• The Journal of Korean Medicine
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• v.26 no.2 s.62
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• pp.95-104
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• 2005

Objectives: This was a double blinded, randomized, placebo-controlled clinical study for evaluation of safety and effective dose finding of Cardiotonic Pills$^{(R)}$ in patients with chest pain and discomfort. Cardiotonic Pills$^{(R)}$ are composed of Salviae Miltiorrhizae Radix (丹蔘), Notoginseng Radix (三七根) and Borneolum (龍腦). Major effects of Salviae Miltiorrhizae Radix and Notoginseng Radix are vasodilatation, sedation and analgesic action. Borneolum has an antibacterial effect, and can stimulate the central nervous system. All of these substances are oriental herbs that have been used for a long time in east Asia. Cardiotonic Pills fi received Investigational New Drug (IND) approval from the Food and Drug Administration (FDA) in the USA and 40 million people in the world take this pill. We performed a phase IV clinical study to confirm its efficacy and safety in patients who have probable cardiogenic or psychogenic chest pain or chest stifling. Methods: This study was planned for a multi-center clinical trial including four university hospitals of oriental medicine in Korea. This was the first time to evaluate the 'planning treatment according to diagnosis (辨證施治)' of chest pain or chest discomfort according to oriental medical guidelines. The patients who were included in this trial were adult volunteers from 20 to 70 years old who had chest pain or chest discomfort more than twice during a recent month, and we received written consent to participate in this study from all of them. After administration of Cardiotonic Pills$^{(R)}$ for 8 weeks, number of occurrences, duration, appearance and degree of chest pain or chest discomfort was observed and degree of symptoms (severity of illness, global improvement) were measured using a patient's global assessment composite scale. Results: In the patient's global assessment scale, the severity of illness of the Cardiotonic Pills$^{(R)}$ group (n=25) was 14/25=0.56 but of the placebo group (n=25) was 7/25=0.28 (p-value=0.0449). This result indicates Cardiotonic Pills$^{(R)}$have a positive effect on the symptoms of chest pain and discomfort. However, the global improvement of the Cardiotonic Pills$^{(R)}$group was 23/25=0.92, and of the placebo group was 22/25=0.88 (p-value=0.6374). The total symptom score of the Cardiotonic Pills$^{(R)}$ group was $1.68\pm20.06$, and of the placebo group was $16.76\pm72.l4$(p-value=0.2285). The number of symptom events of the Cardiotonic Pills$^{(R)}$ group was $72\pm29.78$, and of the placebo group (n=25) was $10.80\pm38.42$ (p­value=0.3660). We could not find any effects on the other factors examined besides the severity of illness, beyond the difference of standard deviations. Conclusions: Cardiotonic Pills$^{(R)}$ significantly reduced chest pain and chest discomfort in patients. Therefore, we expect that Cardiotonic Pills$^{(R)}$ will be helpful for patients with chest pain and chest discomfort not only caused by heart disease but also by other diseases.

• Journal of Life Science
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• v.26 no.1
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• pp.123-128
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• 2016

The object of this study was to obtain accurate information about the co-administration effects of cardiotonic pills on the pharmacokinetics of cilostazol were observed as a process of the comprehensive and integrative medicine. Cilostazol is a synthetic anti-platelet and vasodilator agent developed for the treatment of intermittent claudication resulting from peripheral arterial disease. By increasing intracellular cyclic adenosine monophosphate (cAMP), cilostazol induces the activation of protein kinase A, which activates endothelial nitric oxide synthase. In order to evaluate the effect of a single or repeated cardiotonic pill dose on the pharmacokinetics of cilostazol, a single dose of pure_distilled water or a colloidal suspension of distilled water and cardiotonic pills were administered to the control and test groups, respectively. After 30 min, both groups were administered cilostazol. Plasma was collected 30min before administration, and 0.25, 0.5, 0.45, 1, 2, 4, 6, 8, and 24h after the end of cilostazol treatment. We then evaluated the pharmacokinetic changes observed with cilostazol between the control and test groups. No statistically significant differences were observed. These findings demonstrated that a single dose of cardiotonic pills did not affect the pharmacokinetics of cilostazol. The results obtained in this study suggest that co-administration of cardiotonic pills and cilostazol may not affect the bioavailability of cilostazol as a potential drug interaction.

• The Journal of Korean Medicine
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• v.37 no.4
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• pp.30-35
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• 2016

Objectives: The patients who had arteriosclerotic occlusive disease were treated by reperforating procedures or vessel replacing operations. We divided them by two groups. one(control group) is treated by Pletaal(cilostazole), the other(CP group) is by Pletaal with cardiotonic pills(CP). Methods : Control group was treated by Pletaal, CP group was treated by Pretaal with CP for 8 weeks. We primarily evaluated the outcomes by visual analogue scale(VAS) of pain, coldness, numbness, and edema, secondarily hematologic tests. Results : Coldness, numbness and edema were reduced at both groups. In CP group, the VAS dropped more sharply than control group, but not significant. Otherwise, there was significant reduction of VAS on pain. In hematologic tests, there were no abnormal results of all items. Conclusion : The therapy of Pletaal with CP is effective to relieve PRS specially in pain and safety on hematologic tests.

• The Korea Journal of Herbology
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• v.23 no.2
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• pp.145-150
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• 2008

Objectives : SimJeok-Hwan (CP, Cardiotonic Pills) is the traditional remedy to treat patients with coronary arteriosclerosis, angina pectoris and hyperlipidemia. This study was designed to investigate the effects of CP on changes in serum cholesterol levels in hyperlipidemic rats. Methods : In this study, we investigated the effects of CP on changes in body weights, food and water uptake, fasting blood glucose, total cholesterols, HDL-cholesterol, and triglyceride in hyperlipidemic rats. Results : In our results, body weights of hyperlipidemic rats induced by high fat diet did not changed, and treatment with CP did not affect body weights in hyperlipidemic rats. For experimental period, food and water uptake in CP administered group were the same as those in hyperlipidemic control group. In this experiment, treatment with CP decreased total cholesterol and triglyceride in serum which elevated by high fat diet respectively. Conclusions : These results suggest that CP is useful to treat patients with disease related to hyperlipidemia because CP can decrease cholesterol in serum

• The Korea Journal of Herbology
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• v.23 no.4
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• pp.71-79
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• 2008

Objectives: SimJeok-Hwan(CP, Cardiotonic Pills) was made to treat patients with coronary arteriosclerosis, angina pectoris and hyperlipidemia. This study was designed to investigate the effects of CP on Proliferation rates neuroglia cells and protective effect of CP against oxidative stress, and also investigate the effects on regional Cerebral Blood Flow(rCBF) in normal rats. Methods: In this experiment, effects of CP on proliferation rates of neuroglia cells were measured using modified MTT methods. Oxidative stress was induced by treatment with 200 mM of hydrogen peroxide for 2 hr. rCBF and MABP were measured using Laser doppler flowmeter. Results: Treatment with CP elevated proliferation rates in C6 cells. In addition, CP protected cell death of C6 cells induced by oxidative stress. In results, rCBF was elevated by treatment with CP in normal rats. But, Mean Arterial Blood Pressure(MABP) did not affected by CP. In addition, the elevation of rCBF was blacked by pre-treatment with 1 mg/kg of indomethacin effectively. On the other hand, pre-treatment with 0.01 mg/kg of methylene blue did not affect rCBF level in normal rats. Conclusions: In conclusion, these results suggest that CP can act as anti-oxidant to protect neuroglia cells and also suggest that CP can elevate rCBF, which are involved in cyclooxygenase pathway.

• Journal of Pharmacopuncture
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• v.11 no.4
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• pp.59-64
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• 2008

Objectives The aim of study was to evaluate the effect of Herbal medicine on post stroke cognitive deficit. Methods All groups were treated with acupunture treatment, moxa treatment, herbal medicines, physical and occupational therapy for 4 weeks, additionally cardiotonic pills(CP) were taken in the cardiotonic pills group. The effect of treatment was assessed using Verval fluency, MMSE-KC, Word List Immediate Recall test. Statistical significance was achived if the probability was less than 5%(p,0.05). Results Verval fluency, MMSE-KC, Word List Immediate Recall test scores increased in both group. MMSE-KC, Word List Immediate Recall test scores were significantly increased in the CP group. Verval fluency, MMSE-KC, Word List Immediate Recall test scores were significantly increased in the control group. In the Verval fluency, MMSE-KC, Word List Immediate Recall test of the CP group more increased compared to the control group. There were no significant differences between two groups. In the CP group, the scores of the infarction group more increased compared to the hemorrhage group. Conclusions According to the these results, herbal medicines are effective to improve post stroke cognitive-deficit. Futher studies are needed to know cardiotonic pills in the ischemic stroke.

• The Journal of Korean Medicine
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• v.44 no.4
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• pp.87-103
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• 2023

Backgrounds and objectives: Cardiotonic Pills^® (CP) are used for vascular diseases such as coronary diseases, atherosclerosis, and cerebral infarction. This study aimed to determine the transient effects of CP on cerebrovascular CO₂ reactivity (CVR) and erythrocyte deformability in normal subjects. Methods: This study had a crossover design and included 10 participants who were randomly allocated to 2 groups. The experimental group was given CP with water, while the control group was given only water. CVR was measured by hyperventilation-induced CVR of the middle cerebral artery (MCA) using transcranial Doppler (TCD). Erythrocyte deformability was measured using a Rheoscan-D microfluidic ektacytometer. All measurements were performed prior to and 1, 2, and 3 hours after CP or water administration. Blood pressure and heart rate were also measured before and after administration. Results: CP significantly improved CVR 3 hours after administration in the experimental group compared to the control group (p = 0.042). The corrected blood flow velocity at partial pressure of end-tidal carbon dioxide (PETCO₂) = 40mmHg (CV40) was also significantly improved 2 and 3 hours after administration in the CP group compared to the control group (p = 0.036 and p = 0.021, respectively). CP significantly improved erythrocyte deformability 3 hours after administration in the experimental group compared to the control group (p = 0.027). Mean heart rate and mean blood pressure showed no change. Conclusions: This study demonstrated that CP increases CVR and erythrocyte deformability. These results suggested that CP improves cerebral microcirculation which provide evidence for the future use of CP for prevention of ischemic stroke and neurodegenerative diseases.

• The Korea Journal of Herbology
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• v.27 no.3
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• pp.107-112
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• 2012

Objectives : This study was designed to investigate the effects of Tong Xin Lou (TXL) on lipid accumulation in liver tissue in Hypercholesterolemic mice. TXL is new drug, which is one of Cardiotonic Pills. TXL is used for activating the blood flow in the restoration stage of cerebral infarction, and for alleviation of angina pectoris including the symptoms as chest oppressed and stabbing pain. Methods : Hyperlipidemia was induced by providing high fat diet for 6 weeks. Normal group was provided with normal rodent diet. TXL was administered orally in the concentration of 10 mg/day for 2 weeks (TXL group). D/W was administered orally in CTL group for 2 weeks. We observed histopathological changes in liver and heart tissues, and also investigated the effect on body weights, and levels of total cholesterol, HDL-cholesterol, LDL-cholesterol and triglyceride in serum. Results : In this study, TXL did not affects weight gain in hypercholesterolemic mice. TXL group showed downward tendency of lipid accumulation compared with CTL group. In addition, oral administration of TXL lowered levels of total cholesterol (P < 0.05) and triglyceride (P < 0.05), which were elevated by induction of hypercholesterolemia. Conclusion : These results suggest that TXL can prevent lipid accumulation in liver tissue through regulation of dyslipidemia.

• Advances in Traditional Medicine
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• v.2 no.1
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• pp.28-35
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• 2002

Toad venom, 'Chan su' in Chinese and 'somso' in Korean, is a well-known traditional oriental medicine obtained from the skin venom gland of the toad. Formulations of toad venom have been widely applied in China, Japan, Korea and other oriental countries for a long time. It is often found in traditional Chinese formulations, such as Jiuxin (or Kyushin in Japan), Yixin, Huoxin, Shexiang baoxin wan, Lu shen wan and Laryngitis pills. According to a pharmaceutical chemistry study, toad venom contains multiple biological active substances, such as bufalin, resibufogenin and cinobufagin. Modern pharmacological studies indicated that toad venom has multiple pharmacological actions, including acting as a cardiotonic, antitumor local anesthetic effects, stimulates the respiratory center, vasopressor action, anti-inflammatory and diuretic effects. Like other medications, toad venom also has certain toxicity and adverse effects, for example, inducing delayed afterdepolarization and triggered arrhythmia. The major chemical constituents, basic pharmacological actions and adverse reactions of toad venom are discussed in this article.