title: Does inchinkoto, a herbal medicine, have hepatoprotective effects in major hepatectomy? A prospective randomized study.
abstract: OBJECTIVE
  This randomized clinical trial was designed to investigate whether inchinkoto has a hepatoprotective effect on postoperative outcome after major hepatectomy.
  
  
  METHODS
  Sixty-one patients scheduled for major hepatectomy were randomly assigned to one of two groups in which preoperative inchinkoto was (inchinkoto group, n = 30) or was not (non-inchinkoto group, n = 31) administered. Inchinkoto was administered for at least 7 days before surgery. The primary endpoint was the incidence of post-hepatectomy liver damage. The expression of nuclear factor E2-related factor 2 (Nrf2) and other oxygen stress-related markers in the liver were also determined.
  
  
  RESULTS
  There was no significant difference in clinical characteristics between the inchinkoto and non-inchinkoto groups. Serum levels in liver function tests and incidences of post-hepatectomy liver failure did not differ significantly between the two groups. However, there was a significantly higher induction of antioxidant factors in the liver, such as Nrf2 protein and heme oxygenase-1 mRNA, after hepatectomy in the inchinkoto group than in the non-inchinkoto group.
  
  
  CONCLUSIONS
  The preoperative administration of inchinkoto did not have a significant impact on the overall outcome of major hepatectomy. However, inchinkoto induced the expression of Nrf2 during hepatectomy and may have exerted an antioxidative effect on the liver.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Nagoya University Graduate School of Medicine, Nagoya, Japan.
authors.forename: Tetsushi
authors.initials: T
authors.lastname: Mizutani
authors.forename: Yukihiro
authors.initials: Y
authors.lastname: Yokoyama
authors.forename: Toshio
authors.initials: T
authors.lastname: Kokuryo
authors.forename: Tomoki
authors.initials: T
authors.lastname: Ebata
authors.forename: Tsuyoshi
authors.initials: T
authors.lastname: Igami
authors.forename: Gen
authors.initials: G
authors.lastname: Sugawara
authors.forename: Masato
authors.initials: M
authors.lastname: Nagino
mesh_terms: D015105:3',5'-Cyclic-AMP Phosphodiesterases / Q000037:antagonists & inhibitors; D000368:Aged; D004365:Drugs, Chinese Herbal / Q000627:therapeutic use*; D005260:Female; D006498:Hepatectomy; D006801:Humans; D008107:Liver Diseases / Q000188:drug therapy* / Q000601:surgery; D008297:Male; D008517:Phytotherapy / Q000379:methods*; D011183:Postoperative Complications / Q000517:prevention & control*; D011300:Preoperative Care / Q000379:methods*; D011446:Prospective Studies
chemical_list: D004365:Drugs, Chinese Herbal; C078038:inchinko-to; D015105:3',5'-Cyclic-AMP Phosphodiesterases