Objectives : To examine the effects of the collaborative Oriental and Western medicine, we treated a gouty arthritis patient with acute inflammation and liver injury with a combination of Oriental and Western treatments. Methods : Acupuncture, Bangphungtongsung-San(Fangfengtongsheng-san)', 'Kangwhaljetong-Um(Qianghuochutong-yin)', and 'Sosiho-Tang(Xiaochaihu-tang) were offered to an acute gouty arthritis patient with NSAIDs, Corticosteroids and allopurinol. Laboratory data were observed for the duration of hospital days. Results : In spite of Oriental treatments, NSAIDs administration caused liver injury, but continuous Oriental treatments with small amount of Corticosteroids and allopurinol brought recovery of liver function and gouty arthritis. Confusion : Collaborative treatments of Oriental and Western medicine are better than independent Western treatment for gouty arthritis with acute inflammation and liver injury. Further studies will be required to ascertain the collaborative treatment with Oriental and Western medicine for gouty arthritis and other diseases.
This study investigated the Oriental medicine knowledge and educational requirement of medical staff working in Oriental-Western collaborative medicine hospitals(except for Oriental and Western medicine doctors) based on the recognition that not only mutual understanding and cooperation between Oriental and Western medicine doctors but also the knowledge of Oriental medicine of medical support staff such as nurses, medical technologists, pharmacists and administrative staff are very important to promote Oriental-Western collaborative medical treatment. The study results are summarized as follows : First, it was found that the ratio of nurses who took Oriental medicine education was much higher than those of other groups. They took Oriental medicine education in the types of school curriculum (27.0%) and special lectures in workplace(20.4%). Second, many of the people who took Oriental medicine education were found to be not satisfied with the education in general - 32.7% of them answered the education content was "so so" and 48.4% of them answered "unsatisfactory." Third, the general necessity of Oriental medicine education was found to be an average of 3.60 out of 5, and the number was higher "after employment"(average=3.85) than "before employment"(average=3.04). Fourth, the study found that Oriental-Western collaborative medicine hospital staff are well aware of the necessity of the knowledge of Oriental medicine in the cases of communications between different occupational types, consultations with patients or their guardians, treatment and nursing and the establishment of the practice of specialized Oriental medicine institutes. Fifth, the levels of Oriental medicine knowledge showed a difference in average value according to the role range(p<0.000), and it was found that there is an interaction effect between occupation type and role range(p<0.015).
Objectives : The purpose of this study was to evaluate and compare the cost-effectiveness of Eastern, Western, and collaborative treatments and suggest a cost-effective approach for patients with frozen shoulder pain. Methods : Using the data of fifty-two patients, treatment effectiveness was measured by CSA, SPABI, and ROM scales and changes from the baseline score were evaluated. Data source for cost estimation was based on the national health insurance (NHI) payment system. Because the price in NHI was differentiated by health care institutions, five collaborative types were considered in assessing costs. Cost-effective ratios were computed for economic evaluation. Results : Compared with Eastern treatment, collaborative and Western treatments showed better effects on CSA scale after 4 weeks' treatment. The collaborative approach was also the most effective treatment on SPADI and ROM scales. The direct cost per patient receiving Eastern treatment was less than other treatments. In general, collaborative treatment dominated Eastern and Western treatments in cost-effectiveness an analysis. However, the cost-effectiveness ratio of Eastern treatment resulted in \9,000 compared to \29,000 of collaborative treatment on SPADI. Four different indicators of ROM scales resulted in different approaches as the cost-effective treatment. Conclusions : Considering cost-effectiveness ratios, collaborative treatment was the best treatment on CSh and SPADI scales after 4 weeks' treatment. As for ROM scales, the recommended alternatives were Eastern treatment for patients with abduction and adduction disabilities, Western treatment for those with flexion disability, and collaborative approach fir those with extension disabiliry.
Objectives : Recently, the elderly population and dementia prevalence have been rapidly increasing in Korea. Dementia is a concept of syndrome composed of characteristic symptoms. However, there have been no approved treatments for dementia with proven efficacy. Therefore, we investigated Korean traditional treatment being used in clinic and collaborative practice for dementia in the professional group. Methods : We conducted a survey using questionnaires to professors of oriental neuropsychiatry for a month. Items of the questionnaire consisted of overall Korean traditional medical treatment for dementia, which included herbal medicine, acupuncture, moxibustion, cupping, psychotherapy and others. Results : 1. It was shown that Yukmijihwangtanggamibang, Jowiseungcheongtang, Seonghyangjeonggisan have been used the most in herbal medicine. 2. Chechim, Saamchimbeop, and scalp acupuncture have been used the most in acupuncture treatment. 3. In Korean traditional psychotherapy, Ijeongbyeongi, Jieongoronyobeop, Gigongyobeop have been used, and effective in anxiety, agitation, improvement of comprehension for caregiver and environment. 4. Most professors answered that collaborative practice between Korean traditional medicine and western medicine has been needed for dementia. They suggested that herbal medicine, followed by acupuncture, and moxibustion can be used with western medicine simultaneously. Conclusions : The survey revealed that professors use herbal medicine and acupuncture as main treatments for dementia. They share perspective regarding the need of long period to treat dementia patients, and there are needs of collaborative practice for dementia.
By process of treatment for a case which diagnosed as glossopharyngeal neuralgia and admitted from the 4th, August, 2000 to the 1st, September, 2000, the results are as follows. Method & Resuits : This patient was diagnosed as Flaring up of Heart-fire(心火上炎), medicated Gamichengsimyeonja-eum(JiaWeiQingXinLianZi-Yin) and acupunture therapy was taken on proximal acupoints of right throat and parotid and distal acupoints inciuding Yuji(L10, 魚際), Taixi(K6,太谿), Zhaohai(K3, 照海), Hegu(LI4, 合谷) and Taichong(Liv3, 太衝). And negative therapy was taken on some pressure points of Jianzhongshu(SI15, 肩中兪) Jianjing(G21, 肩井) and Futu(LI18, 扶突). As a result, the patient's paroxysmal megalgia was improved. Conclusion : I consider that idiopathic pain diseases including glossopharyngeal neuralgia can improved by Oriental-Western collaborative medical treatment and continuous research must be accumulated subsequently.
By process of treatment for a case which diagnosed as suppurative arthritis and admitted from the 5th, October, 1999 to the 15th, November, 1999, the results are as follows. Method & Results : In the earlier days of admission, this patient was diagnosed as damp-heat(濕熱) and medicated Cheongyeolsaseup-tang(qingrexieshi-tang). As the result, heating, pain in both knees and heating in both lmees are improved. In the later days of admission, this patient was diagnosed as impairment of the liver and kidney(肝腎虛損) and medicated Samgi-eum(sanqi-yin). As the reslut, weakness in lower limbs is improved. Conclusion : I consider that the rate of recovery for other infectious diseases including suppurative arthritis can be maximized by accumulation of clinical experiences and continuous research through both western medical treatment and oriental medical treatment.
Objectives: To standardize treatment, improve quality of medical service, and reduce medical costs of patients with depression by developing a clinical pathway (CP) of Korean medicine. Methods: CP was developed based on clinical practice guideline (CPG) for depression. To consider the degree of economic burden and satisfaction, the current status of management for patients with depression was examined. After CP was primarily developed, contents of the CP were supplemented by referring to previously developed CPs. Results: Based on CPG, current status survey and previous CP, four types of CP (Korean medicine clinics, Korean medicine hospitals, Western-Korean medicine collaborative hospitals, public medical center) were developed and shown in the algorithm version. However, in the case of Korean medicine hospitals and Western-Korean medicine collaborative hospitals, CPs were detailed according to different clinical scenes of outpatients and inpatients. This study also shows six different time task matrix version. Conclusions: CP for depression is expected to not only reduce financial burden of patients and health insurance, but also increase the quality of treatment and satisfaction.
Objectives : This study aims to analyze the papers of the east-west medical combined treatment and suggest the research direction. Methods : 183 research papers were collected by using 25 keywords including combination(in korean words, 병용), collaborative practice(in korean words, 협진) in Korean Medical Database(KMbase) and Oriental Medicine Advanced Searching Integrated System(OASIS). We analysed the type of studies, the kind of diseases, the treatment method, the kind of herbs and drugs in frequent use, and the result of research. Results : Among the analysed 183 papers, clinical studies are 89 cases and experimental studies are 94. 5 cases of clinical studies are Randomized Controlled Trial(RCT). The cancer(50 papers) and diseases of the circulatory system(25 papers) occupied mostly in treatment studies. Because Combined treatment was actively progressed in oriental medicine, treatment was mainly applied the combined oriental medical treatment with herbs and western drugs. In herbal medicine, Mahwangyounpae-tang(麻黃潤肺湯) and Eunkyo-San(銀翹散) were frequently used in the papers. In western drugs, Cyclophosphamide, Cisplatin, and Mitomycin C were frequently used in the papers. 154 papers introduced the treatment effect, 14 papers announced the safety, and 4 papers mentioned the side effect. Conclusions : We suggested several future research direction as follows. Clinical studies based on experiment studies must be more activated and many RCT shoud be shown. Experimental group in clinical studies should be clearly separated to confirm the treatment method is effective or isn't effective. Studies about the side effect must be expanded, and every study should be confirmed both the treatment effect and safety.
A study on cooperative medical treatment system between oriental and western medical practitioners was conducted from March through August 1997 in order to determine a productive model of cooperation of two medical parts for treatment of patients. Questionnaires were distributed to 195 medical doctors(M.D.) and 195 doctors of oriental medicine(O.M.D.) working in clinics and hospitals in six major cities. Statistical analysis tools used for this study were frequency, t-test and multiple regression by using SPSS/P.C package. The results are summarized as follows: 1. The respondents were composed of male docotors(78%) and female doctors(22%) and 68.2% of M.D. and 97% of O.M.D. were interested in the other medical part. The doctors of both disciplines had some limitation on treatment of patients but they were reluctant to refer their patients to other doctors in different discipline. 2. M.D assumed that oriental medicine was more effective for chronic diseases, and O.M.D. thought that western medicine was more effective for acute diseases. 92.3% of O.M.D.s responded that even though they do not utilize western medical technology for diagnosis, they believed the results of diagnoses by western medical technology. 3. 60.5% of O.M. and 93.3% of O.M.D. said that cooperative medical treatment system could be necessary for patients and it would be effective for control of diseases and 69% of western medical doctors and 99% of oriental medical doctors agreed that oriental medical practice would be more effective for cerebellar vascular accidents than other diseases. 77.4% of western medical doctors and 92.3% of oriental medical doctors responded that the students of two different disciplines have to be taught on the other disciplines. 82.6% of western medical doctors and 83.3% oriental medical doctors agreed that it would be necessary to have collaborative research between scientists in two disciplines. 81.5% of M.D.s and 93.3% of O.M.D.s believed that they had prejudice and distrust on other discipline 4.90% of the doctors were not satisfied with the government medical policies on health insurance, legal matters, and health delivery system. 5. 75.4% of M.D.s and 50.2% of O.M.D.s said that two medical disciplines should be integrated, but they were skeptical on that. 75.3% of M.D.s thought that western hospitals should employ O.M.D.s Finally this study recommended that western medical students study oriental medicine and the vice versa, and M.D.s and O.M.D.s should have seminars and workshops to exchange knowledge, and experiences. It is also recommended that medical laws be revised to allow medical doctors refer the patients whom they can not handle to oriental medical doctors and the vice versa.
Objectives : To evaluate the current status of East-West combination treatment in joint disorders. Methods : The medical records of patients who visited the Joints & Rheumatism Center at the Kyung Hee East-West Neo Medical Center from April 2006 to June 2009 were evaluated. The general characteristics of patients who underwent combination treatment, trend in number of cross-system referrals, and disorders and involved body regions of patients referred to the Eastern medical hospital from the Western medical hospital were initially assessed. 6 major disorders were found from the initial scanning. The trend in number of cross-hospital referrals, number of visits to the Eastern medical hospital, current status of combination treatment, treatment modality, and reason for cross-system referral was evaluated. Results : 1. 1510 patients were referred from the Eastern medical hospital to the Western medical hospital, and 1065 patients were referred from the Western medical hospital to the Eastern medical hospital. First visit patients reached a peak at the second quarter of 2007 and fourth quarter of 2006 respectively, and have steadily decreased from then on. Referrals of female patients were twice as common as male patient referrals. Patients in their sixth or seventh decade of life were most commonly referred, and more outpatients were referred compared to inpatients. 2. Patients with knee joint disorders were most commonly referred from the Western medical hospital to the Eastern medical hospital, followed by hip, shoulder, ankle, wrist, and elbow joint disorders. The most common disorders for each of the above regions in referred patients were knee osteoarthritis, avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. The generalized disorders rheumatoid arthritis and ankylosing spondylitis followed. 3. Patients referred to the Eastern hospital received approximately 3 to 10 Eastern medical treatment sessions. 45 percent remained on constant combination treatment, and 98 percent of referred patients received acupuncture treatment. Conclusions : In regard to the number of patients and duration of combination treatment, combination treatment was successfully performed for knee osteoarthritis, rheumatoid arthritis, and ankylosing spondylitis, while it was not so for avascular necrosis of the hip, adhesive capsulitis, and ankle strain and sprain. Further research on this subject is required.
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