• Title/Summary/Keyword: 말초 신경병증

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The Therapeutic Efficacy of Acupuncture for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 유발 말초신경병증에 대한 침치료의 효과 : 체계적 문헌고찰 및 메타 분석)

  • Kim, Eun Hye;Yoon, Jee-Hyun;Lee, Jee Young;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.41 no.3
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    • pp.350-361
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    • 2020
  • Objective: This study aimed to report the therapeutic effect of acupuncture on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The articles were sourced from databases including PubMed, EMBASE, Cochrane Library, CNKI, CiNii, WHO ICTRP, JSOM, KMBASE, KISS, NDSL, and OASIS as of July 2019. The main search keywords were peripheral neuropathy and acupuncture, and only randomized controlled trials using acupuncture for therapeutic purposes were included. Cochrane's risk of bias was used to assess the risk of bias, and the Review Manager 5.3 program was used for meta-analysis. Results: Six studies with a total 394 participants were included. When combined treatment of acupuncture and usual care was compared with usual care alone, quality of life improved more significantly in the combination treatment group (SMD=-2.71, 95% CI: -5.01 to -0.41, P=0.02, I2=97%). The CIPN pain score was lower among the combination treatment group, but not to a significant degree (SMD=-2.55, 95% CI: -5.14 to 0.04, P<0.05, I2=98%). There were no severe side effects in any studies. Conclusion: Acupuncture combined with usual care may be considered to safely relieve CIPN pain and improve quality of life for cancer patients. However, as there are few randomized controlled trials studying the effect of acupuncture on CIPN, further well-designed research is needed.

A Study of the Peripheral Neuropathy among the Workers Exposed to Carbon Disulfide (이황화탄소에 폭로된 근로자들의 말초신경병증에 관한 연구)

  • Kim, Dae-Seong;Kim, Soon-Duck;Cha, Chul-Whan
    • Journal of Preventive Medicine and Public Health
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    • v.26 no.2 s.42
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    • pp.282-292
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    • 1993
  • Neurotoxicity in the workplace may occur with exposure to scores of chemicals. Although large acute outbreaks of the occupational neurological disease are rare, the incidence of occupational neurotoxicity in its subtler aspects is unknown. A working knowledge of both the major occupational neurotoxic solvents and the tools used by cliniical neurologists and neurotoxicologists to evaluate neurotoxicity in working populations is a necessity fur the occupational physician. To investigate the effects of carbon disulfide($CS_2$) on the peripheral nerve system using the nervous conduction study, 105 male workers working in the spinning room of a viscose rayon factory were examined and compared with a sex and age matched, unexposed 105 male controls using t-test analysis. 72.4% of $CS_2$-exposed workers complained of neurological symptoms, and the abnormal cases in nerve conduction study were 48.6%. The abnormal cases of nerve conduction study increased in number according as the age and duration of exposure increased. In this study, asymptomatic workers were confirmed to have subclinical neuropathy by nerve conduction study. Also as there were abnormal cases even in its duration of exposure below 4 years, nerve conduction study turned out to be ways of discovering of early peripheral neuropathy. In nerve conduction study, the amplitude, velocity, F-wave latency and H-reflex of the motor and sensory nerves in both upper and lower extremities were significant different between $CS_2$-exposed workers and the controls. From the pathological viewpoint, both segmental and axonal degenerations were assumed in this study.

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The Therapeutic Efficacy of Herbal Medicine for Chemotherapy-Induced Peripheral Neuropathy: A Systematic Review and Meta-Analysis (항암화학요법 유발 말초신경병증에 대한 한약의 치료 효과: 체계적 문헌고찰 및 메타 분석)

  • Kim, Eun Hye;Yoon, Jee-hyun;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.25 no.2
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    • pp.23-36
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    • 2020
  • Objective: This study was aimed to report the therapeutic effects of herbal medicine on chemotherapy-induced peripheral neuropathy (CIPN). Methods: The prior studies were searched from the databases included PubMed, Cochrane Library, EMBASE, CNKi, CiNii, KISS, NDSL, KMBASE, and OASIS until September 2020. The main search keywords were chemotherapy, peripheral neuropathy, and herbal medicine, and only randomized controlled trials that analyzed the therapeutic efficacy of herbal medicine were included. The Cochrane's Risk of Bias was used for assessment of the risk of bias and the Review Manager 5.3 program was used for meta-analysis. Meta-analyses were grouped by the administration routes of herbal medicines (oral administration or topical use). Results: Nine studies with a total of 563 participants were included. Compared with usual care, the effective rate was higher in oral administrated herbal medicine (RR 1.67, 95% CI 1.25 to 2.23; p<0.001, I2=31%). In addition, topical herbal medicine showed an significantly higher effective rate than placebo (RR 2.20, 95% CI 1.52 to 3.18; p<0.001, I2=0%) and usual care (RR 2.24, 95% CI 1.74 to 2.89; p<0.001, I2=66%). There was no severe adverse effect in all participants. Conclusions: Herbal medicine appears to improve neuropathy caused by chemotherapy in cancer patients more than conventional therapy of CIPN. However, as there is heterogeneity between the included studies and a lack of blinding, further well-designed researches are more needed.

A Case Report of Chemotherapy-Induced Peripheral Neuropathy Treated with Warm Needling (온침으로 호전된 항암화학요법 유발 말초신경병증 치험 1례)

  • Yoon, Jee-Hyun;Park, Su Bin;Lee, Jee Young;Kim, Eun Hye;Yoon, Seong Woo
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.114-121
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    • 2021
  • Objective: The purpose of this study is to report the effects of warm needling in a patient with cancer who had chemotherapy-induced peripheral neuropathy (CIPN). Methods: A 46-year-old Korean female outpatient diagnosed with malignant ovarian cancer was treated with warm needling therapy on the foot acupuncture points for CIPN. Neuropathic symptoms and quality of life were assessed using the numeric rating scale (NRS) and the functional assessment of cancer therapy/Gynecologic Oncology Group neurotoxicity (FACT/GOG-NTX) score. Results: After 6 months of treatment, the patient showed a reduction in the severity of CIPN symptoms and an improvement in the quality of life, although the severity of symptoms fluctuated as the patient underwent chemotherapy sessions. Conclusion: This study suggests that warm needling may be an effective treatment for CIPN.

Case Report of Chemotherapy-Induced Peripheral Neuropathy Treated with Korean Medicine (항암화학요법 유발 말초신경병증에 대한 한방치험 1례)

  • Shin, Hyeryung;Seo, Wookcheol;An, Sung-Hu;Won, Jin-hee;Song, Bong-keun
    • The Journal of Internal Korean Medicine
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    • v.42 no.2
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    • pp.104-113
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    • 2021
  • Introduction: The aim of this study is to report on the effectiveness of Korean medicine to improve symptoms of chemotherapy-induced peripheral neuropathy (CIPN). Some patients are treated with medication, but medications may have no effect in some patients. Korean medicine treatments have been used in such patients, but few reports exist. Case Presentation: A 58-year-old female patient with CIPN reported symptoms of bilateral limb pain and tingling sensations as well as cold sensations in bilateral lower legs and hands, fatigue, and bilateral limb weakness. To reduce the patient's symptoms, we provided Korean medical treatment, including herbal medicine (Uchashinki-hwan), acupuncture, and moxibation. To evaluate the results of this treatment, we used a numeric rating scale (NRS), the manual muscle test (MMT), the National Cancer Institute Common Toxicity Criteria for Adverse Events (CTCAE), and the European Organization for Research and Treatment of Cancer quality-of-life questionnaire about CIPN (EORTC-QLQ-CIPN20). After 49 days of treatment, the NRS scores decreased for bilateral limb pain and tingling, for bilateral lower leg and hand cold sensation, and for fatigue. The MMT results for the upper and lower extremities were improved. CTCAE Grade and EORTC QLQ-CIPN20 score were also decreased. Conclusion: According to these results, Korean medicine treatment may be considered an effective treatment for CIPN. Prospective studies are needed in the future to confirm and expand these findings.

A Case of Gemcitabine Plus Nanoparticle Albumin Bound (nab)-paclitaxel Induced Cardiotoxicity in Patient of Metastatic Pancreatic Cancer (전이성 췌장암 환자에서 Gemcitabine과 Nanoparticle Albumin Bound (nab)-Paclitaxel로 인한 허혈성 심독성 발생 1례)

  • Mi Kang Kim;Se Woo Park
    • Journal of Digestive Cancer Research
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    • v.5 no.1
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    • pp.62-65
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    • 2017
  • Pancreatic cancer is an aggressive disease and despite the efforts of the past few decades, the 5-year overall survival (OS) rate remains disappointing and does not exceed 10% in Korea. Especially, only 15-20% of patients are candidates for surgical resection because most patients are diagnosed with locally advanced or metastatic disease, and their only treatment approach is palliative chemotherapy. Since the first chemo-regimen of Gemcitabine and Nanoparticle albumin bound (nab) - paclitaxel was brought to clinical practice in 2013, the improvement in overall survival, progression-free survival, and response rate was achieved in patients with metastatic pancreatic adenocarcinoma. We report the case of a young patient with cardiogenic shock accompanied by multi-organ failure after 4th cycle Gemcitabine and nab-paclitaxel chemotherapy with partial response.

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A Case Report on Improvement of Chemotherapy-Induced Peripheral Neuropathy and Pantalgia Side Effects with Integrated Cancer Treatment in a Breast Cancer Patient (유방암 환자의 통함 암 치료를 통한 항암화학요법 유발 말초신경병증, 전신통 호전에 대한 증례 보고)

  • Eun-Ji Kim;Hye-ri Bae;Nam-Hun Lee
    • Journal of Korean Traditional Oncology
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    • v.28 no.1
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    • pp.11-24
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    • 2023
  • Objectives: To report the improvement of chemotherapy-induced peripheral neuropathy and pantalgia with integrative cancer treatment on adverse effects of chemotherapy in a breast cancer patient. Methods: A 63-year-old female patient who has been diagnosed with breast cancer got treated for 103 days with integrative cancer treatment including acupuncture, moxibustion, herbal medicine, physiotherapies, hand and foot bath to decrease side effects of chemotherapy. The patient was also treated Western immunotherapies like Thymosin, Viscum album. Paclitaxel, Carboplatin, Doxorubicin, Cyclophosphamide was applied and chemotherapy-induced peripheral neuropathy(CIPN), pantalgia and nausea occured. The efficacy of treatment was measured by a numeric rating scale(NRS) of symptoms, National Cancer Institute Common Terminology Criteria for Adverse Event(NCI-CTCAE) and Eastern Cooperative Oncology Group(ECOG) Performance Status Scale. Results: The NRS scroes for CIPN, pantalgia, nausea were improved. There was no adverse effects of 3 or higher assessed by the NCI-CTCAE. The ECOG grade improved from grade 2 to 1. Conclusions: This study suggests that integrative cancer treatment could improve CIPN, pantalgia after chemotherapy in breast cancer.

A Review of Domestic Research on Traditional Korean Medicine for Chemotherapy-Induced Peripheral Neuropathy (항암화학요법 유발 말초신경병증의 한의학적 치료에 대한 국내 연구동향 고찰)

  • Su-Hyun Choi;Chae-Rim Yoon;Nahyun Jeong;Dahee Jeong;Yoohyun Sim;Hae-in Jeong;Na-Yeon Ha;Jinsung Kim
    • The Journal of Internal Korean Medicine
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    • v.45 no.3
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    • pp.358-380
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    • 2024
  • Objectives: This study was performed to research Korean medical treatment methods for chemotherapy-induced peripheral neuropathy by summarizing domestic studies. Methods: All domestic research papers on the Korean medical treatment of chemotherapy-induced peripheral neuropathy were selected from the literature published until April 2024 in four domestic databases. In total, 26 domestic papers were selected. Results: Eighteen clinical studies and eight experimental studies were published by April 2024. Most of the studied patients were in their fifties, and 93.4% of the subjects were women. Uchashinki-hwan (牛車腎氣丸) was the most frequently prescribed herbal formula, and Rehmanniae Radix Preparata was the most commonly used herb. All studies showed significant effects of Korean medical treatment, and any adverse events were not reported. Conclusion: This study included all domestic research papers on chemotherapy-induced peripheral neuropathy to identify research trends in the Korean medicine community. Based on this, it is meaningful to confirm areas that need to be supplemented in future research plans. However, large-scale studies are needed.

Treatment Pattern of Patients with Neuropathic Pain in Korea (한국인 신경병성 동통 환자의 치료 양태 연구)

  • Han, Sung-Hee;Lee, Ki-Ho;Kim, Mee-Eun;Kim, Ki-Suk
    • Journal of Oral Medicine and Pain
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    • v.34 no.2
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    • pp.197-205
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    • 2009
  • The purpose of this study was to investigate the treatment pattern of patients with neuropathic pain (NeP) in Korea through computerized database of Health Insurance Review and Assessment Service (HIRAS) over three years' period from 2003 to 2005. The results showed that the numbers of treatment visits were the highest for diabetic neuropathy (DN), followed by postherpetic neuralgia (PHN) and trigeminal neuralgia (TN) in order. Top 3 specialties for treatment visits due to NeP conditions were neurology, neurosurgery and anesthesiology. While cost of a treatment visit was higher in anesthesiology and emergency clinics compared to other clinics, there was a tendency to increase costs for visits to clinics of rehabilitation medicine and family medicine over the three years. Cost of dental visits was relatively high for TN, atypical facial pain (AFP) and atypical odontalgia (AO). Surgeries frequently applied to patients with NeP were sympathetic plexus or ganglion block, block of peripheral branch of spinal nerve and cranial nerve or its peripheral branch block. Most common prescribed medication were anticonvulsants, anti-inflammatory analgesics and anti-psychotic drugs while anti-inflammatory analgesics were overwhelmingly frequently prescribed for AO and glossodynia. Based on the results of this study, NeP disorders more relevant to dentists were AO, TN and AFP, TN of which seems to be the most important in terms of patients' number and cost for treatment visits. This indicates that dentists, especially oral medicine specialists should actively participate in management of TN, AO and AFP and share relevant information with patients and community.

Effects of YideungJetong-Tang on Peripheral Neuropathy Induced by Taxol and Compression Injury in the Rat Sciatic Nerve (이등제통탕(二藤除痛湯)이 Taxol 처리 및 좌골신경의 압박 손상 후 유발된 랫드의 말초신경병증에 미치는 영향)

  • Jeong, Ho Young;Kim, Chul Jung;Cho, Chung Sik
    • The Journal of Korean Medicine
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    • v.33 no.3
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    • pp.133-146
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    • 2012
  • Background: Most antitumor agents have the side effect of chemotherapy-induced peripheral neuropathy (CIPN). Cancer patients who take antitumor agents suffer from CIPN, but there is no known treatment for it. Unlike the central nerve system, the peripheral nerve can self-repair, and the Schwann cell takes this mechanism. Objectives: In this study, we researched the effect of YideungJetong-Tang (YJT) extract on taxol-induced sciatic nerve damage, through in vitro and in vivo experiments. Also, we studied the effect of YJT extract on neurite recovery and anti-inflammatory effect after compression injury of sciatic nerve in vivo. Methods: Vehicle, taxol and taxol+YJT were respectively applied on sciatic nerve cells of rat in vitro, then the cells were cultured. The sciatic nerve cells and Schwann cells were then observed using Neurofilament 200, Hoechst, ${\beta}$ -tubulin, S-$100{\beta}$, caspase-3 and phospho-Erk1/2. CIPN was induced by taxol into the sciatic nerve of rat in vivo, then YJT extract was taken orally. The axons, Schwann cells and neurites of the DRG sensory nerve were then observed using Neurofilament 200, ${\beta}$-tubulin, Hoechst, S-$100{\beta}$, phospho-Erk1/2 and caspase-3. YJT was taken orally after sciatic nerve compression injury, and the changes in axon of the sciatic nerve, Schwann cells and TNF-${\alpha}$ concentration were observed. Results: The taxol and YJT treated group showed significant effects on Schwann cell recovery, neurite growth and recovery. In vivo, YJT compared with control group showed Schwann cell structural improvement and axons recovering effect after taxol-induced Schwann cell damage. After sciatic nerve compression injury, recovery of distal axon, changes of Schwann cell distribution, and anti-inflammatory response were observed in the YJT. Conclusions: Through this study, we found that after taxol-induced neurite damage of sciatic nerve in vivo and in vitro, YJT had significant effects on sciatic nerve growth and Schwann cell structural improvement. In vivo, YJT improved recovery of distal axons and Schwann cells and had an anti-inflammatory effect.