• 제목/요약/키워드: Korean-western cooperative treatment

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한방의료의 이용행태 및 이용결정요인 분석 - 일부 대도시 지역주민을 중심으로 - (Utilization Patterns and Determinants of Oriental Medical Services : Focused on the Residents of Taegu City)

  • 유왕근;류경아
    • 대한예방한의학회지
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    • 제4권2호
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    • pp.1-24
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    • 2000
  • This study was conducted to examine utilization patterns and determinants of oriental medical services. Data were collected from 545 residents in Taegu city The results of this study are summarized as follows 1) 37.8% of subjects used oriental medical services in the past year. Especially, the female, the ages of 50 and 60 over, the single. low-educated. high-income class, white-collar class, medical insured tended to use more oriental medical services than another groups. 2) 46.7% of users of oriental medical services reported that number of visits in the past year was 2 - 5 times 37 1% of them was 1 times, and 4.5% over 10 times. 3) According to the reasons to choose the oriental medical facilities, most was 'on their own judgement'(48.8%) and 'by the advice of relatives and friends'(42.0%) Regarding to the objectives of using oriental medicine, 68.3% was 'treatment', 31.7% 'health counselling and promotion'. And among diseases of users, diseases of musculo-skeletal system was the highest(54.5%). 4) 57.9% of oriental medical services users had experience of utilizing western medicine on the same diseases. Among peoples with experiencing western medicine on the same diseases. 54.4% received oriental medical services 'in addition to western medicine', 45.6%'in place of western medicine 'And 41.2% of using both services reported that they had difficulty in deciding to choose the type of services -oriental medical services or western medicine-for their diseases. 37.3% of them answered that 'providing relevant information' was the most desirable measure to solve this problem, 27.3% 'establishment of effective referral system between oriental and western medical facilities '23.6% 'cooperative medical treatment systems in the same facilities', 11.8%'integration of oriental medicine into western medicine 5) According to the satisfaction level with each items of oriental medical services, the respondents had positive views on efficacy, kindness, and side-effects. They, however, had negative view on the cost of oriental medical services. 6) In regarding to the priority of improvement of oriental medical system,'expansion of insurance benefit package 'ranked first. 'expansion of insurance benefit Package 'ranked second, 'improvement of scientific methods and diagnostic technique 'third, and 'safety of herbal medicine' fourth in order. 7) The significant factors influencing the utilization of oriental medical services were kindness of oriental medical practitioners, efficacy , travel time, age To be brief, utilization rate of oriental medical services in urban area generally tends to be high. There, however, have been various barriers to limit oriental medical services, such as incomplete benefit package of oriental medical insurance and lack of coordination and referral system between oriental and western medical services, lack of scientific diagnostic procedures, high price etc . For the development of oriental medical services, Much attention to remove these limiting factors should be placed. In addition, kindness of oriental medical practitioners , which is expected to be more important factor in the consumer - focused health care environment than ever, should be kept high consistently. Since this study was conducted for specific residents of an urban city. further research including more sampling in different urban areas should be required to generalize the results of the study.

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한의학에 대한 의사들의 인식과 태도 변화에 관한 체계적 문헌 고찰 (Systematic Review of Changes in the Perception and Attitude of Medical Doctors toward Traditional Korean Medicine)

  • 김숙경;문소영;김범수;윤영주
    • 대한예방한의학회지
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    • 제17권3호
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    • pp.31-46
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    • 2013
  • Objective : To find a collaboration strategy between western medicine and traditional Korean medicine (KM), this study aims to figure out the changes in the perception and attitude of medical doctors toward KM through systematic review. Method : Systematic literature searches were performed on six Korean databases. Studies were categorized according to the respondents and question items and analyzed by the context of questions, similarity of respondents and measurement scale. And we analyzed the changes of response regarding to medical doctors' and medical students' perspective and attitude to KM. Results : Eighteen survey studies including attitude of medical doctors and medical students toward KM were selected, which were conducted from 1993 to 2011. Although the attitude toward KM did not show any positive change, medical doctors have had more interest in acupuncture than herbal medicine and appreciated KM's treatment effect for musculoskeletal disease. In spite of little KM education experience, they had intentions for acupuncture education at least. Many medical doctors have listed the unscientific aspect as a major reason why they cannot trust KM. Medical doctors working for cooperative practice showed more positive attitude than other medical doctors and medical students had more positive attitude in general than medical doctors Conclusion : Though the growth of KM service and cooperative practice since 1990s, medical doctors' attitude toward KM seems to become more negative. To improve their attitude, making scientific evidences for KM is required as well as giving more education and treatment experience.

임신오조 한의표준임상진료지침 개발을 위한 일반인 대상 의료 이용 경험 및 인식도 조사 (A Survey on General Public's Experience and Perception of Korean Medicine Treatment for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy)

  • 정효정;최수지;김동일
    • 대한한방부인과학회지
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    • 제36권2호
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    • pp.69-84
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    • 2023
  • Objectives: This study was conducted to reflect the public's perspective when developing Korean Medicine (KM) Clinical Practice Guideline (CPG) for nausea and vomiting of pregnancy (NVP). Methods: 317 respondents who had experienced nausea and vomiting during current or past pregnancy completed the questionnaire online, and we analyzed their answers. Results: 1. 24% of all respondents had received KM treatment. The most common reason for choosing KM treatment was "it would be relatively safe for pregnant women and fetuses", and the reason for not choosing KM treatment was "they did not know much about it". 2. Respondents who had experienced KM treatment for NVP had felt the effects of KM treatment (79%), and chose herbal medicine as the most effective and preferred treatment. 3. 64.1% of respondents who had not experienced KM treatment for NVP preferred cooperative treatment with Western medicine. They answered that herbal medicine would be the most effective treatment, but preferred acupuncture. 4. The most important factor when treating NVP was "the safety of treatments". 59% of all respondents perceived KM treatment is safe for NVP. The treatments perceived as safest were herbal medicine and acupuncture, while the treatments with the least safety information were pharmacopuncture and electro-acupuncture. 5. Treatments that medical consumers were comprehensively interested in were acupuncture, KM treatment & Fluid, herbal medicine, moxibustion, and acupressure, in order. Conclusions: This study revealed the public's experience of using medical care, preference and perception of KM treatment for NVP. Therefore we would reflect the patients' clinical needs in the CPG.

Severe MCA Stenosis로 인한 TIA 환자 1례 (A Case Report of a TIA Patient with Severe MCA Stenosis)

  • 윤창준;김종화;이수길
    • 대한중풍순환신경학회지
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    • 제9권1호
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    • pp.54-58
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    • 2008
  • Transient Ischemic Attack(TIA) is an important risk factor of stroke but often underestimated by clinicians. In this case, we administered oriental-western cooperative therapy to a 72 years old female TIA patient with severe MCA stenosis. After treatment, all symptoms were disappeared and has not reappeared until 1 year follow-up.

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임신오조 한의표준임상진료지침 개발을 위한 한의사의 인식과 치료 실태에 관한 조사 (A Survey on Korean Medicine Doctors' Recognition and Treatment Method for Developing Clinical Practice Guideline of Nausea and Vomiting of Pregnancy)

  • 이흥숙;정효정;최수지;김동일
    • 대한한방부인과학회지
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    • 제36권2호
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    • pp.36-54
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    • 2023
  • Objectives: This study was aimed to develop a Korean Medicine (KM) clinical practice guideline (CPG) of Nausea and Vomiting of Pregnancy (NVP). Methods: We conducted a questionnaire survey targeting KM doctors belonging to the Association of Korean Medicine by e-mail. We received 1,023 responds, and analyzed the answers. Results: 1. 83.0% of respondents knew the concepts and contents of CPG, and 98.1% had practical use plan. 2. 82.1% of respondents used pattern identification diagnosis for NVP patients, and the most commonly diagnosed pattern was spleen-stomach weakness (脾胃虛弱) with 41.3%. 3. The most frequently used treatment for NVP patients was KM combined treatment (46.7%). Herbal medicine+acupuncture (46.8%) was most used among KM combined treatments, and herbal medicine (37.1%) was most used among KM single treatments. 4. Among the contents of CPG for NVP, the fields of interest were selected in the order of KM treatment, KM-Western medicine cooperative treatment, KM diagnosis, prevention and regimen management. In the 'diagnosis part', the use of the symptom evaluation scale questionnaire was 41.8%, higher than the KM pattern diagnosis (34.4%). In the 'treatment part', herbal medicine accounted for 33.8%, higher than that of acupuncture (including electro-acupuncture) at 23.7%. 5. As for the expected development effects, opinions on evidence-based, safety, clinical use, and standardization were the most common. Conclusions: We figured out KM doctors' recognition of KM clinical practice guideline, clinical diagnosis, treatment on NVP to make the contents of the CPG reflecting the clinical situation.

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.

선택적 COX-2 억제제 NS 398과 EGF 수용체 차단제 AG 1478의 복합투여가 HeLa 세포주의 방사선 감수성에 미치는 영향 (The Modulation of Radiosensitivity by Combined Treatment of Selective COX-2 Inhibitor, NS 398 and EGF Receptor Blocker AG 1478 in HeLa Cell Line)

  • 윤선민;오영기;김주헌;박미자;성인옥;강기문;채규영
    • Radiation Oncology Journal
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    • 제23권1호
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    • pp.51-60
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    • 2005
  • 목적 : 분자 표적의 선택적 억제가 방사선 세포 살상 효과를 증진시키는 것으로 알려져 있으므로 선택적 COX-2 억제제와 EGF 수용체 차단제를 HeLa 세포주에 처리한 후 방사선 효과의 상승작용을 알아보고자 하였다. 대상 및 방법 : 자궁경부암 세포주인 HeLa세포에서 EGF 수용체 차단제 AG 1478, 선택적 COX-2 억제제 NS 398과 방사선을 복합 투여하여 세포성장 억제 분석(cell graph inhibition assay)과 세포사멸 분석(apoptosis assay)을 시행하였고, 방사선 감수성 변화를 살펴보기 위해 세포생존 분석(clonogenic survival assay)을 시행하였다. 방사선 감수성 인자로는 2 Gy에서의 세포생존분획($SF_2$)과 linear-quadratic model을 이용한 dose enhancement ratio (DER)를 사용하였다. 방사선 감수성에 대한 작용기전 분석을 위해 flow cytometry로 세포주기 분석(cell cycle analysls)을 시행하였고, western blot 분석을 통하여 bcl-2와 bax 단백질의 발현 변화를 살펴보았다. 결과 : HeLa세포에 NS 398과 AG 1478을 방사선과 함께 복합 투여한 실험 군에서 세포사멸 정도가 가장 높게 나타났다($8.49\%$ vs. $22.70\%$). 세포주기 분석 결과, 방사선과 복합 약물 처리군에서 $G_0/G_l$ 세포주기 정체와 5 세포 분획 소실이 나타났으며 이러한 변화는 72시간 이후까지 지속되었다 세포생존 분석 결과로는 방사선과 AG 1478군에서 $SF_{2}0.68{\pm}0.07$, DER 1.12를 보인 반면, 방사선과 복합약물처리군에서는 $SF_{2}0.12{\pm}0.01,\;DER\;3.00$으로 나타났다. Western blot분석에서는 방사선과 복합약물처리군에서 bcl-2와 bax 단백질 발현이 모두 감소하는 양상을 보였다. 결론 : 신호전달 체계를 억제하는 분자 표적 약제인 선택적 COX-2 억제제와 EGF 수용체 차단제를 방사선과 복합투여함으로써 HeLa세포의 방사선 감수성이 증가됨을 확인하였다.

최근 3년간 일개 불임전문 한방병원에 내원한 불임환자의 실태분석과 한방불임치료정책에 대한 제언 (A Study on the Status of Patients with Infertility in a Department of Oriental Gynecology for the last Three Years and on the Future Policy of Infertility Treatment in Oriental Medicine)

  • 권수경;강명자;김동일
    • 대한한의학회지
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    • 제27권2호
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    • pp.44-56
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    • 2006
  • Objectives : This study was to analyze the status of patients with infertility in the department of oriental gynecology in an oriental medical hospital and propose infertility treatment in oriental medicine. Methods : This study was presented with 2,153 cases of infertile women who had visited the department of oriental gynecology in one oriental hospital in Seoul from 2002 to 2004. Results : The total number infertile patients has decreased year by year. The age range of patients was getting higher and the age group between 30 and 35 took up about one half of the total patients. The duration of infertility for less than 3 years held about 50-60% of the total patients, and the mean duration of infertility was $39.18{\pm}29.57$ months (2004). The most common occupations of females were professionals or administrative managers. The secondary infertility was increasing and unexplained infertility increased from 38.2% (in 2002) to 54.4% (in 2004). However the duration of treatment was shorter. This shows that the age range of the patients having oriental-medicine treatment is gradually getting higher and the number of the patients having oriental-medicine treatment and compliance is decreasing. Conclusions : More studies about objectification of oriental medicine need to precede any other studies. Then, it is thought to be necessary to rebuild cooperative relationships between oriental & western medicine through systematic research and political supports and to establish firm foundations of oriental medicine.

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백굴채가 대식세포의 NO 및 $TNF-{\alpha}$ 생성에 미치는 영향 (The Effects of Chelidonium majus on NO and $TNF-{\alpha}$ Production in Macrophages)

  • 김홍준;문석재;김동웅;문구;원경숙;윤준철;김유경;원진희
    • 대한한의학회지
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    • 제24권2호
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    • pp.138-147
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    • 2003
  • Objectives : In this study, we investigated the mechanism by which Chelidonium majus (CM) regulates nitric oxide (NO) production. Methods : Using mouse peritoneal macrophages, the mechanism by which CM regulates NO or tumor necrosis $factor-{\alpha}(TNF-{\alpha})$ production was examined. NO release was measured by the Griess method. $TNF-{\alpha}$ production was measured by the ELISA method. The protein extracts were prepared and samples were analyzed for the inducible NOS(iNOS) expression and nuclear factor kappa $B(NF-{\kappa}B)$ activation by Western blotting. Results : When CM was used in combination with recombinant $interferon-{\gamma}{\;}(rIFN-{\gamma})$, there was a marked cooperative induction of NO production. CM had an effect on NO production by itself. The expression of the iNOS gene was increased in $rIFN-{\gamma}$ plus CM-stimulated peritoneal macrophages and almost completely inhibited by pre-treatment with pyrrolidine dithiocarbamate (PDTC), an inhibitor of $NF-{\kappa}B$. The $NF-{\kappa}B$ activation was increased in rIFN-{\gamma} plus CM-induced peritoneal macrophages. The increased production of NO from $rIFN-{\gamma}$ plus CM-stimulated peritoneal rnacrophages was decreased by the treatment with $N^{G}-monomethyl-{_L}-arginine{\;}(N^{G}MMA){\;}N^{\alpha}-Tosyl-Phe$ chloromethyl ketone (TPCK) , and was almost completely inhibited by pre-treatment with PDTC. Furthermore, treatment with CM alone or rIFN-{\gamma} plus CM in peritoneal macrophages caused a significant increase in $TNF-{\alpha}$ production. PDTC decreased CM-induced $TNF-{\alpha}$ production significantly. After CM treatment in HT-29 or AGS cells, cell viability decreased. Conclusions : These findings demonstrate that CM increases the production of NO and $TNF-{\alpha}{\;}by{\;}rIFN-{\gamma}-primed$ macrophages and suggest that NF-B plays a critical role in mediating these effects of CM.

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전이된 담도암 환자의 패혈증을 한다열소탕 및 우담과 항생제를 병행하여 치료한 환자 1례 (A Case Study of Metastatic Cholangiocarcinoma with Sepsis who Showed Symptomatic Improvement after Treated with Handayeolso-tang, Fel Tauri, and Antibiotics)

  • 이수민;최성헌;송안나;이지영;채진;정의홍;이수경
    • 사상체질의학회지
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    • 제25권4호
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    • pp.432-441
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    • 2013
  • Objectives Despite the treatment with antibiotics, patients with sepsis has a high mortality (80%) in the underlying disease group. The aim of this study was to report the improvement of septic condition of the cholangiocarcinoma patient after the treatment with Handayeolso-tang, Fel Tauri, and antibiotics. Methods We retrospectively reviewed the medical records. The patient's subjective symptoms such as chilling and abdominal pain were evaluated by NRS and the performance status was evaluated by ECOG. This case was literally compared with relevant published studies on prognosis of sepsis. Results Despite poor prognostic factor(MEDS score 18), the patient's symptoms such as fever, chilling, abdominal pain, and diarrhea and ECOG(Eastern Cooperative Oncology Group) improved. The patient was hemodynamically stabilized on 3rd day from the treatment, and her laboratory test results were normalized on 7th day. Conclusions A female patient of metastatic cholangiocarcinoma came to the hospital for cholangitis, later causing septic shock. Both her symptoms and laboratory tests showed significant improvement after the treatment of antibiotics, Handayeolso-tang and Fel Tauri. To our knowledge, this is the first case reporting the synergistic combination of Korean oriental medicine and Western medicine approaching to sepsis.