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아토피 피부염 치료를 위한 심신의학적 접근

Mind-body Intervention for Treating Atopic Dermatitis

  • 조일영 (전주대학교 대체의학대학) ;
  • 박순권 (전주대학교 대체의학대학)
  • 발행 : 2008.11.28

초록

아토피 피부염은 그 증상이 심각하고 그와 더불어 환자의 심리적 상태도 통제할 수 없을 정도로 황폐화되는 난치성 질환이다. 최근 연구보고들에 따르면 이 질환에 스트레스와 같은 심리적 요인이 중요하게 작용하며, 심리적 문제를 치료하는데 사용되는 기법들이 이 질환에도 유효하게 작용한다고 한다. 따라서 여기에서는 심리적 스트레스를 완화시켜 다양한 정신신체질환을 예방하고 치료하기 위한 목적으로 널리 사용되는 심신의학 프로그램을 아토피 질환의 추가적 치료 수단으로 제안하였다. 또한 심신의학 프로그램 의 치료 효과 모형과 치료자가 갖추어야 할 요건에 대해서도 논의하였다.

Patients with atopic dermatitis, an intractable disease, suffer uncontrollable psychological distress as well as various symptoms in their skin. Recent findings showed that mental factors such as stress may play a role in the disease and that some techniques for alleviating psychological problems were efficacious in the atopic dermatitis. Therefore, we proposed the mind-body medicine that has been used to decrease the negative influences of stress and to cure psychosomatic disorders as an additional remedy for the atopic dermatitis. A model on the therapeutic effect of mind-body medicine and some qualities of practician also were discussed.

키워드

참고문헌

  1. A. Buske-Kirschbaum, A. Gierens, H. Höllig, and D. H. Hellhammer, "Stress-induced immunomodulation is altered in patients with atopic dermatitis," J Neuroimmunol. Vol.129, No.1-2, pp.161-167, 2002. https://doi.org/10.1016/S0165-5728(02)00168-6
  2. U. Raap, T. Werfel, B. Jaeger, G. and Schmid-Ott, "Atopic dermatitis and psychological stress," Hautarzt. Vol.54, No.10, pp.925-929, 2003. https://doi.org/10.1007/s00105-003-0609-z
  3. C. O. Höglund, J. Axén, C. Kemi, S. Jernelöv, J. Grunewald, C. Müller-Suur, Y. Smith, R. Grönneberg, A. Eklund, P. Stierna, and M. Lekander, "Changes in immune regulation in response to examination stress in atopic and healthy individuals," Clin Exp Allergy. Vol.36, No.8, pp.969-971, 2006. https://doi.org/10.1111/j.1365-2222.2006.02538.x
  4. S. Pallanti, T. Lotti, and M. Urpe, "Psychoneuroimmunodermatology of atopic dermatitis: from empiric data to the evolutionary hypothesis," Dermatol Clin. Vol.23, No.4, pp.695-701, 2005. https://doi.org/10.1016/j.det.2005.05.019
  5. H. Hashizume, T. Horibe, A. Ohshima, T. Ito, H. Yagi, and M. Takigawa, "Anxiety accelerates T-helper 2-tilted immune responses in patients with atopic dermatitis," Br J Dermatol. Vol.152, No.6, pp.1161-1164, 2005. https://doi.org/10.1111/j.1365-2133.2005.06449.x
  6. L. E. Vargas, M. L. Peña Payero, and M. A. Vargas, "Influence of anxiety in diverse cutaneous diseases," Actas Dermosifiliogr. Vol.97, No.10, pp.637-643, 2006. https://doi.org/10.1016/S0001-7310(06)73484-6
  7. R. J. Davidson, J. Kabat-Zinn, J. Schumacher, M. Rosenkranz, D. Muller, S. F. Santorelli, F. Urbanowski, A. Harrington, K. Bonus, and J. F. Sheridan, "Alterations in brain and immune function produced by mindfulness meditation," Psychosom Med. Vol.65, No.4, pp.564-570, 2003. https://doi.org/10.1097/01.PSY.0000077505.67574.E3
  8. S. Mitani, M. Fujita, S. Sakamoto, and T. Shirakawa, "Effect of autogenic training on cardiac autonomic nervous activity in high-risk fire service workers for posttraumatic stress disorde," J. Psychosom Res. Vol.60, No.5, pp.439-444, 2006. https://doi.org/10.1016/j.jpsychores.2005.09.005
  9. T. Takahashi, T. Murata, T. Hamada, M. Omori, H. Kosaka, M. Kikuchi, H. Yoshida, and Y. Wada, "Changes in EEG and autonomic nervous activity during meditation and their association with personality traits," Int J Psychophysiol. Vol.55, No.2, pp.199-207, 2005. https://doi.org/10.1016/j.ijpsycho.2004.07.004
  10. P. Bellavite, R. Ortolani, F. Pontarollo, G. Pitari, and A. Conforti, "The Rationale of the 'Simile'," Evid Based Complement Alternat Med. Vol.4, No.2, pp.149-163, 2007. https://doi.org/10.1093/ecam/nel117
  11. M. Cooke, K. Holzhauser, M. Jones, C. Davis, and J. Finucane, "The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter," J Clin Nurs. Vol.16, No.9, pp.1695-1703, 2007. https://doi.org/10.1111/j.1365-2702.2007.01709.x
  12. M. J. Slattery, D. F. Klein, S. Mannuzza, J. L. Moulton, D. S. Pine, and R. G. Klein, "Relationship between separation anxiety disorder, parental panic disorder, and atopic disorders in children: a controlled high-risk study," J Am Acad Child Adolesc Psychiatry, Vol.41, No.8, pp.947-954, 2002. https://doi.org/10.1097/00004583-200208000-00013
  13. A. Buske-Kirschbaum, A. Geiben, and D. Hellhammer, "Psychobiological aspects of atopic dermatitis: an overview," Psychother Psychosom. Vol.70, No.1, pp.6-16, 2001. https://doi.org/10.1159/000056219
  14. A. Buske-Kirschbaum, K. von Auer, S. Krieger, S. Weis, W. Rauh, and D. Hellhammer, "Blunted cortisol responses to psychosocial stress in asthmatic children: a general feature of atopic disease?," Psychosom Med. Vol.65, No.5, pp.806-810, 2003. https://doi.org/10.1097/01.PSY.0000095916.25975.4F
  15. M. E. Faulstich, D. A. Williamson, E. G. Duchmann, S. L. Conerly, and P. J. Brantley, "Psychophysiological analysis of atopic dermatitis," J Psychosom Res. Vol.29, No.4, pp.415-417, 1985. https://doi.org/10.1016/0022-3999(85)90027-3
  16. Y. C. Lin, H. J. Wen, Y. L. Lee, and Y. L. Guo, "Are maternal psychosocial factors associated with cord immunoglobulin E in addition to family atopic history and mother immunoglobulin E?," Clin Exp Allergy, Vol.34, No.4, pp.548-554, 2004. https://doi.org/10.1111/j.1365-2222.2004.1928.x
  17. V. Niemeier, M. Nippesen, J. Kupfer, W. B. Schill, and U. Gieler, "Psychological factors associated with hand dermatoses: which subgroup needs additional psychological care?," Br J Dermatol. Vol.146, No.6, pp.1031-1037, 2002. https://doi.org/10.1046/j.1365-2133.2002.04716.x
  18. L. Misery, "Atopic dermatitis and psychological factors," Ann Dermatol Venereol. Vol.132, Spec No.1, pp.1S112-115, 2005.
  19. P. A. Gustafsson, N. I. Kjellman, and B. Bjorkstén, "Family interaction and a supportive social network as salutogenic factors in childhood atopic illness," Pediatr Allergy Immunol. Vol.13, No.1, pp.51-57, 2002. https://doi.org/10.1034/j.1399-3038.2002.00086.x
  20. J. Kabat-Zinn, "Mindfullness-based intervention in cintext: past, present, and future," Clinical Psychology: Social and Practice, Vol.10, pp.144-156, 2003. https://doi.org/10.1093/clipsy.bpg016
  21. J. Kabat-Zinn, L. Lipworth, and R. Burney, The clinical use of mindfulness meditation for the self-regulation of chronic pain, J Behav Med. Vol.8, No.2, pp.163-190, 1985. https://doi.org/10.1007/BF00845519
  22. J. Kabat-Zinn, E. Wheeler, T. Light, A. Skillings, M. J. Scharf, T. G. Cropley, D. Hosmer, and J. D. Bernhard, Influence of a mindfulness meditation-based stress reduction intervention on rates of skin clearing in patients with moderate to severe psoriasis undergoing phototherapy (UVB) and photochemotherapy (PUVA), Psychosom Med. Vol.60, No.5, pp.625-632, 1998. https://doi.org/10.1097/00006842-199809000-00020
  23. J. Achterberg, Imagery in healing: shamanism and modern medicine, Shambhala, 1985.
  24. S. Lutgendorf, H. Logan, H. L. Kirchner, N. Rothrock, S. Svengalis, K. Iverson, and D. Lubaroff, Effects of relaxation and stress on the capsaicin-induced local inflammatory response, Psychosom Med. Vol.62, No.4, pp.524-534, 2000. https://doi.org/10.1097/00006842-200007000-00011
  25. D. D. Cupal, and B. W. Brewer, Effects of relaxation and guided imagery on knee strength, reinjury anxiety, and pain following anterior cruciate ligament reconstruction, Rehabilitation Psychology, Vol.46, pp.28-43, 2001. https://doi.org/10.1037/0090-5550.46.1.28
  26. L. Freeman, Mosby's complemantary and alternative medicine: a research-based approach, Mosby, 2004.
  27. W. Linden, Psychological perspectives of essential hypertension, S. Karger, 1984.
  28. W. Linden, Autogenic training: a narrative and quantitative review of clinical outcome. Biofeedback Self Regul. Vol.19, No.3, pp.227-264, 1994. https://doi.org/10.1007/BF01721069
  29. E. Jacobson, Progressive relaxation, 2nd ed, University of Chicago Press, 1938.
  30. J. Wolpe, Psychotherapy by reciprocal inhibition, Stanford University Press, 1958.
  31. C. S. Aneshensel, and J. D. Stone, Stress and depression: a test of the buffering model of social support, Arch Gen Psychiatry. Vol.39, No.12, pp.1392-1396, 1982. https://doi.org/10.1001/archpsyc.1982.04290120028005
  32. D. A. Williamson, J. E. Monguillot, M. P. Jarrell, R. A. Cohen, J. M. Pratt, and D. C. Blouin, Relaxation for the treatment of headache. Controlled evaluation of two group programs, Behav Modif. Vol.8, No.3, pp.407-424, 1984. https://doi.org/10.1177/01454455840083007
  33. J. A. Turner, Comparison of group progressive-relaxation training and cognitive-behavioral group therapy for chronic low back pain, J Consult Clin Psychol. Vol.50, No.5, pp.757-765, 1982. https://doi.org/10.1037/0022-006X.50.5.757
  34. S. T. Sigmon and R. O. Nelson, The effectiveness of activity scheduling and relaxation training in the treatment of spasmodic dysmenorrhea, J Behav Med. Vol.11, No.5, pp.483-495, 1988. https://doi.org/10.1007/BF00844841
  35. C. H. Stenström, B. Arge, and A. Sundbom, Dynamic training versus relaxation training as home exercise for patients with inflammatory rheumatic diseases. A randomized controlled study, Scand J Rheumatol. Vol.25, No.1, pp. 28-33, 1996. https://doi.org/10.3109/03009749609082664
  36. D. A. Bernstein and T. D. Borkovec, Progressive relaxation training: a manual for the helping professions, Research Press, 1973.
  37. J. O. Lubar and J. F. Lubar, Electroencephalographic biofeedback of SMR and beta for treatment of attention deficit disorders in a clinical setting, Biofeedback Self Regul. Vol.9, No.1, pp.1-23, 1984. https://doi.org/10.1007/BF00998842
  38. Y. Ogata, T. Sekitani, K. Moriya, and K. Watanabe, Biofeedback therapy in the treatment of tinnitus, Auris Nasus Larynx. Vol.20, No.2, pp.95-101, 1993. https://doi.org/10.1016/S0385-8146(12)80235-5
  39. B. Kappes, W. Mills, and J. O'Malley, Psychological and psychophysiological factors in prevention and treatment of cold injuries, Alaska Med. Vol.35, No.1, pp.131-140, 1993.

피인용 문헌

  1. Factors associated with Atopic Dermatitis in Korean Adults: The Korean National Health and Nutrition Survey 2008 vol.15, pp.2, 2012, https://doi.org/10.7587/kjrehn.2012.83
  2. 6 Case of Atopic Dermatitis Diagnosed as the Febrile Tendency Treated with Gagamchengyoung-tang(Jiājiǎnqīngyíng-tāng) vol.27, pp.3, 2014, https://doi.org/10.6114/jkood.2014.27.3.191