Home | Register | Login | Inquiries | Alerts | Sitemap |  


Advanced Search
JKM > Volume 45(2); 2024 > Article
Lee, Lee, Jo, and Park: A Study on the Relationship Between Sayeok-tang and Systemic Inflammatory Response Syndrome

Abstract

Objectives

This research is designed to analyze the relationship between Sayeok-tang(四逆湯) and systemic inflammatory response syndrome in literature.

Methods

The main treatment symptoms of Sayeok-tang(四逆湯) presented in Sanghanron(傷寒論) and Geumgweyoryak (金匱要略), and the symptoms of Ju-hwang(走黃) and Nae-ham(內陷), which is a sepsis and systemic inflammatory response syndrome in Korean medicine were analyzed. The symptoms of systemic inflammatory response syndrome presented in the related researches including diagnosis criteria and international guideline presented at the consensus conference hosted by the American College of Chest Physicians and The Society of Critical Care Medicine were also compared and analyzed.

Results

The main treatment symptoms of Sayeok-tang(四逆湯) and symptoms of systemic inflammatory response were very similar, and were almost identical to the symptoms of Nae-ham (內陷, especially Gun-ham (乾陷) and Heo-ham(虛陷)), which are the Korean medicine descriptions of sepsis and systemic inflammatory response syndrome.

Conclusions

Based on the research results, Sayeok-tang(四逆湯) can be used as a treatment of systemic inflammatory response syndrome.

Table 1
Statements Related to Sayeok-tang
傷寒論 91. 傷寒 醫下之 續得下利 淸穀不止 身疼痛者 急當救裏 後身疼痛 淸便自調者 急當救表 救裏宜四逆湯 救表宜桂枝湯
92. 病發熱頭痛 脈反沈 若不差 身體疼痛 當救其裏 四逆湯方
225. 脈浮而遲 表熱裏寒 下利淸穀者 四逆湯主之
323. 少陰病 脈沈者 急溫之 宜四逆湯
324. 少陰病 飮食入口則吐 心中溫溫欲吐 復不能吐 始得之 手足寒 脈弦遲者 此胸中實 不可下也 當吐之 若膈上 有寒飮乾嘔者 不可吐也 當溫之 宜四逆湯
353. 大汗出 熱不去 內拘急 四肢疼 又下利 厥逆而惡寒者 四逆湯主之
354. 大汗 若大下利而厥冷者 四逆湯主之
金匱要略 17–14. 嘔而脈弱, 小便復利, 身有微熱, 見厥者, 難治, 四逆湯主之.
17–36. 下利腹脹滿, 身體疼痛者, 先溫其裏, 乃攻其表. 溫裏宜四逆湯, 攻表宜桂枝湯.
Table 2
Symptoms of Ju-hwang and Nae-ham
走黃 ① 傳心: 神志 昏糊, 煩躁, 譫語, 斑疹, 血尿, 流注, 附骨疽
② 傳肺: 胸悶, 氣急, 咳嗽, 喀血, 聲嘶, 咽乾
③ 傳肝: 四肢抽搐, 角弓反張, 上視
④ 傳脾: 脘悶, 惡心, 便祕, 腹瀉, 黃疸
⑤ 傳腎: 目暗睛露, 四肢厥冷, 小便不禁

內陷 ① 火陷證: 發熱, 口渴, 便祕, 尿赤, 煩躁, 神昏, 纖語, 脇肋部痛
② 乾陷證: 發熱, 惡寒, 神疲, 譫語, 氣息, 粗促 / 肢冷, 大便溏薄, 小便頻數
③ 虛陷證: 虛熱, 形神萎頓, 納食日減, 腹痛便泄, 自汗肢冷, 昏迷厥脫
Table 3
Symptoms and Diagnostic Criteria for Systemic Inflammatory Response Syndrome
Diagnosis Criteria for Systemic Inflammatory Response Syndrome QSOFA Systolic Blood Pressure < 100 mm Hg
Highest Respiratory Rate > 21
Lowest Glasgow Coma Score < 15
SIRS Body Temperature > 38 °C or < 36 °C
Pulse Rate > 90/min
Respiratory Rate > 20/min or PaCO2 < 32 mmHg
White Blood Cell > 12,000 μL or < 4,000 μL

* PaCO2: Partial Pressure of Arterial Carbon Dioxide; QSOFA: Quick Sequential Organ Failure Assessment; SIRS: Systemic Inflammatory Response Syndrome

Table 4
Comparison of Sayeok-tang Treatment Symptoms, Systemic Inflammatory Response Syndrome, and Nae-ham
QSOFA, SIRS 傷寒論, 金匱要略 乾陷證, 虛陷證
Body Temperature > 38 °C 發熱, 頭痛, 身體疼痛 痛發熱, 虛熱
Body Temperature < 36 °C 手足寒, 惡寒 惡寒, 肢冷, 自汗肢冷
Systolic Blood Pressure < 100 mm 脈弦遲, 脈浮而遲, 脈沈, 脈弱 脈沈細, 脈虛大無力
Lowest Glasgow Coma Score < 15 - 神疲, 譫語, 形神萎頓, 昏迷厥脫
Multiple Organ Failure (Gastrointestinal) 下利淸穀, 腹脹滿, 心中溫溫欲吐 大便溏薄, 納食日減 腹痛便泄
Multiple Organ Failure (Renal) 小便復利 小便頻數

* QSOFA: Quick Sequential Organ Failure Assessment; SIRS: Systemic Inflammatory Response Syndrome

참고문헌

1. Yoon, JY, & Kwon, JY. (2010). Inflammation and sepsis. Acute Crit Care, 25(1), 1-8. https://doi.org/10.4266/kjccm.2010.25.1.1
crossref

2. Bone, RC, Balk, RA, Cerra, FB, Dellinger, RP, Fein, AM, & Knaus, WA, et al. (1992). Definitions for sepsis and organ failure and guidelines for the use of innovative therapies in sepsis. Chest, 101(6), 1644-1655. https://doi.org/10.1378/chest.101.6.1644
crossref pmid

3. Jaffer, U, Wade, RG, & Gourlay, T. (2010). Cytokines in the systemic inflammatory response syndrome: a review. HSR Proc Intensive Care Cardiovasc Anesth, 2(3), 161-175.
pmid pmc

4. Nyström, PO. (1998). The systemic inflammatory response syndrome: definitions and aetiology. J Antimicrob Chemother, 41(1), 1-7. https://doi.org/10.1093/jac/41.suppl_1.1
crossref

5. Mang WJ. (2015). Sanghanron Commentary. Iksan. Wonkwang University Press Office;p. 276-281.


6. Rho EJ. (2018). Gobangyuchwi. Seoul. Barun Herbal Medicine;p. 592-597.


7. Brislinger, D, Daxböck, C, Roβmanith, E, Stückler, M, Lang, I, Falkenhagen, D, Tang, Bai Hu, Tang, Si Ni, & Bi, Xue. (2018). Tang amplify pro-inflammatory activities and reduce apoptosis in endothelial cells in a cell culture model of sepsis. J Ethnopharmacol, 225, 309-318.
pmid

8. Liu, J, Peter, K, Shi, D, Zhang, L, Dong, G, & Zhang, D, et al. (2014). Anti-inflammatory effects of the Chinese herbal formula Shini Tang in myocardial infarction rats. Evid Based Complement Alternat Med, 2014, 309378.
pmid pmc

9. Jiangsu University of Chinese Medicine Sanghan Laboratory. (2001). Sanghanron Commentary. Seoul. Yeogang Publisher;p. 91-92. p. 209p. 413-417. p. 491-493.


10. Kwak DR. (2002). Geumgweyoryak Commentary. Seoul. Seongbosa;p. 418-419. p. 436-438.


11. College of Korean Medicine Dermatology & Surgery Textbook Compilation Committee. (2007). Text of Traditional Korean Dermatology & Surgery. Pusan. Sunwoo;p. 185-191.


12. Singer, M, Deutschman, CS, Seymour, CW, Shankar-Hari, M, Annane, D, & Bauer, M, et al. (2016). The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA, 315(8), 801-810. https://doi.org/10.1001/jama.2016.0287
pmid pmc

13. Chakraborty RK, Burns B. Systemic inflammatory response syndrome. StatPearls [Internet]. Treasure Island (FL). StatPearls Publishing;(2023). Jan. [cited 2023 Dec 11]. Available from: URL: https://www.ncbi.nlm.nih.gov/books/NBK547669/


14. Gauer, R, Forbes, D, & Boyer, N. (2020). Sepsis: Diagnosis and management. Am Fam Physician, 101(7), 409-418.
pmid

15. Purvis, D, & Kirby, R. (1994). Systemic inflammatory response syndrome: Septic shock. Vet Clin North Am Small Anim Pract, 24(6), 1225-1247.
crossref pmid

16. Horn, KD. (1998). Evolving strategies in the treatment of sepsis and systemic inflammatory response syndrome (SIRS). QJM, 91(4), 265-277. https://doi.org/10.1093/qjmed/91.4.265
crossref pmid

17. Dinarello, CA, Gelfand, JA, & Wolff, SM. (1993). Anticytokine strategies in the treatment of the systemic inflammatory response syndrome. JAMA, 269(14), 1829-1835. https://doi.org/10.1001/jama.1993.03500140081040
crossref pmid

18. Matsuda, N, & Hattori, Y. (2006). Systemic inflammatory response syndrome (SIRS) Molecular pathophysiology and gene therapy. J Pharmacol Sci, 101(3), 189-198. https://doi.org/10.1254/jphs.CRJ06010X
crossref

19. Kung, SE, & Oh, MS. (2013). Effects of Sayeok-tang on papain-Induced osteoarthritis in mice. J Physiol & Pathol Korean Med, 27(2), 212-224.


20. Choi, YK, & Kang, MS. (2007). A case report of Ge-yan-jiu & herbal medicine complex treatment on Jue zheng caused by Wang yang. J Int Korean Med, 28(1), 187-192.


21. Ju YS. (2013). Jeungbo Ungok Herbology. Wanju. Wooseok;p. 767-773. p. 776-779. p. 1219-1224.


22. Kim, MS, & Kim, YS. (1981). Studies on the positive inotropic mechanism of Aconiti Tuber. Korean J of Pharmaoclogy, 17(1), 9-16.


23. Cho, EH, & Lee, TH. (2006). Effects of Coptidis Rhizoma and Aconiti Lateralis Preparata Radix on the change of plasma corticosterone level and rectal temperature induced by LPS. Kor J Herbol, 21(2), 77-85.


24. Choi, CW, & Oh, MS. (2014). Study on antioxidant and anti-inflammatory effects of components of Mahwangbujaseshin-tang. J Korean Med Rehabi, 24(4), 15-28.


25. Li, X, Ao, M, Zhang, C, Fan, S, Chen, Z, & Yu, L. (2021). Zingiberis Rhizoma Recens: A review of its traditional uses, phytochemistry, pharmacology, and toxicology. Evid Based Complement Alternat Med, (2021). https://doi.org/10.1155/2021/6668990


26. Yin, L, Guan, E, Zhang, Y, Shu, Z, Wang, B, & Wu, X, et al. (2018). Chemical profile and anti-inflammatory activity of total flavonoids from Glycyrrhiza Uralensis Fisch. Iran J Pharm Res, 17(2), 726-734.
pmid pmc

Editorial office contact information
3F, #26-27 Gayang-dong, Gangseo-gu Seoul, 157-200 Seoul, Korea
The Society of Korean Medicine
Tel : +82-2-2658-3627   Fax : +82-2-2658-3631   E-mail : skom1953.journal@gmail.com
About |  Browse Articles |  Current Issue |  For Authors and Reviewers
Developed in M2PI