Bongki Park

A prospective study on the safety of herbal medicines, used alone or with conventional medicines

ETHNOPHARMACOLOGICAL RELEVANCE Along with increase of herbal medicine use worldwide, the safety of traditional herbal medicines frequently becomes a medical issue. AIM OF THE STUDY This study aimed to investigate the incidence of herbal medicine-induced adverse effects on liver functions. SUBJECTS AND METHODS A prospective study was performed with 313 inpatients (87 male and 226 female) receiving herbal prescriptions during hospitalization. The patients were classified into two groups based on their treatments: one group received herbal medicines only (57 patients), and another received herbal and conventional medicines concurrently (256 patients). All patients were given liver and renal function tests at the start of hospitalization (baseline) and at approximately 2-week intervals thereafter, until discharge. RESULTS Six of the 313 patients showed abnormal liver function without related clinical symptoms (1.9%, 95% CI 0.38-3.41); none of the patients in the herbal group had abnormal result in liver function tests (0% of 57 patients) while all six had received a combination of herbal and conventional medicines (2.3% of 256 patients, 95% CI 0.46-4.14). CONCLUSION Our findings indicate that herbal drugs used alone are relatively safe, but the risk for adverse reactions may increase when herbal and conventional drugs are taken concurrently.

The traditional drug Gongjin-Dan ameliorates chronic fatigue in a forced-stress mouse exercise model

ETHNOPHARMACOLOGICAL RELEVANCE Gongjin-Dan is a representative traditional Oriental medicine herbal drug that has been used to treat chronic fatigue symptoms for several hundred years. We evaluated the anti-fatigue effects of Gongjin-Dan and the underlying mechanisms in a chronic forced exercise mouse model. METHODS AND MATERIALS Balb/C male mice underwent an extreme treadmill-based running stress (1-h, 5 days/week), and daily oral administration of distilled water, Gongjin-Dan (100, 200, or 400 mg/kg), or ascorbic acid (100 mg/kg) for 28 days. The anti-fatigue effects of Gongjin-Dan were evaluated with behavioral tests (exercise tolerance and swimming tests), and the corresponding mechanisms were investigated based on oxidative stress and inflammatory cytokine and stress hormone levels in skeletal muscle, sera, and brain tissue. RESULTS Gongjin-Dan significantly increased exercise tolerance and latency times but reduced the number of electric shocks and immobilization time on the treadmill running and swimming tests, compared with the control group. Gongjin-Dan also significantly ameliorated alterations in oxidative stress-related biomarkers (reactive oxygen species and malondialdehyde), inflammatory cytokines (tumor necrosis factor-α, interleukin-1 beta, interleukin-6, and interferon-γ) and glycogen and L-lactate levels in skeletal muscle, compared with those in the control group. Moreover, Gongjin-Dan considerably normalized the forced running stress-induced changes in serum corticosterone and adrenaline levels, as well as brain serotonin level. These antioxidant and anti-stress effects of Gongjin-Dan were supported by the results of Western blotting (4-hydroxynonenal and heme oxygenase-1) and the gene expression levels (serotonin receptor and serotonin transporter). CONCLUSION These results support the clinical relevance of Gongjin-Dan regarding anti-chronic fatigue properties. The underlying mechanisms involve attenuation of oxidative and inflammatory reactions in muscle and regulation of the stress response through the hypothalmo-pituitary-adrenal axis.

Korean Studies on Blood Stasis: An Overview

Blood stasis is one of the important pathological concepts in Korean medicine. We analyzed the Korean studies concerning blood stasis. We searched for articles in eight electronic databases from their inception to September, 2014. We included reviews, clinical studies, and preclinical studies that had studied blood stasis and excluded articles in which blood stasis was not mentioned or in which the original authors had not explained blood stasis. Of 211 total included studies, 19 were reviews, 52 were clinical studies, and 140 were preclinical articles. “Stagnant blood within the body” was the most frequently mentioned phrase of the traditional concept of blood stasis. Traumatic injury was the most frequently studied disease/condition in the clinical studies. In the preclinical studies, coagulopathy was studied most frequently, followed by hyperviscosity, hyperlipidemia, inflammation, neoplasm, ischemic brain injury, and atherosclerosis. Hyeolbuchukeo-tang and Angelicae Gigantis Radix were the most frequent formula and single herb, respectively, used in the blood stasis researches. The results showed that blood stasis was mainly recognized as disorder of circulation and many studies showed the effectiveness of activating blood circulating herbs for diseases and pathologies such as traumatic injury or coagulopathy. Further studies are needed in the pathologic mechanisms and various diseases of blood stasis.

Expert opinions on the concept of blood stasis in China: An interview study

ObjectiveTo study various experts’ opinions on the defifinition and diagnosis of blood stasis in China.MethodsWe e-mailed the selected experts to explain the purpose of the study and to invite them to participate and asked them to name a time for the investigator to call them. Eight experts and fifive organizations were interviewed in the research community investigating blood stasis in China.ResultsSix main categories emerged from the interviews: (1) blood stasis concepts; (2) blood stasis-related biomarkers; (3) methods of diagnosing blood stasis; (4) drugs for promoting blood circulation and dissipating stasis; (5) blood stasis-related diseases; and (6) blood stasis-related societies. The consensus among the interviewed experts was that the defifinition of blood stasis is rather complicated and that there is no gold standard marker for detecting blood stasis.ConclusionsThis paper acquired experts’ opinions on the defifinition and diagnosis of blood stasis in order to establish a modern concept of blood stasis. This paper also developed a diagnostic tool and diagnostic indices for blood stasis and identifified biological indices and pathologic mechanisms related to blood stasis, which might be of great reference value in future blood stasis standardization research.

Current research and future directions in pattern identification: Results of an international symposium

A symposium on pattern identification (PI) was held at the Korea Institute of Oriental Medicine (KIOM) on October 2, 2013, in Daejeon, South Korea. This symposium was convened to provide information on the current research in PI as well as suggest future research directions. The participants discussed the nature of PI, possible research questions, strategies and future international collaborations in pattern research. With eight presentations and an extensive panel discussion, the symposium allowed participants to discuss research methods in traditional medicine for PI. One speaker presented the topic, ‘Clinical pattern differentiation and contemporary research in PI.’ Two speakers presented current trends in research on blood stasis while the remaining five other delegates discussed the research methods and future directions of PI research. The participants engaged in in-depth discussions regarding the nature of PI, potential research questions, strategies and future international collaborations in pattern research.

Herbal medicines for cancer cachexia: protocol for a systematic review

Introduction To assess the efficacy of herbal medicines as a treatment of cancer cachexia. Methods and analysis We will search the following 13 electronic databases from their inception. MEDLINE (PubMed), the Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, Allied and Complementary Medicine Database (AMED), China National Knowledge Infrastructure (CNKI), Wanfang, Journal Integration Platform (VIP) and six Korean Medical Databases (KoreaMed, the Korean Traditional knowledge Portal, OASIS, DBPIA, the Research Information Service System and the Korean Studies Information Service System) without restrictions on time or language. The data will be extracted independently by two authors using predefined criteria. Disagreements will be resolved by discussion between the authors. The risk of bias will be assessed using the Cochrane risk of bias tool. Dissemination The review will be published in a journal. The review will also be disseminated electronically and in print. An update of the review will be conducted to inform and guide healthcare practice and policy. Trial registration number PROSPERO 2013:CRD42013006612.