Browse > Article
http://dx.doi.org/10.15429/jkomor.2020.20.1.31

Effect and Safety of Combined Treatment of Gambihwan and Garcinia Cambogia on Weight Loss: A Retrospective Observational Study  

Yoon, Sang-Hoon (Chung-Yeon Central Institute)
Lee, Eunji (Chung-Yeon Central Institute)
Jo, Hyunjung (Chung-Yeon Korean Medicine Hospital)
Han, Yeji (Dongshin Korean Medicine Hospital)
Kim, Hyunho (Chung-Yeon Central Institute)
Yun, Younghee (Research and Development Institute, CY Co., Ltd.)
Choi, Ye-yong (Research and Development Institute, CY Co., Ltd.)
Park, Jongseung (Chung-Yeon Central Institute)
Leem, Jungtae (Chung-Yeon Central Institute)
Publication Information
Journal of Korean Medicine for Obesity Research / v.20, no.1, 2020 , pp. 31-39 More about this Journal
Abstract
Objectives: Obesity is becoming more popular disease worldwide. Because of the side effects of conventional obesity treatment modality, herbal medicine treatment is becoming more preferred. Gambihwan which including Ephedra sinica Staph is widely used in traditional Korean Medicine practice for obesity treatment. Garcinia cambogia is a kind of health functional food that has body fat reducing effect. Nowadays, ephedra and Garcinia cambogia are often used simultaneously in clinical practice of Korean Medicine. However, the effectiveness and safety of combination therapy in obesity treatment is not well established. Methods: We conducted retrospective observational study to explore effectiveness and safety of combination therapy. We evaluated effect of combined treatment of Gambihwan and Garcinia cambogia on body weight, body mass index, body fat mass, and waist hip ratio reduction. We also assessed safety via liver function test and adverse event. Results: Finally, 23 patients were included. In paired t-test, body weight significantly decreased from 64.50±14.50 kg to 62.94±13.85 kg (P<0.001) and body mass index were also significantly decreased from 24.43±3.79 kg/㎡ to 23.83±3.59 kg/㎡ (P<0.001). Body fat mass was also reduced. Aspartate transaminase and alanine aminotransferase were not significantly increased. There were no drug-induced liver injury and no severe adverse event. Conclusions: In our retrospective review, we found combination therapy of Gambihwan and Garcinia cambogia reduce body weight, body mass index and body fat mass. There were no severe adverse event and drug induced liver injury which indicated safety of combination therapy in obesity treatment.
Keywords
Anti-obesity agents; Garcinia cambogia; Korean traditional medicine; Safety; Ephedrine;
Citations & Related Records
연도 인용수 순위
  • Reference
1 Anuurad E, Shiwaku K, Nogi A, Kitajima K, Enkhmaa B, Shimono K, et al. The new BMI criteria for asians by the regional office for the western pacific region of WHO are suitable for screening of overweight to prevent metabolic syndrome in elder Japanese workers. J Occup Health. 2003 ; 45 : 335-43.   DOI
2 World Health Organization. Global status report on noncommunicable diseases 2014. Geneva : WHO Press. 2014.
3 Prospective Studies Collaboration; Whitlock G, Lewington S, Sherliker P, Clarke R, Emberson J, Halsey J, et al. Body-mass index and cause-specific mortality in 900 000 adults: collaborative analyses of 57 prospective studies. Lancet Lond Engl. 2009 ; 373 : 1083-96.   DOI
4 Leibel RL, Rosenbaum M, Hirsch J. Changes in energy expenditure resulting from altered body weight. N Engl J Med. 1995 ; 332 : 621-8.   DOI
5 Greenway FL. Physiological adaptations to weight loss and factors favouring weight regain. Int J Obes. 2015 ; 39(8) : 1188-96.   DOI
6 Bray GA, Fruhbeck G, Ryan DH, Wilding JPH. Management of obesity. The Lancet. 2016 ; 387 : 1947-56.   DOI
7 Tak YJ, Lee SY. Anti-obesity drugs: long-term efficacy and safety: an updated review. World J Mens Health. 2020 ; 38 : e14.
8 Shin C, Park J, Park JJ, Seo SW, Shim JI. Assessment of clinical safety and efficacy for weight loss supplements (Garcinia cambogia extract, Irvingia gabonesis seed extract) in humans. Seoul Repub Korea Natl Evid-Based Healthc Collab Agency. 2017 ; 1-146.
9 Semwal RB, Semwal DK, Vermaak I, Viljoen A. A comprehensive scientific overview of Garcinia cambogia. Fitoterapia. 2015 ; 102 : 134-48.   DOI
10 Jones FJ, Andrews AH. Acute liver injury associated with the herbal supplement hydroxycut in a soldier deployed to Iraq. Am J Gastroenterol. 2007 ; 102 : 2357-8.   DOI
11 Actis GC, Bugianesi E, Ottobrelli A, Rizzetto M. Fatal liver failure following food supplements during chronic treatment with montelukast. Dig Liver Dis. 2007 ; 39 : 953-5.   DOI
12 Melendez-Rosado J, Snipelisky D, Matcha G, Stancampiano F. Acute hepatitis induced by pure Garcinia cambogia. J Clin Gastroenterol. 2015 ; 49 : 449-50.   DOI
13 Song YK, Lim HH. Clinical application of Ma Huang in the obesity treatment. J Soc Korean Med Obes Res. 2007 ; 7 : 1-7.
14 Song MY, Kim HJ, Lee MJ. The safety guidelines for use of Ma-huang in obesity treatment. J Korean Orient Assoc Study Obes. 2006 ; 6 : 17-27.
15 Astrup A, Breum L, Toubro S, Hein P, Quaade F. Ephedrine and weight loss. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 1992 ; 16 : 715.
16 World Health Organization (WHO)-Uppsala Monitoring Centre. The use of the WHO-UMC system for standardized case causality assessment. 2012.
17 Boozer CN, Daly PA, Homel P, Solomon JL, Blanchard D, Nasser JA, et al. Herbal ephedra/caffeine for weight loss: a 6-month randomized safety and efficacy trial. Int J Obes Relat Metab Disord J Int Assoc Study Obes. 2002 ; 26 : 593-604.   DOI
18 Kim H, Han C-H, Lee E-J, Song Y-K, Shin B-C, Kim Y-K. A clinical practice guideline for Ma-huang (Ephedra sinica) prescription in obesity. J Soc Korean Med Obes Res. 2007 ; 7 : 27-37.
19 National Cancer Institute. Grading: General Characteristics of the CTCAE (Common Terminology Criteria for Adverse Events) Grading (Severity) Scale. 2012.
20 Kim YJ, Choi MS, Park YB, Kim SR, Lee MK, Jung UJ. Garcinia cambogia attenuates diet-induced adiposity but exacerbates hepatic collagen accumulation and inflammation. World J Gastroenterol. 2013 ; 19 : 4689-701.   DOI
21 Zheng E, Navarro V. Liver injury due to herbal and dietary supplements: a review of individual ingredients. Clin Liver Dis. 2016 ; 7 : 80-3.   DOI
22 Corey R, Werner K T, S inger A, M oss A, S mith M, Noelting J, et al. Acute liver failure associated with Garcinia cambogia use. Ann Hepatol. 2016 ; 15 : 123-6.   DOI
23 Katial RK, Stelzle RC, Bonner MW, Marino M, Cantilena LR, Smith LJ. A drug interaction between zafirlukast and theophylline. Arch Intern Med. 1998 ; 158 : 1713-5.   DOI
24 Walsky RL, Obach RS, Gaman EA, Gleeson JPR, Proctor WR. Selective inhibition of human cytochrome P4502C8 by montelukast. Drug Metab Dispos Biol Fate Chem. 2005 ; 33 : 413-8.   DOI
25 Shannon JR, Gottesdiener K, Jordan J, Chen K, Flattery S, Larson PJ, et al. Acute effect of ephedrine on 24-h energy balance. Clin Sci. 1999 ; 96 : 483-91.   DOI
26 Saito M, Hirata-Koizumi M, Matsumoto M, Urano T, Hasegawa R. Undesirable effects of citrus juice on the pharmacokinetics of drugs: focus on recent studies. Drug Saf. 2005 ; 28 : 677-94.   DOI
27 Rotblatt M, Ziment I. Evidence-based herbal medicine. Philadelphia, PA : Hanley & Belfus. 2001.
28 Lee MK, Cheng BWH, Che CT, Hsieh DPH. Cytotoxicity assessment of Ma-huang (Ephedra) under different conditions of preparation. Toxicol Sci. 2000 ; 56 : 424-30.   DOI
29 hite LM, Gardner SF, Gurley BJ, Marx MA, Wang P-L, Estes M. Pharmacokinetics and cardiovascular effects of Ma-Huang (Ephedra sinica) in normotensive adults. J Clin Pharmacol. 1997 ; 37 : 116-22.   DOI
30 Shekelle PG, Hardy ML, Morton SC, Maglione M, Mojica WA, Suttorp MJ, et al. Efficacy and safety of ephedra and ephedrine for weight loss and athletic performance: a meta-analysis. JAMA. 2003 ; 289 : 1537-45.   DOI
31 Meyer zum Buschenfelde KH, Lohse AW. Autoimmune hepatitis. N Engl J Med. 1995 ; 333 : 1004-5.   DOI
32 Haller CA, Benowitz NL. Adverse cardiovascular and central nervous system events associated with dietary supplements containing ephedra alkaloids. N Engl J Med. 2000 ; 343 : 1833-8.   DOI
33 Food and Drug Administration, HHS. Final rule declaring dietary supplements containing ephedrine alkaloids adulterated because they present an unreasonable risk. Final rule. Fed Regist. 2004 ; 69 : 6787-854.
34 Borum ML. Fulminant exacerbation of autoimmune hepatitis after the use of ma huang. Am J Gastroenterol. 2001 ; 96 : 1654-5.   DOI
35 Lee E, Yoon S-H, Kim H, Kim YD, Leem J, Park J. Ephedrae Herba in combination with herbal medicine (Zhizichi decoction and Phellodendri Cortex) for weight reduction: a case series. Integr Med Res. 2020 ; 9 : 100408.   DOI
36 Jo DH, Lee S, Lee JD. Effects of Gambisan in overweight adults and adults with obesity: a retrospective chart review. Medicine (Baltimore). 2019 ; 98 : e18060.   DOI