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Efficacy of daikenchuto, a traditional Japanese Kampo medicine, for postoperative intestinal dysfunction in patients with gastrointestinal cancers: meta-analysis

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Abstract

Background

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.

Methods

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).

Results

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.

Conclusion

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.

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Acknowledgements

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.

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Authors and Affiliations

  1. Department of Health Informatics, Kyoto University School of Public Health, Yoshida Konoe, Sakyo-ku, Kyoto, 606-8501, Japan

    Masayoshi Hosaka, Yuko Masuzawa & Takeo Nakayama

  2. Division of Kampo Pharmaceutical Sciences, Nihon Pharmaceutical University, Saitama, 362-0806, Japan

    Ichiro Arai

  3. Department of Respiratory, Oncology and Allergy Medicine, Kansai Medical University Medical Center, Osaka, 570-8507, Japan

    Yoshihisa Ishiura

  4. Department of Internal Medicine, Showa University Northern Yokohama Hospital, Kanagawa, 224-8503, Japan

    Tomohiro Ito

  5. Department of Hematology, Uonuma Institute of Community Medicine, Niigata University Medical and Dental Hospital, Niigata, 949-7302, Japan

    Yoshinobu Seki

  6. Division of Thoracic Oncology, Shizuoka Cancer Center, Shizuoka, 411-8777, Japan

    Tateaki Naito

  7. Department of Medical Oncology, Kanazawa Medical University, Ishikawa, 920-0293, Japan

    Yoshiharu Motoo

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  1. Masayoshi Hosaka
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  9. Yoshiharu Motoo
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Contributions

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.

Corresponding author

Correspondence to Masayoshi Hosaka.

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Hosaka, M., Arai, I., Ishiura, Y. et al. Efficacy of daikenchuto, a traditional Japanese Kampo medicine, for postoperative intestinal dysfunction in patients with gastrointestinal cancers: meta-analysis. Int J Clin Oncol 24, 1385–1396 (2019). https://doi.org/10.1007/s10147-019-01502-1

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  • DOI: https://doi.org/10.1007/s10147-019-01502-1

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