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Kell DB, Pretorius E, Zhao H. A Direct Relationship Between 'Blood Stasis' and Fibrinaloid Microclots in Chronic, Inflammatory, and Vascular Diseases, and Some Traditional Natural Products Approaches to Treatment. Pharmaceuticals (Basel) 2025; 18:712. [PMID: 40430532 PMCID: PMC12114700 DOI: 10.3390/ph18050712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2025] [Revised: 04/29/2025] [Accepted: 05/07/2025] [Indexed: 05/29/2025] Open
Abstract
'Blood stasis' (syndrome) (BSS) is a fundamental concept in Traditional Chinese Medicine (TCM), where it is known as Xue Yu (). Similar concepts exist in Traditional Korean Medicine ('Eohyul') and in Japanese Kampo medicine (Oketsu). Blood stasis is considered to underpin a large variety of inflammatory diseases, though an exact equivalent in Western systems medicine is yet to be described. Some time ago we discovered that blood can clot into an anomalous amyloid form, creating what we have referred to as fibrinaloid microclots. These microclots occur in a great many chronic, inflammatory diseases are comparatively resistant to fibrinolysis, and thus have the ability to block microcapillaries and hence lower oxygen transfer to tissues, with multiple pathological consequences. We here develop the idea that it is precisely the fibrinaloid microclots that relate to, and are largely mechanistically responsible for, the traditional concept of blood stasis (a term also used by Virchow). First, the diseases known to be associated with microclots are all associated with blood stasis. Secondly, by blocking red blood cell transport, fibrinaloid microclots provide a simple mechanistic explanation for the physical slowing down ('stasis') of blood flow. Thirdly, Chinese herbal medicine formulae proposed to treat these diseases, especially Xue Fu Zhu Yu and its derivatives, are known mechanistically to be anticoagulatory and anti-inflammatory, consistent with the idea that they are actually helping to lower the levels of fibrinaloid microclots, plausibly in part by blocking catalysis of the polymerization of fibrinogen into an amyloid form. We rehearse some of the known actions of the constituent herbs of Xue Fu Zhu Yu and specific bioactive molecules that they contain. Consequently, such herbal formulations (and some of their components), which are comparatively little known to Western science and medicine, would seem to offer the opportunity to provide novel, safe, and useful treatments for chronic inflammatory diseases that display fibrinaloid microclots, including Myalgic Encephalopathy/Chronic Fatigue Syndrome, long COVID, and even ischemic stroke.
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Affiliation(s)
- Douglas B. Kell
- Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Crown St., Liverpool L69 7ZB, UK
- The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Søltofts Plads 200, 2800 Kongens Lyngby, Denmark
- Department of Physiological Sciences, Faculty of Science, Stellenbosch University, Stellenbosch Private Bag X1, Matieland 7602, South Africa
| | - Etheresia Pretorius
- Department of Biochemistry, Cell and Systems Biology, Institute of Systems, Molecular and Integrative Biology, Faculty of Health and Life Sciences, University of Liverpool, Crown St., Liverpool L69 7ZB, UK
- The Novo Nordisk Foundation Centre for Biosustainability, Technical University of Denmark, Søltofts Plads 200, 2800 Kongens Lyngby, Denmark
| | - Huihui Zhao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing 100026, China;
- Institute of Ethnic Medicine and Pharmacy, Beijing University of Chinese Medicine, Beijing 100026, China
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Ko MM, Jeon S, Ha W, Kim YE, Jung SY, Kim BY, Kim M, Choi KH, Kang G, Lee SM, Ahn YM, Cho N, Jin H, Leem J, Choi S, Jo J, Lee J, Jung J. The Korean medicine for aging cohort (KoMAC) study: A protocol for a prospective, multicenter cohort study on healthy aging in the population entering old age in South Korea. PLoS One 2025; 20:e0316986. [PMID: 39932955 PMCID: PMC11813093 DOI: 10.1371/journal.pone.0316986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2024] [Accepted: 12/19/2024] [Indexed: 02/13/2025] Open
Abstract
BACKGROUND South Korea is anticipated to enter a super-aged society by 2025, necessitating a focus on healthy aging. In Korean medicine (KM), aging and disease susceptibility are individual specific, emphasizing personalized treatments, and many Korean local governments have integrated KM services for elderly people into the public sector. However, there is a notable absence of research incorporating KM to treat older adults. AIM The proposed study aims to examine the comprehensive health profiles of individuals entering old age in rural and urban areas and explore the significant correlations between healthy aging and four key factors: biological, psychological, social, and KM-based phenotype factors. It will also establish a database and blood biobank, serving as a platform for future research to develop a traditional KM-based healthy aging model. METHODS A multiple randomized controlled trial design will be adopted in this prospective, multicenter cohort study for the clinical investigation of the markers associated with KM-based healthy aging. The aim is to recruit 1,000 participants who are entering old age from both urban and rural settings for this study, and recruitment began in August 2023 with follow-up surveys planned at one-year intervals. Comprehensive health profiles, including biological, psychological, social, and KM-based phenotype factors, will be developed through the creation of a database, a blood biobank, and multi-omics data. RESULTS In the baseline phase of this study, we will focus on identifying markers for KM-based phenotypes and examining how these phenotypes relate to aging and associated diseases. In the next phase, we will implement interventions tailored to KM-based phenotypes to verify the effects of KM on healthy aging. Ultimately, we intend to develop a KM-based integrated health management model, with further substudies aiming to explore factors related to healthy aging. This protocol was approved by the institutional review board of Wonkwang University Korean Medicine Hospital, Iksan, Republic of Korea (approval number: WKUIOMH-IRB-2023-05) on August 16, 2023 and Jangheung Integrative Medical Hospital (approval number: WKUJIM-202307-001) on August 21, 2023. Recruitment started on August 16, 2023. CONCLUSION The anticipated results of our study aim to establish personalized preventive and therapeutic interventions for individuals entering old age. Additionally, we seek to offer an KM-based integrated health management model that incorporates comprehensive diagnosis and an integrative medical treatment strategy for healthy aging. TRIAL REGISTRATION Clinical Research Information Service: KCT0008863 (registered on October 11, 2023, https://cris.nih.go.kr/cris/search/detailSearch.do/25718).
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Affiliation(s)
- Mi Mi Ko
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Seojae Jeon
- Korea Institute of Integrative Medicine, Jangheung, Republic of Korea
| | - Wonbae Ha
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Young-Eun Kim
- Korea Medicine Data Research Division, Korea Institute of Oriental Medicine, Daejeon , Republic of Korea
| | - So Young Jung
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon , Republic of Korea
| | - Bo-Young Kim
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Myunghwa Kim
- Korea Institute of Integrative Medicine, Jangheung, Republic of Korea
| | - Kwang-Ho Choi
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Geonhui Kang
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - So Min Lee
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - You Mee Ahn
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Nahyun Cho
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Hanbit Jin
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Jungtae Leem
- Department of Diagnostics, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Seungkwan Choi
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Jungho Jo
- Department of Internal medicine, College of Korean Medicine, Wonkwang Universty, Iksan, Republic of Korea
| | - Junghan Lee
- Korea Institute of Integrative Medicine, Jangheung, Republic of Korea
- Department of Korean Medicine Rehabilitation, College of Korean Medicine, Wonkwang University, Iksan, Republic of Korea
- Research Center of Traditional Korean Medicine, Wonkwang University, Iksan, Republic of Korea
| | - Jeeyoun Jung
- Korea Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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Han K, Yoo JE, Kim JE, Kwon O, Kim AR, Park HJ, Jung SY, Kim M, Yang C, Cho JH, Lee JH. Beneficial effect of Gyejibokryeong-hwan on climacteric syndrome with blood stasis pattern: A randomized, double-blinded, placebo-controlled clinical pilot trial. Integr Med Res 2023; 12:100951. [PMID: 37187679 PMCID: PMC10176163 DOI: 10.1016/j.imr.2023.100951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2022] [Revised: 04/16/2023] [Accepted: 04/19/2023] [Indexed: 05/17/2023] Open
Abstract
Background Gyejibokryeong-hwan (GBH), a herbal mixture that is widely used for climacteric syndrome, is studied for its efficacy; however, no study evaluated the GBH indication, which is a blood-stasis pattern based on traditional Chinese medicine theory. Methods This is a randomized, double-blinded, placebo-controlled clinical pilot trial. Fifty subjects with climacteric syndrome were recruited and randomly assigned to GBH group or placebo group. Subjects were administered GBH or placebo granules for 4 weeks followed by 4 weeks of observation period. For the primary outcome, the Menopause Rating Scale (MRS) was evaluated. For the secondary outcomes, quality of life, degrees of abdominal resistance and tenderness, blood-stasis pattern questionnaire and degree of upward movement of Qi were evaluated. Results After 4-week intervention, the mean change of total MRS score significantly decreased in the GBH group compared to the placebo group (p = 0.037). The quality of life related to physical health (p = 0.008) and blood-stasis pattern (p = 0.018) significantly improved in the GBH group but not in the placebo group. Conclusion Our findings provide evidence of the feasibility of recruiting subjects with GBH indications and show that GBH may have clinical efficacy for the treatment of menopausal symptoms, especially urogenital symptoms, without any significant adverse events. Trial registration Clinical Research Information Service (CRIS identifier: KCT0002170).
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Affiliation(s)
- Kyungsun Han
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jeong-Eun Yoo
- Department of Obstetrics and Gynecology, College of Korean Medicine, Daejeon University, Daejeon, South Korea
- Laon Integrative Medicine Research Center, Daejeon, South Korea
| | - Jung-Eun Kim
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Biomedical Research Institute, Pusan National University Hospital, Busan, South Korea
| | - Ojin Kwon
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ae-Ran Kim
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Hyo-Ju Park
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - So-Young Jung
- Clinical Research Coordinating Team, R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Mikyung Kim
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Department of Internal Medicine, College of Korean Medicine, Sangji University, Wonju, South Korea
| | - Changsop Yang
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jung-Hyo Cho
- Department of Internal Korean Medicine, College of Korean Medicine, Daejeon University, Daejeon, South Korea
| | - Jun-Hwan Lee
- Korean Medicine Science Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
- Korean Medicine Life Science, University of Science & Technology (UST), Campus of Korea Institute of Oriental Medicine, Daejeon 34054, South Korea
- Corresponding author at: Korea Institute of Oriental Medicine, 1672 Yuseong-daero, Yuseong-gu, Daejeon 34054, South Korea.
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Ko MM, Jang S, Jung J. An observational study on diagnosis index of metabolic disease with blood-stasis. Medicine (Baltimore) 2020; 99:e21140. [PMID: 32629750 PMCID: PMC7337439 DOI: 10.1097/md.0000000000021140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
INTRODUCTION Treating blood stasis is effective in treating obesity and metabolic diseases in traditional Korean medicine. The aim of this prospective observational study is to determine the effectiveness of the diagnosis index for metabolic diseases with blood stasis by analyzing clinical data and blood samples. METHODS AND ANALYSIS We will perform a prospective observational study. Participants who meet the inclusion criteria will be recruited from the Dongguk university Ilsan Oriental hospital. The outcomes are resistin, serum amyloid P component, C-reactive protein, D-dimer, and blood stasis scores. In addition, the blood pressure, ankle-brachial pressure index, brachial-ankle pulse wave velocity, body mass index, waist circumference, and levels of blood lipid will be assessed. DISCUSSION Through this study, we could collect specific data for diagnosing metabolic diseases with blood stasis. Therefore, the findings of this study will provide a summary of the current state of evidence regarding the effectiveness of the diagnosis index in managing metabolic disease with blood stasis. ETHICS AND DISSEMINATION The study was approved by the Institutional Review Board of the Dongguk University Ilsan Oriental Hospital (DUIOH-2018-09-001-007). The results will be published in a peer-reviewed journal and will be disseminated electronically and in print. TRIAL REGISTRATION NUMBER Clinical Research Information Service: KCT0003548.
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Jang S, Sung HK, Ko MM, Shin SM, Go HY, Jung J. Effectiveness of Gyejibongnyeong-Hwan for shoulder pain: study protocol for a randomised, wait-list controlled pilot trial. Trials 2020; 21:193. [PMID: 32066487 PMCID: PMC7027269 DOI: 10.1186/s13063-020-4092-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2019] [Accepted: 01/18/2020] [Indexed: 12/01/2022] Open
Abstract
Background Shoulder pain is an uncomfortable feeling in the muscle around the shoulder. The cause of myalgia is the accumulation of lactic acid in muscles and impaired blood circulation, which is called blood stasis in traditional East Asian medicine. This study aimed to explore the therapeutic effect of Gyejibongnyeong-Hwan (GBH) for shoulder discomfort related to blood stasis before and after treatment. Methods/design This study will be a double-centre, randomised, wait-list controlled pilot trial. Participants with shoulder pain and with a visual analogue scale score of 4 or higher out of 10, blood stasis score of 9 or higher, and triglyceride level of ≥150 mg/dl or total cholesterol level of ≥200 mg/dl will be recruited from two university hospitals. A total of 40 participants will be assigned to the immediate and waiting treatment groups. The immediate treatment group will receive GBH for 8 weeks on enrolment while the waiting treatment group will receive GBH for 8–16 weeks after 8 weeks of controlled waiting. The primary outcome is shoulder pain, and the secondary outcomes are the blood stasis score, blood pressure, ankle–brachial pressure index, brachial–ankle pulse wave velocity, body mass index, waist circumference, indexes of oximetry, and levels of blood lipid, blood sugar, resistin, C-reactive protein, serum amyloid P, and D-dimer. Discussion The results of this pilot trial will be the bases for a full-scale clinical trial of GBH. Trial registration Clinical Research Information Service, KCT0003837. Registered on 23 April 2019. https://cris.nih.go.kr/cris/en/search/search_result_st01.jsp?seq=14258
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Affiliation(s)
- Soobin Jang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyun Kyung Sung
- Department of Pediatrics, College of Korean Medicine, Semyung University, Jecheon, Republic of Korea
| | - Mi Mi Ko
- Clinical Research Coordinating Team, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Seon Mi Shin
- Internal Medicine, College of Korean Medicine, Semyung University, Jecheon, Republic of Korea
| | - Ho-Yeon Go
- Internal Medicine, College of Korean Medicine, Semyung University, Jecheon, Republic of Korea.
| | - Jeeyoun Jung
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
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Ko MM, Jang S, Lee JA, Kang BK, Jung J. Blood Stasis Therapy for Traumatic Injury: A Prospective, Single-Arm, Pre-Post Pilot Study. J Altern Complement Med 2018; 25:359-365. [PMID: 30156424 DOI: 10.1089/acm.2018.0134] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
OBJECTIVES Blood stasis is an important pathophysiologic concept in Traditional East Asian Medicine. It has been considered to be a pathogenic factor in chronic and incurable conditions such as pain, infertility, cancer, coronary heart disease, and others. The aim of this study was to investigate the effects of pain reduction by blood stasis treatment for blood stasis syndromes with traumatic injury. METHODS A single-center prospective pretest-post-test pilot study included 73 patients with a trauma that occurred within the past 2 weeks who were admitted into Jaseng Hospital of Korean Medicine from August 2015 through December 2015. Of the 50 patients analyzed in this study, 42 were women (mean age, 33.52). Triple Energizer-reinforcing Saam acupuncture set, herbal medicine (Dangkwisoo-san), and wet cupping on tender point, which are Korean medical therapies generally executed to treat post-traumatic pain, were performed. The patients had to receive at least six sessions of treatment during the 2 weeks, with subsequent treatment being performed within 3 ± 1 days after the previous treatment. Numeric rating scale (NRS) score and general pain severity indicator was measured as a primary outcome measure. The blood stasis questionnaire, oximetry, and patient's satisfaction were also measured. RESULTS The mean size of subcutaneous bleeding (width and length) and NRS score as a general pain indicator significantly decreased over the visits (all p < 0.01, visit 1 vs. visit 6). Among the blood stasis symptoms in the questionnaire, 11 blood stasis indicators significantly decreased (all p < 0.05). The patients showed significant improvement in the minimum and maximum value of peripheral perfusion index after the treatment (p = 0.011 and p = 0.15, respectively). CONCLUSIONS This study reveals that blood stasis treatment may help improve the pain of patients with traumatic injury by enhancing the peripheral blood flow. The significant results observed in this study support some evidence of the theories of diagnosing blood stasis pattern and treatments of that pattern in Korean Medicine.
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Affiliation(s)
- Mi Mi Ko
- 1 Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Soobin Jang
- 1 Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ju Ah Lee
- 2 Department of Korean Internal Medicine, College of Korean Medicine, Gachon University, Seongnam, Republic of Korea
| | - Byung Kab Kang
- 1 Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jeeyoun Jung
- 1 Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
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