대한한의학회지 (The Journal of Korean Medicine)

  • 제31권5호
  • /
  • Pages.41-59
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  • 2010
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  • 1010-0695(pISSN)
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  • 2288-3339(eISSN)
대한한의학회 (The Society of Korean Medicine)
권호 표지

만성 긴장성 두통의 한의학적 진단 및 변증의 가중치에 대한 접근방법 연구

Study about Oriental Medical Diagnosis and Approach Related to Weighting According to Differentiation of Chronic Tension-type Headaches

  • 이기수 (대전대학교 한의과대학 침구학교실) ;
  • 김민정 (대전대학교 한의과대학 침구학교실) ;
  • 박미라 (을지대학교 의과대학 예방의학교실) ;
  • 이상봉 (카톨릭대학교 의과대학 신경과) ;
  • 홍권의 (대전대학교 한의과대학 침구학교실)
  • Lee, Ki-Su (Dept. of Acupuncture and Moxibustion, College of Oriental Medicine, Daejeon University) ;
  • Kim, Min-Jung (Dept. of Acupuncture and Moxibustion, College of Oriental Medicine, Daejeon University) ;
  • Park, Mi-Ra (Dept. of Preventive Medicine, College of Medicine, Eulji University) ;
  • Lee, Sang-Bong (Dept. of Neurology, College of Medicine, Catholic University) ;
  • Hong, Kwon-Eui (Dept. of Acupuncture and Moxibustion, College of Oriental Medicine, Daejeon University)
  • 투고 : 2010.05.18
  • 심사 : 2010.08.24
  • 발행 : 2010.09.30
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초록

Objective: Headache is one of the most common symptoms in primary medical care. The purpose of this study was to support medical treatment by consideration of a new CTTH (chronic tension-type headache) oriental medical diagnosis index. Methods: An Oriental medical diagnosis questionnaire was administered to a CTTH group, migraine group and normal group. The result was classified by using LDA, CART, factor diagnosis and tested in comparison with the original diagnosis. Also, weighting method based on expert opinions was done. Results: 1. The result analyzed by using LDA has an accuracy of 93.9% in comparison with the original diagnosis. 2. High accuracy showed when the test was performed with about 35 significant questions and four questions selected based on SPSS Wilks' lambda. 3. There was accuracy of 90.9% when differentiation was performed by using CART compared with original diagnosis. 4. 10 factors has a high initial value after factor analysis, consisting of questions to the similar differentiation. 5. Diagnosis formula of headache was made by using weighting method based on expert opinions. Conclusion: Oriental medical diagnosis questionnaires make it possible to classify headaches significantly. The study about weighting method of CTTH can make it possible to classify symptoms more accurately.

키워드

참고문헌

  1. Kenneth W, Lindsay, Ian Bone. 임상신경학. 4판. 서울:이퍼블릭코리아. 2006:92-5.
  2. Roh JK, Kim JS, Ahn YO. Epidemiologic and clinical characteristics of migraine and tensiontype headache in Korea. Headache. 1998;38: 356-65. https://doi.org/10.1046/j.1526-4610.1998.3805356.x
  3. Lee TG, Chung KC, Choi JW. Prevalence of migraine in Korean adults. A nation wide survey. Korean J Headache. 2001;1:57-66.
  4. Headache Classification Committee of the International Headache Society. The Inter national Classification of Headache Dis orders. Cephalalgia. 2004;24(1):1-152. https://doi.org/10.1111/j.1468-2982.2004.00711.x
  5. Cerbo R, Barbanti P, Fabbrini G, Paola Pasccali M, Catarci T. Amitriptyline Is Effective in Chronic But Not in Episodic Tension Type Headache:Pathogenetic Implication s. Headache. 1998;38:453-7. https://doi.org/10.1046/j.1526-4610.1998.3806453.x
  6. Bendtsen L, Jensen R, Olesen J. Amitripty line a combined serotonin and noradrena line re-uptake inhibitor reduces exterocep tive suppression of temporal muscle acti vity in patients with chronic tension-type headache. Electroencephalography and Clinical Neurophysiology. 1996;101(5):418-22. https://doi.org/10.1016/0924-980X(96)96532-7
  7. Yoon JW, Moon DE, Yang SY, Park CM. Therapeutic effect of the patients with chronic migraine in pain clinic. Korean J Pain. 2004; 17:146-52. https://doi.org/10.3344/jkps.2004.17.2.146
  8. 박건우. 두통 치료에 있어 항우울제와 항정신병 약제의 역할. 두통. 2005;6(1):34-39.
  9. 양유걸. 황제내경소문해석. 서울:성보사. 1980: 35,96-8.
  10. 전국한의과대학침구학교실. 침구학(하):집문당. 2004:1211.
  11. 朱震亨. 丹溪心法附餘. 서울:大星文化社. 1982: 461-9.
  12. 張機. 仲景全書. 서울:一中社. 1992:557-8.
  13. 李杲. 東垣十種醫學. 서울:大星文化社. 1983:181-5.
  14. 李梴. 醫學入門. 서울:大星文化社. 1981:24-6.
  15. 허준. 東醫寶鑑. 서울:남산당. 1976:203-8,378-93.
  16. Detsky M, McDonald D, Baerlocher M, Tomlinson G, McCrory D, Booth C. Does this patient with headache have a migraine or need neuroimaging? JAMA. 2006;296:1274-83. https://doi.org/10.1001/jama.296.10.1274
  17. Osterhaus JT, Townsend RJ, Gandek B, Ware JE Jr. Measuring the functional status and well-being of patients with migraine headache. Headache. 1994;34:337-343. https://doi.org/10.1111/j.1526-4610.1994.hed3406337.x
  18. Anderson RT, Aaronson NK, Wilkin D. Critical review of the international assessments of health-related quality of life. Qual Life Res. 1993;2:369-395. https://doi.org/10.1007/BF00422215
  19. Jacobson GP, Ramadan NM, Norris L, Newman CW. Headache disability inven tory (HDI): short-term test-retest reliabi lity and spouse perceptions. Headache 1995;35:534-539. https://doi.org/10.1111/j.1526-4610.1995.hed3509534.x
  20. Stewart WF, Lipton RB, Whyte J, Dowson A, Kolodner K, Liberman JN, et al. An international study to assess reliability of the Migraine Disability Assessment (MIDAS) score. Neurology 1999;53:988-994. https://doi.org/10.1212/WNL.53.5.988
  21. Lee HS, Chung CS, Song HJ, Park HS. The reliability and validity of the MIDAS (Migraine Disability Assess ment) questionnaire for Korean migraine Sufferers. J Korean Neurol Assoc 2000; 18:287-291.
  22. Wagner TH, Patrick DL, Galer BS, Berzon RA. A new instrument to assess the long-term quality of life effects from migraine:development and psychometric testing of the MSQOL. Headache 1996;36:484-492. https://doi.org/10.1046/j.1526-4610.1996.3608484.x
  23. 羅天益. 衛生寶鑑. 常務印書館. 1981:118,124.
  24. 장은하. 두통. 북경:중국중의약출판서. 1997:14-22.
  25. 장삼쇄. 醫學準繩六要(醫部全錄中). 태북:신문충출판공사. 1981.
  26. 황의원 외. 한방신경정신의학. 서울:집문당. 2006: 156-161.
  27. 全國韓醫科大學心系內科學敎室. 心系內科學. 서울:書苑堂. 1999:302, 379-388.
  28. 傳統醫學硏究所. 東洋醫學大辭典. 서울:成輔社. 2000.
  29. Spierings EL, Ranke AH, Schroevers M , Honkoop PC. Chronic daily headache: A time perspective. Headache. 2000;40(4):306-10. https://doi.org/10.1046/j.1526-4610.2000.00045.x
  30. Castillo J, Munoz P, Guitera V, Pascual J: Epidemiology of chronic daily headache in the general population. Headache 1999;39:190-6. https://doi.org/10.1046/j.1526-4610.1999.3903190.x
  31. Abbass A, Lovas D, Purdy A. Direct diagnosis and management of emotional factors in chronic headache patients. Cephalogia 2008;28:1305-14. https://doi.org/10.1111/j.1468-2982.2008.01680.x
  32. Ostergaard S, Russell MB, Bendtsen L, Olesen J. Comparison of first degree relatives and spouses of people with chronic tension headache. BMJ. 1997;14:1092-1093.
  33. Russell MB, Iselius L, Ostergaard S, Olesen J. Inheritance of chronic tension- tension type headache investigated by complex segregation analysis. Hum Gen et 1998;102:138-140. https://doi.org/10.1007/s004390050666
  34. Pielsticker A, Haag G, Zaudig M, Lautenbacher S. Impairm ent of pain inhibition in chronic tension type headache. pain 2005;118:215-223. https://doi.org/10.1016/j.pain.2005.08.019
  35. Ashina M, Bendtsen L, Jensen R, Sak ai F, Olesen J. Muscle hardness in patients with chronic tension type headache. relati on to actual headache state. pain. 1999;79:201-5. https://doi.org/10.1016/S0304-3959(98)00167-5
  36. Fernandez-de-las-Penas C, you Ge H, Arendt- Nielsen L, Luz Cuadrado M, Juan A. Pareja. Referred pain from trapezius muscle trigger points shares similar characteristics with chronic tension type headache. European Journal of Pain. 2007;11:475-82. https://doi.org/10.1016/j.ejpain.2006.07.005
  37. Padberg M, de Bruijn SF, De Haan RJ, Tavy DLJ. Treatment of chronic tension type headache with botulinum toxin: a double-blind, placebocontrolled clinical trial. Cephalagia. 2004;24: 675-80. https://doi.org/10.1111/j.1468-2982.2004.00738.x
  38. Silberstein SD, Göbel H, Jensen R, Elkind AH, DeGryse R, Walcott JMCM, et al. Botulinum toxin type A in the prophylactic treatment of chronic tensio n type headache. a multicenter, double -blind, randomized, placebo-controlled, parallel-group study. Cephalagia. 2006;26:790- 800. https://doi.org/10.1111/j.1468-2982.2006.01114.x
  39. Choi WJ, Chung JY, Lee DI, Shin OY, Kim DS.Comparison of Effectiveness of Stellate Ganglion Block between Chron ic Tension Headache and Chronic Migraine Patients. Korean J Anesthes iol. 2006;51(2):201-6. https://doi.org/10.4097/kjae.2006.51.2.201
  40. 송찬우, 김정원. 만성두통환자 치료에 통증유발 점 치료 및 제 2경추신경 차단술의 효과. 대한통 증학회지. 1995;8(2):272-8.
  41. Park JW, Kim JS, Kim YI, Lee KS. Genetically Determined Serotoner gic Activity Contributes to Development of Analgesics Overuse in Chronic Tension Type Headache. J Korean Neurol Assoc. 2005;23(2):186-91.
  42. Rauchfuss E, Bohland W, Sauer D. Stell ate block in diseases in the area of the upper limb. Zentralbl chir 1971;96:851-64.
  43. Malmqvist E L , engtsson M B, Soren sen J. E fficacy of stellate ganglion block: A clinical study with bupivacaine. Reg Anesth 1992;17: 340-7.
  44. Bonica JJ. The management of pain. Philadelphia, Lea & Febiger. 1990;1941-4.
  45. 박찬홍, 빌리허. 만성 후두통을 영구적 후두신경 자극기로 치료한 경험. 대한통증학회지;21(2): 155-158. https://doi.org/10.3344/kjp.2008.21.2.155
  46. Kwak BM, Kim MJ, Kim YM, Park YC, Jo JH, Jeong IC, et al. Persisting effects of acupuncture method for chronic tension-type headache ; a randomized controlled trial. The journal of korean acupuncture and moxibustion society. 2008;25(2):165-77.
  47. Kim MJ, Lee KS, Kwak BM, Lee EK, Choi EH, Park YC, et al. Clinical characteristic and Roentgenographic finding of the cervical spine in chronic tension-type headache. The journal of korean acupuncture and moxibustion society. 2009;26(2):59-70.
  48. Lee IS, Cho YJ, Cho HS, Kim KK. Astudy on weighting pathogenic factor for Oriental OB and GY questionnaires. The journal of oriental obstetrics and gynecology. 2005;18(4):119-35.
  49. Moon JS, Kang BK, Kang KW, Choi SM. Weighting method based on experts opinions for obesity syndrome differentiation questionnaire. Journal of society of korean medicine for obesity research. 2008;8(1):51-61.