• 제목/요약/키워드: Integrative medical hospital

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Current Research Trends in Randomized Controlled Trials Investigating the Combined Effect of Korean Medicine and Western Medicine Treatment

  • Ha, Dohyung;Kim, Seoyeon;Baek, Yong Hyeon;Won, Jiyoon;Nam, Seri;Shin, Jeeyoung;Kwon, Oh-Hoon;Kim, Soo-Yeon;Lee, Hyangsook
    • Journal of Acupuncture Research
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    • 제37권1호
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    • pp.13-18
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    • 2020
  • This review examined recently published (July 2014 to June 2017), randomized controlled trials (RCTs) which investigated the safety and effectiveness of combined Korean medicine/complementary alternative medicine (CAM) and Western medicine, to indicate the direction for integrative medical practice. The Korean Medicine Convergence Research Information Center evidence-based medicine database (KMCRIC EBM DB) was used to retrieve relevant RCTs indexed in the last 3 years. Study design, country, sample size, disease/condition with the Korean Standard Classification of Diseases code, interventions, direction of outcomes, and adverse events were extracted and summarized. A total of 93 RCTs were included in this review. Acupuncture/moxibustion was the most commonly used intervention (n = 47; 51%), and 19% (n = 18) of the studies treated musculoskeletal disorders, followed by circulatory disorders (n = 16; 17%), and mental and behavioral disorders (n = 9; 10%). Integrative treatment was reported as more effective than monotherapy in approximately 83% of these studies. Adverse events were poorly reported in most studies. This review suggests that integrative treatments are feasible, effective, and safe for various diseases/conditions, based on the evidence from recently published RCTs. Future studies on integrative healthcare are warranted.

A Pilot Study Exploring Temporal Development of Gut Microbiome/Metabolome in Breastfed Neonates during the First Week of Life

  • Imad Awan;Emily Schultz;John D. Sterrett;Lamya'a M. Dawud;Lyanna R. Kessler;Deborah Schoch;Christopher A. Lowry;Lori Feldman-Winter;Sangita Phadtare
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제26권2호
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    • pp.99-115
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    • 2023
  • Purpose: Exclusive breastfeeding promotes gut microbial compositions associated with lower rates of metabolic and autoimmune diseases. Its cessation is implicated in increased microbiome-metabolome discordance, suggesting a vulnerability to dietary changes. Formula supplementation is common within our low-income, ethnic-minority community. We studied exclusively breastfed (EBF) neonates' early microbiome-metabolome coupling in efforts to build foundational knowledge needed to target this inequality. Methods: Maternal surveys and stool samples from seven EBF neonates at first transitional stool (0-24 hours), discharge (30-48 hours), and at first appointment (days 3-5) were collected. Survey included demographics, feeding method, medications, medical history and tobacco and alcohol use. Stool samples were processed for 16S rRNA gene sequencing and lipid analysis by gas chromatography-mass spectrometry. Alpha and beta diversity analyses and Procrustes randomization for associations were carried out. Results: Firmicutes, Proteobacteria, Bacteroidetes and Actinobacteria were the most abundant taxa. Variation in microbiome composition was greater between individuals than within (p=0.001). Palmitic, oleic, stearic, and linoleic acids were the most abundant lipids. Variation in lipid composition was greater between individuals than within (p=0.040). Multivariate composition of the metabolome, but not microbiome, correlated with time (p=0.030). Total lipids, saturated lipids, and unsaturated lipids concentrations increased over time (p=0.012, p=0.008, p=0.023). Alpha diversity did not correlate with time (p=0.403). Microbiome composition was not associated with each samples' metabolome (p=0.450). Conclusion: Neonate gut microbiomes were unique to each neonate; respective metabolome profiles demonstrated generalizable temporal developments. The overall variability suggests potential interplay between influences including maternal breastmilk composition, amount consumed and living environment.

Development and Application of Advance Care Planning Workbooks to Facilitate Communication with Children and Adolescent Patients: A Pilot Test

  • Moon, Yi Ji;Lee, Jung;Choo, In Sil;Kang, Sung Han;Kim, Cho Hee;Song, In Gyu;Kim, Min Sun
    • Journal of Hospice and Palliative Care
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    • 제23권4호
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    • pp.212-227
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    • 2020
  • Purpose: This study presents the process of designing workbooks for advance care planning appropriate for the Korean cultural setting and describes actual case studies. Methods: This study focused on single inductive case studies of the utilization of an advance care planning workbook and recruited individual participants. Results: The workbook for adolescents contained six sessions and the workbook for children contained seven sessions. The workbook sessions led to four major discoveries: 1) considering the Korean cultural context, discussions on life and death must be held indirectly; 2) the role of the counselor as a supporter is crucial for the workbook to be effective; 3) the workbook must be accessible regardless of the seriousness of the illness; and 4) patients must be able to make their own choice between the workbook versions for children and adolescents. Six facilitating factors improved engagement: 1) the role of the counselor as a supporter; 2) building trust with the patient; 3) affirming freedom of expression on topics the patient wished to avoid talking about; 4) having discussions on what private information to keep secret and to whom the information can be disclosed; 5) discovering and regularly discussing relevant topics; and 6) regular communication and information-sharing with the patient's medical service providers. Conclusion: It is necessary to build on actual case studies regarding workbooks for children and adolescents in order to expand the usage of these workbooks to all relevant medical institutions in Korea.

요추 추간판 탈출증의 4종 한의표준임상경로(CP) 개발 및 시범적용 연구 (A Study on the Development and Application of Korean Medical Critical Pathway of Lumbar Disc Herniation in Four Different Medical Associations)

  • 김정현;채상엽;고민정;조민기;장준영;김준연;김하나;박경주;황지민;구본혁;박연철;백용현;남상수;서병관
    • 대한한의학회지
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    • 제42권3호
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    • pp.1-8
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    • 2021
  • Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

한약치료와 표적항암요법(아피니토)을 병행하여 부분 관해 된 신세포암 간전이 환자 1례 (A Case Report of Partial Remission of Renal Cell Carcinoma with Multiple Liver Metastases Treated with Korean Herbal Medicine in Conjunction with Targeted Anticancer Therapy Afinitor)

  • 장성환;박지혜;유화승
    • 대한암한의학회지
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    • 제22권2호
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    • pp.13-24
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    • 2017
  • Objectives: The purpose of this study is to report the effect of Korean Herbal Medicine (KHM) on a Renal Cell Carcinoma with multiple liver metastases patient. Methods: One renal cell carcinoma with multiple liver metastases patient was treated by KHM in conjunction with targeted anticancer agent (Afinitor). The effect of KHM was measured by scanning with Computed Tomography (CT), Blood Test, Visual Analogue Scale (VAS) and Eastern Cooperative Oncology Group scale. Results: Multiple hepatic tumors were reduced after the treatment during 5 months (Partial Remission, PR). As treatment was performed, complications induced by targeted anticancer agent (Afinitor) were alleviated. Conclusions: This case provides us a possibility that Korean Herbal Medicine offers potential benefits for renal cell carcinoma with multiple liver metastases patient.

'항암화학요법을 받은 폐암 환자의 예비 통합의학 임상경로' 개발 및 타당도 평가 (Development and Validity Test on Preliminary Critical Pathway of Integrative Medicine for Lung Cancer Patients Treated with Chemotherapy)

  • 홍미나;심소현;윤성훈;최준용;김윤성
    • 대한한방내과학회지
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    • 제38권6호
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    • pp.917-929
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    • 2017
  • Objectives: The objective of this study was to investigate the validity of the preliminary critical pathway of integrative medicine to improve the quality of life of lung cancer patients who received chemotherapy. Methods: The vertical axis of the preliminary critical pathway of integrated medicine consisted of nine domains: assessment, treatment, activity, consult, diet, medication, Korean medical examination, education, and others. The frame of the horizontal axis was the date from hospitalization to discharge. A total of 105 items in this preliminary critical pathway were validated by an expert group from October 28, 2016 to November 4, 2016. A total of ten experts from two different medical institutions participated in the validity test, using the four-point Content Validity Index (CVI) scale. The items with validity of greater than 80% were considered as significant. Results: The analysis of the content validity of 105 items showed 102 items with greater than 80% agreement. Assessment, treatment, consult, diet, medication, and education showed 100% agreement. Only three items showed a low validity (62.5%). Based on additional comments, the preliminary critical pathway of integrative medicine has been supplemented. Conclusions: This study suggests the possibility of using the integrated medical critical pathway for patients with lung cancer who received chemotherapy.

유방암 환자의 통함 암 치료를 통한 항암화학요법 유발 말초신경병증, 전신통 호전에 대한 증례 보고 (A Case Report on Improvement of Chemotherapy-Induced Peripheral Neuropathy and Pantalgia Side Effects with Integrated Cancer Treatment in a Breast Cancer Patient)

  • 김은지;배혜리;이남헌
    • 대한암한의학회지
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    • 제28권1호
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    • pp.11-24
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    • 2023
  • Objectives: To report the improvement of chemotherapy-induced peripheral neuropathy and pantalgia with integrative cancer treatment on adverse effects of chemotherapy in a breast cancer patient. Methods: A 63-year-old female patient who has been diagnosed with breast cancer got treated for 103 days with integrative cancer treatment including acupuncture, moxibustion, herbal medicine, physiotherapies, hand and foot bath to decrease side effects of chemotherapy. The patient was also treated Western immunotherapies like Thymosin, Viscum album. Paclitaxel, Carboplatin, Doxorubicin, Cyclophosphamide was applied and chemotherapy-induced peripheral neuropathy(CIPN), pantalgia and nausea occured. The efficacy of treatment was measured by a numeric rating scale(NRS) of symptoms, National Cancer Institute Common Terminology Criteria for Adverse Event(NCI-CTCAE) and Eastern Cooperative Oncology Group(ECOG) Performance Status Scale. Results: The NRS scroes for CIPN, pantalgia, nausea were improved. There was no adverse effects of 3 or higher assessed by the NCI-CTCAE. The ECOG grade improved from grade 2 to 1. Conclusions: This study suggests that integrative cancer treatment could improve CIPN, pantalgia after chemotherapy in breast cancer.

근거중심의 보완의학 (Evidence Based Complementary Medicine)

  • 이성재
    • Clinical and Experimental Pediatrics
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    • 제48권9호
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    • pp.915-919
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    • 2005
  • The increasing use of complementary and alternative medicine(CAM) in Korea as well as in U.S.A. and Europe seems to lead to a growing integration of CAM with conventional medicine. By using conventional mainstream medicine with CAM(integrative medicine) proved in efficacy and safety, integrative medicine seeks to treat the whole person, to assist the innate healing properties of each person and to promote health and wellness as well as the prevention of diseases. Also in pediatric diseases, especially for cancer patients, integrative medicine serves as an interdisciplinary, comprehensive, and children-centered care which results in more effective care by synergistically combining therapies. But the research to prove the efficacy and safety of CAM and the education for CAM in the medical school should proceed before applying them to patients.