• Title/Summary/Keyword: 말초 신경병증

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Optimal Combination of Acupoints Based on Network Analysis for Chemotherapy-Induced Peripheral Neuropathy (네트워크 분석에 기반한 항암화학요법으로 유발된 말초신경병증의 최적 경혈 조합)

  • Kim, Min-Woo;Kim, Joong-Il;Lee, Jin-Hyun;Jo, Dong-Chan;Kang, Su-Bin;Lee, Ji-Won;Park, Tae-Yong;Ko, Youn-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.1
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    • pp.107-124
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    • 2022
  • Objectives This study aimed to identify optimal combinations of acupoints used to treat chemotherapy-induced peripheral neuropathy (CIPN). Methods We searched four international databases (MEDLINE, EMBASE, the Allied and Complementary Medicine Databases [AMED], and China National Knowledge Infrastructure [CNKI]) and five Korean databases (DBpia, Research Information Sharing Service [RISS], Korean Studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], and KoreaMed) to identify randomized controlled trials (RCTs) that used acupuncture to treat CIPN. Network analysis was performed on the acupoints used in more than three included articles. We constructed a network by calculating the Jaccard similarity coefficient between acupoints and applied minimum spanning tree. Then, modularity analysis, degree centrality (Cd), and betweenness centrality (Cb) were used to analyze properties of the acupoints. Results A total of 25 articles were included. 24 acupoints were extracted from 25 articles. The combinations of acupoints having the highest Jaccard similarity coefficient were {EX-UE9, EX-LE10} and {ST36, SP6}. In the modularity analysis, acupoints were classified to six modules. ST40, EX-UE11, and KI6 had the highest Cd value while ST40, GB34 had the highest Cb value. Conclusions This study found the systematic framework of acupoint combinations used in CIPN studies. This study is expected to provide new perspectives of CIPN treatment to therapists. A RCT is in progress of using the network of this study as a guideline. If significant results are derived from the RCT, it will be possible to lay the groundwork to consider acupuncture for CIPN treatment.

Case Report of Chemotherapy Induced Peripheral Neuropathy Treated with Korean Medicine (항암화학요법으로 인한 말초신경병증 환자의 한방치험 1례)

  • Lee, Ji Hye;Park, Hye Lim;Lee, Hye Yun;Cho, Min Kyoung;Hong, Mi Na;Han, Chang Woo;Choi, Jun Yong;Park, Seong Ha;Kwon, Jung Nam;Lee, In;Hong, Jin Woo;Kim, So Yeon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.5
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    • pp.565-570
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    • 2014
  • The purpose of this study is to report a clinical case of a patient with CIPN (Chemotherapy Induced Peripheral Neuropathy) successfully treated with Korean medicine interventions including acupuncture, herbal medicine and moxibustion. The patient is a female with CIPN who was diagnosed with ascending colon cancer and suffering from paresthesia of extremities after chemotherapy of platinum compounds. The patient was treated mainly with electroacupuncture (Ex-LE 10), indirect moxibustion and herbal medicine (Ucha-Shinki-hwan granule). The clinical outcomes were measured by NCI CTCAE grade, EORTC QLQ-C30 (CIPN20) scale and patient's assessment of symptoms. In this case, the NCI CTCAE grade was improved from II to I. The scores of global health status and functional scale in QLQ-C30 were increased and symptom scale was decreased. Especially, this case shows a noticeable decrease in sensory scale in QLQ-CIPN20. In patient's general assessment, the scale was changed from 10 to 5. Korean medical interventions including acupuncture, herbal medicine and moxibustion could potentially be an effective treatment for CIPN if further researches are conducted.

A Study on the Correlation between Pain Intensity and HbA1c for Diabetic Peripheral Neuropathy Patients (당뇨병성 말초신경병증 환자에서 통증 정도와 당화혈색소 간의 상관성 연구)

  • Jung, Se Ho;Sung, Hee Jin;Lim, Su Ji;Lee, Cham Kyul;Jo, Na Young;Roh, Jeong Du;Lee, Eun Yong
    • Journal of Acupuncture Research
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    • v.32 no.4
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    • pp.17-27
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    • 2015
  • Objectives : The purpose of this study is to evaluate the correlation between HbA1c and pain intensity in diabetic peripheral neuropathy patients, and to compare the difference between two groups divided by the risk of complications. Methods : The participants were 46 men and women suffering from neuropathic pain diagnosed with diabetes mellitus who visited the Hospital of Traditional Korean Medicine, Semyung University from June, 2014 to August, 2015. Age, duration of diabetes mellitus, numeric rating scale(NRS), and Michigan neuropathy screening instrument(MNSI) were used as evaluation tools. Results : 1. In all 46 cases, there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 2. Among 23 cases with a high risk of complications (more than 7.0 % of HbA1c, group A), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 3. Among 23 cases with a low risk of complications(less than 7.0 % of HbA1c, group B), there were no significant correlations between HbA1c and age, duration of diabetes mellitus, NRS, MNSIQ, or MNSIE. 4. Means of duration of diabetes mellitus, NRS, MNSIQ, and MNSIE were higher in group A than group B, but there were no significant correlations in statistics. Conclusions : This study could not find statistically significant correlations between pain intensity and HbA1c in diabetic peripheral neuropathy patients, so more studies are required in the future.

Evaluation of Chemotherapy Induced Peripheral Neuropathy by Cisplatin, Carboplatin and Oxaliplatin (Cisplatin, Carboplatin, Oxaliplatin 투여로 인한 말초신경병증에 대한 평가)

  • Yoon, Wan Ki;Heo, Mi Jung;Lee, Ok Sang;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.356-366
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    • 2012
  • Background: Chemotherapy-induced peripheral neuropathy (CIPN) involving sensory and motor nerve damage or dysfunction is a common and serious clinical problem that affects many patients receiving cancer treatment. This condition may pose challenges for the clinician to diagnose and manage, particularly in patients with coexisting conditions or disorders that involve the peripheral nervous system. Many chemotherapeutic agents used today are associated with the development of serious and dose-limiting CIPN that can adversely affect the administration of planned therapy and can impair quality of life by interference with the patients' activities of daily living. The most important clinical objective in the evaluation of patients with CIPN is to determine their level of functional impairment involving activities of daily living. These findings are used to make medical decisions to continue, modify, delay, or stop treatment. The most commonly reported drugs to cause CIPN include taxanes, platinum agents, vinca alkaloids, thalidomide, and bortezomib. We aimed to determine PN incidence during cisplatin, carboplatin and oxaliplatin administration. Methods: We collected data from 125 patients who received at least one cycle of cisplatin, carboplatin or oxaliplatin. They completed a self-reported questionnaire and items related to their disease and peripheral neuropathy. The investigators filled in part of items about disease and treatment. Patient Neurotoxicity Qeustionnaire developed by Bionumerik company were applied for PN assessment. Results: The incidences of sensory neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 23%, 56% and 50%. The incidences of motor neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 18%, 42% and 19%. The incidences of severe neurotoxicities of cisplatin, carboplatin and oxaliplatin were respectively 13%, 28% and 14%. The incidences of PN were associated with cumulative dose but not age, gender and concurrent illness. 19.2% of the patients (24/125) were prescribed with gabapentin, nortriptyline or gabapentin plus nortriptyline to reduce these peripheral symptoms and 75% of the patients answered the drug were effective. Conclusion: Incidence of PN after cisplatin or oxaliplatin administration is cumulative dose-related. Physician-based assessments under-reported the incidence and severity of CIPN. To overcome this limitation, diagnostic tools specifically designed to assess peripheral neuropathy severity associated with chemotherapy must be developed.

Preliminary Study to Develop an Instrument for Pattern Identification and Evaluation for Chemotherapy-induced Peripheral Neuropathy (CIPN) (항암화학요법 유발 말초신경병증 변증평가도구 개발을 위한 기초연구)

  • Park, Ji-hye;Jung, In-chul;Lee, Suk-hoon;Lee, Jin-sun;Bae, Kyeo-re;Cho, Chong-kwan;Yoo, Hwa-seung
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.77-89
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    • 2016
  • Objectives: The aim of this study was to develop a standard instrument of pattern identification and evaluation for chemotherapy-induced peripheral neuropathy (CIPN).Methods: The advisory committee for this study was organized by 12 professors of traditional Korean medicine from the Korean Association of Traditional Oncology. The items and structure of the instrument were designed based on a review of previous publications. We revised the instrument in consultation with the advisory committee and received additional advice via email.Results: We divided the symptoms and signs of CIPN into four pattern identifications: wind arthralgia (風痺), cold arthralgia (寒痺), dampness arthralgia (濕痺), and arthralgia of the deficiency type (虛痺). We obtained the mean weights to reflect the standard deviations from each symptom of the four pattern identifications, which were scored on a 5-point scale by the advisor committee. After we obtained the answers to discrimination between variable symptoms (變症) and ordinary symptoms (素症) from the 12 experts, we gained the final weight from the combination of the ratio of pattern identification to the number of total answers of the advisory committee and the mean weight.Conclusions: The Instrument on Pattern Identification and Evaluation for CIPN was developed through a discussion between 12 experts. There was a limitation that the validity and reliability of this instrument have not been proven. However, the significance of this study was that it is the first Instrument on Pattern Identification and Evaluation aimed at assessing CIPN in traditional Korean medicine.

Temporary Threshold Shift of Vibration Sensation by Dental Handpiece (치과용 핸드피스에 의한 일시적 진동감각역치 변화)

  • Kim, Seong-Ah;Lee, Jong-Young;Kim, Doo-Hie;Park, Soon-Woo
    • Journal of Preventive Medicine and Public Health
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    • v.28 no.4 s.51
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    • pp.765-771
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    • 1995
  • This study was performed to investigate the possibility of temporary threshold shift (TTS) of vibration sense could induced by exposure to high-frequency vibration or by work position taking by dentists in drilling or polishing. The vibratory perception thresholds (VPT) of 28 healthy men were measured on the index fingertip pulp of dominant hand at 250 Hz. The vibrating tool used in test was a low-speed handpiece of 34,000 rpm. For the TTS test, the dominant hand was exposed to high-frequency vibration and to work position for five minutes, respectively. The VPTs before and after vibratory exposure were $23.5{\pm}3.5dB,\;30.8{\pm}4.2dB$, respectively and VPT after work position was $23.7{\pm}4.6dB$. The difference between before and after vibartory exposure was statistically significant (p<0.001). The correlation of height, weight and BMI with baseline VPTs was not statistically significant. Also, there was no difference of VPTs by smoking. These results suggest that high-frequency vibration from dental handpieces might cause the impairment of vibration sensation.

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A Case Report of Korean Medicine Treatment of a Lung Cancer Patient with Chemotherapy-induced Peripheral Neuropathy (편평상피세포 폐암 환자의 항암화학요법에 의해 유발된 말초신경병증에 대한 한방치험 1례)

  • Kim, Kyun Ha;Kim, Min-hwa;Heo, Gi-yoon;Lee, Chan;Cho, Im-hak;Kang, Hee-kyung;Kim, So-yeon;Park, Seong-ha;Yun, Young-ju;Lee, In;Han, Chang-woo;Hong, Jin-woo;Kwon, Jung-nam;Choi, Jun-Yong
    • The Journal of Internal Korean Medicine
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    • v.42 no.6
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    • pp.1341-1348
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    • 2021
  • The purpose of this study is to report the effect of Korean medicine on a squamous cell lung cancer patient with chemotherapy induction peripheral neuropathy (CIPN). A 61-year old male patient, who had received 4 cycles of chemotherapy after lung surgery from squamous cell lung cancer, was treated with acupuncture and herbal medicines, including Uchasingi-hwan and Samchilchoongcho-capsule, to control CIPN and dyspnea on exertion. The degree of pain was assessed by a numeric rating scale (NRS). After receiving acupuncture and herbal medicines, the NRS score for CIPN symptoms was reduced from 4 to 1 and the NRS score for dyspnea on exertion decreased from 3 to less than 1. Korean medicine could therefore be useful in reducing peripheral neuropathy occurring after chemotherapy and dyspnea after lobectomy.