The Effect of the Herbal Medicine Dai-Kenchu-to on Post-Operative Ileus

Itoh, T; Yamakawa, J; Mai, M; Yamaguchi, Noriyuki; Kanda, Tsugiyasu

doi:10.1177/147323000203000410

Cited by 99 publications

(81 citation statements)

References 19 publications

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“…Dai-kenchu-to (DKT) is reported to be effective in treating uncomplicated postoperative intestinal obstruction (Ito et al, 2002;Ohya et al, 2003;Endo et al, 2006). It has been considered that DKT improves postoperative ileus by exerting gastroprokinetics effects on gastrointestinal tract.…”

Section: Discussionmentioning

confidence: 99%

“…DKT is used conventionally for abdominal distention in Japan. It has been shown recently that DKT is useful for treatment of postoperative ileus, postoperative intestinal paralysis, irritable bowel syndrome and pediatric constipation (Ito et al, 2002;Ohya et al, 2003;Endo et al, 2006). DKT seems to improve postoperative quality of life (QOL) of patients after surgery for gastrointestinal disorders, since it makes possible for patients to shorten their duration of hospitalization (Endo et al, 2006).…”

Section: Introductionmentioning

confidence: 99%

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Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Kito

Suzuki

2006

J. Smooth Muscle Res.

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The effects of Dai-kenchu-to (DKT), a Chinese medicine, on spontaneous activity of mouse small intestine were investigated. Experiments were carried out with tension recording and intracellular recording. DKT contracted mouse longitudinal smooth muscles in a dose dependent manner (0.1-10 mg/ml). Low concentration of DKT (0.1 mg/ml) did not contract the longitudinal muscles of mouse small intestine. DKT (0.1 mg/ml) inhibited contraction elicited by transmural nerve stimulation (TNS). DKT (1 mg/ml) evoked relaxation before contraction. The initial relaxation was abolished by N ω -nitro-L-arginine (L-NNA). DKT (10 mg/ml)-induced contraction had two components: a transient rapid contraction and a following slow contraction. Atropine inhibited DKT (1 mg/ml)-induced contraction to about 50% of control. In the presence of atropine, tetrodotoxin (TTX) inhibited the contraction elicited by DKT (1 mg/ml) to about 80%. DKT depolarized the membrane and decreased the amplitude of pacemaker potentials recorded from in situ myenteric interstitial cells of Cajal (ICC-MY) with no alteration to the frequency, duration and maximum rates of rise in the presence of nifedipine and TTX.The same results were obtained in slow waves recorded from circular smooth muscle cells. These results indicate that DKT evoked both contraction and relaxation by releasing acetylcholine, nitric oxide and other excitatory neurotransmitters in mouse small intestine. DKT had no effects on pacemaker mechanisms and electrical coupling between ICC-MY and smooth muscle cells in mouse small intestine. The results also suggest that DKT may contract smooth muscles by depolarizing the membrane directly.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Kito

Suzuki

2006

J. Smooth Muscle Res.

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Section: Abstract Aim: Although It Has Been Widely Demonstrated Thatmentioning

confidence: 99%

“…Several studies have demonstrated that DKT enhances GI motility both in vitro (7,8) and in vivo (6, 9, 10), as well as increasing intestinal blood flow (2, 11), reducing the blood ammonia level after hepatectomy (12), and exerting anti-inflammatory effects (13,14). Similarly, recent clinical studies have demonstrated that DKT improves not only GI motility after surgery (15, 16) but also attenuates the progression of adhesional bowel obstruction due to abdominal surgery (17,18).Although several randomized controlled trials (RCTs) have confirmed the effects of DKT (19), previously demonstrated in animal models (13,20), for improving postoperative GI motility in patients undergoing abdominal surgery (21-25), few studies have investigated whether DKT reduces the occurrence of postoperative ileus (PI) in patients undergoing surgery for GI cancer as a primary end-point. Therefore, it seems reasonable to assume that, if DKT 5967…”

mentioning

confidence: 99%

Perioperative Administration of Traditional Japanese Herbal Medicine Daikenchuto Relieves Postoperative Ileus in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis

Ishizuka

Shibuya

Nagata

et al. 2017

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Abstract. Aim: Although it has been widely demonstrated that administration of Daikenchuto (DKT), a traditional Japanese herbal medicine, improves gastrointestinal (GI) motility in patients undergoing abdominal surgery, few studies have investigated the efficacy of perioperative DKT administration for relief of postoperative ileus (PI) in patients undergoingDaikenchuto (DKT) is a well-known traditional Japanese herbal (kampo) medicine for improvement of gastrointestinal (GI) function (1-4). DKT extract powder is manufactured from an aqueous extract containing 2.2% Japanese pepper, 5.6% processed ginger, 3.3% ginseng radix, and 88.9% maltose syrup powder derived from rice (Tsumura & Co., Tokyo, Japan) (3). Because the medicinal effects of DKT have been established through a delicate balance of these three herbal ingredients over many centuries, DKT has not yet been fully accepted by all modern physicians, including those in both eastern (5) and western countries.However, over the past decade, basic studies using animal models have revealed that the effects of DKT on GI function are mediated by cholinergic and serotonergic nerves (6). Several studies have demonstrated that DKT enhances GI motility both in vitro (7,8) and in vivo (6, 9, 10), as well as increasing intestinal blood flow (2, 11), reducing the blood ammonia level after hepatectomy (12), and exerting anti-inflammatory effects (13,14). Similarly, recent clinical studies have demonstrated that DKT improves not only GI motility after surgery (15, 16) but also attenuates the progression of adhesional bowel obstruction due to abdominal surgery (17,18).Although several randomized controlled trials (RCTs) have confirmed the effects of DKT (19), previously demonstrated in animal models (13,20), for improving postoperative GI motility in patients undergoing abdominal surgery (21-25), few studies have investigated whether DKT reduces the occurrence of postoperative ileus (PI) in patients undergoing surgery for GI cancer as a primary end-point. Therefore, it seems reasonable to assume that, if DKT 5967

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“…We reported previously that intraluminal administration of DKT into the upper gut evoked phasic contractions at a locally administered site via cholinergic and 5-hydroxytryptamine 3 (5-HT 3 ) receptors in dogs (Shibata et al 1999a;Jin et al 2001). These observations were considered as the scientific support to the clinical effectiveness of DKT for uncomplicated adhesive bowel obstruction and postoperative ileus (Itoh et al 2002;Nakayama and Tanaka 2009). DKT also appears to be effective for morphine-induced constipation (Sato et al 2010b) and constipation in children (Iwai et al 2007) and in parkinsonian patients (Sakakibara et al 2005), suggest-ing that DKT may enhance motor activity of the colon.…”

Section: Introductionmentioning

confidence: 99%

Intragastric Dai-Kenchu-To, a Japanese Herbal Medicine, Stimulates Colonic Motility via Transient Receptor Potential Cation Channel Subfamily V Member 1 in Dogs

Kikuchi

Shibata

Imoto

et al. 2013

Tohoku J. Exp. Med.

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Japanese herbal medicine, also known as Kampo, is used for various diseases in Japan. One of those medicines, Dai-Kenchu-To (DKT), is considered clinically effective for adhesive bowel obstruction and chronic constipation. Although scientific evidence of DKT to improve adhesive bowel obstruction was shown in several previous reports, mechanism of DKT to improve constipation remains unknown. Our aim was to study the effect of intragastric DKT on colonic motility and defecation, and the involvement of various receptors in DKT-induced colonic contractions. Five beagle dogs were instructed with serosal strain-gauge force transducers to measure circular muscle activity at the proximal, middle, and distal colon. Dogs are suitable for a present study to administer the drugs repeatedly to the same individual and look at its effect on colonic motility. We studied the effects of DKT (2.5 or 5 g) administered into the stomach on colonic motility. Muscarinic receptor antagonist atropine, nicotinic receptor antagonist hexamthonium, or 5-hydroxytryptamine-3 receptor antagonist ondansetron was injected intravenously 10 min before DKT administration. Capsazepine, an antagonist to transient receptor potential cation channel subfamily V member 1 (TRPV1), was administered into the stomach 5 min before DKT administration. Intragastric DKT (2.5 or 5 g) induced colonic contractions within 10 min after administration but did not induce defecation. Pretreatment with atropine, hexamthonium, ondansetron, or capsazepine inhibited DKT-induced colonic contractions. These results indicate that orally administered DKT stimulates colonic motility via TRPV1, muscarinic, nicotinic, and 5-hydroxytryptamine-3 receptors, thereby providing scientific support for the efficacy of oral DKT in chronic constipation.

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The Effect of the Herbal Medicine Dai-Kenchu-to on Post-Operative Ileus

Abstract: Post-operative ileus (PI) is an inevitable

Cited by 99 publications

References 19 publications

Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine

Perioperative Administration of Traditional Japanese Herbal Medicine Daikenchuto Relieves Postoperative Ileus in Patients Undergoing Surgery for Gastrointestinal Cancer: A Systematic Review and Meta-analysis

Intragastric Dai-Kenchu-To, a Japanese Herbal Medicine, Stimulates Colonic Motility via Transient Receptor Potential Cation Channel Subfamily V Member 1 in Dogs

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