• 제목/요약/키워드: Bowel sounds Analysis

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기능성(機能性) 소화불량증(消化不良症) 환자(患者)의 식후(食後) 심하비만과 pyloric valve의 기능장애(機能障碍);장음과 위전도를 중심으로 (Postprandial Epigastric Fullness and Pyloric Valve Disturbance in Patients with Functional Dyspepsia;Analysis of Bowel Sounds and Electrogastrography)

  • 윤상협
    • 대한한방내과학회지
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    • 제28권4호
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    • pp.769-778
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    • 2007
  • Background & Object : Postprandial epigastric fullness is one of common symptoms in functional dyspepsia, but its pathophysiological mechanism has still been unknown. In this study, its association between postprandial epigastric fullness and pyloric valve disturbance was studied through analysis of bowel sounds and electrogastrography. Methods : Bowel sounds and electrogastrography were recorded together for fasting 15 min and postprandial 40 min. Parameters of bowel soundincluding motility index, sound to sound interval, standard deviation of sound to sound interval, sounds per minute, % of bowel sound, sound length, intensity, dominant frequency of sounds, and postprandial / fasting ratio of dominant frequency of sounds were analyzed with a specialized program. By electrogastrography, regularity of slow waves and power ratio were obtained. Results : Significances of bowel sounds appeared in motility index (p=0.046), dominant frequency of fasting (p=0.048), postprandial (p=0.003), and the ratio of postprandial/fasting (p=0.000); those of EGG parameters were shown in postprandial regularity of slow waves (p=0.006) and power ratio (p=0.011). Conclusion : Pyloric valve disturbance was a cause of postprandial epigastric fullness in patients with functional dyspepsia. Analysis of bowel sound might be useful in diagnosing its existence.

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기능성 소화불량증 환자의 위장관 부교감 신경, 위 유문부의 기능 및 임상양상에 대한 조사 (한방병원 내원 환자를 중심으로) (A Study of Gastrointestinal Parasympathetic Nerve Activity and Pyloric Valve Function, and Clinical Characteristerics in Patients with Functional Dyspepsia - Analysis of Bowel Sound)

  • 홍인아;윤상협
    • 대한한방내과학회지
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    • 제29권3호
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    • pp.666-674
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    • 2008
  • Objectives : The aim of this study was to evaluate gastrointestinal parasympathetic nerve activation and pyloric valve function in patients with functional dyspepsia through analysis of bowel sounds and to investigate clinical characteristics associated with the parameters of bowel sounds. Method : We surveyed clinical characteristics of patients by using a questionnaire about functional dyspepsia. Bowel sounds were recorded for 15 minutes during fasting state and for 40 minutes during postprandial state. We then classified the patients into 3 groups by abnormal states of bowel sounds, specifically by the percentage of B.S. and dominenet frequency, and studied clinical characteristics in each group. Results : Among the 182 subjects, patients who had low activity of parasympathetic nerve were 25.8% and showed a tendency of female-dominant, family history and more frequent abdominal pain. Those who had pyloric valve disturbance were 24.1% and showed no tendency by sex distribution, family history and complained of indigestion sensation. Patients who had both disorders were 10.9%, and their clinical characteristics were non-specific. Conclusion : Analysis of bowel sounds may be useful in evaluating pathophysiological factors of functional dyspepsia.

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기능성 소화불량증 환자의 두통은 위 운동성 장애에 의한 증상이 될 수 있는가? (Could Headache be one of Symptoms induced by Gastric Dysmotility in Patients with Functional Dyspepsia?)

  • 박영선;윤상협
    • 대한한방내과학회지
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    • 제30권3호
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    • pp.604-611
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    • 2009
  • Objectives : The aim of this study was to investigate the relationship between headache and gastric dysmotility in patients with functional dyspepsia by using electrogastrogram and bowel sounds analysis. Methods : 127 patients(male 40, female 87) with functional dyspepsia were enrolled. By using inquiry and the questionnaire, we examined whether each patient had headache and abdominal pain. All patients were divided into 4 groups according to the above symptoms. Gastric motility was measured during the fasting-postprandial state by using electrogastrogram and bowel sounds analysis. Results : 33 patients complained of headache. There was a significant difference between headache patients and non-headache patients in gastric arrhythmia of the fasting state. Moreover, in headache patients without abdominal pain, postprandial improvement of gastric arrhythmia was poorer than the other groups. So, headache patients without abnormal pain had more severe gastric myoelectrical rhythm disorder than headache patients with abdominal pain. Conclusion : Headache could be one of symptoms induced by gastric dysmotility in patients with functional dyspepsia. Especially, headache in functional dyspepsia was related to gastric arrhythmia.

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장음 특징 변수의 회귀 분석을 통한 장 운동성 추정법 (Estimation Algorithm of Bowel Motility Based on Regression Analysis of the Jitter and Shimmer of Bowel Sounds)

  • 김거식;서정환;김민호;유상훈;송철규
    • 전기학회논문지
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    • 제60권4호
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    • pp.877-879
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    • 2011
  • Bowel sounds (BS) are produced by the movement of the intestinal contents in the lumen of the gastro-intestinal tract during peristalsis and thus, it can be used clinically as useful indicators of bowel motility. We devised an estimation algorithm of bowel motility based on the regression modeling of the jitter and shimmer of BS signals measured by auscultation. Ten healthy males ($23.5\pm2.1$ years) were examined. Consequently, the correlation coefficient, coefficient of determination and standard error between the colon transit times (CTT) measured by a conventional radiograph and the values estimated by our algorithm were 0.98, 0.96 and 2.86, respectively. Also, through k-fold cross validation, the average value of the absolute differences between them was $5.0\pm2.5$ hours. This method could be used as a complementary tool for the non-invasive measurement of bowel motility.

각기 다른 유문-십이지장의 기질적 병변 3증례에 대한 장음 측정 보고 : 장음의 주주파수를 중심으로 (Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases)

  • 윤상협
    • 대한한방내과학회지
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    • 제36권3호
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    • pp.276-283
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    • 2015
  • Objectives: The purpose of this study is to report bowel sound patterns recorded in 3 diseases associated with structural deformity of the pylorus-duodenum. Methods: : Bowel sound recording is a useful non-invasive tool for the evaluation of gastrointestinal motility. However, the difficulty in manual attachment of the electronic stethoscope on the abdominal wall and noise production against bowel sound signals have prohibited its widespread use. Therefore, I developed a new apparatus that eliminates the noise; it contains a sound absorbing device and a holder for the head of stethoscope. Using the new bowel sound recording system, bowel sounds of the patients were recorded repeatedly. The endoscopic and abdominal computed tomography findings were obtained from other hospitals' medical record, and all patients were confirmed to have structural deformity in the pylorus-duodenum. The records of each patient were compared and assessed. Results: : Patients had either duodenal ulcer scar, pyloric stricture, or far advanced malignant stomach cancer, as diagnosed by the gastroscopy. Their dominant frequency of bowel sound obtained from the new system was checked more than 2 times at regular intervals. All 8 recordings in the 2 patients with duodenal ulcer scar (5 times) or pyloric stricture (3 times) showed a decrease in postprandial than fasting dominant frequency. One patient with stomach cancer showed no significant change between postprandial and fasting states at 2 recordings. Conclusions: The analysis of dominant frequency in bowel sounds can indicate the existence of pyloric obstruction that could delay gastric emptying.

한방치료가 위 미주신경 활성 저하와 유문부 기능 장애가 병발된 기능 소화불량중 환자에 미치는 선택적 효능 (A Selective Effect of Combined Treatment of Electroacupuncture at Zusanli(ST36), Manual Acupuncture, and Pyengwi-san in Function Dyspepsia Patients with Pyloric Valve Disturbance and Hypoactivity of Gastric Vagus Nerve)

  • 김소연;윤상협
    • 대한한방내과학회지
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    • 제30권1호
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    • pp.191-199
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    • 2009
  • 목 적 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에서 전침 및 한약의 복합처치 치료가 이 두가지 면에서 각각 어떤 영향을 미치는지를 살펴보았다. 방 법 : 장음검사상 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 환자 10명을 대상으로 치료 전후의 장음 지표 변화를 비교하였다. 장음지표는 % of bowel sound (%BS)와 주 주파수(dominant frequency, DF)를 사용하였으며, %BS(6인 경우를 위 미주신경 활성저하 DF ratio(식후/식 전)<1를 유문부 기능장애로 평가하였다. 환자들에게 2주간 족삼리전 침과 체침이 매일 시술되었으며 평위산 전탕액이 하루 3회 투여되었다. 결 과 : 2주간의 치료 후 DF ratio는 $0.93\pm0.06$에서 $1.06\pm0.04$으로 유의성있게 증가했으며, 10명 중 9명의 환자가 DF ratio>1의 정상치로 회복되었다. %BS 역시 $2.97\pm1.17%$에서 4.27%로 증가했지만 통계적 유의성은 없었으며, 3명의 환자에서 %BS가 6이상으로 정상회복되었다. 결 론 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에 대한 족삼리 전침과 일반 체침, 평위산의 치료는 미주신경 활성 저하보다는 유문부 기능 장애에 더 유의한 효과를 보였다.

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기능성 소화불량증 환자의 위 미주신경 활성 및 유문부 기능에 대한 족삼리(足三里) 전침과 일반 체침 자극의 복합 효능 (Combination Effects of Zusanli(ST36) Electroacupuncture and Manual Acupuncture of other Acupoints on Gastric Vagal Nerve Activity and Pyloric Valve Function in Patients with Functional Dyspepsia.)

  • 김유승;윤상협
    • 대한한방내과학회지
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    • 제29권3호
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    • pp.621-628
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    • 2008
  • Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.

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