대한중풍순환신경학회지 (The Journal of the Society of Stroke on Korean Medicine)

  • 제24권1호
  • /
  • Pages.67-76
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  • 2023
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  • 2466-0248(pISSN)
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  • 2466-0272(eISSN)
대한중풍순환신경학회 (The Society of Stroke on Korean Medicine)
권호 표지

뇌졸중 후 불안을 동반한 공격성을 호소하는 뇌경색 환자에 대한 복합 한의치험 1례

A Case of Cerebral Infarction Patient Complaining Post-Stroke Aggression Accompanying Anxiety Treated with Combined Korean Medical Treatment

  • 이다빈 (경희대학교 대학원 임상한의학과) ;
  • 전선욱 (경희대학교 대학원 임상한의학과) ;
  • 김근영 (경희대학교 대학원 임상한의학과) ;
  • 조기호 (경희대학교 대학원 임상한의학과) ;
  • 문상관 (경희대학교 대학원 임상한의학과) ;
  • 정우상 (경희대학교 대학원 임상한의학과) ;
  • 권승원 (경희대학교 대학원 임상한의학과) ;
  • 이한결 (경희대학교 한의과대학 순환신경내과학교실)
  • Dabin Lee (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Seon-Uk Jeon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Geun Young Kim (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Ki-Ho Cho (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Sang-Kwan Moon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Woo-Sang Jung (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Seungwon Kwon (Dept. of Clinical Korean Medicine, Graduate school, Kyung-Hee University) ;
  • Han-Kyul Lee (Dept. of Cardiology and Neurology, College of Korean medicine, Kyung-Hee University)
  • 발행 : 2023.12.01
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초록

Post-stroke aggression refers to aggressive behaviors and languages which are occurred after stroke. In stroke patients, over 15% suffer from the anger and the symptom lowers the quality of life of the patients, family, and caregivers. After diagnosing post-stroke aggression, selective serotonin re-uptake inhibitor(SSRI) and beta-blocker, beta adrenergic agonist treatment usually underwent to treat the anger and anxiety of the patient. In the present case, a 81-year-old female patient with post-stroke aggression underwent Korean medical treatment by Jodeungsan and Ukgansan for 49 days. The effect of the treatment was assessed with State-Trait Anger Expression Inventory(STAXI) per a week, roaming time per a week and roaming frequency per a week. After the treatment, STAXI score, roaming time, and roaming frequecy decreased, and the patient could successfully cease to take beta-blocker, which she started to take for treating her aggression, without any side-effects. This case report suggests that Ukgansan might be an effective option with post-stroke aggression patients taking medication including beta-blocker.

키워드

참고문헌

  1. Choi-Kwon S, Han K, Cho K -H., et al. Factors associated with post-stroke anger proneness in ischaemic stroke patients. Euro J of Neurology. 2013;20(9):1305-1310. doi:10.1111/ene.12199 
  2. Kim JS, Choi-Kwon S. Poststroke depression and emotional incontinence: Correlation with lesion location. Neurology. 2000;54(9):1805-1810.  https://doi.org/10.1212/WNL.54.9.1805
  3. Kim JS. Post-stroke Mood and Emotional Disturbances: Pharmacological Therapy Based on Mechanisms. J Stroke. 2016;18(3):244-255. doi:10.5853/jos.2016.01144 
  4. Webb AJS, Fischer U, Rothwell PM. Effects of -blocker selectivity on blood pressure variability and stroke: A systematic review. Neurology. 2011;77(8):731-737. doi:10.1212/wnl.0b013e31822b007a 
  5. Kim JS, Lee EJ, Chang DI, et al. Efficacy of early administration of escitalopram on depressive and emotional symptoms and neurological dysfunction after stroke: a multicentre, double-blind, randomised, placebo-controlled study. The Lancet Psychiatry. 2017;4(1):33-41. doi:10.1016/s2215-0366(16)30417-5 
  6. 약학정보원. https://www.health.kr/ 검색일자:2023-10-11 
  7. Webb AJS, Fischer U, Rothwell PM. Effects of -blocker selectivity on blood pressure variability and stroke: A systematic review. Neurology. 2011;77(8):731-737. doi:10.1212/wnl.0b013e31822b007a 
  8. Hyun Do Kim, et al. The Effect of Anger Expression Style and Stress on Heart Rate Variablity. Anxiety and Mood. 2009;5(1):21-28. 
  9. Ramos-Perdigues S, Mane-Santacana A, Pintor-Perez L. [Prevalence and associated factors of anger post stroke: a systematic review]. Revista de Neurologia. 2015 Jun;60(11):481-489. PMID: 26005071.  https://doi.org/10.33588/rn.6011.2015006
  10. Lau CG, Tang WK, Liu XX, Liang HJ, Liang Y, Wong A, et al. Poststroke agitation and aggression and social quality of life: a case control study. Top Stroke Rehabil. 2017; 24:126-133.  https://doi.org/10.1080/10749357.2016.1212564
  11. Kwon B, Lee EJ, Park S, et al. Long-Term Changes in Post-Stroke Depression, Emotional Incontinence, and Anger. J Stroke. 2021;23(2):263-272. doi:10.5853/jos.2020.04637 
  12. Hukutomi Toshiaki. 한방 123처방 임상해설. 청홍. 2021;1:101-104. 
  13. Nogami A, Sakata Y, Uchida N, et al. Effects of yokukansan on anxiety-like behavior in a rat model of cerebrovascular dementia. J Nat Med. 2010;65(2):275-281. doi:10.1007/s11418-010-0487-5 
  14. Wada S, Inoguchi H, Hirayama T, et al. Yokukansan for the treatment of preoperative anxiety and postoperative delirium in colorectal cancer patients: a retrospective study. Japanese Journal of Clinical Oncology. 2017;47(9):844-848. doi:10.1093/jjco/hyx080 
  15. Liang P, Wang Z, Qian T, Li K. Acupuncture Stimulation of Taichong (Liv3) and Hegu (LI4) Modulates the Default Mode Network Activity in Alzheimer's Disease. Am J Alzheimers Dis Other Demen 
  16. HWANG IK, CHUNG JY, YOO DY, et al. Comparing the Effects of Acupuncture and Electroacupuncture at Zusanli and Baihui on Cell Proliferation and Neuroblast Differentiation in the Rat Hippocampus. 
  17. Dai XJ, Min YJ, Gong HH, Gao L, Wang SY, Zhou FQ, Xiao XZ, Liu BX. [Evaluation of the post-effect of acupuncture at Sanyinjiao (SP 6) under sleep deprivation by resting-state amplitude of low-frequency fluctuation: a fMRI study]. Zhongguo Zhen Jiu. 2012 Jan;32(1):47-52. 
  18. HWANG IK, CHUNG JY, YOO DY, et al. Comparing the Effects of Acupuncture and Electroacupuncture at Zusanli and Baihui on Cell Proliferation and Neuroblast Differentiation in the Rat Hippocampus. 
  19. Liang P, Wang Z, Qian T, Li K. Acupuncture Stimulation of Taichong (Liv3) and Hegu (LI4) Modulates the Default Mode Network Activity in Alzheimer's Disease. Am J Alzheimers Dis Other Demen. 
  20. Dai XJ, Min YJ, Gong HH, et al. [Evaluation of the post-effect of acupuncture at Sanyinjiao (SP 6) under sleep deprivation by resting-state amplitude of low-frequency fluctuation: a fMRI study 
  21. Xiong J, Zhang Z, Ma Y, et al. The effect of combined scalp acupuncture and cognitive training in patients with stroke on cognitive and motor functions. NRE. 2020;46(1):75-82. doi:10.3233/nre-192942 
  22. Lee SJ, Shin BC, Lee MS, Han CH, Kim JI. Scalp acupuncture for stroke recovery: A systematic review and meta-analysis of randomized controlled trials. European Journal of Integrative Medicine. 2013;5(2):87-99.  https://doi.org/10.1016/j.eujim.2012.10.006
  23. Liu H, Sun X, Zou W, et al. Scalp acupuncture attenuates neurological deficits in a rat model of hemorrhagic stroke. Complementary Therapies in Medicine. 2017;32:85-90. https://doi.org/10.1016/j.ctim.2017.03.014