본문 바로가기
KERD
논문KCI 등재

치매 환자의 공격성 관리에 활용가능한 억간산(抑肝散)의 고전적, 비임상적, 임상적 근거현황

Classical, Non-Clinical, and Clinical Evidence of Yokukansan for Alleviating Aggression: Scoping Review

권찬영|이동윤|김제범|하다정
대한한방신경정신과학회 (The Korean Society Of Oriental Neuropsychiatry)|2021.06|동의신경정신과학회지 (The Korean Society of Oriental Neuropsychiatry)|제32권 제2호|pp. 111-127

1

조회

0

다운로드

4

인용

0

참고문헌

키워드

DementiaAggressionAgitationHerbal medicine.BPSD
주제분류한의학

초록

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic–pituitary–adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

Abstract

Objectives: To review and analyze clinical and preclinical evidence of effectiveness, safety, and underlying mechanisms of yokukansan (YKS), a herbal medicine, in alleviating aggression. Methods: Classical records on YKS were searched in the Korean Traditional Medicine Knowledge Database (KTMKD). By searching five electronic databases, prospective clinical studies and preclinical studies of YKS for alleviating aggression/agitation published up to March 30, 2021 were included. Results: Only two classical records on YKS were found from the KTMKD. A total of 11 clinical studies and 15 preclinical studies were found from the five electronic databases. Among 11 clinical studies, seven enrolled patients with dementia and four enrolled patients with other neuropsychiatric disorders. Most clinical studies reported significant improvement in one or more outcomes related to aggression in the YKS group after treatment. Among 15 preclinical studies, all studies except two reported a significant decrease in aggression/agitation-related behavior of YKS or yokukansankachimpihange. Suggested underlying mechanisms of YKS or yokukansankachimpihange for aggression/agitation in these studies included regulation of serotonin receptor, amelioration of abnormal glucocorticoid level related to the hypothalamic–pituitary–adrenal axis, regulation of orexin secretion, amelioration of degeneration in brain cells including glia cells, and suppression of excessive glutamatergic or dopaminergic activity. Conclusions: There were some clinical and preclinical evidence supporting the effectiveness and safety of YKS for alleviating aggression. Given that aggression is the most frequent and destructive symptoms of behavioral and psychological symptoms of dementia, applicability of YKS as a herbal medicine should be further investigated in future high-quality research.

참고문헌 (51)

  1. Lyketsos CG, "Prevalence of neuropsychiatric symptoms in dementia and mild cognitive impairment : results from the cardiovascular health study", JAMA, 288(12), pp.1475~1483 (2002)
  2. Shin IS, "Neuropsychiatric symptoms and quality of life in Alzheimer disease", Am J Geriatr Psychiatry Off J Am Assoc Geriatr Psychiatry, 13(6), pp.469~474 (2005)
  3. Kunik ME, "Consequences of aggressive behavior in patients with dementia", J Neuropsychiatry Clin Neurosci, 22(1), pp.40~47 (2010)
  4. McKeith I, "Behavioural changes and psychological symptoms in dementia disorders", Lancet Neurol, 4(11), pp.735~742 (2005)
  5. 한영애, "요양시설 돌봄제공자의 치매지식, 공감역량 및 치매행동심리증상 부담감", 노인간호학회지, 22(3), pp.216~225 (2020), 한국노인간호학회[DOI]
  6. Majer R, "Neuropsychiatric symptoms, quality of life and caregivers’burden in dementia", Open Med Wars Pol, 15(1), pp.905~914 (2020)
  7. Savva GM, "Prevalence, correlates and course of behavioural and psychological symptoms of dementia in the population", Br J Psychiatry J Ment Sci, 194(3), pp.212~219 (2009)
  8. Lyketsos CG, "Mental and behavioral disturbances in dementia : findings from the Cache County Study on Memory in Aging", Am J Psychiatry, 157(5), pp.708~714 (2000)
  9. Rabins PV, "American Psychiatric Association practice guideline for the treatment of patients with Alzheimer’s disease and other dementias. Second edition", Am J Psychiatry, 164(12 Suppl), pp.5~56 (2007)
  10. Lyketsos CG, "Physical aggression in dementia patients and its relationship to depression", Am J Psychiatry, 156(1), pp.66~71 (1999)
  11. Shub D, "The link between psychosis and aggression in persons with dementia : a systematic review", Psychiatr Q, 81(2), pp.97~110 (2010)
  12. Miyamoto Y, "Formal caregiver burden in dementia : impact of behavioral and psychological symptoms of dementia and activities of daily living", Geriatr Nurs N Y N, 31(4), pp.246~253 (2010)
  13. Matsumoto N, "Caregiver burden associated with behavioral and psychological symptoms of dementia in elderly people in the local community", Dement Geriatr Cogn Disord, 23(4), pp.219~224 (2007)
  14. de Oliveira AM, "Nonpharmacological Interventions to Reduce Behavioral and Psychological Symptoms of Dementia : A Systematic Review", BioMed Res Int, 2015, pp.218980~ (2015)
  15. Azermai M, "Systematic appraisal of dementia guidelines for the management of behavioural and psychological symptoms", Ageing Res Rev, 11(1), pp.78~86 (2012)
  16. Watt JA, "Comparative risk of harm associated with trazodone or atypical antipsychotic use in older adults with dementia : a retrospective cohort study", CMAJ Can Med Assoc J J Assoc Medicale Can, 190(47), pp.E1376~83 (2018)
  17. Kim Y, "Danggui-Shaoyao-San for dementia: A PRISMA-compliant systematic review and meta-analysis", Med U S, 99(4) (2020)
  18. Kim TH, "Herbal Medicine for Vascular Dementia : An Overview of Systematic Reviews", Curr Vasc Pharmacol, 18(4), pp.394~409 (2020)
  19. Lee MS, "Acupuncture for Alzheimer’s disease : a systematic review", Int J Clin Pract, 63(6), pp.874~879 (2009)
  20. Kwon C-Y, "Efficacy and Safety of Auricular Acupuncture for Cognitive Impairment and Dementia : A Systematic Review", Evid-Based Complement Altern Med ECAM, 2018, pp.3426078~ (2018)
  21. Hae In Ahn, "Effectiveness of integrative medicine program for dementia prevention on cognitive function and depression of elderly in a public health center", Integrative Medicine Research, 8(2), pp.133~137 (2019), 한국한의학연구원[DOI]
  22. Hyde AJ, "Herbal medicine for management of the behavioural and psychological symptoms of dementia(BPSD) : A systematic review and meta-analysis", J Psychopharmacol Oxf Engl, 31(2), pp.169~183 (2017)
  23. Mizukami K, "A randomized cross-over study of a traditional Japanese medicine(kampo), yokukansan, in the treatment of the behavioural and psychological symptoms of dementia", Int J Neuropsychopharmacol, 12(2), pp.191~199 (2009)
  24. Matsuda Y, "Yokukansan in the treatment of behavioral and psychological symptoms of dementia : a systematic review and meta-analysis of randomized controlled trials", Hum Psychopharmacol, 28(1), pp.80~86 (2013)
  25. Mizukami K, "A randomized cross-over study of a traditional Japanese medicine(kampo), yokukansan, in the treatment of the behavioural and psychological symptoms of dementia", Int J Neuropsychopharmacol, 12(2), pp.191~199 (2009)
  26. Shinno H, "Effect of Yi-Gan San on psychiatric symptoms and sleep structure at patients with behavioral and psychological symptoms of dementia", Prog Neuropsychopharmacol Biol Psychiatry, 32(3), pp.881~885 (2008)
  27. Okahara K, "Effects of Yokukansan on behavioral and psychological symptoms of dementia in regular treatment for Alzheimer’s disease", Prog Neuropsychopharmacol Biol Psychiatry, 34(3), pp.532~536 (2010)
  28. Nagata K, "Effects of yokukansan on behavioral and psychological symptoms of vascular dementia : an open-label trial", Phytomedicine Int J Phytother Phytopharm, 19(6), pp.524~528 (2012)
  29. Teranishi M, "Efficacy and tolerability of risperidone, yokukansan, and fluvoxamine for the treatment of behavioral and psychological symptoms of dementia : A blinded, randomized trial", J Clin Psychopharmacol, 33(5), pp.600~607 (2013)
  30. Furukawa K, "Randomized double-blind placebocontrolled multicenter trial of Yokukansan for neuropsychiatric symptoms in Alzheimer’s disease", Geriatr Gerontol Int, 17(2), pp.211~218 (2017)
  31. Hayashi Y, "Treatment of behavioral and psychological symptoms of Alzheimer-type dementia with Yokukansan in clinical practice", Prog Neuropsychopharmacol Biol Psychiatry, 34(3), pp.541~545 (2010)
  32. Hatano T, "An exploratory study of the efficacy and safety of yokukansan for neuropsychiatric symptoms in patients with Parkinson’s disease", J Neural Transm, 121(3), pp.275~281 (2014)
  33. Miyaoka T, "Yi-gan san for the treatment of borderline personality disorder : an open-label study", Prog Neuropsychopharmacol Biol Psychiatry, 32(1), pp.150~154 (2008)
  34. Wake R, "Yokukansan(TJ-54)for irritability associated with pervasive developmental disorder in children and adolescents : a 12-week prospective, open-label study", J Child Adolesc Psychopharmacol, 23(5), pp.329~336 (2013)
  35. Miyaoka T, "Yokukansan(TJ-54)for treatment of pervasive developmental disorder not otherwise specified and Asperger’s disorder : a 12-week prospective, open-label study", BMC Psychiatry, 12, pp.215~ (2012)
  36. Tamano H, "Ameliorative effect of Yokukansan on social isolation-induced aggressive behavior of zinc-deficient young mice", Brain Res Bull, 83(6), pp.351~355 (2010)
  37. Katahira H, "Antistress effects of Kampo medicine"Yokukansan"via regulation of orexin secretion", Neuropsychiatr Dis Treat, 13, pp.863~872 (2017)
  38. Iba H, "Effect of Yokukansan and Yokukansankachimpihange on Aggressive Behavior, 5-HT Receptors and Arginine Vasopressin Expression in Social Isolation-Reared Mice", Biol Pharm Bull, 42(12), pp.2009~2015 (2019)
  39. Kanno H, "Effect of yokukansan, a traditional Japanese medicine, on social and aggressive behaviour of para-chloroamphetamine-injected rats", J Pharm Pharmacol, 61(9), pp.1249~1256 (2009)
  40. Sekiguchi K, "Effects of yokukansan and donepezil on learning disturbance and aggressiveness induced by intracerebroventricular injection of amyloid β protein in mice", Phytother Res PTR, 25(4), pp.501~507 (2011)
  41. Sekiguchi K, "Effects of yokukansan, a traditional Japanese medicine, on aggressiveness induced by intracerebroventricular injection of amyloid β protein into mice", Phytother Res, 23(8), pp.1175~1181 (2009)
  42. Ikarashi Y, "Effects of yokukansan, a traditional Japanese medicine, on memory disturbance and behavioral and psychological symptoms of dementia in thiamine-deficient rats", Biol Pharm Bull, 32(10), pp.1701~1709 (2009)
  43. Iizuka S, "Electron-microscopic examination of effects of yokukansan, a traditional Japanese medicine, on degeneration of cerebral cells in thiamine-deficient rats", Neuropathol Off J Jpn Soc Neuropathol, 30(5), pp.524~536 (2010)
  44. Nishi A, "Geissoschizine methyl ether, an alkaloid in Uncaria hook, is a potent serotonin1A receptor agonist and candidate for amelioration of aggressiveness and sociality by yokukansan", Neuroscience, 207, pp.124~136 (2012)
  45. Tamano H, "Influences of yokukansankachimpihange on aggressive behavior of zincdeficient mice and actions of the ingredients on excessive neural exocytosis in the hippocampus of zinc-deficient rats", Exp Anim, 65(4), pp.353~361 (2016)
  46. Tahara E, "Psychosocial stress enhances IgE-mediated triphasic cutaneous reaction in mice : Antagonism by Yokukansan(a kampo medicine)and diazepam", Allergol Int, 50(3), pp.211~221 (2001)
  47. Takeda A, "Therapeutic effect of Yokukansan on social isolation-induced aggressive behavior of zinc-deficient and pair-fed mice", Brain Res Bull, 87(6), pp.551~555 (2012)
  48. Tabuchi M, "Yokukansan and yokukansankachimpihange ameliorate aggressive behaviors in rats with cholinergic degeneration in the nucleus basalis of meynert", Front Pharmacol, 8 (2017)
  49. Uchida N, "Yokukansan inhibits social isolation-induced aggression and methamphetamine-induced hyperlocomotion in rodents", Biol Pharm Bull, 32(3), pp.372~375 (2009)
  50. Fujiwara H, "Yokukansan, a traditional Japanese medicine, ameliorates memory disturbance and abnormal social interaction with anti-aggregation effect of cerebral amyloid β proteins in amyloid precursor protein transgenic mice", Neuroscience, 180(2011), pp.305~313 (2011)
  51. Mizoguchi K, "Cellular Pharmacological Effects of the Traditional Japanese Kampo Medicine Yokukansan on Brain Cells", Front Pharmacol, 8, pp.655~ (2017)

관련 논문AI추천

알츠하이머병 환자의 이상행동심리증상(BPSD)에 대한 한약과 양약의 병용 효과에 대한 연구: 체계적 문헌 고찰구병수, 김근우, 김만기, 장석주, 홍민호대한한방신경정신과학회 · 동의신경정신과학회지2020 · 제31권 제4호치매 치료용 한약 처방의 연구성과에 대한 정성평가강종석, 강형원, 전원경, 허은정대한한방신경정신과학회 · 동의신경정신과학회지2012 · 제23권 제1호치매의 한약물 치료에 대한 체계적 임상논문 고찰 - 국내문헌을 중심으로 -권용주, 조성훈, 조혜영, 황의완대한한방신경정신과학회 · 동의신경정신과학회지2010 · 제21권 제4호Behavioral and Psychological Symptoms of Dementia Treated with Korean Medicine: A Case Report구병수, 성영유, 송서진대한한방신경정신과학회 · 동의신경정신과학회지2017 · 제28권 제4호알츠하이머 치매 의심 환자의 행동심리증상에 대한복합한의치료 1례: 증례 보고김종환, 임혁빈, 조희근대한한방신경정신과학회 · 동의신경정신과학회지2019 · 제30권 제3호치매 한약치료의 인지기능 개선 및 장내 미생물 변화에 대한 연구동향김보경, 박소현, 이정한, 임정화, 최미라대한한방신경정신과학회 · 동의신경정신과학회지2023 · 제34권 제3호

이 간행물의 다른 논문 (3건)

Effect of Hominis Placenta Pharmacopuncture for a Patient with Mild Cognitive Impairment: A Randomized, Double-Blind, Placebo-Controlled, Multi-Center TrialEun Cho, Ji Eun Lee, Seung-Hun Cho, 이재혁, Dohyung Kwon, 김윤나, Yoon Ji Eom, In Chul Jungpp. 81-93Suggestions for Potentially Useful Herbal Medicines for Treating Insomnia in COVID-19 Era: A Mini-ReviewJong Woo Kim, Chan-Young Kwon, Hyo-Weon Suhpp. 95-109단기 심신일여 부부치료를 통한 관계 개선 증례 보고김보경, 임정화, 김병학pp. 129-140
원문 보기