title: Physiological analysis of the effects of rikkunshito on acid and non-acid gastroesophageal reflux using pH-multichannel intraluminal impedance monitoring.
abstract: OBJECTIVE
  To clarify the effects of rikkunshito on acid reflux, non-acid reflux, and esophageal clearance in patients with gastroesophageal reflux disease (GERD).
  
  
  METHODS
  We enrolled seven patients with vomiting and/or stridor (median 6 years; 1 month-17 years), with a percent total time of esophageal pH <4.0 (reflux index) over 4.0%. Rikkunshito (TJ-43; Tsumura Co, Tokyo, Japan) was given in three divided doses before meals. We retrospectively investigated its efficacy using pH-multichannel intraluminal impedance before and 7 (6-10) days after starting treatment. Statistical analyses were conducted using Wilcoxon signed-rank test.
  
  
  RESULTS
  In the pH analyses alone, the median number of acid reflux episodes >5 min (14 versus 10, p = 0.046) and median acid-clearance time (184 versus 134 s, p = 0.03) decreased significantly, although median decrease in reflux index did not reach significance (16.0 versus 17.9%, p = 0.06). In the combined impedance and pH analyses, the median number (36 versus 36, p = 0.03) and median duration (1.9 versus 1.1%, p = 0.046) of acid reflux decreased significantly; non-acid reflux and bolus clearance time did not change.
  
  
  CONCLUSIONS
  Rikkunshito effectively reduced acid reflux, but not esophageal clearance, in patients with GERD.
authors: Department of Pediatric Surgery, Hamamatsu University School of Medicine, 1-20-1 Handayama Higashi-ku, Hamamatsu, Shizuoka, 431-3192, Japan, kawahara@hama-med.ac.jp.
authors: Hisayoshi
authors: H
authors: Kawahara
authors: Yuko
authors: Y
authors: Tazuke
authors: Hideki
authors: H
authors: Soh
authors: Akihiro
authors: A
authors: Yoneda
authors: Masahiro
authors: M
authors: Fukuzawa
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D017097:Electric Impedance; D050782:Esophageal pH Monitoring; D005260:Female; D005764:Gastroesophageal Reflux / Q000188:drug therapy*; D006801:Humans; D006863:Hydrogen-Ion Concentration / Q000187:drug effects; D007223:Infant; D008297:Male; D008516:Medicine, Chinese Traditional / Q000379:methods*; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D004365:Drugs, Chinese Herbal; C084136:liu-jun-zi-tang