title: Effects of rikkunshito, a kampo medicine, on quality of life after proximal gastrectomy.
abstract: BACKGROUND
  The loss of the gastroesophageal junction after proximal gastrectomy (PG) induces various gastrointestinal symptoms, such as regurgitation, anorexia, and body weight loss, leading to impairment of the postoperative quality of life. In the present study, we investigated the long-term quality of life and the effects of rikkunshito, a traditional Japanese medicine (kampo), on the gastrointestinal symptoms and plasma ghrelin levels in patients with gastric cancer who had undergone PG.
  
  
  METHODS
  Nineteen patients who had undergone PG> 6 mo before entry into the present study were enrolled. The plasma ghrelin levels, body weight, appetite, and Gastrointestinal Symptom Rating Scale (GSRS) scores were examined before and after the 4-wk administration of rikkunshito. A subgroup analysis was performed of patients showing a GSRS score of ≥ 2 before treatment, indicating the presence of gastrointestinal symptoms.
  
  
  RESULTS
  The patients' body weight increased significantly after the administration of rikkunshito. Neither their appetite nor plasma acylated and deacylated ghrelin levels were significantly affected. In the subgroup analysis, the mean total GSRS score improved significantly from 2.6 ± 0.6 before the administration of rikkunshito to 1.9 ± 0.7 after administration because of the significant improvement in the subscale scores for abdominal pain, acid reflux, diarrhea, and constipation.
  
  
  CONCLUSIONS
  The long-term quality of life was well preserved in the patients who had undergone PG at our hospital. In the patients with a baseline GSRS score of ≥2, rikkunshito significantly improved the symptoms of postgastrectomy syndrome, and its effect was possibly independent of the plasma ghrelin levels.
authors.affiliation: Department of Gastroenterological Surgery and Oncology, Tazuke Kofukai Medical Research Institute, Kitano Hospital, Osaka, Japan.
authors.forename: Shutaro
authors.initials: S
authors.lastname: Gunji
authors.forename: Shugo
authors.initials: S
authors.lastname: Ueda
authors.forename: Masahiro
authors.initials: M
authors.lastname: Yoshida
authors.forename: Michiyuki
authors.initials: M
authors.lastname: Kanai
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Terajima
authors.forename: Arimichi
authors.initials: A
authors.lastname: Takabayashi
mesh_terms: D000368:Aged; D001066:Appetite / Q000187:drug effects; D004365:Drugs, Chinese Herbal / Q000008:administration & dosage*; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects* / Q000379:methods; D054439:Ghrelin / Q000097:blood; D006801:Humans; D008297:Male; D020835:Medicine, Kampo / Q000379:methods*; D008875:Middle Aged; D011178:Postgastrectomy Syndromes / Q000188:drug therapy*; D011788:Quality of Life; D013274:Stomach Neoplasms / Q000601:surgery*; D016896:Treatment Outcome; D015431:Weight Loss / Q000187:drug effects
chemical_list: D004365:Drugs, Chinese Herbal; D054439:Ghrelin; C084136:liu-jun-zi-tang
keywords: Gastrointestinal Symptom Rating Scale; Ghrelin; Postgastrectomy syndrome; Proximal gastrectomy; Rikkunshito; quality of life