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치매 환자의 공격성 관리에 활용가능한 억간산(抑肝散)의 고전적, 비임상적, 임상적 근거현황

Classical, Non-Clinical, and Clinical Evidence of Yokukansan for Alleviating Aggression: Scoping Review

  • 이동윤 (동의대학교 한의과대학) ;
  • 김제범 (동의대학교 한의과대학) ;
  • 하다정 (동의대학교 한의과대학 한방내과) ;
  • 권찬영 (동의대학교 한의과대학 한방신경정신과)
  • Lee, Dong-Yoon (Dong-Eui University College of Korean Medicine) ;
  • Kim, Je-Beom (Dong-Eui University College of Korean Medicine) ;
  • Ha, Da-Jung (Department of Internal Medicine, Dong-Eui University College of Korean Medicine) ;
  • Kwon, Chan-Young (Department of Oriental Neuropsychiatry, Dong-Eui University College of Korean Medicine)
  • 투고 : 2021.05.31
  • 심사 : 2021.06.25
  • 발행 : 2021.06.30

초록

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic-pituitary-adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

키워드

과제정보

This research was supported by a grant of the Korea Health Technology R&D Project through the Korea Health Industry Development Institute, funded by the Ministry of Health & Welfare, Republic of Korea (grant number: HF20C0207).

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