• 한국한의학연구원논문집
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• 제2권1호
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• pp.40-70
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• 1996

In the literatual study on the cerebral vascular dementia, the results were as follows : 1. Cerebral vascular dementia is so called apoplectic dementia, because it almost occurs after apoplexy, the attack rate has gradually increased by increase of life, so it exert a harmful influence to geriatric diseases. 2. The etiological factors are summarized on deficiency in the heart, kidney, liver(心, 腎, 肝虛), pathogenic wind(豊) pathogenic fire(火) phlegm(痰) and stagnated blood(瘀血) in the oriental medicine, and multiple cerebral infarction, cerebral anemia, decrease of cerebral vascular flow are etiological factors in the occidental medicine. 3. The region of infarction and attack of cerebral vascular dementia have a close connection, and generally the cerebral vascular dementia easily occur in injury of white matter of brain. 4. Symptoms of cerebral vascular dementia are dysphasia, walking disorder, hemiplegia, sensory paralysis, disturbance of memory, judgement, calculation, emotion incontinence, speech impediment, silence or talkative, lower thinking ability and depersonalization, and symptoms are aggravated by stage. 5. Therapeutic herb medicines are Palpungsan(八風散), Baepungsan(排風散), Jinsaanshinhwan(辰砂安神丸), Sabacksan(四白散), Kanghwalyupungsan(姜活愈風散), Woohwangchungshimhwan(牛黃淸心丸), and they are used to dispelling pathogenic wind(祛風), soothe the nerves(安神), dispel pathogenic heat from lung, nourish the blood(淸肺養血).

• 대한간호
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• 제8권6호통권44호
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• pp.49-52
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• 1969

• 대한한방내과학회지
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• 제17권1호
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• pp.107-122
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• 1996

Apoplexy is a disease of a morbid condition manifested as sudden syncope, unconciousness, distortion of face, hemiplegia and dysphasia, usually seen in the middle-aged. The symptoms and signs before sudden onset are headache, dizziness, numbness of extremities, palpitation, etc. This study was performed to investige causes of disease, therapies and prescriptions by insect medicine through the successive medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows; 1. The treatment of apoplexy is divided into stage of attack and sequela. In stage of attack, the principal therapies of apoplexy are calming the liver, suppressed Yang, dissipate phlegm and elimination weatness. In sequela, the principal therapies of apoplexy are invigorating Qi, promote blood circulation and dredge collateral. 2. Insects medicine have more strong effect than herbal medicine, because apoplexy is a kind of critically desease. 3. Insects medicine is effective in a convalscent stage and sequela of apoplexy. The proper dosage for stage of attack is a small dose of insects medicine(about 2-4g), increse gradually. In convalscent stage, about 4g, in sequela, patients need a large dose of insects medicine(about 8g). 4. Hirudo used to remove stagnated blood and to disperse swelling for the treatment of severe cases of blood stasis, such as cerebral infarction, sequela of cerebrovascular accident, contused wounds. Lumbricus used to for the treatment of convulsions due to high fever, and for hemiplegia and hypertension. Scolopendra used to subdue the endogenous wind for the treatment of various kinds of tics, convulsions and tetanus, and it's character is strong because it will be effective Sthenia-Syndrome of apoplexy. Scorpio used to subdue the endogenous wind for the treatment of various kind of tics, convulsions, tetanus and sequela of cerebrovascular accident.

• 대한한의학방제학회지
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• 제7권1호
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• pp.121-130
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• 1999

Oriental medicine prescription has been used for the treatment of various clinical symptoms associated with cerebral apoplexy. However, single herb drug does not used cerebral apoplexy and there mechanisms of action have not been defined, and it is not yet known what effects they have on the hemodynamics of cerebral circulation. The study was aimed to investigate the effect batryticatus bombycis(BB) on the vascular systems including changes in blood pressure (BP), and regional cerebral blood flow (rCBF) and of male Sprague-Dawely rats. The changes in rCBF were determinated by laser-Doppler flowmetry. 1. Blood pressure was not affected by BB in rats. 2. rCBF was increased by BB in a dose-dependent manner. 3. Pretreatment with methylene blue(1mg/kg), and propranolol(1mg/kg) did not inhibited BB induced increased in rCBF. 4. Pretreatment with propranolol(1mg/kg) was increased by BB in a dose-dependent manner in blood perssure. 5. Pretreatment with ODQ($10{\mu}g/kg$) and L-NNA(1mg/kg) were inhibited BB induced increased in rCBF. 6. Pretreatment with L-NNA(1mg/kg) was increased rCBF in a dose-dependent manner. These results suggest that BB causes a diverse response of blood pressure and regional cerebral blood flow(rCBF). The increased in rCBF is also mediated by nitric oxide synthease and guanylate cyclase.

• 한국병원경영학회지
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• 제9권2호
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• pp.76-101
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• 2004

The primary purpose of this study was to provide the basic information for improving collaborating care of Korean traditional medicine and western medicine by surveying utilization and attitude on it among cerebral apoplexy(CA) patients hospitalized at a general hospital with both the western and Korean traditional medical department in Busan metropolitan city, Korea. The survey was conducted on 170 patients, 80 from Korean traditional medical department, and 90 from western medical department. The major results of this study were as below: First, CA patient's medical utilization patterns including selecting medical institution, term of treatment and type of medical institution at first-aid were significantly variated by their socio-demographic characteristics such as religion and job. Second, the perceptions of collaborating care, such as effectiveness and reduction of treatment period, were better at respondents who were hospitalized at oriental medical department and had been experienced with collaborating care. Third, the major contents of collaborating care which utilized by respondents in side of western medicine were physical therapy, x-ray, pathologic diagnosis, and medication, and in side of Korean traditional medicine were acupuncture, herbal medication, moxa cautery, cupping a boil therapy. Fourth, overall satisfaction on collaborating care was good(3.5 of 5.0) and was significantly variated by age and religion. Fifth, respondents perceived that collaborating care was most helpful for rehabilitation and the major problem of current duplicate medical system was increasement of medical expenditures, and the major obstacle of collaborating care was prejudice against each other medicine. The results of this study imply that effective marketing for collaborative care suitable for age and religion of customers and patient satisfaction strategy is needed to activate collaborating care.

• 보험의학회지
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• 제26권
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• pp.41-53
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• 2007

In the course of insurance claim administration, medical experts' opinions are called medical claim reviews. They are classified into two main categories: medical verification and counsel for claim staff. Medical verification compare between product coverage and the insured's physical condition. Medical counsel for claim staff is advice for claim staff when they have a question about medical knowledge to make a claim decision. A common example of medical verification is insurance coding of pituitary apoplexy. Some clinicians have insisted that the ICD coding of pituitary apoplexy is l63 of cerebral infarction, but the exclusion criteria of I code show that neoplasm is coded as C00 to D48. Thus, pituitary apoplexy must be coded as D33. An example of medical counsel for claim staff is interpretation of some medical conditions. It is divided into UCR(usual, customary, and reasonable) assessment, assessment of causality, and so on. Disability evaluation is another subject of medical counsel for claim staff. The final claim decision must be made by claim staff because only the claim staff have the authority of claim decision. Medical claims review is only an expert's opinion.

• 대한한방내과학회지
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• 제26권3호
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• pp.596-604
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• 2005

Objectives : Geopungjeseub-tang(Gufengchushi-tang) has been used in oriental medicine for many centuries as a therapeutic agent for hemiplegia caused by deficiency of qi(氣虛) and damp phlegm(濕痰). This study was performed to evaluate effects of Geopungjeseub-tang extract(GJT) on hemodynamics[regional cerebral blood flow(rCBF), pial arterial diameter(PAD), mean arterial blood pressure(MABP), heart rate(HR)] in normal rats and in rats with cerebral ischemia by middle cerebral artery(MCA) occlusion. Also, effects of adrenergic ${\beta}-receptor$, cyclooxygenase on response to GJT were evaluated. Methods : Laser-doppler flowmetry(LDF) measured changes of rCBF, MABP and HR. Video microscope and width analyzer measured changes in PAD. Results : rCBF and PAD increased after treatment with GJT(10mg/kg, i.v.) during the period of cerebral reperfusion, and pretreatment with indomethacin raised rCBF and PAD increased after treatment with GJT during the same period as above. Pretreatment with propranolol decreased rCBF, but increased after GJT treatment, but raised PAD increased after GJT treatment during this period of reperfusion. Conclusion : CR caused diverse responses were observed in rCBF and PAD after treatment with GJT. ACF action is mediated by adrenergic ${\beta}-receptor$ and cyclooxygenase. Result suggest that GJT has an anti-ischemic effect through the improvement of cerebral hemodynamics and has theraputic potential for cerebral apoplexy.

• 동의생리병리학회지
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• 제16권1호
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• pp.99-103
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• 2002

Geopungdodam-tang(GDT) have been used in oriental medicine for many centuries as a therapeutic agent of apoplexy. The mechanism of GDT on the cerebral blood flow is not known. The purpose of this Study was to investigate effects of GDT on the pial arterial diameter and action mechanism of GDT-induced increased regional cerebral blood flow(rCBF). The changes of regional cerebral blood f1ow(rCBF) was determinated by Laser-Doppler Flowmetry(LDF), and the changes of pial arterial diametet were determinated by video microscopy methods and video analyzer. The results were as follows ; 1. Pial arterial diameter was significantly increased by GDT in a dose-dependent manner. 2. Pretreatment with L-NNA significantly inhibited GDT induced increased rCBF. 3. Pretreatment with methylene blue significantly inhibited GDT induced increased rCBF. 4. Pretreatment with indomethacin inhibited GDT induced increased rCBF. These results suggest that GDT causes a diverse response of cerebral hemodynamics(rCBF and pial arterial diameter). The cerebral hemodynamics is also mediated by nitric oxide synthase, cyclic GMP(guanylyl cydase) and prostaglandin(cyclooxygenase).

• The Journal of Korean Physical Therapy
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• 제15권3호
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• pp.388-411
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• 2003

The purpose of this study has been conducted to reduce the lower limbs' spasticity of the patients with hemiplegia caused by cerebral stroke of apoplexy and find differences about spasticity effects among each group. The objects of this study covered 24 patients with hemiplgia who are either in the oo hospital in Daegu or under treatment from home to hospital. The objects fall into three groups which are a group of neurological development treatment, a group of functional stimulus treatment and a group of neurological development treatment and functional stimulus treatment. The result of this study were as follows : 1) The neurological development treatment has been found to reduce the lower limbs' spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity has been shown to be statistically meaningful ,and gradually over the period of between 4 weeks and 8 weeks(P <.05). 2) The functional electric stimulus treatment has been shown to reduce the lower limb's spasticity of patients with hemiplegia caused by cerebral stroke of apoplexy and compared to before-treatment, the MAS value of spasticity was statistically meaningful and compared to 4 weeks, even at the time of 8 weeks, the MAS value of spasticity have shown statistical meaningness. (P <.05) 3) When neurological development treatment and functional electric stimulus treatment was applied at the same time, the lower limbs' spasticity of patients with hemiplegia was reduced meaningfully(P <.05). Compared to before-treatment at the time of 4 weeks, the MAS value of spasticity was statistically meaningful and compared to 4 weeks at the time of 8 weeks the MAS value of spasticity was also statistically meaningful(P <.05) 4) In the case of time-based MAS value of each group, functional electric stimulus treatment reduced the spasticity more meaningfully than neurological development treatment, and the group of same application of functional electric stimulus treatment and neurological development treatment showed better statistical meaningness than functional electric stimulus treatment alone(P <.05) and finally the group of same application of neurological development treatment and functional electric stimulus treatment showed more meaningful difference than neurological development treatment alone(P <.05)

• 사상체질의학회지
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• 제12권1호
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• pp.265-270
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• 2000

뇌졸중을 일으키는 환자들에서 있어서 심폐의 기능적 및 기질적 이상이 선행요인으로 작용하거나 질병을 악화시키는 요인 및 합병증으로 병발되는 경우가 많다. 심폐질환이 동반된 경우 병의 진행과정이 급격히 악화될 가능성이 크며 예후가 불량한 경향을 띠므로 심폐질환에 주안점을 두어 급히 치료해야 한다. 상지대학교 한방병원 입원환자 중 뇌경색과 함께 울혈성 심부전으로 인하여 폐부종을 동반한 소음인 부종환자를 사상의학적으로 변증하고 치료하는 과정 중에 좋은 결과를 얻었기에 이에 증례보고를 하고자 한다. 68세 여환으로 우반신불수(右半身不遂) 연부장애(嚥不障碍) 어순(語純)의 중풍으로 내원하였으며 병의 진행 과정에 울혈성 심부전으로 진단되었고 폐부종의 소견과 함께 전신부종이 심하였다. 이를 소음인 부종이 태음증(太陰證)에 속한다고 하였으나 식(食) 변(便) 면(眠) 맥(脈) 설태(舌苔) 증상(症狀) 등을 종합하여 소음증(少陰證)으로 변증하고 건비이강음(建脾而降陰)의 치법(治法)에 준하여 궁귀총소이중탕(芎歸蔥蘇理中湯)을 투여하여 증상의 호전을 확인하였다.