• 제목/요약/키워드: diagnosis and treatment of oriental medicine

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퇴행성 슬관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 면접조사 (An Interview Survey for Developing Clinical Trial Protocol on Individualized Acupuncture Treatment for Knee Osteoarthritis)

  • 이상훈;서병관;서정철;이승덕;김선웅;최선미;김용석
    • Journal of Acupuncture Research
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    • 제22권6호
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    • pp.189-199
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    • 2005
  • Objectives : This interview survey was carried out to identify how Korean medical doctors make acupuncture prescriptions for knee osteoarthritis in clinics. Methods : Survey questions were developed based on a consensus of acupuncture professors at Kyung Hee University, Dongguk University, Daegu Haany University. The interviews were conducted to 72 members of the Korea Oriental Medical Association who answered to prefer remote acupuncture prescription at previous telephone survey. Results : Korean medical doctors prefer to use five shu acupuncture points, especially 'hyung' or , 'shu' points, on the contralateral side of lesion and that the first target organ is liver. Five element points theory was mainly based on 'Nanjing' and 'Hwangdi Neijing'. The De-qi sensation of both doctor and patients was emphasized. Diagnosis and evaluation generally depend on subjective evaluation rather than objective scale. Conclusion : This study showed that Koran medical doctors prefer to follow the Korean traditional acupuncture methods respecting the old classic principles. And these results can guide us to develop advanced clinical trial protocols more close to our acupuncture practice.

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급성기 중풍 환자의 사상체질에 따른 제특성 분포에 관한 임상적 연구 (Comparison Study on the Characteristics among Sasang Constitution in Acute Stroke Patients)

  • 선종주;정재환;최창민;김석민;김창현;민인규;정동원;박성욱;정우상;문상관;박정미;고창남;조기호;김영석;배형섭
    • 대한한방내과학회지
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    • 제28권1호
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    • pp.34-46
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    • 2007
  • Objectives: This study was to assess characteristics in acute stroke patients according to Sasangconstitution (SC). Methods : We assessed the type of SC of acute stroke patients in $2^{nd}$ Department of Internal Medicine at KyungHee University Oriental Hospital from October 2005 to September 2006. Each subject's SC type was confirmed when the result of QSCC II+ was in accordance with the opinion of the Sasangconstitutional medicine specialist. We investigated general characteristics, stroke type, blood test results, alcohol drinking, smoking and dietary preferences according to SC. Results: 108 subjects were included in the final analysis. This study showed that out of the total patients, the proportion of So-yang to Tae-eum to So-eum was equal to 5.5 to 3.5 to 1. Especially, men were higher proportion So-yang while women recorded a more significant ratio of Tae-eum. Also, the BMI, waist circumference, hip circumference, and WC/HC ratio recorded significantly high results. The result indicated that even though the Tae-eum let on the highest numerical value in the aspect of their past history and the final diagnosis, no significant difference was revealed according to SC. The ratio of cerebral infarction to cerebral hemorrhage was 9 to 1. SVO, LAA, SUE are the 3 types of cerebral infarction classified by TOAST; SVO ranked the highest while SUE ranked the lowest in all constitutions. The blood test result displayed that averages of both TL and the T-chol were the highest in Tae-eum while that of hematocrit in So-yangand that of HDL-chol in So-eum. However, there was no significant difference. There were no significant differences classified by gender or by SC in the aspect of the alcohol drinking and smoking history. The majority of So-yang and Tae-eum demonstrated a preference for meat while So-eum and So-yang displayed high preferences for sea food. Conclusions : With respect to these results. we could observe the general disposition of various characteristic distributions according to SC of acute stroke patients. For further research in this field. it seems necessary to construct fundamental databases for the prevention and treatment of stroke by increasing the number of patients observed and by analyzing delicate characteristics of each constitution type.

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Valsalva 동맥류 파열;8례 보고 (Ruptured Aneurysm of the Sinus of Valsalva - 8 cases report -)

  • 선현;안병희;오봉석;김상형;이동준
    • Journal of Chest Surgery
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    • 제25권12호
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    • pp.1482-1486
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    • 1992
  • Ruptured aneurysms of the sinus of Valsalva are relatively rare, and the incidence seems to be higher in oriental than in western countries. Eight patients underwent operative treatment at Chonnam University Hospital from June, 1986 to May, 1992. Six of the patients were male and two female. Age ranged from eight to fifty six years. Associated cardiac lesions were common including AR and VSD in four patients respectively. Diagnosis was made by 2D-Echo and cine-angiogram. In six patients aneurysms of the sinus of valsalva ruptured from the right coronary sinus to the right ventricle and in two from right coronary sinus to the right atrium Direct closure of aneurysmal rupture and patch closure of VSD in four cases, resection of the aneurysm and direct closure in one case, direct closure of the fistula and AVR in two cases, direct closure in one case were performed. One patient combined with VSD, pulmonary hypertention and bacterial endocarditis underwent operation, but he died of sudden cardiac arrest the day after the operation. Operative results were relatively good in the other patients.

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중풍의 기능평가에 영향을 미치는 요인에 관한 임상적 고찰 (A Clinical Study on the Factors that Influence Functional Evaluation of Stroke)

  • 박숙자;권정남;김영균
    • 대한한의학회지
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    • 제23권4호
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    • pp.73-90
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    • 2002
  • Objectives: This study investigated significant factors that influence functional evaluation of stroke so as to be a fundamental data for estimating prognosis of stroke patients. Methods: 204 patients were studied within 7 days of admission, after the diagnosis of stroke through brain CT scan, brain MRI scan and clinical observations. They were hospitalized in the oriental medical hospital of Dongeui University from February to July in 2001. They were examined at the early stage of onset, after 2 weeks, 4 weeks and 6 weeks, and measured for average mark and the degree of improvement by using the Activity Index. Results: Ischemic stroke, past history of stroke, hypertension, diabetes mellitus, risk factor of obesity, non-professional emergency treatment and hospitalizing time after 1 day from onset, high blood pressure, tachycardia pulse and high blood sugar in abnormal vital sign in acute stage, conscious, cognitive or communication disorder, motor aphasia, dysphagia, constipation for more than 3 days, urinary incontinence, visual field defect, insomnia, and chest discomfort in early stage of onset had a negative influence on functional evaluation. Conclusions: Type of stroke, past history, risk factors, emergency treatment and hospitalizing time after onset, abnormal vital sign and intercurrent symptoms in Acute stage were relevant factors in predicting functional evaluation of stroke.

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자동차회사 근로자를 대상으로 한 근골격계 자각증상과 moire 영상 진단과의 관계 연구 (Research on the Relation between Musculoskeletal symptoms and Diagnosis using Moire Topography among Workers at an Automobile Manufacturing Plant)

  • 천은주;이영길;장두섭;이기남;송용선
    • 대한예방한의학회지
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    • 제5권2호
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    • pp.69-92
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    • 2001
  • The purposes of this study were to offer foundation making more certain standards of musculoskeletal disorder diagnosis, We researched musculoskeletal symptoms degrees, frequencies, and cares and then examined relation between musculoskeletal symptoms and diagnosis of musculoskeletal conditions using moire topography among workers at an automobile manufacturing plant. Therefore we propose the possibility of moire topography as diagnosing utilities of musculoskeletal disorders. Methods: This study was to examine the general characteristics, complaints of musculoskeletal symptoms, and work-related musculoskeletal disorder rates of cervicobrachial and lumbar area by survey among 435 workers at an automobile manufacturing plant and then to show each frequency and percentage, In the diagnosis using moire topography, we studied pain control necessity of cervicobrachial and lumbar area, 435 subjects were classified by 5 levels: A(no symptoms), B(need management), C(need treatment) and then more divided by B1(light symptoms)/B2(heavy symptoms), C1(light symptoms)/C2(heavy symptoms), And musculoskeletal areas were divided by 2 parts, cervicobrachial area(neck, shoulder, arm&elbow, and wrist&hand) and lumbar area, Then, frequency and percentage of each musculoskeletal areas(cervicobrachial and lumbar area) were appeared. At last, Pearson's chi-square test analysis was utilized to observe the relation between diagnosis using moire topography and general characteristics and the relation between diagnosis using moire topography and work-related complaint of musculoskeletal symptoms of cervicobrachial and lumbar area, Results: The subjects employed for this research were categorized into; by gender, all of them were males(l00%): by age, under 35 years 12 %, 36-40 years 56.3%, 41-45 years 26.3 %, and above 46 years 5.3% with 36-40 years accounting for most of it. By living location, owned houses represented 69.7%, rented houses 23.4%, monthly-rented 1.6%, the others 5.3%; by education, middle school and lower represented 3.0%, high school 89.4%, and junior college and higher 7.6% with high school occupying most of the group. By marital status, married represented 95.2%, unmarried 4.1%, and the others 0.7% with most of them married; by alcohol, drinking represented 81.8% and non-drinking 18.2%; by smoking status, smoking represented 53.6%, non-smoking 46.4% with no big difference between them. By working time(hours/week), below 50 represented 26.9%, 50-60 67.6%, above 60 5.5%; by working time(hours/day), below 9 represented 21.6%, 10-12 73.1%, above 13 5.3%; by job tenure(years), below 10 represented 25.1%, 11-15 54.3%, 16-20 15.2%, above 21 5.5%. By personal income per year, below 30 million won represented 11.0%, 30-40 84.8%, above 40 4.1%; by sleeping hours, below 6 hours represented 26.7%, 7-8 hours 69.9%, above 9 hours 3.4%. Complaint rates of musculoskeletal symptoms and work-related musculoskeletal disorder rates were 63.9% and 54.9% with shoulder area occupying most of both them. By pain degree of musculoskeletal symptoms, shoulder area represented $2.73{\pm}0.84$, lumbar area $2.66{\pm}0.86$, wrist and hand area $2.59{\pm}0.86$, neck area $2.55{\pm}0.74$, and arm and elbow area $2.48{\pm}0.71$. By cares about musculoskeletal symptoms, taking medication or care represented 34.4%-46.7%, absence or leave 15.4%-28.7%, and job transfer 6.3%-11.5%. So experienced cases more than one thing among cares about musculoskeletal symptoms represented 39.6%-54%. In the diagnosis using moire topography, pain control necessity of cervicobrachial area was shown below; A(no symptoms) 20.7%, B1(need management/light symptoms) 64.6%, B2(need management/heavy symptoms) 11.5%, C1(need treatment/light symptoms) 3.0%, C2(need treatment/heavy symptoms) 0.2%. By lumbar area, A(no symptoms) 8.7%, B1(need management/light symptoms) 52.2%, B2(need management/heavy symptoms) 30.3%, C1(need treatment/light symptoms) 8.7%, C2(need treatment/heavy symptoms) was none. In the relation between pain control necessity and general characteristics, age(P=0.013), education(P=0.000), and job tenure(P=0.012) with pain control necessity showed differences with significance. The relation between pain control necessity and complaint of musculoskeletal symptoms of cervicobrachial and lumbar area showed no difference with significance; in cervicobrachial area represented P=0.708, lumbar area P=0.318 Conclusions: This study for musculoskeletal symptoms on workers at automobile manufacturing plant showed that complaint rates of musculoskeletal symptoms for cervicobrachial and lumbar area were so high, 63.9%. But Pearson's chi-square test analysis was utilized to study the relation between musculoskeletal symptoms and the diagnosis using moire topography, showed no differences with significance. They have no differences with significance, but the prevalence rates of diagnosis using moire topography for cervicobrachial and lumbar area were more higher than complaint rates of musculoskeletal symptoms; complaint rates of musculoskeletal symptoms were 52.4%, 34.5% and the diagnosis using moire topography were 79.3%, 91.3% for cervicobrachial and lumbar area. The results of this study indicate that the diagnosis using moire topography can find weak musculoskeletal disorders that an individual can not feel, not be judged work-related musculoskeletal disease. Therefore, this study has an important meaning that diagnosis using moire topography can predict and control own physical condition complete musculoskeletal disorders beforehand, since oriental medicine theory considers that prevention is important.

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한의학 임상연구에서의 심박변이도 검사 활용현황과 측정조건에 대한 고찰 (Review on Current Status of Use and Measurement Condition of Heart Rate Variability in Clinical Study of Korean Medicine)

  • 김상호
    • Journal of Acupuncture Research
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    • 제29권5호
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    • pp.127-137
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    • 2012
  • Objectives : The purpose of this study is to review on current status of use and measurement condition of heart rate variability(HRV) by reviewing clinical studies published in journal of Korean medicine registered Korea citraion index(KCI). Methods : One hundred twenty articles were found by searching the representative Korean databases. At first analysis was performed by current status of use(journal, academic field of corresponing author, purpose of study, disease of subject, HRV measurement devices, intervention methods and tests compared to HRV). At second analysis was performed by measurement condition(uncontrolled study, relaxation before measurement, measurement position, measurement place, measurement time period and restriction of smoking, alcohol, caffeine, meal). Results : The analysis showed that department of acupuncture & moxibustion, department of oriental neuropsychiatry are major part in journal & academic field. The purpose of study were classified under studies to verify therapeutic effect on normal subject(39%), to verify therapeutic effect on the patients(8%), to investigate characteristics of the patients(34%) and to be compared with other test(19%). Disease of subject & measurement devices in article were so various. Major intervention methods were acupuncture(61.4%), mind-body intervention(19.2%). Studies that measurement condition were not controlled were relax time(24%), measurement position(19%), measurement place(26%), measurement time period(91%) and restriction of smoking, alcohol, caffeine, meal(49%). Conclusions : This study showed that current status of use of HRV is widespread in Korean medicine but more controlled measurement conditon are needed to get more reliable result from clinical studies and to improve diagnosis and treatment of Korean medicine.

양.한방 협진병원 뇌졸중 입원환자 진료이용실태와 협진에 대한 태도에 관한 연구 (Utilizing Patterns and Attitude on Collaborating Care of Korean Traditional Medicine and Western Medicine among Cerebral Apoplexy Patients)

  • 김대환;이기효
    • 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.

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과체중 및 비만 환자에서 한·양방 의료 이용과 관련된 요인분석: 제2기 한국의료패널 자료를 중심으로 (Analysis of Factors Related to the Use of Both Korean and Western Medicine Treatment in Patients with Overweight and Obesity: Based on the Korea Health Panel Annual Data 2019)

  • 권찬영
    • 한방비만학회지
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    • 제24권1호
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    • pp.41-53
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    • 2024
  • 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.

금궤요략${\cdot}$경계토뉵하혈흉만어혈병맥증병치 제십육(第十六)에 대(對)한 연구(硏究) (Study on the 'Diagnosis and Treatment of Terror and Palpitation due to Fright and the Several Hemorrhagic Diseases' in Synopsis of Golden Chamber)

  • 윤주헌;박금숙;권미자;임동국;정헌영
    • 동의생리병리학회지
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    • 제22권1호
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    • pp.13-24
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    • 2008
  • This Chapter mentioned Terror and Palpitation due to Fright(驚悸) and Hemorrhagic disease(血證). Terror and Palpitation due to FrightAcctually Terror(驚) is different from Palpitation(悸). Terror(驚) is one of the seven emotions. But in this case, It refer to the Palpitation and the uneasiness of mind due to one's hearing a strange sound of seeing a strange. Tremulous Pulse can be appear. So Terror(驚) is caused by Exopathic Factors(外因) and belongs to Excess syndrome(實證). Palpitaion(悸) is the sensation of plamus, palpitation and unrest not because of being frightened. It is usurally caused by the deficiency of Ki(氣) and blood(血). So Deep, Thready and weak pulse can be appear. So Palpitaion(悸) is caused by Endopathic Factors and belongs to Deficiency Syndrome. In this Chapter, Terror and Palpitation due to Fright(驚悸) treat with the Kyeji-ke-jakyak-ka-chokchil-moryu-yongkol-kuyuk-tang(桂枝去芍藥加蜀漆牡蠣龍骨救逆湯) and Banha-mahwang-hwan(半夏麻黃丸). There are two type in Hemorrhagic disease(血證). One is bleeding(出血) and another is blood stasis(瘀血). The contents which relate with the Hemorrhagic disease(血證) are Hematemisis(吐血), Rhinorrhagia, Hemafecia(下血). In hemorrhage pathological mechanisms, there are two mechanisms. One is that Fire and Heat(火熱) pressure blood. Another is that cold and deficiency(虛寒) disable Ki(氣) from keeping blood flowing within vessels. Blood stasis(瘀血) can be called Extravasated Blood(惡血), Coagulated Blood, Blood retention(蓄血,積血), Dead Blood(死血) and Emaciation due to Blood disorder(乾血). It refer to a morbid state of unsmooth circulation and blood stagnancy often resulting from Ki(氣) stagnation, Ki(氣) deficiency and accumulation of pathogenic coldness. The symptom of Blood stasis are 'Fullness sensation in the chest, Lip Flaccidity, Cyonotic Tongue and Dryness of Mouth'. And the man who have Blood stasis, want to rinse his mouth with the water, but he can't drink the water because there isn't interior Heat of Excess Type. The symptom of Cyonotic Tongue(舌靑) had influence on diagnosing Blood stasis(瘀血) in offspring.

"편작심서(扁鵲心書).권상(卷上)"에 나타난 뜸법에 대한 연구(硏究) (Studies on the method and the theory of moxibustion in "BianQueXinShu(扁鵲心書) (vol. I)")

  • 김현동;이용범
    • 대한한의학원전학회지
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    • 제20권2호
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    • pp.175-193
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    • 2007
  • A theory of the school which attach great importance to moxibustion therapy was more developed from 'Ge Hong(葛洪)', 'Wang Tao(王燾)' up to "BianQueXinShu(扁鵲心書)" of 'Dou Cai(竇材)' in Song Dynasty. The first volume of "BianQueXinShu" was described about the principles of health preserving method, diagnosis, treatment related with meridian system, support Yang theory, moxibustion therapy over the 10 chapters and in the continued 3 chapters, explained the symptoms and related moxibustion therapies. The summary is as follows. The Yang energy is the essence of the human body and it is minutely explained in "Hwangdineijing(黃帝內經)". However, the younger scholars after 'Zhang Zhongjing(張仲景)' held different views with "Hwangdineijing" so they didn't control serious diseases. Supporting the Yang energy, it will be possible to human body in good health and long life and perennial youth and longevity. To do like this, the first important thing is a moxibustion, the second is a Taoist hermit medication(丹藥) and the third is well usage of Radix Aconiti Lateralis Preparata. According to the sequence of Yang energy deficiency, the stages of diseases are classified as Ordinary Gi(平氣), Latter deficient state(微虛), The more deficient state(甚虛), Exhausting state(將脫), Exhausted state(已脫) and in the consideration of each stage, it is used gradually with warm-natured berbs, warm-acrid herbs, warm-heated herbs and moxibustion therapy. If it comes to the stage of Exhausted state, the Yang energy is too weak to treat a disease. Therefore it is easy to harm human body with usage the treatment of the Purgationist school theory or the Cold and cool medical school theory, so it is needed a great attention to use these therapies. To summarized the keynote of 'Du Jae''s moxibustion therapy, the one is a minority of selection of points(1$^{\sim}$2 acupuncture points), the second is a majority of moxibustion units(50$^{\sim}$500 units), and the other is a focused selection of points on spleen and kidney(especially Gwanwon, CC4). And in this book, it was explained concretely about the size of moxibustion, according to the experiment with mentioned size, the burning time of moxibustion was almost 4 min 40 sec, so the big size moxibustion was one of the characteristic of moxibustion therapy revealed in this book. Also it was used 'Suseongsan(睡聖散)' - a kind of analgesic herb complexes - to reduce a pain during the usage of moxibustion therapy in this book. To develop the moxibustion theory, it is more investigated in the future that there wasn't significant relation between Gwanwon(CC4) and spleen and kidney meridian in theory, compared to many used Gwanwon(CC4) in the prescription, where as mentioned the importance of spleen and kidney in treatment, that considering the burning time(1 unit - 4 min 40 sec, 12 units an hour, maximum 288 units a day) there were no guidances about meals, sleeping, stool and urine, and that there was no concrete study about the toxicity of 'Suseongsan' as analgesic moxibustion therapy.

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