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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

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.

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
jkm-39-1-95f1.gif

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.

참고문헌

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