Anti-hypertensive effect by Single adminstration of Chunghyul-dan : A CASE SERIES

Sang-Kwan Moon; Su Bin Kim; Seungwon Kwon; Seung-Yeon Cho; Seong-Uk Park; Woo-sang Jung; Jung-Mi Park; Chang-Nam Ko; Ki-Ho Cho; Moon, Sang-Kwan; Kim, Su Bin; Kwon, Seungwon; Cho, Seung-Yeon; Park, Seong-Uk; Jung, Woo-sang; Park, Jung-Mi; Ko, Chang-Nam; Cho, Ki-Ho

doi:10.13048/jkm.18010

JKM > Volume 39(1); 2018 > Article

Moon, Kim, Kwon, Cho, Park, Jung, Park, Ko, and Cho: Anti-hypertensive effect by Single adminstration of Chunghyul-dan: A CASE SERIES

Case Report

The Journal of Korean Medicine 2018; 39(1): 95-103.

Published online: March 31, 2018

DOI: https://doi.org/10.13048/jkm.18010

Anti-hypertensive effect by Single adminstration of Chunghyul-dan: A CASE SERIES

Sang-Kwan Moon¹^{, 2}, Su Bin Kim¹, Seungwon Kwon¹^{, 2}, Seung-Yeon Cho¹^{, 2}, Seong-Uk Park¹^{, 2}, Woo-sang Jung¹^{, 2}, Jung-Mi Park¹^{, 2}, Chang-Nam Ko¹^{, 2}, Ki-Ho Cho¹^{, 2}

¹Department of Cardiology and Neurology, Kyung Hee University Korean Medicine Hospital

²Department of Cardiology and Neurology, College of Korean Medicine, Kyung Hee University

Correspondence to: 김수빈 (Su Bin Kim), 경희대학교 한의과대학 순환신경내과학 교실, Tel: +82-2-958-9129, E-mail: sbsb4726@naver.com

Received February 22, 2017 Revised March 13, 2018 Accepted March 15, 2018

Abstract

Objectives

This study was designed to investigate antihypertensive effect by single adminstration of Chunghyul-dan in stroke patients.

Methods

This is a 31-patient case series from retrospective chart review of inpatients who diagnosed with stroke at a Kyung Hee University Korean Medicine Hospital (Seoul) between October 2016 to October 2017. We reviewed patient’s charts with transient and sudden increases in blood pressure who were treated with Chunghyul-dan and analyzed blood pressure over time. In addition we classified patients by using the standardized predictive models for Korean medical diagnostic pattern-identification to find out if there are some differences in responder ratios.

Results

Thirty one patients who took Chunghyul-dan were identified. 60 minutes, 120 minutes after 1200mg administration, systolic and diastolic blood pressure decreased significantly compared to baseline. We could not identify the difference between the groups of each pattern-identification because of small number of some groups.

Conclusions

Although limited by its retrospective nature, this study suggests that Chunghyul-dan may be effective as short term antihypertensive method for stroke patient.

Keywords: Chunghyul-dan, Hypertension, Stroke, Diagnostic Pattern identification, Antihypertensive effect

Fig. 1

Changes in blood pressure over time

CHD, chunghyul-dan; SBP, Systolic Blood pressure; DBP, Diastolic Blood pressure;

The line means 95% CI of SBP &DBP

Table 1

Composition of Chunghyul-dan

Constitute Herbs	Percentage
Scutellariae Radix (黃芩)	0.28
Coptidis Rhizoma (黃連)	0.28
Phellodendri Cortex(黃柏)	0.28
Gardeniae Fructus (梔子)	0.28
Rhei Rhizoma (大黃)	0.07

Total	1.2 (g)

* Chunghyul-dan was made by the department of pharmacy of Kyung Hee University Korean Medicine Hospital.

Table 2

Type of Antihypertensive Treatment

Type of Antihypertensive Treatment	Patients (n=25)
Monotherapy	10 (45)
ARB	0 (0)
ACEI	0 (0)
Diuretics	0 (0)
β-Blocker	2 (20)
CCB	8 (80)

Combinations	15 (55)
ARB+β-Blocker	2 (13)
ARB+Diuretics	1 (7)
ARB+CCB	5 (33)
CCB+β-Blocker	1 (7)
ARB+CCB+β-Blocker	2 (13)
ARB+CCB+Diuretics	1 (7)
ARB+CCB+β-Blocker+Diuretics	3 (20)

* N(%) values are shown.

ACEI, angiotensin-converting enzyme inhibitor; ARB, angiotensin II receptor blocker;β-Blocker, cardioselective β-Blocker; CCB, calcium channel blocker.

Table 3

Change in Blood Pressure after CHD (1200mg) Administration

(N=31)	Mean SBP (mmHg)	ΔSBP	p*	p^**
Before	153.39± 9.52		0.001
After 30min	146.35±13.06	−7.03		0.196
After 60min	140.48±14.57	−12.90		0.001
After 120min	141.52±13.51	−11.87		0.002

(N=31)	Mean DBP (mmHg)	ΔDBP	p*	p^**

Before	93.32±9.07		0.003
After 30 min	88.45±7.28	−4.87		0.120
After 60 min	86.26±8.61	−7.06		0.005
After 120 min	88.71±8.51	−6.52		0.012

* Mean±SD values are shown, p^*: time effect of treatment by one way repeated measures ANOVA, p^**: Bonferrni multiple comparisons.

CHD, chunghyul-dan; min, minute; SBP, Systolic Blood pressure; DBP, Diastolic Blood pressure; NA, not applicable;

Table 4

Distribution of Blood Pressure according to Hypertension Stage

SBP (mmHg)	Before CHD administration	After 60min of CHD administration	p
Normal / Pre-hypertension (120–139)	0 (0)	14 (46.7)	<0.001
Stage 1 (140–159)	19 (61.3)	11 (36.7)
Stage 2 (≥160)	12 (38.7)	5 (16.7)

DBP (mmHg)	Before CHD administration	After 60min of CHD administration	p

Normal / Pre-hypertension (≤89)	4 (12.9)	15 (50.0)	0.022
Stage 1 (90–99)	17 (54.8)	11 (36.7)
Stage 2 (≥100)	10 (32.3)	4 (13.3)

* N(%) values are shown, p: Chi-square test.

SBP, Systolic Blood pressure; min, minute; DBP, Diastolic Blood pressure

Table 5

Blood Pressure of Each Pattern after CHD Administration

Fire Heat pattern (N=13)	Mean SBP (mmHg)	p	Mean DBP (mmHg)	p
Before	150.38± 9.23	0.025	91.00±9.56	0.380
After 30min	144.77±14.14		88.62±6.70
After 60min	138.46±11.97		85.69±9.20
After 120min	138.08± 9.69		87.00±6.22

Qi Deficiency pattern (N=10)	Mean SBP (mmHg)	p	Mean DBP (mmHg)	p

Before	155.50±10.66	0.237	96.00±10.75	0.064
After 30min	152.00±11.60		88.00± 6.32
After 60min	142.50±17.83		87.00± 9.49
After 120min	146.00±18.97		86.00± 8.43

Phlegm Dampness pattern (N=5)	Mean SBP (mmHg)	p	Mean DBP (mmHg)	p

Before	157.00± 9.75	0.068	94.00± 5.48	0.340
After 30min	139.00±14.32		88.00±13.04
After 60min	136.00±11.40		84.00± 5.48
After 120min	141.00±13.42		86.00± 8.94

Yin Deficiency pattern (N=3)	Mean SBP (mmHg)	p	Mean DBP (mmHg)	p

Before	153.33± 5.77	0.663	93.33± 5.77	0.802
After 30min	146.67± 5.77		90.00± 0.0
After 60min	150.00±20.00		90.00±10.00
After 120min	142.33± 4.04		86.67±11.55

* Mean±SD values are shown, p: time effect of treatment by one way repeated measures ANOVA.

CHD, chunghyul-dan; min, minute; SBP, Systolic Blood pressure; DBP, Diastolic Blood pressure.

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