Rikkunshito

Rikkunshito

Chinese: Liu Jun Zi Tang

English: Six-Gentleman Decoction

Source: Jiao zhu fu ren liang fang (Revised Five Formulas for Women)

Pulse: weak vacuous, slippely vacuous

Tongue: pale body, wet white greasy fur

Abdomen: shinsuion, midline lead

Indications: This herbal formula has been used for patients with following health conditions and symptoms:

  • Poor appetite
  • Loose stools
  • Diarrhea
  • Indigestion
  • Heart burn
  • Nausea
  • Bloating (epigastric region)
  • Fatigue

There are many other health conditions that may respond well to this herbal formula, in particular, patients exhibiting indicative traditional diagnostic signs and symptoms.

Herbs in This Formula

Note: Suggested dosages of each herb in Kampo formulas are often smaller than those of Traditional Chinese Medicine (TCM). Individual dosages of herbs may be adjusted depending on each patient’s condition, constitutional patterns, quality of the herbs, and other factors involved.

Abdominal pattern (fukusho) of Rikkunshito (from Fukusho Kiran, 1800)

Basic and Clinical Research on Rikkunshito (Liu Jun Zi Tang) – Updated on Mar 30, 2011

Arai, M., Matsumura, T., Yoshikawa, M., Imazeki, F. & Yokosuka, O. Analysis of the Rikkunshito efficacy on patients with functional dyspepsia. Nippon yakurigaku zasshi 137, 18-21 (2011).

Yakabi, K., et al. Rikkunshito and 5-HT2C receptor antagonist improve cisplatin-induced anorexia via hypothalamic ghrelin interaction. Regulatory peptides 161, 97-105 (2010).

Takeda, H., et al. Rikkunshito ameliorates the aging-associated decrease in ghrelin receptor reactivity via phosphodiesterase III inhibition. Endocrinology 151, 244-252 (2010).

Shiratori, M., Shoji, T., Kanazawa, M., Hongo, M. & Fukudo, S. Effect of rikkunshito on gastric sensorimotor function under distention. Neurogastroenterol Motil (2010).

Miwa, H., et al. Rikkunshito, a traditional Japanese medicine, may relieve abdominal symptoms in rats with experimental esophagitis by improving the barrier function of epithelial cells in esophageal mucosa. Journal of gastroenterology 45, 478-487 (2010).

Matsumura, T., et al. The traditional Japanese medicine Rikkunshito increases the plasma level of ghrelin in humans and mice. Journal of gastroenterology 45, 300-307 (2010).

Kusunoki, H., et al. Efficacy of Rikkunshito, a traditional Japanese medicine (Kampo), in treating functional dyspepsia. Internal medicine (Tokyo, Japan) 49, 2195-2202 (2010). Full Text PDF

Hattori, T. Rikkunshito and ghrelin. International journal of peptides 2010(2010).

Tominaga, K., et al. The Traditional Japanese Medicine Rikkunshito Promotes Gastric Emptying via the Antagonistic Action of the 5-HT3 Receptor Pathway in Rats. Evid Based Complement Alternat Med (2009).

Arai M. Rikkunshito significantly enhances the secretion of ghrelin in patients with functional dyspepsia. Kampo Igaku (Kampo Medicine) 33: 405-6 (2009).

Takahashi T, Endo S, Nakajima K, et al. Effect of rikkunshito, a chinese herbal medicine, on stasis in patients after pylorus-preserving gastrectomy. World journal of Surgery 33: 296-302 (2009).

Takahashi, T., Endo, S., Nakajima, K., Souma, Y. & Nishida, T. Effect of rikkunshito, a chinese herbal medicine, on stasis in patients after pylorus-preserving gastrectomy. World journal of surgery 33, 296-302 (2009).

Kawahara, H., et al. Impact of rikkunshito, an herbal medicine, on delayed gastric emptying in profoundly handicapped patients. Pediatric surgery international 25, 987-990 (2009).

Takeda, H., et al. Rikkunshito, an herbal medicine, suppresses cisplatin-induced anorexia in rats via 5-HT2 receptor antagonism. Gastroenterology 134, 2004-2013 (2008).

Oka T. Rikkunshito attenuates milnacipran–induced adverse gastrointestinal symptoms and potentiates its antidepressant effect. Medical Tribune 41:82 (2008).

Okuno S, Hirayama K, Inoue J, et al. Effects of rikkunshito on the postoperative nausea and vomiting (PONV) after laparoscopic gynecological surgery. Masui (Japanese Journal of Anesthesiology) 57: 1502-9 (2008).

Kawahara, H., et al. Effects of rikkunshito on the clinical symptoms and esophageal acid exposure in children with symptomatic gastroesophageal reflux. Pediatric surgery international 23, 1001-1005 (2007).

Oka T, Tamagawa Y, Hayashida S, et al. Rikkunshi-to atenuates adverse gastrointestinal symptoms induced by fluvoxamine. Biopsychosocial Medicine 1: 21 (2007).

Yamaguchi T, Koide A. Usefulness of Rikkun-shi-to (TJ-43), a Chinese herbal medicine, for the treatment of gastro-esophageal reflux disease (GERD). Medical Science Digest 33: 748-52 (2007).

Ozaki, M., Nagatomo, T., Maeda, T., Kishioka, S. & Yamamoto, H. Pharmacological differences between Liu-Jun-Zi-Tang, a traditional Chinese herbal medicine, and domperidone on isolated guinea-pig ileum. Biological & pharmaceutical bulletin 29, 1349-1354 (2006).

Nishida T. Effect of rikkunshito on gastrointestinal function in patients after gastrectomy. Progress in Medicine 26: 3224-5 (2006).

Fushiki H, Saeki A, Shiozaki A. Attempt to reduce adverse reactions associated with oral iron preparation for anemia in pregnancy by combination with rikkunshito (TJ-43). Sanfujinka Kampo Kenkyu no Ayumi (Recent Progress of Kampo Medicine in Obstetrics and Gynecology) 20: 138-9 (2003).

Mizuno S, Yamagiwa K, Iwata M, et al. Effect of early treatment with TSUMURA Rikkunshito on gastrointestinal symptoms after resection of gastric cancer – focusing on reflux esophagiti. Progress in Medicine 21: 1366-7 (2001).

Hayakawa, T., et al. Liu-Jun-Zi-Tang, a kampo medicine, promotes adaptive relaxation in isolated guinea pig stomachs. Drugs under experimental and clinical research 25, 211-218 (1999).

Harasawa S. The role of rikkunshito against NUD (non-ulcer dyspepsia) – especially its efficacy in dysmotility-like NUD. Progress in Medicine 19: 843-8 (1999).

Arakawa, T., et al. Gastroprotection by Liu-Jun-Zi-Tang (TJ-43): possible mediation of nitric oxide but not prostaglandins or sulfhydryls. Drugs under experimental and clinical research 25, 207-210 (1999).

Hasegawa T, Yamaki K, Muraoka I, et al. Effects of traditional Chinese medicines on pharmacokinetics of levofloxacin. Antimicrobial Agents and Chemotherapy 39: 2135-37 (1995).

Hasegawa T, Yamaki K, Nadai M, et al. Lack of effect of Chinese medicines on bioavailability of ofloxacin in healthy volunteers. International Journal of Clinical Pharmacology and Therapeutics 31: 57-61 (1994).

Harasawa S, Miyoshi A, Miwa T, et al. Double-blind multicenter post-marketing clinical trial of TJ-43 TSUMURA Rikkunshi-to for the treatment of dysmotility-like dyspepsia. Igaku no Ayumi (Journal of Clinical and Experimental Medicine) 187: 207-29 (1998).

Tatsuta, M. & Iishi, H. Effect of treatment with liu-jun-zi-tang (TJ-43) on gastric emptying and gastrointestinal symptoms in dyspeptic patients. Alimentary pharmacology & therapeutics 7, 459-462 (1993).

Komatsuzaki O. Clinical effect of TSUMURA Rikkunshito on indefinite epigastric distress – comparison with a control agent, and assessment mainly based on the endoscopic findings and the histology of gastric mucosal biopsy specimens before and after the treatment. Kampo Igaku (Kampo Medicine) 17: 120-31 (1993).

Kawamura S, Okita K, Tada M, et al. Clinical comparison of TSUMURA Rikkunshito and sulpiride in the treatment of indefinite complaints of epigastric distress – mainly the antidepressive effect and the improvement of gastric emptying. Progress in Medicine 12: 1156-62 (1992).

Miyoshi A, Kaneko E, Nakazawa S, et al. Clinical evaluation of TJ-43 TSUMURA Rikkunshito in the treatment of gastritis (acute gastritis and acute exacerbation of chronic gastritis) – multicenter comparative study using sodium azulene sulfonate as a control. Shindan to Chiryo (Diagnosis and Treatment) 79: 789-810 (1991).

Miyoshi A, Yachi A, Masamune O, et al. Clinical evaluation of TJ-43 TSUMURA Rikkunshito in the treatment of indefinite complaints of gastrointestinal disorders including chronic gastritis – a multicenter comparative study using cisapride as a control. Progress in Medicine 11: 1605-31 (1991).

Ohta Y, Nishioka M, Yamamoto Y, et al. Multicenter clinical evaluation of Kampo preparations for medical use in the treatment of gastritis (acute gastritis and acute exacerbation of chronic gastritis) – comparison with gefarnate as a control. Shindan to Chiryo (Diagnosis and Treatment) 78: 2935-46 (1990).

Takemoto T, Matsuda K, Tada M, et al. Clinical evaluation of the efficacy of TJ-43 Tsumura Rikkunshi-To on gastritis with abdominal symptom – multicenter group study in comparison with cetraxate -. Shokakika (Gastroenterology) 12: 223-34 (1990).