E-mail Survey for Developing Clinical Guideline Protocol on Acupuncture Treatment for Low Back Pain

요통에 관한 침구임상 진료지침 프로토콜 개발을 위한 전자우편 설문조사

  • Lee, Seung-Hoon (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Kyung Hee University) ;
  • Nam, Dong-Woo (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Kyung Hee University) ;
  • Kang, Jung-Won (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Kyung Hee University) ;
  • Kim, Eun-Jung (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Dongguk University) ;
  • Kim, Hyun-Wook (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Wonkwang University) ;
  • Song, Ho-Sueb (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Kyungwon University) ;
  • Kim, Sun-Woong (Dept. of Statistics, College of Natural Science, Dongguk University) ;
  • Kim, Kap-Sung (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Dongguk University) ;
  • Lee, Geon-Mok (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Wonkwang University) ;
  • Lee, Jae-Dong (Dept. of Acupuncture & Moxibustion, College of Oriental Medicine, Kyung Hee University)
  • 이승훈 (경희대학교 한의과대학 침구학교실) ;
  • 남동우 (경희대학교 한의과대학 침구학교실) ;
  • 강중원 (경희대학교 한의과대학 침구학교실) ;
  • 김은정 (동국대학교 한의과대학 침구학교실) ;
  • 김현욱 (원광대학교 한의과대학 침구학교실) ;
  • 송호섭 (경원대학교 한의과대학 침구학교실) ;
  • 김선웅 (동국대학교 이과대학 통계학과) ;
  • 김갑성 (동국대학교 한의과대학 침구학교실) ;
  • 이건목 (원광대학교 한의과대학 침구학교실) ;
  • 이재동 (경희대학교 한의과대학 침구학교실)
  • Published : 2009.06.20

Abstract

Objectives: This survey was done in order to find out how Korean medical doctors derive pattern identification for acupuncture prescriptions in treating low back pain in real clinical practice. Methods : The survey questionnaire was developed by the committee of experts who major in acupuncture & moxibustion or statistics for acupuncture clinical trial protocol development. The questionnaires were distributed via e-mail to 75 members of Korean Acupuncture & moxibustion society from March 26th to April 14th in 2009. 57 members completed answers, and the computerized data were analyzed by SPSS 17.0 statistical program. Results : 1.57 Korean medical doctors selected meridian pattern identification based on the course of the meridians(44.6%), visceral pattern identification(32.1%), pattern identification based on cause of disease(14.3%) as the most commonly used pattern identification methods for acupuncture prescription when treating low back pain patients in real clinical practice. 2. In meridian pattern identification based on the course of the meridians, gallbladder meridian of hypochondriac region(13.0%), bladder meridian of lateral low back region(11.2%), governer vessel of central low back region(11.7%) were selected 3. In visceral pattern identification, yang deficiency of kidney(20.2%), deficiency of kidney(19.3%), liver(16.7%), yin deficiency of kidney(14.0%), violence qi of kidney(8.8%), small intestine(7.9%) were selected. Conclusions : In our e-mail survey, Korean medical doctors answered that Meridian Pattern Identification based on the course of the meridians is the most often used diagnosis method. Visceral pattern identification, pattern identification based on cause of disease, meridian pattern identification based on symptom and pattern identification based on qi-blood-yin-yang theory in order of frequency used, were selected for low back pain diagnosis in real clinical practice.

Keywords

References

  1. 배희준. 근거중심의학.대한소화기학회지. 2007;49(4) : 93-104.
  2. Sackett DL, Straus SE, Richardson WS, Rosenberg W, Haynes RB. Evidence-based medicine: how to practice and teach EBM. 2nd ed. Churchil Livingstone. 2000.
  3. 김남순. 임상진료지침 개발현황 및 정책과제. 보건 복지포럼 통권. 2004 ; 96 : 5-19.
  4. Grimshaw JM, Russell IT. Effect of clinical guidelines on medical practice: a systematic review of rigorous evaluations. Lancet. 1993 ; 342(8883) : 1317-22. https://doi.org/10.1016/0140-6736(93)92244-N
  5. 대한신경외과학회, 신경외과학. 제2판. 서울 : 중앙문화사. 2002 : 457, 467-8
  6. Furlan AD, van Tulder M, Cherkin D, Tsukayama H, Lao L, Koes B, Berman B. Acupuncture and dry-needling for low back pain: an updated systematic review within the framework of the cochrane collaboration. Spine. 2005 ; 30(8) : 944-63. https://doi.org/10.1097/01.brs.0000158941.21571.01
  7. Araki S, Kawamura O, Mataka T, et al. Randomized controlled trial comparing manual acupuncture with sham acupuncture for acute low back pain. J Japan Soc Acupunct Moxibustion. 2001 ; 51 : 382.
  8. Kittang G, Melvaer T, Baerheim A Acupuncture contra antiphlogistics in acute lumbago. Tidsskr Nor Laegeforen. 2001 ; 121 : 1207-10.
  9. Carlsson CP, Sjolund BH. Acupuncture for chronic low back pain: a randomized placebocontrolled study with long-term follow-up. Clin J Pain. 2001; 17 : 296 - 305. https://doi.org/10.1097/00002508-200112000-00003
  10. Cherkin DC, Eisenberg D, Sherman KJ et al. Randomized trial comparing traditional Chinese medical acupuncture, therapeutic massage, and self-care education for chronic low back pain. Arch lnt Med. 2001 ; 161: 1081-8.
  11. 이승덕, 김선웅, 최선미, 서정철, 이상훈, 김용석. 무릎 관절염의 맞춤형 침구 임상시험 프로토콜 개발을 위한 전자우편 설문 조사. 대한침구학회지. 2005 ; 22(4) : 197-204.
  12. 염승철, 이건목, 이길숭, 김성철. 동의보감의 십종 요통에 근거한 요통환자의 임상적 연구. 대한침구학회지. 2005 ; 22(4) : 95- 111.
  13. 성수민, 박민제, 김정욱, 황민섭, 윤종화. 십종요통 중 식적, 습열 요통의 증례보고. 대한침구학회지. 2005 ; 22(4) : 143-53.
  14. 허준. 동의보감. 동의보감출판사. 2005 : 705-16.
  15. 식품의약품안전청. 한약제재 등의 임상시험 가이드 라인 제정연구 중약신약임상연구지도원칙. 식품의약품안정청. 2005 : 106-10, 472-78.
  16. 니시료카즈시, 쿠마자와 타가오. 과학적인 침구임상의학. 군자출판사. 177-202.
  17. 대한침구학회 교재편찬위원회. 침구학(하). 집문당. 2008 : 72-80.
  18. 신순식 외. 한의진단명과 진단요건의 표준화 연구 (Ill). 한국한의학연구소. 415-27.
  19. 박영배, 김태희. 변증진단학. 성보사. 1995 : 173-467.
  20. Evidence Based Medicine Working Group. Evidence-based medicine: a new approach to teaching the practice of medicine. JAMA. 1992 ; 268 : 2420-5. https://doi.org/10.1001/jama.268.17.2420
  21. 김병성. 임상진료지침 및 근거 중심 의학. 가정의학회지. 1997 ; 19(8) : 87-97.
  22. Field MJ, Lohr KN, EDs. Institute of Medicine Committee to advise the Public Health Service on Clinical Practice Guideline, Clinical Practice Guidelines: Directions for an New Program. Washington DC, USA: National Academy Press. 1990.
  23. 안형식. 임상진료지침의 개념과 활성방안. 대한소화기학회지. 2007 ; 49(4).
  24. 김남현, 이환모. 요통치료의 평가지수. 대한정형외과학회지 1990 ; 25(3) : 927-32.
  25. Chou R, Qaseem A, Snow V, Casey D, Cross JT Jr, Shekelle P, Owens DK Clinical Efficacy Assessment Subcommittee of the American College of Physicians; American College of Physicians; American Pain Society Low Back Pain Guidelines Panel. Diagnosis and Treatment of Low Back Pain: A Joint Clinical Practice Guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007 ; 147 : 478-91. https://doi.org/10.7326/0003-4819-147-7-200710020-00006
  26. Burton AK, Waddell G. Clinical guidelines in the management of low back pain. Baillieres Clin Rheumatol. 1998 ; 12(1) : 17-35. https://doi.org/10.1016/S0950-3579(98)80004-6
  27. Arnau JM, Vallano A, Lopez A, Pellise F, Delgado MJ, Prat NA. Critical review of guidelines for low back pain treatment. Eur Spine J. 2000 ; 15(5) : 543-53. https://doi.org/10.1007/s00586-005-1027-y
  28. http://www.guideline.or.kr/contents/index.php?code= 015
  29. 유태성. 근막통증증후군의 변증을 위한 연구(1). 대한한의진단학회지. 2000 ; 4(1) : 82-98.
  30. 이봉교 외. 한방진단학. 서울 : 성보사. 1988 ; 21, 27, 103.
  31. Rishma Walji, Heather Boon. Redefinding the randomized controlled trial in the context of acupuncture research. Complementary Therapies in Clinical Practice. 2006 ; 12, 91-6. https://doi.org/10.1016/j.ctcp.2005.10.001
  32. 이정현, 김민수, 이은용. 요통환자의 양도락 변화에 대한 임상적 고찰. 대한침구학회지. 2003 ; 20(1) : 74-84.
  33. 한정우, 육태한. 협통의 원인과 치료혈에 대한 문헌적 고찰. 대한침구학회지. 1997 ; 14(1) : 239-59.
  34. 최익선 외. 요통증의 침구치료에 관한 문헌적 고찰. 경희대한의대논문집 제1권. 1978 : 159-187.
  35. 이윤호. 요각통의 침구치료와 치험례. 월간행림. 1977 ; 2 : 22-4.
  36. 송형근, 송민식, 김정호, 강재희, 김영화, 김영일, 홍권의, 이현, 이환동. 급성기 요통의 치료에 자락 요법의 병행이 미치는 영향. 대한침구학회지. 2004 ; 21(5) : 113-22.
  37. 최용태, 이혜정, 임사비나 공역. 경전침구학. 일중사. 2002 ; 92.
  38. 안종철 외. 성인 요통 환자의 요추부 X선 소견에 의한 통계학적 고찰. 대한정형외과학회지. 1976 ; 11 (1) : 29-33.
  39. 김재홍. 박은주, 박춘하, 조명래, 유충렬, 채우석. 요통 및 요각통 환자의 체침료법과 오행침법의 신정격병용에 의한 증상호전 비교. 대한침구학회지. 2002 ; 19(1) : 84-91.
  40. 황우준 외. 두면척추 사지병의 진단과 치료. 서울 : 대성문화사. 1995 : 141-63.
  41. 전성하, 류헌식, 장병선, 김수현, 박회진. 요통환자 80례에 대한 임상적 고찰. 대한침구학회지.2007 ; 24(2) : 155-67.
  42. 문석재, 나상효, 최현. 하지방산성 요통에 대한 임상적 고찰. 대한한의학회지. 1983 ; 4(2) : 16-26.