Effects of Rikkunshito traditional Japanese medicine on enteral feeding and the plasma ghrelin level in critically ill patients: a pilot studyReport as inadecuate




Effects of Rikkunshito traditional Japanese medicine on enteral feeding and the plasma ghrelin level in critically ill patients: a pilot study - Download this document for free, or read online. Document in PDF available to download.

Journal of Intensive Care

, 2:53

First Online: 02 September 2014Received: 27 June 2014Accepted: 25 August 2014

Abstract

BackgroundRikkunshito is a traditional Japanese medicine that has been widely prescribed for patients with various gastrointestinal symptoms. Recently, the prokinetic effects of Rikkunshito in patients with a variety of diseases have attracted attention in Japan. The prokinetic effects of Rikkunshito are believed to result from an increase of active ghrelin, which is most abundant in the stomach and which has a gastrokinetic function. The aim of the present pilot study was to investigate the effects of Rikkunshito on intragastric enteral feeding and plasma ghrelin levels in critically ill patients.

MethodsThe study population consisted of critically ill patients who were projected to require intragastric tube feeding for more than 7 days. The patients were prospectively assigned to one of two treatment groups and were randomized to receive either Rikkunshito 2.5 g or metoclopramide 10 mg every 8 h. All patients received standard enteral nutrition. Patients in both groups were begun on intragastric tube feeding according to our institution’s feeding protocol.

ResultsAll patients were undergoing mechanical ventilation at the time of enrollment. The portions of enteral nutrition provided to the target amount and the quantity of gastric discharge were not statistically significantly different between the two groups. The Rikkunshito group reached 50% of the target amount of enteral feeding significantly earlier than the metoclopramide group, although the proportion of patients in whom enteral feeding was successful did not differ significantly between the two groups. Patients in the Rikkunshito group showed significantly higher plasma levels of active ghrelin compared to those in the metoclopramide group.

ConclusionsThe administration of Rikkunshito increased the plasma level of active ghrelin, and induced prokinetic effects that were greater than those observed following treatment with metoclopramide in critically ill patients.

Trial registrationUMIN00000356

KeywordsEnteral nutrition Prokinetic drug Gastroparesis Complementary therapies Metoclopramide Electronic supplementary materialThe online version of this article doi:10.1186-s40560-014-0053-4 contains supplementary material, which is available to authorized users.

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Author: Mineji Hayakawa - Yuichi Ono - Takeshi Wada - Yuichiro Yanagida - Atsushi Sawamura - Hiroshi Takeda - Satoshi Gando

Source: https://link.springer.com/



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