Rikkunshito for upper gastrointestinal symptoms: A systematic review and meta-analysis

Hoshino, Nobuaki; Nishizaki, Daisuke; Hida, Koya; Obama, Kazutaka; Sakai, Yoshiharu

doi:10.1016/j.ctim.2018.11.025

Cited by 15 publications

(17 citation statements)

References 20 publications

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“…12 However, clinical trials showed inconclusive results, and a recent meta-analysis could not find any influence of rikkunshito on plasma levels of active ghrelin in patients with various diseases. 13 Similar to these findings, we also could not find any differences in the plasma levels of active ghrelin between the three study groups.…”

Section: Discussionsupporting

confidence: 85%

“…Previous animal studies implied that rikkunshito improved gastric emptying through increasing the action of ghrelin by ameliorating ghrelin resistance or inhibiting ghrelin deacylation (inactivation) . However, clinical trials showed inconclusive results, and a recent meta‐analysis could not find any influence of rikkunshito on plasma levels of active ghrelin in patients with various diseases . Similar to these findings, we also could not find any differences in the plasma levels of active ghrelin between the three study groups.…”

Section: Discussionsupporting

confidence: 84%

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The effect of standard and high dose of rikkunshito on achievement of enteral nutrition target in critically ill patients: a pilot randomized controlled trial

Doi

Miyamoto

Shimokawa

et al. 2019

Acute Medicine & Surgery

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Aim: Rikkunshito is a traditional Japanese medicine used for delayed gastric emptying in intensive care units in Japan. This study aimed to investigate whether standard-or high-dose rikkunshito can improve the achievement of enteral calorie target among critically ill adults. Methods: This open-label, single-center, pilot randomized controlled trial was carried out from March 2018 until December 2018 and enrolled critically ill adult patients requiring enteral nutrition by gastric tube for at least 5 days. Patients were randomized into the control group, the standard-dose rikkunshito group (2.5 g three times daily), and the high-dose rikkunshito group (5 g three times daily). Intervention was given for 5 days. The primary outcome measure was the percentage of enteral calorie intake achieved in the target at the fifth day after randomization. Results: The cohort comprised 26 patients; of these, 9, 8, and 9 were included in the control group, the standard-dose group, and the high-dose group, respectively. Twenty-one patients (81%) were included in the primary analysis. The percentage of enteral calorie intake achieved in the target at the fifth day was 59% (interquartile range [IQR], 39-63%), 40% (IQR, 26-61%), and 62% (IQR, 17-83%) in the control, the standard-dose, and the high-dose groups, respectively (P = 0.42). The number of adverse events did not differ significantly between the groups (control group, 4 [44%]; standard-dose group, 3 [38%]; and high-dose group, 4 [44%], P = 1.00). Conclusions: Standard-or high-dose rikkunshito did not improve the achievement of enteral calorie target in critically ill adults.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionsupporting

confidence: 84%

The effect of standard and high dose of rikkunshito on achievement of enteral nutrition target in critically ill patients: a pilot randomized controlled trial

Doi

Miyamoto

Shimokawa

et al. 2019

Acute Medicine & Surgery

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“…First, this study updated the results of the latest RCT on FD patients, diagnosed with Rome criteria. Some previous reviews were focused on gastrointestinal symptoms, 9,10 and other reviews included patients diagnosed based on criteria similar to the Rome criteria. 7,12 Second, to our knowledge, this is the first meta-analysis to confirm the efficacy of combination therapy (RKT and western medicine) for FD patients.…”

Section: Discussionmentioning

confidence: 99%

“…8 Several systematic reviews and meta-analyses for the efficacy of RKT were published. 7,[9][10][11][12] However, some reviews included studies on gastrointestinal symptoms or anorexia induced by drugs, gastritis, or cancer. 9,10 Other reviews did not compare RKT with placebo, or combination therapy (RKT and western medicine) with western medicine alone.…”

Section: Introductionmentioning

confidence: 99%

“…7,[9][10][11][12] However, some reviews included studies on gastrointestinal symptoms or anorexia induced by drugs, gastritis, or cancer. 9,10 Other reviews did not compare RKT with placebo, or combination therapy (RKT and western medicine) with western medicine alone. 7,11,12 Further, the selection of patients used the Rome criteria (I, II, III, or IV depending on the date of the study) and criteria similar to Rome (requiring that dyspeptic symptoms should last at least 4 weeks).…”

Section: Introductionmentioning

confidence: 99%

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Effects of the herbal medicine Rikkunshito, for functional dyspepsia: A systematic review and meta‐analysis

Park

Kim

et al. 2020

J of Gastro and Hepatol

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Background and AimFunctional dyspepsia (FD) is characterized by chronic and unexplained indigestion at upper abdomen. Because of unsatisfactory effect of conventional treatments, demand is growing for complementary and alternative medicine. Rikkunshito (RKT) is a herbal medicine, which has been widely used for FD in Asia; however, the evidence is lacking. We carried out systematic review and meta‐analysis to evaluate the effect and safety of RKT in the treatment of FD.MethodsElectronic databases were searched in April 2019, including PUBMED, EMBASE, and Cochrane Library. All eligible studies should be randomized controlled trials (RCTs) comparing RKT or combination therapy (RKT and western medicine) group to western medicine group. The primary outcome measure was the total clinical efficacy rate (TCE). The secondary outcomes were total dyspepsia symptom scale, gastric emptying rate, gastrin, motilin, recurrence 6 months after treatment, and Hamilton depression rating scale.ResultsFifty‐two RCTs with 5475 patients were involved in this systematic review and meta‐analysis. Compared with western medicine, RKT showed significant better result, with higher TCE (relative risk = 1.21, 95% confidence interval 1.17 to 1.25, P < 0.001). RKT presented higher reduction of total dyspepsia symptom scale, more improved gastric emptying rate, and lower recurrence 6 months after treatment compared with western medicine. However, there was no significant difference in Hamilton depression rating scale between RKT and western medicine group. Combination therapy brought significant symptom improvement with TCE compared with western medicine alone.ConclusionsRikkunshito and combination therapy might be considered an effective alternative treatment for FD. Further rigorously designed and high‐quality RCTs are needed.

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United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia

Wauters

Dickman

Drug³

et al. 2021

UEG Journal

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Rikkunshito for upper gastrointestinal symptoms: A systematic review and meta-analysis

Cited by 15 publications

References 20 publications

The effect of standard and high dose of rikkunshito on achievement of enteral nutrition target in critically ill patients: a pilot randomized controlled trial

The effect of standard and high dose of rikkunshito on achievement of enteral nutrition target in critically ill patients: a pilot randomized controlled trial

Effects of the herbal medicine Rikkunshito, for functional dyspepsia: A systematic review and meta‐analysis

United European Gastroenterology (UEG) and European Society for Neurogastroenterology and Motility (ESNM) consensus on functional dyspepsia

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