Combination therapy with traditional medicines for perianal abscess in children. Issue 10 (30th October 2019)

• Record Type: Journal Article
• Authors: Sueyoshi, Ryo; Lane, Geoffrey J.; Kusafuka, Junichi; Yamataka, Atsuyuki; Doi, Takashi
• Is Part Of: Pediatrics international. Volume 61:Issue 10(2019)
• Page Start: 1025
• Page End: 1029
• Publication Date: 2019-10-30
• Subjects: hainosankyuto -- juzentaihoto -- kampo -- perianal abscess -- traditional medicine formulation; Pediatrics -- Periodicals; 618.92
• DOI: 10.1111/ped.13988
• Languages: English
• ISSNs: 1328-8067

Abstract

Abstract: Background: Combination therapy with two different traditional medicine formulations called hainosankyuto and juzentaihoto (TJ‐122 and TJ‐48; Tsumura & Co, Tokyo, Japan) may be effective for perianal abscess (PA), but their effectiveness has not been established. The present study investigated the effectiveness of combination therapy with TJ‐122 and TJ‐48 as the most effective conservative treatment for PA. Methods: We identified 69 patients with PA under 2 years of age and divided them into four groups according to the formulations used: group 1, TJ‐122 ( n = 17); group 2, TJ‐48 ( n = 14); group 3, TJ‐122 and TJ‐48 ( n = 19); and group 4, no traditional medicines ( n = 19). Treatment was continued for 3–6 months after resolution of the PA in groups 1 and 2, and for 1 year in group 3. Age at presentation, duration of purulent discharge (PD), frequency of surgical intervention (incision and drainage [ID]; fistulotomy/fistulectomy), and recurrence rates were statistically analyzed. Results: Mean age (months) was 8.6 ± 9.2, 6.9 ± 7.3, 5.2 ± 4.7, and 3.8 ± 3.1 in groups 1, 2, 3, and 4, respectively ( P = n.s.). Mean PD (weeks) was 2.5 ± 2.2, 7.1 ± 10.8, 2.0 ± 0.0, and 2.7 ± 1.0, respectively. Duration of PD was significantly longer in group 2 than in groups 1 and 3 ( P < 0.05). Mean number of ID procedures was 1.0 ± 0.2, 2.3 ± 0.5, 0, and 1.6 ± 0.2, respectively. Group 1 had significantly less ID than group 2 ( P < 0.01). Recurrence rates were 6%, 36%, 0%, and 32%, respectively. Groups 1 and 3 had significantly less recurrence than group 2 ( P < 0.05), and group 3 had significantly less recurrence than group 4 ( P < 0.01). Conclusions: Combination therapy with TJ‐122 and TJ‐48 decreased recurrence and surgical intervention to zero in this study, demonstrating high effectiveness for treating PA in children.