Safety and efficacy of Dai-kenchu-to in postoperative infants with gastroschisis

DOI: 10.4236/ojped.2012.24045   PDF   HTML     3,311 Downloads   5,673 Views  


Purpose: Intestinal dysfunction is a major problem after gastroschisis repair, and causes poor oral intake and poor body weight gain in infants with gastroschisis. Dai-kenchu-to (DKT) is often used in the treatment of gastrointestinal dysfunction in Japan. The purpose of this study was to analyze the effect of DKT on infants with uncomplicated gastroschisis. Methods: In this retrospective cohort study from 1991 to 2009, we assessed 16 infants with uncomplicated gastroschisis. Eight infants received 0.3 g/kg/day of DKT for 12 months (group 1) and 8 infants did not receive DKT (group 2). We analyzed their body weight as an indicator of the effect of DKT. Results: There were no significant differences in the background characteristics. The body weight of group 1 was significantly increased at the ages of 9 months (p = 0.0348) and 12 months (p = 0.0097), compared with group 2. Multivariate analyses revealed that only DKT administration had a significant impact on body weight gain at the ages of 9 months (p = 0.0201) and 12 months (p = 0.0111). No side effects related to DKT were reported. Conclusion: DKT administration might work safely and effectively for improving the body weight gain in infants with uncomplicated gastroschisis.

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Otake, K. , Uchida, K. , Koike, Y. , Inoue, M. , Matsushita, K. , Hashimoto, K. , Ide, S. , Nagano, Y. and Kusunoki, M. (2012) Safety and efficacy of Dai-kenchu-to in postoperative infants with gastroschisis. Open Journal of Pediatrics, 2, 272-277. doi: 10.4236/ojped.2012.24045.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Christison-Lagay, E.R., Kelleher, C.M. and Langer, J.C. (2011) Neonatal abdominal wall defects. Seminars in Fetal and Neonatal Medicine, 16, 164-172.
[2] Dicken, B.J., Sergi, C., Rescorla, F.J., Breckler, F., et al. (2011) Medical management of motility disorders in patients with intestinal failure: a focus on necrotizing enterocolitis, gastroschisis, and intestinal atresia. Journal of Pediatric Surgery, 46, 1618-1630.
[3] Curry, J.I., Lander, A.D. and Stringer, M.D. (2004) A multicenter, randomized, double-blind, placebo-controlled trial of the prokinetic agent erythromycin in the postoperative recovery of infants with gastroschisis. Journal of Pediatric Surgery, 39, 565-569.
[4] Lander, A., Redkar, R., Nicholls, G., Lawson, A., et al. (1997) Cisapride reduces neonatal postoperative ileus: Randomised placebo controlled trial. Archives of Disease in Childhood. Fetal and Neonatal, 77, 119-122. doi:10.1136/fn.77.2.F119
[5] Itoh, T., Yamakawa, J., Mai, M., Yamaguchi, N., et al. (2002) The effect of the herbal medicine dai-kenchu-to on post-operative ileus. The Journal of International Medical Research, 30, 428-432.
[6] Ohya, T., Usui, Y., Arii, S., Iwai, T. et al. (2003) Effect of dai-kenchu-to on obstructive bowel disease in children. Am J Chin Med, 31, 129-135.
[7] Kono, T., Kanematsu, T. and Kitajima, M. (2009) Exodus of Kampo, traditional Japanese medicine, from the complementary and alternative medicines: Is it time yet? Surgery, 146, 837-840.
[8] Manabe, N., Camilleri, M., Rao, A., Wong, B.S., et al. (2010) Effect of daikenchuto (TU-100) on gastrointestinal and colonic transit in humans. American Journal of Physiology—Gastrointestinal and Liver Physiology, 298, 970-975.
[9] Iwai, N., Kume, Y., Kimura, O., Ono, S., et al. (2007) Effects of herbal medicine dai-kenchu-to on anorectal function in children with severe constipation. European Journal of Pediatric Surgery, 17, 115-118. doi:10.1055/s-2007-965016
[10] Fukuda, H., Chen, C., Mantyh, C., Ludwig, K., et al. (2006) The herbal medicine, Dai-Kenchu-to, accelerates delayed gastrointestinal transit after the operation in rats. Journal of Surgical Research, 131, 290-295.
[11] Mochiki, E., Yanai, M., Ohno, T. and Kuwano, H. (2010) The effect of traditional Japanese medicine (Kampo) on gastrointestinal function. Surgery Today, 40, 1105-1111. doi:10.1007/s00595-010-4388-8
[12] Shibata, C., Sasaki, I., Naito, H., Ueno, T., et al. (1999) The herbal medicine Dai-Kenchu-To stimulates upper gut motility through cholinergic and 5-hydroxytryptamine 3 receptors in conscious dogs. Surgery, 126, 918-924.
[13] Satoh, K., Kase, Y., Hayakawa, T., Murata, P., et al. (2001) Dai-kenchu-to enhances accelerated small intestinal movement. Biological & Pharmaceutical Bulletin, 24, 1122-1126. doi:10.1248/bpb.24.1122
[14] Kawasaki, N., Nakada, K., Nakayoshi, T., Furukawa, Y., et al. (2007) Effect of Dai-kenchu-to on gastrointestinal motility based on differences in the site and timing of administration. Digestive, Diseases, Sciences, 52, 2684-2694. doi:10.1007/s10620-006-9391-y
[15] Murata, P., Kase, Y., Ishige, A., Sasaki, H., et al. (2002) The herbal medicine Dai-kenchu-to and one of its active components 6—Shogaol increase intestinal blood flow in rats. Life Sciences, 70, 2061-2070. doi:10.1016/S0024-3205(01)01552-1
[16] Kono, T., Koseki, T., Chiba, S., Ebisawa, Y., et al. (2008) Colonic vascular conductance increased by Daikenchuto via calcitonin gene-related peptide and receptor-activity modifying protein 1. Journal of Surgical Research, 150, 78-84.
[17] Kono, T., Omiya, Y., Hira, Y., Kaneko, A., et al. (2011) Daikenchuto (TU-100) ameliorates colon microvascular dysfunction via endogenous adrenomedullin in Crohn’s disease rat model. Journal of Gastroenterology, 46, 1187-1196. doi:10.1007/s00535-011-0438-2
[18] Nagano, T., Itoh, H. and Takeyama, M. (1999) Effect of Dai-kenchu-to on levels of 3 brain-gut peptides (motilin, gastrin and somatostatin) in human plasma. Biological and Pharmaceutical Bulletin, 22, 1131-1133. doi:10.1248/bpb.22.1131
[19] Sato, Y., Inoue, S., Katagiri, F., Itoh, H., et al. (2006) Effects of pirenzepine on Dai-kenchu-to-induced elevation of the plasma neuropeptide levels in humans. Biological and Pharmaceutical Bulletin, 29, 166-171.
[20] Nagano, T., Itoh, H. and Takeyama, M. (2000) Effects of Dai-kenchu-to on levels of 5-hydroxytryptamine (serotonin) and vasoactive intestinal peptides in human plasma. Biological and Pharmaceutical Bulletin, 23, 352-353. doi:10.1248/bpb.23.352
[21] Kito, Y. and Suzuki, H. (2006) Effects of Dai-kenchu-to on spontaneous activity in the mouse small intestine. Journal of Smooth Muscle Research, 42, 189-201.
[22] Akiho, H. and Nakamura, K. (2011) Daikenchuto ameliorates muscle hypercontractility in a murine T-cell-mediated persistent gut motor dysfunction model. Digestion, 83, 173-179.
[23] Satoh, K., Hayakawa, T., Kase, Y., Ishige, A., et al. (2001) Mechanisms for contractile effect of Dai-kenchu-to in isolated guinea pig ileum. Digestive, Diseases, Sciences, 46, 250-256. doi:10.1023/A:1005636412287
[24] Yasunaga, H., Miyata, H., Horiguchi, H., Kuwabara, K., et al. (2011) Effect of the Japanese herbal kampo medicine dai-kenchu-to on postoperative adhesive small bowel obstruction requiring long-tube decompression: A propensity score analysis. Evidence-Based Complementary and Alternative Medicine, 2011, 264-289. doi:10.1155/2011/264289
[25] Tokita, Y., Yuzurihara, M., Sakaguchi, M., Satoh, K., et al. (2007) The pharmacological effects of Daikenchuto, a traditional herbal medicine, on delayed gastrointestinal transit in rat postoperative ileus. Journal of Pharmacological Sciences, 104, 303-310.
[26] Tokita, Y., Yamamoto, M., Satoh, K., Nishiyama, M., et al. (2011) Possible involvement of the transient receptor potential vanilloid type 1 channel in postoperative adhesive obstruction and its prevention by a kampo (traditional Japanese) medicine, daikenchuto. Journal of Pharmacological Sciences, 115, 75-83.
[27] Kono, T., Kaneko, A., Hira, Y., Suzuki, T. et al. (2010) Anticolitis and adhesion effects of daikenchuto via endogenous adrenomedullin enhancement in Crohn’s disease mouse model. Journal of Crohn’s and Colitis, 4, 161-170.
[28] Yoshikawa, K., Kurita, N., Higashijima, J., Miyatani, T., et al. (2008) Kampo medicine “Dai-kenchu-to” prevents bacterial translocation in rats. Digestive, Diseases, Sciences, 53, 1824-1831. doi:10.1007/s10620-008-0281-3
[29] Molik, K.A., Gingalewski, C.A., West, K.W., Rescorla, F.J., et al. (2001) Gastroschisis: A plea for risk categorization. Journal of Pediatric Surgery, 36, 51-55.
[30] Abdullah, F., Arnold, M.A., Nabaweesi, R., Fischer, A.C., et al. (2007) Gastroschisis in the United States 1988-2003: Analysis and risk categorization of 4344 patients. Journal of Perinatology, 27, 50-55.
[31] Baird, P.A. and MacDonald, E.C. (1981) An epidemiologic study of congenital malformations of the anterior abdominal wall in more than half a million consecutive live births. The American Journal of Human Genetics, 33, 470-478.
[32] Wilson, R.D. and Johnson, M.P. (2004) Congenital abdominal wall defects: An update. Fetal Diagnosis and Therapy, 19, 385-398.
[33] Suita, S., Okamatsu, T., Yamamoto, T., Handa, N. et al. (2000) Changing profile of abdominal wall defects in Japan: Results of a national survey. Journal of Pediatric Surgery, 35, 66-71.
[34] Eggink, B.H., Richardson, C.J., Malloy, M.H. and Angel, C.A. (2006) Outcome of gastroschisis: A 20-year case review of infants with gastroschisis born in Galveston, Texas. Journal of Pediatric Surgery, 41, 1103-1108.
[35] Rasmussen, S.A. and Frias, J.L. (2008) Non-genetic risk factors for gastroschisis. American Journal of Medical Genetics, 148, 199-212. doi:10.1002/ajmg.c.30175
[36] Castilla, E.E., Mastroiacovo, P. and Orioli, I.M. (2008) Gastroschisis: International epidemiology and public health perspectives. American Journal of Medical Genetics, 148, 162-179. doi:10.1002/ajmg.c.30181
[37] Loane, M., Dolk, H. and Bradbury, I. (2007) Increasing prevalence of gastroschisis in Europe 1980-2002: A phe- nomenon restricted to younger mothers. Paediatric and Perinatal Epidemiology, 21, 363-369.
[38] Alvarez, S.M. and Burd, R.S. (2007) Increasing prevalence of gastroschisis repairs in the United States: 1996-2003. Journal of Pediatric Surgery, 42, 943-946.
[39] Kitchanan, S., Patole, S.K., Muller, R. and Whitehall, J.S. (2000) Neonatal outcome of gastroschisis and exomphalos: A 10-year review. Journal of Paediatrics and Child Health, 36, 428-430. doi:10.1046/j.1440-1754.2000.00551.x
[40] Curry, J.I., McKinney, P., Thornton, J.G. and Stringer, M.D. (2000) The aetiology of gastroschisis. BJOG: An International Journal of Obstetrics and Gynaecology, 107, 1339-1346. doi:10.1111/j.1471-0528.2000.tb11645.x
[41] Dilsiz, A., Gundogan, A.H., Aktan, M., Duman, S. et al. (1999) Nitric oxide synthase inhibition prevents intestinal damage in gastroschisis: a morphological evaluation in chick embryos. Journal of Pediatric Surgery, 34, 1248-1252.
[42] Fasching, G., Haeusler, M., Mayr, J., Schimpl, G. et al. (2005) Can levels of interleukins and matrix metalloproteinases in the amniotic fluid predict postnatal bowel function in fetuses with gastroschisis. Journal of Pediatric Surgery, 40, 1887-1891.
[43] Langer, J.C., Longaker, M.T., Crombleholme, T.M., Bond, S.J. et al. (1989) Etiology of intestinal damage in gastroschisis. I: Effects of amniotic fluid exposure and bowel constriction in a fetal lamb model. Journal of Pediatric Surgery, 24, 992-997.
[44] Langer, J.C., Bell, J.G., Castillo, R.O., Crombleholme, T.M. et al. (1990) Etiology of intestinal damage in gastroschisis, II. Timing and reversibility of histological changes, mucosal function, and contractility. Journal of Pediatric Surgery, 25, 1122-1126.
[45] Midrio, P., Faussone-Pellegrini, M.S., Vannucchi, M.G. and Flake, A.W. (2004) Gastroschisis in the rat model is associated with a delayed maturation of intestinal pacemaker cells and smooth muscle cells. Journal of Pediatric Surgery, 39, 1541-1547.
[46] Keys, C., Drewett, M. and Burge, D.M. (2008) Gastroschisis: The cost of an epidemic. Journal of Pediatric Surgery, 43, 654-657.
[47] Sato, Y., Katagiri, F., Inoue, S., Itoh, H. et al. (2004) Daikenchu-to raises levels of calcitonin gene-related peptide and substance P in human plasma. Biological and Pharmaceutical Bulletin, 27, 1875-1877.

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