• Title/Summary/Keyword: 병행치료

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Comparison of the Result of Radiation Alone and Chemoradiation in Cervical Cancer (자궁 경부암에서 방사선 단독치료와 방사선 및 화학요법 병행치료의 비교)

  • Kim, Jae-Cheol;Park, In-Kyu
    • Radiation Oncology Journal
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    • v.13 no.2
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    • pp.191-198
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    • 1995
  • Purpose: This analysis was to compare the result of radiation alone and chemoradiation in cervical cancer in terms of response, survival, failure, and complication. Materials and Methods: A retrospective analysis of 135 cervical cancer patients treated with definitive radiotherapy from November 1985 to December 1991 was performed. Fifty-six patients were treated with radiation alone and 79 patients were treated with cisplatin-based chemotherapy plus radiation. Follow-up period ranged from 5 to 105 months with a median 47 months. According to the FIGO classification, the patients were subdivided into 18 $(13.3\%)$ stage IB, 7 $(5.2\%)$ stage IIA, 97 $(71.9\%)$ stage IIB, and 9 $(6.7\%)$ stage IIIB. Results: A complete response was noted in 51 patients $(91.1\%)$ of the radiation alone group, and 68 patients $(86.1\%)$ of the chemoradiation group. There was no statistical difference in complete response rate between the two groups. Overall survival rate at 5 years was $73.3\%$. According to stage, overall survival rates at 5 years were $88.9\%$ in stage IB, $85.7\%$ in stage IIA, $73.8\%$ in stage IIB, and $37.5\%$ in stage IIIB, respectively. According to treatment modality, overall survival rates at 5 years were $81.9\%$ in the radiation alone group, $67.0\%$ in the chemoradiation group (p=0.22). Disease-free survival rate at 5 years were $70.4\%$ in the radiation alone group. $68.5\%$ in the chemoradiation group (p=0.85) Locoregional control rates at 5 years were $76.1\%$ in the radiation alone group, $73.8\%$ In the chemoradiation group (p=0.70). Distant disease-free survival rates at 5 years were $83.9\%$ in the radiation alone group, $90.3\%$ in the chemoradiation group (p=0.59). Treatment-related bone marrow suppressions were noted in 3 $(5.4\%)$ patients of the radiation alone group, 14 patients $(17.7\%)$ of the chemoradiation group (p(0.05). Grade 2 vesical complications were noted in 14 patients of the radiation alone group. and 10 Patients of the chemoradiation group. Grade 2 rectal complications were noted in 2 patients of the radiation alone group, and 3 Patients of the chemoradiation group. One case of rectal perforation was noted in the chemoradiation group, and grade 2 small bowel obstructions were noted in 2 patients of the radiation alone group. There were no statistical differences in the incidence of vesicar, rectal, and small bowel complicaions between the two groups. Conclusion: No statistical difference was found between the radiation alone group and the chemoradiation group in terms of response, survival, and failure. but the incidence of bone marrow suppression was higher in the chemoradiation group.

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중서의결합치료소아백혈병사로(中西醫結合治療小兒白血病思路) -중서의 결합으로 소아백혈병 치료에 대한 접근-

  • Seok Hyo-Pyeong
    • The Journal of Pediatrics of Korean Medicine
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    • v.15 no.1
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    • pp.71-75
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    • 2001
  • 백혈병은 조혈계통의 악성 증식성 질환으로서 현재까지 주로 화학약물요법에 의존하고 있는 실정이다. 화학약물요법은 백혈병 세포를 소멸시킬 수 있지만 또한 인체에 여러 가지 독성 반응 및 부작용을 일으키기도 한다. 따라서 중서의결합으로 백혈병 치료에 접근하는 것은 중요한 의미를 갖는다. 중의학에서 소아 백혈병을 치료하는 경우 청열해독법(淸熱解毒法), 부정보허법(扶正補虛法), 활혈화어법(活血化瘀法)을 주로 사용한다. 청열해독법은 백혈병의 조기치료에 주로 활용되는데, 인체의 저항력을 증강시켜 화학약물요법을 실시하는 동안 흔히 나타날 수 있는 감염증상을 예방하는 효과를 얻을 수 있다. 부정보허법(扶正補虛法)은 주로 화학약물요법의 유도 완화기 및 치료효과의 유지를 위하여 활용되는데, 이는 인체의 면역력을 향상시켜 화학약물요법이 인체에 미치는 손상을 경감시킬 수 있다. 활혈화어법(活血化瘀法)은 미세순환을 개선시키는 작용을 하며 골수의 조혈기능을 촉진하고 면역기능을 조절하며 또한 일부 활혈화어제(活血化瘀劑)는 백혈병 세포에 직접적인 억제효과를 보인다. 소아백혈병에 대하여 화학약물요법을 진행하는 동안 중약을 같이 병행하는 경우 다음과 같은 과정으로 나누어 실시할 수 있다. 1. 유도완화치료(화학요법)단계: 이와 같은 치료과정은 대개 화학약물요법으로 인한 극심한 독성반응이나 주작용을 나타내게 되는데, 이 과정에서 중약치료를 병행하면 신속하게 증상을 개선시킬 수 있다. 만약 구토나 설사와 같은 소화계 부작용이 나타나면 화위강역법(和胃降逆法)을 활용하고, 감염 증상이 나타나면 부정(扶正)과 거사법(祛邪法)을 병행할 수 있다. 화학약물요법을 진행한 후 신체가 극도로 허약해지고 골수의 기능이 심하게 억제되는 경우는 주로 부정(扶正)시키는 중약을 사용하면서 익기양혈제(益氣養血劑)를 곁들이고 보조적으로 단삼(丹蔘), 당귀(當歸), 천궁(川芎), 계혈등(鷄血藤) 등과 같은 활혈화어제(活血化瘀劑)를 사용하여 골수의 조혈기능을 회복시킨다. 2. 치료효과의 유지단계: 본 과정에서는 중약치료에 있어서 부정(扶正)과 거사법(祛邪法)을 병행한다. 화학약물요법을 실시하는 동시에 거사제(祛邪劑)를 중용(重用)함으로써 화학약물요법의 효과를 강화시킨다. 화학약물요법이 끝난 뒤 부정(扶正)시키는 약물을 중용(重用)하여 인체의 면역기능을 증강시키고 백혈병세포를 억제시킨다. 3. 치료효과의 유지 및 강화단계: 치료효과의 유지단계에서는 변증논치(辨證論治)의 원칙에 입각하여 항암효과가 있는 중약을 활용할 수 있는데, 예를 들어 백화사설초(白花蛇舌草), 산자고(山慈?), 청대(靑黛), 용규(龍葵) 등을 사용할 수 있고, 육신환(六神丸)을 장기적으로 복용하여도 된다. 소아백혈병 치료에 있어서 중서의결합의 치료법을 활용하는 경우 다음과 같은 내용에 주안점을 둘 수 있다. 화학약물요법을 진행하는 과정에서 중약을 병행하여 투여하는 경우 사진합삼(四診合參)을 근간으로 종합적인 분석을 통하여 병인(病因)을 살피어 치료에 임하도록 한다. 약물의 선택과 처방의 구성은 반드시 변증논치(辨證論治)의 원칙하에 이루어져야 한다. 화학약물요법과 중약치료를 병행하는 과정에서 변증(辨證)과 변병(辨病)이 서로 결합되고 부정(扶正)과 거사법(祛邪法)을 병행하여 활용한다. 정체관(整體觀)에서 출발하여 환자를 관찰하는 동시에 특징적인 증후(證候)에 대한 변증논치(辨證論治)도 중요하며, 또한 백혈병 환자의 유형(類型)이나 임상 혈액검사 소견, 골수의 양상, 화학요법의 진행단계 및 환자의 연령과 체질 등을 충분히 가만하여 종합적인 분석을 토대로 치료법을 선택하여야 중약요법과 화학약물요법의 협동적인 효과를 증폭시키고 백혈병치료에 새로운 전기를 마련할 수 있을 것이다.

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Randomized Controlled Trial of East-West Collaborate Medical Treatment on Female Chronic Shoulder Pain Patients (여성 만성견비통 환자에 대한 동서 협진 치료의 무작위 대조군 연구)

  • Nam, Dong-Woo;Choi, Yang-Sik;Kim, Haeng-Beom;Kim, Jong-In;Lim, Sabina;Kim, Keon-Sik;Lee, Doo-Ik;Lee, Jae-Dong;Lee, Yun-Ho;Choi, Do-Young
    • Journal of Acupuncture Research
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    • v.24 no.6
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    • pp.113-122
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    • 2007
  • 목적 : 만성 견비통 환자에 대한 침 치료와 신경 차단술 병행 치료의 효과를 검증하고자 함. 방법 : 만성 견비통 환자 60명을 대상으로 동서병행치료군(EW group, n=20), 한방 침치료군(E group, n=20), 무처치 대조군(C group, n=20)으로 무작위 배정한 후 연구를 시작했다. 동서병행치료군은 먼저 견갑상 신경차단술, 견봉하 주사 및 압통점 국소 마취제를 맞은 후 5분간 휴식을 취한 후 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 주 2회 4주간 받았다. 한방 침치료군은 주 2회, 4주간 견우($LI_{15}$), 견요($TE_{14}$), 견정(肩井)($GB_{21}$) 및 동씨침의 견중혈(肩中穴)과 신관혈(腎關穴)에 침치료를 받았으며, 무처치 대조군은 4주간 특별한 처치를 받지 않았다. 모든 환자들은 일상생활에서 자가 운동을 실시하도록 지시 받았다. 치료 시작전과 치료 4주 후 Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI), 및 환자의 주관적 통증 평가를 Visual Analogue Scale(VAS) 로 측정하여 모인 데이터 통계를 분석하였다. 결과 : 동서병행치료군 및 한방 침치료군 모두 CSA, SPADI 및 VAS 상에서 유의한 (p<0.05) 호전을 보였다, 동서병행치료군의 CSA, SPADI, VAS는 무처치 대조군과 비교하여 유의한 우의를 나타냈으며, 한방 침 치료군과 비교하여 VAS 에서 유의한 차이를 나타냈다. 결론 : 침치료와 신경차단술 병행 치료방법은 만성 견비통을 유의하게 호전시켰다. 무처치 대조군과의 차이는 3개의 측정 도구 모두에서 유의한 차이가 있었으며, 침치료만 받은 환자들과도 주관적 통증 척도에서 유의한 차이를 보였다.

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The Outcome of Conventional External Beam Radiotherapy for Patients with Squamous Cell Carcinoma of the Esophagus (식도의 편평상피세포암 환자에서 외부방사선치료의 결과)

  • Jang, Ji-Young
    • Radiation Oncology Journal
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    • v.26 no.1
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    • pp.17-23
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    • 2008
  • Purpose: The best treatment for advanced esophageal cancer is chemoradiotherapy followed by surgery. In spite of the advance of multimodality therapy, most patients with esophageal cancer are treated with radiation therapy alone. This study reports the outcome of the use of conventional external beam radiotherapy alone for the treatment of esophageal cancer. Materials and Methods: Between January 1998 and December 2005, 30 patients with squamous cell carcinoma of the esophagus were treated with external beam radiotherapy using a total dose exceeding 40 Gy. Radiotherapy was delivered with a total dose of 44-60 Gy(median dose, 57.2 Gy) over $36{\sim}115$ days(median time, 45 days). Thirteen patients(43.3%) had a history of disorders such as diabetes, hypertension, tuberculosis, lye stricture, asthma, cerebral infarct, and cancers. Four patients metachronously had double primary cancers. The most common location of a tumor was the mid-thoracic portion of the esophagus(56.7%). Tumor lengths ranged from 2 cm to 11 cm, with a median length of 6 cm. For AJCC staging, stage III was the most common (63.3%). Five patients had metastases at diagnosis. Results: The median overall survival was 8.3 months. The survival rates at 1-year and 2-years were 33.3% and 18.7%, respectively. The complete response rate $1{\sim}3$ months after radiotherapy was 20%(6/30) and the partial response rate was 70%(21/30). Sixteen patients(53.3%) had an improved symptom of dysphagia. Significant prognostic factors were age, tumor length, stage, degree of dysphagia at the time of diagnosis and tumor response. Cox regression analysis revealed the aim of treatment, clinical tumor response and tumor length as independent prognostic factors for overall survival. Twenty-eight patients had local failure and another four patients had metastases. Three patients were detected with double primary cancers in this analysis. A complication of esophageal stricture was observed in three patients(10%), and radiation pneumonitis occurred in two patients(6.7%). Conclusion: The prognosis of esophageal cancer remains poor, in spite of advances in radiotherapy techniques. Radiotherapy is one of the main treatment modalities for the relief of dysphagia and treatment related complications are minimal. It is expected that the addition of chemotherapy or another systemic modality to radiotherapy will improve tumor control and increase the survival rate in advanced esophageal cancer.

The Effects of Muscle Energy Technique (MET) for Peroneal Nerve Palsy after Normal Delivery: A Case Report (자연분만 후 발생한 비골신경마비 환자에 대한 Muscle Energy Technique(MET)의 병행치료 효과 증례보고)

  • Jo, Na-Young;Roh, Jeong-Du
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.4
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    • pp.46-56
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    • 2016
  • Objectives: The purpose of this study is to evaluate the clinical effects of Muscle Energy Technique (MET) for peroneal nerve palsy after normal delivery. Methods: Two patients with peroneal nerve palsy were treated with acupuncture, moxibustion, cupping and MET. MET was performed in piriform, gluteus medius, anterior tibial and adductor muscles. To evaluate the effect of MET, we analyzed Ankle dorsiflexion range of motion (ROM), Manual Muscle Test (MMT), Numerical Rating Scale (NRS) and Ankle Hindfoot Scale (AHS). Results: In Case 1, ROM score was changed from −5 to 20, and MMT score was changed from 0 to 4. NRS score was changed from 5 to 1, and her AHS score was changed from 54 to 94 after treatment. In Case 2, ROM score was changed from 0 to 20, and her MMT score was changed from 1 to 5. NRS score was changed from 4 to 1, and her AHS score was changed from 64 to 97 after treatment. Conclusions: MET may be a useful treatment for patients who, shortly after childbirth or while breastfeeding, strongly refuse to treat the irritation.

The Anticancer Effect of Combination of Genistein and Photofrin PDT in Human AMC-HN3 Head and Neck Cancer Cell Lines (AMC-HN3 인체 두경부 암세포에서 genistein과 photofrin PDT의 병행처리에 의한 세포 독성능의 증가)

  • Kang, Jung-Wook;Chung, Phil-Sang;Shin, Jang-In;Son, Seung-Yeol;Ahn, Jin-Chul
    • Journal of Life Science
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    • v.18 no.9
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    • pp.1257-1262
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    • 2008
  • Photodynamic therapy (PDT) is a treatment utilizing the generation of singlet oxygen and other reactive oxygen species (ROS), which selectively accumulated in target cells. Genistein, soy-derived phytoestrogen, is one of the anticancer agents found in soybean. In the current study, we investigated the effect of photofrin-induced PDT and genistein on apoptotic cell death in head and neck cell line (AMC-HN3) to confirm the photodynamic therapy of genistein. It was determined by MTT assay that the combination group had more cytotoxicity effect than PDT group alone. Combination of photofrin PDT and genistein induced apoptosis more when comparing with PDT alone. Our data also showed that ROS was increased in combination therapy, indicating apoptosis by mitochondrial damage. These results indicated that the combination of photofrin PDT and genistein showed more cytotoxic effect and induced apoptosis in head and neck cancer cell line.

The Effects of the Sensory Integration Intervention Focused on Combined Both Individual Therapy and Group Therapy for Sensory Integration Ability and Occupational Performance Abilities in Children With Somatodyspraxia: Case Study (체성실행장애 아동을 위한 개별치료와 그룹치료를 병행한 감각통합치료가 감각통합능력 및 작업수행능력에 미치는 효과: 개별 실험 연구)

  • Cho, Hye-Jin;Bong, Young-Soon;Lee, Ji-Young
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.2
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    • pp.13-26
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    • 2013
  • Objective : The purpose of the study was to investigate The effects of the sensory integration intervention focused on combined both individual therapy and group therapy for sensory integration ability and occupational performance abilities in children with somatodyspraxia. Methods : Once in a total of 12 weeks, baseline period of four sessions and twenty-four session intervention period, research process had combined individual therapy and group therapy for sensory integration therapy. The Design is ABA design of single-subject research design. For a comparison of each-side of the operation performance change in therapy for children, through the assessment Baseline at four sessions and reassessment at two sessions after intervention, the Occupational performance ability change was measured. During intervention period, Process changed the Sensory Integration ability was measured through the Goal Attainment Scale (GAS). Results : The Sensory Integration Ability combined Individual therapy and Group therapy have effect about improvement of the Sensory Integration ability and the Occupational performance ability for children with Somatodyspraxia. Conclusion : Henceforth, subject will undergo systematized experimental design, and when dependent variable such as Sensory Integration ability and the Occupational performance was measured, effect-measuring study needs through using reliable tools.

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A Convergence Study on the Effects of functional electrical stimulation with mirror therapy on balance and gait ability in chronic stroke patients. (기능적 전기자극을 병행한 거울치료가 만성 뇌졸중 환자의 균형 및 보행능력에 미치는 영향에 관한 융합적 연구)

  • Kim, Dong Hoon;Kim, Kyung Hun
    • Journal of the Korea Convergence Society
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    • v.9 no.10
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    • pp.109-120
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    • 2018
  • The purpose of this study was to investigate the effects of functional electrical stimulation (FES) with mirror therapy on balance and gait ability in chronic stroke patients. Thirty-five subjects who met the inclusion criteria were randomly allocated into three groups: the functional electrical stimulation with mirror therapy group(FMT group, n=11), mirror therapy group(MT group, n=12), and control group (n=12). The exercises were conducted for 30 min per day, five, per week for four weeks. Balance and gait ability were examined at baseline and after 4 weeks of intervention. After training, the FMT group showed significant improvement in berg balance scale (BBS), center of pressure (COP) length, affected step length (ASL), Cadence and average gait speed (AGS) compared MT group and control group(p<0.05). This findings show that FES and MT convergence can be an effective intervention for stroke patients balance and gait ability. Continued development of convergence interventions for stroke patients with balance and gait ability in practice, are suggested.

The Effects of Oral Activity With Sensory Integration Intervention on Breathing and Oral Diadochokinetic Movement of a Child With Developmental Disability (구강활동을 병행한 감각통합치료가 발달장애 아동의 호흡 및 구강협응능력에 미치는 효과)

  • Choi, Yeon-Woo;Jung, Hye-Rim;Kim, Kyeong-Mi
    • The Journal of Korean Academy of Sensory Integration
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    • v.11 no.1
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    • pp.1-9
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    • 2013
  • Objective : This study was to investigate effects of sensory integration intervention with oral activity on breathing and oral diadochokinetic movement of child with developmental disability. Methods : A subject of this study was 6years and 7month old boy, living in G city which was diagnosed as developmental disability. The study performed from November, 2012 to February, 2013. Research design used in this study is AB design for single-subject research. The experimental period was divided into two phase: 3 sessions for baseline phase (A), 16 sessions for treatment phase (B). There was sensory integration therapy on the baseline phase, and sensory integration intervention with oral activity was conducted on the treatment phase. Breathing measured a Spirometer, oral diadochokinetic movement was measured by measuring the time secondly when repeating "phathakha" ten times. Results : In comparison with the baseline phase, the child's breathing and diadochokinetic movement increased during the treatment phase. Conclusion : Sensory integration intervention with oral activity brought positive results to child's breathing and oral diadochokinetic movement.

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A Case of Combination Therapy of Cognitive - Behavioral Therapy and Oriental Medical Treatment On Panic Disorder (한방치료와 인지행동치료를 병행한 공황장애 환자 1례에 대한 임상적 고찰)

  • Jung, Hyo-Chang;Sung, Woo-Yong;Kim, Jin-Won;Jeong, Byeong-Ju;Jang, Ha-Jeong
    • Journal of Oriental Neuropsychiatry
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    • v.15 no.2
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    • pp.211-219
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    • 2004
  • Panic disorder is a frequent anxiety disorder. Recently many studies raised that the course of panic disorder is the interaction of biological and psychological factor. So we used Oriental Medicine Treatment to control biological factor and Cognitive - Behavioral Therapy to control psychological factor of panic disorder, obtained good results. Practicing Cognitive - Behavioral Therapy, we were able to destroy catastrophic misunderstanding. And then in this case, patient is diagnosed Deficiency of Kidney(腎虛) with Fire from stagnation of Liver(肝鬱化火). So we used herbal medicine and acupuncture according to oriental medical theory and these efforts helped the case of disease.

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