대한중풍순환신경학회지 (The Journal of the Society of Stroke on Korean Medicine)

  • 제24권1호
  • /
  • Pages.25-40
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  • 2023
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  • 2466-0248(pISSN)
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  • 2466-0272(eISSN)
대한중풍순환신경학회 (The Society of Stroke on Korean Medicine)
권호 표지

동측 반맹 및 시력저하를 호소하는 후두엽 및 측두엽 뇌출혈 환자 한의복합치료 1례

A Case of Combined Korean Medicine Treatment for Homonymous Hemianopia and Loss of Visual Acuity after hemorrhagic Stroke

  • 성시윤 (경희대학교 대학원 임상한의학과) ;
  • 이다빈 (경희대학교 대학원 임상한의학과) ;
  • 이영선 (경희대학교 대학원 임상한의학과) ;
  • 조기호 (경희대학교 대학원 임상한의학과) ;
  • 문상관 (경희대학교 대학원 임상한의학과) ;
  • 정우상 (경희대학교 대학원 임상한의학과) ;
  • 권승원 (경희대학교 대학원 임상한의학과) ;
  • 이한결 (경희대학교 한의과대학 순환신경내과학교실)
  • Si Yun Sung (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Dabin Lee (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Youngseon Lee (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Ki-Ho Cho (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Sang-Kwan Moon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Woo-Sang Jung (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Seungwon Kwon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Han-Gyul Lee (Dept. of Cardiology and Neurology, College of Korean medicine, Kyung-Hee University)
  • 발행 : 2023.12.01
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초록

Background: Although not clarified, the overall prevalence of visual field loss after stroke was estimated at 52% of stroke survivors and for visual acuity loss, at 70% of them. Among visual field loss patients after stroke, homonymous hemianopia is the most common symptom. Visual defect degrades the quality of life by disrupting independent life and affecting the survival of the patients, but highly-evidenced treatment has not been found until now. ■Case report A 51-year-old female with left-side homonymous hemianopia and central vision loss by a right occipital-temporal hemorrhage was treated with Hyeolbuchukeo-tang, Ikgibohyeol-tang, acupuncture, electroacupuncture, and moxibustion. We used a confrontation visual field exam, automated perimetry and visual analog scale, and visual acuity test to observe changes in the patient's symptoms and evaluate the efficacy of the treatment. After 61 days of such interventions, the patient's subjective discomfort lessened, followed by positive changes in the scales of tests mentioned above. ■Conclusion This case suggests that combined Korean medicine treatment might be an effective tool for treating post-stroke homonymous hemianopia and central vision loss. More studies should be conducted to support the effectiveness of the treatment.

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참고문헌

  1. Rowe FJ, Hepworth LR, Howard C, Hanna KL, Cheyne CP, Currie J. High incidence and prevalence of visual problems after acute stroke: An epidemiology study with implications for service delivery. PLoS One. 2019 Mar 6;14(3):e0213035. 
  2. Hepworth LR, Rowe FJ, Walker MF, Rockliffe J, Noonan C, Howard C, et al. Post-stroke visual impairment: A systematic literature review of types and recovery of visual conditions. Ophthalmology Research. 2016;5 10.9734/OR/2016/21767 
  3. Freeman CF, Rudge NB. The orthoptist's role in the management of stroke patients. 6th International Orthoptic Congress. 1987:333-337. 
  4. Edwards DF, Hahn MG, Baum CM, Perlmutter MS, Sheedy C, Dromerick AW. Screening patients with stroke for rehabilitation needs: Validation of the post-stroke rehabilitation guidelines. Neurorehabilitation and Neural Repair.2006;20:42-48 10.1177/1545968305283038. 
  5. Rowe FJ, Wright D, Brand D, Jackson C, Harrison S, Maan T, et al. A prospective profile of visual field loss following stroke: Prevalence, type, rehabilitation and outcome. BioMed Research International. 2013;2013 10.1155/2013/719096 
  6. Sand KM, Wilhelmsen G, Naess H, et al. Vision problems inischaemic stroke patients: effects on life quality and disability. Eur JNeurol 2016;23:1-7.  https://doi.org/10.1111/ene.12848
  7. Ali M, Hazelton C, Lyden P, Pollock A, Brady M; VISTA Collaboration. Recovery from poststroke visual impairment: evidence from a clinical trials resource. Neurorehabil Neural Repair 2013:Feb;27(2):133-41.  https://doi.org/10.1177/1545968312454683
  8. Sabel BA, Kasten E. Restoration of vision by training of residual functions. Current Opinion in Ophthalmology 2000; 11:430-436.  https://doi.org/10.1097/00055735-200012000-00008
  9. Jung MH et al. A Case Series of Post-stroke Vision Disorders Using Korean Medical Treatment. The Journal of Internal Korean Medicine 2018;39(2):217-23.  https://doi.org/10.22246/jikm.2018.39.2.217
  10. Jin C et al. A case report of a cerebral infarction patient with homonymous hemianopsia treated by traditional Korean Medicine. The Journal of Internal Korean Medicine 2012:287-91. 
  11. Kim GY et al. A Case of Combined Korean Medicine Treatment for Homonymous Hemianopia and Prosopagnosia after Ischemic Stroke. The Journal of the Society of Stroke on Korean Medicine 2021;22(1):21-30 
  12. Jeong SH et al. A Case of homonymous Hemianopia after Occipital-Parietal Lobe Hemorrhage Treated with Combined Korean Medical Treatment. The Journal of the Society of Stroke on Korean Medicine 2022; 23(1):65-72 
  13. Won Jung Ha et al., Clinical Effectiveness of Ikgibohyeol-tang(Yiqibuxue-tang) and Deer Antler on Fatigue Symptoms and HRV Results in Outpatients at Korean Medical Hospital: A Retrospective Chart Review Study. J Korean Med. 2022;43(3):139-149.  https://doi.org/10.13048/jkm.22036
  14. Wang Y, Zhang XB, Xiao W, Wang Z, Kong HB, Wang J, Jiang LS, Yan LG, Guo XL. Effect of nape cluster-acupuncture treatment on brain microcirculation in ischemic stroke rats. Zhen Ci Yan Jiu. 2013 Jun;38(3):220-3. Chinese. 
  15. Ratmansky M, Levy A, Messinger A, Birg A, Front L, Treger I. The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial. J Altern Complement Med. 2016 Jan;22(1):33-7.  https://doi.org/10.1089/acm.2015.0066
  16. NishinakaA, Nitta K, Seki T, Hara H, ShimazawaM. The Changes in Blood Flow Seen in the Eye after Foot Acupuncture Treatment in Mice. Evid Based Complement Alternat Med. 2020 Apr 6;2020:6405471. 
  17. Shu Q, Wang H, Litscher D, Wu S, Chen L, Gaischek I, Wang L, He W, Zhou H, Litscher G, Liang F. Acupuncture and Moxibustion have Different Effects on Fatigue by Regulating the Autonomic Nervous System: A Pilot Controlled Clinical Trial. Sci Rep. 2016 Nov 25;6:37846. 
  18. Flammer J. Automatisierte Perimetrie [Automated perimetry]. Ther Umsch. 1990 Apr;47(4):298-302. 
  19. Iutaka NA, Grochowski RA, Kasahara N. Correlation between Visual Field Index and Other Functional and Structural Measures in Glaucoma Patients and Suspects. J Ophthalmic Vis Res. 2017 Jan-Mar;12(1):53-57.  https://doi.org/10.4103/jovr.jovr_98_16
  20. Ruia S, Tripathy K. Humphrey Visual Field. [Updated 2023 Jul 31]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK585112/ 
  21. Aggarwal A, Chhabra K, Kaur P, Singh K, Khosa I, Bansal P. Automated achromatic perimetry. Oman J Ophthalmol. 2018 JanApr;11(1):3-10. 
  22. Johnson LN, Baloh FG. The accuracy of confrontation visual field test in comparison with automated perimetry J Natl Med Assoc. 1991 Oct; 83(10): 895-898. 
  23. Pambakian ALM, Kennard C. Can visual function be restored in patients with homonymous hemianopia? British Journal of Ophthalmology. 1997;81(4):324-328.  https://doi.org/10.1136/bjo.81.4.324
  24. Pollock A, Hazelton C, Henderson CA, Angilley J, Dhillon B, Langhorne P, et al. Interventions for visual field defects in patients with stroke. Stroke 2012:43(4):e37-e38.  https://doi.org/10.1161/STROKEAHA.111.639815
  25. Gall C, Franke GH, Sabel BA. Vision-related quality of life in first stroke patients with homonymous visual field defects. Health and Quality of Life Outcomes. 2010;8, article 33. 
  26. Racette L, Casson EJ. The impact of visual field loss on driving performance: evidence from on-road driving assessments. Optometry and Vision Science. 2005;82(8):668-674.  https://doi.org/10.1097/01.opx.0000174719.25799.37
  27. Ramrattan RS, Wolfs RCW, Panda-Jonas S, et al. Prevalence and causes of visual field loss in the elderly and associations with impairment in daily functioning: the Rotterdam Study. Archives of Ophthalmology. 2001;119(12):1788-1794.  https://doi.org/10.1001/archopht.119.12.1788
  28. Bowers AR, Keeney K, Peli E. Community-based trial of a peripheral prism visual field expansion device for hemianopia. Arch Ophthalmol. 2008 May;126(5):657-664.  https://doi.org/10.1001/archopht.126.5.657
  29. Pambakian AL, Mannan SK, Hodgson TL, Kennard C. Saccadic visual search training: a treatment for patients with homonymous hemianopia. J Neurol Neurosurg Psychiatry. 2004 Oct;75(10):1443-1448.  https://doi.org/10.1136/jnnp.2003.025957
  30. Choi WW, Lee K, Lee BJ, Park SU, Park JM, Ko CN, Bu Y. The Effects of Chunghyul-Dan, an Agent of Korean Medicine, on a Mouse Model of Traumatic Brain Injury. Evid Based Complement Alternat Med. 2017;2017:7326107. 
  31. Jung WS, Min IK, Jin C, et al. Inhibitory Effect of Chunghyul-dan on Stroke Recurrence in Small Vessel Disease Patients: A 5-Year Observational Study. J Evid Based Integr Med. 2018;23:2515690X18789374. 
  32. SK Moon, MH Jung, SW Kwon et al. Effect of Geopungchunghyul-dan on Circumferential Strain of Carotid Artery: A Case Series. J Korean Med. 2018;39(1):86-94.  https://doi.org/10.13048/jkm.18009
  33. Park TH, Lee HG, Cho SY, Park SU, Jung WS, Park JM, Ko CN, Cho KH, Kwon S, Moon SK. A Comparative Study on the Neuroprotective Effect of Geopung-Chunghyuldan on In Vitro Oxygen-Glucose Deprivation and In Vivo Permanent Middle Cerebral Artery Occlusion Models. Pharmaceuticals (Basel). 2023 Apr 15;16(4):596. 
  34. Min KY et al. Anticoagulant effects of Hyulbuchookau-tang in vitro. J Int Korean Med. 2009;30 (110): 79-90. 
  35. Lee MS, Roh SS, Lim RH, Song HC, Shin SS, Kim SH. Antithrombotic Activity and Protective Effects of hexane fraction of Kamihyulbuchukeotang (KHBCT) on brain injury by KCN and MCA occlusion. Kor J Pharmacongn 2000:31(4):373-382. 
  36. Cho EH et al. Neuroprotective Effects of Hyulbuchookau-tang(血府逐瘀湯) on Global Cerebral Ischemia of the Rats. J Korean Med. 2007; 28(2), 44-53. 
  37. Cho EH. "Effects of Hyulbuchookau-tang(血府逐瘀湯) on Global Cerebral Ischemia of the Rats." Dongui University, 2006. Busan. 
  38. Kim Y et ak. Effects of Hyulboochucke-tang on the Collagenase-Induced Intracerebral Hemorrhage in Rats. J. Korean Med. Rehabilitation. 2016; 26(1): 1-11.  https://doi.org/10.18325/jkmr.2016.26.1.1
  39. Jeong HW, Kim HS, Yang GH. Mechanism of Jaeumgenby-tang on the Regional Cerebral Blood Flow, Mean Arterial BloodPressure and Cardiac Muscle Contractile Force in Rats. Journal of Physiology &Pathology in Korean Medicine 2002;16(3):507-13. 
  40. Choi IS, Kwon JN, Kim YK. Neurological Effects of Bojungikki-tang and ojungikki-tang-gamibang on Focal Cerebral Ischemia of the MCAO Rats. The Journal of Korean Medicine 2009;30(6):53-68. 
  41. Lu L et al. Acupuncture for neurogenesis in experimental ischemic stroke : a systematic review and meta-analysis. Nature Publishing Group 2016;6:1952. 
  42. Lee SH et al. Effect of Seven Points of CVA Acupuncture on Cerebral Blood Flow. Journal of Korean Acupuncture & Moxibustion Society 2004;21(3):83-97. 
  43. Park SU, Shin AS, Jahng GH, Moon SK, Park JM. Effects of scalp acupuncture versus upper and lower limb acupuncture on signal activation of blood oxygen level dependent (BOLD) fMRI of the brain and somatosensory cortex. J Altern Complement Med. 2009 Nov;15(11):1193-200.  https://doi.org/10.1089/acm.2008.0602
  44. Ratmansky M, Levy A, Messinger A, Birg A, Front L, Treger I. The Effects of Acupuncture on Cerebral Blood Flow in Post-Stroke Patients: A Randomized Controlled Trial. J Altern Complement Med. 2016 Jan;22(1):33-37.  https://doi.org/10.1089/acm.2015.0066
  45. Wang Y, Zhang XB, Xiao W, Wang Z, Kong HB, Wang J, Jiang LS, Yan LG, Guo XL. Effect of nape cluster-acupuncture treatment on brain microcirculation in ischemic stroke rats. Zhen Ci Yan Jiu. 2013 Jun;38(3):220-223. 
  46. Bittner AK, Seger K, SalvesonR, KayserS, Morrison N, Vargas P, Mendelsohn D, Han J, Bi H, DagnelieG, BenaventeA, Ramella-Roman J. Randomized controlled trial of electro-stimulation therapies to modulate retinal blood flow and visual function in retinitis pigmentosa. Acta Ophthalmol. 2018 May;96(3):e366-e376.  https://doi.org/10.1111/aos.13581
  47. Li, G., Cheung, R. T., Ma, Q. Y., & Yang, E. S. (2003). Visual cortical activations on fMRI upon stimulation of the vision-implicated acupoints. Neuroreport, 14(5), 669-673.  https://doi.org/10.1097/00001756-200304150-00002
  48. Zhang Y, Liang J, Qin W, Liu P, von Deneen KM, Chen P, Bai L, Tian J, Liu Y. Comparison of visual cortical activations induced by electro-acupuncture at vision and nonvision-related acupoints. NeurosciLett. 2009 Jul 10;458(1):6-10. https://doi.org/10.1016/j.neulet.2009.04.027