마황 단기복용이 사상체질인의 불안에 미치는 영향 : 이중맹검 임상시험

형례창,양창섭,이태호,김락형,곽민정,서의석,장인수,Hsing, Li-Chang,Yang, Chang-Sop,Lee, Tae-Ho,Kim, Lak-Hyung,Kwak, Min-Jung,Seo, Eui-Seok,Jang, In-Soo 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.1

Background : Mahuang (Ephedrae Herba, Ephedra sinica $S_{TAPE}$) has been widely used to treat respiratory disease in Asian over the past thousand years. The main ingredient of Mahuang is ephedrine, whose affects on the autonomic nervous system induce some adverse effects like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, etc. Although there were lots of reports about adverse effects of Mahuang, there were no clinical studies which evaluated the adverse effects of Mahuang on the autonomic nervous system by objective numerical value in the past decade. Objectives : The purpose of this report was to provide an objective assessment of state-trait anxiety that is caused by Mahuang, and to identify anxiety of Mahuang according to different Sasang constitution classifications. Methods : The study design was a double-blind randomized placebo-controlled trial. The subjects of this study were 79 adults aged between 20 to 40 who agreed to participate. Because 8 adults dropped out, a total of 71 subjects entered the study. They were allocated through randomization to a Mahuang group (N=50) and placebo group (N=21). Each group took three opaque capsules (every opaque capsule containing 2g of Mahuang or none) twice a day. To compare the state and trait anxiety before and after taking Mahuang, we checked the anxiety by using STAI-KYZ. Results : The following results were obtained. Short-term administration of Mahuang significantly increased state-anxiety, but in the placebo group, there were no significant changes in state-anxiety. In the Mahuang group except females, there was more significant increase in state-anxiety of Soeumin than Soyangin and Taeumin in the 2nd measurement. Conclusion : It is suggested that the ingestion of Mahuang can increase sympathetic activity and induce anxiety. There was a significant difference among Sasang constitution classification. Especially, the response is stronger in Soeumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only minimize the anxiety but maximize the potential curative value.

마황용량에 따른 이상반응에 관한 예비연구: 무작위배정이중맹검시험

형례창,이태호,손동혁,여진주,양창섭,서의석,장인수,Hsing, Li-Chang,Lee, Tae-Ho,Son, Dong-Hyug,Yeo, Jin-Ju,Yang, Chang-Sop,Seo, Eui-Seok,Jang, In-Soo 대한한방내과학회 2006 大韓韓方內科學會誌 Vol.27 No.1

Background: Ma-huang (Ephedra sinica) has been widely used to treat respiratory disease in oriental medicine for over a hundred years. Ma-huang preparations contain approximately 1.25% ephedrine alkaloids. Recently, the ephedra alkaloids have received much press lately due to adverse effects in those using whole extracts as 'dietary supplements' for weight loss or athletic performance enhancement, and these reports are troubling given the increasing use of Ma-huang by the general public. The purpose of this report is to determine the proper dosage to minimize adverse effects and maximize the potential curative value. Objectives : The object of this study was to find an effective yet low risk dosage of Ma-huang. Methods : The study was designed as a double-blind randomized placebo-controlled trial. The subjects of this study were 26 adults between 20 to 40 of age who agreed to participate in this study. They were allocated through randomization into three groups. Each group took three opaque capsules three times a day. A group (N=9) took one Ma-huang capsule and two placebo capsules, B group (N=8) took two Ma-huang capsules and one placebo capsule, C group (N=9) took three Ma-huang capsules. The total trial periods was two days. To compare the adverse effects of Ma-huang according to dosage, blood pressure and pulse were checked, and other adverse effects were assessed using a morning questionnaire, patient's global assessment scale and Wong-Baker faces pain rating. Results : The following result were obtained: 1. After taking 18 g of Ma-huang per day, pulse rate had a significant increase. 2. After taking more than 6 g of Ma-huang per day, palpitation would be increased significantly. 3. After taking more than 18 g of Ma-huang per day, tiredness would be increased significantly. Conclusion: According to the results, 12 g of Ma-huang per day will minimize adverse effects and maximize the potential curative value.

특이 병력 없는 건강한 젊은 여성 환자에서 발생한 간문맥 내 공기를 동반한 급성 기종성 위염

형례창 ( Li-chang Hsing ),정기욱 ( Kee Wook Jung ) 대한소화기학회 2019 대한소화기학회지 Vol.74 No.4

위마비

형례창 ( Li-chang Hsing ),정기욱 ( Kee Wook Jung ) 대한내과학회 2020 대한내과학회지 Vol.95 No.4

Gastroparesis is a condition characterized by delayed gastric emptying without evidence of mechanical obstruction in the stomach. Its symptoms include nausea, vomiting, early satiety, abdominal bloating, and abdominal pain. Most cases of gastroparesis are either idiopathic, due to diabetes mellitus, or post-surgical complications. The diagnosis of gastroparesis requires upper endoscopy, contrast radiography, or validated gastric scintigraphy. Gastroparesis is managed with nutritional support and treatment of any underlying disorders, such as diabetes. Pharmacological treatments have been tried, including prokinetics and novel medications. Interventions focused on the pylorus have shown promising results. (Korean J Med 2020;95:244-250)

마황복용이 성인여성의 상태-특성 불안에 미치는 영향: 무작위배정 이중맹검 임상연구

양창섭,형례창,정현숙,김락형,곽민정,서의석,장인수,Yang, Chang-Sop,Hsing, Li-Chang,Jeong, Hyun-Suk,Kim, Lak-Hyung,Kwak, Min-Jung,Seo, Eui-Seok,Jang, In-Soo 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.2

Background : Over a thousand years of clinical preparation of Ephedrain traditional Korean medicine has confirmed effectiveness and security. Recently. Ephedra-containing herbal preparations to treat obesity are common. The aim of this study is to identify effects of Ephedra on psychological anxiety. Objectives : To determine effects of Ephedraon psychoactivity and autonomic nervous system. Methods : The study design was a double-blind randomized controlled trial. The subjects of this study were healthy adults. They were allocated to either the Ephedragroup (N =66) or the placebo group (N =32), Ephedra(8 g) or a placebo in similar opaque capsules was given twice a day for 2 weeks. Anxiety score was estimated with State-Trait Anxiety Inventory before first and after last medication. 36 of the Ephedragroup and 24 of the placebo group finished the trial and were analyzed. Paired samples T-test and independent samples T-test were applied to statistical analysis. Results : The following result was obtained: After taking Ephedra. state anxiety increased significantly. In the placebo group. both state and trait anxiety increased although significance was not reached. Conclusions : It is concluded that the intake of Ephedraplays a significant role in the increase of anxiety in healthy adults. It is suggested that anxiety level change should be considered when using Ephedra in clinics.

중증급성호흡기증후군(SARS)의 한약 치료에 관련된 WHO 임상논문 보고에 대한 개관

장인수,형례창,한창호,Jang, In-Soo,Hsing, Li-Chang,Han, Chang-Ho 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.2

Objective: In the winter of 2002, severe acute respiratory syndrome(SARS) began to spread throughout the world. More than 5,000 cases were reported in China, including over 1,700 cases in Hong Kong Special Administrative Region(Hong Kong SAR). The total number of cases reported from Canada and Singapore was more than 200. The total number of SARS cases world-wide reached 8,437 with incidences in 29 counties. Mortality from SARS is estimated at $10{\sim}12%$. When the SARS outbreak occurred in China, the State Administration of Traditional Chinese Medicine of China immediately initiated clinical research projects on the use of integrated herbal medicine and Western medicine for treating SARS. and, in Hong Kong SAR, research on the use of herbal medicine for the prevention and treatment of SARS. Reports were released during convalescence. The objective of this study is to overview twelve clinical SARS reports of WHO on the treatment of SARS with herbal medicine and evaluate the efficacy and safety of treatment of SARS with herbal medicine, and further to share experiences and knowledge of the treatment of SARS. Methods: Twelve clinical reports about SARS from the WHO were selected, overviewed and evaluated for efficacy and safety of treatments of SARS. Results and Conclusion: Twelve clinical reports about SARS showed that the integrated treatment may have advantages, and the advantages are reflected in the following findings: Firstly, herbal medicine is not targeted only at a specific etiology or a certain pathological link, but also at the pathological status of the patients at that particular time. Therefore, comprehensive readjustment was made through various angles, targets and channels to restore the balance of the body. Secondly, there are advantages in the differentiation of the disease and the treatment. Based on the various symptoms, herbal medicine enables the physician to adopt the most suitable principle, provide individual treatment, and to administer medicine in accordance with the actual process and nature of the illness. Thirdly, there are advantages in the results of the treatment; herbal medicine can relieve symptoms, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other Western medicines, and reduce case fatality rate, in addition to lowering the cost of treatment.

마황복용이 정상성인의 체중 감소와 심박변이도에 미치는 영향에 관한 예비 연구: 무작위배정 이중맹검시험

양창섭,형례창,여진주,서의석,장인수,Yang, Chang-Sop,Hsing, Li-Chang,Yeo, Jin-Ju,Seo, Eui-Seok,Jang, In-Soo 대한한방내과학회 2006 大韓韓方內科學會誌 Vol.27 No.4

Background: Mahuang (Ephedra sinica STAPF) is well known as an herbal medicine and has been widely used to reduce body weight and increase athletic ability. However, as a result of reporting many cases of adverse effects on the cardiovascular system, use of dietary supplements containing ephedra was prohibited by the FDA. Objectives : The object of this study was to find the effectiveness of ephedra on weight loss without severe adverse effect. Methods : 16 healthy volunteers consisting of an ephedra group (N=8) and a placebo group (N=8) were investigated. Study form was a randomized, controlled, double-blind clinical trial. The ephedra group took 12g of ephedra while the placebo group took 12g of glutinous rice powder. Both groups were measured with BCA (body composition analysis) on weight loss and with HRV (heart rate variability) on its adverse effect before and after medication. Results : The following results were obtained after taking 12g of ephedra for 14 days. In the ephedra group, body weight reduced significantly. In the placebo group, there were no significant differences of body weight between before and after placebo treatment. There was a slight increase of heart beat rate and deactivation of cardiac activity. Parasympathetic nerves were deactivated, but balances of autonomic nervous system were well maintained. Conclusions : The results suggest that ephedra in healthy adults tends to reduce body weight and deactivation of autonomic nervous system and cardiac activity.

마황복용 후 사상체질별 이상반응에 관한 임상연구 : 무작위배정 이중맹검시험

이태호,형례창,양창섭,김락형,서의석,장인수,Lee, Tae-Ho,Hsing, Li-Chang,Yang, Chang-Sop,Kim, Lak-Hyung,Seo, Eui-Seok,Jang, In-Soo 대한한방내과학회 2009 大韓韓方內科學會誌 Vol.30 No.1

Background : Ephedra (Ephedra sinica) has been widely used to treat respiratory disease in traditional medicine of East Asia for over a hundred years. Despite safety concerns raised by some, the use of ephedra in traditional medicine is documented over more than 1,800 years. It is well established that ephedra is one of the central medicines in Korean 'Seseng constitution' medicine. In Sasang constitution medicine, all humans can be divided into one of four types: Soeumin, Soyangin, Taeumin or Taeyangin, and each constitution type has their own typical characteristics. Accordingly, it is hypothesized that the adverse effects of ephedra differ depending on the Sasang constitution classification. Objectives : The aim of this study was to determine adverse effects of ephedra which is classified as a Taeumin herb, and to observe whether the response differs or not. according to Sasang constitution classification. Methods : The study design was a double-blind randomized controlled trial. The subjects were healthy adults 20 - 50 years old who agreed to participate in this study. They were allocated through randomization to either ephedra group (N=55) or placebo group (N=24). where ephedra extract (6 g of dried ephedra) and placebo with similar opaque capsules were given twice for one day. To compare the adverse events of ephedra according to Sasang constitution classification, we analyzed blood pressure (systolic and diastolic), pulse rate, the morning questionnaire, and patient's global assessment scale score for well known adverse events: palpitation, headache, sweating, tiredness, dyspepsia, and dry mouth. Results : After ingestion of ephedra, the pulse rate had a significant increase in all constitution types. The changes of diastolic pressure in Soeumin and the changes of pulse rate in Soeumin, Soyangin and Taeumin had a significant increase in the ephedra over the control group. In the ephedra group, the palpitation and dyspepsia score of the patients' global assessment scale had a significant increase in Soeumin, with palpitation and sweating score increasing in Soyangin. Others observations were insignificant results. Conclusion : The results of this study may confirm that the physical responses or adverse effects of herbs differ for each type of Sasang constitution. Future studies using other herbs will be required to ascertain the herbal drug reaction of Sasang constitutions.

마황복용이 성인의 체중감소에 미치는 영향에 대한 이중맹검 임상연구

여진주(Jin-ju Yeo),형례창(Li-chang Hsing),양창섭(Chang-sop Yang),정승일(Seung-il Jeong),서의석(Eui-seok Seo),장인수(In-soo Jang) 대한한의학회 2007 대한한의학회지 Vol.28 No.1

식도종격동누공을 형성한 결핵 종격동 림프절염 1예

김진영 ( Jinyoung Kim ),김호연 ( Hoyun Kim ),이형경 ( Hyeungkyeung Lee ),정민선 ( Minseon Cheong ),형례창 ( Li Chang Hsing ),김도훈 ( Do Hoon Kim ),정훈용 ( Hwoon-yong Jung ) 대한내과학회 2018 대한내과학회지 Vol.93 No.5

결핵의 식도 침범 및 이의 합병증인 식도종격동누공 형성은 매우 드물고 국내 보고가 거의 없다. 대부분 종격동 림프절염에서 식도 침범이 이루어지고 이러한 경우 식도종격동누공을 형성할 수 있다. 저자들은 식도종격동누공 치료에 내시경적 클립 결찰술을 먼저 시도하였으나 누공 폐쇄에 실패하였고, 경피적 내시경 위루술을 통한 항결핵제 치료만으로 누공 폐쇄를 경험하였기에 보고한다. Tuberculosis rarely involves the esophagus, and most esophageal tuberculosis occurs secondary to adjacent tuberculous lymphadenitis. An esophago-mediastinal fistula is a very unusual complication of tuberculous lymphadenitis. Herein, we report a case of an esophago-mediastinal fistula due to tuberculous lymphadenitis. A 28-year-old woman who had dysphagia was assessed by chest computed tomography, endoscopy, esophagogram, and a lymph node biopsy. An esophago-mediastinal fistula was found and an antituberculous agent was considered initially. However, because of her severe dysphagia, she managed with endoscopic clipping as an alternative. However, the fistula remained on follow-up esophagography. A gastrostomy was eventually performed, and she was treated with an antituberculous agent. The fistula had closed after 4 weeks of medication. Antituberculous agents are the mainstay treatment for esophago-mediastinal fistula due to tuberculous lymphadenitis; endoscopic clipping may be a complementary treatment. (Korean J Med 2018;93:477-481)