The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
권호 표지
DOI QR코드

DOI QR Code

Familial Gastric Dysmotility in Monozygotic Twins with Functional Dyspepsia and Their Mothers and the Effect of Korean Traditional Medicine on Symptoms and Gastric Dysmotility in Twins

기능성 소화불량증의 일란성 쌍생아와 이들 모친의 가족적 위 운동성 장애와 한방치료가 쌍둥이의 임상증상과 위 운동성에 미친 영향

  • Yoon, Sang-hyub (Dept. of Gastroenterology, College of Korean Medicine, Kyung Hee University)
  • 윤상협 (경희대학교 한의과대학 비계내과학교실)
  • Received : 2018.08.01
  • Accepted : 2018.09.27
  • Published : 2018.09.30
Download PDF
⟨ Previous Next ⟩

Abstract

The aims of this study were to use the Rydoraku test, electrogastrography, and enterotachography to examine the presence of familial gastric dysmotility among monozygotic twins and their mothers; to determine the relationship between the symptoms and the indexes of the Rydoraku test, electrogastrography, and enterotachography; and to observe the therapeutic reaction for each differential treatment between twins with familial gastric dysmotility. The same herbal medication (Banhasasim-tang extract three times/day and Sojuckkunbi-tang extract three times/day) was given to each twin, but the younger twin also underwent manual acupuncture on the CV 10, 12, and 13 points of the abdominal wall and electrical stimulation of both ST 36 points of the lower leg 2-3 times per week. Evaluation of the therapeutic effect was followed after six weeks. The presence of familial gastric dysmotility was shown in the autonomic nerve system and gastric muscle and was thought to be a common pathophysiology induced by genetic co-ownership. Only the younger twin showed any marked relief of the dyspeptic symptoms associated with improvement of pyloric sphincter function, which was induced by acupuncture treatment. The Rydoraku test, electrogastrography, and enterotachography results showed the presence of familial gastric dysmotility. Although Korean traditional medicine had no effect on the familiar gastric dysmotility associated with genetic influences, the acupuncture treatment had a beneficial effect on the secondary disorder of pyloric sphincter function, which is associated with the relief of dyspeptic symptoms.

Keywords

References

  1. Talley NJ, Walker MM, Holtmann G. Functional dyspepsia. Curr Opin Gastroenterol 2016;32(6) :467-73. https://doi.org/10.1097/MOG.0000000000000306
  2. Stanghellini V, Chan FK, Hasler WL, Malagelada JR, Suzuki H, Tack J, et al. Gastroduodenal Disorders. Gastroenterology 2016;150(6):1380-924. https://doi.org/10.1053/j.gastro.2016.02.011
  3. Sarnelli G, D'Alessandro A, Pesce M, Palumbo I, Cuomo R. Genetic contribution to motility disorders of the upper gastrointestinal tract. World J Gastrointest Pathophysiol 2013;4(4):65-73. https://doi.org/10.4291/wjgp.v4.i4.65
  4. Saito H, Tsutsumi O, Noda Y, Ibuki Y, Hiroi M. Do assisted reproductive technologies have effects on the demography of monozygotic twinning? Fertil Steril 2000;74(1):178-9. https://doi.org/10.1016/S0015-0282(00)00557-4
  5. Silventoinen K, Jelenkovic A, Sund R, Hur YM, Yokoyama Y, et al. Genetic and environmental effects on body mass index from infancy to the onset of adulthood: an individual-based pooled analysis of 45 twin cohorts participating in the COllaborative project of Development of Anthropometrical measures in Twins (CODATwins) study. Am J Clin Nutr 2016;104(2):371-9. https://doi.org/10.3945/ajcn.116.130252
  6. Kourikou A, Karamanolis GP, Dimitriadis GD, Triantafyllou K. Gene polymorphisms associated with functional dyspepsia. World J Gastroenterol 2015;21(25):7672-82. https://doi.org/10.3748/wjg.v21.i25.7672
  7. Oshima T, Toyoshima F, Nakajima S, Fukui H, Watari J, Miwa H. Genetic factors for functional dyspepsia. J Gastroenterol Hepatol 2011;26 Suppl 3 :83-7.
  8. Tahara T, Arisawa T, Shibata T, Wang F, Nakamura M, Sakata M, et al. Homozygous 825T allele of the GNB3 protein influences the susceptibility of Japanese to dyspepsia. Dig Dis Sci 2008;53(3):642-6. https://doi.org/10.1007/s10620-007-9923-0
  9. Breitner JC, Welsh KA, Gau BA, McDonald WM, Steffens DC, Saunders AM, et al. Alzheimer's disease in the National Academy of Sciences-National Research Council Registry of Aging Twin Veterans. III. Detection of cases, longitudinal results, and observations on twin concordance. Arch Neurol 1995;52(8):763-71. https://doi.org/10.1001/archneur.1995.00540320035011
  10. Kendler KS, Robinette CD. Schizophrenia in the National Academy of Sciences-National Research Council Twin Registry: a 16-year update. Am J Psychiatry 1983;140(12):1551-63. https://doi.org/10.1176/ajp.140.12.1551
  11. Kieseppa T, Partonen T, Haukka J, Kaprio J, Lonnqvist J. High concordance of bipolar I disorder in a nationwide sample of twins. Am J Psychiatry 2004;161(10):1814-21. https://doi.org/10.1176/ajp.161.10.1814
  12. Hrubec Z, Omenn GS. Evidence of genetic predisposition to alcoholic cirrhosis and psychosis: twin concordances for alcoholism and its biological end points by zygosity among male veterans. Alcohol Clin Exp Res 1981;5(2):207-15. https://doi.org/10.1111/j.1530-0277.1981.tb04890.x
  13. Hyttinen V, Kaprio J, Kinnunen L, Koskenvuo M, Tuomilehto J. Genetic liability of type 1 diabetes and the onset age among 22,650 young Finnish twin pairs: a nationwide follow-up study. Diabetes 2003;52(4):1052-5. https://doi.org/10.2337/diabetes.52.4.1052
  14. Carmelli D, Cardon LR, Fabsitz R. Clustering of hypertension, diabetes, and obesity in adult male twins: same genesor same environments? Am J Hum Genet 1994;55(3):566-73.
  15. Smalley SL, Asarnow RF, Spence MA. Autism and genetics. A decade of research. Arch Gen Psychiatry 1988;45(10):953-61. https://doi.org/10.1001/archpsyc.1988.01800340081013
  16. Kim SY, Yoon SH, Kim YB, Jung SK. Study of Ryodoraku Parameters for Diagnosing Gastric Dysmotility in Functional Dyspepsia. Journal of Korean Oriental Internal Medicine 2008; 29(2):401-12.
  17. Yoon SH. Bowel Sound Recording for Structural Deformity in the Pylorus-Duodenum: Report of 3 Cases. Journal of Korean Oriental Internal Medicine. 2015;36(3):276-83.
  18. Kim HK, You JM, Jang SY, Lee JS, Um KH, Kim JS, et al. Association of Skin Sympathetic Tone or Cardiovascular Reactivity on the Fatigue Index in Patients with Functional Dyspepsia. Journal of Korean Oriental Internal Medicine 2005;26(2):390-7.
  19. You JM, Jang SY, Kim HK, Lee JS, Yum KH, Lee SR, et al. Effects of Traditional Korean Medical Therapy on Gastric Myoelectrical Activity in Patient with Functional Dyspepsia. Journal of Korean Oriental Internal Medicine 2005;26(2) :360-8.
  20. Yoon SH. Postprandial Epigastric Fullness and Pyloric Valve Disturbance in Patients with Functional Dyspepsia; Analysis of Bowel Sounds and Electrogastrography. Journal of Korean Oriental Internal Medicine 2007;28(4):769-78.
  21. Kyung Hee Medical Center. Kyung Hee Hanbang Prescription. Seoul: Twin Print Agency; 1997, p.410.
  22. Saito YA, Mitra N, Mayer EA. Genetic approaches to functional gastrointestinal disorders. Gastroenterology 2010;138(4):1276-85. https://doi.org/10.1053/j.gastro.2010.02.037
  23. Shuli L, Shengli Z, Ying Y. Research progress of regulatory mechanism of DNA methylation in complex traits using monozygotic twins. Yi Chuan 2016;38(12):1043-55.
  24. Sparks TN, Norton ME, Flessel M, Goldman S, Currier R. Observed Rate of Down Syndrome in Twin Pregnancies. J Obstet Gynecol 2016; 128(5):1127-33. https://doi.org/10.1097/AOG.0000000000001690
  25. Hicks BM, Johnson W, Iacono WG, McGue M. Moderating Effects of Personality on the Genetic and Environmental Influences of School Grades Helps to Explain Sex Differences in Scholastic Achievement. Eur J Pers 2008;22(3) :247-68. https://doi.org/10.1002/per.671
  26. Song YZ, You HY, Zhu ZH, Wen ZD, Xu HY, Chen BC, et al. The C825T Polymorphism of the G-Protein $\beta$3 Gene as a Risk Factor for Functional Dyspepsia: A Meta-Analysis. Gastroenterol Res Pract 2016;2016:5037254.
  27. Morris-Yates A, Talley NJ, Boyce PM, Nandurkar S, Andrews G. Evidence of a genetic contribution to functional bowel disorder. Am J Gastroenterol 1998;93(8):1311-7. https://doi.org/10.1111/j.1572-0241.1998.440_j.x
  28. Saito YA, Petersen GM, Locke GR 3rd, Talley NJ. The genetics of irritable bowel syndrome. Clin Gastroenterol Hepatol 2005;3(11):1057-65. https://doi.org/10.1016/S1542-3565(05)00184-9
  29. Uhm JH. Update on Genetic Studies of Functional Gastrointestinal Disorders. Kr Pediatr Gastroenterol Hepatol Nutr 2010;13 suppl 1:25-31. https://doi.org/10.5223/kjpgn.2010.13.Suppl1.S25
  30. Pallotta N, Pezzotti P, Corazziari E. Relationship between antral distension and postprandial symptoms in functional dyspepsia. World J Gastroenterol 2006;12(43):6982-91. https://doi.org/10.3748/wjg.v12.i43.6982
  31. Szarka LA, Camilleri M. Methods for measurement of gastric motility. Am J Physiol Gastrointest Liver Physiol 2009;296(3):G461-75. https://doi.org/10.1152/ajpgi.90467.2008
  32. Kim SY, Yoon SH. A Selective Effect of Combined Treatment of Electroacupuncture at Zusanli(ST36), Manual Acupuncture, and Pyengwi-san in Function Dyspepsia Patients with Pyloric Valve Disturbance and Hypoactivity of Gastric Vagus Nerve. Journal of Korean Oriental Internal Medicine 2009;30(1) :191-9.
  33. Kim YS, Yoon SH. Combination Effects of Zusanli(ST36) Electroacupuncture and Manual Acupuncture of other Acupoints on Gastric Vagal Nerve Activity and Pyloric Valve Function in Patients with Functional Dyspepsia. Journal of Korean Oriental Internal Medicine 2008; 29(3):621-8.
  34. Lee JS, Kim JS, Ryu BH, Yoon SH. Effect of Banhasasimtang Granule on Gastric Emptying in Rats. Journal of Korean Oriental Internal Medicine 2006;27(2):471-9.
  35. Yoon SH, Ryu BH, Ryu KW, Kim JS. Evaluation for Therapeutic Effectiveness of Banwhasashim-tang in Functional Dyspepsia. Journal of Korean Oriental Internal Medicine 2003;24(2):329-36.
  36. Hong JH, Kim JS, Ryu BH, Yoon SH. Effect of Sojukgunbihwan granule on Gastric Motility in Rats. Journal of Korean Oriental Internal Medicine 2006;27(1):276-87.
  37. Kim JJ, Choi YT, Lim JG, Lee YH. The Newest Acupuncture and Moxibustion Study. Seoul: Seongbosa; 1979, p. 190-2.
  38. Iwa M, Nakade Y, Pappas TN, Takahashi T. Electroacupuncture improves restraint stress-induced delay of gastric emptying via central glutaminergic pathways in conscious rats. Neurosci Lett 2006 May 15;399(1-2):6-10. https://doi.org/10.1016/j.neulet.2005.11.069
  39. Hong IA, Yoon SH. Effect of Zusanli (ST36) Electroacupuncture Stimulation on Delayed Gastric Emptying in Rats with Partial Pyloric Obstruction. Journal of Korean Oriental Internal Medicine 2009;30(1):1-8.
  40. Shiotani A, Tatewaki M, Hoshino E, Takahashi T. Effects of electroacupuncture on gastric myoelectrical activity in healthy humans. Neurogastroenterol Motil 2004;16(3):293-8. https://doi.org/10.1111/j.1365-2982.2004.00504.x

Cited by

  1. 기능성소화불량과 만성 위축성 위염이 병발된 여성 환자에 대해 한방치료 경험 1례 vol.40, pp.4, 2018, https://doi.org/10.22246/jikm.2019.40.4.697
  2. 한약재 함유 소화효소제품 복용에 대한 소비자들의 체험에 관한 질적 연구 vol.41, pp.1, 2018, https://doi.org/10.22246/jikm.2020.41.1.14
  3. 담즙 역류가 동반된 위 운동성 장애의 기능성 소화불량증에 대한 한방치료 경험 2례 vol.41, pp.6, 2018, https://doi.org/10.22246/jikm.2020.41.6.1162
  4. 족삼리와 상완, 중완, 하완혈의 침 자극으로 기능성 소화불량증 환자의 위 평활근 전기적 활성 장애를 정상화시켰던 증례 2례 vol.42, pp.4, 2018, https://doi.org/10.22246/jikm.2021.42.4.707