• Title/Summary/Keyword: Kidney-yin deficiency syndrome

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The Literatual Study on Pathologic Change Cognition to the Liver Disease (간장의 병리변화 인식에 대한 문헌적 고찰)

  • Lee Young Su;Kwack Jeong Jin;Lee Gang Nyoung;Choi Chang Won;Kim Hee Chul
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.16 no.4
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    • pp.630-636
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    • 2002
  • After The Yellow Emperor's Canon of Internal Medicine, The text researches of pathologic change to the liver disease concluded the next, 1, The category of liver-disease(肝病) include the Symptoms of abnormality due to vital energy and blood motion, emotion and intention, muscular and reproductive function, and legions around descending liver channel. 2. In the theory that Liver-Yang energy(肝陽氣) is always overproducing, Liver-Yin blood(肝陰血) is always lacking, pathologic characteristics for liver disease is functional change of malfunction of the use of body(體用失調), So nourishing the liver and kidney is used for the principal aspects of a disease. regulating and calm the liver is used for the secondary aspects of a disease as the treatment plan, 3. If malfunctioning of the functions of dispersion and discharge(疏泄), Iiver-energy(肝氣) is becoming degected, So overproduct and overflow of ascent and exhalation of liver-yang(肝陽) is becoming blood are ascending following energy. complete usage of Yin-blood(陰血) is responsible for some kinds of mass formed by blood stasis in the early stage of pathogenesis of liver disease syndrome of the energy system as the progession of disease extravasated blood is forming. the pathologic characteristics is appeared loss of control of the vital energy and blood(體用失調) at the liver disease. 4. Sthenia-syndrome of liver(肝實證) and liver-heat syndrome(肝熱證) is appered that overproducing and overflow of dispersion(疏泄太過) and discharge is responsible for overfunctioning of liver disease or some kinds of heat syndrome such as liver fire(肝火), Sthenia of liver-yang(肝陽上亢), the syndromes of sthenic liver heat(肝實熱) are appered. deficiency of the liver(肝虛證) and cold syndrome of liver(肝寒證) is classified pathologic characteristics of cold and heat, deficiency and excess that regression of sensory, motor, mental due to lack of dispersion and discharge(疏泄不及), or intruding of the cold miasma, are degected. 5. The liver is close relation of physiologic function and internal organ such as spleen, stomach, lung, heart, kidney, gall bladder by the meridian channels, because of property of wind Zang, rapid progession is classified by phthologic charateristics.

The Literatual Study on the Wea symptom in the View of Western and Oriental Medicine (위증에 대한 동서의학적(東西醫學的) 고찰(考察))

  • Kim, Yong Seong;Kim, Chul Jung
    • Journal of Haehwa Medicine
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    • v.8 no.2
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    • pp.211-243
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    • 2000
  • This study was performed to investigate the cause, symptom, treatment, medicine of Wei symptom through the literature of oriental and western medicine. The results obtained were as follows: 1. Wei symptom is the symptom that reveals muscle relaxation without contraction and muscle relaxation occures in the lower limb or upper limb, in severe case, leads to death. 2. Since the pathology and etiology of Wei symptom was first described as "pe-yeol-yeop-cho"(肺熱葉焦) in Hung Ti Nei Ching(黃帝內經), for generations most doctors had have accepted it. but after Dan Ge(丹溪), it had been classified into seven causes, damp-heat(濕熱), phlegm-damp(濕痰), deficiency of qi(氣虛), deficiency of blood(血虛), deficiency of yin(陰處), stagnant blood(死血), stagnant food(食積). Chang Gyeng Ag(張景岳) added the cause of deficiency of source qi(元氣). 3. The concept of "To treat Yangming, most of all"(獨治陽明) was emphasized in the treatment of Wei symptom and contains nourishment of middle warmer energy(補益中氣), clearance of yangming-damp-heat(淸化陽明濕熱). 4. Since Nei-ching era(內經時代), Wei and Bi symptom(痺症) is differenciated according to the existence of pain. After Ming era(明代) appeared theory of co-existence of Wei symptom and pain or numbness but they were accepted as a sign of Wei symptom caused by the pathological factor phelgm(痰), damp(濕), stagnancy(瘀). 5. In the western medical point of view, Wei symptom is like paraplegia, or tetraplegia. and according to the causative disease, it is accompanied by dysesthesia, paresthsia, pain. thus it is more recommended to use hwal-hyel-hwa-ae(活血化瘀) method considering damp-heat(濕熱), qi deficiency of spleen and stornach(脾胃氣虛) as pathological basis than to simply differenciate Wei and Bi symptom according to the existence of pain. 6. The cause of Gullian-Barre syndrome(GBS) is consist of two factors, internal and external. Internal factors include asthenia of spleen and stomach, and of liver and kidney. External factors include summur-damp(暑濕), damp-heat(濕熱), cold-damp(寒濕) and on the basis of "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治), the cause of GBS is classified into injury of body fluid by lung heat(肺熱傷津), infiltration of damp-heat(濕熱浸淫), asthenia of spleen and kidney(脾腎兩虛), asthenia of spleen and stomach(脾胃虛弱), asthenia of liver and kidney (肝腎兩虛). 7. The cause of GBS is divided by according to the disease developing stage: Early stage include dryness-heat(燥熱), damp(濕邪), phlegm(痰濁), stagnant blood(瘀血), and major treatment is reducing of excess(瀉實). Late stage include deficiency of essence(精虛), deficiency with excess(虛中挾實), and essencial deficiency of liver and kidney(肝腎精不足) is major point of treatment. 8. Following is the herbal medicine of GBS according to the stage. In case of summur-damp(暑濕), chung-seu-iki-tang(淸暑益氣湯) is used which helps cooling and drainage of summer-damp(淸利暑濕), reinforcement of qi and passage of collateral channels(補氣通絡). In case of damp-heat, used kun-bo-hwan(健步丸), In case of cool-damp(寒濕), used 'Mahwang-buja-sesin-tang with sam-chul-tang'(麻黃附子細辛湯合蓼朮湯). In case of asthenia of spleen and kidney, used 'Sam-lyeng-baik-chul san'(蔘笭白朮散), In case of asthenia of liver and kidney, used 'Hojam-hwan'(虎潛丸). 9. Following is the herbal medicine of GBS according to the "classification and treatment according to the symptom of Zang-Fu"(臟腑辨證論治). In the case of injury of body fluid by lung heat(肺熱傷津), 'Chung-jo-gu-pae-tang'(淸燥救肺湯) is used. In case of 'infiltration of damp-heat'(濕熱浸淫), us-ed 'Yi-myo-hwan'(二妙丸), In case of 'infiltration of cool-damp'(寒濕浸淫), us-ed 'Yui-lyung-tang', In case of asthenia of spleen, used 'Sam-lyung-bak-chul-san'. In case of yin-deficiency of liver and kidney(肝腎陰虛), used 'Ji-bak-ji-hwang-hwan'(知柏地黃丸), or 'Ho-jam-hwan'(虎潛丸). 10. Cervical spondylosis with myelopathy is occuered by compression or ischemia of spinal cord. 11. The cause of cervical spondylosis with myelopathy consist of 'flow disturbance of the channel points of tai-yang'(太陽經兪不利), 'stagnancy of cool-damp'(寒濕凝聚), 'congestion of phlegm-damp stagnant substances'(痰濕膠阻), 'impairment of liver and kidney'(肝腎虛損). 12. In treatment of cervical spondylosis with myelopathy, are used 'Ge-ji-ga-gal-geun-tang-gagam'(桂枝加葛根湯加減), 'So-hwal-lack-dan-hap-do-hong-eum-gagam(小活絡丹合桃紅飮加減), 'Sin-tong-chuck-ue-tang-gagam(身痛逐瘀湯加減), 'Do-dam-tang-hap-sa-mul-tang-gagam'(導痰湯合四物湯加減), 'Ik-sin-yang-hyel-guen-bo-tang'(益腎養血健步湯加減), 'Nok-gakyo-hwan-gagam'(鹿角膠丸加減). 13. The cause of muscle dystropy is related with 'the impairement of vital qi'(元氣損傷), and 'impairement of five Zang organ'(五臟敗傷). Symptoms and signs are classified into asthenia of spleen and stomach, deficiency with excess, 'deficiency of liver and kidney'(肝腎不足) infiltration of damp-heat, 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 14. 'Bo-jung-ik-gi-tang'(補中益氣湯), 'Gum-gang-hwan'(金剛丸), 'Yi-gong-san-hap-sam-myo-hwan'(異功散合三妙丸), 'Ja-hyel-yang-gun-tang'(滋血養筋湯), 'Ho-jam-hwan'(虎潛丸) are used for muscle dystropy. 15. The causes of myasthenia gravis are classified into 'insufficiency of middle warmer energy'(中氣不足), 'deficiency of qi and yin of spleen and kidney'(脾腎兩處), 'asthenia of qi of spleen'(脾氣虛弱), 'deficiency of qi and blood'(氣血兩虛), 'yang deficiency of spleen and kidney'(脾腎陽虛). 16. 'Bo-jung-ik-gi-tang-gagam'(補中益氣湯加減), 'Sa-gun-ja-tang-hap-gi-guk-yang-hyel-tang'(四君子湯合杞菊地黃湯), 'Sa-gun-ja-tang-hap-u-gyi-eum-gagam'(四君子湯合右歸飮加減), 'Pal-jin-tang'(八珍湯), 'U-gyi-eum'(右歸飮) are used for myasthenia gravis.

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A Correlation Study of Pattern Identification Instrument and Biomarkers for Polycystic Ovary Syndrome (다낭성난소증후군 변증도구와 생체지표 간의 상관성 연구)

  • Park, Eun-Ji;Baek, Seon-Eun;Kang, Byoung-Kab;Yoo, Jeong-Eun;Jung, In-Chul
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.3
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    • pp.33-49
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    • 2018
  • Objectives: The purpose of this study was to investigate the correlation between Pattern identification instrument and biomarkers in polycystic ovary syndrome patients. Methods: Pattern identification instrument questionnaire, Sasang constitutional test, body composition test, pulse analyzing test, laboratory test were performed and the results were analyzed. Correlation analysis was performed between pattern identification and laboratory test results. Results: Testosterone, SHBG, $17{\alpha}$-OH-progesterone, AMH were highest in the Kidney-Yang Deficiency (腎陽虛) group. LH, FSH, LH/FSH ratio were the highest in the Endogenous Heat due to Yin Deficiency (陰虛內熱) group. DHEA-S was the highest in the Dampness-Heat in Liver Meridian (肝經濕熱) group. E2, Prolactin, Cholesterol, Triglyceride, HDL-Cholesterol, LDL-Cholesterol, Glucose (FBS), Insulin, HOMA-IR ratio, HbA1c were the highest in the Phlegm-Dampness (痰濕) group. Conclusions: In this study, we obtained basic data analyzing the correlation between pattern identification instrument and biomarkers in polycystic ovary syndrome patients. If further studies are performed, we expect to be able to obtain clues to study the mechanism of polycystic ovary syndrome.

A Study on a paradigm of Radix Aconiti(附子) in the treatment of heart-systemic disease(心系疾患) due to heat syndrome(熱證) (심계영역질환(心系領域疾患) 화열증(火熱證)에 사용된 부자(附子)의 활용(活用)에 대한 문헌적(文獻的) 연구(硏究))

  • Lee, Kyung-Ae;Kweon, Jung-Nam;Lee, Won-Chul
    • The Journal of Dong Guk Oriental Medicine
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    • v.6 no.2
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    • pp.145-165
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    • 1998
  • We inquired into the prescription including Radix Aconiti(附子) on the records of the past. According to the role of Radix Aconiti(附子), we can divide into four group. (1) In the case of excess in the upper and deficiency in the lower(上盛下虛), heat in the upper and cold in the lower(上熱下寒), Radix Aconiti(附子) supplies the fire from the gate of life(命門火) and the fire of deficiency type(虛火) is recurred into the origine(根源) by it. (2) In the case that Yang(陽) is kept externally by Yin(陰)-excess in the interior(陰盛格陽), and there is heat syndrome in the exterior with cold syndrome in the interior(裏寒外熱), Radix Aconiti(附子) can remove cold(祛寒) and revitalizes(回陽). (3) In the case of the heat of excess type syndrome(實熱證), Radix Aconiti(附子) treats heat-syndrome(熱證) with heat-clearing(淸熱) drug. (4) In the case of wind-syndrome(風證) and phlegm-syndrome(痰證), Radix Aconiti(附子) supplies the kidney-Yang(元陽) and promotes movement of the other drugs. According to frequency in use of drugs, we can divide into four group. (1) In e case of the fire of deficiency type(虛火), Radix Aconiti(附子) is used with drugs of invigorating-Yin(補陰), invigorating-Yang(補陽) and diuresis(利水), such as Rhizoma rehmanniae(熟地黃), Cortex cinnamomi(肉桂), Fructus comi(山茱萸), Poria, etc. (2) In the case that Yang is kept externally by Yin(陰)-excess in the interior(陰盛格陽), Radix Aconiti(附子) is used with drugs of dispelling cold(祛寒) and revitalization(回陽), such as Rhizoma zingiberis siccatum(乾薑), Radix glycyrrhizae(甘草), Radix ginseng(人蔘), etc. (3) In the case of the heat of excess type syndrome(實熱證), Radix Aconiti(附子) is used with drugs of heat-clearing(淸熱), such as Rhizoma coptidis(黃蓮). (4) In the case of wind-syndrome(風證) and phlegm-syndrome(痰證), Radix Aconiti(附子) is used with drugs of dispersing(發散), invigorating(補氣), enriching the blood(補血), removing the phlegm(去痰), heat-clearing(淸熱). such as Radix oxterici koreani(羌活), Radix ledebouriellae(防風), Radix ginseng(人蔘), Radix angelicae gigantis(當歸), etc. Especially in many of cases, Radix Aconiti(附子) is used with drugs of nourishing-Yin(滋陰), but it is hardly used with drugs of treating middle-jiao energy(中氣).

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A Clinical Study on the Pattern-Specific Cut-Point for the Pattern Identification Diagnostic Tool for Climacteric and Postmenopausal Syndrome (갱년기장애 및 폐경기증후군 변증진단 도구의 진단결과 도출을 위한 변증별 절단점 연구)

  • Lee, In-Seon;Kim, Jong-Won;Jeon, Soo-Hyung;Chi, Gyoo-Yong;Kang, Chang-Wan
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.2
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    • pp.29-49
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    • 2019
  • Objectives: This study was a methodological study to verify the reliability and validity and to make a diagnosis of a diagnostic tool for climacteric and postmenopausal syndrome pattern identification (CaPSPI). Methods: This study was conducted from June 1, 2018 to October 18, 2018 with ${{\bigcirc}{\bigcirc}}$ University Korean Medicine Hospital IRB's approval (2018-3). To make a diagnosis using CaPSPI, we decided the cut-points for the tool. Three professors of ${{\bigcirc}{\bigcirc}}$Korean Medical University conducted pattern identification diagnosis. The result is marked from 0 to 3, 0 is 'No', 1 is 'Slightly Yes', 2 is 'Yes' and 3 is 'Very Yes'. And if two or more professors' diagnoses are the same, we took the diagnoses as a diagnostic criteria. The decision of pattern by three experts converted to 0-1 scores in two ways. In "method 1", if the diagnosis was zero points, the score was 0 (have no such identification), and the rest was 1 (have such identification). In "method 2", if the diagnosis was zero or 1 point, the score was 0, and the rest was 1. After that, intraclass correlation was calculated for experts agreement. And logistic regression was conducted. A response variable was the results of the experts' diagnosis and an explanatory variable was the results of the pattern identification diagnostic tool. Results: The diagnosis of the three experts showed excellent concordance of more than 0.794 and showed a significant correlation with the diagnostic tool. Both 'Method 1' and 'Method 2' showed statistically significant effects with the diagnosis of 3 experts and the results of the diagnostic tool. The frequency of cumulative pattern identification diagnosis in 'Method 1' and 'Method 2' were found to be 578 occasions and 203 occasions, respectively. The average number of pattern held by participants in 'Method 1' and 'Method 2' were found to be 5.26 and 1.85, respectively. In both "Method 1" and "Method 2," the yield frequency of liver qi depression was the highest, and the frequency of kidney yin deficiency and liver-kidney yin deficiency was relatively high. Conclusions: Based on the above results, it is thought that, in diagnosis using CaPSPI of menopausal women, 'method 1' could be used for the health diagnosis and prevention, 'method 2' could be used for the pattern diagnosis. On the conclusion, CaPSPI is thought to be available for pattern diagnosis of menopause women.

Literature Review on Alternative Traditional Treatment of Spasmodic Torticollis - focusing on Chinese Traditional Medicine's Journals - (연축성 사경 치료에 관한 문헌적 고찰 - 중국 논문 중심으로 -)

  • Lee, Won Chul;Sun, Seung Ho
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.1
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    • pp.34-42
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    • 2013
  • Our study is to review Chinese traditional medicine's journals about the diagnosis and treatment of spasmodic torticollis such as category, syndrome differentiation, acupoints of treatment, and herbal medicine. The journal search was performed using the search engine of China Academic Journal (CAJ) and China Doctor/Master's Dissertation (CDMD) in China National Knowledge Infrastructure (CNKI) from January 1982 to October 2012. Searching key words were the diverse combination of "spasmodic torticollis", "cervical dystonia", "Chinese traditonal medicine", "herbal medicine", "acupuncture", and "syndrome differentiation". The inclusion criteria was all kinds of journals including Chinese traditional medicine approach except for experiment study. The category, syndrome differentiation, acupoints of treatment, and herbal medicine from finally selected journals were extracted and summarized. The fourty-seven Chinese journals were selected finally. The category was divided into wind syndrome, trembling syndrome, convulsive syndrome, and convulsions. The syndrome differentiation was classified as internal stirring of liver wind, yin-blood depletion, invasion of external contraction, uncontrol of governor vessel, internal obstruction of phlegm turbidity, dual deficiency of qi and blood, and blood stasis due to qi stagnation. The combination of acupoints to unblock the meridian and dissipate binds and to tonify governor vessel and repel tremor was mainly used in acupuncture treatment. Galgun-tang or galgun-tanggami was primarily used and the others were the prescriptions to tonify liver and kidney, to calm convulsion, and to dispeling wind-phlegm. We suggests that spasmodic torticollis could be treated using Korean medicine's approach in Korea.

A Comparative Study of the Oriental and the Occidental Medical Literature on the Etiologies & Treatments for Palmoplantar Hyperhidrosis (수족한(手足汗)의 원인(原因)과 치료법(治療法)에 대한 동(東).서의학적(西醫學的) 고찰(考察))

  • Ko, Young-Chul;Shin, Jo-Young
    • The Journal of Internal Korean Medicine
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    • v.18 no.2
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    • pp.268-295
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    • 1997
  • Sweating is natural phenomenon necessary for the regulation of an individual's body-temperature. The secretion of sweat is mediated by a portion of our vegetative nervous system(the sympathetic nervous system). In some people, this system is working at a very high activity level, far higher than needed to keep a constant temperature. This condition is referred to as hyperhidrosis. Especially excessive sweating of the hands and the feet is palmoplantar hyperhidrosis or volar hyperhidrosis. This is by far the most distressing condition. It was founded that the first important cause of this was emotional factor. The hands are much more exposed in social and prefessional activities than any other part of our body. Many individuals with palmoplantar hyperhidrosis are limited in their choice of proffession, because unable to manipulate materials sensitive to humidity or reluctant to shake hands; some patients arrive to the point to avoid social contact. The occidental medical treatments for palmoplantar hyperhidrosis include application of topical agents(chemical antiperspirants such as aluminum chloride), iontophoresis(treatment with electrical current), or surgery(thoracic sympathectomy). It was reported that the most effective treatment was thoracic sympathectomy. So this study was started to find the easy and effective oriental medical treatments against the occidental medical treatments through the oriental medical literature. The occidental medical idea for palmoplantar hyperhidrosis is only limited in neurologic system, so surgery is the best treatment. But the oriental medical idea for palmoplantar hyperhidrosis is much wider, so the oriental medical causes and treatments for this are able to be veriety. And the oriental medical teatment is freely in treating the patients of palmoplantar hyperhidrosis, because entire idea including pulse, facial color, mental condition, constitution and other symptom exists in the oriental medicine. The results of a bibliographic study of causes and treatments for palmoplantar are as follows; 1. The main causes of pa1moplantar hyperhidrosis are heat in the stomach, damp-heat in the spleen and the stomach, insufficiency of the spleen-qi and the stomach-qi, deficiency of the spleen-yin and the stomach-yin, and the others are the stomach-cold syndrome, stasis of blood and dyspepsia in the stomach, disorder of the liver-qi, deficiency of the heart-yin and the kidney-yin, deficiency of the heart-yang and the kidney-yang, stagnated heat in the liver and the spleen, the lung channel-heat etc. 2. The main methods of medical treatments for palmoplantar hyperhidrosis are clearing out the stomach-heat, eliminating dampness and heat in the spleen and the stomach, invigorating the spleen-qi and the stomach-qi, reinforcing the spleen-yin and the stomach-yin, warming the stomach, relaxing the liver and alleviating of mental depression and tonifying the heart and the kidney etc. 3. The main prescriptions of palmoplantar hyperhidrosis are Taesihotang, Palmultang-kakam, Samyeongbaechusan, Chongbisan, Sasammaekmundongtang, the others are Leejungtang, Hwangkikonjungtang, Seungkitang, Boyumtang, Baekhotang, Chongsimyonjayum, Moyrosan, etc. 4. Local medicine for external use are liquid after boiling alum in water for about 1 or 2 hours, liquid after boiling alum and pueraria root in water and liquid after boiling stragalus root, pueraria root, ledebouriella root and schizonepeta in water, etc. 5. The methods of acupuncture therapy include invigorating Bokyru, Yumkuk and purgating Hapkouk, or invigorating Bokyru, Kihae and purgating Hapkouk, or steadying Hapkouk, Nokung.

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A literatual studies on the yupung(油風). (油風의 病因, 病機 및 治療藥物에 關한 文獻的 考察)

  • Kim, Nam-uk;Roh, Sek-seon
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.11 no.1
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    • pp.162-179
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    • 1998
  • In the literatual studies on the yupung(油風), the results were as follows. 1. Yupung(油風) was called 'Quijidu(鬼지頭)', 'Quichedu(鬼剃頭)', 'Ballak(髮落)' etc. It was a localized loss of hair in round or oval ares without any subjective symptom 2. The etiology and pathogenesis of Yupung were disorder of vital energy& blood circulation caused by deficiency of blood and wind-dryness syndrome, energy-stagnation and blood stasis, impairment of the liver & kidney. The treatments of Yupung were invigorating the liver & kidney, clearing away heat-evil and cooling blood, nourishing the liver & kidney, activating blood circulation to dissipate blood stasis etc, 3. In the frequency of prescription, the most numerous prescription is Shineuingyangjindan(神應養眞丹) and the next are Tonggyuhwalhyultang(通竅活血湯) & Chilbomiyumdan(七寶美髥丹), 4. In the frequency of medicine, the most numerous medicine is Radix Angelicae Sinensis(當歸) and the next are Rhizoma Rehmanniae Praeparatae(熟地黃) & Rhizoma Ligusiici Chuanxiong(川芎). 5. In classification of drug action, medicines of clearing away wind-heat evil and invigorating yin used to be very busy. 6. In classification of four characters, the most parts are warm medicine. 7. In classification of five tastes, the most numerous tastes are sweet and bitter tastes. 8. In classification of toxicity, the most is non-toxic medicines. 9. In classification of the channel distribution, the most is the medicine that belongs to liver channel. 10. In acupuncture theraphy, it was used 'GV20(百會)', 'G20(風池)', 'GV16(風府)', 'GV14(大椎)', 'LI4(合谷)' etc. in body acupuncture, was used 'S25(天樞)', 'GV14(大椎)', 'B13(肺兪)', 'LI11(曲池)' etc. in moxibustion.

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Current Status of N-of-1 Trials for Herbal Medicine -Literature Review (한약에 대한 N-of-1 임상시험의 현황 - 문헌 고찰)

  • Jeung, Chang-woon;Jeon, Sun-woo;Jo, Hee-Geun
    • The Journal of Korean Medicine
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    • v.41 no.1
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    • pp.107-116
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    • 2020
  • Objectives: To overcome the limitations of randomized controlled trials, many other trials design is tested. The n-of-1 trial is a promising research method in the field of Korean medicine because of this methodology can examine the optimal treatment for each patient strictly. Therefore, we reviewed the status of N-of-1 studies on herbal medicine. Methods: A systematic literature review was conducted based on the pubmed database. The search term were 'N-of-1 Trial', 'Chinese Medicine', 'Herbal Medicine', 'Kampo'. There was no restriction in year. Results: Four clinical trials have been identified to demonstrate the effectiveness of herbal medicines for Kidney-yin-deficiency syndrome, bronchiectasis and gastric cancer. These studies suggest that the N-of-1 design is a study that encourages patient involvement, demonstrates the effectiveness of herbal medicines and helps reduce unnecessary medication. Conclusion: The N-of-1 clinical trial may be a rigorous methodology suitable for the clinical setting and may help the development of evidence-based Korean medicine. Attention is also needed in this research method in Korea.

A Clinical Study of Tinnitus (耳鳴에 관한 임상적 연구)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.14 no.2
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    • pp.134-145
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    • 2001
  • Introduction: Noises in the ear, whether real or imagined, are called tinnitus. Subjective causes of tinnitus(which is heard only by the patient) are extremely common and the majority of them are treated conservatively. For certain individuals their tinnitus is a major handicap; for others a trivial concern. The most common from of subjective tinnitus is a rushing, hissing or buzzing noise; it is frequently associated with sensorineural heanng loss. The patient may be unaware of the hearing loss, especially if it is a high frequency deficit of moderate severity. The character of the tinnitus may give a clue to the etiology. But the patient often has difficulty in explaining his/her tinnitus in absolute terms, as they have no other tinnitus with which to compare it but their own Tinnitus, like pain, is a subjective state and trying to objectively assess the severity is problematic. Audiological techniques to match subjective loudness to machine-produced noise may offer some help, in that sound intensity matches can bear little correspondence to subjective complaint. In spite of many studies, most patients presently seen complaining of tinnitus are told by their doctors that there is no treatment and that they will have to learn to live with this symptom. Objectives: To perform a clinical analysis of tinnitus and estimate the efficacy of Oriental Medical treatment according to the Byeonjeung(辨證). Subject: We studied 34 patients with complaints of tinnitus who had visited Pundang Cha Oriental Medicine Hospital Department of Otorhinolaryngology from March 1998 to February 2000. All of them had been treated 2 or 3 times a week with acupuncture treatment and had taken herbs according to the Byeonjeung(辨證) method. It was therefore possible for me to know whether their symptoms improved or not. Parameters Observed and Method: We treated them with acupuncture & herb-medication. Sometimes we gave them moxibustion or negative therapy with bloodletting at the acupuncture points(耳門, 聽宮, 聽會). Parameters Observed 1) Distribution of age & sex 2) Chief complaints 3) The sites of tinnitus 4) The quality of tinnitu 5) The duration of disease 6) The problem induced tinnitus 7) Factors increasing disease severity 8) The classification of the Byeonjeung(辨證) 9) The efficacy of treatments Results: 1. Age and sex distribution: The most common occurrence was found in males in their twenties: 6 males($17.7\%$), and in females in their thirties and over sixty: 8 females($23.5\%$). Total patient numbers for men and women were 20 men($58.8\%$), 14 women ($41.2\%$). 2. The most frequent major complaints were hearing disturbances related to tinnitus; and dizziness with tinnitus; each comprising 10 cases($29.4\%$). There were also 7 patients($20.6\%$) with only tinnitus. 3. Tinnitus sites: 13($38.2\%$) said that they felt tinnitus in both ears, equally. In the right ear, 9($26.5\%$), in the left, 6($17.7\%$). 4. The most frequent descriptive symptoms of tinnitus were: humming, hissing, buzzing etc. 5. The duration of disease. 14cases($41.2\%$) had a duration of less than 1 year. 6. 15cases($44.1\%$) complained that it was hard to watch TV or make a phone call because of tinnitus. 10 cases($29.4\%$) complained about depression. 7. Factors increasing severity of tinnitus: ⅰ) fatigue: 18cases($52.9\%$) ⅱ) stress/ tension: 10 cases($29.4\%$) ⅲ) alcohol and tobacco: 5cases($l4.7\%$) 8. Classification through Byeonjeung : ⅰ) 19 cases($55.9\%$) were classified as showing Deficiency syndrome. ⅱ) 15 cases($44.l\%$) were classified as showing Excess syndrome. The deficiency of Qi was 7($20.6\%$), deficiency of Xue, 8($23.5\%$) and insufficiency of the Kidney Yin & Yang, 4($11.8\%$). The flare of Liver fire was 8($23.5\%$) and phlegm-fire, 7($20.6\%$), 9. The efficacy of treatments showed: an improvement in 17cases($50.0\%$); no real improvement or changes in 13 cases($38.2\%$); and some worsening in 4 cases($11.8\%$). In the group with deficiency in Qi, 4($57.1\%$) improved, 1($14.3\%$) showed no change and 2($28.6\%$) were aggravated. In the cases of deficiency in Xue, 6($75.0\%$) improved, 2($25.0\%$) showed no change. In the cases of insufficiency of Kidney Yin & Yang, 3($75.0\%$) showed no change and 1($25.0\%$) were aggravated. In the group of flare of Liver fire, 4($50.0\%$) improved, 3($37.5\%$) no change and 1($12.5\%$) were aggravated. In the cases of phlegm-fire, 3($42.9\%$) improved, 4($57.1\%$) showed no change. Conclusion: We would recommend that any further studies of tinnitus utilize trial treatments of longer than 2 months duration, as any positive effects observed in our study showed that improvement occurred fairly slowly. And we suggest that this study could be utilized as a reference for clinical Oriental Medical treatment of tinnitus. If we try to apply music or sound therapy treatment properly combined with ours, we expect it to provide psycological stability in addition to inducing masking effects, even though it may not directly decrease or completely remove tinnitus.

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