Maeda Hiromichi, Okada Ken-Ichi, Fujii Tsutomu, Oba Mari S, Kawai Manabu, Hirono Seiko, Kodera Yasuhiro, Sho Masayuki, Akahori Takahiro, Shimizu Yasuhiro, Ambo Yoshiyasu, Kondo Naru, Murakami Yoshiaki, Ohuchida Jiro, Eguchi Hidetoshi, Nagano Hiroaki, Sakamoto Junichi, Yamaue Hiroki
Department of Surgery, Kochi Medical School, Nankoku, Kochi 780-8505, Japan.
Second Department of Surgery, Wakayama Medical University, Wakayama 641-8510, Japan.
Clin Exp Gastroenterol. 2020 Oct 19;13:461-466. doi: 10.2147/CEG.S262082. eCollection 2020.
TJ-100 is a traditional Japanese medicine that affects inflammation and gastrointestinal motility, and is used as a preventive and treatment for paralytic ileus. This study aims at determining the effect of TJ-100 on the peritoneal levels of IFN-γ/IL-9, cytokines related to ileus, after pancreaticoduodenectomy (PD) in a clinical setting.
This was a subsidiary study of the clinical trial investigating the effect of TJ-100 on postoperative bowel function. Ascites was collected from 180 patients using an abdominal drainage tube on postoperative day 1 and 3 after PD (POD 1 or POD 3) and used to measure 27 cytokines. We performed univariate and multivariate analyses using several perioperative variables and administration of TJ-100/placebo to determine the effect of TJ-100 on the levels of IFN-γ and IL-9.
Peritoneal levels of IL-9 and IFN-γ decreased between POD 1 and 3 (Wilcoxon signed-rank test p<0.001). Multivariate analysis was performed after univariate analysis to select the variables and patients with a body mass index of ≥22 kg/m, older age, use of epidural anesthesia, and longer surgery correlated with the levels of IL-9 and IFN-γ. However, we could not detect a correlation between the use of TJ-100 and cytokine levels in ascites either on POD 1 or 3.
TJ-100 did not affect peritoneal IL-9 and IFN-γ levels after PD. This was in accordance with published clinical findings showing no improvement in bowel function after PD and TJ-100 treatment.
TJ - 100是一种传统的日本药物，可影响炎症和胃肠蠕动，用于麻痹性肠梗阻的预防和治疗。本研究旨在确定在临床环境中，TJ - 100对胰十二指肠切除术（PD）后与肠梗阻相关的细胞因子IFN -γ/IL - 9的腹腔水平的影响。
这是一项关于TJ - 100对术后肠道功能影响的临床试验的辅助研究。在PD术后第1天和第3天（POD 1或POD 3），使用腹腔引流管从180例患者中收集腹水，用于测量27种细胞因子。我们使用几个围手术期变量以及TJ - 100/安慰剂的给药情况进行单变量和多变量分析，以确定TJ - 100对IFN -γ和IL - 9水平的影响。
POD 1和POD 3之间腹腔内IL - 9和IFN -γ水平下降（Wilcoxon符号秩检验p<0.001）。在单变量分析后进行多变量分析，以选择体重指数≥22 kg/m²、年龄较大、使用硬膜外麻醉以及手术时间较长的变量和患者，这些因素与IL - 9和IFN -γ水平相关。然而，我们在POD 1或POD 3时均未检测到TJ - 100的使用与腹水中细胞因子水平之间存在相关性。
TJ - 100对PD术后腹腔内IL - 9和IFN -γ水平无影响。这与已发表的临床研究结果一致，即PD术后使用TJ - 100治疗后肠道功能无改善。
