Efficacy of daikenchuto, a traditional Japanese Kampo medicine, for postoperative intestinal dysfunction in patients with gastrointestinal cancers: meta-analysis
- 9 Downloads
The Japan Society for Oriental Medicine makes a compilation of structured abstracts of randomized controlled trials (RCTs) of Kampo medicines available on its Evidence Reports of Kampo Treatment (EKAT) website.
Using EKAT, we conducted a systematic review and meta-analysis on the efficacy of using daikenchuto (https://mpdb.nibiohn.go.jp/stork) for bowel dysfunction after surgery for gastrointestinal cancer. The primary outcomes were the time to first postoperative flatus and the time to first postoperative bowel movement (BM).
We found nine relevant RCTs. The mean differences between the daikenchuto group and control group (daikenchuto was not administered) were − 0.43 (95% CI: − 0.77 to − 0.09) days for the time to first postoperative flatus, − 0.29 (95% CI: − 0.59 to 0.01) days for the time to first postoperative BM, and − 0.95 (95% CI: − 1.70 to − 0.21) days for the length of postoperative hospital stay, and the risk ratio of the incidence of intestinal obstruction was 0.60 (95% CI: 0.35–1.03). The time to first postoperative flatus and the length of postoperative hospital stay were significantly shorter in the daikenchuto group than those in the control group (P = 0.01). However, only double-blind studies were evaluated; the results turned to be non-significant.
As a result of meta-analysis by all retrieved according to the registered protocol, daikenchuto was efficacious in improving postoperative bowel dysfunction in patients with gastrointestinal cancers. However, limiting to articles with description of COI and blindness, significance disappeared.
KeywordsDaikenchuto Kampo Gastrointestinal cancers Postoperative intestinal dysfunction Meta-analysis
We would like to express our gratitude to Dr. Kiichiro Tsutani (Faculty of Health Sciences, Tokyo Ariake University of Medical and Health Sciences) for general instruction and Dr. Aya Hirata (Department of Preventive Medicine and Public Health, Keio University School of Medicine) for the evaluation of articles. We also sincerely thank the authors for kindly providing us with the important data. The present study was supported by the Japan Agency for Medical Research and Development (AMED) Research Project for Improving Quality in Healthcare and Collecting Scientific Evidence on Integrative Medicine, Grant number: JP16lk0310023. The authors thank all respondents in this study.
All the authors have contributed to this article. MH, IA, TN and YM contributed to the conception and design of this research; MH, YI, TI, YS, TN, YM, TN and YM evaluated articles; MH and TN contributed to statistical analysis and interpretation of data.
Compliance with ethical standards
Conflict of interest
The authors declare no competing interests.
- 2.EBM in Kampo 2002, Interim Report (2002). Kampo Medicine 53(5 supplementary issue)Google Scholar
- 3.Evidence Reports of Kampo Treatment (2005). Kampo Medicine 56 (EBM supplementary issue)Google Scholar
- 4.Nunome S, Sasaki H (1999) The history of dai-kenchu-to and the component crude drugs (in Japanese). Jpn J Orient Med 50:413–437Google Scholar
- 7.Ishizuka M, Shibuya N, Nagata H et al (2017) Perioperative administration of traditional Japanese herbal medicine daikenchuto relieves postoperative ileus in patients undergoing surgery for gastrointestinal cancer: a systematic review and meta-analysis. Anticancer Res 37:5967–5974Google Scholar
- 15.Takagi K, Nagata H, Horie T et al (2007) Effects of prophylactic Kampo therapy with daikenchuto on bowel disorder following colorectal cancer resection: prospective randomized study (in Japanese). Prog Kampo Med 429:2–3Google Scholar
- 16.Fujii S (2011) Effects of daikenchuto on early postoperative bowel motility following surgery for colorectal cancer (in Japanese). Prog Med 31:468–469Google Scholar
- 18.Yaegashi M, Otsuka K, Itabashi T et al (2014) Daikenchuto stimulates colonic motility after laparoscopic-assisted colectomy. Hepatogastroenterology 61:85–89Google Scholar
- 20.Katsuno H, Maeda K, Ohya M et al (2016) Clinical pharmacology of daikenchuto assessed by transit analysis using radiopaque markers in patients with colon cancer undergoing open surgery: a multicenter double-blind randomized placebo-controlled study (JFMC39-0902 additional study). J Gastroenterol 51:222–229CrossRefGoogle Scholar
- 24.Satoh Y, Itoh H, Takeyama M (2010) Daikenchuto raises plasma levels of motilin in cancer patients with morphine-induced constipation. J Tradit Med 27:115–121Google Scholar
- 28.Yasunaga H, Miyata H, Horiguchi H et al (2011) Effect of the Japanese herbal kampo medicine dai-kenchu-to on postoperative adhesive small bowel obstruction requiring long-tube decompression: a propensity score analysis. Evid Based Complement Altern Med 2011:264289. https://doi.org/10.1155/2011/264289 CrossRefGoogle Scholar