Effectiveness and safety of Injinoryung-San-Gagambang (Yinchen Wuling powder) decoction on stroke patients with elevated serum liver enzymes: Three case reports

Rationale: Injinoryung-San-Gagambang (IJORS) effectively improves hepatic dysfunction caused by polypharmacy in stroke patients. Patient concerns: We present 3 cases of hepatic dysfunction caused by polypharmacy, one of which was a 51-year-old man with cerebellum infarction and pneumonia as a complication of stroke. He took multiple medications because of baseline diseases. After recurrence of pneumonia, his laboratory tests showed abnormal aminotransferase levels. Another patient was an 81-year-old woman with cerebral infarction at the right-middle cerebral artery. She was also taking >5 medications. Her laboratory tests conducted on admission showed abnormally elevated aminotransferase levels. The last patient was 77-year-old man with cerebral infarction at the left-middle cerebral artery. He also had an abdominal aneurysm, a thoracic aortic aneurysm, and a myocardial infarction. After taking multiple medications including healthy functional foods, his laboratory tests showed abnormally elevated aminotransferase levels. Diagnosis: Diagnosis is conducted with the result of laboratory test including blood count, chemistry test. Interventions: All 3 patients received the same herbal treatment (IJORS decoction) for 1 to 3 weeks. Outcomes: All 3 patients’ abnormal serum aminotransferase level were significantly improved by IJORS decoction treatment while keeping other medicines. Lessons: IJORS can be considered as an effective treatment for hepatic dysfunction induced by numerous medications in stroke patients.