• 정신신체의학
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• 제11권1호
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• pp.25-35
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• 2003

연구목적: 파킨슨병 환자에서 다양한 정신증상이 동반되는 것으로 보고되고 있으며, 특히 우울증상의 동반율이 매우 높다고 보고되고 있다. 특히 파킨슨병은 완치가 어렵고, 치료의 초점이 질병의 진행 억제나 증상의 완화에 있기 때문에 파킨슨병 환자에서의 우울증상에 대한 관심과 치료는 중요하다. 본 연구는 통원치료 중인 파킨슨병 환자들을 대상으로 파킨슨병 관련 임상요인들과 우울증상 사이의 관련성을 조사하는데 목적이 있다. 연구대상 및 방법: 일 대학교병원 신경과 파킨슨병 클리닉에서 특발성 파킨슨병으로 진단 받고 치료중인 환자들 중 본 연구에 참여하기로 동의한 118명의 환자를 대상으로 하였다. 일반적인 인구통계학적 자료, 파킨슨병 관련 자료[발병연령, 치료약물 용량, 임상양상, Hoehn과 Yahr의 단계(Hoehn and Yahr stage, H&Y stage), 일상생활 평가척도(Modified Schwab and England Activities of Daily Living, ADL)], 파킨슨병 환자의 삶의 질 설문지(Parkinson's Disease quality of Life questionnaire, PDQL), 스필버그 상태/특성 불안척도, 간이정신 검사 등을 조사하였고, 우울증상의 평가는 Beck 우울척도(Beck Depression Inventory, BDI)를 이용하였다. 결 과: 대상군의 평균 연령은 $60.4\pm7.1$세(범위:34-73세)였고, 남성이 56명(47.5%), 여성이 62명(52.5%)이었다. 대상군은 BDI 점수에 따라 비우울군 39명(33.1%), 경도 우울군 15명(12.7%), 중등도 우울군 16명(13.6%), 중증 우울군 48명(40.7%)으로 분류되었다. 파킨슨병 환자의 우울증상은 H & Y stage(r=0.34, p<0.001) 및 파킨슨병 증상의 정도(r=0.35, p<0.001), 스필버그 특성 불안 척도(TAI)(r=0.33, p<0.001)와 양의 상관관계가 있었고, 교육정도(r=-0.34, p<0.001), ADL(r=-0.37, p<0.001), PDQL(r=-0.69, p<0.001)과 음의 상관관계를 보였다. 본 연구에서 사용한 검사도구 중 우울증을 예측하는데 가장 의미있는 척도는 PDQL(p<0.005)이었다. 결 론: Beck 우울척도를 이용한 평가에 의하면 본 연구 대상 환자 118명 중 79명(67%)이 주관적인 우울증상을 호소하고 있었다. 본 연구 결과는 파킨슨병 증상이 심할수록, 그리고 H & Y stage가 높을수록 우울증상이 심각함을 보여준다. 또한 BDI 점수가 높을수록 일상생활에서의 활동에 제한이 많으며, 삶의 질이 저하되어 있음을 시사한다. 따라서 본 연구결과는 파킨슨병 환자의 신체증상에 대한 치료 이외 우울증상에 대한 정신의학적 관심과 치료가 중요함을 뒷받침한다.

• Journal of Acupuncture Research
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• 제24권4호
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• pp.43-54
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• 2007

Objectives : This study was designed to evaluate the effect of acupuncture with various scales on symptoms of Idiopathic Parkinson's disease. Methods: Subjects were voluntarily recruited through newspapers and internet advertisement. All the subjects were confirmed as idiopathic parkinson's disease by a neurologist. The acupuncture therapy was performed twice a week for 4 weeks by oriental medical doctor at Kyung-hee University hospital. Patients were randomly assigned to three groups : sham acupuncture group, acupuncture treatment group and Sasang-Constitution acupuncture treatment group. Acupun cture points used in acupuncture treatment group were $GB_{34}$, $LR_3$, and $ST_{36}$, which were proven to be effective in rat Parkinson's disease study. Acupuncture points used in sham treatment were non-acupoints near $GB_{34}$, $LR_3$, and $ST_{36}$. In Sasang-Constitution acupuncture treatment, we classfied Sasang constitution of patients by QSCCII. Acupuncture was applied based on theory of Korean medicine. The patient's symptoms were assessed at baseline and after 4 weeks of treatment by one evaluator with Unified Kingdom Parkinson's Disease Rating Scale (UPDRS), modified Hoehn-Yahr(H-Y) stage, and Schwab & England activ ity of daily living and freezing of gait questionnaire (FOGQ). Results : The results were as follows ; 1. UPDRS IV score differences between sham group and Sasang-Constitution acupuncture treatment were statistically significant(p=0.001). 2. UPDRS total score differences between Sasang-Constitution acupuncture treatment and acupuncture treatment group, Sasang-Constitution acupuncture treatment and sham group were statistically significant(p=0.041, p=0.014). 5. FOGQ score differences between Sasang-Constitution acupuncture treatment and acupuncture treatment group, Sasang-Constitution acupuncture treatment and sham group were statistically significant(p=0.001, p=0.001). Conclusion : The results suggest Sasang-Constitution acupuncture treatment can be applicable to improve symptoms in patients with idiopathic Parkinson's disease.

• 기본간호학회지
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• 제12권2호
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• pp.231-239
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• 2005

Purpose: Investigation of the quality of life (QoL), family support and associated variables in patients with Parkinson's disease. Methods: The data were collected from 102 patients registered in the neurology department of C University Hospital. QoL was assessed using the Parkinson's Disease Questionnaire (PDQ-39) and Family Support Scale. Modified Hoehn and Yahr (H & Y) stages were obtained from an interview and clinical examination by a neurologist. Collected data were analyzed using the SAS program. Results: The participants' PDQ-39 average score was 34.34. The scores were significantly higher for participants who were older, who had a job and who were over 2.5 on the H & Y stage. The average for Family support scores was 41.6. Participants who had a living spouse, religion and a job scored higher than those who did not. PDQ-39 score had a positive correlation with age, job, and H & Y stage. Family support and PDQ-39 score were also positively correlated. Conclusion: It is recommended a program involving family that improves family support and be developed and that it be varied according to different H & Y stages, in order to improve QoL.

• 대한한방내과학회지
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• 제38권2호
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• pp.103-109
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• 2017

Objective: To describe the effects of traditional Korean medicine (TKM) on a patient diagnosed with Parkinson's disease. Methods: The patient was treated with Korean medicine, including pharmacopuncture, acupuncture, and Chungpajunsin-bang. The Unified Parkinson's Disease Rating Scale (UPDRS) and modified Hoehn and Yahr staging (H-Y stage) were used to measure changes in amplitude and improvements in the patient's symptoms. Results: After treatment with the Korean medicine, according to the UPDRS and H-Y stage assessments, the patient's tremor improved, with the tremor amplitude decreasing from 30 cm to 5 cm. Conclusions: We suggest that TKM could be effective in reducing tremor in Parkinson's disease.

• 대한한방내과학회지
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• 제27권4호
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• pp.954-961
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• 2006

As society ages, the seriousness of Parkinson's disease in the elderly increases. This study was performed in order to evaluate the effect of Korean medical treatments on Parkinson's symptoms. An elderly patient was diagnosed with Parkinson's disease by clinical symptoms, which were resting tremor, pill-rolling tremor and mild bradykinesia. We treated her disease with Korean medical treatment, including herbal medicine and acupuncture therapy and excluding western medication. For the herbal medicine, Insamyangyeong-tang (人參養榮湯), Bobi-tang (補脾湯), Dokhwaljihwang-tang (獨活地黃湯) and Sipimijihwang-tang (十二味地黃湯) were primarily used. In result, the clinical symptoms, measured by unified Parkinson's disease rating scale (UPDRS) and modified Hoehn and Yahr stage (H-Y stage), of Parkinson's disease in this patient had improved after the Korean medical treatment. This study suggests that Korean medical treatments can be applicable to improve symptoms in patients with Parkinson's disease.

• 성인간호학회지
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• 제23권4호
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• pp.363-373
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• 2011

Purpose: Fatigue is a common problem in Parkinson's disease (PD), affecting 30~65% of patients with that diagnosis. Only recently has fatigue been recognized as an important clinical feature of PD. The aim of this study was to investigate the level of fatigue and related factors in patients with PD. Methods: Between March 1, and September, 30, 2010, a sample of 181 PD patients agreed to be interviewed. Results: The female patients' PFS (Parkinson Fatigue Scale) score was higher than those of the male patients. Household income and having a Job were significantly correlated with the PFS scores. Among the disease characteristics, motor fluctuations, dyskinesia and modified Hoehn and Yahr stage were significantly correlated with the PFS scores. On stepwise regression analysis, the most important factors related to the PFS scores were depression and sleep disturbance. Conclusion: Fatigue in patients with PD was associated with many factors and strongly associated with depression and sleep disturbance. Fatigue is a multidimensional construct; therefore, multidimensional strategies for relieving specific aspects of fatigue are needed.

• 대한한의학회지
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• 제24권3호
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• pp.172-183
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• 2003

Objective : This study was designed to determine whether manual acupuncture therapy is effective for symptoms of patients with idiopathic Parkinson's disease. Methods : Nineteen patients consecutively enrolled in this study. The subjects were divided into two groups : the first group (n=12) discontinued antiparkinsonian drug treatment, the second group (n=7) continued antiparkinsonian drug treatment Acupuncture therapy was performed twice a week for 8 weeks. In the first group, the acupuncture was performed after 2 weeks of drug wash-out period. The patient's symptoms were assessed at pre-treatment, 4 weeks and 8 weeks after the acupuncture by unified Parkinson's disease rating scale (UPDRS), modified Hoehn-Yahr (H-Y) stage, Schwab & England activity of daily living and Freezing of Gait Questionnaire(FOGQ). Results : In the first group that discontinued. antiparkinsonian drug treatment, the total UPDRS scores were significantly improved after 4 weeks (p=0.0l4) and after 8 weeks (p=0.049) compared to the pre-treatment. Particularly, the scores of UPDRS III were significantly improved after 8 weeks (p=0.032). In the second group that continued antiparkinsonian drug treatment, the total UPDRS scores were significantly improved after 4 weeks (p=0.027) and after 8 weeks (p=0.018). Particularly, the scores of UPDRS II were significantly improved after 4 weeks (p=0.042) and after 8 weeks (p=0.043), and UPDRS IV were significantly improved after 8 weeks (p=0.043). The scores of ADL were significantly improved after 8 weeks (p=0.046). Conclusion : This study suggests that manual acupuncture therapy is effective for the improvement of certain symptoms in patients with idiopathic Parkinson's disease.

• Journal of Acupuncture Research
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• 제22권1호
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• pp.91-97
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• 2005

2004 년 3월 9일부터 5월 15일까지 경희의료원 침구과 외래를 내원하여 8주간 연구과정을 마친 환자 29명의 환자를 관찰하여 뜸치료 전, 후의 파킨슨병 증상의 호전도를 여러 임상 척도를 이용하여 살펴 본 결과를 다음과 같이 보고하는 바이다. 1. UPDRS 점수는 침치료 전, 4주 후, 8주 후 각각 $35.41{\pm}22.98$, $31,93{\pm}23.44$, $30.75{\pm}24.55$로 나타나 통계적으로 매우 유의한 차이가 있었다 (p<0.01). 2. HY stage의 변화는 4주후(p=0.046)에는 유의한 변화가 있으나, 8주후에는 (0.063) 유의한 변화가 없었다. 3. Schwab과 England에 의한 ADL의 변화는 4 주후, 8주후 모두 유의한 변화가 없었다(p>0.05). 4. FOCQ의 변화는 치료 4주후에는 유의한 차이가 있었으나(p=0.05) 8주 후에는 유의한 차이가 없었다(p=0.13) 5. 뜸치료를 통해 환자에게서 파킨슨병 임상척도의 변화 외에 움직임의 유연성이나, 덜 피로함과 같은 다양한 변화가 나타났다.

• Journal of Acupuncture Research
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• 제21권5호
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• pp.59-68
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• 2004

Objective : This study was designed to evaluate the effect of electroacupuncture with various scales on symptoms of idiopathic Parkinson's disease. Methods : Subjects were voluntarily recruited by newspapers and internet. All the subjects are confirmed as idiopathic parkinson's disease by a neurologist. The acupuncture therapy was performed twice a week for 8 weeks. Acupuncture points for EA group were GB34, and LR3, electrical stimulation frequency was 120Hz, duration 15 minutes, and intensity is up to pain threshold according to patients. The patient's symptoms were assessed before, after 4 weeks and after 8 weeks treatments by unified Parkinson's disease rating scale(UPDRS), modified Hoehn-Yahr(H-Y) stage, Schwab & England activity of daily living and freezing of gait questionnaire(FOGQ). Results : UPDRS I, II, III, IV and total UPDRS scores were significantly improved after 4 weeks(p<0.05) and after 8 weeks(p<0.05) compared to the pre-treatment. The scores of ADL were significantly improved after 4 weeks(p<0.05) and after 8 weeks(p<0.05). There were significant changes in H-Y stage after 4 weeks(p<0.05), but There were no significant changes in H-Y stage after 8 weeks. There were significant changes in FOGQ scale after 4 weeks(p<0.05) and after 8 weeks(p<0.05). Conclusion : This study suggests that electroacupuncutre treatments can be applicable to improve symptoms in the patients with idiopathic Parkinson's disease.

• 대한중풍순환신경학회지
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• 제8권1호
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• pp.34-39
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• 2007

Objective : To report cases of patients with Parkinson's syndrome. Design : Case-series Patients and methods : 35 of patients with Parkinson's syndrome who visited Department of Cardiovascular and Neurologic Diseases of Kyunghee Oriental Medical Center were treated by acupuncture and herbal medicine from May until December 2007. 35 patients were participated in this study. 21 patients were dropped out during the trial, and we evaluated symptom progress of 14 patients by using several questionnaires such as Unified Parkinson's Disease Rating Scale(UPDRS), modified Hoehn & Yahr stage (H&Y stage) and Schwab & England ADL scale(S&E ADL scale). Results : The whole group consists of 14 male patients and 21 female patients. Mean±SD age range is 64.5±8.4. There were no significant differences of the demographic and clinical characteristics between the case group and drop-out group. The mean±SD medical treatment period of the Case group were 8.4±6.3weeks, the mean±SD of the total score in first medical treatment UPDRS section 1~3 were 29.6±11.0, the mean±SD of the final score were 27.1±12.6, all of which showed significant improvement(p=0.007). There were no significant changes on the H&Y stage and S&E ADL scale. Conclusion : Patients with Parkinson's syndrome who visited Department of Cardiovascular and Neurologic diseases of Kyunghee Oriental Medical Center had a tendency of showing improvement in clinical symptoms.