title: Rikkunshito improves globus sensation in patients with proton-pump inhibitor-refractory laryngopharyngeal reflux.
abstract: OBJECTIVE
  To investigate the effect of rikkunshito on laryngopharyngeal reflux (LPR) symptoms and gastric emptying in patients with proton-pump inhibitor (PPI)-refractory LPR.
  
  
  METHODS
  In total, 22 patients with LPR were enrolled. Following a 2-wk treatment with PPI monotherapy, PPI-refractory LPR patients were randomly divided into two treatment groups (rikkunshito alone or rikkunshito plus the PPI, lansoprazole). LPR symptoms were assessed using a visual analog scale (VAS) score, gastrointestinal symptoms were assessed using the gastrointestinal symptom rating scale (GSRS), and gastric emptying was assessed using the radio-opaque marker method prior to and 4 wk following treatments.
  
  
  RESULTS
  The 4-wk treatment with rikkunshito alone and with rikkunshito plus the PPI significantly decreased the globus sensation VAS scores. The VAS score for sore throat was significantly decreased following treatment with rikkunshito plus PPI but not by rikkunshito alone. Neither treatment significantly changed the GSRS scores. Rikkunshito improved delayed gastric emptying. We found a significant positive correlation between improvements in globus sensation and in gastric emptying (r² = 0.4582, P < 0.05).
  
  
  CONCLUSIONS
  Rikkunshito improved globus sensation in patients with PPI-refractory LPR, in part, because of stimulation of gastric emptying. Thus, rikkunshito is an effective treatment for PPI-refractory LPR.
authors: Department of Otolaryngology, Tokyo Medical University, Tokyo 160-0023, Japan. tokachanman@yahoo.co.jp
authors: Ryoji
authors: R
authors: Tokashiki
authors: Isaku
authors: I
authors: Okamoto
authors: Nobutoshi
authors: N
authors: Funato
authors: Mamoru
authors: M
authors: Suzuki
mesh_terms: D000328:Adult; D000368:Aged; D004351:Drug Resistance; D004365:Drugs, Chinese Herbal / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D005746:Gastric Emptying / Q000187:drug effects; D005765:Gastrointestinal Agents / Q000009:adverse effects / Q000627:therapeutic use*; D006801:Humans; D007564:Japan; D057045:Laryngopharyngeal Reflux / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D010614:Pharynx / Q000294:innervation*; D054328:Proton Pump Inhibitors / Q000627:therapeutic use*; D012677:Sensation / Q000187:drug effects*; D013997:Time Factors; D017211:Treatment Failure
chemical_list: D004365:Drugs, Chinese Herbal; D005765:Gastrointestinal Agents; D054328:Proton Pump Inhibitors; C084136:liu-jun-zi-tang
keywords: Gastric emptying; Gastroesophageal reflux disease; Globus sensation; Laryngopharyngeal reflux; Rikkunshito
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