In many cases, traditional Chinese herbal (Kampo) medicines have been used in the empirical treatment of chronic hypofunction. In recent years, some Kampo medicines used to treat those experiential gastrointestinal diseases have been elucidated pharmacologically from the viewpoint of gut-regulated hormone levels. Among these medicines, Dai-kenchuto increases gastrointestinal motility and relieves bowel obstruction. These effects were reported to cause significant increases in the levels of motilin and vasoactive intestinal peptide (VIP) in human plasma.
1-3)Sho-hange-ka-bukuryo-to, a Kampo medicine, is prepared from three herbs: Pinelliae Tuber, Zingiberis Rhizoma and Hoelen. The medicine has been used for thousands years for the treatment of nausea, vomiting, acute and chronic gastritis and upper gastrointestinal function abnormalities (gastric atony). Especially, it has been widely used to treat the hyperemesis of pregnancy. Naito et al. investigated several Kampo medicines, including Pinelliae Tuber and Zingiberis Rhizoma. [4][5][6] Kampo medicines, such as Rikkunshi-to, Hange-shashin-to and Hange-koboku-to, usually use longterm administration to treat chronic hypofunction. But the Kampo medicines that consist of multiple herbs, such as Sho-hange-ka-bukuryo-to, are administered to treat acute hypofunction. Sho-hange-ka-bukuryo-to is often used for treatment of motion sickness or acute nausea. Furthermore, there is a report that Kampo medicines which include Pinelliae Tuber, i.e. Hange-koboku-to, Hange-shashin-to and Shohange-ka-bukuryo-to, were effective against nausea or vomiting as side effects of anticancer drugs.
7)Generally nausea or vomiting is caused by stimulation of the vomiting center located in the medulla oblongata. Vomiting is subclassified into central vomiting and reflex vomiting. The former is caused by brain hypertension (e.g. cerebral tumor, subarachnoidal hemorrhage or meningitis), stimulation from a labyrinth, vestibule or cerebellum (e.g. motor sickness and Meniere's disease), mental stimulation from the cerebral cortex (e.g. unrest, hatred, hysteria or depression) or stimulation via the chemoreceptor trigger zone (CTZ), which receives drugs (morphine, alcohol and anticancer drugs etc.), abnormalities of the metabolic or internal secretion system, bacterial toxins etc., and transmits these stimulations to the vomiting center. The latter is caused by stimulations via afferent nerves from the tongue, pharynx and internal organs (i.e. diseases related to the digestive system). Especially, vomiting is promoted by conditions that slow gastric emptying. CTZ has a dopamine D 2 receptor and a 5-hydroxytriptamine (serotonin) 5-HT 3 receptor. These receptors are also located in the stomach or intestine, and they are assumed to regulate gastrointestinal motility.
8)One of the gastrointestinal motility regulatory factors on empirical effects has been assumed to be the induction of changes in the levels of peptides (gastrin, somatostatin, motilin and VIP) in plasma. Itoh et al. reported that cisapride...