A Comparative Study about Cerebrovascular Reactivity from a Single Medication and Continuous Medication on Healthy Subjects

우황청심원(牛黃淸心元)의 단독투여 및 연속투여에 따른 정상인의 뇌혈관반응도의 비교연구

  • Hwang, Jae-Woong (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Kim, Chang-Hyun (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Min, In-Kyu (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Kim, Young-Ji (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Leem, Jung-Tae (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Na, Byong-Jo (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Park, Sung-Wook (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Park, Jung-Mi (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Ko, Chang-Nam (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Bae, Hyung-Sup (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Jung, Woo-Sang (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Moon, Sang-Kwan (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Cho, Ki-Ho (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University) ;
  • Kim, Yong-Suk (Department of Cardiovascular and Neurologic Diseases(StrokeCenter) College of Oriental Medicine, Kyung-Hee University)
  • 황재응 (경희대학교 한의과대학 심계내과학교실) ;
  • 김창현 (경희대학교 한의과대학 심계내과학교실) ;
  • 민인규 (경희대학교 한의과대학 심계내과학교실) ;
  • 김영지 (경희대학교 한의과대학 심계내과학교실) ;
  • 임정태 (경희대학교 한의과대학 심계내과학교실) ;
  • 나병조 (경희대학교 한의과대학 심계내과학교실) ;
  • 박성욱 (경희대학교 한의과대학 심계내과학교실) ;
  • 박정미 (경희대학교 한의과대학 심계내과학교실) ;
  • 고창남 (경희대학교 한의과대학 심계내과학교실) ;
  • 배형섭 (경희대학교 한의과대학 심계내과학교실) ;
  • 정우상 (경희대학교 한의과대학 심계내과학교실) ;
  • 문상관 (경희대학교 한의과대학 심계내과학교실) ;
  • 조기호 (경희대학교 한의과대학 심계내과학교실) ;
  • 김영석 (경희대학교 한의과대학 심계내과학교실)
  • Published : 2009.01.30

Abstract

Objectives: Uwhangchungsim-won (DC) has been used in various medical fields such as stroke, hypertension, atherosclerosis, autonomic imbalance and mental instability, etc. The aim of this study was to evaluate the effect of UC on cerebral hemodynamics and estimate the appropriate dose of UC. Methods: We studied changes of hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of middle cerebral arteries (MCA) using transcranial Doppler. We observed the changes of mean blood pressure, pulse rate and expiratory CO2 using S/5 Compact Anesthesia Monitor from 10 healthy young volunteers who were administered UC twice a day in the 1 st section and then once a day in the 2nd section. Results: Mean blood pressure tended to decrease at 1 hour and pulse rate tended to decrease at 2 hours after second administration. After 2 hours, mean blood pressure rose to state before administration, but pulse rate maintained from 2 hours to 4 hours. The changes were not statistically significant. Cerebral blood flow velocity in middle cerebral artery was not statistically significant after second administration. Cerebrovascular reactivity increased from 2 hours to 4 hours after second administration. Conclusions: This study provides that administration of UC twice a day is more effective on hyperventilation-induced cerebrovascular reactivity than administration of UC once a day.

Keywords

References

  1. 陳師文. 太平惠民和劑局方. 臺北, 族風出版社. 1975;3.
  2. Hong ND, Kim NJ, Kim KS. Studies on the Efficacy of Combined Preparation of Crude Drugs(XXXV) Effect of Woohwangchungsimwon on the Cardiovascular System. Natural Product Sciences. 1987;18(4):241-48.
  3. So CS, Purdy RE, Giolli RA, Blanks RH. The In Vitro Characterization of the Vasodilating Action of Woo Hwang Chung Sim Won(Niu Hung Win Xing Wan). The 9th international congress of oriental medicine(The 9th ICOM). 1998.
  4. 고용석. 牛黃淸心元이 평활근에 미치는 영향. 서울. 경희대학교대학원. 1976.
  5. Sang Gyung Nam. Experimental Studies on The Effect of Woohwangchungsimwon and Sohaphyangwon. The Journal of Kyung Hee University Medical Center. 1990;6(2):220-37.
  6. Cho TS, Lee SM, Lee EB, Cho SI, Kim YK, Shin DH, Park DK. Pharmacological Actions of New Woohwangchungsimwon Pill on Cerebral Ischemia and Central Nervous System. YAKHAK HOEJI. 1997;41(6):817-28.
  7. Young-suk Kim. Effects fo Uwahngchungsimwon on Cerebral Blood Flow and Systemic Blood Pressure in Humans. The Journal of Korean Oriental Internal Medicine. 1999;20(1):222-31.
  8. Lee-dong Kim, Sang-pil Yun, Sang-ho Lee, Eunju Kim, Byong-jo Na, Dong-won Jung, Won-jun Shin, Sang-kwan Moon, Hyung-sup Bae. Effects of Uwhangchungsim-won(Niuhuangqungxin-yuan) on Systemic Blood Pressure, Pulse, Rate, Cerebral Blood Flow and Cerebrovascular Reactivity in Humans. The Journal of Korean Oriental Internal Medicine. 2004;25(3):440-50.
  9. Seong-Uk Park, Sang-Kwan Moon, Chang-Nam Ko, Ki-Ho Cho, Young-Suk Kim, Hyung-Sup Bae, Kyung-Sup Lee. The Clinical Study of The Effect of Electrical Stimulation at Sugu-Sungjang Point(GV26-CV24) on Blood Pressure, Pulse and Cerebral Blood Flow in Ischemic Stroke Patients. The Journal of Kyung Hee University Medical Center. 1997;13(4):390-403.
  10. Sang-Kwan Moon, Chang-Nam Ko, Ki-Ho Cho, Young-Suk Kim, Hyung-Sup Bae, Kyung-Sup Lee. Effects of Opposing-Needling on Upper Limb on Cerebral Blood Flow in Ischemic Stroke Patients. The Journal of Kyung Hee University Medical Center. 2000;16(1):94-101.
  11. Soon-Hyun Ryu, Bon-soo Koo, Sung-Hwan Kim, Sang-Kwan Moon, Ki-Ho Cho, Young-Suk Kim, Hyung-Sup Bae, Kyung-Sup Lee. Effects of Sahyangsohap-won on Cerebral Hemodynamics in Healthy Subjects. The Journal of Korean Oriental Internal Medicine. 2001;22(2):199-205.
  12. Sang-Kwan Moon, Young-Suk Kim, Seong-Uk Park, Woo-Sang Jung, Chang-Nam Ko, Ki-Ho Cho, Hyung-Sup Bae. Effect of Gastrodia Elata BL Water Extract on Human Cerebral Blood Flow using Transcranial Doppler. The journal of Korean Oriental Medicine. 2005;26(1):115-22.
  13. Dong-Won Jeong, Sang-Kwan Moon, Jin-Woo Hong, Won-Jun Shin, Young-Min Park, Jae-Han Jung, Chang-Hyun Kim, In-Kyu Min, Seong-Uk Park, Woo-Sang Jung, Jung-Mi Park, Chang-Nam Go, Ki-Ho Cho, Young-Suk Kim, Hyung-Sup Bae. Effects of Korean Ginseng, Korean Red Ginseng and Fermented Korean Red Ginseng on Cerebral Blood Flow, Cerebrovascular Reactivity, Systemic Blood Pressure and Pulse Rate in Humans. The journal of Korean Oriental Medicine. 2006;27(3):38-50.
  14. Ko CN, Moon SK, Cho KH, Cho KS, Kim YS, Bae HS, Lee KS. Effects of Woohwangchungsimwon on the Isolated Rat Hearts under Langendorff Apparatus. Journal of Oriental Medicine. 1997;2(1):33-44.
  15. Cho TS, Lee SM, Kim ND, Huh IH, Ann HS, Kwon KI, Park SK, Shim SH, Shin DH, Park DK. Pharmacological Actions of New Wonbang Woohwangchungsimwon Liquid on Cardiovascular System. Journal of Applied Pharmacology. 1999;7:320-32.
  16. Dahl A, Russell D, Hansen RN, Rootwelt K. Effect of nitroglycerin on cerebral circulation measured by transcranial doppler and SPECT. Stroke. 1989;20:1733-36. https://doi.org/10.1161/01.STR.20.12.1733
  17. 한병인. 사진과 그림으로 배우는 초음파 뇌혈류 검사. 푸른솔. 2004;14-5.
  18. 신완균. 임상약동학. 서울대학교 출판부. 1997.
  19. Hee-Joon Hae. Various Clinical Applications of TCD. Korean Journal of Stroke. 2001;3(1):21-30.
  20. Kim KH, Son YH, Lee SM, Lee JH, Kim DS, Kim JY, Kim JS. The Reference Values and Influencing Factors of TCD Measurements in 200 Normal Korean Adults. Journal of the Korean Neurological Association. 1995;13(4):815-824.
  21. Seong Min, Kwang Soo Lee, Jae Young Choi, Yeong In Kim. Cerebral Vasoreactivity in Carotid Stenosis or Occlusion Cases - a Transcranial Doppler Study with Acetazolamide(Diamox) Test. Journal of the Korean Neurological Association. 1998;16(4):439-443.
  22. Hong KS, Roh JK. Evaluation of Cerebrovascular Reactivity in normal and Atherosclerotic subject: using Transcranial Doppler. Journal of the Korean Neurological Association, 1994;12(2):237-244.
  23. Czernicki Z, Jurkiewicz J, Bojanowski K, Piechnid S, Cervos-Navarro J. Effects of the calcium channel blockers Dotarizine and Flunarizine on cerebrovascular reactivity. J neurol sciences. 1996;143:60-63. https://doi.org/10.1016/S0022-510X(96)00114-1
  24. Kuridze N, Czernicki Z, Jarus-Dziedzic K, Jurkiewicz J, Cervos-Navarro J. Resional differences of cerebrovascular reactivity effected by calcium channel blocker-Dotarizine. J neurol sciences. 2000;175(1):13-16. https://doi.org/10.1016/S0022-510X(00)00275-6
  25. Eicke BM, Buss E, Bahr RR, Hajak G, Paulus W. Infuluence of acetazolamide and $CO_2$ on extra cranial flow volume and intracranial blood flow velocity. Stroke. 1999;30(1):76-80. https://doi.org/10.1161/01.STR.30.1.76
  26. Yoshinary Izumi, Yoshiyasu Tsuda, Shin-Ichito Ichihara, Tsutomu Takahashi, Hitohide Matsuo. Effects of defibrination on hemorheology, cerebral blood flow velocity and $CO_2$ reactivity during hypocapnia in normal subjects. Stroke. 1996;27:1328-32. https://doi.org/10.1161/01.STR.27.8.1328
  27. Thomas-Marc Markwalder, Peter Grolimund, Rolf W. Seiler, Fritz Roth, Rune Aaslid. Dependency of blood flow velocity in the middle cerebral artery on end-tidal carbon dioxide partial pressure - A transcranial ultrasound doppler study. J Cereb Blood Flow Metab. 1984;4:368-72. https://doi.org/10.1038/jcbfm.1984.54