DOI QR코드

DOI QR Code

Therapeutic Effect of Nangan-geon for an Elderly Patient with Refractory Abdominal Pain: a Case Report

  • Son, Chang-Gue (Liver and Immunology Research Center, Oriental Medical College in Daejeon University)
  • Received : 2022.03.22
  • Accepted : 2022.05.19
  • Published : 2022.06.01

Abstract

Objectve: To inform a clinical usefulness of Nangan-geon (暖肝煎) decoction to treat a refractory abdominal pain especially in eldery. Methods: This case report presents an 85-year old male patient who had been suffered with a refractory abdominal pain without any abnormality in laboratory test and radiological examination for 5-years. The clinical outcome was observed by numerical rating scale (NRS) of self-reporting method. Results: Based on his previous multiple normal examination results from Western hospitals and clinical features including thin body (19.6 BMI), nocturnal pain around lower abdomen and cold-sensitivity, author diagnosed him as "deficiency and cold of liver-Qi (肝氣虛寒)" similar to intestinal spasm. After prescription with Nangan-geon (暖肝煎) for one month, all symptoms became improved notably (NRS 5), and almost completely recovered as a level of normal condition in 3 months (NRS 1). Conclusion: This study would show the potential of traditional Korean medicine (TKM) therapies for a refractory functional abdominal pain, and especially efficacy of Nangan-geon against cold-pattern of nonspecific abdominal pain in elderly patients.

Keywords

References

  1. Leuthauser, A & McVane, B. (2016). Abdominal Pain in the Geriatric Patient. Emerg Med Clin North Am. 34(2), 363-375. https://doi:10.1016/j.emc.2016.04.008.
  2. Martinez, J. P. & Mattu, A. (2006). Abdominal pain in the elderly. Emerg Med Clin North Am. 24(2), 371-388. https://doi:10.1016/j.emc.2006.01.010.
  3. Henden, Cam. P., Baydin, A., Yuruker, S., Erenler, A. K. & Senguldur, E. Investigation of Geriatric Patients with Abdominal Pain Admitted to Emergency Department. (2018). Curr Gerontol Geriatr Res. 2018, 9109326. https://doi:10.1155/2018/9109326.
  4. Lacey, J. I., Hughes, R. M. & Noble, V. (2019). Abdominal Pain in the Elderly: An Unusual Case of Chronic Mesenteric Ischemia in the Emergency Department. Clin Pract Cases Emerg Med. 3(3), 275-277. https://doi:10.5811/cpcem.2019.5.41886.
  5. Hustey, F. M., Meldon, S. W., Banet, G. A., Gerson, L. W., Blanda, M. & Lewis, L. M. (2005). The use of abdominal computed tomography in older ED patients with acute abdominal pain. Am J Emerg Med. 23(3), 259-265. https://doi:10.1016/j.ajem.2005.02.021.
  6. Laurell, H., Hansson, L. E. & Gunnarsson, U. (2006). Acute abdominal pain among elderly patients. Gerontology. 52(6), 339-344. https://doi:10.1159/000094982.
  7. Bharucha, A. E. & Camilleri, M. (2001). Functional abdominal pain in the elderly. Gastroenterol Clin North Am. 30(2), 517-529. https://doi:10.1016/s0889-8553(05)70193-x.
  8. Chang, C. C. & Wang, S. S. (2007). Acute abdominal pain in the elderly. Int J Gerontology. 1(2), 77-82. https://doi:10.1016/S1873-9598(08)70026-7.
  9. Poulin, M. F. & Yegneswaran, B. (2011). Acute abdominal pain in an elderly patient. J Fam Pract. 60(12), 755-756. https://pubmed.ncbi.nlm.nih.gov/22163359/.
  10. Gun, B., Yolcu, S., Degerli, V., Elcin, G., Tomruk, O., Erdur, B., et al. (2014). Multi-detector angio-CT and the use of D-dimer for the diagnosis of acute mesenteric ischemia in geriatric patients. Ulus Travma Acil Cerrahi Derg. 20(5):376-81. https://doi:10.5505/tjtes.2014.57639.
  11. Eom, H. D., Oh, S. S., Park, S. H., Yoo, S. I., Jung, J. H. & Won, H. S. (2009). Clinical Analysis of Elderly Patients with Acute Abdominal Pain in Emergency Department. J Korean Geriatr Soc. 13(2), 89-94. https://doi.org/10.4235/jkgs.2009.13.2.89.
  12. Zhu, C. P., Jiang, F., Wang, R.Q., Guo, X. Z., Hou, X. H., Xu, H., et al. (2017). Comparison of efficacy and safety of hyoscine butylbromide versus anisodamine for acute gastric or intestinal spasm-like pain: A randomized, double-blinded, multicenter Phase III trial. J Dig Dis. 18(8), 453-460. https://doi:10.1111/1751-2980.12504.
  13. MedicalNewsToday, What to know about colon spasms. Available from: https://www.medicalnewstoday.com/articles/colon-spasm.
  14. Ge, Z., Yuan, Y., Zhang, S., Hou, X., Wang, J., Cai, J., et al. (2011). Schaefer E. Efficacy and tolerability of two oral hyoscine butylbromide formulations in Chinese patients with recurrent episodes of self-reported gastric or intestinal spasm-like pain. Int J Clin Pharmacol Ther. 49(3), 198-205. https://doi:10.5414/cp201485.
  15. He, J., Huang, M., Zhang, Q., Liao, W., Wang, L. & Zhang, Y. (2004). Treatment of unstable angina pectoris with modified nuan gan jian--a report of 33 cases. J Tradit Chin Med. 24(4), 263-265. https://pubmed.ncbi.nlm.nih.gov/15688691/. https://doi.org/10.3969/j.issn.0255-2922.2004.04.006
  16. Han, J. H., Woo, S. H., Park, Y. K. & Lee, H. J. (2021). Korean medicine treatment, including Nangan-jeon, of chronic constipation and abdominal pain in Lambert-Eaton myasthenic syndrome: A case report. J of Herbal Formula Sci. 29(4):321-329. https://doi.org/10.14374/HFS.2021.29.4.321.
  17. Lee, S. H. & Lee, Y. H. (2013). Case Reports of Treatment of Nangan-jeon for Female Infertility. J Naturopathy. 2(1), 83-88.
  18. Bosque, J. J., Calvo, G. F., Perez-Garcia, V. M. & Navarro, M. C. (2021). The interplay of blood flow and temperature in regional hyperthermia: a mathematical approach. R Soc Open Sci. 8(1), 201234. https://doi:10.1098/rsos.201234.
  19. Krauchi, K. & Wirz-Justice, A. (2001). Circadian clues to sleep onset mechanisms. Neuropsy-chopharmacology. 25, S92-96. https://doi:10.1016/S0893-133X(01)00315-3.
  20. Korean Statistical Information Service. Population. Available from: https://kosis.kr/statisticsList/statisticsListIndex.do?vwcd=MT_ZTITLE&menuId=M_01_01.
  21. Kang, S. B. & Park, Y. S. (2009). The Approach to Geriatric Disease in Traditional Korean Medicine. J Jea-han Ori Med Acad. 7(1):13-22. https://kiss16.kstudy.com/kiss6/download_viewer.asp