Safety and Efficacy Assessment of Chungpyesagan-tang for Acute Ischemic Stroke

Abstract

Chungpyesagan-tang is one of the most well-known traditional herbal formulations frequently used for treatment of acute stroke in Korea. Therefore, this study aims to assess the clinical safety and efficacy of chungpyesagan-tang on acute ischemic stroke. We recruited acute cerebral infarction subjects within 1 week after onset time. Then, we prescribed chungpyesagan-tang to an Oriental medical treatment group (OM-group) for 2 weeks and enrolled a Western medical treatment group (WM-group) which received only Western biomedical care as a control. In this study, the OM-group was composed of 75 subjects. However, 14 of them dropped out, as two had progressive stroke while 12 complained of diarrhea. Thus, 61 cases were included in the analysis and compared to the 76 cases of the WM-group. The improvement of OM-group was better than that of the WM-group according to the National Institute of Health Stroke Scale (NIHSS), but not by the Modified Barthel Index (MBI). There were no definite abnormalities on labortory safety asessment. Therefore, we suggest that chungpyesagan-tang may have therapeutic effects, acting to reduce the severity of stroke and improving functional recovery without definite hepatic or renal toxicity when given for the first 2 weeks after a stroke.

Effect of Herbal Prescriptions in Accordance with Pattern Identification in Acute Cerebral Infarction Patients: Based on Fire-Heat Pattern

“…Usage of herbal prescriptions on acute ischemic stroke patients has been studied over the years [7–9], but no research was carried out to verify the necessity and usefulness of the pattern identification. Pattern identification is a meaningful diagnostic tool of TKM as it allows individualized treatment, maximizing its effectiveness and minimizing its adverse effects.…”

“…However, the necessity and usefulness of pattern identification have not been verified yet. Many herbal prescriptions have been proven to have a beneficial effect in acute stroke patients [7–9], but the relation between the efficacy and the pattern identification was not indicated.…”

Effect of Xiongbing compound on the pharmacokinetics and brain targeting of tetramethylpyrazine

“…Other anti‐platelet drugs such as clopidogrel, ticlopidine, extended‐release dipyridamole and warfarin have potentially severe complications or are not readily available [3] . On the other hand, increasing preliminary studies in animal models have indicated that traditional Chinese medicines may be useful for treating or preventing AIS [4–8] . However, large, randomized clinical trials and further research into the action mechanisms are necessary to ensure the safety and efficacy of these Chinese medicines [8] …”

“…The traditional Chinese herb, Rhizoma ligustricus , has a long history as a treatment for cardiovascular and cerebrovascular diseases in Asia [5,9–11] . Tetramethylpyrazine (TMP), the active component of Rhizoma ligustricus , has been studied in several animal models of AIS with promising results; [12–15] but most Rhizoma ligusticus on the market are cultivars with extremely low concentrations of TMP which can also be easily lost by sublimation during the extraction procedure.…”

Safety and Efficacy Needs to be Tested in an Appropriate Design

“…Jung et al (2003) suggested in their alleged safety and efficacy assessment that Chungpyesagan-tang may have therapeutic effects in reducing the severity of ischemic stroke and improving functional recovery without the danger of a tendency to hemorrhage. We have concerns relating to this preparation, as tested, on the following grounds.…”