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To evaluate the clinical usefulness of during puerperium.

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Evidence Reports of Kampo Treatment

Task Force for Evidence Reports / Clinical Practice Guideline Committee for EBM, the Japan Society for Oriental Medicine

010016e

15. Ante/Post-partum Diseases Reference

Narimatsu A, Ito A, Usefulness of kyukichoketsuin during puerperium. Rinsho Iyaku (Journal of Clinical Therapeutics & Medicine) 2001; 17: 1329-35 (in Japanese with English abstract). Ichushi Web ID: 2002057351 MOL, MOL-Lib

1. Objectives

To evaluate the clinical usefulness of kyukichoketsuin (キュウ帰調血飲) during puerperium.

2. Design

A randomized controlled trial (RCT).

3. Setting

Department of Obstetrics and Gynecology, Ogori-Daiichi General Hospital, Japan.

4. Participants

Eighty women who had normal vaginal delivery at the above facility between July 2000 and March 2001.

5. Intervention

Arm 1: postpartum administration of an oral antibiotic for 5 days + kyukichoketsuin (キュウ帰調血飲) (manufacturer not specified) 2.0 g t.i.d. before meals for 4 weeks, n=40.

Arm 2: postpartum administration of an oral antibiotic and methylergometerine maleate for 5 days, n=40.

6. Main outcome measures

Incidence of poor uterine contraction at 4 weeks postpartum, amount of milk sucked at 2 days postpartum, percentage of participants with ≥15 g/day of lactation, total amount of milk sucked, and incidences of “maternity blues” and depression at 5 days postpartum.

7. Main results

No poor uterine contraction or intrauterine infection occurred in either arm. Those receiving Kampo medicine suffered significantly less afterbirth pains (P<0.05). Kampo medicine suppressed the decrease in newborn weight in all participants, especially in primiparas (P<0.05). Postpartumly, kyukichoketsuin significantly reduced the frequency of hot flushes and twilight state. There was no between-arm difference in the incidence of maternity blues and no incidence of depression in either arm.

8. Conclusions

Kyukichoketsuin safely promotes the physical and mental restoration of puerperants, ultimately contributing to growth of newborns.

9. From Kampo medicine perspective

The increase in lactation is due to the ingredients of kyukichoketsuin (jio [地黄], toki [当帰], kobushi [香 附子], chinpi [陳皮], and uyaku [烏薬]), which are also involved in nutritional fortification and physical reconditioning. In addition, kobushi and uyaku have a qi-conditioning effect and prevent postpartum depression.

10. Safety assessment in the article Not mentioned.

11. Abstractor’s comments

This study verified the efficacy of kyukichoketsuin for “restoration of the postpartum psychosomatic condition” as described in Wanbinghuichun (萬病回春, Recovery from All Ailments). Although difference in uterine contraction should have been evaluated by measuring the length of the uterine fundus, the study should be praised for evaluating lactation by accurately measuring the amount of sucked milk. Biological evidence of the contribution of mental and physical factors to the restoration of puerperants should be sought. Scientific verification of the efficacy of kyukichoketsuin in various combinations (frequent in Manbyokaishun) is desired.

12. Abstractor and date

参照

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