• Title/Summary/Keyword: 복합 통증

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하지 피부색의 변화를 동반한 골절 후 발생 복합부위 통증 증후군(CRPS) 치험 1례 (A Case Report of a Patient with Complex Regional Pain Syndrome accompanied with Changes in the Color of the Lower Limbs after a Fracture)

  • 김경준
    • 한방안이비인후피부과학회지
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    • 제37권2호
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    • pp.113-122
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    • 2024
  • Objectives : To report the R/O CRPS patient after Korean medicine treatment, suffering severe buring pain and insomnia. Methods : The patient was a 56-year-old female patient and treated with herbal medicines and acupuncture in 32 days. The treatment effect was evaluated by measuring VNRS of pain, sleeping time and change in mood status. Results : The Korean Medical therapy had good effect on the patient. Especially, relaxing mental treatment is effective in improving and maintaining symptoms. Conclusions : The Korean medical treatments appeared to be effective in reducing R/O CRPS symptoms. Further clinical research of patients with CRPS is needed.

간질성 방광염에 대한 침치료 효과 (Effects of Acupuncture on Symptoms in a Patient with Interstitial Cystitis)

  • 최유행;이승덕;김갑성
    • Journal of Acupuncture Research
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    • 제18권4호
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    • pp.212-220
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    • 2001
  • 간질성 방광염이란 성인여성에게 생기는 질환으로 일종의 근육에 생긴 염증이며 미국에서는 아주 흔한 질환이나 국내에서는 그 동안 진단기준이 없어 단순한 방광염으로 오인 되어왔다. 증상은 일반적인 방광염과 비슷하나 너무 자주 재발하고 잘 낫지 않으며 방광용적의 감소로 빈뇨와 급뇨, 하복부와 회음부의 통증이 흔하고 방광을 비우면 증상은 호전되는 양상을 보인다. 진단을 확진할 정확한 검사가 없기 때문에 반드시 다른 질환이 없슴을 증명하여야 한다. 즉 방광염을 일으키는 원인들인 요로 감염, 골반염, 결핵, 결석, 성병, 전립선염, 방광암 등이 없이 빈뇨와 소변을 참지 못하고 하복통이 있을 때 일단 의심을 하고 방광내시경상에 방광 벽의 염증이나 점상성 출혈, 궤양이 있으면 확진한다. 양방에서는 한가지 완벽한 치료가 없어 여러 가지 복합적인 치료를 하며 일차적으로는 약물요법과 방광확장술을 시도한다. 먹는 약으로는 아직 공인된 것은 없으며 이 약들은 증상의 호전은 기대할 수 있으나 일시적인 경우가 많으며 결국은 방광확장술을 추가하는 경우가 대부분이다. 이에 이 질환을 갖고 있는 여자 환자에게 침 치료를 시행한 결과 주관적인 통증과 급박감에 있어서 감소와 객관적인 소변 횟수의 감소에 있어 만족할 만한 효과를 얻었기에 보고하는 바이다.

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자궁내막증 여성의 질병관련 특성과 증상 스트레스가 자궁내막증관련 삶의 질에 미치는 영향 (The Influence of Disease-related Characteristics and Symptom Stress on Endometriosis Quality of Life of Women with Endometriosis)

  • 박정현;하영미
    • 디지털융복합연구
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    • 제16권8호
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    • pp.243-252
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    • 2018
  • 본 연구의 목적은 자궁내막증을 진단받은 여성의 질병관련 특성, 증상 스트레스, 자궁내막증관련 삶의 질의 관계를 파악하고, 이들의 삶의 질에 영향을 미치는 요인을 규명하기 위함이다. B시에 위치한 종합명원 산부인과에 내원하는 여성 99명을 대상으로 설문조사를 실시하였다. 연구결과 자궁내막증을 진단받은 여성의 삶의 질에 영향을 미치는 요인은 질병으로 인한 병가여부(${\beta}=-.27$, p=.000)과 증상 스트레스(${\beta}=.59$, p=.000)으로, 이들의 설명력은 57.0%(F=11.39, p<.001)인 것으로 나타났다. 본 연구결과를 바탕으로 가임기 여성의 자궁내막증관련 삶의 질을 향상시키기 위해서 만성통증관리를 위한 자가 간호프로그램을 개발하고, 자궁내막증을 경험하는 여성의 삶의 질을 향상시키기 위한 간호중재를 개발할 필요가 있다.

복합부위통증증후군 환자에서 척수자극술과 교감신경 고주파열응고술 -증례 보고- (Thoracic Spinal Cord Stimulation and Radiofrequency Thermocoagulation of Lumbar Sympathetic Ganglion in a Patient with Complex Regional Pain Syndrome in the Lower Extremity -A case report-)

  • 김시현;문동언;박종민;유건희;서경수;유시현
    • The Korean Journal of Pain
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    • 제18권2호
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    • pp.240-245
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    • 2005
  • Herein is described the successful treatment of complex regional pain syndrome type II with the combination treatment of spinal cord stimulation and radiofrequency thermocoagulation of the lumbar sympathetic ganglion. A 62 years old male patient, suffering from CRPS type II in his left lower extremity, visited our pain clinic. Medication and nerve blockade produced only slight improvement in his symptoms and signs. Therefore, a linear type spinal cord simulator was inserted into the thoracic epidural space, using a non-surgical percutaneous approach, with the cephalad lead located at the T11 level. Two months later, the repositioning of the electrode to the T12 level for more effective pain control, with radiofrequency thermocoagulation of lumbar sympathetic ganglion also performed at the left L2 and 3 levels for the control of trophic change. These resulted in significant pain relief and decreased trophic change, with no complications, after which the patient was able to resume a normal life.

주관적인 3차원 피로감 측정 방법에 대한 휴먼팩터 연구 (Human Factor Research on the Measurement of Subjective Three Dimensional Fatigue)

  • 이형철
    • 방송공학회논문지
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    • 제15권5호
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    • pp.607-616
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    • 2010
  • 현재까지 제안된 3차원 시각피로 측정 방법은 측정의 타당도가 결여되어 있고 시각피로의 복합적인 특성을 제대로 파악해 내지 못 하는 단점이 있다. 본 연구의 목적은 3차원 시각피로의 구성요인을 분석하고 안정적으로 타당하게 주관적인 시각피로를 측정하는 방법을 제안하는 것이다. 연구결과는 다음과 같이 요약된다. 첫째, 시각피로가 네 개의 독립적인 하위요인(시각적 스트레스, 안구 통증, 신체 통증, 상 흐림 요인)으로 구성되어 있음을 규명하였고, 둘째, 네 개의 요인으로 구성되어 있는 3차원 시각피로를 측정할 수 있는 29개의 문항을 개발하였으며, 셋째, 시각피로에 영향을 미칠 것으로 기대되는 시청시간과 양안시차의 조작이 개발된 측정 방법을 이용하여 측정된 시각피로에 실제로 영향을 미침을 확인하였다. 이와 같은 결과는 본 연구에서 제안하는 시각피로 측정 방법이 3차원 시각피로를 타당하게 측정함을 시사한다.

복합부위통증증후군 1형 환자에서 한냉부하 적외선체열촬영의 유용성 평가 (Effectiveness of Cold Stress Thermography in the Diagnosis of Complex Regional Pain Syndrome Type 1)

  • 박은정;한경림;채윤정;정원호;김찬
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.159-163
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    • 2006
  • Background: Despite the enormous amount of basic research on neuropathic pain, there is the lack of an objective diagnostic test for complex regional pain syndrome (CRPS). The aim of this study was to evaluate the usefulness of cold stress thermography in the diagnosis of CRPS. Methods: The study involved 12 patients with CRPS type 1, according to the IASP criteria, who were compared with 15 normal healthy volunteers. All subjects underwent thermographic examination under baseline conditions at $21^{\circ}C$. A cold stress test (CST; $10^{\circ}C$ water for 1 minute) was then applied to both hands below the wrists, immediate, and after 10 and 20 minutes. Results: The temperature asymmetry between the patients with CRPS and the volunteers showed significant discrimination at the baseline and after a 20 minute recovery period from the CST. Among the study subjects having temperature asymmetry of both hands of less than $1^{\circ}C$ (8 out of 12 CRPS patients and 14 out of 15 volunteer), 7 (87.5%) of the 8 CRPS patients and 3 (21%) of the 14 volunteers showed a temperature difference of more than $1^{\circ}C$ after the 20 minute recovery period. The actual temperature values during the four periods did not discriminate between the patients with CRPS and the volunteers. Conclusions: Thermography, under the CST, could be a more objective test for the diagnosis of CRPS. A temperature asymmetry greater than $1^{\circ}C$ during the 20 minute recovery period following CST provides strong diagnostic information about CRPS, with both high sensitivity and specificity.

복합부위통증증후군 환자에서 척수자극술의 효능 (The Effect of Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome)

  • 김원영;문동언;최진환;박종민;한성민;김시현
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.152-158
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    • 2006
  • Background: Complex regional pain syndrome (CRPS) is a painful, disabling disorder for which no proven treatment has been established. The purpose of this investigation was to assess the evidence of the efficacy of spinal cord stimulation (SCS) in the management of pain in CRPS patients. Methods: Between March 2004 and June 2006, 11 patients with CRPS were treated with SCS. The visual analog scale (VAS) score for pain (0⁣-10) and pain disability index (PDI) were obtained in all patients prior to treatment, and 1, 3 and 6 months post-implantation. Results: All 11 patients, 5 men and 6 women, with a median age and duration of CRPS of 44 years and 48.8 months, respectively, successfully received a lead implantation for SCS. The mean VAS pain score prior to the treatment was 85.5 out of 100 mm. After SCS implantation, the mean VAS pain scores were 49.5, 57.0 and 56.0 at 1, 3 and 6 months after the procedure, respectively. The mean pain score for allodynia was decreased by 50%, with a significant reduction of the PDI also observed after the treatment. Conclusions: Our current study suggests that SCS implantation is a safe and effective method in the management of CRPS patients.

복합부위통증증후군 제I형 환자에서 조기 척수자극술이 필요한가? -증례보고- (Is Early Spinal Cord Stimulation in Patients with Complex Regional Pain Syndrome Necessary? -A case report-)

  • 민형기;한경림;이상은;김경태;김찬
    • The Korean Journal of Pain
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    • 제19권2호
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    • pp.223-227
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    • 2006
  • Complex regional pain syndrome (CRPS) is clinically characterized by pain, abnormal regulation of blood flow and sweating, edema of skin and subcutaneous tissues, sensory and motor disturbances, and trophic changes of the skin. A 21-year-old man was suffering from pain and swelling in his right hand and forearm. His arm had been in splints for 3 weeks following an extension injury of the right fingers and wrist, with the pain having developed 2 weeks after the splinting. He was treated with various nerve blocks including continuous epidural infusion, thoracic sympathetic block and peripheral nerve blocks, and squeezing his edematous region under general anesthesia as well as intravenous lidocaine and ketamine infusions. However, all of the performed treatments had no effect on the patient's pain or hand swelling. As a next line therapy, spinal cord stimulation should be considered because of intractable severe pain and swelling to almost all other modalities of therapy. We therefore performed an early intervention of spinal cord stimulation for the patient with refractory CRPS type I 5 months after the onset of pain and have got an excellent result.

복합부위통증증후군 환자에서 삼상 골스캔의 유용성 평가 (The Effectiveness of a Three Phase Bone Scan for Making the Diagnosis of Complex Regional Pain Syndrome)

  • 김난설;박경언;김세영;채윤정;김찬;한경림
    • The Korean Journal of Pain
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    • 제22권1호
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    • pp.33-38
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    • 2009
  • Background: Complex regional pain syndrome (CRPS) is still difficult to diagnose in the field of chronic pain management. CRPS is diagnosed by purely clinical criteria based on the characteristic signs and symptoms, which have to be differentiated from similar pain conditions like posttraumatic neuropathic pain. Until now, there has been a lack of objective diagnostic tools to confirm the diagnosis of CRPS. The aim of this study was to evaluate the usefulness of a three phase bone scan (TBS) for making the diagnosis of CRPS. Methods: A total of 121 patients who had been diagnosed with CRPS were evaluated. All the patients were examined by performing a TBS as a part of the diagnostic work-up. A diffuse increased tracer uptake on the delayed image (phase III) was defined as a positive finding for CRPS. Results: Forty-one patients (33.9%) out of 121 showed the positive results on the TBS. The patients with a duration of pain of less than 24 months had a significantly higher positive result (43.4%) on the TBS than did the patients with duration of pain longer than 24 months (12.1%). Conclusions: A TBS could give a better objective result for diagnosing CRPS for patients with a shorter duration of pain and a TBS gives little information for the diagnosis of CRPS in patients with a duration of pain longer than 24 months.

복합부위통증증후군 환자의 인지기능 평가 (Cognitive Assessment in Complex Regional Pain Syndrome Patients)

  • 문지연;김용철;박미정;이평복;이상철;강도형;신민섭;권태명
    • The Korean Journal of Pain
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    • 제22권1호
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    • pp.28-32
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    • 2009
  • Background: Complex regional pain syndrome (CRPS) is characterized by severe neuropathic pain and disability, which can result in psychological and behavioral dysfunction. The goal of the present study was to evaluate neurocognitive disability, and to assess the relationship between clinical variables and neuropsychological features in CRPS patients. Methods: We investigated the neuropsychological features of 15 CRPS I patients. The neuropsychological tests that we made comprised of a full intelligence quotient, memory quotient, trail-making test A, trail-making test B (TMT-B), and MMPI (Minnesota multiphasic personality inventory). Results: The results showed severe disability in performance on TMT-B. There was no significant correlation between specific cognitive variables and MMPI scales. Conclusions: Decreased performance on TMT-B which shows mental flexibility in the prefrontal lobe exists independently from depressive disorders in CRPS patients.