고유수용감각이상으로 인한 균형장애를 호소하는 환자 치험 1례

A Case Study of A Patient Complaining of Disequilibrium Due to Proprioceptive Disorder

  • 이경화 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 허혜민 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 김동주 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 이혜진 (강동경희대학교병원 뇌신경센터 한방내과) ;
  • 조승연 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박성욱 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 박정미 (경희대학교 대학원 한방순환신경내과학교실) ;
  • 고창남 (경희대학교 대학원 한방순환신경내과학교실)
  • Kyeong-Hwa Lee (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Hye-Min Heo (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Dong-Ju Kim (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Hye-Jin Lee (Stroke and Neurological Disorders Center, Kyung Hee University Hospital at Gangdong) ;
  • Seung-Yeon Cho (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Seong-Uk Park (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Jung-Mi Park (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University) ;
  • Chang-Nam Ko (Department of Cardiology and Neurology of Clinical Korean Medicine, Graduate School, Kyung Hee University)
  • 발행 : 2023.12.01

초록

■Objectives This work reports the case of a patient complaining of disequilibrium due to proprioceptive disorder whose condition improved following Korean medicine treatment. ■Methods The patient was hospitalized for 15 days and treated with herbal medicine, mainly doinseunggi-tang-gami, and acupuncture, electroacupuncture, and moxibustion. Disequilibrium was clinically estimated using Korean dizziness handicap inventory(K-DHI) and the patient's subjective discomfort in this regard was also checked by numeral rating scale. The degree of improvement in blood stasis syndrome was evaluated using modified Blood Stasis Questionnaire II(modified BSQ-II) to assess the clinical effects of the treatment. ■Results After treatment, the K-DHI classification improved from severe to mild, and the patient's subjective discomfort was greatly improved from NRS 6 to NRS1. In addition, the degree of improvement in blood stasis syndrome improved from blood stasis group to blood stasis risk group compared to time of admission. ■Conclusion These results suggest that Korean medicine is effective in treating disequilibrium caused by proprioceptive disorder.

키워드

참고문헌

  1. Lim HW, Chae SW. Evaluation and treatment of the patient with acute dizziness in primary care. Journal of the Korean Medical Association. 2010;53(10):898-910.  https://doi.org/10.5124/jkma.2010.53.10.898
  2. Kroenke K, Lucas CA, Rosenberg ML, Scherokman B, Herbers JE, Jr., Wehrle PA, et al. Causes of persistent dizziness. A prospective study of 100 patients in ambulatory care. Ann Intern Med. 1992;117(11):898-904.  https://doi.org/10.7326/0003-4819-117-11-898
  3. Karatas M. Central vertigo and dizziness: epidemiology, differential diagnosis, and common causes. The neurologist. 2008;14(6):355-64.  https://doi.org/10.1097/NRL.0b013e31817533a3
  4. Colledge NR, Wilson JA, Macintyre CC, MacLennan WJ. The prevalence and characteristics of dizziness in an elderly community. Age and ageing. 1994;23(2):117-20.  https://doi.org/10.1093/ageing/23.2.117
  5. Drachman DA, Hart CW. An approach to the dizzy patient. Neurology. 1972;22(4):323-34.  https://doi.org/10.1212/WNL.22.4.323
  6. Chang WH. Common disorders causing balance problems. Brain & Neurorehabilitation. 2013;6(2):54-7.  https://doi.org/10.12786/bn.2013.6.2.54
  7. Sung K, Park S, Lee T. Understanding of dizziness. Res Vestibul Sci. 2002;1(1):157-64. 
  8. Lee EJ. Korean Medicine Clinical Practice Guideline for Dizziness. 2021-05 ed: The Society of Sasang Constitutional Medicine; 2021. p. 46. 
  9. Rockwood K, Awalt E, Carver D, MacKnight C. Feasibility and measurement properties of the functional reach and the timed up and go tests in the Canadian study of health and aging. J Gerontol A Biol Sci Med Sci. 2000;55(2):M70-3.  https://doi.org/10.1093/gerona/55.2.M70
  10. 사암, 이태호. (國文譯註)舍巖道人鍼灸要訣. 서울: 행림출판; 1989. 
  11. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care & Research. 2011;63(S11):S240-S52. 
  12. Jacobson GP, Newman CW. The development of the dizziness handicap inventory. Archives of Otolaryngology-Head & Neck Surgery. 1990;116(4):424-7.  https://doi.org/10.1001/archotol.1990.01870040046011
  13. Han G, Lee E, Lee J, Park S, Lee H, Jeon E, et al. The study of standardization for a Korean adaptation of self-report measures of dizziness. J Korean Bal Soc. 2004;3(2):307-25. 
  14. Jang SN, Cho SI, Ou SW, Lee ES, Baik HW. The validity and reliability of Korean fall efficacy scale (FES) and activities-specific balance confidence scale (ABC). Journal of the Korean Geriatrics Society. 2003;7(4):255-68. 
  15. Powell LE, Myers AM. The activities-specific balance confidence (ABC) scale. The Journals of Gerontology Series A: Biological Sciences and Medical Sciences. 1995;50(1):M28-M34.  https://doi.org/10.1093/gerona/50A.1.M28
  16. Jang S, Kang B-K, Ko MM, Kim P-W, Jung J. Revision of the modified Blood Stasis Questionnaire II. Journal of Society of Preventive Korean Medicine. 2020;24(2):95-102. 
  17. Kang B-K, Park T-Y, Jung J, Ko M, Lee MS, Lee JA. The optimal cut-off value of blood stasis syndrome score in BSS diagnosis in Korea. Evidence-Based Complementary and Alternative Medicine. 2017;2017. 
  18. 한의임상어혈프로그램(beta1.0.0). 한국한의학연구원 한의 임상 정보서비스[Available from: http://www.kmpedia.kr/startbootstrap/diag_extrab01.php. 
  19. Garcia FV. Disequilibrium and its management in elderly patients. International Tinnitus Journal. 2009;15(1):83. 
  20. Kim EH, Kim SM. Differential diagnosis and treatment of dizziness. Korean Journal of Family Pracice. 2013;3(3):260-6. 
  21. Post RE, Dickerson LM. Dizziness: a diagnostic approach. American family physician. 2010;82(4):361-8. 
  22. 강석윤, 강지훈, 고성범, et al. 신경학. 서울: 범문에듀케이션; 2012. 
  23. Ferlinc A, Fabiani E, Velnar T, Gradisnik L. The importance and role of proprioception in the elderly: a short review. Materia socio-medica. 2019;31(3):219. 
  24. 전국한의과대학. 한방순환.신경내과학. 서울: 우리의학서적; 2016. 
  25. 金楨氾, 崔昇勳, 安圭錫. 桃仁承氣湯 및 그 構成藥物이 瘀血病態模型에 미치는 影響. 동의생리병리학회지. 1997;11(1):65-76. 
  26. Oh K-C. A Clinical report on episodic vertigo with Meniere's disease treated by saam acupuncture sojangjungkyuk. The Journal of the Society of Korean Medicine Diagnostics. 2012;16(1):35-44. 
  27. Kim S-Y, Lee S-H, Park J-Y, et al. A Study on Acupoint SP3 in Saam Acupuncture Method. Korean Journal of Acupunct. 2014;31(4):179-87.  https://doi.org/10.14406/acu.2014.31.4.179
  28. Lee TK, Sung KB. Disequilibrium without vertigo. Journal of the Korean Balance Society. 2008;7(2):253-9.ness