Chan-Young Kwon;Sunghun Yun;Bo-Hyoung Jang;Il-Su Park
대한약침학회지
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제27권2호
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pp.110-122
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2024
Objectives: This study analyzed the Korea Health Panel Annual Data 2019 to investigate factors related to the use of non-insured Korean medicine (KM) treatment in individuals with chronic diseases. The non-insured KM treatments of interest were herbal decoction (HD) and pharmacopuncture (PA). Methods: Among adults aged 19 or older, 6,159 individuals with chronic diseases who received outpatient KM treatment at least once in 2019 were included. They were divided into three groups according to the KM treatment used: (1) basic insured KM non-pharmacological treatment (BT) group (n = 629); (2) HD group (n = 256); (3) PA group (n = 184). Logistic regression analysis was used to explore factors associated with favoring HD or PA use over BT. Potentially relevant candidate factors were classified using the Andersen Behavior Model. Results: Compared to BT, the 1st to 3rd quartiles of income compared to the 4th quartile (odds ratio: 1.50 to 2.06 for HD; 2.03 to 2.83 for PA), health insurance subscribers compared to medical aid (odds ratio: 2.51; 13.43), and presence of musculoskeletal diseases (odds ratio: 1.66; 1.91) were significantly positively associated with HD and PA use. Moreover, the presence of cardiovascular disease (odds ratio: 1.46) and neuropsychiatric disease (odds ratio: 1.97) were also significantly positively associated with HD use. Conclusion: The presence of some chronic diseases, especially musculoskeletal diseases, was significantly positively associated with HD and PA use, while low economic status was significantly negatively associated with HD and PA use, indicating the potential existence of unmet medical needs in this population. Since chronic diseases impose a considerable health burden, the results of this study can be used for reference for future health insurance coverage policies in South Korea.
Objectives: We used the Korea Health Panel Annual Data 2019 to analyze factors related to visits to both Korean medicine and Western medicine (WM) outpatient clinics among patients with overweight and obesity. Methods: The inclusion criteria for this study are as follows: 1) adults over 18 years of age, 2) overweight or obese with a body mass index of 25.0 or more, 3) visited WM outpatient clinics at least once during 2019. Total 2,963 individuals were included in WM group or integrative medicine (IM) group. Using the Andersen healthcare utilization model, factors related to healthcare utilization of the participants were classified. Binomial logistic regression analysis was used to analyze factors associated with IM use. Results: Among the participants, 80.49% (n=2,385) were assigned to WM group and 19.51% (n=578) to IM group. As a result of the regression analysis, factors significantly related to the use of IM included the elderly over 65 years of age, sex (men), college or higher education level, residential area (Gwangju/Jeolla/Jeju), presence of cancer, and presence of musculoskeletal disease. The main diagnosis associated with both WM and IM use was most frequently musculoskeletal conditions. Also, IM group received WM treatment for musculoskeletal conditions more frequently compared to WM group. Conclusions: This study is the first to analyze healthcare utilization patterns among overweight or obese patients in Korea. The current findings suggest that the presence of musculoskeletal conditions, especially in this population, may be strongly associated with concurrent use of IM services.
Objects: This study was conducted to examine the effect of acupuncture on hot flashes symptoms that occurred after adjuvant endocrine therapy in breast cancer patients. Methods: A total of 7 electronic databases, including Pubmed, Cochrane Central, Embase, and CNKI, were used to search for randomized controlled trials studies on acupuncture treatment for hot flashes that occurred after adjuvant endocrine therapy in breast cancer patients. Studies published from January 2014 to March 2024 were targeted, and Breast Cancer, Hot Flashes, Acupuncture, and Electroacupuncture were used as search keywords. The intervention method, treatment period and follow-up period, results, side effects, and acupuncture points were analyzed. Results: According to the inclusion criteria, 7 studies were finally selected. Acupuncture, electroacupuncture, acupuncture and enhanced self-care were combined as intervention methods of the treatment group, and the most common control group was the use of sham acupuncture. The selected study was evaluated by the symptoms of hot flashes, quality of life, depression, and quality of sleep. In terms of hot flashes, quality of life, and depression, a significant number of treatment groups showed improvement results than control group. The most commonly used acupuncture points in the study were 百會 (GV20), 關元 (CV4), 氣海 (CV6) each of which was used twice. Conclusions: According to this study, the improvement of symptoms was confirmed when acupuncture and electroacupuncture treatment were used for hot flashes that occurred during breast cancer adjuvant endocrine therapy.
Objectives : Anxiety is an important mental health symptom associated with healthcare utilization. This research aims to identify the demographic, socio-economic, and health-related factors associated with the use of Korean medicine (KM) treatments in adults experiencing anxiety. Methods : We conducted a cross-sectional analysis using the Korea Health Panel Annual Data 2019. Logistic regression models were employed to examine the relationships between KM utilization and various factors such as economic activity, perceived stress levels, and presence of physical discomfort. The study sample included 552 adults experiencing anxiety. Results : Among the subjects, 19.20% were using both conventional treatment and KM treatment. The analysis revealed that individuals engaged in economic activities were more likely to use KM treatments compared to those who were not (odds ratio [OR] = 2.207, 95% confidential interval [CI] = 1.316 to 3.699). Additionally, individuals reporting high levels of pain or discomfort showed a significantly higher likelihood of using both KM and conventional medical services (OR = 2.933, 95% CI = 1.645 to 5.231). Musculoskeletal conditions were the most common reason for KM utilization among the study participants. Conclusion : The findings suggest that economic activity and the severity of physical discomfort significantly influence the use of KM treatments among adults with anxiety. These insights could inform healthcare policy and the integration of KM services into broader health management strategies for anxiety.
Parkinson's disease (PD) progresses severely by a gradual loss of dopaminergic neurons in the substantia nigra (SN). Epidemiological studies showed that the incidences of PD were reduced by smoking of which the major component, nicotine might be neuroprotective. But the function of nicotine, which might suppress the incidences of PD, is still unknown. Fortunately, recently it was reported that a glial reaction and inflammatory processes might participate in a selective loss of dopaminergic neurons in the SN. The levels of tumour necrosis factor (TNF)-${\alpha}$ synthesised by astrocytes and microglia are elevated in striatum and cerebrospinal fluid (CSF) in PD. TNF-${\alpha}$ kills the cultured dopaminergic neurons through the apoptosis mechanism. TNF-${\alpha}$ release from glial cells may mediate progression of nigral degeneration in PD. Nicotine pretreatment considerably decreases microglial activation with significant reduction of TNF-${\alpha}$ mRNA expression and TNF-${\alpha}$ release induced by lipopholysaccharide (LPS) stimulation. Thus, this study was intended to explore the role of nicotine pretreatment to inhibit the expressions of TNF-${\alpha}$ mRNA in human fetal astrocytes (HFA) stimulated with IL-$1{\beta}$. The results are as follows: HFA were pretreated with 0.1, 1, and $10{\mu}g/mL$ of nicotine and then stimulated with IL-$1{\beta}$ (100 pg/mL) for 2h. The inhibitory effect of nicotine on expressions of TNF-${\alpha}$ mRNA in HFA with pretreated $0.1{\mu}g/mL$ of nicotine was first noted at 8hr, and the inhibitory effect was maximal at 12 h. The inhibitory effect at $1{\mu}g/mL$ of nicotine was inhibited maximal at 24 h. Cytotoxic effects of nicotine were noted above $10{\mu}g/mL$ of nicotine. Moreover, Nicotine at 0.1, 1 and $10{\mu}g/mL$concentrations significantly inhibited IL-$1{\beta}$-induced TF-${\kappa}B$ activation. Collectively, these results indicate that in activated HFA, nicotine may inhibit the expression of TNF-${\alpha}$ mRNA through the pathway which suppresses the NF-${\kappa}B$ activation. This study suggests that nicotine might be neuroprotective to dopaminergic neurons in the SN and reduce the incidences of PD.
The present study was performed to investigate the effect of Yangkyuksanhoa-tang on the morphological changes of the basilar artery after experimentally induced subarachnoid hemonrrhages(SAH). Yangkyuksanhoa-tang has been used freguently for cerebrovascular accident Sprague Dawley rats weighing between 350-400 g were used. The 6 normal rats and 24 SAH elicited rats were used, The SAH induced by injection of the fresh autologus heart blood (0.3-0.4 ml) into the cisterna magna through the posterior atlanta-occipital membrane, Sample group was given 3.3 ml/kg/day of Yangkyuksanhoa-tang extracts for 2 days after SAH. The experimental animals were killed at 48hrs after SAH. The morphological changes of the arterial walls were examined by light and electron microscopy. Following are the obtained results: 1. In SAH elicited rats, the size of the lumen in basilar artery was diminished by about 45% and the thickness of arterial wall was increased by about 82%. In SAH elicited rats with Yangkyuksanhoa-tang treatment, the size of the lumen in basilar artery was merely diminished by about 18% and the thickness of arterial wall was merely increased by about 19%. 2. In light microscopic examination, the endothelium was swollen into a cuboid shape and the layer of smooth muscle was increased in the basilar artery of SAH elicited rats. In SAH elicited rats with Yangkyuksanhoa-tang treatment, the size of the lumen in basilar artery was enlarged and the thickness was decreased than in SAH elicited rats. The endothelium was flattened into a squamous shape and the layer of smooth muscle was decreased more than in SAH elicited rats. 3. In electron microscopic examination, the endothelial cells with fragmentation nuclei were changed into a cuboid shape and the internal elastic lamina were folded at the basilar artery of SAH elicited rat. The nuclei of smooth muscle cells were changed into a round or crumpled shape. The length of smooth muscle was shorten and thickness was increased. But all kinds of morphologic changes were diminished in SAH elicited rats with Yangkyuksanhoa-tang treatment. Conclusion : Yangkyuksanhoa-tang extracts were effective to treat cerebral vasospasm after experimentally induced subarachnoid hemorrhage in rats.
Objectives This study aimed to identify optimal combinations of acupoints used to treat chemotherapy-induced peripheral neuropathy (CIPN). Methods We searched four international databases (MEDLINE, EMBASE, the Allied and Complementary Medicine Databases [AMED], and China National Knowledge Infrastructure [CNKI]) and five Korean databases (DBpia, Research Information Sharing Service [RISS], Korean Studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], and KoreaMed) to identify randomized controlled trials (RCTs) that used acupuncture to treat CIPN. Network analysis was performed on the acupoints used in more than three included articles. We constructed a network by calculating the Jaccard similarity coefficient between acupoints and applied minimum spanning tree. Then, modularity analysis, degree centrality (Cd), and betweenness centrality (Cb) were used to analyze properties of the acupoints. Results A total of 25 articles were included. 24 acupoints were extracted from 25 articles. The combinations of acupoints having the highest Jaccard similarity coefficient were {EX-UE9, EX-LE10} and {ST36, SP6}. In the modularity analysis, acupoints were classified to six modules. ST40, EX-UE11, and KI6 had the highest Cd value while ST40, GB34 had the highest Cb value. Conclusions This study found the systematic framework of acupoint combinations used in CIPN studies. This study is expected to provide new perspectives of CIPN treatment to therapists. A RCT is in progress of using the network of this study as a guideline. If significant results are derived from the RCT, it will be possible to lay the groundwork to consider acupuncture for CIPN treatment.
Objectives The purpose of this study is to investigate the corelation between traffic accident severity and treatment period and cost by traffic accident. Methods Outpatients who visited Jaseng Korean medicine hospital traffic accident clinic were investigated by hospital computer system about period and cost of treatment. And we requested for repair cost of car, a sort of car groups and agreement date with car insurance company to insurance company. Therefore we could analysis statistical correlation of traffic accident severity (repair cost of car) with period of treatment, cost of treatment, number of treatment in same sort of car groups. For statistics, we used SPSS version 18.0 for windows. Results A significant positive correlation was found between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment in semi-midsize car, midsize car group. But, any significant correlation wasn't found between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment in small car, full-sized car group. In SUV (sport utility vehicle) car group some significant correlation was found, but it isn't between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment. Conclusions It was found that traffic accident severity (repair cost of car) had an effect on cost of car, cost of treatment and number of treatment by statistical analysis. But, it was also suggested strongly that other factors like a cost of car and ages had an effect on them.
Objectives: The aim of this study was to develop a standard instrument of pattern identification and evaluation for chemotherapy-induced peripheral neuropathy (CIPN).Methods: The advisory committee for this study was organized by 12 professors of traditional Korean medicine from the Korean Association of Traditional Oncology. The items and structure of the instrument were designed based on a review of previous publications. We revised the instrument in consultation with the advisory committee and received additional advice via email.Results: We divided the symptoms and signs of CIPN into four pattern identifications: wind arthralgia (風痺), cold arthralgia (寒痺), dampness arthralgia (濕痺), and arthralgia of the deficiency type (虛痺). We obtained the mean weights to reflect the standard deviations from each symptom of the four pattern identifications, which were scored on a 5-point scale by the advisor committee. After we obtained the answers to discrimination between variable symptoms (變症) and ordinary symptoms (素症) from the 12 experts, we gained the final weight from the combination of the ratio of pattern identification to the number of total answers of the advisory committee and the mean weight.Conclusions: The Instrument on Pattern Identification and Evaluation for CIPN was developed through a discussion between 12 experts. There was a limitation that the validity and reliability of this instrument have not been proven. However, the significance of this study was that it is the first Instrument on Pattern Identification and Evaluation aimed at assessing CIPN in traditional Korean medicine.
Background : Mahuang (Ephedrae Herba, Ephedra sinica $S_{TAPE}$) has been widely used to treat respiratory disease in Asian over the past thousand years. The main ingredient of Mahuang is ephedrine, whose affects on the autonomic nervous system induce some adverse effects like vasoconstriction, hypertension, tachycardia, miosis, insomnia, dizziness, headache, etc. Although there were lots of reports about adverse effects of Mahuang, there were no clinical studies which evaluated the adverse effects of Mahuang on the autonomic nervous system by objective numerical value in the past decade. Objectives : The purpose of this report was to provide an objective assessment of state-trait anxiety that is caused by Mahuang, and to identify anxiety of Mahuang according to different Sasang constitution classifications. Methods : The study design was a double-blind randomized placebo-controlled trial. The subjects of this study were 79 adults aged between 20 to 40 who agreed to participate. Because 8 adults dropped out, a total of 71 subjects entered the study. They were allocated through randomization to a Mahuang group (N=50) and placebo group (N=21). Each group took three opaque capsules (every opaque capsule containing 2g of Mahuang or none) twice a day. To compare the state and trait anxiety before and after taking Mahuang, we checked the anxiety by using STAI-KYZ. Results : The following results were obtained. Short-term administration of Mahuang significantly increased state-anxiety, but in the placebo group, there were no significant changes in state-anxiety. In the Mahuang group except females, there was more significant increase in state-anxiety of Soeumin than Soyangin and Taeumin in the 2nd measurement. Conclusion : It is suggested that the ingestion of Mahuang can increase sympathetic activity and induce anxiety. There was a significant difference among Sasang constitution classification. Especially, the response is stronger in Soeumin than other constitutions. If we use Mahuang according to the Sasang constitution classification in clinic, we could not only minimize the anxiety but maximize the potential curative value.
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