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

  • Masayoshi HosakaEmail author
  • Ichiro Arai
  • Yoshihisa Ishiura
  • Tomohiro Ito
  • Yoshinobu Seki
  • Tateaki Naito
  • Yuko Masuzawa
  • Takeo Nakayama
  • Yoshiharu Motoo
Original Article



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.


Using EKAT, we conducted a systematic review and meta-analysis on the efficacy of using daikenchuto ( 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).


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.


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.


Daikenchuto Kampo Gastrointestinal cancers Postoperative intestinal dysfunction Meta-analysis 



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.

Author 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.

Compliance with ethical standards

Conflict of interest

The authors declare no competing interests.


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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  • Masayoshi Hosaka
    • 1
    Email author
  • Ichiro Arai
    • 2
  • Yoshihisa Ishiura
    • 3
  • Tomohiro Ito
    • 4
  • Yoshinobu Seki
    • 5
  • Tateaki Naito
    • 6
  • Yuko Masuzawa
    • 1
  • Takeo Nakayama
    • 1
  • Yoshiharu Motoo
    • 7
  1. 1.Department of Health InformaticsKyoto University School of Public HealthKyotoJapan
  2. 2.Division of Kampo Pharmaceutical SciencesNihon Pharmaceutical UniversitySaitamaJapan
  3. 3.Department of Respiratory, Oncology and Allergy MedicineKansai Medical University Medical CenterOsakaJapan
  4. 4.Department of Internal MedicineShowa University Northern Yokohama HospitalKanagawaJapan
  5. 5.Department of HematologyUonuma Institute of Community Medicine, Niigata University Medical and Dental HospitalNiigataJapan
  6. 6.Division of Thoracic OncologyShizuoka Cancer CenterShizuokaJapan
  7. 7.Department of Medical OncologyKanazawa Medical UniversityIshikawaJapan

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