The current status of the combination therapy of frequently used herbal extracts and anti-platelet drug, anti-coagulant drug in ischemic stroke patients hospitalized in oriental medical hospital

한방병원 입원 허혈성 뇌경색 환자에서 한방 의료보험용 엑스산제와 항혈소판제 및 항응고제의 병용투여 현황

  • Han, Su-Ryun (Dept. of Internal medicine, College of Oriental Medicine, Kyung Hee University) ;
  • Park, Sung-Hwan (Dept. of Internal medicine, College of Oriental Medicine, Kyung Hee University) ;
  • Ahn, Young-Min (Dept. of Internal medicine, College of Oriental Medicine, Kyung Hee University) ;
  • Ahn, Se-Young (Dept. of Internal medicine, College of Oriental Medicine, Kyung Hee University) ;
  • Lee, Byung-Cheol (Dept. of Internal medicine, College of Oriental Medicine, Kyung Hee University)
  • 한수련 (경희대학교 한의과대학 신계내과학교실) ;
  • 박성환 (경희대학교 한의과대학 신계내과학교실) ;
  • 안영민 (경희대학교 한의과대학 신계내과학교실) ;
  • 안세영 (경희대학교 한의과대학 신계내과학교실) ;
  • 이병철 (경희대학교 한의과대학 신계내과학교실)
  • Received : 2011.01.10
  • Accepted : 2011.02.28
  • Published : 2011.03.30

Abstract

Objective: Nowadays the combined use of herbal extracts and western medicines has been prevalent, but concern about its risk is also increasing. Even though the importance of clinical trials is well recognized, there have been only a few studies on the combined use of herbal extracts and western medicines. This study was aimed to examine which herbal extracts and antiplatelets or anticoagulants are most commonly prescribed together to inpatient ischemicstroke patients and investigate the combined prescription rate. Methods: We investigated the most frequently prescribed herbal extracts from two different sources. First, we chose herbal medicine extracts from 2008 Traditional Korean Medicine Utilization Status. Then, among patients who were admitted to Kyung-Hee Oriental Medical Center diagnosed with ischemic stroke, we found patients who were administered with these herbal medicine extracts and among these patients, we investigated how many were concomitantly administered with antiplatelets or anticoagulants. Second, we chose other herbal medicine extracts that were most often prescribed within Kyung-Hee Oriental Medical Center and found patients who were administered with these herbal medicine extracts, then investigated how many of them were concomitantly administered with specific antiplatelets or anticoagulants. Results: The most commonly prescribed herbal medicine extracts among ischemic stroke patients were Ojeok-san, Bojungikgi-tang, Sochungryong-tang and Samsoeum. About 46 to 69 percent were concomitantly administered with either specific antiplatelets or anticoagulants. Conclusions: The most often prescribed herbal medicine extracts in inpatient ischemic stroke patients are Ojeok-san, Bojungikgi-tang, Sochungryong-tang, and Samsoeum. Among patients who were prescribed with Ojeok-san, Bojungikgi-tang, Sochungryong-tang, Samsoeum, patients who were concomitantly administered with either antiplatelets or anticoagulants were about 46% to 69%.

Keywords

References

  1. Tachjian A, Maria V, Jahangir A. Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol. 2010;55(6):515-25. https://doi.org/10.1016/j.jacc.2009.07.074
  2. Ernst E. Herb-drug interactions: Potentially important but woefully under-researched. Eur J Clin Pharmacol. 2000;56(8):523-4. https://doi.org/10.1007/s002280000194
  3. Fugh-Berman A, Ernst E. Herb?drug interactions: Review and assessment of report reliability. Br J Clin Pharmacol. 2001;52(5):587-95. https://doi.org/10.1046/j.0306-5251.2001.01469.x
  4. Engelsen J, Nielsen JD, Hansen KF. Effect of coenzyme Q10 and ginkgo biloba on warfarin dosage in patients on long-term warfarin treatment. A randomized, double-blind, placebo- controlled cross-over trial. Ugeskr Laeger. 2003;165(18): 1868-71.
  5. Savovic J, Wider B, Ernst E. Effects of ginkgo biloba on blood coagulation parameters: A systematic review of randomised clinical trials. Evidence-Based Integrative Medicine. 2005;2(3): 167-76. https://doi.org/10.2165/01197065-200502030-00007
  6. Eun JS. Kim DK. Song JM. The Combined Effect of Moschus and Anti-tumor drug Mitomycin C. Korean Journal of Oriental Physiology and Pathology. 2003;17(6): 1004-8.
  7. Oh JJ. Won JH. Lee UJ. Moon SJ. Effects of Paljintanggagambang extract on antitumoral immunological response and the side effect induced by antitumoral agents. Korean J.Orient. Int.Med. 1998;19(2):219-32.
  8. Lee SW, Park SW, Lee HC, Ko CN, Yun SW, Han JY. The effects of Constant Use of Herbal Medicine with Western Medicine On Liver and Kidney Functions. Korean J.Orient.Int.Med. 2003; 24(1):68-74.
  9. Kwon OH, Ryu KW, Ryu BH, Yoon SH, Paek TH. Protective and healing effects of both Jiguyangwi-tang and Gamijiguyangwi-tang on gastric mucosa injuries induced by cyclophosphamide in mice. J Korean Oriental Med. 2001;22:84-93.
  10. Kim TS. Kim CY. Min JY. Choi YG. Kang DH. The Effects of Use of Sasang-Bang with Western Medicine on Liver and Kidney Function. The Society of Sasang Constitutional Medicine. 2004; 16(3):70-5.
  11. Shin HT, Lee SD. Effects of kidney function in blood of drug users(herbal and western) in koreans. The Korean Society For Oriental Preventive Medicine. 2004;8(2):157.
  12. 통계청. 2002년 연간사망 통계보고서. 2004.
  13. 한국한의학연구원. 2008년 한방 의료 이용 실태 조사. 보건복지가족부. 2008;11-1351000-000223-01: 314-6.
  14. Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van Rompay M et al. Trends in alternative medicine use in the united states, 1990-1997: Results of a follow-up national survey. JAMA. 1998;280(18):1569-75. https://doi.org/10.1001/jama.280.18.1569
  15. 한국한의학연구원. 일본한방의약품이용실태. 2009; 8:5.
  16. Saw JT, Bahari MB, Ang HH, Lim YH. Potential drug-herb interaction with antiplatelet/anticoagulant drugs. Complement Ther Clin Pract. 2006;12(4): 236-41. https://doi.org/10.1016/j.ctcp.2006.06.002
  17. Park JK, Yoo JS, Koh KW, Kim CB, Choi SY. The Combined Treatment with Oriental Herbal Medicine and Western Biomedical Medicine among Cerebrovascular Attack Patients. J Korean Oriental Med. 2006;27(1):1-10
  18. Antiplatelet Trialists Collaboration. Collaborative overview of randomised trials of antiplatelet therapy--I: Prevention of death, myocardial infarction, and stroke by prolonged antiplatelet therapy in various categories of patients. BMJ. 1994;308:81-106. https://doi.org/10.1136/bmj.308.6921.81
  19. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med. 2000;343(25):1833-8. https://doi.org/10.1056/NEJM200012213432502
  20. Aggarwal A, Ades PA. Interactions of herbal remedies with prescription cardiovascular medications. Coron Artery Dis. 2001;12(7): 581-4. https://doi.org/10.1097/00019501-200111000-00009
  21. Watson R, Woodman R, Lockette W. Ephedra alkaloids inhibit platelet aggregation. Blood Coagul Fibrinolysis. 2010;21(3):266-71. https://doi.org/10.1097/MBC.0b013e328337b39f
  22. Holbrook AM, Pereira JA, Labiris R, McDonald H, Douketis JD, Crowther M et al. Systematic overview of warfarin and its drug and food interactions. Arch Intern Med. 2005;165(10): 1095-106. https://doi.org/10.1001/archinte.165.10.1095
  23. Yuan CS, Wei G, Dey L, Karrison T, Nahlik L, Maleckar S et al. Brief communication: American ginseng reduces warfarin's effect in healthy patients: A randomized, controlled trial. Ann Intern Med. 2004;141(1):23-7. https://doi.org/10.7326/0003-4819-141-1-200407060-00011
  24. Lee SH, Kim YS, Kang CH, Song MG. Doo HK, Ahn SY et al. A Retrospective Sectional Study about the Effect of the Interaction of Herbal Medicines and Warfarin on Prothrombin Time (INR) in Stroke Patients. Korean J.Orient.Int. Med. 2007;28(3):464-72.
  25. 尹吉榮. 동의임상방제학. 서울: 明寶出版社. 1985: 49-52
  26. Kim KW, Han SH, Jung BJ, Woo SH, Kim BC, Kim YH. A case report of diabetic hyperlipidemia in a patient with cerebral infarction treated with Ojeok-san. Korean J.Orient.Int.Med. 2005;26(1): 275-80.
  27. 허준. 동의보감. 서울:동의보감출판사. 2005:734-1073.