Yaegashi Mizunori, Otsuka Koki, Itabashi Tetsuya, Kimura Toshimoto, Kato Kuniyuki, Fujii Hitoshi, Koeda Keisuke, Sasaki Akira, Wakabayashi Go
Hepatogastroenterology. 2014 Jan-Feb;61(129):85-9.
BACKGROUND/AIMS: Paralytic ileus after laparoscopic-assisted surgery often occurs. We investigated whether daikenchuto (DKT), a traditional Japanese herbal medicine, improves intestinal motility in patients undergoing laparoscopic-assisted colectomy for colon cancer.
Fifty-four patients who underwent colectomy at Iwate Medical University Hospital between October 2010 and March 2012 were randomized to either the DKT group (7.5 g/day, p.o.) or the control group (lactobacillus preparation, 3g/day, p.o.). Primary endpoints included time to first flatus, bowel movement, and tolerance of diet after extubation. Secondary endpoints were WBC count, C-reactive protein (CRP) level, length of hospital stay, and postoperative ileus. Colonic transit time was measured using radiopaque markers and abdominal radiographs.
Fifty-one patients (DKT, 26 vs. control, 25) were included in the per-protocol analysis. The DKT group had significantly faster time until first flatus (67.5 +/- 13.6h vs. 77.9 +/- 11.8h, P < 0.01) and bowel movement (82.9 +/- 17.8h vs. 99.5 +/- 18.9h, P < 0.01) and colonic transit time (91.9 +/- 19.8h vs. 115.2 +/- 12.8 h, P < 0.05). There were no significant intergroup differences in secondary endpoints and adverse events.
DKT accelerates colonic motility in patients undergoing laparoscopic-assisted colectomy for colon cancer.
背景/目的：腹腔镜辅助手术后麻痹性肠梗阻经常发生。我们研究了日本传统草药大建中汤（DKT）是否能改善接受腹腔镜辅助结肠癌切除术患者的肠道蠕动。
2010年10月至2012年3月在岩手医科大学医院接受结肠切除术的54例患者被随机分为DKT组（口服，7.5克/天）或对照组（口服乳酸菌制剂，3克/天）。主要终点包括首次排气时间、排便时间和拔管后饮食耐受性。次要终点为白细胞计数、C反应蛋白（CRP）水平、住院时间和术后肠梗阻。使用不透X线标志物和腹部X线片测量结肠转运时间。
51例患者（DKT组26例，对照组25例）纳入符合方案分析。DKT组首次排气时间（67.5±13.6小时对77.9±11.8小时，P<0.01）、排便时间（82.9±17.8小时对99.5±18.9小时，P<0.01）和结肠转运时间（91.9±19.8小时对115.2±12.8小时，P<0.05）明显更快。次要终点和不良事件在组间无显著差异。
DKT可加速接受腹腔镜辅助结肠癌切除术患者的结肠蠕动。
