Gui Zhi Fu Ling Wan

Hot flashes are one of the main problems in postmenopausal patients. Hormone replacement therapy is the standard treatment for this vasomotor symptom, but long-term estrogen treatment can produce serious adverse effects such as higher risks of cardiovascular disease and breast cancer. For this reason, hormone replacement therapy may not be advisable for young patients. Gui-zhi-fu-ling-wan is an herbal decoction for hot flashes used in traditional Chinese medicine. We have extensive experience treating hot flashes in young women; this preliminary case series evaluates the effectiveness of Gui-zhi-fu-ling-wan for alleviating hot flashes in young patients. In this retrospective case series, we reviewed the medical records of outpatients who visited the Department of Cardiovascular and Neurologic Disease, Kyung Hee Oriental Medical Center for hot flashes from October 1, 2003 to October 1, 2008. Of the 60 cases, 37 met the inclusion criteria. Mean improvement in symptoms, as assessed using the visual analog scale, was 40.4 ± 28.5{d382666222b3cff0b1122f689bebcc8d35b41f83934c69a0d9586603ddee8f2f}; 51.3{d382666222b3cff0b1122f689bebcc8d35b41f83934c69a0d9586603ddee8f2f} of patients experienced a 50{d382666222b3cff0b1122f689bebcc8d35b41f83934c69a0d9586603ddee8f2f} improvement. According to the secondary analysis, the results of differential diagnosis of cold and hot syndrome and blood stasis syndrome did not affect scores. Only 2.7{d382666222b3cff0b1122f689bebcc8d35b41f83934c69a0d9586603ddee8f2f} of the patients reported adverse events. Our findings suggest that Gui-zhi-fu-ling-wan improves hot flashes in young patients in a relatively safe manner. However, rigorous clinical studies are needed to confirm these results.

An increasing death rate due to cardiovascular disease in patients with rheumatoid arthritis (RA) has been reported. Keishibukuryogan (KBG) is a traditional Chinese/Japanese (Kampo) formula that has been administered to patients with blood stagnation, e.g. thrombotic disease and atherosclerosis. The objective of this study was to evaluate the efficacy of KBG on disease activity and endothelial dysfunction in RA patients. Sixteen RA patients were enrolled and administered KBG (12 g per day) for 12 weeks in addition to continuing other drugs. The disease activity of RA was assessed by modified disease activity scores for 28 joints (DAS(28)). Plasma levels of adhesion molecules, soluble E-selectin (sE-selectin), soluble intercellular adhesion molecule-1 (sICAM-1) and soluble vascular cell adhesion molecule-1 (sVCAM-1) were evaluated. C-reactive protein (CRP), inflammatory cytokines (IL-1beta, IL-6 and TNF-alpha) and lipid peroxide (LPO) were also evaluated. Fourteen patients completed the study. The disease activity of RA, tender joint count, swollen joint count and DAS(28) decreased significantly. Among adhesion molecules, only sVCAM-1 decreased significantly. LPO also decreased significantly, whereas CRP and inflammatory cytokines remained unchanged. These results suggest that KBG has insufficient anti-inflammatory or immunomodulating effect but does have a beneficial effect on articular symptoms and a protective effect against endothelial dysfunction in RA patients.

Comparing the effects of estrogen and an herbal medicine on peripheral blood flow in post-menopausal women with hot flashes: hormone replacement therapy and gui-zhi-fu-ling-wan, a Kampo medicine.