Clinical effectiveness of KSS formula, a traditional folk remedy for alcohol hangover symptoms

Abstract

A formula (KSS formula) containing the pith of Citrus tangerine Hort. et Tanaka (Kitsuraku), the rhizome of Zingiber officinale (Shokyo), and brown sugar has been traditionally used in China for the treatment of discomfort and cold sensation in the abdomen after ingestion of large amounts of alcohol. We evaluated the clinical effectiveness of this formula on signs and symptoms of alcohol hangover (AH). Of the twenty-two symptoms listed, significant decreases in severity scores were shown in nausea, vomiting, and diarrhea when the formula was administered in scheduled prophylactic doses. The score in overall well-being, ranging from 0 to 100 (worst possible condition), was 68.9 +/- 16.5 (mean +/- SD) in the control group and it decreased to 46.9 +/- 27.3 and to 44.4 +/- 26.4 in the two groups that included a dosing point prior to alcohol ingestion. Regardless of dosing schedules, KSS formula did not alter the time required for complete recovery from AH symptoms. These findings suggest the possibility that KSS formula may become a candidate for AH remedy when administered prophylactically.

Interventions for treatment and/or prevention of alcohol hangover: Systematic review

“…Four of the studies were randomized (Bang et al, ; Lee et al, ; Lee et al, ; Verster & Berthélemy, ), whereas in the remaining studies, the details of randomization were not described. Five of the studies were conducted in a cross‐over fashion (Bang et al, ; Lee et al, ; Lee et al, ; Noh et al, ; Takahashi, Li, Koike, & Sadamoto, ). Only males were included in four studies (Bang et al, ; Lee et al, ; Lee et al, ; Noh et al, ), whereas in the remaining two, both males and females were included.…”

“…The studies tested the effectiveness of a plant‐based product or formula, namely, (a) polysaccharide rich extract of Acanthopanax senticosus (Bang et al, ), (b) Korean pear juice (Lee et al, ), (c) red ginseng antihangover drink (Lee et al, ), (d) dandelion juice (Noh et al, ), (e) KSS formula (Takahashi et al, ), and (f) After‐Effect© (Verster & Berthélemy, ). Three types of alcohol administration methods were used: amount depending on the body weight (Bang et al, ), specific amount of alcohol for all the participants (Lee et al, ; Lee et al, ; Noh et al, ), and alcohol amount preferred by individual participant (Takahashi et al, ; Verster & Berthélemy, ).…”

“…In four studies, only a single substance was used as the intervention (Bang et al, ; Lee et al, ; Lee et al, ; Noh et al, ); in the remaining two studies, a compound preparation made of several substances was used (Takahashi et al, ; Verster & Berthélemy, ). The interventions were administered either after alcohol (Lee et al, ), before alcohol (Lee et al, ; Noh et al, ; Takahashi et al, ), or both before and after alcohol ingestion (Bang et al, ; Takahashi et al, ; Verster & Berthélemy, ). In one study, the intervention substrate was given daily for 7 days prior to alcohol consumption (Noh et al, ).…”

Natural Products for the Prevention and Treatment of Hangover and Alcohol Use Disorder

“…A formula (KSS formula) consisting of pith of citrus tangerine, the rhizome of Zingiber officinale, and brown sugar has been traditionally used in China for the treatment of discomfort after excessive alcohol ingestion. In a clinical effectiveness evaluation study, the hangover symptoms such as nausea, vomiting and diarrhea were alleviated after administration of formula in scheduled prophylactic doses [79].…”

“…Mice Amelioration of liver and brain alcohol injuries through decreasing L-γ-glutamyl transpeptidase and butyryl cholinesterase [76] Humans Decreased signs and symptoms of alcohol hangover [79] Essential oil and citral Mice Hepatoprotective property against AFLD by decreasing levels of D-glucurono-6,3-lactone, glycerol-3-phosphate, and pyruvic acid in serum [80] Opuntia ficus-indica Flavones and phenolics Cladode Humans Reduced hangover symptoms by inflammatory mediator production inhibition [88,89] Rats Suppression of liver damage induced by alcohol through ending free radical chain reactions or enhancing the endogenous antioxidant activities [90] Panax ginseng Ginsenosides Root Humans Relief from hangover symptoms through reduced expiratory and plasma alcohol levels and hangover severity [91] Linoleic acid Mice Alleviation of hangover through reduced alcohol and acetaldehyde levels and enhanced ADH and ALDH activities [92] Mice Suppressed alcohol-induced toxicity on male fertility [93] Ricefish Suppressed alcohol-induced toxicity on embryogenesis [94] Mouse embryos Suppressed alcohol-induced toxicity in the neurocranium through its effects on antioxidant activity [95] Rats Suppressed alcohol-induced toxicity in the gastric system via the restoration of heat-shock proteins [96] Hypericum perforatum Hypericin and hyperforin Leave and flowering tops Rats and mice Reduced voluntary alcohol intake in acute and chronic alcohol treatment through neurochemical mechanisms [101,104,105] Rats Attenuated alcohol withdrawal syndrome by inhibition of the effects on tremors and audiogenic seizures [102] Salvia miltiorrhiza…”