• Title/Summary/Keyword: 비약물적 치료

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Analysis of Effect of Non-drug intervention on the Elderly with Dementia in Korea: Meta-Analysis (국내 치매노인의 비약물적 중재에 대한 효과분석: 메타분석)

  • Lee, Na Rae;Park, Yun Ji;Jang, Jong Sik
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.4
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    • pp.466-472
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    • 2021
  • This paper aims to guide experts who manage dementia by exploring the various non-drug interventions and analyzing the effective intervention methods applicable according to the functional level of the elderly with dementia. Fourteen studies were analyzed in this study. Meta-analysis was performed using the means, standard deviations, and the number of samples. Subsequent meta-analysis showed that the Holnis program had the largest effect size in cognitive function, the bakery activity program in memory, and the composite intermediation program with ADL was the largest. In addition, client-centric cognitive stimulation interventions showed the most significant effect sizes, while in depression and BPSD, rhythmic movement activities had the most significant effect size. Elderly with dementia exhibit various symptoms depending on their characteristics and the progress of the disease. Therefore, more efficient arbitration could be provided if the effects of each intervention can be applied differently.

A Systematic Review on Non-Medication Intervention for Self- Injurious Behavior of Individuals With Autism Spectrum Disorders (자폐스펙트럼장애의 자해행동 중재에 관한 체계적 고찰 : 비약물치료 중심으로)

  • Kim, Seul-kee;Choi, Jeong-sil
    • The Journal of Korean Academy of Sensory Integration
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    • v.17 no.1
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    • pp.30-42
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    • 2019
  • Objective : The purpose of this study is to analyze non-medication interventions for self-injurious behavior of individuals with autism spectrum disorders, using a systematic review, and to provide evidence of appropriate services for individuals with autism spectrum disorders with self-injury behaviors in the clinical practice of occupational therapy. Methods : Using the electronic databases PubMed, Medline (ProQuest), DBpia, RISS, KISS, and NDSL, we searched for articles published in Korean and international journals from December 2004 to November 2018. The main search term were "Autism OR Autism Spectrum Disorder AND Therapy OR Treatment Or Intervention AND Self Injurious Behavior." Qualitative analysis was performed, and the results are presented in the PICO format. Results : A total of 12 articles were selected. The quality of the evidence was highest in level IV and level V. Single studies with an experimental design were the most common. Behavior therapy was the most common type of intervention. The next most common interventions were behavioral therapy, brain stimulation and control, and sensory integration therapy with behavioral therapy. The self-injury behaviors of individuals autism spectrum disorders were decreased, and was statistically significant. Conclusion : This study investigated the use of non-medication interventions for children with autism spectrum disorders who showed self-injury behavior. Future research should use higher-level designs, and investigate differences between various non-medication interventions.

Pharmacotherapy for Patients Complaining With Somatic Symptoms (신체증상을 호소하는 환자의 약물치료)

  • Lee, Kyung-Kyu
    • Korean Journal of Psychosomatic Medicine
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    • v.29 no.2
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    • pp.95-101
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    • 2021
  • Patients complaining with somatic symptoms are very common in clinical practice, and are often consulted to medical department. But it is difficult to treat well. The treatment of somatic symptom disorder is multi-modal as none of the methods on their own provide a satisfactory outcome. The treatment of somatic symptoms disorders is complicated by lack of boundary, conceptual clarity, and overemphasis on psychosocial causation and effectiveness of psychological treatments. In clinical practice all classes of psychotropics are used to treat somatic symptoms disorder. Drugs such as tricyclic antidepressants, serotonin reuptake inibitors(SSRI), serotonin and noradrenalin reuptake inhibitors (SNRI), atypical antipsychotics are studied. The evidence indicates that these drugs are effective in somatic symptom disorders. All classes of antidepressants seem to be effective against somatic symptom disorders. SSRIs are more effective against hypochondriasis and body dysmorphic disorder, and SNRIs appear to be more effective than other antidepressants when pain is predominant. The author suggest that psychiatrists should know how to treat patients complaining with somatic symptoms by using not only psychotherapeutic approach but also pharmacological treatment. It will be helpful to reduce suffering and increase quality of life of these patients.

Growth Retardation in Chronic Renal Failure : Pathophysiology and Therapy

  • 김영미
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1996.11a
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    • pp.85-89
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    • 1996
  • 성장저해는 만성신부전 (chronic renal failure, CRF) 소아환자나 실험동물에게서 나타나는 합병증의 하나로, 그 발생기전이 잘 알려져 있지 않다. 성장저해를 일으키는 원인으로 비내분비적 요인 (metabolic acidosis, renal osteodystrophy, anemia)과 내분비적 요인의 복합적 결과로 생각하나, 비내분비적 요인들은 약물투여로 그 증세를 완화시켜도 성장저해에 대한 궁극적 치료효과는 나타나지 않는다. 따라서 성장 호르몬 (Growth Hormone, GH)이 관여하는 내분비적 요인의 변화에 그 병리기전이 있을 것으로 연구되어 왔다. GH는 직접적 성장 효과와 Insulin-like growth factor-1(IGF-I)을 간으로부터 유리시켜 나타나는 간접적 성장효과를 가지고 있다. 그런데 CRF환자의 GH 및 IGF-I 의 혈중 농도는 정상이거나, 흑은 오히려 증가상태에 있음에도 볼구하고 성장저해가 일어나는 것으로 보아, 환자의 말단기관 (end-organ)에 원인을 알 수 없는 저항성 (resistance)이 있다고 규정되어진다.

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Current Knowledge on Fatigue in Advanced Cancer Patients (진행된 암환자에서 피로의 최신지견)

  • Kim, Jung-Hyun;Choi, Youn-Seon
    • Journal of Hospice and Palliative Care
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    • v.11 no.4
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    • pp.175-180
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    • 2008
  • 진행된 암환자에서 피로는 70% 이상이 경험하게 되는 흔한 증상이며 삶의 질을 저하시키는 주된 요인이다. 피로에 대한 선별검사는 "피곤하거나 지친감이 있나요?"라는 단순한 질문으로 가능하며 이미 개발된 평가도구를 사용하여 평가할 수 있다. 동반 질환이나 피로의 원인을 알기 위한 병력청취와 검사실 검사가 필요할 수 있으며 결과에 따라 가역적 인자를 치료하는 과정이 우선되어야 한다. 적절한 약물치료를 시행하여 증상을 호전시킬 수 있으며 이중 methylphenidate는 암 연관 피로를 호전시키고 마약성 진통제에 의한 진정에 효과가 입증되었다. 환자의 여명에 따라 부신 피질 호르몬제도 사용할 수 있고, 운동 및 환자의 교육과 영양관리 또한 중요하다.

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Psychosomatic Intervention of Delirium (섬망에 대한 정신신체의학적 중재)

  • Kim, Byung-Su
    • Korean Journal of Psychosomatic Medicine
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    • v.16 no.2
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    • pp.75-80
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    • 2008
  • Delirium independently contributes to poor outcomes including prolonged hospital stays and increased risk of mortality. The reported prevalence of delirium in variety of medical and surgical hospital settings is from 15% to 70% ; delirium is, therefore, one of major reason for consultation that is required for psychosomatic interventions. This article reviews the psychosomatic interventions to treat delirium including 1) identification of risk factors and precipitating causes ; 2) non-pharmacological interventions, such as modifying treatment environment and educating patient's family and care-giver ; and 3) pharmacological approaches to control the various symptoms that are frequently presenting with delirium.

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발성치료

  • 남도현
    • Proceedings of the KSLP Conference
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    • 2003.11a
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    • pp.215-218
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    • 2003
  • 발성치료는 약400여년간 내려오고 있는 성악발성법 (벨칸토 발성)을 이용하여 음성을 교정하고 치료하는 방법으로 과학적이고 의학적으로 인정된 방법을 통하여 음성을 교육하고 교정하는 약물적이고 비 수술적인 치료 방법이다. 음성크리닉검사 1) 공기역학검사(Phonatory function analyzer test) 2) 최대발성지속시간(Maximum phonation time) 3) 컴퓨터 음성검사(Dotor speech. MDVP) 4) 듣기평가 5) 내시경검사(Stroboscopy) 6) 전기성문파형검사(EGG) 7) 호흡근력검사. (MIP. MEP. 등)및 호흡검사(FVC. FEVI. PF. 등) 8) 음성전문의사의 확진 후 발성치료권유 (중략)

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Efficacy and Safety during the Combination Therapy of Imipramine and Desmopressin in Primary Monosymptomatic Nocturnal Enuresis (어린이의 일차성 단일 증상성 야뇨증에서 Imipramine과 Desmopressin 복합 약물치료의 효과 및 안전성)

  • Yeo Ji-Hyun;Choi Jung-Youn;Chung Hyo-Seok;Lee Kyung-Soo;Ko Cheol-Woo;Kim Kyo-Sun;Kim Kee-Hyuk;Kim Jung-Soe;NamGoong Mee-Kyung;Park Young-Seo;Pai Ki-Soo;Yoo Kee-Hwan;Park Yong-Hoon
    • Childhood Kidney Diseases
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    • v.8 no.2
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    • pp.129-137
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    • 2004
  • Purpose : Nocternal enuresis is a common disorder. Tricyclic antidepressant and desmopressin have been accepted pharmacological treatment for this disorder We conducted a cooperative study to investigate the efficacy and adverse reactions of imipramine, desmopressin and combination treatment in children with primary monosymptomatic nocturnal enuresis(PMNE). Methods: Data from a large multicenter study were analysed. In the period of 8 months in 2002, the study comprised of 168 children(78 boys and 90 girls, 5 to 15 years old) with PMNE for imipramine, desmopressin or combination treatment. Before treatment a history, physical examination and laboratory tests were performed and the children were observed for 2 weeks. Response rate, adverse reactions and enuresis episodes after stopping drug administration were evaluated after 12-weeks of imipramine, desmopressin or combination of both. Results: After 4 weeks, the frequency of bed wetting in all treated patients decreased during treatment significantly Even though a 30-50%, reduction in the number of wet nights were 68.6%, 74.4% and 86.1% during 12 weeks treatment by imipramine, desmopressin and both of them respectively, there was no significant difference between them. The most common adverse reaction was decreased appetite from imipramine administration. But no serious drug-related adverse events were reported. Conclusion: Efficacy of the combination therapy of imipramine and desmopressin in PMNE appears not to be better than either drug alone. It is necessary to pay attention on account of adverse reactions during imipramine treatment even though imipramine and desmopressin were generally well tolerated.

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Hepatic Expression of Drug Metabolizing Enzyme in Diabetes (당뇨병에서 간의 약물대사효소 발현변화)

  • Oh, Jung-Min;Kim, Bong-Hee
    • Environmental Analysis Health and Toxicology
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    • v.23 no.3
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    • pp.165-170
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    • 2008
  • 간의 약물대사는 흡수된 외인성물질의 배설을 위한 중추적인 역할을 수행하면 이 반응은 일상대사와 이상대사효소로 구성된 약물대사효소계에 의해 매개된다. 약물대사효소의 발현과 활성은 외인성물질의 노출에 의해 유도되거나 억제되며 이 결과는 약물상호작용을 발생시키는 주요한 원인이다. 또한 당뇨, 비만, 영양실조, 음주, 염증반응 등의 병적인 생리상태는 간에서 약물대사효소의 발현과 활성을 조절하는 것으로 보고되고 있다. 이러한 변동은 치료약물 또는 환경오염물질에 대한 인체의 반응성에 영향을 미치며 결과적으로 예측하지 못한 부작용이나 독성을 발생시킬 수 있다. 본 논문에서는 당뇨병에서 약물대사효소의 발현변화를 정리하였다.

A CLINICAL STUDY OF THE EFFECTS OF STIMULANT DRUGS IN ATTENTION-DEFICIT HYPERACTIVE CHILDREN (주의력결핍 과잉운동장애 아동의 중추신경흥분제 치료에 대한 임상적 연구)

  • Kim, Haeng-Sook
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.1 no.1
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    • pp.89-93
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    • 1990
  • 60 Attention-deficit hyperactive patients treated with stimulant drugs such as methylphenidate and pemoline were evaluated in regards to the therapeutic benefit and side effects of these drugs. The results were as follows : 1) Of the 60 subjects 34 showed considerable imporvement and only 8 showed little or no improvement. 2) Hyperactivity, inattention and impulsivity were improved markedly by stimulants These behavioral changes were accompanied by improved performance in classroom. 3) School age children tended to show more improvement than preschool children or adolescence. 4) Of the 60 subjects 25 showed no side effect and only 6 showed severe side effects, and common side effects were decreased appetite, insomnia and irritability or nervousness. It is the author's impression that despite of the therapeutic efficacy of these drugs when they were administered on a short-term basis, long-term outcome dose not seem to be altered by the administration of these agents.

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