DOI QR코드

DOI QR Code

경추부 및 하악부 약침 치료를 포함한 한의복합치료로 호전된 만성 메니에르병 환자 1례 - 증례 보고

A Case of Chronic Meniere's Disease Improved by Korean Medicine Treatment Including Pharmacoacupuncture of Cervical and Temporomandibular Area - A Case Report

  • 김동주 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 허경화 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 이경화 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 이혜진 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 조승연 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박정미 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 고창남 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박성욱 (경희대학교 대학원 한방순환신경내과학교실)
  • Dong-Joo Kim (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Kyeong-Hwa Heo (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Kyeong-Hwa Lee (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Hye-Jin Lee (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Seung-Yeon Cho (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Jung-Mi Park (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Chang-Nam Ko (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Seong-Uk Park (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 투고 : 2023.07.20
  • 심사 : 2023.08.22
  • 발행 : 2023.09.01

초록

Meniere's disease is characterized by episodic vertigo, fluctuating hearing loss, tinnitus and ear fullness. The main pathological finding is endolymphatic hydrops, but the etiology of disease and effective treatment methods are still disputed. Recently, Cervical spine disorders(CSD) and Temporomandibular disorders(TMD) have been attracting attention as one of the causes of Meniere's disease. A 65-year-old female Meniere patient with musculoskeletal problems in the cervical and mandible area was treated by Korean medical therapies including pharmacoacupuncture treatment. After 5 weeks of treatment, there was no meaningful change in hearing level evaluated with pure tone audiometry, but the subjective symptoms of Meniere improved significantly. Numerical rating scale (NRS) decreased from 10 to 0 for hearing loss, 10 to 3 for tinnitus and 8 to 3 for ear fullness. Also NRS of cervicalgia was reduced from 5 to 0 after treatment. The result suggests that the Korean medical therapy including pharmacoapuncture targeting CSD and TMD could be safe and effective method for patients with Meniere's disease.

키워드

참고문헌

  1. Espinosa-Sanchez, J. & Lopez-Escamez, J. (2016). Meniere's disease. Handbook of clinical neurology. 137(257-277) https://doi.org/10.1016/B978-0-444-63437-5.00019-4
  2. Rauch, S. D.Merchant, S. N. & Thedinger, B. A. (1989). Meniere's syndrome and endolymphatic hydrops: Double-blind temporal bone study. Annals of Otology, Rhinology & Laryngology. 98(11). 873-883. https://doi.org/10.1177/000348948909801108
  3. Okuno, T. & Sando, I. (1987). Localization, frequency, and severity of endolymphatic hydrops and the pathology of the labyrinthine membrane in meniere's disease. Annals of Otology, Rhinology & Laryngology. 96(4). 438-445. https://doi.org/10.1177/000348948709600418
  4. Horner, K. (1993). Morphological changes associated with endolymphatic hydrops. Scanning microscopy. 7(1). 223-238.
  5. Goebel, J. A. (2016). 2015 equilibrium committee amendment to the 1995 aao-hns guidelines for the definition of meniere's disease. Otolaryngology-Head and Neck Surgery. 154(3). 403-404. https://doi.org/10. 1177/0194599816628524 https://doi.org/10.1177/0194599816628524
  6. Kim, M. H. & Cheon, C. (2020). Epidemiology and seasonal variation of meniere's disease: Data from a population-based study. Audiology and Neurotology. 25(4). 224-230. https://doi.org/10.1159/000506921
  7. Dieterich, M. (2008). Dizziness. A practical approach to diagnosis and management. BMJ Publishing Group Ltd.
  8. Kim, D., Kim, J., Kim, C., Kim, H., Kim, H. & Mun, I. (2010). Current otolaryngology. Head and neck surgery. 1st ed. Seoul: Doodam. 645-646.
  9. Jain, S., Jungade, S., Ranjan, A., Singh, P., Panicker, A., Singh, C., et al. (2021). Revisiting "meniere's disease" as "cervicogenic endolymphatic hydrops" and other vestibular and cervicogenic vertigo as "spectrum of same disease": A novel concept. Indian Journal of Otolaryngology and Head & Neck Surgery. 73(174-179). https://doi.org/10.1007/s12070-020-01974-y
  10. Lee, J.-H.Kim, M.-W. & Keum, D.-H. (2014). Two cases report on the patients with ear fullness by acupuncture therapy and scenar therapy on sternocleidomastoid muscle. Journal of Korean Medicine Rehabilitation 24(1). 125-132.
  11. Oh, K.-C. (2012). A clinical report on episodic vertigo with meniere's disease treated by saam acupuncture sojangjungkyuk. The Journal of the Society of Korean Medicine Diagnostics. 16(1). 35-44.
  12. Lee, M.-S.Park, Y.-G. & Bae, N.-Y. (2014). A case study of a taeeumin patient with meniere's disease treated with cheongsimyeonja-tang. Journal of Sasang Constitutional Medicine. 26(3). 328-337. https://doi.org/10.7730/JSCM.2014.26.3.328
  13. Jang, S.-Y. & Shin, H.-C. (2011). Clinical reports of the meniere's disease in the diagnosis of deficiency-excess. The Journal of Internal Korean Medicine. 32(1). 121-128.
  14. Lee, S.-e.Kim, J.-h. & Kim, Y.-b. (2004). Oriental medical treatment in meniere's disease. Journal of Acupuncture Research. 21(6). 269-279.
  15. Hong, S.-H.Hwang, C.-Y.Yoon, H.-J. & Park, J.-Y. (2006). One cases of meniere's disease. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology. 19(2). 288-295.
  16. Lee, S.-Y., Kim, M.-Y., Kim, Y.-J., Choi, W.-W., Min, I.-K., Park, J.-Y., et al. (2008). One case of meniere's disease. The Journal of the Society of Stroke on Korean Medicine. 9(1). 40-45.
  17. Kong GS, L. Y., Oh JH, Song JY, Kim SW, & Kang MH, E. G., Lee HC, Song WS (2020). The effect of korean medicine treatment on suspected meniere's disease with headache in a patient hospitalized at a korean medicine hospital: A case report. The Journal of Internal Korean Medicine. 41(2). 213-223. https://doi.org/10.22246/jikm.2020.41.2.213
  18. Eon-ji, R.Hwangbo, M. & Dong-chui, K. (2022). A case report of patient with menieres disease treated with korean medicine. THE JOURNAL OF EAST - WEST MEDICINES. 47(1). 7-14.
  19. Cho, S.-h. (2021). A case report of meniere's disease treated by oryeong-san based on shanghanlun provisions. The Journal of Korean Medical Association of Clinical Sanghan-Geumgwe. 13(1). 99-110.
  20. Ho, L. H. (2002). A clinical report on 8 constitutional acupuncture therapies for treatment one case of dissiness suggested menieres syndrome. Journal of physiology & pathology in Korean Medicine. 16(5). 1079-1083.
  21. Jung, H.-J.Ko, W.-S. & Yoon, H.-J. (2017). Korean medicinal review of the latest research trend on pathology of meniere's disease. The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology. 30(3). 103-118. https://doi.org/10.6114/jkood.2017.30.3.103
  22. Lee, K.-Y. & Hong, C.-H. (2018). Recent clinical research trends on acupuncture treatment of meniere's disease. The Journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology. 31(3). 26-38. https://doi.org/10.6114/jkood.2018.31.3.026
  23. Jeong, Y. T. & Lee, B. R. (2002). The bibliographical study on the cause and etiology of vertigo (眩暈). Journal of Haehwa Medicine. 11(1). 163-177.
  24. Jin, S. & Nam, H.-J. (2023). Analysis of the active compounds and therapeutic mechanisms of yijin-tang on meniere's disease using network pharmacology (i). The Journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology. 36(1). 50-63.
  25. Jin, S. & Nam, H.-J. (2023). Analysis of the active compounds and therapeutic mechanisms of yijin-tang on meniere's disease using network pharmacology (ii). The Journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology. 36(2). 1-9.
  26. Hearing, C. o. & Equilibrium (1995). Committee on hearing and equilibrium guidelines for the diagnosis and evaluation of therapy in meniere's disease. Otolaryngology-Head and Neck Surgery. 113(3). 181-185. https://doi.org/10.1016/S0194-5998(95)70102-8
  27. Goh, E.-K. & Lee, I.-W. (2005). Differential diagnosis of meniere's disease. Journal of Clinical Otolaryngology Head and Neck Surgery. 16(1). 33-40. https://doi.org/10.35420/jcohns.2005.16.1.33
  28. Song, J. J., Koo, J. W., Kim, K. S., Byun, J. Y., Han, G. C. & Chae, S. W. (2012). The diagnosis criteria of meniere's disease and related objective tests. Korean Journal of Otorhinolaryngology-Head and Neck Surgery. 55(8). 476-481. https://doi.org/10.3342/kjorl-hns.2012.55.8.476
  29. Seong-Uk Park. The essence of pharmacoacupuncture: Seoul: wooripub. 2020:1-2, 13-21, 57-82
  30. Shim, S.-Y.Park, H.-J.Lee, J.-M. & Lee, H.-S. (2007). An overview of pain measurements. Korean Journal of Acupunct. 24(2). 77-97.
  31. Clark, J. G. (1981). Uses and abuses of hearing loss classification. Asha. 23(7). 493-500.
  32. Siegel, L. G. (1975). The treatment of idiopathic sudden sensorineural hearing loss. Otolaryngologic Clinics of North America. 8(2). 467-473. https://doi.org/10.1016/S0030-6665(20)32783-3
  33. Newman, C. W.Jacobson, G. P. & Spitzer, J. B. (1996). Development of the tinnitus handicap inventory. Archives of Otolaryngology-Head & Neck Surgery. 122(2). 143-148. https://doi.org/10.1001/archotol.1996.01890140029007
  34. Han, G., Lee, E., Lee, J., Park, S., Lee, H., Jeon, E., et al. (2004). The study of standardization for a korean adaptation of self-report measures of dizziness. J Korean Bal Soc. 3(2). 307-325.
  35. Kim, N.-J., Park, H.-O., Sim, C.-S., Lee, C.-R., Kwon, Y.-J. & Lee, J.-H. (2012). The characteristics of tinnitus and hearing threshold-in workers with noise induced hearing loss from a hospital setting. Korean Journal of Occupational and Environmental Medicine. 24(4). 431-440. https://doi.org/10.35371/kjoem.2012.24.4.431
  36. Kim, H. H.Wiet, R. J. & Battista, R. A. (2005). Trends in the diagnosis and the management of meniere's disease: Results of a survey. Otolaryngology-Head and Neck Surgery. 132(5). 722-726. https://doi.org/10.1016/j.otohns.2005.01.007
  37. Sajjadi, H. & Paparella, M. M. (2008). Meniere's disease. The Lancet. 372(9636). 406-414. https://doi.org/10.1016/S0140-6736(08)61161-7
  38. Bjorne, A.Berven, A. & Agerberg, G. (1998). Cervical signs and symptoms in patients with meniere's disease: A controlled study. CRANIO®. 16(3). 194-202. https://doi.org/10.1016/S0140-6736(08)61161-7
  39. Kempf, H.Roller, R. & Muhlbradt, L. (1993). Correlation between inner ear disorders and temporomandibular joint diseases. HNO. 41(1). 7-10.
  40. Bjorne, A. & Agerberg, G. (2003). Symptom relief after treatment of temporomandibular and cervical spine disorders in patients with meniere's disease: A three-year follow-up. CRANIO®. 21(1). 50-60. https://doi.org/10.1080/08869634.2003.11746232
  41. Ku, J.Jung, C. & Hwang, J. H. (2022). Toxicological study of su-eohyeol pharmacopuncture in an in vivo micronucleus test in sprague-dawley rats. Korean Journal of Acupuncture. 39(2). 54-62. https://doi.org/10. 14406/acu.2022.008 https://doi.org/10.14406/acu.2022.008
  42. Yeom, S. & Kim, K. Effects of ohyaksungisan and jungsongouhyul pharmacopuncture on pain reduction and nervere generation after crush injury inratsciatic nerve. The Journal of Korean Medicine Rehabilitation 2009. 19(2). 51-72.
  43. IM, J. (2010). Neuroprotective effects of neutral pharmacopuncture for blood stasis and tangguisusangami-tang (dangguixusanjiawei-tang) in the experimental traumatic brain injury rats. Journal of Korean Medicine Rehabilitation. 20(1). 13-26.
  44. HY, K. (2010). Effects of bee venom and cervi cornu parvum pharmacoacupuncture in monosodium iodoacetate (mia)-induced osteoarthritis rat. Journal of Korean Medicine Rehabilitation. 20(1). 61-77. https://doi.org/10.13048/jkm.13013