중성어혈 약침과 인삼백하오관중탕으로 호전된 비심인성 흉통 증례 1례

A Case Report of non-cardiac chest pain treated with Jungsongouhyul Pharmacopuncture and Insambaekhaokwanjung-tang

  • 김서영 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 최정우 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 정혜선 (강동경희대학교한방병원 뇌신경센터 한방내과) ;
  • 임태빈 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 고창남 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박정미 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 조승연 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박성욱 (경희대학교 대학원 한방순환신경내과학교실)
  • Kim, Seo-Young (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Choi, Jeong-Woo (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Jeong, Hye-Seon (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Yim, Tae-Bin (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Ko, Chang-Nam (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Park, Jung-Mi (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Cho, Seung-Yeon (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Park, Seong-Uk (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 발행 : 2020.12.01

초록

■ Objectives The purpose of this study is to report the effectiveness of Korean medicine in the treatment of non-cardiac chest pain. ■ Methods The patient with non-cardiac chest pain was treated with herbal medicine, Insambaekhaokwanjung-tang, and Jungsongouhyul pharmacoacupuncture. The severity of symptom was assessed by daily chest pain frequency, Numerical Rating Scale(NRS) of chest pain. ■ Results After the treatment, the severity of chest pain was reduced from NRS 9 to NRS 0 and the palpitation intensity was reduced from 9 to 0. The chest pain frequency was reduced from 7 to 0. In addition, other symptoms such as anorexia, sleep disturbance, and fatigue have shown improvements. ■ Conclusion The findings of this study suggests that treatment with Korean medicine can be an effective option in treating non cardiac chest pain.

키워드

참고문헌

  1. Kim JH. Clinical Approach on the management for patients with noncardiac chest pain in korea. Jorean J Med. 2011;80:649-655.
  2. Ronnie Fass, Sami R Achem. Noncardiac Chest Pain: Epidemiology, Natural Course and Pathogenesis. J Neurogastroenterol Motil. 2011;17(2):110-123. https://doi.org/10.5056/jnm.2011.17.2.110
  3. Karamanolis G, Triantafyllou K, Psatha P, et al. Bravo 48-hour wireless ph monitoring in patients with non-cardiac chest pain. Objective gastroesophageal reflux disease parameters predict the responses to proton pump inhibitors. J Neurogastroenterol Motil. 201218:169-173. https://doi.org/10.5056/jnm.2012.18.2.169
  4. Udom Kachintorn. How do we define non-cardiac chest pain? Journal of Gastroenterology and Hepatology. 2005;20:S2-S5. https://doi.org/10.1111/j.1440-1746.2005.04164.x
  5. Eslick GD, Talley NJ. Non-cardiac chest pain: predictors of health care seeking, the types of health care professional consulted, work absenteeism and interruption of daily activities. Aliment Pharmacol Ther. 2004;20:909-915. https://doi.org/10.1111/j.1365-2036.2004.02175.x
  6. Richter JE, Bradley LA, Castell DO. Esophageal chest pain: current controversies in pathogenesis, diagnosis, and therapy. Ann Intern Med. 1989;110:66-78. https://doi.org/10.7326/0003-4819-110-1-66
  7. Eslick GD. Noncardiac chest pain: epidemiology, natural history, health care seeking and quality of life. Gastroenterol.Clin. North Am. 2004; 33: 1-23. https://doi.org/10.1016/S0889-8553(03)00125-0
  8. DiMarino AJ Jr, Allen ML, Lynn RB et al. Clinical value of esophageal motility testing. Dig. Dis. 1998;16:198-204. https://doi.org/10.1159/000016867
  9. Hiroki Teragawa, Chikage Oshita, Yuichi Orita. Is Noncardiac Chest Pain Truly Noncardiac? Clinical Medicine Insights: Cardiology. 2020;14:1-5.
  10. Wielgosz AT, Fletcher RH, McCants CB, et al. Unimproved chest pain in patients with minimal or no coronary disease:a behavioral phenomenon. Am Heart J. 1984;108:67-72. https://doi.org/10.1016/0002-8703(84)90546-5
  11. Potts S, Bass CM. Psychological morbidity in patients with chest pain and normal or near-normal coronary arteries: a long-term follow-up study. Psychol Med. 1995;25:339-347. https://doi.org/10.1017/S0033291700036242
  12. Oranu AC, Vaezi MF. Non cardiac chest pain: gastroesophageal reflux disease. Med Clin North AM. 2010;94(2):233-42. https://doi.org/10.1016/j.mcna.2010.01.001
  13. Yelland M, Cayley WE Jr, Vach W. An Algorithm for the diagnosis and management of chest pain in primary card. Med Clin North Am. 2010;94(2):349-74. https://doi.org/10.1016/j.mcna.2010.01.011
  14. George N, Abdallah J, Maradey-Romero C, Gerson L, Fass R.Review article: the current treatment of non-cardiac chest pain.Aliment Pharmacol Ther. 2016;43:213-239. https://doi.org/10.1111/apt.13458
  15. 이해영. 임상의를 위한 심장학. 서울: 우리의학서적. 2017:32-7.
  16. Dickman R, Emmons S, Cui H, et al. The effect of a therapeutic trial of high-dose rabeprazole on symptom response of patients with non-cardiac chest pain: a randomized, double-blind, placebo-controlled, crossover trial. Aliment Pharmacol Ther. 2005;22:547-555. https://doi.org/10.1111/j.1365-2036.2005.02620.x
  17. Shah NH, LePendu P, Bauer-Mehren A, et al. Proton pump inhibitor usage and the risk of myocardial infarction in the general population. PLoS ONE. 2015;10(6):e0124653. https://doi.org/10.1371/journal.pone.0124653
  18. Ho PM, Maddox TM, Wang L, et al. Risk of adverse outcomes associated with concomitant use of clopidogrel and proton pump inhibitors following acute coronary syndrome. JAMA. 2009;301(9):937-944. https://doi.org/10.1001/jama.2009.261
  19. O'Donoghue ML, Braunwald E, Antman EM, et al. Pharmacodynamic effect and clinical efficacy of clopidogrel and prasugrel with or without a proton-pump inhibitor: an analysis of two randomised trials. Lancet. 2009;374(9694):989-997. https://doi.org/10.1016/S0140-6736(09)61525-7
  20. Ray WA, Murray KT, Griffin MR, et al. Outcomes with concurrent use of clopidogrel and proton-pump inhibitors: a cohort study. Ann Intern Med. 2010;152(6):337-345. https://doi.org/10.7326/0003-4819-152-6-201003160-00003
  21. Korean Pharmacopuncture Institute Scholarship Committee. Pharmacopuncture Medicine Laboratory. Seoul:Pharmacopuncturology. 2011:1-32,93-115.
  22. 박성욱. 약침의 정석 통증편. 서울:우리의학서적. 2020:13,16-17.
  23. Meridians & acupoints compilation committee of Korean Oriental Medical colleges. Principles of meridians & acupoints; a guidebook for college students. Daejeon:JongRyeoNaMu Publishing. 2012:321.
  24. Moore, Keith L, Agur AMR. Essential Clinical Anatomy. 2nd ed. Lippincott Philadelphia:Williams&Wilkins. 2002:38-47.
  25. Furness JB. The organisation of the autonomic nervous system:peripheral connections. Autonomic neuroscience:Basic&Clinical. 2006;130(1):1-5. https://doi.org/10.1016/j.autneu.2006.05.003
  26. Gunn CC. The Gunn approach to the treatment of chronic pain. Edinburgh: Churchill Livingstone. 1996:7
  27. 황민우. 사상의학 강설. 서울: 군자출판사. 2012:160-161.
  28. 전국한의과대학 심계내과학 교수협의회. 한방순환.신경내과학 I. 서울: 우리의학서적. 2016:119,121.
  29. 신희연, 최정우, 김하리 외 6인. 흉통에 대한 평진수점산의 효과: 후향적 연구. 대한한방내과학회지. 2019;40(6):1051-1062. https://doi.org/10.22246/jikm.2019.40.6.1051
  30. 장인수, 고창남, 이인 외 3인. 심적환이 흉통 흉민에 대하여 미치는 영향에 대한 다기관 무작위 배정 이중맹검 임상연구. 대한한의학회지. 2005;26(2):95-104.
  31. 이동근, 황선혜, 고지윤 외 2인. 과루해백백주탕과 과루해백반하탕을 이용한 본태성 비정형성흉통 환자 호전 2례. 대한한방내과학회지. 2017;38(3):383-391. https://doi.org/10.22246/jikm.2017.38.3.383
  32. 김보람, 최동준, 임성우. 흉통이 있는 심근교환자의 치험 1례. 대한중풍학회지. 2009;10(1):74-80.
  33. 고영탁, 유영은, 심상민 외 4인. 현훈, 두통을 동반한 심장성 흉통 환자 1례의 한방치료에 의한 증례보고. 동의신경정신과학회지. 2007;18(3):309-319.
  34. 진용인. 노심으로 인한 흉통 치험 2례. 소문학회지. 2006;9(1):69-75.
  35. 하상규, 김동우, 김수용 외 3인. 대동맥판 폐쇄부전증으로 흉통을 호소하는 태음인환자의 가미조리폐원탕 치험례. 대한한방내과학회지. 2004;25(4-2):464-472.
  36. 김명호, 안립, 최동준. 불안전협심증을 진단받은 환자의 흉통 한방치험 1례. 대한중풍학회지. 2014;15(1):72-79.