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BACKGROUND: Animals treated with a Japanese herbal medicine Rikkunshito (Tj43) showed an enhancing effect on gastric emptying. The mechanism by which Tj43 alleviates the gastrointestinal disorders induced by anticancer agents was to increase serum ghrelin levels.
Aim: In this study, the effects of Tj43 on serum ghrelin and other intestinal polypeptide levels, and food intake were investigated after surgery.
METHODS: Forty-one patients who underwent pylorus-preserving pancreatico-duodenectomy (PpPD) due to pancreato-biliary malignant tumors at the University of Yamanashi Hospital between 2012 and 2015 were assigned to receive Tj43 just after surgery [Tj43 (+) patients, n = 21, 7.5 g daily dose starting the day after surgery], or 3 weeks after surgery [Tj43 (-) patients, n = 20]. One week after surgery, meals were starting. Oral calorie intake from carbohydrates and protein/fat were assessed in the two groups 2 weeks after starting meals. Blood samples were obtained before and after surgery for regular blood tests. Plasma acyl and desacyl ghrelin levels were assayed by ELISA, together with serum peptide YY (PYY), gastric inhibitory peptide (GIP), spexin, and cholecystokinin (CCK) levels.