23/10/2024
# # # Clinical Case Report: Management of a 63-Year-Old Female with Long-Term Statin Use and Post-COVID-19 Vaccination Complications
# # # # Patient Background
- **Age**: 63 years
- **Medical History**:
- 15 years of prescription medication use, including statins for hyperlipidemia
- Significant discomfort following the third COVID-19 vaccination
- **Intervention**: Discontinuation of statins and introduction of herbal medicine regimen
- **Herbal Prescription**:
- **Unmo Hae-dok-hwan** (1 sachet, 3 times daily)
- **Unmo An-sim-hwan** (2 sachets, 3 times daily)
- **Duration**: 4 months, 90 sachets prescribed for daily use
# # # # Biochemical Marker Changes Before and After Herbal
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# # # # Observations & Dietary Recommendations
- **Protein Intake**:
- Patient experienced low protein levels, indicating insufficient protein consumption.
- Advised to increase daily intake of small amounts of meat (about the size of a hand joint).
- Following this recommendation for two weeks led to normalized protein markers.
- **Liver Function and External Factors**:
- Liver function markers, including ALT, AST, and A/G ratio, respond well to Unmo Hae-dok-hwan when inflammation is present.
- Factors contributing to elevated liver enzymes that require monitoring include:
1. Multiple dietary supplements
2. High-dose Vitamin C therapy
3. Vegetable juices (especially for cancer patients)
4. Overwork and sleep deprivation
5. Continued prescription medication (notably statins and analgesics, which are hepatotoxic)
# # # # Clinical Reflection
- **Medication Discontinuation**: The patient’s lack of improvement over four months led to the discontinuation of her statin medication. Within two months of stopping the statin and continuing herbal therapy, her biochemical markers returned to normal.
- **Rationale for Discontinuation**: To achieve successful treatment outcomes, prescription medications with potential side effects on liver function were stopped, allowing for the herbal medicine to exert its full therapeutic effects.
# # # # Conclusion
This case demonstrates the effective use of traditional herbal medicine, including Unmo Hae-dok-hwan and Unmo An-sim-hwan, in managing both liver function and protein levels in a patient with a complex medical history. It also highlights the importance of addressing dietary factors, particularly protein intake, and the careful management of concurrent prescription medication to optimize treatment outcomes.
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