• 제목/요약/키워드: Diagnosis and prescription

검색결과 205건 처리시간 0.025초

Effective Management of Acute Necrotizing Ulcerative Gingivitis with Proper Diagnosis and Immediate Treatment

  • Kwon, Eun-Young;Choi, Youn-Kyung;Choi, Jeomil;Lee, Ju-Youn;Joo, Ji-Young
    • Journal of Korean Dental Science
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    • 제9권2호
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    • pp.81-89
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    • 2016
  • Necrotizing periodontal diseases, especially acute necrotizing ulcerative gingivitis (ANUG), it should be noted, occur abruptly and progress rapidly, eventually causing severe soft-tissue and alveolar bone loss. This report presents the cases of two ANUG patients and provides a brief treatment protocol for easy and effective clinical management. After proper diagnosis, sequential treatment with cessation of mechanical brushing, along with a prescription of systemic antibiotics and chlorhexidine as a mouth rinse, scaling, root planing, and supportive periodontal therapy, was utilized. In all cases discussed in this report, there was marked improvement in a few days. ANUG, though an uncommon disease, can be efficiently managed with proper diagnosis and immediate treatment.

附骨疽에 關한 文獻的 考察 (A literatual studies on the suppurative osteomylitis(附骨疽))

  • 황도건;노석선
    • 한방안이비인후피부과학회지
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    • 제11권1호
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    • pp.99-140
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    • 1998
  • In the literatual studies on the suppurative osteomylitis(附骨疽), the results were as follows. Suppurative osteomylitis(附骨疽) is called 'Mudujur(無頭疽)', is concerned with Pyogenic osteomyelitis in western medicine. The pathogenic factors of Suppurative osteomylitis were caused by exposing to wind-cold-wetness evil, or body weakness, or wound a bodily injury caused by physical means. The symptoms of Suppurative osteomylitis was alternating episodes of chills and fever, pain on buttock or thigh in onset. The differential diagnosis of Suppurative osteomylitis was divided three parts. One was the stagnation of virulent fire-evil. Another was the deficiency of both vital energy & blood. The other was wind-cold-wetness evil. The treatments of Suppurative osteomylitis was clearing away heat-evil and wetness evil, removing blood stasis and promoting meridian. In the frequency of prescription, the most numerous prescription were Osintang(五神湯) and Hwangyunhaidoktang(黃連解毒湯), the next were Neitakganghwaltang(內托羌活湯), Taibangpungtang(大防風湯) etc.

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의약분업 실시 전후 보건소 내소환자 진료내용 변화 (The Changes in Patients and Medical Services by Separation of Prescribing and Dispensing Practice in Health Center)

  • 천재경;감신;한창현
    • 농촌의학ㆍ지역보건
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    • 제27권2호
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    • pp.75-86
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    • 2002
  • 의약분업실시 전후 보건소 투약환자의 특성변화, 질병양상변화 그리고 진료내용변화를 알아보기 위해 의약분업 전인 2000년 3월과 의약분업 후인 2001년 3월 각각 한 달 동안 경상남북도에 소재한 4개 보건소(도농복합형 시보건소 2개소, 군보건소 2개소)를 의약분업 전과 후에 이용한 투약환자 5,890명(의약분업 전)과 3,496명(의약분업 후)을 대상으로 건강 보험 및 의료급여 청구서를 이용하여 투약환자의 성, 연령, 주 진단명, 의료보장종류, 내소일수, 투약일수를 조사하였다. 또한 의약품 처방의 변화를 알기 위해 급성 호홉기질환 및 근골격계 질환자에 처방한 약제 종류수, 주사제 사용률, 항생제 사용률, 고가소염제 사용률를 조사하였다. 투약환자의 질환별로는 분업 전에 비해 급성호흡기 질환자는 49.7%, 고혈압환자는 18.1%, 근골격계질환자는 70.5%, 당뇨병환자는 8.5%, 소화기계질환자는 71.2%, 만성호흡기질환자는 76.4% 감소하였으며, 요도감염질환자는 의약분업 전에 비해 66.7% 증가하였다. 의약분업 전후 평균 내소일수의 변화는, 성별로는 남녀 모두 의약분업 전 보다 후가 유의하게 감소하였고(p<0.01), 의료보장형태별도는 건강보험은 유의하게 감소하였으나(p<0.01), 의료급여는 유의한 변화가 없었다. 질환별로는 고혈압, 당뇨병, 근골격계질환에서 유의하게 감소하였다(p<0.01). 의약분업 전후 평균 투약일수는 유의하게 증가하였다(p<0.01). 질환별로는 요도감염을 제외한 다른 질환들은 유의하게 증가하였으며(p<0.01), 요도감염은 증가는 하였으나 통계적으로 유의하지는 않았다. 의약분업 전후 급성호흡기질환자에 대한 평균 처방 약제 종류수는 4.9개에서 4.7개로 유의하게 감소하였고, 주사제 사용률은 63.8%에서 7.7%로 유의하게 감소하였으며, 항생제 사용률은 33.7%에서 19.1%로 유의하게 감소하였 다(p<0.01). 의약분업 전후 근골격계질환자에 대한 평균 처방약제 종류수는 3.7개에서 3.2개로 유의하게 감소하였으며, 주사제 사용률은 64.9%에서 1.7%로 유의하게 감소하였고, 고가 소염제 사용률은 29.1%에서 39.7%로 유의하게 증가하였다(p<0.01). 이상의 결과 의약분업 후 내소환자의 평균 내소일수는 감소한 반면 평균 투약일수는 증가하였다. 의사의 처방형태의 변화로는 평균 약재 종류수는 감소하였고 주사제나 항생제 처방률은 급격히 감소하였으나, 고가 소염제의 처방률은 증가하였다.

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기초 온톨로지 기반 한의 진단 시스템 (Traditional Korean Medicine Diagnosis System Based on Basic Ontology)

  • 김상균;장현철;김진현;오용택;김철;예상준;송미영
    • 동의생리병리학회지
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    • 제24권6호
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    • pp.1111-1116
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    • 2010
  • We in this paper design and implement a traditional korean medicine diagnosis system based on basic ontology. If doctors put the symptoms or tongues or pulses of a patient in the diagnosis system, they can be recommended for the diagnosis results. To support the doctors decision, the diagnosis system make the inference based on the basic ontology and compute the similarity between symptoms of patient and those of ontology. The diagnosis systems also provide the learning mechanism about diagnosis results which save the results in the ontology and reuse them in the next diagnosis. Thus, doctors can share their knowledge for the diagnosis by exchanging their ontology each other. In future, we will expand the knowledge of the basic ontology continuously so that doctors can get the more accurate diagnosis results. We also implement the prescription function and integrate it to the diagnosis system.

노인 입원환자에 대한 항궤양약물 처방양상 분석 (Drug Utilization Review of Antiulcerative Agents in Korean Elderly Inpatients)

  • 이원식;이승미;구혜원;박병주
    • Journal of Preventive Medicine and Public Health
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    • 제35권1호
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    • pp.41-48
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    • 2002
  • Objectives : To review the drug prescription pattern of antiulcerative agents for elderly inpatients, Methods : The study population comprised inpatients of community hospitals who were members of the Korean Elderly Pharmacoepidemiologic Cohort (KEPEC), aged 65 years or over, beneficiaries of the Korea Medical Insurance Corporation (KMIC) and residing in Busan city in 1993. The drug prescription information was collected from the claims data of hospitals where the cohort members received medical care between January 1993 and December 1594. The information included personal identification, age, gender, diagnosis, drug dosage, date of hospital admission and name of medical institutions where the study subjects received drug prescriptions. The data analysis produced outcomes in terms of distribution of antiulcerative agents by class and by medical institution and trend of relative prescription, Analysis was also performed in terms of combined prescriptions of antiulceratives and drugs that could induce risk from drug interaction with antiulceratives. Results : The number of patients prescribed antiulcerative agents was 1,059 (64,9%) male and 1,724 (65.5%) female among the total inpatients. An antacid and composite agent was the most frequently prescribed antiulcerative agent (70.8%), followed by $H_2$ antagonist (16.0%), Among the potential drugs that could induce risk from drug interaction with the antiulcerative agents, diazepam was the most frequently prescribed. The proportion of diazepam co-prescription was 22.5% of the total cimetidine prescriptions and 14.5% of the fetal omeprazole prescriptions. Conclusions : Antiulcerative drugs were frequently prescribed in the elderly inpatients. The adverse drug reaction could possibly be due to drug interaction. The study results could be used as fundamental data for further drug utilization review of antiulceratiye agents.

정신건강의학과 개방병동 입원 환자의 진단군별 약물 처방 경향 변화 : 경기도 소재 일 대학병원에서의 11년 비교 연구 (Changes in Psychotropic Prescription Patterns in Patients Admitted to an Open Psychiatric Ward : Eleven-Year Comparison in a University Hospital in Gyeonggi-Do)

  • 변선정;김의태;유희정;하태현;윤인영;김기웅
    • 생물정신의학
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    • 제22권4호
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    • pp.195-204
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    • 2015
  • Objectives This study investigated the patterns of psychotropic medications prescribed to patients admitted to an open psychiatric ward. Methods We reviewed 4282 medical records of patients who were discharged from an open psychiatric ward from May 2003 through April 2014. Data were collected on each patient's age, sex, length of hospital stay, number of past admissions, discharge diagnosis, and kinds and dosages of psychotropic medications at discharge. Results Among the 1384 male and 2898 female patients, 3.56 psychotropic medications were prescribed on average, with the number increasing across years, from 3.30 in 2003-2008 to 3.76 in 2009-2014. Prescription rates of antipsychotics, anxiolytics, and hypnotics significantly increased in patients with depressive disorders, bipolar disorders, anxiety disorders, delirium, dementia, and amnestic and other cognitive disorders. Only lithium prescription rates decreased significantly. Prescriptions for two or more anxiolytics and antipsychotics increased during the survey years, while antidepressant polypharmacy rates decreased. Conclusions Recently, there has been a significant increase in the number of psychotropic medications prescribed, including antipsychotics, anxiolytics, and hypnotics. Caution should be exercised when prescribing medications to avoid cost increases and the risk of side effects, with uncertain gains in the quality of care.

지황음자(地黃飮子)의 기원(起源), 방해(方解) 및 활용(活用)에 대한 고찰(考察) (Study on The Origin, Explanation and Application of Jihwangeumja(地黃飮子))

  • 홍승헌;김윤경;권동렬
    • 대한한의학방제학회지
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    • 제11권1호
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    • pp.37-44
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    • 2003
  • The source of prescription of Jihwangeumja to treat the mental confusion due to phlegm caused by kidney 'deficiency and Yin and Yang deficiency is found in 'Hwangjesomunseonmyeongronbang $\ll$黃帝素問宣明論方$\gg$'. The source of prescription of Jihwangeum is found in 'Seongjechongnok $\ll$聖濟總錄$\gg$'. Therefore, it seems reasonable to change the prescription to 'Jihwangeum' from 'Jihwangeumja' and to change the source of prescription to 'Seongjechongnok $\ll$聖濟總錄$\gg$' from 'Hwangjesomunseonmyeongronbang $\ll$黃帝素問宣明論方$\gg$'. In addition, 'Jihwangeum' is influenced by 'Naebosan' in 'Cheongeumbang $\ll$千金方$\gg$'. Jihwangeumja gave the substantial influence on the treatment of 'Endogenous wind due to hyperactivity' of Yeopcheonsa. Jihwangeumja supplements the true Yuan, smooths the circulation of the flow inside a body and coordinates the interaction between heart and kidney so that it ultimately eliminates sputum and activates circulation inside a body. If the guideline of diagnosis is accurate, many kinds of diseases can be effectively treated through the principle of treating different disease with the same therapy. In addition, it will be also effectively used for headache after cerebral hemorrhage, trigeminal neuralgia(sore tongue), diabetes insipidus, nervous breakdown, hyperthyroidism, chronic glomerulonephritis, infertility and anemia.

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8증례를 통한 사암침법(舍巖鍼法)의 형상의학적(形象醫學的) 운용에 관한 고찰 (A Study of Eight Cases According to Hyeongsang Diagnosis Applying Sa-am Acupuncture Therapy)

  • 최준영;남상수;김용석;이재동
    • Journal of Acupuncture Research
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    • 제29권1호
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    • pp.139-150
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    • 2012
  • 1. 형상의학(形象醫學)에서는 사람을 얼굴형태에 따라 정(精) 기(氣) 신(神) 혈(血)과로 이목구비(耳目口鼻)의 기능에 따라 어(魚) 조(鳥) 주(走) 갑류(甲類)로 분류하며, 이러한 분류에 따른 장부(臟腑)의 특성을 사암침(舍巖鍼) 운용에 활용하면 임상에서 활용도가 높다. 2. 어류(魚類)는 수(水)의 기운(氣運)이 많아 수체(水體)라고도 하며 신장(腎臟)이 발달하여 신장(腎臟)과 관련된 병이 오기 쉽다. 그 본치(本治)가 보정보기(補精補氣)이며 주로 신정격(腎正格)을 운용하고 신양허쇠(腎陽虛衰)인 경우 신열격(腎熱格), 신음허(腎陰虛)인 경우 신한격(腎寒格)을 쓰며 정혈(精血)의 휴손(虧損)이 심한 경우 간정격(肝正格)도 운용할 수 있다. 3. 조류(鳥類)는 화(火)의 기운(氣運)을 많이 받아 화체(火體)라고도 하며 심장(心臟)이 발달하여 심장병(心臟病) 신경성 질환이 잘 온다. 그 본치(本治)가 자음강화(滋陰降火)며 심장(心臟)의 음혈(陰血)을 보(補)하고 화(火)를 내리는 심한격(心寒格)을 위주로 하여, 심화(心火)를 사(瀉)하면서 음혈(陰血)을 보해주고 신지(神志)를 안정시키는 심승격(心勝格), 심기(心氣)가 부족한 경우 심정학(心正格), 심담(心膽)이 모두 허(虛)한 경우 담정격(膽正格)을 운용할 수 있다. 4. 주류(走類)의 목(木)의 기운(氣運)이 많아 목체(木體)라고도 하며 간(肝)이 발달(發達)하여 간(肝)과 관련된 병(病)이 잘 온다. 그 본치(本治)가 청열사습(靑熱瀉濕), 자혈양근(滋血養筋)이므로 간정격(肝正格)을 주로 운용하고, 간화(肝火)가 동(動)하거나 간실증(肝實證)이 나타난 경우 간한격(肝寒格)이나 간승격(肝勝格)을, 간기(肝氣)가 항진(亢進)으로 인해 비기(脾氣)가 허(虛)해져 있는 경우 비정격(脾正格)을, 습열이 너무 성(盛)한 경우 대장정격(大場正格)을 운용할 수 있다. 5. 갑류(甲類)는 금(金)의 기운(氣運)이 많아 금체(金體)라고도 하며 폐(肺)가 발달하여 폐(肺)와 관련된 병이 잘 온다. 그 본치(本治)가 해울소담(解鬱消痰)이므로 폐정격(肺正格)을 통해 보폐순기(補肺順氣)하며 울증(鬱症)이 심한 경우 폐승격(肺勝格)으로 통해 소담(消痰)시켜주고 기울방(氣鬱方)으로 해울(解鬱)하기도 한다. 6. 정과(精科)는 그 특성상 정(精)의 누설(漏泄)에 의한 증상 및 정부족(精不足), 양허증상(陽虛證狀)과 정(精)의 과도한 응집(凝集)에 의한 습열(濕熱)이 기본 병리이며 기본처방은 신기(腎氣)를 강화하는 신정격(腎正格)을 중심으로 하여, 신열격(腎熱格) 신한격(腎寒格) 등을 변증에 따라 운용하며 습열(濕熱)이 성한 경우 대장정격(大腸正格) 비승격(脾勝格) 등 습열(濕熱)을 다스리는 처방과 비정격(脾正格), 습담방(濕痰方) 등 습담(濕痰)을 다스리는 처방이 운용될 수 있다. 7. 기과(氣科)의 기본 병리(病理)는 기울(氣鬱), 기체(氣滯)에 의한 구기(九氣), 칠기(七氣), 중기(中氣), 매핵기(梅核氣), 불면증(不眠症) 등 신경성 질환이 많고 특히 여자의 경우 손발과 하복부가 차고 대소변이 안좋으며 징가(癥痂), 현벽(痃癖) 등의 질환이 많다. 또한 지나친 발산(發散)으로 인하여 기허증(氣虛證)이 나타나기도 한다. 따라서 기본처방은 기울방(氣鬱方), 담음방(痰飮方), 담현방(痰眩方), 기수방(氣嗽方), 폐승격(肺勝格), 삼초정격(三焦正格) 등이며, 기허증(氣虛證)이 나타나는 경우 폐정격(肺正格)을 사용할 수 있다. 8. 신과(神科)의 기본병리는 칠정울결(七情鬱結)이나 담화(痰火), 화성음허(火盛陰虛)이며 대표적인 증상은 경계(驚悸), 정충(怔忡), 건망(健忘), 불면(不眠), 전간(癲癎), 전광(癲狂) 등이다. 따라서 기본처방은 심한격(心寒格), 심승격(心勝格), 심정격(心正格), 담정격(膽正格), 비한격(脾寒格)을 중심으로 열담방(熱痰方), 군화방(君火方), 상화방(相火方), 화울방(火鬱方) 등을 사용할 수 있다. 9. 혈과(血科)의 기본병리는 어혈(瘀血) 및 출혈이며 대표적인 증상은 구규출혈(九竅出血)과 어혈(瘀血), 혈허증(血虛證)이다. 따라서 기본처방은 간정격(肝正格), 손혈방(損血方), 심한격(心寒格) 비한격(脾寒格) 심비한격(心脾寒格), 소장정격(小腸正格), 소장한격(小腸寒格), 어혈방(瘀血方), 뉵혈방(衄血方) 등을 사용할 수 있다.

한의진단명과 진단요건의 표준화 연구III - 3차년도 연구결과 보고 - (Standardization and unification of the terms and conditions used for diagnosis in oriental medicine III)

  • 최선미;양기상;최승훈;박경모;박종현;심범상;김성우;노석선;이인선;정진홍;이진용;김달래;임형호;김윤범;박성식;송태원;김종우;이승기;최윤정;신순식
    • 한국한의학연구원논문집
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    • 제3권1호
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    • pp.41-65
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    • 1997
  • The diagnostic requirements were suggested and explained regarding the systems of differentiation of symptoms and signs in the third year study of standardization and unification of the terms and conditions used for diagnosis in oriental medicine. The systems were as follows : - analysing and differentiating of epidemic febrile disease - analysing and differentiating in accordance with the Sasang constitutional medicine baced on four-type recognition - differentiation of diease according to pathological changes of Chong and Ren channels - standards for diagnosis of women's disease - standards for diagnosis of children's disease - standards for diagnosis of motor and sensor disturbance(-muscle born joint etc.) - standards for diagnosis of neuropsychiatric diease - standards for diagnosis of five sense organ diease - standards for diagnosis of external disease. The indivisual diagnosis pattern was arranged by the diagnostic requirments in the following odor : another name, notion of diagnosis pattern, index of differentiation of symptoms and signs, the main point of diagnosis, analysis of diagnosis pattern, discrimination of diagnosis pattrrn, prognosis, a way of curing a diseases, prescription, herbs in common use, dieases appearing the diagnosis pattern, documents. The standards for diagnosis of each disease was arranged by the diagnostic requirments in the following odor. another name, notion of diease, the main point of diagnosis, analysing and differentiating of disease, analysis of diease, discrimination of disease, prognosis, a way of curing and prescription of disease, dieases In western medicine appearing the disease in oriental medicine, documents.

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의안(醫案) 『역시만필(歷試漫筆)』의 맥진(脈診) 실행(實行)에 대한 연구 (A Study on the Pulse Diagnosis of the Medical Charts of Youksimanpil)

  • 전종욱
    • 대한한의학원전학회지
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    • 제30권2호
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    • pp.59-81
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    • 2017
  • Objectives : This paper studies the pulse diagnosis as found in Youksimanpil, which is a series of medical charts containing 150 diagnosis records of Yi Suki, a doctor who was active in Joseon during the 17-18th centuries. Through this effort, the paper aims to shed light on how pulse was utilized in the Korean medicine, and in process tries to reveal the essence of Korean medicine's treatment method. Methods : 60 charts where pulse method was used are selected in Youksimanpil and a table is created with them. Figures are drawn to explain four steps of pulse-sensing from the simple method to highly advanced method. Charts are presented with the corresponding original texts and their translations. With these efforts, the paper attempts to reveal the broad understanding of the doctor of Joseon period who consistently kept to the most basic principle of pulse diagnosis. Results : The efficiency of pulse diagnosis depends on the unity and simplicity in diagnosis and prescription. There were continued efforts between the doctors in Joseon to collect and compare the experiences they gained from clinical practices in order to organize their findings and form a system. These are: (1) individual pulse, (2) patternized pulse, (3) balance between left and right pulses, (4) balance between pulse and body, and (5) the doctor's extemporaneous diagnosis. In that efforts, they protect the principle of holistic diagnosis, which is one of Korean medicine's core principles. Conclusions : Thanks to the existence of medical charts that presents in detail how the texts of Donguibogam were applied in real clinical practices, today we can see Korean medicine's highly advanced synergy between textual knowledge and clinical experiences as recorded in the form of charts.