• 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

• Archives of Pharmacal Research
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• v.7 no.2
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• pp.133-136
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• 1984

Higenamine (I), cardiotonic principle of Aconite root, was synthesized from 4-methoxy-phenylacetic acid (II) and .betha.-(3, 4-dimethoxyphenyl)-ethylamine (IV). Condensation of IV with 4-mehoxyphenylacetyl chloride (III) was followed by cyclodehydration yielding 1-(4'-methoxybenzyl)-6, 7- dimethoxy-3, 4-dihydroisoquinoline (VI). Reduction of VI to 1, 2, 3, 4-tetrahydroisoquinoline (VII) and subsequent demethylation provided desired product higenamine, 1-(4'-hydroxybenzyl)-6, 7- dihydroxy-1, 2, 3, 4, -tetrahydroisoquinoline.

• CELLMED
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• v.2 no.3
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• pp.21.1-21.8
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• 2012

Heart disease that ultimately leads to heart failure (HF) has been the number one cause of death in the United States as well as in many other countries for over a century. Inotropic therapy utilizing cardiotonics to increase cardiac contractility remains a significant component of the management of HF. However, adverse effects of currently available cardiotonics have been compromising their therapeutic value and often lead to further myocardial dysfunction. Thus, discovery of safe cardiotonics remains a main challenge to improvement of inotropic therapy for HF. This review briefly summarized cellular mechanisms underlying the inotropic action of currently available cardiotonics, newly-developed carditonics and the bark of Terminalia arjuna (TA), a tropical tree used in ayurvedic medicine. The potential of TA bark as a new cardiotonic in inotropic treatment for HF was also discussed.

• Proceedings of the PSK Conference
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• 2002.10a
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• pp.281.2-281.2
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• 2002

Chan Su the dried toad venom. has been used in Asian countries as the traditional medicine for the purpose of the alleviation of pain, cardiotonic diuresis. hemostasis and et al.. However, Chan Su is the special attention-needed medication because it is known to contain the highly toxic compounds such as bufotenine, an hallucinogen and aphrodisiac, and a series of bufadienolides, cardiotonic steroids that produce physiological symptoms similar to digoxin. (omitted)

• 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.

• CELLMED
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• v.8 no.3
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• pp.14.1-14.6
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• 2018

Santalum album Linn. [Family: Santalaceae] is commonly known as white sandalwood, sandal safaid and safed chandan. It is one of the most valuable trees and second costliest wood in the world. Sandalwood and its oil is extensively used in the Unani and other traditional systems of medicine as it has blood purifier, anti-inflammatory, analgesic, exhilarant, cardiotonic, antiseptic, nervine tonic and expectorant properties. It is used in skin, cardiac, liver, gastrointestinal, respiratory, integument and urogenital disorders. These uses are supported and proven by many in vitro or in vivo studies. The proven pharmacological activities of S. album are antimicrobial, anti-oxidant, anti-inflammatory, antimutagenic and anti-fatigue. The research has proven that sandal oil or its constituents have anti-microbial activity. Sandalwood oil showed skin cancer preventive effect in mice and its constituent alpha santalol showed the anticancer property. The methanolic extract of wood was confirmed for antioxidant, free radical scavenging, analgesic and anti-inflammatory activities. ${\alpha}$ and ${\beta}$ santalols present in sandal oil showed sedative effects. Sandalwood tea had a significant effect on heart muscles of frog and showed increased myocardial contractility. Its oil showed significant changes in hepatic xenobiotic metabolizing enzymes. Sandalwood oil and its major constituents showed less acute oral and dermal toxicity in laboratory animals. Hence, the aforementioned studies justify the uses of sandalwood and its oil mentioned in the classical Unani literature. However, further clinical trials are suggested to confirm its efficacy and safety in humans.