A Case of Panic Disorder Patient Improved by Gyeji-tang(Guizhi-tang) Based on Shanghanlun Provision

Article information

J Korean Med. 2021;42(2):98-106
Publication date (electronic) : 2021 June 01
doi : https://doi.org/10.13048/jkm.21019
Roh-Young-Beum Korean medical clinic, 105, Jomaru-ro, Wonmi-gu, Bucheon, Gyeonggi-do, Korea
Correspondence to:김지영 경기도 부천시 원미구 조마루로 105번길 34-13 노영범한의원, Tel: +82-32-666-7575, Fax: +82-303-3444-9168, E-mail: alsidbaba@hanmail.net
Received 2021 January 28; Revised 2021 March 6; Accepted 2021 March 16.

Abstract

Objectives

The objective of this case report is to find a therapeutic effect of Gyeji-tang in panic disorder patients, based on Shanghanlun provision.

Methods

At patient’s first visit, we had conducted a medical interview in order to diagnose the physical and mental symptoms of the patient. A questionnaire called BAI had been also used to measure the degree of anxiety in panic disorder. After all the diagnoses had been done, the patient was allowed to take 120cc of Gyeji-tang, three times a day for 25 weeks. 25 weeks later, we conducted a second medical interview to compare with the initial treatment and to evaluate whether his physical and mental symptoms had been decreased or not. Likewise, the patient was asked to fill out the BAI questionnaire to measure the decline of anxiety degree.

Results

Based on Shanghanlun provision, the patient with panic disorder due to overwork was diagnosed as Tai-yang-bing. Considering that the patient was having dyspnea, 15th provision of Gyeji-tang was selected and administered for 25 weeks. After 25 weeks, we could have observed that the main physical symptoms such as palpitation, dyspnea, stifling, headache, and fatigue were moderately improved. Moreover, the BAI score, which was evaluated to measaure the degree of anxiety, was also decreased from 49 points to the level of normal condition, 16 points.

Conclusions

A 44 year old male patient who suffered from panic disorder due to overwork was allowed to take 15th provision Gyeji-tang for 25 weeks, based on Shanghanlun Provision. In results, the main physical symtpoms including dyspnea, palpitation, stifling, headache, and fatigue, and mental symptom such as extreme anxiety were all effectively improved.

Composition and Administration of GyeJi-tang (Guizhi-tang)

Change of Treatment and Symptoms

Changes of BAI Score

References

1. Korean NeuroPsychiatric Assoclation. Textbook of neuropsychiatry 2nd rev. edth ed. Seoul: Joongang moonhwasa; 2005. 204p. 221.
2. The Textbook Compilation Committee of Neuro-psychiatry of Oriental Medical Schools in Nation. Revised Edition. The Neuropsychiatry of Oriental Medicine Seoul: Jipmoondang; 2011. 페이지.
3. Hwnag UW, Kim JH. Oriental Neuropsychiatry Seoul: modern medical books; 1987. p. 601.
4. Kim JH, Seok SH, Koo BS, Kim GW. A Case Report of Panic Disorder with Agoraphobia; Focusing on Observation from Recent Onset. Journal of korean neuropsychiatric association 2008;19(2):251–63.
5. Suh HU, Hwnag EY, Jung SY, Kim JW. A Case of a Panic Disorder(with Agoraphobia) Patient Improved by Herbal Extracts - Gyejigayonggolmoryo-tang (Guizhijialonggumuli-tang) and Jakyakgamcho-tang(Shaoyaogancao-tang). Journal of korean neuropsychiatric association 2010;21(4):207–18.
6. Roh YB, Yun SM, Joh ES. Case Reports and Studies on the Functional Process of Panic Disorder, treated with Ling-Gui-Gan-Zao-Tang. Journal of Korean Medical Association of Clinical Sanghan-Geumgwe 2012;4(1):1–12.
7. YooK SP, Kim JS. Clinical research of Korean edition Beck Anxiety Inventory: Comparison between patients and non-patients. Korean Journal of psychology In : 96 Workshop Presentation file; 1996; p. 41–9.
8. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders Fourth Editionth ed. Seoul: Hana medical publishing; 1995. p. 514–26.
9. Asmundson GJ, Taylor S, Smits AJJ. Panic disorder and agoraphobia: an overview and commentary on DSM-5 changes. Depress Anxiety 2014;31(6):480–6.
10. Jung IC, Lee SR. The Clinical Analysis on 19 Cases of Anxiety Disorder. Journal of korean neuropsychiatric association 1998;9(2):161–9.
11. Lee SW, Lee YJ, Yoo SW, Lee RD, Park SJ. Case Series of Panic Disorder Patients Treated by Oriental Medical Treatments and EFT. Journal of korean neuropsychiatric association 2014;25(1):13–28.
12. Park KM, Choi SH. The comparative study of Sanghanron and HwangHenaegyeong through historical study on Gangpyung Sanghanron. Journal of Korean Medical Classics 1996;9:265–301.
13. Lee SJ, Lim JE. A diagnostic system and clinical application based on <Shanghanlun> six meridian patterns and provisions Seoul: Kmediacs publishing house; 2013.
14. Lim JE, Lee SJ. A case report form based on Shanghanlun six clinical patterns and provisions. Journal of Korean Medical Association of Clinical Sanghan-Geumgwe 2013;5(1):1–17.
15. Lee SJ, Heo J. A case report of tinnitus treated by CyeJigagalgeun-tang. Journal of Korean Medical Association of Clinical Sanghan -Geumgwe 2015;7(1):15–20.
16. Abraham HM. Motivation and Personality. Gyeonggi-do:book21 2009;:92. :93.
17. Roh YB. Clinical Shanghanlun; The application of Shanghanlun-psychopathy and intractable disease Seoul: badabooks; 2020. 129p. 130.
18. Lee SJ, Kim YM. A study of ‘Ji-Qi-Shang-Chong (其氣上衝)’ and Gui-Zhi-Tang(桂枝湯)in Shang -han-lun. Journal of The Korean Medicine Society For The Herbal Formula Study 2012;20(2):165–176.
19. Kim KI. Shanghanlun; Chinese Paleographical translation Seoul: badabooks; 2015. 87p. 88.

Article information Continued

Table 1

Composition and Administration of GyeJi-tang (Guizhi-tang)

Herbal name Daily dose(g)
Cinnamormi Ramulus 9
Paeoniae Radix 9
Zizyphi Fructus 8
Zingiberis Rhizoma Recens 9
Glycyrrhizae Radix 6

Dried herbs above were decocted in boiled water. 120cc tid.

Table 2

Change of Treatment and Symptoms

Weak Herbal Medicines Symptoms Other Symptoms

Palpitation/ Dyspnea Anxiety Fatigue/Headache
Chest tightness Neckstiffness

2nd Gyeji-tang +++/+++ +++ +++ +++/+++ Sleeplessness

4th Gyeji-tang ++/+++ ++ ++ +++/++

6th Gyeji-tang +/++ + + ++/++

8th Gyeji-tang ++/+++ ++ ++ ++/++ Sleeplessness

10th Gyeji-tang +/++ + + +/+ Sneeze

14th Gyeji-tang +/++ + +/+ Sneeze Nasal stuffiness

16th Gyeji-tang +/+ +/−

18th Gyeji-tang +/+ −/−

20th Gyeji-tang −/+ −/−

22th Gyeji-tang −/− −/−

25th Gyeji-tang −/− −/−

Table 3

Changes of BAI Score

First Medical Examination 6th 25th
Score 49 23 16