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Recent Research Trends of Sayeok-tang Used in Ischemic Heart Disease

허혈성 심질환에 활용된 사역탕(四逆湯)의 최신 연구 동향

  • Received : 2021.12.03
  • Accepted : 2021.12.14
  • Published : 2021.12.31

Abstract

Purpose : Sayeok-tang (Sini decoction, SND) is a cold-dispelling formula used for cold deficiency syndrome and is composed of Aconiti Lateralis Radix Preperata, Zingiberis Rhizoma, and Glycyrrhizae Radix et Rhizoma. It is used for diseases such as myocardial infarction, heart failure, acute and chronic gastroenteritis, and gastric effusion. This study proposes the possibility of expansion of basic research and clinical applications for ischemic heart disease (IHD) through systematic analysis of domestic and foreign studies on SND. Methods : We collected studies within the last 10 years on the use of SND in IHD and excluded those lacking relevance. Selected studies were classified by research method and the main themes of the studies were analyzed for each classification. Result: Out of 15 studies, there were 5 animal studies, 8 metabolite analyses in animals, 1 in vitro study, and 1 systematic review. Our review suggests that SND may be used as an adjuvant to nitroglycerin and percutaneous transluminal coronary angioplasty, and may improve symptoms and quality of life of patients with IHD. Myocardial protective effects through antioxidant, anti-inflammatory, anti-apoptotic, and anti-hypertensive actions were confirmed through these studies. Effects on carbohydrate, protein, and lipid metabolism were also reported. Conclusions : This study suggests that SND has potential as a treatment for IHD.

Keywords

Acknowledgement

이 성과는 정부(과학기술정보통신부)의 재원으로 한국연구재단의 지원을 받아 수행된 연구임(No. 2021R1A2C1009604).

References

  1. Moon JJ, Ahn GS, Kim SH, Park JH, Kim DH, Choi DY, Shin YI , Ji GY, Shin SW, Ha GT, Lee SG, Kim JB, Lee GG, Kim YM. Shanghanlunjeonghae. Seoul : Publication Haneuimunhwasa. 2020 : 103-4,206-8,610-2,717-8.
  2. Lee SI, Cho HR. The comparison of Shanghanlun texts. Seoul:KMediACs. 2020 : 214,229.
  3. Hu X. Shanghanlun lecture. Paju:Fish forest publication. 2019 : 75-84, 498, 571.
  4. Feng SR. Six meridians and Diagnosis in Shanghanlun prescriptions. Gyungsan:Omniherb. 2012 : 360-6.
  5. Otsuka K. Explanation of Shanghanlun. Wonju : Publications of Euibang. 2004 : 170-7,425-7,452-3.
  6. The committee of HFS textbook. Herbal Formula Science in Korean Medicine. Seoul:Kunja Publications. 2020 : 484-90.
  7. Lee RC, Min JH. A case report of overactive bladder treated by Gamchogungang-tang, Hoiyeok-tang based on Shanghanlun provisions. KMediACS. 2013 ; 5(1) : 45-52.
  8. Lee W, Lee S. A case report of Psoriasis treated by Hoeyeok-tang based on Shanghanlun provisions. KMediACS. 2019 ; 11(1) : 83-94.
  9. Ha HY, Lee SJ. A case report of dyshidrotic eczema treated by Hoiyeok-tang based on Shanghanlun provisions. KMediACS. 2019 ; 11(1) : 139-51.
  10. Do IS, Lee SJ. A Case Report of Atopic Dermatitis treated by Hoiyeok-tang based on Shanghanlun Provisions. KMediACS. 2019 ; 11(1) : 73-82.
  11. Choi YK, Kang MS. A case report of Ge-yan-jiu & herbal medicine complex treatment on Juezheng caused by Wangyang. Korean J. Orient.Int. Med. 2007 ; 28(1) : 187-92.
  12. Irwin S. Clinical manifestations and assessment of ischemic heart disease. Phys Ther. 1985 ; 65(12) : 1806-11. https://doi.org/10.1093/ptj/65.12.1806
  13. Rezende PC, Ribas FF, Serrano CV Jr, Hueb W. Clinical significance of chronic myocardial ischemia in coronary artery disease patients. J Thorac Dis. 2019 ; 11(3) : 1005-15. https://doi.org/10.21037/jtd.2019.02.85
  14. Kaski JC, Crea F, Gersh BJ, Camici PG. Reappraisal of Ischemic Heart Disease. Circulation. 2018 ; 138(14) : 1463-1480. https://doi.org/10.1161/circulationaha.118.031373
  15. Jeon DS. Textbook of cardiology for medical students. Seoul:Daehan medical books. 2014 : 120-76.
  16. Jeon DS. Textbook of cardiology for medical students. Seoul:Daehan medical books. 2014 : 120-76.
  17. Kim SS, Kim HK. Pharmacotherapy for acute myocardial infarction. J Korean Med Assoc. 2021 ; 64(2) : 139-51. https://doi.org/10.5124/jkma.2021.64.2.139
  18. Jeong MH. Percutaneous coronary intervention for coronary artery disease. J Korean Med Assoc. 2004 ; 47 : 736-57. https://doi.org/10.5124/jkma.2004.47.8.736
  19. Jung MG, Park JY, Lee US, Kim YC, Oh YS, Lim M, Sin MG, Kim EY, Kim SJ. A case study of acute myocardiac infarction to follow cerebral infarction. Korean J. Orient. Int. Med. 2001 ; 22(4) : 755-9.
  20. Nihon Kampo Igaku Kenkyujo. Kinki yoryaku kowa. Wonju:Ui-bang publishing company. 2003 : 171-8.
  21. Oh W, Park CA, Byun SH, Kim SC. A review study of researches on three decoctions including Fructus trichocanthis and Bulbus allii macrostemi in Geum-gwe-yo-ryak. Herbal Formula Science. 2020 ; 28(4) : 407-28. https://doi.org/10.14374/HFS.2020.28.4.407
  22. Wu J, Yuan D, Yang M, Xia W, Zhang Z, Zhang H, Fei Y, Yang G. Sini decoction as an adjuvant therapy for angina pectoris: a systematic review of randomized controlled trials. J Tradit Chin Med. 2017 ; 37(1) : 12-22. https://doi.org/10.1016/S0254-6272(17)30021-3
  23. Liao HC, Liu Y, Zhou B. Effects of Sini decoction on the expressions of Smad2 and Smad7 in isoproterenol induced myocardial fibrosis rats. Zhongguo Zhong Xi Yi Jie He Za Zhi. 2012 ; 32(7) : 934-8.
  24. Liu J, Peter K, Shi D, Zhang L, Dong G, Zhang D, Breiteneder H, Bauer R, Jakowitsch J, Ma Y. Anti-inflammatory effects of the chinese herbal formula sini tang in myocardial infarction rats. Evid Based Complement Alternat Med. 2014 ; 2014 : 309378.
  25. Liu J, Peter K, Shi D, Zhang L, Dong G, Zhang D, Breiteneder H, Jakowitsch J, Ma Y. Traditional formula, modern application: chinese medicine formula sini tang improves early ventricular remodeling and cardiac function after myocardial infarction in rats. Evid Based Complement Alternat Med. 2014 ; 2014 : 141938.
  26. Shi Y, Liu C, Zhai J. Effect of Sini decoction on angiotensin II transforming growth factor β1 and connective tissue growth factor in rats with myocardial fibrosis-induced banding of the abdominal aorta. J Tradit Chin Med. 2018 ; 38(3) : 427-432. https://doi.org/10.1016/S0254-6272(18)30634-4
  27. Zhu Y, Zhao J, Han Q, Wang Z, Wang Z, Dong X, Li J, Liu L, Shen X. The Effect and Mechanism of Chinese Herbal Formula Sini Tang in Heart Failure after Myocardial Infarction in Rats. Evid Based Complement Alternat Med. 2018 ; 2018 : 5629342.
  28. Tan G, Lou Z, Liao W, Zhu Z, Dong X, Zhang W, Li W, Chai Y. Potential biomarkers in mouse myocardium of doxorubicin-induced cardiomyopathy: a metabonomic method and its application. PLoS One. 2011 ; 6(11) : e27683. https://doi.org/10.1371/journal.pone.0027683
  29. Tan G, Liao W, Dong X, Yang G, Zhu Z, Li W, Chai Y, Lou Z. Metabonomic profiles delineate the effect of traditional Chinese medicine sini decoction on myocardial infarction in rats. PLoS One. 2012 ; 7(4) : e34157. https://doi.org/10.1371/journal.pone.0034157
  30. Tan G, Lou Z, Liao W, Dong X, Zhu Z, Li W, Chai Y. Hydrophilic interaction and reversed-phase ultraperformance liquid chromatography TOF-MS for serum metabonomic analysis of myocardial infarction in rats and its applications. Mol Biosyst. 2012 ; 8(2) : 548-56. https://doi.org/10.1039/C1MB05324H
  31. Chen S, Wu Si, Li W, Chen X, Dong X, Tan G, Zhang H, Hong Z, Zhu Z, Chai Y. Investigation of the therapeutic effectiveness of active components in Sini decoction by a comprehensive GC/LC-MS based metabolomics and network pharmacology approaches. Mol Biosyst. 2014 ; 10(12) : 3310-21. https://doi.org/10.1039/C4MB00048J
  32. Zhou J, Ma X, Shi M, Chen C, Sun Y, Li J, Xiong Y, Chen J, Li F. Serum metabolomics analysis reveals that obvious cardioprotective effects of low dose Sini decoction against isoproterenol-induced myocardial injury in rats. Phytomedicine. 2017 ; 31 : 18-31. https://doi.org/10.1016/j.phymed.2017.01.009
  33. Tan G, Wang X, Liu K, Dong X, Liao W, Wu H. Correlation of drug-induced and drug-related ultra-high performance liquid chromatography-mass spectrometry serum metabolomic profiles yields discovery of effective constituents of Sini decoction against myocardial ischemia in rats. Food Funct. 2018 ; 9(11) : 5528-5535. https://doi.org/10.1039/c8fo01217b
  34. Zhou Q, Meng P, Wang H, Dong X, Tan G. Pharmacokinetics of monoester-diterpenoid alkaloids in myocardial infarction and normal rats after oral administration of Sini decoction by microdialysis combined with liquid chromatography-tandem mass spectrometry. Biomed Chromatogr. 2019 ; 33(1) : e4406. https://doi.org/10.1002/bmc.4406
  35. Zhou Q, Meng P, Zhang Y, Chen P, Wang H, Tan G. The compatibility effects of sini decoction against doxorubicin-induced heart failure in rats revealed by mass spectrometry-based serum metabolite profiling and computational analysis. J Ethnopharmacol. 2020 ; 252 : 112618. https://doi.org/10.1016/j.jep.2020.112618
  36. Li Y, Fu CM, Ren B, Liu Y, Gao F, Yang H, Peng W, Gan YX. Study on attenuate and synergistic mechanism between aconiti lateralis praeparata radix and glycyrrhizae radix for toxicity reduction based on metabonomic of MI-RI mouse cardiomyocytes. Zhongguo Zhong Yao Za Zhi. 2014 ; 39(16) : 3166-71.
  37. Munzel T, Daiber A, Gori T. Nitrate therapy: new aspects concerning molecular action and tolerance. Circulation. 2011 ; 123(19) : 2132-44. https://doi.org/10.1161/CIRCULATIONAHA.110.981407
  38. Munzel T, Daiber A, Gori T. More answers to the still unresolved question of nitrate tolerance. Eur Heart J. 2013 ; 34(34) : 2666-73. https://doi.org/10.1093/eurheartj/eht249
  39. Chen Z, Foster MW, Zhang J, Mao L, Rockman HA, Kawamoto T, Kitagawa K, Nakayama KI, Hess DT, Stamler JS. An essential role for mitochondrial aldehyde dehydrogenase in nitroglycerin bioactivation. Proc Natl Acad Sci U S A. 2005 ; 102(34) : 12159-64. https://doi.org/10.1073/pnas.0503723102
  40. Gutkowska J, Jankowski M, Mukaddam-Daher S, McCann SM. Oxytocin is a cardiovascular hormone. Braz J Med Biol Res. 2000 ; 33(6) : 625-33. https://doi.org/10.1590/s0100-879x2000000600003
  41. Von Hoff DD, Layard MW, Basa P, Davis Jr HL, Von Hoff AL, Rozencweig M, MuggiaFM. Risk factors for doxorubicin-induced congestive heart failure. Ann Intern Med. 1979 ; 91(5) : 710-7. https://doi.org/10.7326/0003-4819-91-5-710
  42. Chang SC, Ren S, Rau CD, Wang JJ. Isoproterenol-Induced Heart Failure Mouse Model Using Osmotic Pump Implantation. Methods Mol Biol. 2018 ; 1816 : 207-220. https://doi.org/10.1007/978-1-4939-8597-5_16
  43. Lee Y, Sun WJ, Kim KM, Jun KS, Paik HK, Lee SY. Clinical Study on Aconitine Intoxication. The Korean Journal of Medicine. 1976 ; 19(3) : 240-7.
  44. Na CS, Yoon YC. A study on Buja, Ohdu toxicosis. K.O.M.S. 1995 ; 16(1) : 451-67.
  45. Kim WS, Lim SS, Kang HS, Choue CW, Kwon SK, Son JS, Bae JH. Cardiovascular aspects of aconitine poisoning. Korean Circulation J. 2000 ; 30(7) : 855-60. https://doi.org/10.4070/kcj.2000.30.7.855
  46. Xu X, Xie X, Zhang H, Wang P, Li G, Chen J, Chen G, Cao X, Xiong L, Peng F, Peng C. Water-soluble alkaloids extracted from Aconiti Radix lateralis praeparata protect against chronic heart failure in rats via a calcium signaling pathway. Biomed Pharmacother. 2021 ; 135 : 111184. https://doi.org/10.1016/j.biopha.2020.111184
  47. Wang QH, Gao JH, Chen HM, Xie XF, Peng C. Transcriptomics study on mechanism of Aconiti Lateralis Radix Praeparata in treatment of rats with acute heart failure. Zhongguo Zhong Yao Za Zhi. 2019 ; 44(1) : 131-40.
  48. Zhao D, Wang J, Cui Y, Wu X. Pharmacological effects of Chinese herb aconite (fuzi) on cardiovascular system. J Tradit Chin Med. 2012 ; 32(3) : 308-13. https://doi.org/10.1016/S0254-6272(13)60030-8
  49. Zhou G, Tang L, Zhou X, Wang T, Kou Z, Wang Z. A review on phytochemistry and pharmacological activities of the processed lateral root of Aconitum carmichaelii Debeaux. J Ethnopharmacol. 2015 ; 160 : 173-93. https://doi.org/10.1016/j.jep.2014.11.043
  50. Kim C, Mun DW, Jeong JG. Bibliographic study about the origin of Bu-Ja, Cho-O, Cheon-O. KMediACS. 2009 ; 1(1) : 63-73.
  51. Kang GH, Choi GY, Kim HJ, Ju YS. A study on morphological and pattern analysis in two kinds of Aconiti Radix. Korean Journal of Oriental Medicine. 2006 ; 12(1) : 23-38.
  52. Kim IR. The daily dose of Aconiti Lateralis Radix Preparata and Aconiti Lateralis Radix in treatise on cold damage diseases. Kor. J. Herbol. 2015 ; 30(4) : 51-5. https://doi.org/10.6116/KJH.2015.30.4.51.
  53. Mun DW, Kim C, Jeong JG, Cho HW, Ryu JH, Cho JH, Kim DS. Effects of various processing methods on the contents of aconitine in the Aconitum plants. KMediACS. 2010 ; 2(1) : 99-108.
  54. Tong P, Wu C, Wang X, Hu H, Jin H, Li C, Zhu Y, Shan L, Xiao L. Development and assessment of a complete-detoxication strategy for Fuzi (lateral root of Aconitum carmichaeli) and its application in rheumatoid arthritis therapy. J Ethnopharmacol. 2013 ; 146(2) : 562-71. https://doi.org/10.1016/j.jep.2013.01.025
  55. Zhang Y, Yu L, Jin W, Fan H, Li M, Zhou T, Wan H, Yang J. Reducing toxicity and increasing efficiency: aconitine with liquiritin and glycyrrhetinic acid regulate calcium regulatory proteins in rat myocardial cell. Afr J Tradit Complement Altern Med. 2017 ; 14(4) : 69-79. https://doi.org/10.21010/ajtcam.v14i4.9
  56. Hassanien MH. Ameliorating effects of ginger on isoproterenol-induced acute myocardial infarction in rats and its impact on cardiac nitric oxide. J Microsc Ultrastruct. 2020 ; 8(3) : 96-103. https://doi.org/10.4103/jmau.jmau_70_19
  57. Fakhri S, Patra JK, Das SK, Das G, Majnooni MB, Farzaei MH. Ginger and heart health: from mechanisms to therapeutics. Curr Mol Pharmacol. 2020. doi : 10.2174/1874467213666201209105005.
  58. Li Z, Bao H, Zhang S, Ye T, Yang C, Li Y. Study on intersection and regulation mechanism of "efficacy-toxicity network" of aconite in combination environment of Sini decoction. Zhongguo Zhong Yao Za Zhi. 2015 ; 40(4) : 733-8.
  59. Pei M, Wang S, Li J. Correlativity analysis of detoxicating effect of radix Glycyrrhizae on radix Aconiti preparata in sini decoction. Zhongguo Zhong Yao Za Zhi. 1996 ; 21(1) : 50-2.
  60. Xie S, Zhang G, Sun G, Zhu X, Chen R, Zhang S, He L, Ye Z. Detoxication experimental study on different compatibility proportion of Aconiti Lateralis Radix Praeparata and glycyrrhizae radix et rhizoma. Zhongguo Zhong Yao Za Zhi. 2012 ; 37(15) : 2210-4.
  61. Li B, Shen Y, Liao R, Gao G, Ke L, Zhou J, Rao P. Investigating mechanism of toxicity reduction by combination of Glycyrrhizae Radix et Rhizoma and Aconiti Lateralis Radix Preparata on terms of proteins self-assembly. Zhongguo Zhong Yao Za Zhi. 2015 ; 40(4) : 661-6.