title: 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.
abstract: OBJECTIVE
  To objectively evaluate the effect of TJ-68 on colonic spasms during colonoscopy.
  
  
  METHODS
  One hundred and one patients subjected to screening colonoscopy were randomly assigned to two groups: TJ-68 in 51 subjects and saline as the control in 50. The endoscope was inserted into the sigmoid colon, then a spastic region was identified and the tip of the colonoscope was positioned at a distance of about 10 mm from the spastic region. The endoscopic view was recorded before and after direct spraying of the TJ-68 solution or warm saline. The intraluminal area of the spastic region was serially measured using a computer image analyzer and expressed as pixel counts. The area under the curve (AUC) was calculated from the pixel curve. Statistical significance was assessed by Wilcoxon's test and Mann-Whitney U test.
  
  
  RESULTS
  The mean AUC of the spastic region before and after TJ-68 spraying was 29,128 and 121,943 pixels, respectively, while with saline, it was 31,635 pixels and 48,617 pixels, respectively. Thus, the AUC significantly increased after TJ-68 spraying compared with the spraying of saline (P<0.001).
  
  
  CONCLUSIONS
  Direct spraying of TJ-68 on the colonic mucosa suppressed colonic spasm and it may be useful during colonoscopy when anticholinergic agents are contraindicated.
authors.affiliation: Department of Medicine and Oncology, Graduate School of Medicine, Chiba University 1-8-1 Inohana, Chuo-ku, Chiba 260-8670, Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Ai
authors.forename: Taketo
authors.initials: T
authors.lastname: Yamaguchi
authors.forename: Takeo
authors.initials: T
authors.lastname: Odaka
authors.forename: Kanae
authors.initials: K
authors.lastname: Mitsuhashi
authors.forename: Tadayuki
authors.initials: T
authors.lastname: Shishido
authors.forename: Jun
authors.initials: J
authors.lastname: Yan
authors.forename: Ayaka
authors.initials: A
authors.lastname: Seza
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Saisho
mesh_terms: D000368:Aged; D003106:Colon / Q000187:drug effects* / Q000502:physiology; D003113:Colonoscopy; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000494:pharmacology*; D005260:Female; D006035:Glycyrrhiza; D006801:Humans; D008297:Male; D008875:Middle Aged; D009126:Muscle Relaxation / Q000187:drug effects; D029596:Paeonia; D010276:Parasympatholytics / Q000494:pharmacology*; D011446:Prospective Studies
chemical_list: D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D010276:Parasympatholytics; C038462:shakuyaku-kanzoh-toh