DOI QR코드

DOI QR Code

Clinical Case Report of PPI-refractory Gastro-Esophageal Reflux Disease (GERD) with Korean Medicine Treatment - A Focus on Evaluation of the Abdominal Examination

한의 복합치료로 호전된 불응성 위식도역류질환 (PPI-refractory GERD) 환자 1례 - 복진소견 평가를 중심으로 -

  • Lee, Jae-hong (Dept. of Clinical Korean Medicine, Graduate School of Kyung Hee University) ;
  • Cho, Soo-ho (Dept. of Clinical Korean Medicine, Graduate School of Kyung Hee University) ;
  • Ko, Seok-jae (Dept. of Clinical Korean Medicine, Graduate School of Kyung Hee University) ;
  • Park, Jae-woo (Dept. of Clinical Korean Medicine, Graduate School of Kyung Hee University)
  • 이재홍 (경희대학교 대학원 임상한의학과) ;
  • 조수호 (경희대학교 대학원 임상한의학과) ;
  • 고석재 (경희대학교 대학원 임상한의학과) ;
  • 박재우 (경희대학교 대학원 임상한의학과)
  • Received : 2017.09.11
  • Accepted : 2017.10.28
  • Published : 2017.10.30

Abstract

This case report describes a 60-year-old man who had reflux symptoms despite treatment with proton pump inhibitors (PPIs). Korean traditional medicine, including a herbal prescription, acupuncture, and moxibustion was administered to the patient during his 19 days of hospitalization. The visual analogue scale (VAS), gastrointestinal scale (GIS), and gastrointestinal symptom rating scale (GSRS) scores were assessed on the dates of admission and discharge. An abdominal examination, which is one of the Korean medicine diagnostic tools, was performed every day to evaluate the treatment progress. During the treatment, the improvement of symptoms was clinically correlated with abdominal examination outcomes. We suggest that administration of traditional Korean Medicine on PPI-refractory GERD patients could be effective and we recommend utilization of the abdominal examination as an assessment tool for Korean Medicine treatment.

Keywords

References

  1. Vakil N, van Zanten SV, Kahrilas P, Dent J, Jones R, Global Consensus Group. The Montreal definition and classification of gastroesophageal reflux disease: a global evidence-based consensus. Am J Gastroenterol 2006;101:1900-20. https://doi.org/10.1111/j.1572-0241.2006.00630.x
  2. El-Serag HB, Sweet S, Winchester CC, Dent J. Update on the epidemiology of gastro-oesophageal reflux disease: a systematic review. Gut 2014;63(6):871-80. https://doi.org/10.1136/gutjnl-2012-304269
  3. Jung HK, Hong SJ, Jo YJ, Jeon SW, Cho YK, Lee KJ, et al. Updated guidelines 2012 for gastroesophageal reflux disease. Korean J Gastroenterol 2012;60(4):195-218. https://doi.org/10.4166/kjg.2012.60.4.195
  4. Kahrilas PJ, Jonsson A, Denison H, Wernersson B, Hughes N, Howden CW. Regurgitation is less responsive to acid suppression than heartburn in patients with gastroesophageal reflux disease. Clinical Gastroenterology and Hepatology 2012;10(6):612-9. https://doi.org/10.1016/j.cgh.2012.01.022
  5. Park HJ, Park SH, Shim KN, Kim YS, Kim HJ, Han JP, et al. The prevalence and clinical features of non-responsive gastroesophageal reflux disease to practical proton pump inhibitor dose in Korea: A multicenter study. Korean J Gastroenterol 2016;68(1):16-22. https://doi.org/10.4166/kjg.2016.68.1.16
  6. Association of Department of Gastroenterology in College of Korean Medicine. Gastroenterology in Korean Meidicine. 1st ed. Seoul: Gunja Publicaion; 2008, p. 45-8, 314-8.
  7. Bashashati M, Hejazi RA, Andrews CN, Storr MA. Gastroesophageal reflux symptoms not responding to proton pump inhibitor: GERD, NERD, NARD, esophageal hypersensitivity or dyspepsia? Canadian Journal of Gastroenterology and Hepatology 2014;28(6):335-41. https://doi.org/10.1155/2014/904707
  8. Liu JJ, Saltzman JR. Refractory gastro-oesophageal reflux disease: Diagnosis and management. Drugs 2009;69(14):1935-44. https://doi.org/10.2165/11318520-000000000-00000
  9. Jo YJ. Proton pump inhibitor for gastroesophageal reflux disease: Intelligent prescription. The Korean journal of medicine 2013;84(2):186-95. https://doi.org/10.3904/kjm.2013.84.2.186
  10. Kim MJ, Jang IS, Kang SY. A case study of 4 patients with reflux esophagitis who had improved gastroesophageal reflux disease after treatment with SokPyeonAnGel. J Int Korean Med 2015;36(1):40-8.
  11. Park JW, Yoon SW. A clinical case report of non-erosive reflux disease treated with traditional oriental medicine. J Int Korean Med 2006;27(4):991-8.
  12. Han GJ, Leem JT, Lee NL, Kim JS, Park JW, Lee JH. Development of a standart tool for pattern identification of gastroesophageal reflux disease(GERD). J Int Korean Med 2015;36(2):122-52. https://doi.org/10.13048/jkm.15039
  13. Dickman R, Schiff E, Holland A, Wright C, Sarela SR, Han B, et al. Clinical trial: acupuncture vs. doubling the proton pump inhibitor dose in refractory heartburn. Aliment Pharmacol Ther 2007;26(10):1333-44. https://doi.org/10.1111/j.1365-2036.2007.03520.x
  14. Tominaga K, Kato M, Takeda H, Shimoyama Y, Umegaki E, Iwakiri R, et al. A randomized, placebo-controlled, double-blind clinical trial of rikkunshito for patients with non-erosive reflux disease refractory to proton-pump inhibitor: the G-PRIDE study. J gastroenterol 2014;49(10):1392-405. https://doi.org/10.1007/s00535-013-0896-9
  15. Tominaga K, Iwakiri R, Fujimoto K, Fujiwara Y, Tanaka M, Shimoyama Y, et al. Rikkunshito improves symptoms in PPI-refractory GERD patients: a prospective, randomized, multicenter trial in Japan. J gastroenterol 2012;47(3):284-92. https://doi.org/10.1007/s00535-011-0488-5
  16. Hwang. MW, Park HS, Lee EJ. Clinical practice guideline for soeumin disease of sasang constitutional medicine: Greater Yin Symptomatology. J Sasang Constitut Med 2014;26(1):45-54. https://doi.org/10.7730/JSCM.2014.26.1.045
  17. Kim YJ. A study on Zhong Guo Fu Zhen(中國腹診). Doctorate thesis, Department of oriental medicine, Dong Guk University 2012.
  18. Zerbib F, Belhocine K, Simon M, Capdepont M, Mion F, Bruley des Varannes S, et al. Clinical, but not oesophageal pH-impedance, profiles predict response to proton pump inhibitors in gastro-oesophageal reflux disease. Gut 2011;61(4):501-6. https://doi.org/10.1136/gutjnl-2011-300798
  19. Jones R, Junghard O, Dent J, Vakil N, Halling K, Wernersson B, et al. Development of the GerdQ, a tool for the diagnosis and management of gastro-oesophageal reflux disease in primary care. Aliment Pharmacol Ther 2009;30(10):1030-8. https://doi.org/10.1111/j.1365-2036.2009.04142.x
  20. Kim SJ, Lee JH, Ko SJ, Park JW. Clinical case report of functional dyspepsia with Gyejibanhasaenggang-tang, Acupuncture, and Moxibustion. J Int Korean med 2016;37(2):406-11.