Effects of Rikkunshi‐to on infantile hypertrophic pyloric stenosis, refractory to atropine

Oyachi, Noboru; Takano, Kunio; Hasuda, Norio; Arai, Hiroshi; Koshizuka, Kozo; Matsumoto, Masahiko

doi:10.1111/j.1442-200x.2008.02682.x

Cited by 10 publications

(5 citation statements)

References 9 publications

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“…Rikkunshi‐to (RKT, TJ‐43) is prepared from eight crude herbs: Atractylodes Lancea Rhizome, Ginseng, Pinellia Tuber, Poria Sclerotium, Jujube, Citrus Unshiu Peel, Glycyrrhiza and Ginger (Table 1). RKT is widely prescribed in Japan for patients with a variety of GI symptoms including anorexia, 5 nausea and vomiting 6,7 …”

Section: Resultsmentioning

confidence: 99%

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Japanese herbal medicine in functional gastrointestinal disorders

Suzuki

Inadomi

Hibi

2009

Neurogastroenterology Motil

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Background Management of functional gastrointestinal disorders is hindered by both poor efficacy and adverse effects of traditional pharmacological therapy. Herbal medicine may be an attractive alternative based on the perception of its “natural” approach and low risk of side effects; however, the lack of standardization of drug components has limited the ability to perform rigorous clinical studies in Western countries. Japanese herbal medicine (JHM) is a standardized form of herbal medicine with regards to the quality and quantities of ingredients. While extensively studied and widely used in Asia, there is a paucity of data upon which physicians in other parts of the world may draw conclusions regarding the effectiveness of herbal medicine for gastrointestinal disorders. Aim To summarize the most recent developments in JHM for treatment of functional gastrointestinal disorders. Methods Animal and human studies were systematically reviewed to identify published data of JHM used for treatment of gastrointestinal disorders. The herbal components of JHM were examined. Results describing the physiological and clinical effects of JHM were abstracted, with an emphasis on functional gastrointestinal disorders. Results JHM are associated with a variety of beneficial physiological on the gastrointestinal system. Patient-based clinical outcomes are improved in several conditions. Rikkunnshi-to reduces symptoms and reverses physiological abnormalities associated with functional dyspepsia, while Dai-Kenchu-to improves symptoms of post-operative ileus and constipation in children. Conclusions This updated summary of JHM in the field of gastrointestinal disorders illustrates the potential for herbal medication to serve a valuable role in the management of patients with functional disorders.

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Section: Resultsmentioning

confidence: 99%

“…One case report illustrated that oral administration of RKT stopped the vomiting of infantile hypertrophic pyloric stenosis refractory to atropine, possibly by improving gastric motility and restoring normal gastric myoelectric activity 7 …”

mentioning

confidence: 99%

Japanese herbal medicine in functional gastrointestinal disorders

Suzuki

Inadomi

Hibi

2009

Neurogastroenterology Motil

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“…Rikkunshito, which mimics these ghrelin effects, effectively improved food intake and GI motor activities in this study. Rikkunshito is a traditional herbal medicine used to treat GI tract disorders such as functional dyspepsia 32, 33, 34, 35, 36 and gastroesophageal reflux. 37 Oral administration of rikkunshito increases plasma acyl ghrelin levels in humans, mice, 38 rats 14, 15 and dogs (data not shown).…”

Section: Discussionmentioning

confidence: 99%

Potentiation of ghrelin signaling attenuates cancer anorexia–cachexia and prolongs survival

Fujitsuka

Asakawa

Uezono³

et al. 2011

Transl Psychiatry

128

184

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Cancer anorexia–cachexia syndrome is characterized by decreased food intake, weight loss, muscle tissue wasting and psychological distress, and this syndrome is a major source of increased morbidity and mortality in cancer patients. This study aimed to clarify the gut–brain peptides involved in the pathogenesis of the syndrome and determine effective treatment for cancer anorexia–cachexia. We show that both ghrelin insufficiency and resistance were observed in tumor-bearing rats. Corticotropin-releasing factor (CRF) decreased the plasma level of acyl ghrelin, and its receptor antagonist, α-helical CRF, increased food intake of these rats. The serotonin 2c receptor (5-HT2cR) antagonist SB242084 decreased hypothalamic CRF level and improved anorexia, gastrointestinal (GI) dysmotility and body weight loss. The ghrelin receptor antagonist (D-Lys3)-GHRP-6 worsened anorexia and hastened death in tumor-bearing rats. Ghrelin attenuated anorexia–cachexia in the short term, but failed to prolong survival, as did SB242084 administration. In addition, the herbal medicine rikkunshito improved anorexia, GI dysmotility, muscle wasting, and anxiety-related behavior and prolonged survival in animals and patients with cancer. The appetite-stimulating effect of rikkunshito was blocked by (D-Lys3)-GHRP-6. Active components of rikkunshito, hesperidin and atractylodin, potentiated ghrelin secretion and receptor signaling, respectively, and atractylodin prolonged survival in tumor-bearing rats. Our study demonstrates that the integrated mechanism underlying cancer anorexia–cachexia involves lowered ghrelin signaling due to excessive hypothalamic interactions of 5-HT with CRF through the 5-HT2cR. Potentiation of ghrelin receptor signaling may be an attractive treatment for anorexia, muscle wasting and prolong survival in patients with cancer anorexia–cachexia.

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“…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%). Several studies have shown that many Japanese herbal medicines, including Rikkunshito, improve gastroduodenal motility-related disorders and are therefore clinically efficacious against FD to some extent (10)(11)(12)(13)(14). However, few studies have been reported on the action mechanism of this medicine in humans (15); although Rikkunshito has been demonstrated to improve the impairment in the gastric AR in vitro (16), no clinical reports have been published on the effects of Rikkunshito on the gastric AR.…”

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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Effects of Rikkunshi‐to on infantile hypertrophic pyloric stenosis, refractory to atropine

Abstract: DiscussionIt is considered that muscular spasm rather than hypertrophic pyloric muscle accounts for the symptoms typical of IHPS and

Cited by 10 publications

References 9 publications

Japanese herbal medicine in functional gastrointestinal disorders

Japanese herbal medicine in functional gastrointestinal disorders

Potentiation of ghrelin signaling attenuates cancer anorexia–cachexia and prolongs survival

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

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