Yagi M, Homma S, Kubota M, Iinuma Y, Kanada S, Kinoshita Y, Ohtaki M, Yamazaki S, Murata H
Department of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, 1-757 Asahimachi-dori, Niigata-City, 951-8510 Niigata, Japan.
Pediatr Surg Int. 2004 Jan;19(12):760-5. doi: 10.1007/s00383-003-1053-y. Epub 2004 Jan 9.
Rikkunshi-to (TJ-43), a gastroprotective herbal medicine, has been used for the symptomatic relief of adult patients with dyspepsia. However, its mechanism has yet to be fully elucidated. The aim of this study is to evaluate the effect of TJ-43 on the gastric myoelectric activity in post-operative dyspeptic patients, whose symptoms persisted for over 1 year after gastrointestinal surgery. Electrogastrography (EGG) recordings were performed to calculate the biomechanical parameters on the dominant peak frequency (DPF). Eight pediatric patients with dyspeptic symptoms after gastrointestinal surgery were examined and six age-matched children without any dyspeptic symptoms were used as controls, and they were compared with nine age-matched children without any dyspeptic symptoms after gastrointestinal surgery as subcontrols. All patients exhibited symptomatic relief after the administration of TJ-43, and the mean symptom score decreased significantly after the treatment of TJ-43 over a 1-month period ( P<0.0001). The variability index (VI) and the percentage of normal waves (PNW) were calculated as irregularity parameters of DPF. The power ratio (PR) was calculated as a parameter of the gastric contractile activity. There were no significant differences in the VI and PNW between the controls and patients during the postprandial state after therapy, even though significant differences existed regarding those parameters between the controls and patients before the therapy. There were no significant differences in the DPF, VI, and PNW between the controls and subcontrols. Furthermore, PR exhibited a significant increase after therapy ( P<0.05). However, there was a significant difference in the PR between the controls and subcontrols ( P<0.05). Postprandial dip was observed in all control subjects, eight patients in the subcontrols, and two patients after administration of TJ-43, respectively. An abnormal gastric electrical activity therefore seems to be an important factor in the pathophysiology of post-operative dyspeptic children. The coordinating and stimulating effect of TJ-43 on the gastric myoelectric activity therefore seems to play an important role in the reduction of dyspeptic symptoms.
理气剂（TJ - 43）是一种具有胃保护作用的草药，已用于缓解成人消化不良患者的症状。然而，其作用机制尚未完全阐明。本研究的目的是评估TJ - 43对胃肠道手术后消化不良症状持续超过1年的患者胃肌电活动的影响。通过进行胃电图（EGG）记录来计算主导峰频率（DPF）的生物力学参数。对8例胃肠道手术后有消化不良症状的儿科患者进行了检查，并将6例年龄匹配且无任何消化不良症状的儿童作为对照，同时将他们与9例年龄匹配且胃肠道手术后无任何消化不良症状的儿童作为亚对照进行比较。所有患者在服用TJ - 43后症状均得到缓解，且在1个月的TJ - 43治疗后平均症状评分显著降低（P < 0.0001）。计算变异指数（VI）和正常波百分比（PNW）作为DPF的不规则参数。计算功率比（PR）作为胃收缩活动的参数。治疗后餐后状态下，对照组与患者之间的VI和PNW无显著差异，尽管治疗前这些参数在对照组与患者之间存在显著差异。对照组与亚对照组之间的DPF、VI和PNW无显著差异。此外，治疗后PR显著增加（P < 0.05）。然而，对照组与亚对照组之间的PR存在显著差异（P < 0.05）。分别在所有对照受试者、亚对照组中的8例患者以及服用TJ - 43后的2例患者中观察到了餐后波谷。因此，异常的胃电活动似乎是术后消化不良儿童病理生理学中的一个重要因素。TJ - 43对胃肌电活动的协调和刺激作用似乎在减轻消化不良症状方面发挥着重要作用。
