation and blood stasis patterns(TM1) are related to a number of different accompanying symptoms in the patients with hypersensitivity to cold sensation.

  • Prediction of deficiency-excess pattern in Japanese Kampo medicine: Multi-centre data collection

    Maeda-Minami A., Yoshino T., Katayama K., Horiba Y., Hikiami H., Shimada Y., Namiki T., Tahara E., Minamizawa K., Muramatsu S., Yamaguchi R., Imoto S., Miyano S., Mima H., Mimura M., Nakamura T., Watanabe K.

    Complementary Therapies in Medicine (Complementary Therapies in Medicine)  45   228 - 233 2019.08

    ISSN  09652299

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    © 2019 Elsevier Ltd Objective: The purpose of the present study was to compare important patient questionnaire items by creating a random forest model for predicting deficiency-excess pattern diagnosis in six Kampo specialty clinics. Design: A multi-centre prospective observational study. Setting: Participants who visited six Kampo specialty clinics in Japan from 2012 to 2015. Main outcome measure: Deficiency-excess pattern diagnosis made by board-certified Kampo experts. Methods: To predict the deficiency-excess pattern diagnosis by Kampo experts, we used 153 items as independent variables, namely, age, sex, body mass index, systolic and diastolic blood pressures, and 148 subjective symptoms recorded through a questionnaire. We extracted the 30 most important items in each clinic's random forest model and selected items that were common among the clinics. We integrated participating clinics’ data to construct a prediction model in the same manner. We calculated the discriminant ratio using this prediction model for the total six clinics’ data and each clinic's independent data. Results: Fifteen items were commonly listed in top 30 items in each random forest model. The discriminant ratio of the total six clinics’ data was 82.3%; moreover, with the exception of one clinic, the independent discriminant ratio of each clinic was approximately 80% each. Conclusions: We identified common important items in diagnosing a deficiency-excess pattern among six Japanese Kampo clinics. We constructed the integrated prediction model of deficiency-excess pattern.

  • Risk factors associated with pseudoaldosteronism in patients with chronic hepatitis: A retrospective cohort study

    Komatsu A., Yoshino T., Suzuki T., Nakamura T., Kanai T., Watanabe K.

    Basic and Clinical Pharmacology and Toxicology (Basic and Clinical Pharmacology and Toxicology)  124 ( 5 ) 607 - 614 2019.05

    ISSN  17427835

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    © 2018 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society) Glycyrrhizin is used to treat chronic hepatitis, but it also plays an important role in pseudoaldosteronism. Multidrug resistance-associated protein 2 is important for glycyrrhizin excretion. Dysfunction of this transporter increases the serum levels of direct bilirubin, glycyrrhizin and its metabolites. Hence, elevated direct-bilirubin levels could predict the risk of pseudoaldosteronism. This study aimed to evaluate the relationship between elevated direct-bilirubin levels and hypokalaemia, which is the most sensitive marker of pseudoaldosteronism. This retrospective cohort study was conducted in a Japanese university hospital. The occurrence of hypokalaemia is defined as a serum potassium level of ≤3.5 mEq/L after the administration of a glycyrrhizin-containing medication, and a further decline of ≥0.5 mEq/L or an increase of ≥0.5 mEq/L after discontinuing the glycyrrhizin-containing medication was examined in patients with chronic hepatitis between January 2009 and December 2015. This analysis involved 1392 patients, including 596 women. Hepatitis C virus infections were the most common cause of chronic hepatitis in this study. Seventy-nine patients received glycyrrhizin (exposed group; mean age: 60.5 ± 14.2) and 1313 did not receive glycyrrhizin (control group; mean age: 58.3 ± 15.8 years). Synergistic effects of glycyrrhizin-containing medications and elevated direct-bilirubin levels were associated with hypokalaemia. Elevated direct-bilirubin levels and hypoalbuminaemia were associated with hypokalaemia in the exposed group. Older age, female sex, high daily glycyrrhizin dosage, longer duration of glycyrrhizin intake, and potassium-lowering medications were not associated with hypokalaemia after the model adjustment. Elevated direct-bilirubin levels and hypoalbuminaemia may predict pseudoaldosteronism caused by glycyrrhizin.

  • The use of maoto (Ma-Huang-Tang), a traditional Japanese Kampo medicine, to alleviate flu symptoms: A systematic review and meta-analysis

    Yoshino T., Arita R., Horiba Y., Watanabe K.

    BMC Complementary and Alternative Medicine (BMC Complementary and Alternative Medicine)  19 ( 1 )  2019.03

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    © 2019 The Author(s). Background: Influenza is a common viral infection worldwide. Maoto (ma-huang-tang) was developed in ancient China and is used to alleviate flu symptoms. Currently, no meta-analyses have evaluated the efficacy and safety of maoto for alleviating flu symptoms. Methods: In the present study, we searched MEDLINE/PubMed, the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, a Japanese database (Ichushi), two Chinese databases (China National Knowledge Infrastructure and VIP), and two Korean databases (Korean Medical database and Korean Association of Medical Journal Editors) for studies published in or before October 2017. Clinical studies that compared maoto plus neuraminidase inhibitors (NAIs) vs. NAIs alone, or maoto alone vs. NAIs alone, were included in the present analysis. The primary outcome measure (efficacy) was the length of time from the start of medication to resolution of influenza symptoms (fever, headache, malaise, myalgia, and chills) and virus isolation. The secondary outcome measures (safety) were as follows: (1) side effects and adverse reactions, such as nausea, abnormal behaviour, or discontinuation of symptomatic treatment; (2) morbidity (complications caused by influenza infection) or mortality; and (3) hospitalisation for any reason. Results: Twelve relevant studies were identified, including two randomised controlled trials (RCTs, N = 60) and ten non-randomised studies (NRSs, N = 1110). We found that maoto plus NAIs was superior to NAIs alone in terms of the duration of fever in one RCT (P < 0.05, median difference = - 6 h) and four NRSs (P = 0.003, weighted mean difference = - 5.34 h). The duration of symptoms or virus isolation did not differ between maoto and NAIs. No severe side effects or adverse reactions were reported related to maoto or NAIs. Conclusions: Although we could not reach a definitive conclusion because of the small sample sizes and high risk of bias in the analysed studies, maoto may lower the duration of fever when it is used alone or in combination with NAIs and may be a well-tolerated treatment. More RCTs are needed to determine the efficacy and safety of maoto.

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