Kusunoki Hiroaki, Haruma Ken, Hata Jiro, Ishii Manabu, Kamada Tomoari, Yamashita Naohito, Honda Keisuke, Inoue Kazuhiko, Imamura Hiroshi, Manabe Noriaki, Shiotani Akiko, Tsunoda Tsukasa
Department of General Medicine, Kawasaki Medical School, Kurashiki.
Intern Med. 2010;49(20):2195-202. doi: 10.2169/internalmedicine.49.3803. Epub 2010 Oct 15.
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.
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.
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.
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.
日本传统汉方药物理气剂,作为治疗功能性消化不良(FD)的口服制剂被广泛应用。在我们之前的研究中,我们报道了体外超声检查(US)是评估胃容受性反射(AR)和十二指肠-胃动力的一种有用技术。在本研究中,我们研究了理气剂对FD患者胃十二指肠功能的影响。
16例FD患者(中位年龄45岁)在接受理气剂(7.5 g,每日2次)治疗14天前后接受超声检查。为评估AR,在递增摄入高达400 mL流食后测量胃近端的横截面积。扩张率用作确定AR的参数。然后,使用先前报道的方法评估胃排空率(GER)、动力指数(MI)和反流指数(RI)。
尽管胃肠道症状评分量表(GSRS)总分未见显著变化,但理气剂治疗后GSRS的15项症状中的3项得分显著降低。理气剂治疗后胃近端的扩张率显著高于治疗前。尽管GER和MI显著增加,但理气剂治疗后RI未见显著差异。
这些观察结果表明,理气剂可能对AR和胃动力受损的FD患者有益。这些结果还表明,理气剂对FD和胃食管反流病具有治疗潜力。