Effect of Rikkunshito, a Chinese Herbal Medicine, on Stasis in Patients After Pylorus‐Preserving Gastrectomy

Takahashi, Tsuyoshi; Endo, Shunji; Nakajima, Kiyokazu; Souma, Yoshihito; Nishida, Toshirou

doi:10.1007/s00268-008-9854-8

Cited by 42 publications

(38 citation statements)

References 33 publications

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“…Rikkunshito relieved GERD-related symptoms, via its gastric emptying-enhancing actions, resulting in reducing the intraesophageal acid exposure time by improving clearance [9,22]. Other clinical studies of FD-like patients [23,24], cancer patients [25], and patients after surgery [26], have proven that rikkunshito reduced gastrointestinal tract symptoms by improving gastric emptying. Recently, rikkunshito was also shown to have increased the fasting level of plasma acyl-ghrelin, a peptide that is an orexigenic hormone associated with gastrointestinal tract motility, in healthy adults [27].…”

Section: Discussionmentioning

confidence: 99%

Rikkunshito improves symptoms in PPI-refractory GERD patients: a prospective, randomized, multicenter trial in Japan

et al. 2011

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Section: Discussionmentioning

confidence: 99%

Rikkunshito improves symptoms in PPI-refractory GERD patients: a prospective, randomized, multicenter trial in Japan

et al. 2011

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“…Rikkunshito is an orally administered Japanese herbal (Kampo) preparation that is widely prescribed for patients showing various gastrointestinal symptoms such as gastroesophageal reflux (5,6), dyspeptic symptoms of post gastrointestinal surgery (7,8), and chemotherapy-induced nausea (9). Rikkunshito is composed of 8 constituents: Glycyrrhizae radix (4.7%), Zingiberis rhizoma (2.3%), Atractylodis lanceae rhizoma (18.6%), Zizyphi fructus (9.3%), Aurantii nobilis pericarpium (9.3%), Ginseng radix (18.6%), Pinelliae tuber (18.6%), and Hoelen (18.6%).…”

Section: Introductionmentioning

confidence: 99%

Efficacy of Rikkunshito, a Traditional Japanese Medicine (Kampo), in Treating Functional Dyspepsia

et al. 2010

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Background Rikkunshito, a traditional Japanese (Kampo) medicine, is widely prescribed as an oral preparation for the treatment of functional dyspepsia (FD). In our previous study, we reported that extracorporeal ultrasonography (US) is a useful technique for the assessment of the gastric accommodation reflex (AR) and duodenogastric motility. In this study, we examined the effects of Rikkunshito on the gastroduodenal function in patients with FD. Methods Sixteen FD patients (median age, 45 y) underwent US, before and after 14 days of treatment with Rikkunshito (7.5 g b.d.). For assessment of the AR, a cross-sectional area of the proximal stomach was measured after incremental ingestion of a liquid meal up to 400-mL. The expansion rate was used as the parameter to determine the AR. Then, the gastric emptying rate (GER), motility index (MI), and reflux index (RI) were evaluated using previously reported methods. Results Although no significant changes were observed in the total score of the Gastrointestinal Symptom Rating Scale (GSRS), the scores of 3 of the 15 symptoms of GSRS decreased significantly after treatment with Rikkunshito. The expansion rate of the proximal stomach was significantly greater after treatment with Rikkunshito than before the treatment. Although the GER and MI increased significantly, no significant differences in the RI were observed after treatment with Rikkunshito. Conclusion These observations suggested that Rikkunshito may be beneficial for the treatment of FD patients with impaired AR and gastric motility. These results also suggested that Rikkunshito has a therapeutic potential for FD and GERD.

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“…In another study, it was reported that, postoperatively, dyspeptic pediatric patients exhibited symptomatic relief and a significant reduction in the mean symptom score after treatment with rikkunshito over a 1-month period [21]. In the sphere of gastrointestinal surgery, rikkunshito improved gastric emptying and ameliorated the postoperative symptoms of patients who had undergone a pyloruspreserving gastrectomy (PPG) [22]. Although the attenuation of postoperative symptoms observed in these studies was reproduced in our present study, we failed to detect significant differences in the VAS scores or in any of the DAUGS items between the patient groups with high and low mean ratios of acyl-/total ghrelin concentration.…”

Section: Discussionmentioning

confidence: 99%

“…In rats, a flavonoid in rikkunshito suppressed cisplatin-induced decreases in the plasma acylated ghrelin level and increased food intake mediated by 5-HT2B/2C receptors [16]. In general, rikkunshito is used to treat various gastrointestinal tract disorders such as functional dyspepsia (FD) [17,18], gastro-esophageal reflux [19,20], dyspeptic symptoms of post-gastrointestinal surgery [21,22], and chemotherapy-induced nausea [23]. In animal experiments, rikkunshito is reported to ameliorate gastric distension via a nitric oxide-mediated pathway, and it has also been shown to improve delayed gastric emptying [24].…”

Section: Introductionmentioning

confidence: 99%

Effect of rikkunshito, a Japanese herbal medicine, on gastrointestinal symptoms and ghrelin levels in gastric cancer patients after gastrectomy

et al. 2012

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Background Gastric cancer patients who undergo gastrectomy suffer from a post-gastrectomy syndrome that includes weight loss, dumping syndrome, reflux esophagitis, alkaline gastritis, and finally malnutrition. It is important to ameliorate the post-gastrectomy symptoms to restore postoperative quality of life (QoL). The aim of this study was to investigate the effect of rikkunshito, a Japanese herbal medicine, on postoperative symptoms and ghrelin levels in gastric cancer patients after gastrectomy. Methods Twenty-five patients who had undergone gastrectomy received 2.5 g of rikkunshito before every meal for 4 weeks, and a drug withdrawal period was established for the next 4 weeks. Changes in gastrointestinal hormones, including ghrelin, and appetite visual analog scale scores were measured, and QoL was estimated by using the European Organization for Research and Treatment of Cancer core questionnaire QLQ-C30. The Dysfunction After Upper Gastrointestinal Surgery for Cancer (DAUGS) scoring system was used to evaluate gastrointestinal symptoms after gastrectomy. Results Sixteen men and nine women (mean age 61.9 years) were enrolled in the study. All patients had either stage I (n = 24) or II (n = 1) disease and had undergone either distal gastrectomy (n = 17) or total gastrectomy (n = 8) by a laparoscopy-assisted approach. The mean ratio of the acyl-/total ghrelin concentration increased significantly after rikkunshito administration (Pre: 7.8 ± 2.1, 4 weeks: 10.5 ± 1.7 %, p = 0.0026). The total DAUGS score, as well as the scores reflecting limited activity due to decreased food consumption, reflux symptoms, dumping symptoms, and nausea and vomiting significantly improved after rikkunshito administration. Conclusions The present study demonstrated a significant attenuation of gastrointestinal symptoms after gastrectomy by treatment with rikkunshito. Rikkunshito is potentially useful to minimize gastrointestinal symptoms after gastrectomy.

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Effect of Rikkunshito, a Chinese Herbal Medicine, on Stasis in Patients After Pylorus‐Preserving Gastrectomy

Abstract: Rikkunshito improved gastric emptying and ameliorated postoperative symptoms of patients who had undergone a PPG.

Cited by 42 publications

References 33 publications

Rikkunshito improves symptoms in PPI-refractory GERD patients: a prospective, randomized, multicenter trial in Japan

Rikkunshito improves symptoms in PPI-refractory GERD patients: a prospective, randomized, multicenter trial in Japan

Efficacy of Rikkunshito, a Traditional Japanese Medicine (Kampo), in Treating Functional Dyspepsia

Effect of rikkunshito, a Japanese herbal medicine, on gastrointestinal symptoms and ghrelin levels in gastric cancer patients after gastrectomy

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