Rikkunshito increases appetite by enhancing gastrointestinal and incretin hormone levels in patients who underwent pylorus-preserving pancreaticoduodenectomy: A retrospective study

Figure 1 Study protocol. TJ-43: Rikkunshito; TJ-43(-): Patients without TJ-43 treatment; TJ-43(+): Patients with TJ-43 treatment; POD: Postoperative day.

Figure 2 Plasma acylated and desacylated ghrelin levels. A: Plasma levels of acylated ghrelin; B: Plasma levels of desacylated ghrelin. Plasma levels of acylated and desacylated ghrelin were measured by ELISA. ^aP < 0.05 compared with the Tj-43(-) group by ANOVA with Bonferroni’s post-hoc test. TJ-43: Rikkunshito; TJ-43(-): Patients without TJ-43 treatment; TJ-43(+): Patients with TJ-43 treatment; POD: Postoperative day.

Figure 3 Oral dietary intake after pancreatic surgery. After starting meals, the amount of oral dietary intake of each meal was scored from 0 to 100% (staple food and side dishes), and the average oral intake for 7 d (postoperative day 21) was calculated and analyzed in the two groups. ^aP < 0.05 compared with carbohydrate intake in the TJ-43(-) group by ANOVA with Bonferroni’s post-hoc test. TJ-43: Rikkunshito; TJ-43(-): Patients without TJ-43 treatment; TJ-43(+): Patients with TJ-43 treatment.

Figure 4 Plasma cholecystokinin and peptide YY levels. A: Plasma levels of cholecystokinin (CCK); B: Plasma levels of peptide YY (PYY). Plasma levels of CCK and PYY were measured by ELISA. ^aP < 0.05 compared with the TJ-43(-) group by ANOVA with Bonferroni’s post-hoc test. TJ-43: Rikkunshito; TJ-43(-): Patients without TJ-43 treatment; TJ-43(+): Patients with TJ-43 treatment; CCK: Cholecystokinin; PYY: Peptide YY; POD: Postoperative day.

Figure 5 Plasma incretin levels. A: Plasma levels of gastric inhibitory peptide; B: Plasma levels of glucagon-like polypeptide-1. Plasma levels of gastric inhibitory peptide and glucagon-like peptide-1 were measured by ELISA. ^aP < 0.05 compared with the TJ-43(-) group by ANOVA with Bonferroni’s post-hoc test. TJ-43: Rikkunshito; TJ-43(-): Patients without TJ-43 treatment; TJ-43(+): Patients with TJ-43 treatment; GIP: Gastric inhibitory peptide; active GLP-1: Glucagon-like polypeptide-1; POD: Postoperative day.

Figure 6 Effect of rikkunshito on insulin secretion. Immunoreactive insulin levels are shown. TJ-43: Rikkunshito; TJ-43(-): Patients without TJ-43 treatment; TJ-43(+): Patients with TJ-43 treatment; IRI: Immunoreactive insulin.