Responder Analysis of Daikenchuto Treatment for Constipation in Poststroke Patients: A Subanalysis of a Randomized Control Trial

Abstract

A traditional Japanese medicine, daikenchuto (DKT), is used for treating abdominal bloating and pain with coldness. In modern medicine, it is used to treat postoperative intestinal dysfunction and ileus. We previously showed the effective improvement in functional constipation with DKT in poststroke patients. However, response prediction for the treatment has not been elucidated. We investigated the data from the prior trial (UMIN000007393) to predict the DKT treatment response. We assessed the efficacy of DKT for chronic constipation in poststroke patients. Neurogenic bowel dysfunction score (NBDS) and the Gastrointestinal Symptom Rating Scale–constipation subscale (GSRS-C) score were newly analyzed comparing the pre- and postintervention data after intake of 15 g of DKT extract granule daily for 4 weeks. Single and multiple regression analyses were performed to examine the correlations between the changes in NBDS, GSRS-C score, patient characteristics, clinical symptom score, gas volume in the gut, and serum calcitonin gene–related peptide level. The total NBDS and GSRS-C score were significantly reduced after DKT administration. The total NBDS, GSRS-C score, and gas volume score at baseline were significantly correlated with the change in these scores. Higher NBDS and GSRS-C scores and more gas volume in the gut may be possible predictors of response to DKT when treating constipation.