• The Journal of Korean Medicine
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• v.24 no.3
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• pp.45-50
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• 2003

Background and Purpose : Chunghyul-dan has been widely used in the Department of Cardiovascular ＆ Neurologic Diseases, Kyung Hee Oriental Medical Center to prevent stroke by lowering serum cholesterol level. Previous experimental and clinical studies revealed that Chunghyul-dan had therapeutic effects on hyperlipidemia by inhibiting HMG-CoA reductase and pancreatic lipase. It was also reported that Chunghyul-dan showed an anti-oxidation effect by scavenging free radicals and inhibiting nitric oxide synthesis. Therefore, we examined the safety of Chunghyul-dan on all subjects who had been treated with it. Methods : We performed a retrospective study by reviewing the medical records of those who had been administrated Chunghyul-dan at Kyung Hee Oriental Medical Center from February 8,2001 to December 31,2002. The subjects' general characteristics (gender, age, medical history, and present illness), recorded adverse effects, and the results of laboratory findings were obtained and analyzed to assess the clinical safety of Chunghyul-dan. Results : Six hundred fifty six subjects were treated with Chunghyul-dan. Clinical adverse effects appeared in 13 subjects, the major symptom being indigestion (8 subjects). The apparent frequency of adverse effects was much lower than that in previous reports on the safety of certain medications. On investigation of laboratory findings, we could not find any hepatic or renal toxicity. Conclusion : We suggest that our results contribute towards confirming the safety of Chunghyul-dan by offering clinical evidence.

• Journal of Oriental Neuropsychiatry
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• v.20 no.1
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• pp.21-42
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• 2009

Objectives : This Study was performed to assess the antioxidant and neuroprotective effect of Chunghyul-dan(Qingxuedan) in PC12 cells and primary rat mesencephalic dopaminergic neurons. Methods : The anioxidant effect was investigated using the DPPH radical and ABTS cation scavenging assays and total polyphenol amout of Chunghyul-dan(Qingxuedan). The neuroprotective effect of Chunghyul-dan(Qingxuedan) in PC12 cells was evaluated using MTT assay. The scavenging activity of Chunghyul-dan(Qingxuedan) on ROS production induced by 6-OHDA(6-hydroxydopamine) in PC12 cells was evaluated, as well as the attenuating effect on GSH reduction. Finally, we examined the neuroprotective effect of Chunghyul-dan(Qingxuedan) against 6-0HDA-induced toxicity in the primary culture of rat mesencephalic doperminergic neurons. Results : Chunghyul-dan(Qingxuedan) showed concentration-dependent scavenging activities in DPPH radical and ABTS cation scavenging assays and it was not cytotoxic to PC12 cells. In postand co-treatment, Chunghyul-dan(Qingxuedan) protected PC12 cells from the 6-OHDA induced toxicity at 50 and 100 ${\mu}$g/mL significantly. And Chunghyu!-dan(Qingxuedan) decreased the 6-OHDA induced ROS production at a dose dependent manner, while increaing the 6-OHDA induced GSH reduction at 50 and 100 ${\mu}$g/mL significantly. Finally, Chunghyul-dan(Qingxuedan) showed signicant protection of rat mescencephalic dopaminergic neurons from 6-OHDA at 1 ${\mu}$g/mL. Conclusions : These results demonstrate that Chunghyul-dan(Qingxuedan) has the antioxidant and neuroprotective effect against 6-0HDA induced cytotoxicity through decreasing ROS production and increasing GSH reduction.

• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.77-84
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• 2005

Objectives: Chunghyul-dan is a combinatorial herbal medicine, and previous studies reported it had therapeutic effects for microangiopathy, which is a major part. in the progression of stroke, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities, Therefore, we examined the inhibitory effect of Chunghyul-dan on stroke occurrence in patients with silent brain infarction. Methods: We prescribed Chunghyul-dan at 600 mg a day to patients with silent brain infarction confirmed by brain MRI, and monitored stroke occurrence, drug compliances, and adverse effects for 1 year, We then performed follow-up brain MRI to detect new vascular lesions after 1 year of Chunghyul-dan medication. As for the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results: There were twenty-one subjects who were treated with Chunghyul-dan for more than 1 year, None of them experienced new clinical syndromes characterized by rapidly developing clinical symptoms and signs of focal and at times global loss of brain function, which could be accompanied with evidence of stroke occurrence, or any adverse effects during the Chunghyul-dan medication period. These results might be explained by various biochemical effects of Chunghyul-dan on microangiopathy, which is closely related with cell cycle progression, hypertension, hyperlipidemia, vascular inflammation, and oxidative damage. Of the 10 subjects lost to follow-up, six were reached; two of them had stroke occurrence. Conclusions: We suggest Chunghyul-dan could be useful for prevention of stroke occurrence in patients with silent brain infarction by preventing the progression of microangiopathy. Further study with a randomized controlled trial is needed to confirm this suggestion.

• The Journal of Korean Medicine
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• v.28 no.1 s.69
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• pp.224-236
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• 2007

Background : Chunghyul-dan is a combinatorial herbal medicine; previous studies reported it had therapeutic effects for microangiopathy, a major part in the progression of small vessel disease, as well as having anti-hypertensive, anti-hyperlipidemic, anti-apoptotic, anti-oxidative, and anti-inflammatory activities. Therefor, we examined the inhibitory effect of Chunghyul-dan on stroke recurrence in patients with small vessel disease. Methods : We prescribed Chunghyul-dan at 600 mg a day to patients with small vessel disease, and monitored stroke recurrence, drug compliances, and adverse effect for 1 year. We then performed follow-up brain MRI to find new vascular lesions after 1 year of Chunghyul-dan medication. For the subjects lost to follow-up, we assessed their prognosis after 1 year by telephone. Results : There were 73 subjects treated with Chunghyul-dan for 1 year; new vascular events were found in 3. Of the 85 subjects lost to follow-up, fifty four could be contacted, and eight of them had stroke recurrence. One year of Chunghyul-dan medication reduced the odds ratio of stroke recurrence by 75% compared to the subjects lost to follow-up and the rate increased to 88%, when adjusted for other relevant risk factors for stroke recurrence. These reductions were much higher than those of aspirin and other kinds of conventional anti-platelets. There was no adverse effect in any of the study subjects. Conclusions : We suggest Chunghyul-dan could be useful for inhibition of stroke recurrence. Further study with a randomized controlled trial is needed to confirm this suggestion.

• The Journal of Korean Medicine
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• v.39 no.1
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• pp.95-103
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• 2018

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.

• The Journal of Internal Korean Medicine
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• v.25 no.2
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• pp.195-201
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• 2004

Background and Purpose : Hypertension is one of the modifiable risk factors for stroke. Lowering blood pressure is a primary or secondary preventative measure for stroke. This study aims to assess the efficacy of Chunghyul-dan(Qingxue-dan) in stage 1 hypertensive patients who have suffered a stroke by 24 hour ambulatory blood pressure monitoring(24ABPM). Subjects& Methods : We enrolled 40 hospitalized stroke patients with stage 1 hypertension and divided them into 2 groups by stratified randomization; group A took 1200mg of Chunghyul-dan(Qingxue-dan) at 8:00 a.m. for two weeks without changing herbal medicine, and group B was the control group. 28 patients were included in the final analysis(15 in group A. 13 in group B). Blood pressure is monitored from 8:00 am to 7:30 am every 30 minutes for 24 hours. Blood pressure was monitored two times at baseline and again two weeks later. We used 3 parameters for evaluating the efficacy of Chunghyul-dan(Qingxue-dan); The first parameter is change from baseline to two weeks later in blood pressure and pulse rate. The second parameter is the trough/peak ratio(TPR) and smoothness index(SI). The third parameter is antihypertensive rate by antihypertensive efficacy guideline. Results : There is no significant difference in the baseline assessment hetween the two groups. Systolic blood pressure $(141.37{\pm}8.96\;mmHg\;vs\;132.28{\pm}9.46\;mmHg)$ decreased after two weeks of 1200mg(P=0.03) intake of Chunghyul-dan(Qingxue-dan). Systolic TPR and SI was 0.87 and 1.04 in group A. Antihypertensive rate was higher in group A. Conclusion: These results suggest that 1200mg doses of Clunghyul-dan(Qingxue-dan) is an effective antihypertensive agent on stage 1 hypertension patients who have suffered a stroke.

• The Journal of Korean Medicine
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• v.29 no.5
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• pp.52-66
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• 2008

Objectives :Ginkgo-Chunghyul-dan (GCHD) is newly developed herbal medicine to prevent and treat stroke. In this study, we investigated whether the GCHD had antioxidant activity and anti-platelet aggregation effect in vitro and hypolipidemic activities in vivo. Methods :Anti-oxidant activity of GCHD was measured using the Blois method, anti-platelet effect of GCHD was assessed by the Born method, and hypolipidemic activities of GCHD were evaluated in corn oil- or Triton WR-1339-induced and cholesterol-fed rats. Results :GCHD showed anti-oxidant activity in the study inhibiting the formation of 1-diphenyl-2-picrylhydrazyl radicals and xanthine oxidase activity. GCHD had anti-platelet aggregation activity. GCHD significantly lowered total cholesterol (TC), triglyceride (TG), and low density lipoprotein cholesterol (LDL-C) in high cholesterol diet and Triton WR-1339 induced model TG in corn oil-induced model. GCHD had no acute toxicity at a single dosage. Conclusion : These results suggest that GCHD has the potential to treat hyperlipidemia and stroke.

• Animal cells and systems
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• v.14 no.4
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• pp.275-282
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• 2010

Chunghyul-dan (CHD) is a combinatorial drug known to exert anti-inflammatory effects in endothelial cells. In this study, we employed global transcriptional profiling using cDNA microarrays to identify molecular mechanisms responsible for the anti-inflammatory activity of CHD in endothelial cells. An analysis of the microarray data revealed that transcript levels of monocyte chemotactic protein-1 (MCP-1), vascular cell-adhesion molecule-1 (VCAM-1) and activated leukocyte cell-adhesion molecule were dramatically altered in CHD-treated endothelial cells. These changes in gene expression were confirmed by RT-PCR, Western blotting and ELISA. Chronic CHD treatment also appeared to decrease MCP-1 secretion, probably as a result of decreased MCP-1 expression. In addition, we determined that chronic CHD treatment inhibited lipopolysaccharide-stimulated adhesion of THP-1 leukocytes to endothelial cells. The inhibitory effect of CHD on LPS-stimulated adhesion resulted from downregulation of VCAM-1 expression. Transmigration of THP-1 leukocytes through endothelial cells was also inhibited by chronic CHD treatment. In conclusion, CHD controls a variety of inflammatory activities by regulating MCP-1 and VCAM-1 gene expression.

• The Journal of Korean Medicine
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• v.27 no.2 s.66
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• pp.253-261
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• 2006

Backgrounds : Hyperlipidemia is a major cause of cardiovascular disease (CVD). Lowering serum cholesterol levels could reduce the risk of CVD. Insamsansa-eum (Renshenshanzha-yin, ISE), composed of Ginseng Radix and Crataegii Fructus, is a new medicine developed to treat hyperlipidemia and CVD. Objectives : In this study, we intended to explore the clinical effects of ISE on patients with hypercholesterolemia, and moreover we also compared its effects according to the pattern identification. Methods : Subjects were administered ISE with the dose of 600 mg three times a day for 4 weeks. Patterns of subjects were identified with diagnostic scoring system for Yin-Yang and the condition of Excess-Deficiency before treatment. Serum lipids were measured at baseline and after 4 weeks of medication. Results : ISE lowered total cholesterol(TC), triglyceride(TG), total lipid(TL), phospholipid(PL) and low density lipoprotein cholesterol(LDL) significantly. Compared with the data of our previous study, it was less effective than Atorvastatin but showed equal lipids-lowering effect to Chunghyul-dan (Qingxue-dan, CHD). In Yang pattern group, ISE was less effective in lowering TG and LDL than it was in not-Yang-not-Yinpattern group. On safety assessment, there was no adverse effect, hepatic or renal toxicity. Conclusions : We suggest that ISE is a safe and useful herbal medicine for hypercholesterolemia, and moreover it could be more useful when it is used for patients with not Yang pattern.