Effect of Geopungdan and Chunghyuldan Combination Therapy on Cardio-Ankle Vascular Index: Retrospective Chart Review

Dabin Lee; Sang-Kwan Moon; Seungwon Kwon; Seung-Yeon Cho; Woo-Sang Jung; Seong-Uk Park; Jung-Mi Park; Chang-Nam Ko; Han-Gyul Lee; Lee, Dabin; Moon, Sang-Kwan; Kwon, Seungwon; Cho, Seung-Yeon; Jung, Woo-Sang; Park, Seong-Uk; Park, Jung-Mi; Ko, Chang-Nam; Lee, Han-Gyul

doi:10.13048/jkm.25005

JKM > Volume 46(1); 2025 > Article

Lee, Moon, Kwon, Cho, Jung, Park, Park, Ko, and Lee: Effect of Geopungdan and Chunghyuldan Combination Therapy on Cardio-Ankle Vascular Index: Retrospective Chart Review

Original Article

The Journal of Korean Medicine 2025; 46(1): 57-69.

Published online: March 01, 2025

DOI: https://doi.org/10.13048/jkm.25005

Effect of Geopungdan and Chunghyuldan Combination Therapy on Cardio-Ankle Vascular Index: Retrospective Chart Review

Dabin Lee¹^{, §}

, Sang-Kwan Moon¹^{, 2}^{, §}

, Seungwon Kwon¹^{, 2}

, Seung-Yeon Cho¹^{, 2}

, Woo-Sang Jung¹^{, 2}

, Seong-Uk Park¹^{, 2}

, Jung-Mi Park¹^{, 2}

, Chang-Nam Ko¹^{, 2}

, Han-Gyul Lee¹^{, 2}^{, *}

¹Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University

²Dept. of Cardiology and Neurology, College of Korean medicine, Kyung-Hee University

Correspondence to: Han-Gyul Lee, KyungHeeDae-ro 23, KyungHee University Medical Center, Dongdaemun-Gu, Seoul, Republic of Korea, Tel: +82-2-958-9190, Fax: +82-2-958-9132, E-mail: gyulee0614@hanmail.net

§ These authors contributed equally to this work.

Received January 8, 2025 Revised February 5, 2025 Accepted February 11, 2025

Abstract

Backgrounds and objectives

Cardio-Ankle Vascular Index (CAVI) is one of the indicators used for cardiovascular indexes, which are not affected by blood pressure so that it can independently measure the cardiovascular risk. Herbal medicines including Geopungdan and Chunghyuldan are already known as preventive effect of vascular diseases including stroke and arteriosclerosis. In this study, the cases in which patients were measured by CAVI before and after taking these herbal medicines were retrospectively collected.

Methods

This is a 13-patient case series from a retrospective chart review of patients with high CAVI (>8.0) who were treated with a combination of Geopungdan 300mg and Chunghyuldan 600mg per day for a month from 1st, January 2019 to 30th, June 2023. Changes of both CAVI before and after the treatment were collected. Also, medical records were reviewed such as general characteristics, disease-related characteristics, social history, treatment-related characteristics and chief complaints of each patient.

Results

After taking a combination of Geopungdan and Chunghyuldan for a month, both CAVI was significantly decreased (Left, 9.72±0.28 to 8.90±0.29, p<0.001; Right, 9.87±0.31 to 9.14±0.31, p=0.003). CAVI for the combined left and right also decreased significantly after treatment (9.79±1.04 to 9.02±1.06, p<0.001). The estimated ages of each CAVI after the treatment was also decreased compared to those before the treatment (p=0.004). No adverse effects or sequelae were found.

Conclusions

CAVI was significantly decreased in patients who took combination of Geopungdan and Chunghyuldan for a month. This result may infer that combination of Geopungdan and Chunghyuldan may have preventive effects to the patients who have vascular risks.

Keywords: Cardio-Ankle Vascular Index, Arteriosclerosis, Geopungdan, Chunghyuldan

Fig. 1

Decrease of Left(A) and Right CAVI(B) After the Treatment. Both CAVI after treatment were significantly decreased compared with those before treatment.

CAVI, Cardio-Ankle Vascular Index.

Fig. 2

Changes of Both CAVI before and after the treatment

*, by Fisher’s exact test.

Table 1

Composition of Chunghyuldan and Geopungdan

	Components	Scientific Name	Weight(mg)
Chunghyul-dan	Scutellariae Radix	Scultellaria Bailcalensis GEORGI	70.59
	Coptidis Rhizoma	Coptis japonica MAKINO	70.59
	Phellodendri Cortex	Phellodendron Amurense RUPPECHT	70.59
	Gardeniae Fructus	Gardenia jasminoides ELLIS	70.59
	Rhei Rhizoma	Rheum palmatum L.	17.65
	Total		300.00

Geopung-dan	Scutellariae Radix	Salvia miltiorrhiza BUNGE	125.00
	Coptidis Rhizoma	Panax notoginseng F.H.CHEN	25.00
	Total		150

Table 2

General Characteristics of Subjects

	General characteristics	Number of patients (%)
Sex	Male	11(84.6)
Sex	Female	2(15.4)

Age	40s	1(7.7)
	50s	1(7.7)
	60s	3(23.1)
	70s	6(46.2)
	80s	2(15.4)

Main Impression	Angina	2(15.4)
	Arrhythmia	1(7.7)
	Dizziness with unknown causes	1(7.7)
	Essential tremor	1(7.7)
	HTN	2(15.4)
	Migraine	1(7.7)
	Stroke (including Cerebral infarction, Cerebral hemorrhage)	5(38.5)

Chief Complaint	Chest discomfort	1(7.7)
	Dizziness	1(7.7)
	Dysarthria	2(15.4)
	Facial palsy	1(7.7)
	Headache	4(30.8)
	Tremor	1(7.7)
	Weakness	3(23.1)

Risk factors	Heart disease	3(23.1)
	Diabetes Mellitus	3(23.1)
	Dyslipidemia	6(46.2)
	Hypertension	8(61.5)

Social history	Alcohol	5(38.5)
Social history	Smoking	2(15.4)

Table 3

The difference of CAVI between before and after treatment

	Before the treatment	A month after the treatment	p-value*
CAVI (Lt.)	9.72±0.28	8.90±0.29	p<0.001
CAVI (Rt.)	9.87±0.31	9.14±0.31	p=0.003
CAVI (Both)	9.79±1.04	9.02±0.06	p<0.001

CAVI, Cardio-Ankle Vascular Index;

* , by paired t test.

Table 4

Summary of the Clinical Information of Patients

Case	Age/Sex	Main Impression	Chief Complaints	Past history	Initial LFT	Initial RFT	Adverse event
P1	67/M	Arrhythmia	Chest discomfort	HTN Dyslipidemia	None	None	None
P2	76/M	Angina s/p stent insertion	Dysarthria	HTN Dyslipidemia BPH Spinal stenosis s/p op	None	None	None
P3	82/M	Stable Angina s/p CAG #2, PCI #1	Headache Dizziness	HTN Dyslipidemia	AST 28 ALT 34 ALP 54 rGTP 46	BUN 22 Cr 1.19 eGFR 56.9	None
P4	76/M	Cerebral infarction (Lt. parietal lobe, temporal lobe)	Dysarthria	Cerebrovascular disease Gastric cancer	None	None	None
P5	79/M	Cerebral infarction of Rt. Periventricular White Matter	Facial palsy	HTN	None	None	None
P6	74/F	Headache	Headache Cervicalgia	HTN Dyslipidemia	AST 30 ALT 30 ALP 74 rGTP 46	BUN 21 Cr 0.50 eGFR 96.01	None
P7	74/M	Dizziness	Dizziness	DM	None	None	None
P8	47/M	Headache	Headache	HTN Dyslipidemia	None	None	None
P9	80/M	Headache	Headache	Dyslipidemia	None	None	None
P10	60/M	Cerebral infarction (Rt. Basal Ganglia and Corona Radiata)	Discomfort of movement	HTN DM	None	None	None
P11	57/M	Cerebral infarction (Rt. Middle Cerebral Artery territory)	Left side weakness (IV+/IV+) Dysarthria	-	None	None	None
P12	66/M	ICH (Rt. Basal Ganglia and Corona Radiata)	Left side weakness (IV/IV)	HTN	None	None	None
P13	74/M	Essential tremor	Hand tremor c Anxiety	DM	None	None	None

LFT, Liver Function Test. RFT, Renal Function Test. HTN, hypertension. BPH, Benign Prostatic Hypertrophy. CAG, Coronary Angiography. PCI, Percutaneous Coronary Intervention. AST, Aspartate Transaminase. ALT, Alanine Transaminase. ALP, Alkaline Phosphatase. rGTP, Gamma-glutamyl transpeptidase. BUN, Blood Urea Nitrogen. Cr, Creatinine. eGFR, Estimated Glomerular Filtration Rate, DM, Diabetes Mellitus. ICH, Intracerebral Hemorrhage.

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