Effects of the herbal medicine Inchinko-to on liver function in postoperative patients with biliary atresia--a pilot study.
OBJECTIVE
A continuation of liver fibrosis after undergoing successful Kasai operation has become the important clinical issue in the long-term follow-up of patients with biliary atresia (BA). The aim of this study is to evaluate the efficacy of the herbal medicine Inchinko-to (TJ-135) on the treatment of liver fibrosis in patients with BA without jaundice, especially from the viewpoint of the long-term effects of TJ-135.


METHODS
Six postoperative patients with BA ranging between 3 and 13 years of age with normal serum total bilirubin levels (total bilirubin < 1.0 mg/dL [17 micromol/L]) received TJ-135 from 2 to 4 years. The liver enzyme (glutamic oxaloacetic transaminase [GOT], glutamic pyruvic transaminase [GPT], gamma glutamyl transpeptidase[gamma-GTP]transpeptidase[gamma-GTP] levels and hyaluronic acid (HA) levels were compared before and after the administration of TJ-135. The monthly collected data were averaged on a 1-year basis. The record of one postoperative patient with BA and a normal serum total bilirubin level was incorporated as a control. This patient showed portal hypertension and did not receive TJ-135.


RESULTS
Five of the six patients who showed abnormal values for liver enzymes, exhibited a significant decrease in serum GOT, gamma-GTP, or GPT levels after a 1 to 3-year administration of TJ-135, and the improvement in these parameters persisted thereafter. Furthermore, one patient who had an abnormally high value of HA also showed a significant decrease in the serum level of HA. In the remaining patient with normal liver enzyme values, no significant change was observed during the administration of TJ-135. The control patient exhibited a chronological decrease in the serum GOT and GPT levels by 5 years of age, but the serum gamma-GTP and HA levels remained stable throughout the postoperative period.


CONCLUSIONS
The long-term effectiveness of TJ-135 was only found in those patients with abnormal liver enzyme levels and HA, thereby suggesting that TJ-135 has a protective and antifibrotic effect on the liver.
Iinuma
Yasushi
Y
Division of Pediatric Surgery, Niigata University Graduate School of Medical and Dental Sciences, Niigata-City, Niigata, Japan.
Kubota
Masayuki
M
Yagi
Minoru
M
Kanada
Satoshi
S
Yamazaki
Satoru
S
Kinoshita
Yoshiaki
Y
D000293:Adolescent; D000410:Alanine Transaminase / Q000097:blood; D001219:Aspartate Aminotransferases / Q000097:blood; D001656:Biliary Atresia / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D004341:Drug Evaluation; D004359:Drug Therapy, Combination; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D006820:Hyaluronic Acid / Q000097:blood; D008099:Liver / Q000187:drug effects* / Q000601:surgery; D008103:Liver Cirrhosis / Q000517:prevention & control*; D008297:Male; D010865:Pilot Projects; D011183:Postoperative Complications / Q000517:prevention & control*; D013654:Taurine / Q000627:therapeutic use; D014580:Ursodeoxycholic Acid / Q000627:therapeutic use; D005723:gamma-Glutamyltransferase / Q000097:blood
D004365:Drugs, Chinese Herbal; C078038:inchinko-to; D013654:Taurine; D014580:Ursodeoxycholic Acid; D006820:Hyaluronic Acid; D005723:gamma-Glutamyltransferase; D001219:Aspartate Aminotransferases; D000410:Alanine Transaminase