The Journal of Korean Medicine (대한한의학회지)

The Society of Korean Medicine (대한한의학회)
권호 표지
DOI QR코드

DOI QR Code

E-mail survey on the current status of clinical practice and activation measures for Korean medicine in stroke care

한의 중풍 진료 현황 파악 및 활성화 방안 모색을 위한 전자우편 설문조사

  • Kim, Mikyung (Clinical research division, Korea Institute of Oriental Medicine) ;
  • Han, Chang-ho (Department of internal medicine, College of Korean medicine, Dongguk University)
  • 김미경 (한국한의학연구원 임상연구부) ;
  • 한창호 (동국대학교 한의과대학 내과학교실)
  • Received : 2017.09.01
  • Accepted : 2017.09.18
  • Published : 2017.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives: The aim of this study was to investigate the current status of and seek for measures to activate Korean medicine in stroke care. Methods: This is an e-mail survey targeting the members of Korean medical doctors registered at the association of Korean medicine. The project team of the society of stroke on Korean medicine for the development of clinical practice guideline for stroke has devised the items for the questionnaire. The survey was conducted for 15 days in November 2016. Results: The percentage of the respondents who have treated patients with stroke for the past month was 11.2% in the acute phase, 20.5% in the convalescent phase, and 32.4% in the chronic phase. Approximately 80% of the respondents answered they had a decrease in the number of patients compared to 10 years ago, regardless of the stroke phase. Most of the respondents were using Western medicine together with traditional Korean medicine for physical examination. Acupuncture and herbal medicine were the main therapeutic interventions. The two measures chosen by the most respondents to activate the Korean medicine usage for stroke care were the expansion of the insurance coverage (34.9%) and the generation of evidence on the effectiveness of traditional Korean medicine (25.1%) Conclusion: It is necessary to actively show the role of the Korean medicine through the establishment of the evidence on the effectiveness of Korean medicine and the promotion based on the evidence. In addition, optimal treatment methods should be derived based on the traditional knowledge and modern scientific research and the methods should be educated to every Korean medical clinics and hospitals so that they can be implemented in clinical practice. At the same time, the government should provide policy support to ensure that the optimal treatment can be timely and appropriately implemented.

Keywords

References

  1. Association of Korean medicine professors for cardiovascular and neurological medicine. Cardiovascular and Neurological Medicine in Korean Medicine. Seoul:Wooripub. 2016:243.
  2. Feigin VL, Forouzanfar MH, Krishnamurthi R, et al. Global and regional burden of stroke during 1990-2010: findings from the Global Burden of Disease Study 2010. The Lancet. 2014;383(9913):245-55. https://doi.org/10.1016/S0140-6736(13)61953-4
  3. Statistics Korea. Cause-of-death statistics 2015 (summary). 2016 Sep 27;[cited 2016 Dec 27]. Available at: URL:https://kostat.go.kr/portal/korea/kor_nw/2/6/2/index.board?bmode=read&bSeq=&aSeq=356345&pageNo=1&rowNum=10&navCount=10&currPg=&sTarget=title&sTxt=.
  4. World Health Organization. The Top 10 Causes of Death. 2014 May;[cited 2016 Dec 27]. Available at: URL:http://www.who.int/mediacentre/factsheets/fs310/en/.
  5. Clinical research center for stroke. Korean Clinical Practice Guidelines for Stroke (revised edition). 2013 Feb;[cited 2016 Dec 27]. Available at: URL: http://www.stroke-crc.or.kr/%EB%87%8C%EC%A1%B8%EC%A4%91%EC%A7%84%EB%A3%8C%EC%A7%80%EC%B9%A8%2020130322.pdf.
  6. Health insurance review & assessment service. National health insurance statistics index 2006. 2015 July;[cited 2016 Dec 27]. Available at: URL:http://opendata.hira.or.kr/op/opc/selectStcPblc.do?sno=10437&odPblcTpCd=001&searchCnd=&searchWrd=&pageIndex=1.
  7. Health insurance review & assessment service. Medical expenses statistics index 2011. 2015 July;[cited 2016 Dec 27]. Available at: URL: http://opendata.hira.or.kr/op/opc/selectStcPblc.do?sno=10408&odPblcTpCd=001&searchCnd=&searchWrd=&pageIndex=1.
  8. Health insurance review & assessment service. Medical expenses statistics index 2015. 2016 Feb;[cited 2016 Dec 27]. Available at: URL: http://opendata.hira.or.kr/op/opc/selectStcPblc.do?sno=10900&odPblcTpCd=001&searchCnd=&searchWrd=&pageIndex=1.
  9. Korea health industry development institution. Healthcare workforce-number of licensed Korean medical doctors. 2015 Dec 23;[cited 2016 Dec 27]. Available at: URL: https://www.khiss.go.kr/khidi/themestat/sublistThemeSubjectstat.jsp?htxt_code=12599056317038554276471450314736&uplist_id=358_E&list_id=358_EB.
  10. Ministry of Health and Welfare. Survey on Korean medicine use and consumption 2014. 2011 Dec 7;[cited 2016 Dec 27]. Available at: URL:http://www.prism.go.kr/homepage/theme/retrieveThemeDetail.do;jsessionid=8C0E78708F3DAB1DD75E9C6186430BE8.node02?cond_research_name=&cond_organ_id=&cond_research_year_start=&cond_research_year_end=&cond_brm_super_id=NB000120061201100060495&research_id=1351000-201100127&pageIndex=6&leftMenuLevel=110.
  11. Bak YH, Huang DS, Shin HK. A Survey of the Medical Treatment Environment in Traditional Korean Medicine Clinics. Journal of Korean Oriental Medicine. 2011;32(4):25-36.
  12. Korea health industry development institution. Health industry white paper 2014. 2015 Sep 21;[cited 2016 Dec 27]. Available at: URL: http://khiss.go.kr/board/bbs_read.jsp?tname=MINBOARD358&bbsid=B301&cat_bbsid=B307&bbs_seq=420&jkey=&jword=&pg=1&htxt_code=13789506829741518083358661986895&wj_vcs=&reverseNum=19&forwardNum=1.
  13. Shin HK. Clinical study on CVA patients in Hospital attached to college of oriental medicine and NMC department oriental medicine. Korean Journal of Oriental Medicine. 1995;1(1):1-14.
  14. Zhou L, Chen Y, Liu J, et al. Evaluating the implementation of evidence-based TCM Clinical Practice Guidelines for Cerebral Infarction. European Journal of Integrative Medicine. 2014;6(2):147-55. https://doi.org/10.1016/j.eujim.2014.03.006
  15. Ko MM, Lee JA, Cha MH, et al. Stroke in Traditional Korean Medicine: A Nine-Year Multicentre Community-Based Study in South Korea. Scientific Reports. 2016;6:28286. https://doi.org/10.1038/srep28286
  16. Chang CC, Lee YC, Lin CC, et al. Characteristics of traditional Chinese medicine usage in patients with stroke in Taiwan: a nationwide population-based study. Journal of ethnopharmacology. 2016;186:311-21. https://doi.org/10.1016/j.jep.2016.04.018
  17. Yam W, Wilkinson JM. Is acupuncture an acceptable option in stroke rehabilitation? A survey of stroke patients. Complementary therapies in medicine. 2010;18(3):143-9. https://doi.org/10.1016/j.ctim.2010.05.033
  18. Liao CC, Lin JG, Tsai CC, et al. An investigation of the use of traditional Chinese medicine in stroke patients in Taiwan. Evidence-Based Complementary and Alternative Medicine. 2012;2012:387164.
  19. Chang CC, Chen TL, Chiu HE, et al. Outcomes after stroke in patients receiving adjuvant therapy with traditional Chinese medicine: A nationwide matched interventional cohort study. Journal of ethnopharmacology. 2016;177:46-52.. https://doi.org/10.1016/j.jep.2015.11.028
  20. Chen L, Fang J, Ma R, et al. Additional effects of acupuncture on early comprehensive rehabilitation in patients with mild to moderate acute ischemic stroke: a multicenter randomized controlled trial. BMC Complementary and Alternative Medicine. 2016;16(1):226. https://doi.org/10.1186/s12906-016-1193-y
  21. Fang J, Chen L, Ma R, et al. Comprehensive rehabilitation with integrative medicine for subacute stroke: A multicenter randomized controlled trial. Scientific Reports. 2016;6:25850. https://doi.org/10.1038/srep25850
  22. Liu AJ, Li JH, Li HQ, et al. Electroacupuncture for acute ischemic stroke: a meta-analysis of randomized controlled trials. The American journal of Chinese medicine. 2015;43(08):1541-66. https://doi.org/10.1142/S0192415X15500883
  23. Zhang T, Zhang L, Zhang HM, et al. Systematic review of acupuncture therapy for acute ischemic stroke. China Journal of Traditional Chinese Medicine and Pharmacy. 2009;24(1):101-4.
  24. Vados L, Ferreira A, Zhao S, et al. Effectiveness of acupuncture combined with rehabilitation for treatment of acute or subacute stroke: a systematic review. Acupuncture in Medicine. 2015;33(3):180-7. https://doi.org/10.1136/acupmed-2014-010705
  25. Zhang X, Liu XT, Kang DY. GRADE in Systematic Reviews of Acupuncture for Stroke Rehabilitation: Recommendations based on High-Quality Evidence. Scientific Reports. 2015;5:16582. https://doi.org/10.1038/srep16582
  26. Yang A, Wu HM, Tnag JL, et al. Acupuncture for stroke rehabilitation, Cochrane Database of Systematic Reviews. Cochrane Database of Systematic Reviews. 2016;26(8):CD004131.
  27. Zhang JH, Wang D, Liu M. Overview of systematic reviews and meta-analyses of acupuncture for stroke. Neuroepidemiology. 2013;42(1):50-8. https://doi.org/10.1159/000355435
  28. Zhang S, Liu M, Asplund K, et al. Acupuncture for acute stroke. Cochrane Database of Systematic Reviews. 2005;18(2):CD003317.
  29. Zhang S, Wu B, Liu M, et al. Acupuncture efficacy on ischemic stroke recovery multicenter randomized controlled trial in China. Stroke. 2015;46(5):1301-6. https://doi.org/10.1161/STROKEAHA.114.007659
  30. Shih CC, Liao CC, Sun MF, et al. A retrospective cohort study comparing stroke recurrence rate in ischemic stroke patients with and without acupuncture treatment. Medicine. 2015;94(39):e1572. https://doi.org/10.1097/MD.0000000000001572
  31. Chuang SF, Shih CC, Yeh CC, et al. Decreased risk of acute myocardial infarction in stroke patients receiving acupuncture treatment: a nationwide matched retrospective cohort study. BMC complementary and alternative medicine. 2015;15:318. https://doi.org/10.1186/s12906-015-0828-8
  32. Wei YX, Zhao X, Zhang BC. Synergistic effect of moxibustion and rehabilitation training in functional recovery of post-stroke spastic hemiplegia. Complementary therapies in medicine. 2016;26:55-60. https://doi.org/10.1016/j.ctim.2016.02.014
  33. Kuang AK, Wang CX, Zhao GS, et al. Long-term observation on qigong in prevention of stroke--follow-up of 244 hypertensive patients for 18-22 years. Journal of traditional Chinese medicine. 1986;6(4):235-8.
  34. Han CH. Clinical Practice Guideline of Korean Medicine for Stroke: Preliminary Guideline and Recommendation. Korean Journal of Oriental Internal Medicine. 2012;33(4):347-66.
  35. Lee MS, Shin BC, Kim JI, et al. Moxibustion for stroke rehabilitation systematic review. Stroke. 2010;41(4):817-20. https://doi.org/10.1161/STROKEAHA.109.566851
  36. Lee MS, Choi TY, Shin BC, et al. Cupping for stroke rehabilitation: a systematic review. Journal of the neurological sciences. 2010;294(1):70-3. https://doi.org/10.1016/j.jns.2010.03.033
  37. Blunt SB, Lee HP. Can traditional "cupping" treatment cause a stroke? Medical hypotheses. 2010;74(5):945-9. https://doi.org/10.1016/j.mehy.2009.11.037
  38. Leung K, Yan T, Li L. Intracerebral haemorrhage and Qigong, Hong Kong medical journal. 2001;7(3):315-8.
  39. Liu CH, Hsieh YT, Tseng HP, et al. Acupuncture for a first episode of acute ischaemic stroke: an observer-blinded randomised controlled pilot study. Acupuncture in Medicine. 2016;34(5):349-55. https://doi.org/10.1136/acupmed-2015-010825
  40. Wang C, Wu Z, Li N, et al. Clinical curative effect of electric acupuncture on acute cerebral infarction: a randomized controlled multicenter trial. Journal of Traditional Chinese Medicine. 2014;34(6):635-40. https://doi.org/10.1016/S0254-6272(15)30075-3
  41. Gonzalez-Fraile E, Martín-Carrasco M, Ballesteros J. Efficacy of MLC601 on functional recovery after stroke: A systematic review and meta -analysis of randomized controlled trials. Brain injury. 2016;30(3):267-70. https://doi.org/10.3109/02699052.2015.1118764

Cited by

  1. Development of an Evidence-Based Clinical Practice Guideline of Korean Medicine for Stroke: A Study Protocol vol.39, pp.4, 2018, https://doi.org/10.13048/jkm.18032
  2. 뇌혈관질환에 대한 다빈도 처방 한약의 임상적 유효성 : 후향적 연구 vol.40, pp.6, 2017, https://doi.org/10.22246/jikm.2019.40.6.1063
  3. 뇌졸중의 약침 치료에 대한 메타분석의 통합적 고찰 vol.40, pp.6, 2019, https://doi.org/10.22246/jikm.2019.40.6.1081
  4. 뇌졸중의 추나요법에 대한 체계적 문헌 고찰 vol.14, pp.2, 2017, https://doi.org/10.30581/jkcmm.2019.14.2.15