• Title/Summary/Keyword: 자가치료제

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Effects of Gout Web based Self-management Program on Knowledge Related to Disease, Medication Adherence, and Self-management (통풍 환자를 위한 웹기반 자가-관리 중재 프로그램이 통풍 관련 지식, 치료제 복용 순응도 및 자가-관리에 미치는 효과)

  • Oh, Hyun Soo;Park, Won;Kwon, Seong Ryul;Lim, Mie Jin;Suh, Yeon Ok;Seo, Wha Sook;Park, Jong Suk
    • Journal of Korean Academy of Nursing
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    • v.43 no.4
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    • pp.547-556
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    • 2013
  • Purpose: This study was conducted to examine the changing patterns of knowledge related to disease, medication adherence, and self-management and to determine if outcomes were more favorable in the experimental group than in the comparison group through 6 months after providing a web-based self-management intervention. Methods: A non-equivalent control group quasi-experimental design was used and 65 patients with gout, 34 in experimental group and 31 in comparison group, were selected from the rheumatic clinics of two university hospitals. Data were collected four times, at baseline, at 1 month, 3 months, and 6 months after the intervention. Results: According to the study results, the changing patterns of knowledge and self-management were more positive in the experimental group than in the control group, whereas difference in the changing pattern of medication adherence between two groups was not significant. Conclusion: The results indicate that the web-based self-management program has significant effect on improving knowledge and self-management for middle aged male patients with gout. However, in order to enhance medication adherence, the web-based intervention might not be sufficient and other strategies need to be added.

Relationships between Specific self-efficacy, Family support, and Self-care performance for Patients with Stomach Cancer after Gastrectomy (위암 수술환자의 구체적 자기효능감, 가족지지와 자가간호수행의 관계)

  • Jeon, Yun Hwa;Park, Geum Ja
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.1
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    • pp.456-465
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    • 2018
  • This study was conducted to investigate the relationships among self-efficacy, family support, and self-care performance of gastric cancer surgery patients. The study was conducted from 11 October to 15 November 2013. Data were collected by self-report questionnaires from 121 patients who were diagnosed with stomach cancer and had undergone surgery at D university hospital in B city and were in follow-up care for 3 months to 5 years after surgery. Data were analyzed using SPSS/PC WIN 18.0 to obtain the percentage, average, mean rating, and standard deviation. In addition, t-test, ANOVA, Scheffe's test, Pearson's correlation and stepwise multiple regression were conducted. The degree of self-care performance in research targets showed significant differences by sex (t=-2.25, p=0.027), religion (F=3.67, p=0.028) and profession (F=4.17, p=0.008). Self-care performance was positively correlated (r=0.60, p<0.001) with the degree of specific self-efficacy. There was a significant difference in self-care performance by specific self-efficacy, religion and gender. The total explanatory power was 37.9% and the explanatory power of the degree of specific self-efficacy (${\beta}=0.53$) was greater than that of other factors. Therefore, it is necessary to provide interventions that improve specific self-efficacy to help patients with gastric cancer patients conduct self-care performance, and practical measures should be made with respect to religion and gender.

희귀 의약품의 현재 상황과 발전 방향

  • Son, Yeong-Bae;Gu, Hyeon-Min;Jin, Dong-Gyu
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.13 no.1
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    • pp.62-68
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    • 2013
  • 우리나라의 경우 희귀질환은 국내 유병인구가 2만명 이하로 드물게 나타나는 질환으로 적절한치료 방법과 대체의약품이 개발되지 않은 병을 말한다. 희귀의약품은 대상 환자 수가 적어 연구개발이 어렵고 시장에서 수익성을 기대하기 어려워 제약기업이 쉽게 개발할 동기를 갖기 어렵기 때문에 선진국에서는 희귀의약품의 개발을 촉진하기 위한 제도를 운영하고 있다. 국내에서도 희귀질환자들에게 치료기회를 확대 제공하기 위한 일환으로, 1999년 정부의 적극적인 지원하에 한국희귀의약품센터가 설립되었다. 한국희귀의약품센터는 적용대상이 드물고 대체의약품이 없어 긴급한 도입이 요구되는 의약품 및 희귀질환자 치료용 약품의 구입공급과 제반 정보의 수집 및 제공을 함으로써 국민의 건강증진에 기여하고 있다. 한국희귀의약품센터의 주요 역할은 희귀의약품 및 희귀질환에 대한 최신정보를 수집 분류 데이터베이스화하여 이를 희귀의약품의 수요자 및 공급자 등 필요로 하는 자에게 제공하고 있으며, 특히 적용 대상이 드물고 대체의약품이 없어 긴급하게 도입할 필요가 있는 의약품 및 희귀질환자 치료용 의약품에 대하여 자가 치료용 의약품의 수입추천 안내 및 수입대행, 희귀의약품의 지정추천업무 등을 수행하고 있다. 희귀의약품 지정에 관한 규정은 1998년 4월 16일에 식품의약품 안전처에서 고시하였으며 2013년 2월에 식약처에서 고시 제 2013-8호로 개정하였다. 개정 이유는 지속적인 투자, 연구 개발이 필요한 희귀의 약품의 개발을 활성화하고 지정 한도액을 상향하는 등 희귀의약품 지정제도 개선하고자 하는 것이다. 이번 개정의 주요 내용은 개발 초기부터 '개발단계 희귀의약품' 지정하고 지정 갱신을 위해 별도 생산(수입)실적 보고를 폐지하며, 위탁제조판매업자의 희귀의약품 지정 신청을 가능하게 하고, 유병인구 500명 이하인 경우 지정한도 금액 상향 등이다. 이번 개정을 통해 희귀의약품에 대한 연구 개발이 더욱 확대 될 것으로 기대하며, 앞으로도 희귀질환 환자들에게 원활하게 희귀의약품이 공급되도록 지원 정책이 추진되어야 할 것이다.

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Patients' perspectives on taking insulin in diabetes - Perspectives of convergence (인슐린 치료에 대한 당뇨병 환자의 지각과 경험 - 융복합적 관점)

  • Song, Youngshin;Ah, Eunkyong
    • Journal of Digital Convergence
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    • v.14 no.12
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    • pp.283-292
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    • 2016
  • The purpose of this study was to explore the cultural perspectives and experiences relating to insulin therapy among the diabetes. The authors conducted four semi-structured focus groups and individual interviews with 19 adults with type 1 and 2 diabetes, focusing on the personal experiences and thoughts regarding insulin therapy. Patients' perspectives and experiences relating to taking insulin formed three categories of themes: preoccupations about insulin, barriers to taking insulin, and benefits to taking insulin. The theme for preoccupations about insulin was "vague fear," while the theme of barriers to taking insulin were "worrisome insulin-related issues", "ambivalent feelings (trust/mistrust) about healthcare providers," "dependent life," "feeling about supporters(family, friends, and religion)," "inconvenience," "regret about the past," and "embarrassment." The theme of benefits to taking insulin were "recognition" and "physical recovery and confidence in regulating blood glucose". Based on this study, patients' feelings about their insulin should be respected by healthcare providers.

Change of Pulmonary Artery Hemodynamics and Pulmonary Vascular Resistance in Experimental Pulmonary Embolism (실험적 급성 폐색전증에서 폐동맥혈역학 및 폐혈관저항의 변화)

  • Chung, Hee-Soon;Lee, Jae-Ho;Kim, Cheol-Ho
    • Tuberculosis and Respiratory Diseases
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    • v.42 no.6
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    • pp.913-922
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    • 1995
  • Background: When we define the pressure of pulmonary vasculature in which a recruitment of blood flow occurs as $P_I$ and the proportion of change in pulmonary artery to that in cardiac output as IR and then we compare PI and IR with pulmonary vascular resistance, we would find some problems in pulmonary vascular resistance. In other words, it is the theory that, IR should be increased mainly in pulmonary embolism in which decreases the cross sectional area of pulmonary vasculature. But there are many contradictory reports resulted from various researches and the fact is known widely that any difference exists between PVR and PI, IR. For this reason, the purpose of this study is to observe how PI and IR change at the time of the outbreak and during treatment of the pulmonary embolism, and to find out the meaning of these new indicators and the difference from the pulmonary vascular resistance used generally when we subdivide the pulmonary vascular resistance into PI and IR. Method: After making AV fistula in experimental dog, we controlled cardiac output at the intervals of 15 minute in case of three kinds(all AV fistula are obstructed, only one of fistula is open and all of fistula is open), and after evoking massive pulmonary embolism with radioactive autologous blood clots, we measured the mean pulmonary artery pressure, and calculated PI and IR. We observed the pattern of change in PI and IR, without giving the control group any specific treatment and with injecting intravenously rtPA in the Group 1 and Group 2 at the dose of 1mg per kg, for 15 minutes fot the former and 3 hours for the latter. Result: 1) Pulmonary vascular resistance showed a change similar to that of pulmonary artery pressure and in all three group, PVR increased significantly, but group 1 and group 2 showed tendency that PVR keeps on decreasing after treatment, and the rate of decrease in group 1 is more rapid than group 2 significantly. 2) Both intersection(PI) and degree(IR) are proved statistically significant, in view of the straight line relationship between cardiac output and pulmonary artery pressure, calculated by minimal regression method. 3) PI changed similarly to pulmonary vascular resistance, while in the IR which is theoretically more similar to PVR, there was no significant difference or change after rtPA infusion. Conclusion: In the pulmonary embolism, Both change in IR which means real resistance of pulmonary vasculature and PI which was developed due to secondary vasoconstriction by pulmonary embolism are reflected same time.

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Long-Term Result of Surgical Treatment for Renovascular Hypertension (신혈관성 고혈압의 외과적 치료 결과)

  • 우건화;김창호
    • Journal of Chest Surgery
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    • v.29 no.4
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    • pp.393-396
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    • 1996
  • During the past eight years, we have encountered 9 patients, aged between 2 and 61 years, with renovascular hypertension. The renovascular hypertension In this series included Takayasu's disease with renal artery stenosis, arteriosclerosis of renal artery, fibromuscular dysplas a of renal artery Aortd-renal bypass was performed In 8 patients, iliac-to-renal bypass in 1 patient. 9 patients have been followed form 2 months to 5.1 years. Postoperatively, all patients'hypertension was improved. Only 2 patients need to take small dose of antihypertensive medication after discharge. These data indicated the good results of renovascular reconstruction for the patients with renovascular hypertension.

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Efficacy of Herbal Medicines for the Treatment of Seborrheic Dermatitis : Systematic Review (지루성 피부염의 한약 치료 효과에 대한 체계적 문헌고찰)

  • Kim, Jeong-Yoon;Jang, Young-Woo;Kim, Hye-Gyeong;Lim, Seung-Hwan
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.31 no.3
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    • pp.67-83
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    • 2018
  • 목적 : 체계적 문헌고찰을 통하여 지루피부염에 한약복용의 효과와 연구의 질을 평가하기 위함. 방법 : OASIS, NDSL, EMBASE, Pubmed, Cochrane Library, CINAHL, CNKI, WANFANG, CiNii, J-STAGE를 이용하여 검색하였다. 검색은 2018년 6월 21일에 시행되었으며 P는 지루성 피부염, I는 한약 복용으로 진행하였다. 두 명의 연구자가 독립적으로 연구를 평가하고 선정하였으며, 의견이 다를 경우 제 3자가 개입하여 다수결로 결정하였다. 결과 : 중복 검색을 제외하고 총 952개의 연구가 검색되었으며 제목과 초록을 검토한 결과 897개의 연구가 제외되었다. 나머지 55개 연구의 전문을 검토한 결과 4개의 RCT연구가 최종 선정되었다. 선정된 연구는 발행연도, 대상, 중재법, 평가방법, 효과, 부작용, RoB를 통해 평가하였다. 한약 복용을 한 치료군에서 대조군에 비해 유의하게 호전을 보였으며 중대한 부작용은 없었다. 결론 : 지루성 피부염에 있어 한약 복용은 효과적이며 안전성이 있는 하나의 치료법이다. 향후 다양하고 체계적인 RCT의 시행이 요구된다.

Comparison of clinical and laboratory characteristics in children with type 1 diabetes according to pancreatic autoantibodies (췌장 자가 항체 유무에 따른 제 1형 당뇨병의 임상 및 검사 소견의 비교)

  • Choi, Ji Hae;Kim, Min Sun;Kim, Chan Jong;Kim, Jong Duk;Lee, Dae-Yeol
    • Clinical and Experimental Pediatrics
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    • v.53 no.3
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    • pp.414-419
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    • 2010
  • Purpose : The purpose of this study was to determine whether there is any difference in the clinical and laboratory characteristics of patients with autoantibody-positive and patients with autoantibody-negative type 1 diabetes at initial presentation. Methods : We analyzed 96 patients under 18 years of age with newly diagnosed type 1 diabetes. One or both of the pancreatic autoantibodies-glutamic acid decarboxylase autoantibodies (GADA) and insulin autoantibody (IAA)-were measured in all patients, and we reviewed clinical and laboratory characteristics according to the presence of these autoantibodies. Results : GADA was examined in 48 of 87 patients, and 55.2% of patients were positive. IAA was checked in 88 patients, and 39.8% were positive. Both GADA and IAA were measured in 83 patients, and 22.8% had both antibodies. The patients who had one or both autoantibodies (autoantibody-positive group) were younger than those not having any autoantibody (autoantibody-negative group). The autoantibody-positive group had lower BMI, corrected sodium level, and serum effective osmolarity, compared to the autoantibody-negative group (P <0.05). Similar differences were found between the GADA-positive and GADA-negative groups. However, there were no significant differences between the IAA-positive and IAA-negative groups. Conclusion : The prevalence of pancreatic autoantibodies was significantly higher in the under-6 years age group than in the other age groups. These findings suggest that measurement of autoantibodies at the initial diagnosis of diabetes is very useful for detecting immune-mediated type 1 diabetes and providing intensive insulin therapy, especially in younger children.

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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Multiple low-dose Streptozotocin 유도 Type I 당뇨병 상태의 면역 기능에 미치는 Brazilin의 영향

  • 문창규;양경미
    • Proceedings of the Korean Society of Applied Pharmacology
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    • 1994.04a
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    • pp.321-321
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    • 1994
  • 다양하고 복잡한 기전에 의하여 정교히 조절되고 있는 면역 체계의 비정상적인 기능에 비롯된 자가 면역 질환을 개선, 치료하기 위하여 지금까지 많은 면역 조절제가 개발되어 온 바 있으며, 이들의 면역 조절 기전은 약물에 따라 그 효능에 있어 차이가 크고 독성등의 부작용등으로 인해 그 사용이 현저히 제한되고있는 경우가 많아 보다 안전하고 효능있는 새로운 면역 조절제의 개발은 아직도 매우 중요한 의의를 지니고 있다. 이러한 관점에서 본 연구실에서는 천연물로부터의 새로운 면역 조절제의 검색을 수행하여 온 바 있으며, 그중 Brazilin이 Low-dose Streptozotocin의 반복 투여에 의해 유도되는 당뇨병 상태의 면역 조절 기능에 미치는 영향에 대해서 검색하고자 하였다. 실험의 결과를 종합하여보면, Brazilin은 외부항원 (SRBC)의 유입시 정상 대조군에 비해 현저히 저하되어 있는 T cell의 기능을 정상 대조군 혹은 그 이상으로 증가시키는 효과를 나타내었으며, B cell의 기능 역시 활성화 시키는 것으로 관찰되었다. 이로부터 Brazilin은 Streptozotocin 유도 당뇨병 상태의 면역기능을 정상화시키는 면역 조절활성을 갖는 것으로 판단되었다.

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