Journal of Natural Medicines

, Volume 63, Issue 2, pp 200–203

Confirmation of the antispasmodic effect of shakuyaku-kanzo-to (TJ-68), a Chinese herbal medicine, on the duodenal wall by direct spraying during endoscopic retrograde cholangiopancreatography

  • Yuji Sakai
  • Toshio Tsuyuguchi
  • Takeshi Ishihara
  • Kazuki Kato
  • Masaru Tsuboi
  • Yoshihiko Ooka
  • Kiyotake Katsuura
  • Tadashi Ohara
  • Seiji Takayama
  • Michio Kimura
  • Junji Kasanuki
  • Masato Ai
  • Osamu Yokosuka
Note

Abstract

The purpose of the study was to evaluate the suppressive effect of TJ-68 on duodenal spasms during endoscopic retrograde cholangiopancreatography (ERCP). At the point when the duodenal papilla was confirmed after insertion of the endoscope during ERCP, 5.0 g TJ-68 (Tsumura Co., Tokyo, Japan) was dissolved in 50 ml of saline at 36°C, and the whole volume was sprayed slowly using a spray tube from the orifice of the forceps to the duodenal papilla of the 50 patients who demonstrated peristalsis of the digestive tract (“duodenal spasm”). The endoscopic procedure was not performed during that time, and the time until the spasm was suppressed was determined. After the arrest of the spasm, the intended tests and treatment were conducted, and the time until the duodenal spasm started again was determined. The suppressive effect on duodenal spasm was observed in 38 (76%) of 50 patients. The duration from the spraying of TJ-68 of the patients who observed the suppressive effect on duodenal spasm was 50–182 s (mean 122 ± 21 s). The spasm arrest duration was 7.2–21 min (mean 9.6 ± 1.2 min). Direct spraying of TJ-68 on the duodenal mucosa suppressed duodenal spasm, and it may be useful during ERCP when anticholinergic agents are contraindicated.

Keywords

ERCP Antispasmodic effect Shakuyaku-kanzo-to (TJ-68) Wall motion Duodenal spasm 

References

  1. 1.
    Fujita N, Maguchi H, Komatsu Y, Yasuda I, Hasebe O, Igarashi Y, Murakami A, Mukai H, Fujii T, Yamao K, Maeshiro K, JESED study group (2003) Endoscopic sphincterotomy complications and endoscopic papillary balloon dilatation for bile duct stones: a prospective randomized controlled multicenter trial. Gastrointest Endosc 57(2):151–155PubMedCrossRefGoogle Scholar
  2. 2.
    Tsujino T, Isayama H, Komatsu Y, Ito Y, Tada M, Minagawa N, Nakata R, Kaeabe T, Omata M (2005) Risk factors for pancreatitis in patients with common bile duct stones managed by endoscopic papillary balloon dilatation. Am J Gastroenterol 100(2):5007Google Scholar
  3. 3.
    Freeman ML, Gauda NM (2004) Prevention of post-ERCP pancreatitis: a comphensive review. Gastroinetest Endosc 59(7):845–864 ReviewCrossRefGoogle Scholar
  4. 4.
    Yamamoto N, Nakai Y, Sasahira N, Hirano K, Tsujino T, Isayama H, Komatsu Y, Tada M, Yoshida H, Kawabe T, Hiki N, Kaminishi N, Kurosaka H, Omata M (2006) Efficacy of peppermint oil as an antispasmodic during endoscopic retrograde cholangiopancreatography. J Gastroenterol Hepatol 21(11):1768CrossRefGoogle Scholar
  5. 5.
    Fujinami H, Hirano K, Sugiyama T (2006) Examination of digestive tract motility inhibitory effect of Shakuyaku-kanzo-to as premedication of ERCP. Gastroenterological Endoscopy (0387–1207) 48:2062 (in Japanese abstract)Google Scholar
  6. 6.
    Ai M, Yamaguchi T, Odaka T, Mitsuhashi K, Shishido T, Yan J, Seza A, Saisho H (2006) Objective assessment of the antispasmodic effect of Shakuyaku-kanzo-to (TJ-68) a Chinese herbal medicine on the colonic wall by direct spraying during colonoscopy simple inexpensive and effective. World J Gastroenterol 12(5):760–764PubMedGoogle Scholar
  7. 7.
    Arai M, Sato H, Shirota F (1994) An investigation into the relief of the pain accompanying with colonoscopy with Shakuyaku-kanzo-to. Kampo Med 44(3):123–128 (Abstract in English)Google Scholar
  8. 8.
    Nishikawa T, Yoshimura H, Imoto I, Sakai H, Akiyama T (2003) A clinical study of efficacy for suppression of peristaltic motion with Shakuyaku-kanzoh-to (Tsumura No.68) and peppermint oil for barium enema. Gastroenterol mass surv 41(2):170–176 (in Japanese)Google Scholar
  9. 9.
    Maeda T, Shinozuka K, Baba K, Hayashi M, Hayashi E (1983) Effect of shakuyaku-kanzoh-toh, a prescription composed of shakuyaku (Paeoniae Radix) and kanzoh (Glycyrrhizae Radix) on guinea pig ileum. J Pharmacobiodyn 6:153–160PubMedGoogle Scholar
  10. 10.
    Takeda S, Goto K, Ishige A, Jiann WW, Tsuen IR, Fong CC et al (2003) General pharmacological properties of Shakuyaku-kanzo-to. Oyo Yakuri/Pharmacometrics 64:23–31Google Scholar

Copyright information

© The Japanese Society of Pharmacognosy and Springer 2008

Authors and Affiliations

  • Yuji Sakai
    • 1
    • 2
  • Toshio Tsuyuguchi
    • 1
  • Takeshi Ishihara
    • 1
  • Kazuki Kato
    • 2
  • Masaru Tsuboi
    • 2
  • Yoshihiko Ooka
    • 2
  • Kiyotake Katsuura
    • 2
  • Tadashi Ohara
    • 2
  • Seiji Takayama
    • 2
  • Michio Kimura
    • 2
  • Junji Kasanuki
    • 2
  • Masato Ai
    • 1
  • Osamu Yokosuka
    • 1
  1. 1.Department of Medicine and Clinical Oncology (K1)Graduate School of Medicine, Chiba UniversityChibaJapan
  2. 2.Department of Internal MedicineFunabashi Central HospitalFunabashiJapan

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