title: 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.
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 degrees 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.
authors.affiliation: Department of Medicine and Clinical Oncology (K1), Graduate School of Medicine, Chiba University, 1-8-1 Inohana, Chuou-ku, Chiba, Japan. sakai4754@yahoo.co.jp
authors.forename: Yuji
authors.initials: Y
authors.lastname: Sakai
authors.forename: Toshio
authors.initials: T
authors.lastname: Tsuyuguchi
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ishihara
authors.forename: Kazuki
authors.initials: K
authors.lastname: Kato
authors.forename: Masaru
authors.initials: M
authors.lastname: Tsuboi
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Ooka
authors.forename: Kiyotake
authors.initials: K
authors.lastname: Katsuura
authors.forename: Tadashi
authors.initials: T
authors.lastname: Ohara
authors.forename: Seiji
authors.initials: S
authors.lastname: Takayama
authors.forename: Michio
authors.initials: M
authors.lastname: Kimura
authors.forename: Junji
authors.initials: J
authors.lastname: Kasanuki
authors.forename: Masato
authors.initials: M
authors.lastname: Ai
authors.forename: Osamu
authors.initials: O
authors.lastname: Yokosuka
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014670:Ampulla of Vater / Q000187:drug effects / Q000378:metabolism; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods*; D004338:Drug Combinations; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage / Q000494:pharmacology*; D004386:Duodenum / Q000187:drug effects* / Q000378:metabolism; D005260:Female; D006035:Glycyrrhiza; D006801:Humans; D007413:Intestinal Mucosa / Q000187:drug effects / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D029596:Paeonia; D010276:Parasympatholytics / Q000008:administration & dosage / Q000494:pharmacology*; D011446:Prospective Studies; D013035:Spasm / Q000188:drug therapy
chemical_list: D004338:Drug Combinations; D004365:Drugs, Chinese Herbal; D010276:Parasympatholytics; C038462:shakuyaku-kanzoh-toh