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

Gastric Cancer, 2013, Vol.16(2), pp.167-174 [Peer Reviewed Journal]

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  • Title:
    Effect of rikkunshito, a Japanese herbal medicine, on gastrointestinal symptoms and ghrelin levels in gastric cancer patients after gastrectomy
  • Author: Takiguchi, Shuji ; Hiura, Yuichiro ; Takahashi, Tsuyoshi ; Kurokawa, Yukinori ; Yamasaki, Makoto ; Nakajima, Kiyokazu ; Miyata, Hiroshi ; Mori, Masaki ; Hosoda, Hiroshi ; Kangawa, Kenji ; Doki, Yuichiro
  • Found In: Gastric Cancer, 2013, Vol.16(2), pp.167-174 [Peer Reviewed Journal]
  • Subjects: Rikkunshito ; Ghrelin ; Gastric cancer ; Gastrectomy
  • Language: English
  • Description: Byline: Shuji Takiguchi (1), Yuichiro Hiura (1), Tsuyoshi Takahashi (1), Yukinori Kurokawa (1), Makoto Yamasaki (1), Kiyokazu Nakajima (1), Hiroshi Miyata (1), Masaki Mori (1), Hiroshi Hosoda (2), Kenji Kangawa (2), Yuichiro Doki (1) Keywords: Rikkunshito; Ghrelin; Gastric cancer; Gastrectomy Abstract: 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. Author Affiliation: (1) Division of Gastroenterological Surgery, Department of Surgery, Graduate School of Medicine, Osaka University, 2-2, E2, Yamadaoka, Suita, Osaka, 565-0871, Japan (2) Department of Biochemistry, National Cardiovascular Center Research Institute, Osaka, Japan Article History: Registration Date: 11/05/2012 Received Date: 05/12/2011 Accepted Date: 11/05/2012 Online Date: 16/08/2012
  • Identifier: ISSN: 1436-3291 ; E-ISSN: 1436-3305 ; DOI: 10.1007/s10120-012-0164-3

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