Rikkunshito as a Therapeautic Agent for Functional Dyspepsia and its Prokinetic and Non-Prokinetic Effects

Inokuchi, K; Masaoka, Tatsuhiro; Kanai, Takanori

doi:10.3389/fphar.2021.640576

Cited by 14 publications

(10 citation statements)

References 47 publications

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“…A low-risk and good safety profile of the administered medicines is important in order to have an acceptable risk-benefit ratio for the therapy, contributing to patient compliance [20,21]. Rikkunshito has a long-standing history as a safe herbal treatment option for therapy of upper gastrointestinal symptoms with a special focus on functional dyspepsia [22]. This study is the first to evaluate the effectiveness and patient satisfaction in terms of safety and tolerability of a two-week treatment with the traditional herbal medicine YamatoGast in Germany.…”

Section: Discussionmentioning

confidence: 99%

Treatment of dyspeptic symptoms with YamatoGast. A non-interventional study of a registered traditional herbal Rikkunshito extract product from Japanese Kampo Medicine in routine practice in Germany

Reißenweber-Hewel,

Pehl,

Cameron

et al. 2023

Z Gastroenterol

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Introduction Dyspeptic symptoms belong to the most frequent reasons to seek medical advice and are a burden both for the individual affected and the healthcare system. In Japan, the traditional herbal Kampo prescription rikkunshito has proven benefit for this indication. Methods In a prospective, multicentre, non-interventional study (NIS), the effectiveness, safety, and tolerability of a two-week treatment with the registered rikkunshito extract product YamatoGast was assessed in German patients with an acute episode of dyspeptic symptoms of functional origin under real-world conditions. The primary endpoint was the responsiveness to treatment assessed by the overall treatment effect (OTE) score. Secondary endpoints were the change in severity of dyspeptic symptoms and the change in quality of life (QoL). Safety evaluation was based on reported adverse drug reactions, drug compliance, and ratings of tolerability by physicians and patients. Results Sixty-six patients were enrolled (mean age 48.9 years, 74% females). The treatment was well tolerated and highly beneficial, as expressed by pronounced responder rates of 78.9% for the primary endpoint OTE. All secondary endpoints were also met. The severity of dyspeptic symptoms significantly improved by 62–77% compared to baseline, confirmed by a remarkable improvement of QoL. Significant symptom relief started from the third day of treatment onwards. Conclusion In this non-interventional study, two-week treatment with YamatoGast resulted in a significant improvement of dyspeptic symptoms and was associated with high patient response and satisfaction. YamatoGast was confirmed as a safe and clinically relevant therapeutic option for patients suffering upper gastrointestinal complaints in routine practice.

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Section: Discussionmentioning

confidence: 99%

Treatment of dyspeptic symptoms with YamatoGast. A non-interventional study of a registered traditional herbal Rikkunshito extract product from Japanese Kampo Medicine in routine practice in Germany

Reißenweber-Hewel,

Pehl,

Cameron

et al. 2023

Z Gastroenterol

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“…In contrast, RKT was effective against dysmotility in FD via enhancement of ghrelin secretion. 33 Thus, YKS is effective against gastric hypersensitivity, whereas RKT is useful against dysmotility in FD. Therefore, the co-application of YKS and RKS may be a useful strategy to address all FD symptoms.…”

Section: Discussionmentioning

confidence: 99%

Yokukansan Suppresses Gastric Hypersensitivity and Eosinophil-associated Microinflammation in Rats With Functional Dyspepsia

Duan

Imamura

Kondo

et al. 2022

J Neurogastroenterol Motil

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Background/AimsHerbal medicine is an important complementary therapy for functional dyspepsia (FD). However, its effect against gastric hypersensitivity in patients with FD has rarely been evaluated. Yokukansan (YKS), a traditional Japanese herbal medicine, is effective against neuropathic and inflammatory pain. This study aims to use a maternal separation (MS) stress-induced FD model to investigate the effects of YKS against gastric hypersensitivity, gastric motility, and duodenal micro-inflammation. MethodsThe MS stress model was established by separating newborn Sprague-Dawley rats from their mothers for 2 hours a day from postnatal days 1 to 10. At the age of 7-8 weeks, the rats were treated with YKS at a dose of 5 mL/kg (1 g/kg) for 7 consecutive days. After YKS treatment, electromyographic activity in the acromiotrapezius muscle by gastric distention and the gastric-emptying rate were assessed. Immunohistochemical analysis of eosinophils in the duodenum and phosphorylated extracellular signal-regulated kinase (p-ERK) 1/2 in the spinal cord was performed. ResultsYKS treatment suppressed MS stress-induced gastric hypersensitivity and decreased the elevated levels of p-ERK1/2 in the spinal cord. In the gastroduodenal tract, YKS inhibited eosinophil-associated micro-inflammation but did not improve gastric dysmotility. ConclusionsYKS treatment improved gastric hypersensitivity by alleviating eosinophil-associated micro-inflammation in the gastroduodenal tract. This treatment may be considered an effective therapeutic option for epigastric pain and micro-inflammation in patients with FD.

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“…Cancer patients are increasingly seeking nonconventional modalities to complement their cancer care, especially in symptom control. Rikkunshito has been offered to effectively treat the digestive tract symptoms (33), especially in relieving nausea/vomiting and improving nausea (23,34). While the usefulness of rikkunshito in managing the chemotherapies-induced digestive tract symptoms remains unknown.…”

Section: Discussionmentioning

confidence: 99%

Rikkunshito for Upper Gastrointestinal Syndrome in Patients With Cancer: A Systematic Review and Meta-analysis Protocol

Liu

Ren

Wang

et al. 2021

Preprint

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BackgroundUpper gastrointestinal syndrome including nausea, vomiting, and anorexia is a common side effect of chemotherapy, which are associated with treatment interruptions, reduced food intake, decreased functionality and a worse quality of life. Rikkunshito is a traditional herbal medicine that has gained increasing attention in recent years for its effect on relieving gastrointestinal disorders in various digestive diseases, while its efficacy for upper gastrointestinal syndrome induced by chemotherapy remains uncertain. MethodsDatabases including PubMed, EMBASE, MEDLINE, Cochrane Library, Chinese databases, and Japanese database will be systematically searched from their inception onwards. Randomized controlled trials will be assessed. The primary outcome parameters are the complete control (CC) rate, complete response (CR) rate, and complete protection (CP) rate in the overall phase (0–120 hours). The secondary outcomes include: (I) the CC rate, CR rate and CP rate during the acute phase (0–24 hours) and delayed phase (24–120 hours); (II) the score and frequency of vomiting, nausea, and anorexia occurring; (III) the daily dietary intake and body weight; (IV) plasma ghrelin level; (V) quality of life; (VI) incidence of adverse events. The overall quality of the data will be assessed using the Grading of Recommendations, Assessment, Development and Evaluation guidelines. Risk of bias will be evaluated by the Cochrane tool. Reporting bias will be estimated using Begg and Egger tests. Heterogeneity will be evaluated by the I2 statistic and Q test. If I2 > 50%, sensitivity analysis and subgroup analysis of different items will be performed. DiscussionFrom the study, we will ascertain the efficacy and safety of rikkunshito in chemotherapy-induced upper gastrointestinal syndrome. This review may provide evidence for rikkunshito as an adjuvant to treat upper gastrointestinal symptoms in patients with cancer. Systematic review registrationCRD42020214299 in PROSPERO.

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Rikkunshito as a Therapeautic Agent for Functional Dyspepsia and its Prokinetic and Non-Prokinetic Effects

Cited by 14 publications

References 47 publications

Treatment of dyspeptic symptoms with YamatoGast. A non-interventional study of a registered traditional herbal Rikkunshito extract product from Japanese Kampo Medicine in routine practice in Germany

Treatment of dyspeptic symptoms with YamatoGast. A non-interventional study of a registered traditional herbal Rikkunshito extract product from Japanese Kampo Medicine in routine practice in Germany

Yokukansan Suppresses Gastric Hypersensitivity and Eosinophil-associated Microinflammation in Rats With Functional Dyspepsia

Rikkunshito for Upper Gastrointestinal Syndrome in Patients With Cancer: A Systematic Review and Meta-analysis Protocol

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