Design
Randomised, single-blind crossover trial; nine adults with low back pain were analysed. Kanshoho and a control procedure were given 2 weeks apart, and 580 blood metabolites were measured with HMT Dual Scan. Trial registration: UMIN000049180.
Crossover design
→
→
Each participant received both conditions in the allocated order.
What was reported
The presentation highlights 21 metabolites that changed from baseline within the Kanshoho condition. “First significant” in the list below means the first time point at which the within-condition comparison with baseline reached P<0.05. Comparison with the control procedure is reported alongside.
| Example | Within-condition change | Between-condition P value |
|---|---|---|
| Retinol-2 | Increased at 10 and 30 min | 10 min: 0.4597 / 30 min: 0.0987 |
| Acylcarnitine (13:1)-3 | Increased at 10 and 30 min | 10 min: 0.8321 / 30 min: 0.3935 |
For both examples the between-condition comparison gave P≥0.05. The within-condition changes are therefore a starting list of candidates; effect sizes, confidence intervals and time courses against the control are the next step.
All 21 metabolites
Nine metabolites increased and twelve decreased. Names and suffix numbers follow the presentation.
| Metabolite (as named in the presentation) | Direction | First significant |
|---|---|---|
| 3β-Hydroxy-5-cholestenoic acid-3 | Increase | 30 min |
| 5β-Tetrahydrocortisol-1 | Decrease | 30 min |
| Acylcarnitine (13:1)-3 | Increase | 10 min |
| Acylcarnitine (17:0)-2 | Increase | 30 min |
| Auraptene-1 | Increase | 30 min |
| Biliverdin | Decrease | 30 min |
| cis-Aconitic acid | Decrease | 10 min |
| Dehydroisoandrosterone 3-sulfate-2 | Increase | 30 min |
| Deoxycholic acid | Decrease | 30 min |
| Gluconic acid | Decrease | 10 min |
| Glycochenodeoxycholic acid | Decrease | 10 min |
| Homoarginine | Increase | 30 min |
| N1-Acetylspermidine | Decrease | 30 min |
| N2-Phenylacetylglutamine | Decrease | 30 min |
| Pyrocatechol sulfate | Decrease | 10 min |
| Retinol-2 | Increase | 10 min |
| Ricinoleic acid-3 | Increase | 30 min |
| Ser | Increase | 30 min |
| Taurolithocholic acid 3-sulfate | Decrease | 10 min |
| Trilaurin-4 | Decrease | 30 min |
| β-Estradiol-117/α-Estradiol | Decrease | 30 min |
From metabolites to testable questions
Research direction
| Direction of interest | Observed candidates | Question to test |
|---|---|---|
| Energy metabolism and fatigue | Acylcarnitine (13:1)-3 and (17:0)-2 increased; cis-aconitic acid decreased | How do blood levels relate to substrate use, metabolic flux and fatigue when all are measured together? |
| Inflammation and redox state | Retinol-2 and auraptene-1 increased; biliverdin decreased | Do inflammatory markers, redox indices and symptoms move on the same time axis? |
| Endocrine, stress and pain | 5β-Tetrahydrocortisol-1 and estradiol decreased; dehydroisoandrosterone 3-sulfate-2 increased | Which step — production, metabolism or excretion — is involved, and does it track pain or stress? |
| Bile acids and the gut | Deoxycholic acid, glycochenodeoxycholic acid and others decreased | Does the pattern replicate when meals, sampling time and gut-derived influences are standardised? |
| Polyamines and amino acids | N1-Acetylspermidine and N2-phenylacetylglutamine decreased; Ser increased | Can related metabolites, measured together, be linked to the local tissue response or to symptoms? |
Pathway analysis
| Pathway (as named in the presentation) | Reported P value | Reading |
|---|---|---|
| Steroid hormone biosynthesis | 0.0104 | Candidate steroid-related pathway |
| Retinol metabolism | 0.0923 | P≥0.05; impact 0.263. To be explored with related markers |
| Glyoxylate metabolism | 0.012 | Pathway name as given; correspondence with human metabolism to be examined |
Enrichment and impact scores place the changed metabolites on pathways and help choose what to verify next. The P values are those shown in the presentation (MetaboAnalyst, slide 8).
Scope and next steps
Nine participants and 580 metabolites make this a hypothesis-generating screen.
Research direction
A proposed collaborative study would quantify the candidates against reference standards in an independent sample, with meals, activity and sampling time standardised, and to report between-condition differences with effect sizes and confidence intervals, including order and carry-over effects. Recording lipid use, inflammation and pain on the same time axis would help investigate which physiological functions the blood changes correspond to.
Ethics and funding
Approved by the ethics review board of Ueno Asagao Clinic; written informed consent was obtained. The study was funded by the Japan Health Organization. Safety recording methods and totals will be added to this page when the full paper is reported.
A related manuscript is titled “Comprehensive analysis of changes in blood metabolites after muscle relaxation treatment Kanshoho: a randomized, single-blind, crossover study”.
Sources
Sections marked “Research direction” describe hypotheses and proposed studies for discussion with collaborators. Observations are presented with their participants, methods and sources.
Last updated: 21 September 2026