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Keishi-ka-shakuyaku-to (also known as Gui-Zhi-Jia-Shao-Yao-Tang or TJ-60) is a traditional Japanese Kampo medicine widely used for the treatment of irritable bowel syndrome (IBS) and associated abdominal symptoms, such as abdominal pain, bloating, diarrhea, and constipation. It is composed of five crude drugs: Peony Root (Paeoniae Radix), Cinnamon Bark (Cinnamomi Cortex), Jujube Fruit (Zizyphi Fructus), Glycyrrhiza Root (Glycyrrhizae Radix), and Ginger Rhizome (Zingiberis Rhizoma). Keishi-ka-shakuyaku-to works by regulating gastrointestinal motility, reducing visceral hypersensitivity, and exerting antispasmodic and antinociceptive effects. These actions are partly mediated by the inhibition of acetylcholine release from cholinergic nerves and the modulation of transient receptor potential vanilloid 1 (TRPV1) signal transduction.
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