title: Daikenchuto, a traditional Japanese herbal medicine, for the maintenance of surgically induced remission in patients with Crohn's disease: a retrospective analysis of 258 patients.
abstract: OBJECTIVE
  Despite numerous studies, the best postoperative therapy for Crohn's disease is still undefined. We retrospectively evaluated the effects of postoperative maintenance therapy with daikenchuto, a traditional Japanese Kampo medicine, on the reoperation rate at 3 years in patients with Crohn's disease.
  
  
  METHODS
  A total of 258 patients who underwent surgery for Crohn's disease were identified for the study. For the prevention of postoperative recurrence, patients were stratified to receive 5-aminosalicylic acid, azathioprine or daikenchuto, and their effects on preventing reoperation at 3 years were evaluated.
  
  
  RESULTS
  Of the 258 patients, 44 required reoperation with intestinal resection within 3 years due to disease recurrence. The 3-year reoperation rate was significantly lower in the postoperative daikenchuto group than in the non-daikenchuto group (11.3 vs. 24.5 %, P = 0.01), and was similarly significantly lower in the postoperative 5-aminosalicylic acid group than in the non-5-aminosalicylic acid group (14.8 vs. 29.6 %, P = 0.0049). A multivariate Cox analysis showed that postoperative daikenchuto (P = 0.035) and postoperative 5-aminosalicylic acid (P = 0.022) were significantly and independently associated with the rate of reoperation at 3 years in patients with Crohn's disease.
  
  
  CONCLUSIONS
  We propose that continuous daikenchuto therapy is a clinically useful and feasible maintenance therapy for the prevention of postoperative reoperation in patients with Crohn's disease.
authors.affiliation: Department of Coloproctology, Social Health Insurance Medical Center, 3-22-1 Hyakunincho, Shinjuku-ku, Tokyo, 169-0073, Japan, amanex2009@gmail.com.
authors.forename: Amane
authors.initials: A
authors.lastname: Kanazawa
authors.forename: Minako
authors.initials: M
authors.lastname: Sako
authors.forename: Masakazu
authors.initials: M
authors.lastname: Takazoe
authors.forename: Tokuma
authors.initials: T
authors.lastname: Tadami
authors.forename: Takaaki
authors.initials: T
authors.lastname: Kawaguchi
authors.forename: Naoki
authors.initials: N
authors.lastname: Yoshimura
authors.forename: Kinya
authors.initials: K
authors.lastname: Okamoto
authors.forename: Tetsuo
authors.initials: T
authors.lastname: Yamana
authors.forename: Rikisaburo
authors.initials: R
authors.lastname: Sahara
mesh_terms: D000328:Adult; D003424:Crohn Disease / Q000188:drug therapy* / Q000517:prevention & control / Q000601:surgery*; D005260:Female; D006801:Humans; D060046:Maintenance Chemotherapy; D008297:Male; D019804:Mesalamine / Q000008:administration & dosage; D005894:Panax; D010936:Plant Extracts / Q000008:administration & dosage*; D011182:Postoperative Care; D012008:Recurrence; D012074:Remission Induction; D012086:Reoperation / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013997:Time Factors; D032106:Zanthoxylum; D030521:Zingiberaceae
chemical_list: D010936:Plant Extracts; C121414:dai-kenchu-to; D019804:Mesalamine