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Clinical and Experimental Obstetrics & Gynecology  2020, Vol. 47 Issue (4): 560-564    DOI: 10.31083/j.ceog.2020.04.5261
Original Research Previous articles | Next articles
Hemostatic effects of kyukikyogaito in dienogest treatment
H. Takagi1, *(), S. Yamada1, J. Sakamoto1, S. Fujita1, T. Sasagawa1
1Department of Obstetrics and Gynaecology, Kanazawa Medical University, School of Medicine, Japan
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Abstract  

Purpose of Investigation: A frequent side effect of treatment with dienogest (DNG) is irregular bleeding. The present study investigated the benefits of adding traditional Japanese Kampo medicine (kyukikyogaito), which has known hemostatic effects, on DNG treatment. Materials and Methods: This retrospective study assessed the occurrence of irregular bleeding in 175 patients following oral administration of DNG (2 mg/day) for three months or more. The authors also investigated the clinical hemostatic effects of kyukikyogaito (TJ-77; 9.0 g/day) administered for 30 days in patients with irregular bleeding. Results: The frequency of irregular bleeding in patients who received DNG was 80.0%. The continuation rates for DNG treatment were 62.3% in the DNG alone group and 85.0% in the DNG plus kyukikyogaito group (p = 0.016). The efficacy of kyukikyogaito among patients with irregular bleeding was 82.6%. Conclusion: Administration of kyukikyogaito, which includes Artemisia leaf and donkey glue, was effective and could improve the continuation rate for DNG treatment by reducing irregular bleeding.

Key words:  Endometriosis      Adenomyosis      Dienogest      Irregular bleeding      Kyukikyogaito     
Submitted:  23 May 2019      Accepted:  01 August 2019      Published:  15 August 2020     
*Corresponding Author(s):  H. Takagi     E-mail:  terry-1@kanazawa-med.ac.jp

Cite this article: 

H. Takagi, S. Yamada, J. Sakamoto, S. Fujita, T. Sasagawa. Hemostatic effects of kyukikyogaito in dienogest treatment. Clinical and Experimental Obstetrics & Gynecology, 2020, 47(4): 560-564.

URL: 

https://ceog.imrpress.com/EN/10.31083/j.ceog.2020.04.5261     OR     https://ceog.imrpress.com/EN/Y2020/V47/I4/560

Figure 1.  — Flowchart for patients treated with dienogest.

Table 1  — Characteristics of patients with DNG treatment.
Demographics n (%)
Number of Patients 145
Age * 39.8 ± 6.8 (20?54)
BMI * 22.2 ± 4.0 (15.1?35.9)
Diagnosis
Endometriosis 78 (53.8)
Adenomyosis 16 (11.0)
Uterine fibroid with endometriosis 51 (35.2)
and/or adenomyosis
Initial bleeding time
1?3 months 92 (79.3)
≥ 4 months 24 (20.7)
Extent of Bleeding
None 29 (20.0)
Spotting 13 (9.0)
Light 46 (31.7)
Medium 49 (33.8)
Heavy 8 (5.5)
Treatment
Dienogest alone 110 (75.9)
GnRH agonist pre-treatment 35 (24.1)
Smoking status
Non-smoker 116 (80.0)
Smoker 29 (20.0)
Kampo medicine
No prescription 99 (68.3)
Kyukikyogaito prescription 46 (31.7)
Table 2  — Characteristics of patients with irregular bleeding.
Characteristics Irregular bleeding n (%) Odds ratio (95% CI) p value
Patients treated with dienogest
Total 116/145 (80.0)
Diagnosis
Endometriosis 59/78 (75.6) 1.00
Adenomyosis 15/16 (93.8) 1.24 (0.57-2.71)
Uterine fibroid with endometriosis 42/51 (82.4) 1.09 (0.64-1.85)
and/or adenomyosis
Treatment
Dienogest 89/111 (80.2) 1.05 (0.59-1.88) 0.88
GnRH agonist pre-treatment 26/34 (76.5)
Smoking status
Non-smoker 91/116 (78.4) 0.95 (0.52-1.74) 0.88
smoker 24/29 (82.8)
Table 3  — Comparison between patients treated with dienogest alone or dienogest plus kyukikyogaito.
Demographics Dienogest alone Dienogest plus kyukikyogaito p value
Patients (n) 99 46
Age * 39.3 ± 7.0 (20?54) 40.7 ± 6.3 (24?50) 0.20
BMI * 22.3 ± 3.8 (16.2?35.9) 22.0 ± 4.6 (15.1?35.2) 0.28
Initial bleeding time, n (%)
1?3months 56 (80.0) 36 (78.3) 0.43
≥ 4 months 14 (20.0) 10 (21.7)
Treatment
Dienogest alone 72 (72.7) 38 (82.6) 0.22
GnRH agonist pre-treatment 27 (27.3) 8 (17.4)
Smoking status
Non-smoker 76 (76.8) 40 (87.0) 0.18
Smoker 23 (23.2) 6 (13.0)
Table 4  — Effectiveness of kyukikyogaito among patients with irregular bleeding.
Demographics Effective rate of kyukikyogaito, n (%) Odds ratio (95% CI)
Dienogest patients
Total 38/46 (82.6)
Diagnosis
Endometriosis 18/19 (94.7) 1.0
Adenomyosis 4/5 (80.0) 0.84 (0.20 to 3.65)
Uterine fibroid with endometriosis
and/or adenomyosis
16/22 (72.7) 0.77 (0.31 to 1.91)
Bleeding volume
Spotting 0
Light 10/11 (90.9) 1.0
Medium 25/31 (80.6) 0.89 (0.32 to 2.43)
Heavy 3/4 (75.0) 0.83 (0.15 to 4.63)
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