뚜렛 장애에 대한 『傷寒論』 回逆散의 활용 가능성 탐색: 증례 보고와 네트워크 약리학

Abstract

Objective: This study aimed to report a clinical case in which Hoeyeoksan was applied to Tourette disorder and to investigate its potential therapeutic mechanisms using network pharmacology. Methods: A 28-years-old male patient with Tourette disorder was treated with Hoeyeoksan for 75 days. The clinical course was analyzed, and network pharmacology was employed to predict the relevant genes, signaling pathways, and molecular mechanisms through which Hoeyeoksan may exert its therapeutic effects in Tourette disorder. Results: The 28-year-old male patient had longstanding Tourette disorder and recently experienced worsening symptoms associated with emerging anxiety and other neuropsychiatric complaints. During 75 days of treatment with Hoeyeoksan, the Korean version of the Yale Global Tic Severity Scale (YGTSS) score markedly improved from 114 to 8. Notably, tic symptoms, heat sensations, caffeine intolerance, and gastrointestinal discomfort showed substantial improvement within 15 days. Network pharmacology analysis suggested that the therapeutic potential of Hoeyeoksan may be mediated through modulation of dopaminergic signaling pathways and attenuation of neuroinflammation. Conclusions: These findings suggest that Hoeyeoksan may represent a potential therapeutic option for Tourette disorder. Further research is needed to validate and refine these observations.