• 제목/요약/키워드: 난치성

검색결과 218건 처리시간 0.028초

국내 난치성 천식의 특징 - 파일럿 연구 (Characteristics of Difficult to Treat Asthma in Korea)

  • 유광하;이관호;어수택;박용범;이양근;오연목;천식연구회
    • Tuberculosis and Respiratory Diseases
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    • 제69권5호
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    • pp.361-367
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    • 2010
  • Background: Difficult-to-treat asthma afflicts a small percentage of the asthma population. However, these patients remain refractory to treat, and account for 40% to 50% of the health costs of asthma treatment, incurring significant morbidity. We conducted a multi-center cross-sectional study to characterize difficult-to-treat asthma in Korea. Methods: Subjects with difficult-to-treat asthma and subjects with controlled asthma were recruited from 5 outpatient clinics of referral hospitals. We reviewed medical records of previous 6 months and obtained patient-reported questionnaires composed of treatment compliance, asthma control, and instruments for stress, anxiety, and depression. Results: We recruited 21 subjects with difficult-to-treat asthma and 110 subjects with controlled asthma into the study. The subjects with difficult-to-treat asthma were associated with longer treatment periods, more increased health care utilization, more medication (oral corticosteroids, number of medication), and more anxiety disorder compared to those of well-controlled asthmatics. There was no difference in age, gender, history of allergy, serum IgE, blood eosinophil count, or body mass index between the 2 groups. Conclusion: Difficult-to-treat asthma is characterized by increased health care utilization and more co-morbidity of anxiety.

소아의 난치성 신증후군의 한약 치료에 대한 최신 임상연구 동향 (Review of Clinical Research for Herbal Medicine Treatment on Refractory Nephrotic Syndrome in Children)

  • 장은하;민상연;김장현
    • 대한한방소아과학회지
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    • 제34권3호
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    • pp.1-17
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    • 2020
  • Objectives The purpose of this study is to analyze clinical studies on effectiveness of herbal medicine in refractory nephrotic syndrome (RNS). Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on RNS from the Pubmed, CNKI, OASIS, NDSL, J-stage, and CiNii. The demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Results 11 RCT studies were selected and analyzed. The children in the control group were given western medicine therapy, and the treatment group was given herbal medicine along with the same western medicine of the control group. The most commonly used herbal medicines were the prescriptions to treat 'Kidney Deficiency with Blood Stasis (腎虛兼瘀血)' which composed of 'Promoting blood circulation (化瘀)', 'Diuresis-inducing (利水)', or 'Heating Yang (溫陽)' medicine based on 'Replenishing Kidney or Spleen (補腎, 補脾)' medicine. In the treatment group, proteinuria and serum lipid was significantly decreased, serum albumin was significantly increased, and total effective rate was significantly higher than the control group. Hypercoagulation and relapse rate was also significantly reduced. Adverse events were significantly lower in the treatment group. Conclusions Herbal medicine treatment on pediatric RNS can be suggested as a new treatment for children who have less response to the conventional therapy. It can also supplement the limitations of the western medicine by reducing adverse events from the steroids and immuno-suppressive agents, and lower the relapse rate as well.

뇌교경색 발병후 병발된 난치성 애역의 치험 1례 (Case of Oriental Medicine Therapy on Intractable Hiccup Induced by Pontine Infarction)

  • 강백규;이선우;박상무;한덕진;이정욱;김혜정;문병순;이인
    • 동의생리병리학회지
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    • 제22권1호
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    • pp.222-225
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    • 2008
  • Hiccup is one of common symptoms that remains poorly understood. The hiccups coordinating center is located in the brain-stem reticular formation. Hiccups may be derived from 400 medical origins. Stroke is an infrequent cause of intractable hiccups. Intractable hiccups in pontine infarction remain poorly understood. As for treatments of hiccups, physical stimulating methods, pharmacological therapies and surgery are occidental conventional methods. In Pharmacological therapies, antidepressants, gastric motility stimulants, antispastic drugs are commonly used. Oriental medicines and acupuncture are also used frequently to treat hiccups. We have treated a case of intractable hiccup induced by pontine infarction with herbal medication; Gwakhyangjeonggi-san gami, acupuncture and moxibustion, and successfully improved. This case showed oriental medicine therapy is effective in intractable hiccup induced by pontine infarction.

Midazolan과 Baclofen 투여에 의한 난치성 딸꾹질 환자의 치료 경험 -증례 보고- (Treatment of Intractable Hiccup with Midazolam and Baclofen -A case report-)

  • 양내윤;문동언;박철주;권오경;박종민;심재용;최종호
    • The Korean Journal of Pain
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    • 제10권2호
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    • pp.246-249
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    • 1997
  • Hiccup is defined as an abrupt involuntary contraction of the diaphragm and intercostal muscles with sudden closure of the glottis 35 msec after onset. The term "intractable" is given to those hiccups with a duration ranging from 24 hours to more than 25 years. Short hiccup bouts are mostly associated with gastric distention or alcohol intake, resolved spontaneously or with simple remedies. In contrast, intractable hiccup is a rare but disabling condition which can induce depression, weight loss and sleep deprivation. Although the pathophysiologic mechanisms of hiccup are still poorly understood, wide variety of pathological conditions such as: brain tumor, abdominal tumor, myocardial infarction, renal failure, abdominal surgery etc., can cause intractable hiccup. A 58-year-old male who had suffered from hepatocellular cancer was consulted from medical department due to intractable hiccup. Initial treatment modalities with administrations of metoclopramide and chlorpromazine and nerve block including phrenic nerve block, cervical epidural block and glossopharyngeal nerve block were not effective. Administration of midazolam and baclofen however achieved desirable effect.

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간세포암에 동반된 난치성 복수를 호전시킨 소양인 환자 치험1례 (A Case of Refractory Ascites Due To Hepatocellular Carcinoma Treated with Sasang Constitutional Medicine)

  • 정의홍;김은희;서영광;최원철;이수경;어완규
    • 사상체질의학회지
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    • 제20권2호
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    • pp.164-170
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    • 2008
  • 1. Objectives This is a case of refractory ascites due to hepatocellular carcinoma treated with Sasang Constitutional Medication. Refractory ascites, which did not respond to diuretics, was improved with Jeoryeongchajeonja-tang. 2. Methods We recorded the patient's abdominal circumference, body weight and urine output daily. We also investigated the TTKG(transtubular potassium gradient) values 3 times during the treatment course. 3. Results the TTKG value of the patient was siginificantly decreased. TTKG values before administration of Jeotyeongchajeonja-tang were 8.41, 10.82, respectively and 4.25 after administration of Jeotyeongchajeonja-tang. 4. Conclusions We guess that Jeoryeongchajeonja-tang functions as an aldosterone antagonist or increases spironolactone activity through interaction between Jeotyeongchajeonja-tang and spironolactone. But the mechanism of Jeotyeongchajeonja-tang is not clear, so we need more clinical study of refractory ascites improved with Jeotyeongchajeonja-tang and biological study of interaction between Jeotyeongchajeonja-tang and spironolactone.

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소아와 성인의 난치성 간질 환자에서 미주신경 자극술의 효과 (Effects of Vagus Nerve Stimulation on Adults and Children with Refractory Epilepsy)

  • 김천식;노영주;최상용;김대식
    • 대한임상검사과학회지
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    • 제38권2호
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    • pp.141-146
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    • 2006
  • Vagal nerve stimulation (VNS) has been proposed as a possible way to improve the control of refractory epilepsy. We report the effects following VNS treatment in patients with refractory epilepsy. Seventeen patients with a mean age of 12.8 years, ranging from 5 to 29 years, underwent the implantation of vagal nerve stimulation (Cyberonics, Houston, TX). We reviewed the clinical findings before and after VNS in seizure frequency, number of antiepileptic drugs (AED), and quality of life (QOL). All of the patients had intractable seizures, eleven of the patients had additional medical complications, three had hippocampus atrophy, one had encephalomalacia, five had encephalitis, one had pachygyria, and one had schizencephaly. Thirteen patients had symptomatic partial epilepsies, three patients had Lennox-Gastaut syndrome and one had cryptogenic partial epilepsy. The mean follow up duration was 35 months. The mean reduction of seizure frequency compared with baseline before VNS was 26.1% after 3 months (p<0.005), 41.9% after 6 months (p<0.001), 46.9% after 1 year (p<0.001), and 53% at the latest follow-up (p<0.001). Twelve patients showed an improvement of QOL such as mood, language, alertness, expression, and motor function. The most common side effects were transient hoarseness or voice change or cough, which was detected in six patients (35%) and wound infection in one patient (5%). This study has shown a good anti-seizure effect of VNS, decrease in seizure frequency and improvements in QOL. We concluded that VNS is a beneficial therapy in refractory epilepsy with a non-resectable epileptic focus. Further studies should be focused on the prediction of unresponsiveness and the adjustment of VNS parameters for maximum efficacy in patients with various medical histories.

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형방지황탕가미로 치료한 만성 난치성 설사 치험 3례에 대한 임상적 고찰 (Three Case Reports of Treatment of Chronic Intractable Diarrhea Using Hyungbangjihwang-tang-gami)

  • 이준영;채한나;문연주;이윤승;곽시라;문구;백동기
    • 대한한방내과학회지
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    • 제40권5호
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    • pp.822-831
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    • 2019
  • Objective: This study reports the effect of Hyungbangjihwang-tang-gami as a treatment for Soyang-in patients with chronic diarrhea. Methods: We treated three male patients with chronic diarrhea who did not improve after taking herbal medicine, as determined by zang-fu (organ) pattern diagnosis. After changing our approach to a Sasang constitution, we prescribed Hyungbangjihwang-tang-gami and assessed the effect by the frequency or form of defecation. Results: The patients' complaints worsened when they were administered a herbal medicine unsuited to their Soyang constitutions, which caused an exuberance of Yang. Changing the herbal medicine to Hyungbangjihwang-tang-gami improved their symptoms. Conclusions: This study suggested that Soyang-in patients may have side effects when administered unsuitable herbs, even if they were diagnosed using zang-fu (organ) pattern diagnosis. When we treat patients, we have to consider their Sasang constitution, as well as the zang-fu (organ) pattern diagnosis.

한방복합치료로 난치성 통증을 동반한 요추 추간판탈출증이 호전된 증례보고 (Intractable Pain Management by Combined Korean Medicine Treatment Including Acupotomy in Lumbar Disc Herniation: A Case Report)

  • 최현규;이영록;차현지;성기정;김범석;김민주;이예지;전주현;김영일
    • Korean Journal of Acupuncture
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    • 제38권3호
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    • pp.175-181
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    • 2021
  • A 57-year-old female diagnosed with L5-S1 lumbar intervertebral disc herniation, suffering from severe pain despite taking tapentadol received combined Korean medicine treatment, including acupotomy, acupuncture, pharmacopuncture, and herbal therapies for 53 days. To assess pain, Numeric Rating Scale (NRS) and lumbar range of motion (ROM) were checked daily from the day of admission. Moreover, the Oswestry Disability Index (ODI) and European Quality of Life-5 Dimensions (EQ-5D) were used to evaluate function and quality of life. After combined Korean medicine treatment, reabsorptioin of intervertebral disc was confirmed by radiological examination; pain reduced from NRS 5~7 to NRS 1~2; lumbar ROM in extention increased from 20° to 30°; and function and quality of life improved. The results suggest the possibility that a combined Korean medical treatment, including acupotomy, can be used as an alternative to opioids for pain management of lumbar vertebral disc herniation.

전신 강직-근간대성 발작을 호소하는 약물 난치성 뇌전증 환자에 대한 한의 치험 1례 (A Case Report of a Drug-resistant Epilepsy Patient Complaining Generalized Tonic-Clonic Seizures Treated with Korean Medical Treatment)

  • 이영선;정성훈;배인후;조기호;문상관;정우상;권승원
    • 대한한방내과학회지
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    • 제43권3호
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    • pp.460-468
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    • 2022
  • Objective: In this case report, we address the case of a 22-year-old man complaining of generalized tonic-clonic seizures due to drug-resistant epilepsy. Methods: A patient was treated with Korean medicine, including herbal medication, Shihogyeji-tang (SGT), and acupuncture. We evaluated improvements in symptoms using the Korean version of the Epilepsy Self-Efficacy Scale and quality of life. Results: After 37 days of Korean medicine treatment, there were improvements in the patient's quality of life and self-efficacy in seizure control. Conclusions: This case report suggests that SGT and acupuncture might be effective in drug-resistant epilepsy via action on neurons. SGT showed excellent tolerability for drug-resistant epilepsy patients. Our experience provides evidence that SGT and acupunctue may be used as alternative treatment options when antiepileptic drugs do not work in epilepsy patients.

중추신경계 질환자에게 이환된 난치성 딸꾹질의 한방치험1례 (A Case Report of Central Nervous System Disorder Induced Intractable Hiccups Treated with Korean Medicine)

  • 문지성;민선우;김예슬;박지윤;홍정화;최동준
    • 대한한방내과학회지
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    • 제43권2호
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    • pp.191-200
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    • 2022
  • Intractable hiccups are those which persist for more than one month and can often occur in patients with disorders of the central nervous system, such as stroke, epilepsy, or brain tumor. An 80-year-old male patient undergoing conservative hemodialysis for diabetic nephropathy, recently developed paralysis and dysphagia due to central nervous system complications including stroke and epilepsy. He was admitted to the ◯◯ Oriental Medicine Hospital, and treated with herbal medicine (Gyulpijugyeo-tang, Jeonssiigong-san, and Ijin-tang) and electrical acupuncture for 30 days. No side effects were observed during hospitalization. The frequency and duration of hiccups were measured daily and found to reduce, and the effect persisted during his admission. The patient took no other nervous system drugs. In conclusion, Korean medicine like gyulpijugyeo-tang and acupuncture can be effective for patients with intractable hiccups who cannot use alternative drugs or treatment, because of other complications.