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

Amane Kanazawa, Minako Sako, Masakazu Takazoe, Tokuma Tadami, Takaaki Kawaguchi, Naoki Yoshimura, Kinya Okamoto, Tetsuo Yamana, Rikisaburo Sahara

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Purpose: 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. Conclusion: 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.

Original languageEnglish
Pages (from-to)1506-1512
Number of pages7
JournalSurgery today
Volume44
Issue number8
DOIs
Publication statusPublished - 2014 Aug

Keywords

  • 5-aminosalicylic acid
  • Crohn's disease
  • Daikenchuto
  • Reoperation rate

ASJC Scopus subject areas

  • Surgery

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