Obstetrics & gynecology science

Korean Society of Obstetrics and Gynecology (대한산부인과학회)
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Comparative Study on Treatment of Postmenopausal Symptoms with Black Cohosh Root Extract and Hormone Replacement Therapy

폐경기증상 치료에서 승마추출물과 호르몬보충용법의 비교연구

Lee, Byoung-Ick;Koh, Seung-Kwon;Hwang, Seong-Ook;Park, Jee-Hyun;Kim, Chong-Wha
이병익;고승권;황성욱;박지현;김종화

  • Published : 20020800
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Abstract

Objective : The fears and side effects of a prolonged hormone replacement therapy on the postmenopausal symptoms reinforce a growing interest about alternatives. The present study was performed to investigate whether black cohosh root extract (BCRE) can be used or not as an alternative to hormone replacement therapy (HRT) in order to relieve postmenopausal symptoms. Material & Methods : Randomized, double-blind prospective clinical trial examined the effects of BCRE and HRTon Kupperman index, biochemical bone markers, lipid profiles, and side effects in 74 women with postmenopausal symptoms. Treatments included placebo (Festal$^{\circledR}$) (n=12), BCRE (Feramin$^{\circledR}$) (n=32) and HRT (Premarin$^{\circledR}$) (n=30) for 3 months. Kuppennan index, biochemical bone markers (osteocalcin and deoxypyridinoline), and lipid profiles (total cholesterol, triglyceride and HDL-cholesterol) were measured at 0, 1 and 3 months. Side effects were checked at 3 months. Results : BCRE was significantly effective in lowering of Kupperman index as much as HRT at two control times (1 month: p<0.05, 3 months: p<0.001). It also showed slightly favorable effects on biochemical bone markers and lipid profiles but not statistically significant. Fewer side effects were seen in BCRE than HRT. Conclusion : BCRE appears to be a safe and effective alternative to HRT for early postmenopausal symptoms and may be especially useful in women with intolerances or contraindications to traditional HRT.

목적 : 폐경 증상에 대한 장기간의 호르몬 보충 요법은 유방암에 대한 공포와 부작용으로 말미암아 새로운 대체요법에 대한 관심이 절실하게 요구되는 실정이다. 이에 본 연구는 승마추출물이 폐경 여성에 있어서 폐경증상을 완화시키는데 호르몬 보충 요법의 대체요법으로 사용될 수 있는 지 알아보고자 시행하였다. 연구방법 : 폐경 증상을 호소하는 폐경 74명을 위약군 (Placebo: 12명), 승마추출물군 (Feramin: 32명), 호르몬보충요법군 (Premarin: 30명)으로 나누어 3개월간 약물을 투여하였다. 총 3회 (약물 투여전, 투여 1개월, 투여 3개월)에 걸쳐 폐경 증상의 변화는 Kupperman index의 변화로, 골대사의 변화는 Osteocalcin과 Deoxypyridinoline을 측정하여, 지질대사의 변화는 총 콜레스테롤, 중성지방 및 고밀도 콜레스테롤을 측정하여 계량화 하였다. 약물투여에 대한 부작용은 투여 3개월 후 조사하였다. 결과 : 위약군과 비교하여 승마추출물은 Kupperman index를 낮추는데 있어서 호르몬 보충 요법만큼 효과적이었다. (투여 1개월: p<0.05, 투여 3개월: p<0.01). 골대사 및 지질대사의 변화에 있어서 위약군에 비하여 약간의 긍정적인 효과를 보이나 통계학적으로 유의하지 않았다. 부작용은 호르몬 보충요법에 비하여 훨씬 적었다. 결론 : 승마추출물은 폐경 증상을 완화시키기 위한 목적으로 호르몬 보충 요법을 대치할 수 있는 안전하고 효과적인 치료제이며 특히 호르몬 보충 용법의 부작용이나 장기간투여에 따른 유방암에 대한 공포로 말미암아 투여를 거부하는 경우 새로운 대체요법으로 생각된다.

Keywords

References

  1. Drug facts and comparisons, Olin BR, Hebel SK, eds, St. Lousis: Facts and Comparisons, Inc. 1998:96.
  2. Colditz GA, Hankinson SE, Hunter DJ, et al, The use of estrogens and progestins and the risk of breast cancer in postmenopausal women. New Eng J Med 1995;332:1589-93.
  3. Foster S Black cohosh(Cimicifuga racemosa): a literature review. Herbalgram. 1999;45:35-49.
  4. Mowrey DB. The scientific validation of herbal medicine. Cormorant Books. 1986.
  5. Cimicifuga racemosae Rhizome. Bonn: Bundesanzeiger; 1989.
  6. Goodennough J. Homecures and berbal remedies. The favorite medicinal receipt book and home doctor, Revised. New York: Avenal Books; 1982.
  7. Beuscher N. Cimicifuga racemosa. Die Traubensilberkerze. Z Phytother, 1995;16:301-10.
  8. Hirabayashi T, Ochiai H, Sakai S et al.lnhibitory effect of ferulic acid and isoferulic acid on murine interleukin-8-production in response to inlluenza virus infections in vitro and in vivo. Plant Med. 1995;61:221-6. https://doi.org/10.1055/s-2006-958060
  9. Sakurai M, NagaiM. Chemical constituents of original plants of Cimicifugae rhizoma in chinese medicine. Yakugaku Zasshi. 1996;116;850-65.
  10. Clay A, Reichert R. Cimicifuga racemosa L.-black cohosh. Q Rev Nat Med 1996;Spring:19.
  11. Remifemin, a plant-based gynecological agent. Salzglitrer, Germany: Schaper & Blummer; 1997:1-38.
  12. Jarry H, Harnischfeger G, Duker E. Studieson the endocrine efficacy of the constituents of Cimicifuga racemosa: 1. Inlluence on the serum concentration of pituitary hormones in ovariectomized rats. Planta Med. 1985;51:46-9.
  13. Lehmann-Willenbrock E, Riedel H. Clinical and endocrinologic-al examinations concerning therapy of climacteric symptoms following hysterectomy with remaining ovaries. Zentrabl Gynekol. 1988;110:611-8.
  14. Duker EM, Kopanski L, Jarry H, Wuttke W. Effects of extracts from Cimicifuga racemosa on gonadotropin release in menopausal womenand ovariectomized rats. Planta Med. 1991;57:420-4. https://doi.org/10.1055/s-2006-960139
  15. Eagon P, Tress N, Ayer H et al. Medical botanicals with hormonal activity. ProcAm Assoc Cancer Res. 1999;40. Abstract.
  16. Einer-Jensen N, Zhao J, Anderson K et al, Cimicifuga and Melbrosia lack estrogenic effects in mice & rat. Maturitas. 1996;24:149-53.
  17. Liske E. Wustenburg P, Therapy of climacteric complaints with Cimicifuga racemosa: herbal medicine with clinically proven evidence. Menopause. 1998;5:250.
  18. Liao JF. Jan YM. Huang SY, Wang HH, Yu LL, Chen CF: Evaluation with receptor binding assay on the water extracts of ten CNS-active chinese herbal drugs Procedings of the National Science Council. Republic of China. Lite Sci(B). 1995;19:151-8.
  19. Yoo JS, Jung JS Lee TH. et al. Inhibitory effects of extract, from traditional herbal drugs on 5-hydroxytryptophan-induced diarrhea in mice. Korean J Pharmacog 1995;26:355-9.
  20. Vorberg G. Therapy of climacteric complaints. Z Allgemeinmed. 1984;36:871-4.
  21. Brucker A. Essay on the phytotherapy of hormonal disorders in women. Med Welt 1960;44:233.
  22. Warnecke G. Using phyto-treatrnenr to inlluence menopausal symptoms. Med Welt 1985;36:87.
  23. Stoll W. Phytotherapy influences atrophic vaginal epithelium. Therapeutikon 1987;1:23.
  24. Li JX. Kadota S, Li HY, Miyahara T, Namba T. The effect of traditional medicines on bone resorption induced by parathyroid hormone(PTH) in tissueculture: a detailed study on Cimicifugae rhizoma. Wakan Iyakugaku Zasshi. 1996;13:50-8
  25. LiJX, Li HY, Miyahara T. et al. Anti-osteoporotic activity of traditional medicine: active constituents of Cimicifugae rhizoma. Wakan Iyakugaku Zasshi. 1995;12:316-7.
  26. Scietific Brochure of Remifemin(English translation). Salzgitter, Germany: Scharper & Brummer; 1997.
  27. Freudenstein J, Bodmer C. Intluence of an isopropanolic aqueous extract of Cimicifuga racemosae rhizome on the proliferation of MCF-7 cells. 23 rd International LOF-Symposium on phytoesrrogens. Universityof Ghent, Belgium; 1999.
  28. Storze H An alternative to treat menopausal complaints, Gyne. 1982;3:14-6.