Monitoring Plasma Neuropeptide-Like Immunoreactivity Levels in a Patient Given Hange-koboku-to for a Week for Swallowing Reflex Disorder

Hange-koboku-to (Banxia-houpo-tang), a Traditional Chinese Medicine remedy, has been used to treat swallowing reflex disorder, and it has been recently suggested that one of the mechanisms for the empirical effect of Hange-koboku-to involves humoral changes in neuropeptide levels. We suggested to administer Hange-koboku-to to a 70-year-old man with swallowing reflex disorder due to multiple cerebral infarctions and investigated the relationship between changes in plasma-neuropeptide-like immunoactivity (LI) levels and swallowing for a period of 1 week. On the 4 th and 7 th day of administration, the patient' s plasma calcitonin gene-related peptide (CGRP) -LI levels were twice the concentration on day 0 and Hange-koboku-to had increased the patient' s plasma substance P-LI levels approximately 5-fold on these 2 days. The plasma substance P-LI levels on days 4 and 7 were close to the levels (mean±SD) of elderly subjects without swallowing reflex disorder. Following the administration of Hange-koboku-to, plasma somatostatin-LI and vasoactive intestinal polypeptide (VIP) -LI levels in this patient exceeded those of elderly subjects without swallowing reflex disorder (mean + SD). With regard to symptoms, the patient' s difficulty in swallowing had disappeared on the third day of administration.This study suggests that Hange-koboku-to relieves swallowing reflex disorder by stimulating neuropeptidergic nerves and that this effect is achieved within 1 week of administration. However, we need to study more cases of the use of Hange-koboku-to for swallowing reflex disorder and further investigate the relationship between changes in neuropeptide-LI levels and its pharmacological effects.