Journal of Physiology & Pathology in Korean Medicine (동의생리병리학회지)

The Physiological Society of Korean Medicine and The Society of Pathology in Korean Medicine (대한동의생리학회·한의병리학회)
권호 표지
DOI QR코드

DOI QR Code

A Review of Clinical Studies about Bojungikgi-tang Combined with Surgical Therapy on Rectal Prolapse - Focusing on Randomized Controlled Trial

직장 탈출증에 대한 보중익기탕과 수술 치료 병용요법의 임상 연구 고찰 - 무작위 대조군 연구를 중심으로

  • Kyung-hwan Kong (Department of Korean Internal Medicine, College of Korean Medicine, Se-Myung University) ;
  • Do-hyeon Kim (Department of Korean Internal Medicine, College of Korean Medicine, Se-Myung University)
  • 공경환 (세명대학교 한의과대학 한방내과학교실) ;
  • 김도현 (세명대학교 한의과대학 한방내과학교실)
  • Received : 2024.01.03
  • Accepted : 2024.02.23
  • Published : 2024.04.25
Download PDF
⟨ Previous Next ⟩

Abstract

Rectal prolapse is a condition where the rectal wall protrudes outside the anus. While it is a rare condition, it can cause discomfort for patients due to the protrusion of the rectal structure, discharge of mucus and blood, fecal incontinence, constipation, and other inconveniences. In this review, we analyzed a randomized controlled trial (RCT) study that used the herbal medicine Bojungikgi-tang(Buzhongyiqi-tang) as a complementary therapy to improve the weaknesses and side effects of the standard treatment, surgical therapy, for rectal prolapse. The analysis included 12 RCT studies, and in all studies, the prescription involved the use of Astragali Radix at the highest dosage. Among the 11 studies that evaluated efficacy, 7 studies showed a significant effect compared to the control group. In all 3 studies that evaluating recurrence rates and all 5 studies investigating complications after surgery, the experimental group showed significant effects. Based on these findings, this study could be considered as a foundational evidence for the application of bojungikgi-tang(Buzhongyiqi-tang) in clinical practice in Korean medicine for patients with rectal prolapse. It could also serve as foundational data for future research.

Keywords

References

  1. Jeongukhanuigwadaehak Bigyenaegwahakgyosil. Bigyenae gwahak. Paju: Koonja Publishing Co; 2008. p. 234-7, 431. 
  2. Bordeianou L, Paquette I, Johnson E, et al. Clinical practice guidelines for the treatment of rectal prolapse. Dis Colon Rectum. 2017;60(11):1121-31.  https://doi.org/10.1097/DCR.0000000000000889
  3. Bordeianou L, Hicks CW, Kaiser AM, Alavi K, Sudan R, Wise PE. Rectal prolapse: an overview of clinical features, diagnosis, and patient-specific management strategies. J Gastrointest Surg. 2014;18:1059-69.  https://doi.org/10.1007/s11605-013-2427-7
  4. Gonzalez-Argente FX, Jain A, Nogueras JJ, Davila GW, Weiss EG, Wexner SD. Prevalence and severity of urinary incontinence and pelvic genital prolapse in females with anal incontinence or rectal prolapse. Dis Colon Rectum. 2001;44:920-6.  https://doi.org/10.1007/BF02235476
  5. Glasgow SC, Birnbaum EH, Kodner IJ, Fleshman JW, Dietz DW. Preoperative anal manometry predicts continence after perineal proctectomy for rectal prolapse. Dis Colon Rectum. 2006;49:1052-8.  https://doi.org/10.1007/s10350-006-0538-x
  6. Deng ZJ. Deungjunggap bangjehakgangui. Paju: FishWood; 2019. p. 484-90. 
  7. Park SH, Kim YJ, Lee SH, Lee JY. The Trend of Clinical Research on Treatment for Pediatric Inguinal Hernia and Pediatric Rectal Prolapse-Focusing on Recent Studies in the China National Knowledge Infrastructure (CNKI)-. J Pediatr Korean Med. 2020;34(2):40-56. 
  8. Jadad AR, Moore RA, Carroll D, et al. Assessing the quality of reports of randomized clinical trials: is blinding necessary?. Control Clin Trials, 1996;17(1):1-12.  https://doi.org/10.1016/0197-2456(95)00134-4
  9. Dou XJ, Zhou AY, Lu YC. Clinical effect of procedure for prolapse and hemorrhoids combined with modified Buzhong Yiqi Decoction in treatment of intrarectal proctoptosis: An analysis of 60 cases. Hunan journal of traditional chinese medicine. 2021;37(5):12-5. 
  10. Lu JD, Peng X, Guo SX. Impact of Buzhong Yiqi Decoction Combined with Procedure for Prolapse and Hemorrhoids on the Inflammatory Response and Defecation Ability of Patients with Rectal Prolapse. Clinical Medicine & Engineering. 2021;28(4):451-2. 
  11. Qiu BS. Observation on the effect of selective hemorrhoidal mucosal anastomosis combined with Buzhong Yiqi Decoction in the treatment of rectal mucosal prolapse. Journal of Baotou Medical College. 2020;36(7):103-6. 
  12. Cheng YS, Li XH, Li C, Chen K, Fang L. Clinical observation of the treatment of rectal mucosal prolapse with modified Buzhong Yiqi Decoction combined with TST. China Rural Health. 2020;12(8):83. 
  13. Ma D, Zhou YY, Zhou JY, Li HS. Buzhong Yiqi Decoction Combined with RPH (Fourth Generation) Ligation for the Treatment of Rectal Prolapse. Smart Healthcare. 2019;5(23):102-22. 
  14. Wang XQ. Study on the clinical efficacy of Buzhong Yiqi Decoction combined with minimally invasive surgery in the treatment of rectal mucosal prolapse. Electronic Journal of Clinical Medical Literature. 2019;6(47):91. 
  15. Yu XY, An MW, Ai LF, Tang Y. Treatment of rectal prolapse with the combination of Buzhong Yiqi Decoction and rectal mucosal shortening surgery: A study of 21 cases. Jiangxi Journal of Traditional Chinese Medicine. 2018;49(5):53-4. 
  16. Zhao XM, Deng ZH, Zhao YJ. The Clinical Observation on Buzhong Yiqi Decoction Combined with RPH in the Treatment of Rectal Intramucosal Prolapse. Chinese Medicine Modern Distance Education of China. 2018;16(7):119-21. 
  17. Jiang LY, Tang ZJ. Clinical observation on 30 cases of II° rectal prolapse treated with modified Buzhong Yiqi Decoction combined with rectal mucosal columnar ligation. Hunan Journal of Traditional Chinese Medicine. 2018;34(3):66-8. 
  18. Chen C, Wu XH. Study on the effect of Buzhong Yiqi Decoction combined with PPH surgery in the treatment of anal distention caused by rectal mucosal prolapse. Contemporary Medical Symposium. 2017;15(23):109-10. 
  19. Li S, Jian YJ, Lai RC, Huang LF, Chen HS. Clinical observation of the treatment of rectal mucosal prolapse with modified Buzhong Yiqi Decoction combined with TST. Guangming Journal of Chinese Medicine. 2017;32(19):2848-50. 
  20. Ge GD, Hu WH. Observation of the therapeutic effect of pelvic floor reconstruction with biological patching combined with Buzhong Yiqi Decoction in the treatment of complete rectal prolapse. Modern Journal of Integrated Traditional Chinese and Western Medicine. 2016;25(22):2463-5. 
  21. Cunin D, Siproudhis L, Desfourneaux V, et al. No surgery for full-thickness rectal prolapse: what happens with continence? World J Surg. 2013;37:1297-302. https://doi.org/10.1007/s00268-013-1967-z
  22. Tou S, Brown SR, Nelson RL. Surgery for complete (full-thickness) rectal prolapse in adults. Cochrane Database Syst Rev. 2015;(11). 
  23. Ju YS. Ungok Herbology. 2nd ed. Jeonju: Woosuk Press; 2013. p. 1208-11. 
  24. Xu J, Huang F. A study of efficacy of traditional Chinese medicine combined with biofeedback electrical stimulation on postpartum pelvic organ prolapse. Int J Clin Exp Med. 2020;13(12):10031-8.