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Antioxidative and Hepatoprotective Effects of Injinho-Tang and Osumogwa-Tang (인진호탕(茵蔯蒿湯)과 오수목과탕(吳茱木瓜湯)의 항산화(抗酸化) 및 간세포(肝細胞) 보호효과(保護效果))

  • Lee, Sang-Hyun;Kim, Young-Bok
    • Herbal Formula Science
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    • v.16 no.1
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    • pp.117-130
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    • 2008
  • Korean traditional medicine has been used for the treatment of the various diseases based on both oriental medicinal theory and clinical trials. Thus, the prescriptions of Korean traditional medicine would be useful for the development of new therapeutics. This research focuses on the fundamental study in Korean traditional prescriptions for the development of new hepatoprotective agents. We found two prescriptions. Injinho-Tang and Osumogwa-Tang, showed the significant DPPH free radical scavenging and hepatoprotective effect, respectively. It is well-known that free radical scavenging effect is related to the prevention of various pathological events including liver injury. This paper deals with hepatoprotective effects on tacrine-induced cytotoxicity in Hep G2 cells, free radicals scavenging on both DPPH and superoxide of above two prescriptions. Hot water extract of Injinho-Tang did not show the significant hepatoprotective effect on tacrine-induced cytotoxicity in Hep G2 cells, however, it shows the significant scavenging effects for both DPPH and superoxide radicals. On the other hand, all of the hot water extracts of constituent herbal drugs in Injinho-Tang exhibited the promising protective effect on tacrine-induced cytotoxicity in Hep G2 cells. Of these, water extract of Rhei Rhizoma showed the most prominent effect on tacrine-induced cytotoxicity in Hep G2 cells. Bioassay-guided fractionation of Rhei Rhizoma extract has furnished four compounds, and their chemical structures have been identified by comparison of their spectral data with those of literature as chrysophanol (1), emodin (2), 3,5-dihydroxy-4'- methoxystilbene (3), and rhapontigenin (4), respectively. Among the isolated compounds, compounds 2-4 revealed the significant hepatoprotective effect in vitro when their $EC_{50}$ values compare with that of silybin, as a positive control. It also exhibited that emodin possessed the most hepatoprotective effect among these active compounds. In case of Osumogwa-Tang, its hot water extract showed the moderate protective effect on tacrine-induced cytotoxicity in Hep G2 cells. Hot water extract of Chaenomelis Fructus, one of the constituent herbal drug of this prescription, exhibited the significant hepatoprotective effect with $EC_{50}$ value of $7.8{\pm}0.1\;{\mu}g/ml$, however, it showed strong cytotoxicity in Hep G2 cells above the concentration of $25\;{\mu}g/ml$. It was revealed that both hot water extract of Evodiae Fructus and its butanol soluble fraction showed the moderate hepatoprotective effect but concentration-dependent activity in Hep G2 assay system. Two quinolone alkaloids, evocarpine and dihydroevocarpine, also tested for their hepatoprotective effects on tacrine-induced cytotoxicity in Hep G2 cells, however, these two compounds derived from the Evodiae Fructus as the major constituents did not show in vitro hepatoprotective effect. From these results, it would be necessary to further isolation of its hepatoprotective compounds from the butanol soluble fraction of the hot water extract of Evodiae Fructus.

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Screening of Genetic Polymorphisms of CYP3A4 and CYP3A5 Genes

  • Lee, Jin Sol;Cheong, Hyun Sub;Kim, Lyoung Hyo;Kim, Ji On;Seo, Doo Won;Kim, Young Hoon;Chung, Myeon Woo;Han, Soon Young;Shin, Hyoung Doo
    • The Korean Journal of Physiology and Pharmacology
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    • v.17 no.6
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    • pp.479-484
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    • 2013
  • Given the CYP3A4 and CYP3A5's impact on the efficacy of drugs, the genetic backgrounds of individuals and populations are regarded as an important factor to be considered in the prescription of personalized medicine. However, genetic studies with Korean population are relatively scarce compared to those with other populations. In this study, we aimed to identify CYP3A4/5 polymorphisms and compare the genotype distributions among five ethnicities. To identify CYP3A4/5 SNPs, we first performed direct sequencing with 288 DNA samples which consisted of 96 Koreans, 48 European-Americans, 48 African-Americans, 48 Han Chinese, and 48 Japanese. The direct sequencing identified 15 novel SNPs, as well as 42 known polymorphisms. We defined the genotype distributions, and compared the allele frequencies among five ethnicities. The results showed that minor allele frequencies of Korean population were similar with those of the Japanese and Han Chinese populations, whereas there were distinct differences from European-Americans or African-Americans. Among the pharmacogenetic markers, frequencies of $CYP3A4^*1B$ (rs2740574) and $CYP3A5^*3C$ (rs776742) in Asian groups were different from those in other populations. In addition, minor allele frequency of $CYP3A4^*18$ (rs28371759) was the highest in Korean population. Additional in silico analysis predicted that two novel non-synonymous SNPs in CYP3A5 (+27256C>T, P389S and +31546T>G, I488S) could alter protein structure. The frequency distributions of the identified polymorphisms in the present study may contribute to the expansion of pharmacogenetic knowledge.

Evaluation of Potential Drug-Drug Interactions in Patients Taking HMG CoA-reductase Inhibitors (HMG CoA-reductase inhibitors를 복용하는 환자의 잠재적 약물상호작용 연구)

  • Lee, Kyeong Ju;Kim, Kyung Rim;Seong, Jae Min;Ryu, Seung Wan;Lee, Hyun Yoon;Cho, Sekyoung;Cheong, Yeji;Nam, Ki Nam;Lee, Yu Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.30 no.1
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    • pp.31-35
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    • 2020
  • Objective: The 3-hydroxy-3-methylglutaryl coenzyme A reductase inhibitors (statins) are frequently prescribed medications worldwide for the treatment of hypercholesterolemia. Statins are considered to be well tolerated; however, they have a potential for myotoxicity. Concomitant drugs that inhibit cytochrome P450 3A4 can increase the concentration of statins and thus the risk of developing myotoxicity. The purpose of this study was to evaluate risk factors associated with potential drug-drug interactions in patients receiving statins. Methods: The subjects of this study were patients aged more than 18 years who received at least one prescription of statins in a general hospital located in Chuncheon-si, Korea, between January 1, 2018, and March 31, 2018. Data regarding statin use and baseline characteristics was collected from the computerized hospital database. Logistic regression analysis was used to identify risk factors associated with potential drug-drug interactions. Results: A total of 1061 patients were finally included in the study. The incidence of potential drug-drug interactions was 45% in all subjects. According to the results of the multivariate logistic regression analysis, myocardial infarction as the indication of statin, arrhythmia or heart failure as a comorbidity, and aspartate aminotransferase levels higher than 40 IU/L were significant risk factors for potential drug-drug interactions in study subjects. Diltiazem was the most commonly co-prescribed drug that caused potential drug-drug interactions with statins. Conclusion: There was a considerable rate of potential drug-drug interactions in patients receiving statins. Health care professionals should attempt to reduce potential drug-drug interactions during statin administration.

A Survey on Korean Medicine Doctors' Recognition and Clinical Fields of Treating Primary Dysmenorrhea for Developing Korean Medicine Clinical Practice Guideline for Dysmenorrhea (월경통 한의표준임상진료지침 개발을 위한 한의사의 인식과 원발성 월경통 치료에 관한 실태조사)

  • Woo, Hye-Lin;Ji, Hae-Ri;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Chang-Hoon;Jang, Jun-Bock;Lee, Jin-Moo
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.2
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    • pp.93-106
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    • 2017
  • Objectives: This study is aimed to figure out Korean medicine doctors' recognition of Korean Medicine clinical practice guidelines (CPG) and clinical fields of treating primary dysmenorrhea before developing CPG for dysmenorrhea. Methods: We conducted a questionnaire survey targeting 515 Korean medicine doctors belonging to the Association of Korean Medicine by e-mail and analyzed the answers. Results: 81.2% of the respondents knew the concepts and contents of CPG, and 98.7% agreed about the necessity of CPG. 94.2% were willing to use CPG for dysmenorrhea in learning and treating. Average number of patients visiting the respondents' clinics for dysmenorrhea was 3.9, the main age group was 20s (63.1%), and the treatments the patients given before were mostly Western treatments such as pain killers and hormonal drugs. The respondents answered that they diagnosed patients with dysmenorrhea mainly with pattern diagnosis (41.6%), and treated them with herbal medicine (39.2%), acupuncture (31.6%) and moxibustion (22.6%) for 2-3 months. They answered that the acupoint they use most was San yin jiao, and the prescription was Gui-zhi-fu-ling-wan, They answered that the field considered to need further study was decoction of herbal medicine most (27.4%), and the field considered to need insurance coverage was also decoction of herbal medicine most (40.2%). Conclusions: We figured out Korean Medicine doctors' recognition of CPG, clinical diagnosis, treatment, cost for treating dysmenorrhea, and fields of clinical research and policy they required.

Study on Synergistic Anti-tumor Effect of Combination with Adriamycin and Palginhonhapwhajucwhan (팔진탕합화적환(八珍湯合化積丸)과 Adriamycin의 병용처리시 나타나는 synergistic 항종양(抗腫瘍) 효과(效果)에 관(關)한 작용기전 연구(硏究))

  • Moon, Gu;Moon, Seok-Jae;Won, Jin-Hee;Cho, Jung-Yun;Park, Sang-Gu;Song, Bong-Gil;Park, Rae-Gil;Lee, Byung-Gu
    • The Journal of Internal Korean Medicine
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    • v.21 no.3
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    • pp.443-452
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    • 2000
  • Objective : This study was designed to evaluate the synergistic effect on cytotoxicity of combination with adriamycin and Palginhonhapwhajucwhan, a traditional prescription for cancer treatment in oriental medicine, in Chang, HL-60, Hep-3B and Alexander cells. Methods : We observed cell viability in Chang, HL-60, Hep-3B, and Alexander cells by crystal violet staining. Those cells were treated with various concentrations of adriamycin alone, Palginhonhapwhajucwhan alone and combination of two medications for 10 hr. On condition of $0.5{\mu}l/ml$ adriamycin alone, $15.6{\mu}l/ml$ Paljintanghapwhajucwhan alone and combination of two medications, at first, we observed colony forming of Chang and HL-60 cells. Second, we observed DNA fragmentation by agarose electrophoresis in Chang, HL-60, Hep-38 and Alexander cells. Third, we measured the catalytic activation of caspase-1, 2, 3, 6, 8, and 9 protease in Chang cells and caspase-3 protease in Chang, HL-60, Hep-3B and Alexander cells by using fluorogenic substrate. Finally, we isolated mRNA of Fas in Chang, HL-60, Hep-38 and Alexander cells and observed that Fas gene was amplified by RT-PCR Results : 1. The combination of adriamycin and Palginhonhapwhajucwhan synergistically augmented the cytotoxicity of Chang and HL-60 cells whereas did not in Hep-38 and Alexander cells. 2. Cotreatment of two drugs also markedly inhibited the colony forming ability both in Chang and HL-60 cells. 3. The cytotoxicity of these medicatons was revealed as apoptosis characterized by high molecular wight DNA fragmentaton. 4. The apoptotic cytotoxicity was mediated by activation of caspase-3 protease in Chang cells. 5. Synergistic increase in apoptotic cytotoxicity by combination of two medications was dependent on the expression of Fas in cancer cells. Conclusions : Combination of adriamycin and Palginhonhapwhajucwhan significantly augmented apoptotic cytotoxicity of Fas-positive cells such as Chang and HL-60 cells via acticaton of apoptosis signaling pathway.

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A Clinical Study of Headache in 58 Cases (두통(頭痛)의 임상양상(臨床樣狀) 및 생체전기자율반응에 대(對)한 임상적(臨床的) 고찰(考察))

  • Lee Sang-Ryong;Kim Myung-Jin
    • Journal of Oriental Neuropsychiatry
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    • v.12 no.2
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    • pp.103-122
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    • 2001
  • The clinical study was carried out the 58 patients with Headache who were treated in Department of Neuropsychiatry, College of Oriental Medicine, Dae Jeon University from 14 October 1999 to 15 October 2001. The results were summarized as follows. 1. The ratio of male and female was 15:43, 40s(36.2%) was frequent, the ratio of Tension headache and Migraine was 43:12, hypernoia and overwork oneself were the most inducing factor. 2. In distribution of the period of the clinical history, Tension headache was comparatively short term within 1 month(62.8%) and Migraine was comparatively long term over 1 year(91.7%), Tension headache was frequent at whole portion(41.3%) and occipital portion(26.1%), Migraine was frequent at temporal portion(76.9%). 3. In pain type, Tension headache has many vandlike discomport type, Migraine has many pulsatile type, neck-stiffness-pain and dizziness were mainly coexited. 4. Toung aspect has many SULDAMHONGTAEBAEKHOO(舌淡紅苔白厚), GINMAEK(緊脈) and HEUNMAEK(弦脈) were frequent in Pulse type, the GAEDAMSUNKIJEETONG(祛淡順氣止痛) prescription drugs were frequent such as GEYNTONGA(肩痛A), GEYNTONGDODAMTANG(?通導淡湯), Tension headache patients were well treated(90.7%). 5. In Tension headache and Migraine, the Curve has many SL except Tension headache‘s 2th SANGHAN(상한), in Regulation RR was frequent at 1th, 2th, 3th, 4th, 7th SANGHAN and RL was frequent at 5th, 6th SANGHAN, the result of Graph, Activity and Reactivity have many low response at the whole. 6. The Curve was within normal limit at whole portion and frequent SL at temporal portion, the whole and temporal portion s Regulation also have many RR at 1th, 2th, 3th, 4th, 7th SANGHAN and RL at 5th, 6th SANGHAN, Activity and Reactivity have many low response at the whole. 7. The occipital and frontal portion‘s Curve have many SL at 1th SANGHAN, the occipital portion’s Regulation has many RR at 1th, 2th, 4th, 7th SANGHAN and RL at 5th, 6th SANGHAN, Activity has many low response at the whole, Reactivity has many low response at 1th, 4th, 5th, 6th SANGHAN and high response 2th, 3th SANGHAN, the frontal portion s Regulation has many RL at 1th, 3th, 5th, 6th, 7th SANGHAN and RR at 4th SANGHAN, Activity and Reactivity also have many low response at the whole except 6th, 7th SANGHAN respectively.

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Evaluation of Peri-procedural Anticoagulation Drug Therapy undergoing Radiofrequency Ablation in Patients with Atrial Fibrillation (심방세동 환자의 고주파 도자절제술 전.후의 항응고약물요법 사용실태 분석)

  • Kim, Su-Hyun;An, Sung-Shim;Kim, Soon-Joo;Bang, Joon-Seok;La, Hyen-Oh
    • Korean Journal of Clinical Pharmacy
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    • v.20 no.2
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    • pp.159-164
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    • 2010
  • Radiofrequency ablation (RA) is being used to manage atrial fibrillation (AF) with patients failed at the $1^{st}$-line anti-arrhythmic medications. Patients undergoing this procedure are at increased risk of thromboembolism after ablation, and anticoagulation management surrounding the ablation remains controversial. Although no conclusive recommendations can be made, published guidelines and data support therapeutic anticoagulation with warfarin. The purpose of this study was to analyze effectiveness of current therapy and to find factors fluctuate International Normalized Ratio (INR) values in patients undergone RA followed by anticoagulation service (ACS). Retrospective review was conducted utilizing database in a hospital. Among 110 patients under warfarin around ablation between January 2006 to September 2007, 54 patients were selected and allocated into 2 groups: Group A included 47 who discontinued warfarin after ablation, while 7 in B continued the medication. Information on demographics, amount and length of warfarin dosing, INR values and measuring frequencies, and the causing factors on INR fluctuation were abstracted. Differences were analyzed using chi-squared test, Fisher's Exact test, and unpaired Student t-test. Mean amount of warfarin before and after surgery was 4.0 mg, 4.1 mg in Group A and was 5.1 mg, 4.6 mg in Group B, respectively. Average duration of warfarin doing before ablation was 73.7 days in Group A, 129.9 days in B with no significant difference (p = 0.312). The duration time of warfarin on groups after ablation lasted several months. The number of checking INRs was 4.1 and 7.6, respectively. Inter-individual variability of INR fluctuations were $2.1{\pm}0.6$ in Group A and $2.2{\pm}0.7$ in B which were not significantly different (p = 0.062). 164 cases of decreased INR were: 'omission in taking medication, stressfulness and headache, 'increased intake of high vitamin K foods', 'lifestyle change of increased physical activities', and 'increase of food-intakes'. To the contrary, 36 cases of increased INR were: 'reduce of food-intake', 'use of non-prescription drugs', 'reduction in physical activities', and 'excessive restriction on food-intake', consecutively. In conclusion, the study validated therapeutic outcomes of RA patients who we treated with standard guideline and demonstrated 9 factors of INR fluctuations in the patient. A well-trained, pharmacist-monitored anticoagulation service could reduce the risk of adverse effects and prevent complications in patients with AF around RA operation.

Validation of Nursing-sensitive Patient Outcomes;Focused on Knowledge outcomes (지식결과에 대한 타당성 검증;간호결과분류(NOC)에 기초하여)

  • Yom, Young-Hee;Lee, Kyu-Eun
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.357-374
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    • 2000
  • The purpose of this study was to validate knowledge outcomes included Nursing Outcomes Classification(NOC) developed by Johnson and Maas at the University of Iowa. A sample of 71 nurse experts working in university affiliated hospitals participated in this study. They were asked to rate indicators that examplified the outcomes on a scale of 1(indicator is not all characteristic) to 5(indicator is very characteristic). A questionnaire with an adaptation of Fehring's methodology was used to establish the content validity of outcomes. The results were as follow: 1. All indicators were considered to be 'supporting' and no indicators were considered to be 'nonsupporting'. 2. 'Knowledge: Treatment Regimen' attained and OCV score of 0.816 and was the highest OCV score among outcomes. 3. 'Knowledge: Energy Conservation' attained an OCV score of 0.748 and was the lowest OCV score among abuse outcomes. 4. 'Knowledge: Breastfeeding' attained an OCV score of 0.790 and was the highest indicator was 'description of benefits of breastfeeding'. 5. 'Knowledge: Child Safety' attained an OCV score of 0.778 and was the highest indicator was 'demonstration of first aids techniques'. 6. 'Knowledge: Diet' attained an OCV score of 0.779 and was the highest indicator was 'performance of self-monitoring activities'. 7. 'Knowledge: Disease Process' attained an OCV score of 0.815 and was the highest indicator was 'description of signs and symptoms'. 8. 'Knowledge: Health Behaviors' attained an OCV score of 0.800 and was the highest indicator was 'description of safe use of prescription drugs'. 9. 'Knowledge: Health Resources' attained an OCV score of 0.794 and was the highest indicator was 'description of need for follow-up care'. 10. 'Knowledge: Infection Control' attained an OCV score of 0.793 and was the highest indicator was 'description of signs and symptoms'. 11. 'Knowledge: Medication' attained an OCV score of 0.789 and was the highest indicator was 'description of correct administration of medication'. 12. 'Knowledge: Personal Safety' attained an OCV score of 0.804 and was the highest indicator was 'description of measures to reduce risk of accidental injury'. 13. 'Knowledge: Prescribed Activity' attained an OCV score of 0.810 and was the highest indicator was 'proper performance of exercise'. 14. 'Knowledge: Substance Use Control' attained an OCV score of 0.809 and was the highest indicator was 'description of signs of dependence during substance withdrawl'. 15. 'Knowledge: Treatment Procedure(s)' attained an OCV score of 0.795 and was the highest indicator was 'description of appropriate action for complications'. 16. 'Knowledge: Treatment Regimen' attained an OCV score of 0.816 and was the highest indicator was 'description of self-care responsibilities for emergency situations'. More outcomes need to be validated and outcomes sensitive to Korean culture need to be developed.

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Study on Utilization of Oriental Medicine by Residents in Rural Areas (농촌지역(農村地域)의 한방의료이용실태(韓方醫療利用實態) 일부(一部) 농촌지역(農村地域)의 군보건소이용자(群保建所利用者)를 중심(中心)으로-)

  • Kim, Jin-Soon
    • Journal of agricultural medicine and community health
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    • v.15 no.2
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    • pp.118-129
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    • 1990
  • Socioeconomic status in this county progressed rapidly, this has brought about many changes in health care fields, namely, pattern of disease prevalence and morbidity, increase of the aged people, and also availability of health care in rural areas. According to the utilization study of medical care, it showed that the oriental medicine is used for the treatment of lasted chronic disease not the minor and common diseases which is quick in its effect. Particularly, in rural areas. prevalence of chronic disease is higher than that in urban areas. Although the health cafe need of the oriental medicine is high in rural areas, the distribution of manpower and facilities is lower than that in urban areas. Therefore the government has planned to implement the demonstration project for the oriental medicine at the designated 3 health centers in rural areas. The purpose of this study was to collect the utilization level of oriental medical care of the people in rural areas. To meet the purpose of this study, patient interview were applied. 790 patients visited to health center in project areas were selected and analyzed by experienced interviewers from 2 April to 21 April 1990. The major findings of this study were as follows ; 1) Of the 790 patients, 32.6 percent of the respondents had experience of using the oriental medicine. As for the utilization by age and sex. 54.8% of those was female and 70.7% was 40 years of age and more. 2) Reaction to the question of educational achievement showed that on schooling and primary school graduates accounted for 63.1%. 3) The most user of oriental medicine resides in country level, where the health center is located, and 80 percent of those users resides within 10Km. 4) More than 50% of the total was the chronic diseases which lingered for more than 3months. 5) 32.6 percent of the total cases used the oriental medicine. 61.2% among those was treated by oriental medical care hospital and 38.8% by oriental drug dispensaries etc. 6) The contont of oriental medical care varied ; 50.1% for prescription of herb drugs for treatment, 25.1% for health maintenance and 23.9% for acupuncture, moxibustion etc. 7) As for the motivation for using the oriental medicine. 56.6% of the respondents was for treatment of diseases and 27.9% wes for strengthening the physical weakness. 8) As for the effectiveness of the oriental medicine. 70.3% of the total cases satisfied with that treatment and 84.2% of the total cases will use the oriental medicine when is provided by health center.

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A Study on Application of Pyungwuisan Blended Prescriptions From Dongeuybogam (동의보감(東醫寶鑑) 중(中) 평위산연계방(平胃散連繫方)의 활용(活用)에 대한 고찰(考察))

  • Liu Chin-The;Lee Hak-Jae;Kim Young-Il;Lee Young-Sook;Cho Dae-Yeon;Park Jong-Chan;Yun Yong-Gab
    • Herbal Formula Science
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    • v.12 no.1
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    • pp.1-27
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    • 2004
  • The following are the conclusions obtained by the philological study of the prescriptions introduced in Dongeuybogam such as Pyungwuisan, Pyungwuisan-added prescriptions, Pyungwuisan blended prescriptions: 1. Pyungwuisan and drugs based on Pyungwuisan were prescribed for stomach diseases, food poisoning, indigestion, impaired spleen, symptoms developed by dampness, diseases caused by changing water, diarrhea, edema, malignant malaria, an intestinal convulsion, blood in excrement, malaria, abortion, sparrow eye. 2. Dual prescriptions using Pyungwuisan and other independent prescriptions were applied to internal diseases concerning digestion, diarrhea and dysentery, abscess, intestinal swelling jaundice, symptoms developed by dampness, malaria, vomit, etc. 3. Etiological factors and diseases for which Pyungwuisan and medicines based on Pyungwuisan, dual prescriptions using Pyungwuisan were prescribed, were surveyed to include indigestion, weak spleen and stomach, drying dampness of spleen and stomach, dysfunctioning gall bladder, infection, damaged internals, external sensitiveness and internal damage, hypochondria, chilliness due to lack of chi. 4. A prescription for each disease needed specially added medicines to Pyungwuisan as the following: 1) For indigestion and dyspepsia, Pyungwuisan were prescribed with optional addition of Hoisaengsan, Sagunjatang, Ryukgunjatang, Ijintang, Sosihotang, etc., according to the symptoms, and were most frequently used with aromatic and digestive medicines such as mawwa medivata fermentata, malt, natgrass galingale rhizome, vilous amomum fruit, aucklandia root, round cardamom seed etc. 2) For diseases originated from damage by coldness, Pyungwuisan was taken with suitable amount of Jichulhwan, Hyangsosan, Hyangyusan, according to the symptoms. 3) For diarrhea and dysentery, Pyungwuisan were prescribed with the recipes of Oryeongsan, Sambaektang, Ijintang. 4) For jaundice, prescriptions always included natgrass galingale rhizome in the recipe of Pyungwuisan. 5) For malaria, mostly added prescriptions to Pyungwuisan were Sagunjatang, Ryukgunjatang, Ijintang, with usual addition of antifebrile dichroa root, tsaoko, green tangerine orange peel. 6) Pyungwuisan was prescribed with Hoisaengsan for vomit, with Oryeongsan for edema, and with kinds of Ueolgukhwan for hypochondria.

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