Clinical Observation of Changes in Subjective Evaluation Index and Electrogastrography Parameters of Patients with Functional Dyspepsia before and after Oriental Medical Interventions

기능성 소화불량 환자의 한방치료 전후의 주관적 평가지표와 Electrogastrography Parameters를 이용한 객관적 지표의 변화 관찰

  • Han, Ga-Jin (Division of Gastroenterology, Dert. of Internal Medicine, Oriental Medicine Hospital, Kyung-Hee University) ;
  • Kim, Jin-Sung (Division of Gastroenterology, Dert. of Internal Medicine, Oriental Medicine Hospital, Kyung-Hee University) ;
  • Ryu, Bong-Ha (Division of Gastroenterology, Dert. of Internal Medicine, Oriental Medicine Hospital, Kyung-Hee University)
  • 한가진 (경희대학교 한방병원 소화기내과) ;
  • 김진성 (경희대학교 한방병원 소화기내과) ;
  • 류봉하 (경희대학교 한방병원 소화기내과)
  • Published : 2011.12.30

Abstract

Objectives : Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disease. The aim of this study was to analyze the characteristics of functional dyspepsia patients and evaluate changes in symptoms, quality of life, and electrogastrography parameters before and after oriental medical interventions. Methods : We recruited forty-six functional dyspepsia patients who visited gastroenterology clinic in the oriental medicine hospital of Kyung Hee University between November 2009 and February 2011. Patients were assessed for their frequency of dyspepsia (based on short form-Leeds Dyspepsia Questionnaire: SF-LDQ), quality of life (based on functional dyspepsia-related quality of life questionnaire: FD-QoL), gastric motility (based on electrogastrography: EGG) on the first visit. Then, the effect of oriental medical interventions was evaluated using EGG on the second visit. Results : The majority of patients had symptoms of nausea and indigestion. The largest decrease in EGG parameters was found in the indigestion group. The frequency of regurgitation and postprandial EGG power % bradygastria showed a significant correlation. Also, significant correlations were found between some items of FD-QoL and some EGG parameters. Compared to the EGG parameters before oriental medical interventions, some parameters after treatment had positive results, implying the improvement of gastric motility disorder. We also found improvement of EGG parameters in both digestant medicinal group and digestant combined with qi-tonifying medicinal group. Conclusions : The results of this study suggest that clinical application of EGG can be an objective diagnostic tool in functional dyspepsia patients visiting oriental medical hospital.

Keywords

References

  1. 김현경, 윤상협, 이준석, 엄국현, 이선령, 김소연, 등. 기능성 소화불량증 환자의 피로도와 기혈수 변증의 상관성 분석. 대한한방내과학회지 2006;27(2):510-20.
  2. Tack J, Talley NJ, Camilleri M, Holtmann G, Hu P, Malagelada JR, et al. Functional gastroduodenal disorders. Gastroenterology 2006;130(5):1466-79. https://doi.org/10.1053/j.gastro.2005.11.059
  3. Lieberman D, Fennerty MB, Morris CD, Holub J, Eisen G, Sonnenberg A. Endoscopic evaluation of patients with dyspepsia: results from the national endoscopic data repository. Gastroenterology 2004;127(4):1067-75. https://doi.org/10.1053/j.gastro.2004.07.060
  4. 류광현, 김영호, 손희정, 이풍렬, 김재준, 고광철, 등. Dyspepsia를 주소로 내원한 환자들의 원인에 대한 고찰. 대한소화관운동학회지 1998;4(2):112-7.
  5. Drossman DA. The functional gastrointestinal disorders and the Rome III process. Gastroenterology 2006;130(5):1377-90. https://doi.org/10.1053/j.gastro.2006.03.008
  6. 최명규. 기능성 소화불량증의 정의 및 역학. 대한소화관운동학회지 2000;6(2):235-40.
  7. 지삼룡, 정혜경, 민병훈, 최기돈, 이풍렬, 강영우, 등. 기능성 소화불량증 치료에 관한 임상진료지침. 대한소화기학회지 2011;57(2):67-81.
  8. Malagelada JR, Stanghellini V. Manometric evaluation of functional upper gut symptoms. Gastroenterology 1985;88(5 Pt 1):1223-31.
  9. 김선혁, 박영재, 박영배. 위전도의 최근 연구 동향. 대한한의진단학회지 2008;12(1):13-21.
  10. Chen K, McCallum RW. Electrogastrography: measurement, analysis, and prospective applications. Med Biol Eng Comput 1991;29(4):339-50. https://doi.org/10.1007/BF02441653
  11. Fraser A, Delaney BC, Ford AC, Qume M, Moayyedi P. The Short-Form Leeds Dyspepsia Questionnaire validation study. Aliment Pharmacol Ther 2007;25(4):477-86. https://doi.org/10.1111/j.1365-2036.2006.03233.x
  12. Moayyedi P, Duffett S, Braunholtz D, et al. The Leeds Dyspepsia Questionnaire: a valid tool for measuring the presence and severity of dyspepsia. Aliment Pharmacol Ther 1998;12(12):1257-62. https://doi.org/10.1046/j.1365-2036.1998.00404.x
  13. Moayyedi P, Duffett S, Braunholtz D, Mason S, Richards ID, Dowell AC, et al. The Leeds Dyspepsia Questionnaire: a valid tool for measuring the presence and severity of dyspepsia. Aliment Pharmacol Ther 1998;12(12):1257-62. https://doi.org/10.1046/j.1365-2036.1998.00404.x
  14. Lee EH, Hahm KB, Lee JH, Park JJ, Lee DH, Kim SK, et al. Development and validation of a Functional Dyspepsia-Related Quality of Life (FD-QOL) scale in South Korea J Gastroenterol Hepatol 2006;21(1 pt 2):268-74.
  15. 홍상선, 윤상협, 임중화, 한숙영, 박석규, 김진성, 등. 위마비 환자에 대해 위전도 검사로 한방치료 효과를 확인한 치험 1례. 대한한방내과학회지 2002;23(3):519-27.
  16. 김유승, 류봉하, 김진성, 홍인아, 박영선, 정용재, 등. 기능성 소화불량증 환자에서 침구 처치 후 다채널 위전도 소견의 변화. 동의생리병리학회지 2010;24(1):152-7.
  17. Chen JDZ, McCallum RW. Electrogastrographic parameters and the clinical significance in Electrogastrography: principles and applications. New York: Raven; 1994, p. 45-73.
  18. Koch KL, Stern RM, Stewart WR. Vasey MW. Gastric Emptying and Gastric Myoelectrical Activity in Patients with Diabetic Gastroparesis: Effect of Long-Term Domperidone Treatment. Am J gastroenterology 1989;84(9):1069-75.
  19. Rothstein RD, Alavi A, Reynolds JC. Electrogastrography in Patients with Gastroparesis and Effect of Long-Term Cisapride. Digestive Diseases and Sciences 1993;38(8):1518-24. https://doi.org/10.1007/BF01308614
  20. 이광재, 김진홍, 함기백, 김영수, 조성원. 위전도검사로 측정된 지표들의 재현성. 대한소화기학회지 1999;33(6):735-40.
  21. Smout AJPM, Schee EJVD, Grachuis JL. What Is Measured in Electrogastrography?. Digestive Disease and Sciences 1980;25(3):179-87. https://doi.org/10.1007/BF01308136
  22. Wang ZS, Elsenbruch S, Orr WC, Chen JD. Detection of gastric slow wave uncoupling from multi-channel electrogastrogram: validations and applications. Neurogastroenterol Motil 2003;15(5):457-65. https://doi.org/10.1046/j.1365-2982.2003.00430.x
  23. Parkman HP, Hasler WL, Barnett JL, Eaker EY. Electrogastrography: a document prepared by the gastric section of the American Motility Society Clinical GI Motility Testing Task Force. Neurogastroenterol Motil 2003;15(2):89-102. https://doi.org/10.1046/j.1365-2982.2003.00396.x
  24. 대한침구학회 교재편찬위원회. 침구학 하. 경기도: 집문당; 2008, p. 294.
  25. 이상인. 기능성 소화불량증의 정의 및 역학. 임상내과 2003;1(7):113-6.
  26. 김선혁, 박영배, 박영재, 오환섭. 위전도에 영향을 미치는 요인에 대한 고찰. 대한한의진단학회지 2009;13(1):11-9.
  27. 이광재. 기능성 소화불량증의 병태생리와 치료. 대한소화관운동학회지 2003;9(2):85-91.
  28. Kenneth L. Koch, Robert M. Stern. Handbook of Electrogastrography. New York: Oxford University Press; 2004, p. 149-83.
  29. Ruhland C, Koschke M, Greiner W, Peupelmann J, Pietsch U, Hocke M, et al. Gastric dysmotility in patients with major depression. J Affect Disord 2008;110(1-2):185-90. https://doi.org/10.1016/j.jad.2007.12.236
  30. Lee GS, Rho SW, Shin MK, Hong MC, Min BI, Bae HS. The association of cholecystokinin-A receptor expression with the responsiveness of electroacupuncture analgesic effects in rat. Neuroscience Lett 2002;325(1):17-20. https://doi.org/10.1016/S0304-3940(02)00214-8
  31. 이기석, 민병일, 홍무창. 침자극에서의 반응군과 비반응군간의 뇌하수체에서 CCK-A receptor와 CCK-B receptor 유전자 발현량 비교연구. 동의생리병리학회지 2001;15(2):227-34.
  32. 노삼웅, 이기석, 이진우, 홍무창, 신민규, 민병일, 등. cDNA microarray를 이용한 침자극에 대한 반응군과 비반응군의 유전자적 특이성 연구. 동의생리병리학회지 2001;15(4):574-80.
  33. 김종윤, 이진용, 윤상협. 기능성 소화불량증 환아의 위전도에 대한 內消和中湯의 효과. 대한한방소아과학회지 2002;16(2):199-213.