• 사상체질의학회지
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• 제12권1호
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• pp.120-135
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• 2000

본(本) 논문(論文)은 중풍입원환자(中風入院患者)를 대상으로 소양인(少陽人) 태음인(太陰人) 체질병증유형(體質病證類型)의 특징(特徵)을 얻기 위하여 시도(試圖)되었다. 1999년 7월 1일부터 1999년 9월 20일까지 경희의료원(慶熙醫療院) 한방병원(韓方病院)에 입원(入院)한 중풍환자(中風患者) 중(中) 소양인군(少陽人群) 31명과 태음인군(太陰人群) 39명, 총 70명을 대상으로 문진(問診)을 하였고, 이를 통계처리 소양인군(少陽人群)과 태음인군(太陰人群)간의 자각증상(自覺症狀)의 차이를 찾아 다음과 같은 결론(結論)을 얻었다. 1. 소양인군(少陽人群)과 태음인군(太陰人群)간의 일반적 특성에 관한 차이 분석에 있어서 연구대상자(硏究對象者) 총 70명 중 소양인군(少陽人群)은 31명(44.3%), 태음인군(太陰人群)은 39명(55.7%)이었고, 남자(男子)는 43명(61.4%), 여자(女子)는 27명(38.6%)으로 남자(男子)가 많았다. 평균체중(平均體重)은 태음인군(太陰人群)이 더 많이 나갔고, 비만도(肥滿度)가 높은 사람 태음인군(太陰人群)에 더 많았으며, 흡연력(吸煙歷)이 많은 군은 소양인군(少陽人群)이었다. 신경학적 증상에 있어서 소양인군(少陽人群)이 현운(眩暈)을 더 많이 호소하였다. 2. 설문조사결과분석 (1) 수면(睡眠)은 태음인군(太陰人群)이 소양인군(少陽人群)보다 취침 기상 시간 및 전체 수면시간이 일정하지 않았고, 수면 후에도 피로감을 많이 호소(呼訴)하였다. (2) 대변(大便)은 태음인군(太陰人群)이 소양인군(少陽人群)보다 그 양상이 다양하였다. (3) 소변(小便)은 소양인군(少陽人群)이 태음인군(太陰人群)보다 배뇨(排尿)에 관한 자각증상(自覺症狀)을 많이 호소(呼訴)하였다. (4) 소화장태(消化狀態)는 태음인군(太陰人群)이 식욕항진(食慾亢進) 및 하복부(下腹部)에서의 자각증상(自覺症狀)을 많이 호소(呼訴)하였으며, 소음인군(少陰人群)은 식욕저하(食慾低下) 및 상복부(上腹部)세서의 자각증상(自覺症狀)을 많이 호소(呼訴)하였다. (5) 두면부(頭面部) 자각증상(自覺症狀)에 있어서 소양인군(少陽人群)이 태음인군(太陰人群)보다 자각증상(自覺症狀)을 많이 호소(呼訴)하였다. (6) 안이비부(眼耳鼻部)의 자각증상(自覺症狀)에 있어서 소양인군(少陽人群)이 태음인군(太陰人群)보다 안부(眼部) 및 이부(耳部)에서의 자각증상(自覺症狀)을 많이 호소(呼訴)하였다. (7) 흉부(胸部)의 자각증상(自覺症狀)에 있어서 소양인군(少陽人群)은 "답답하다", 태음인군(太陰人群) "두근거린다"라고 호소(呼訴)하는 경우가 많았다. (8) 피부(皮膚)의 자각증상(自覺症狀)에 있어서 태음인군(太陰人群)은 색택(色澤)의 변화를 많이 호소(呼訴)하였고, 소양인군(少陽人群)은 피부(皮膚)의 건조(乾燥)를 많이 호소(呼訴)하였다.

• 동의생리병리학회지
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• 제28권5호
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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.

• Journal of Hospice and Palliative Care
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• 제20권3호
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• pp.159-166
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• 2017

항레트로바이러스제 치료의 확립, 조기치료로 HIV 감염인들의 바이러스의 조절과 면역저하의 개선이 이루어지고 있다. 다수의 환자들이 더 이상 에이즈 관련 합병증으로 사망하지 않고, 심혈관질환, 대사성질환, 간질환, 신장질환, 신경계질환과 같은 만성합병질환을 갖고 고령화되고 있다. 그러나 지금도 여전히 사회적 차별과 낙인이 존재하는 가운데 후기 발현자로 후천면역결핍증 상태로 방문하여 사망하거나 중증의 신경계합병증으로 장애를 갖는 환자들이 있다. 환자의 다양한 증상들에 대해 이른 시기부터의 완화의료적 접근이 필요하다. 원위 대칭성 감각 다발신경병증 등의 환자의 만성 통증은 저평가되어 왔고 이에 대한 적극적인 통증 중재가 필요하다. 이전 호스피스 기준은 현재 시점에서 새롭게 제시한다. 감염인의 약제 지속 등의 의학적 필요, 심리적 상태, 사회적 여건에 대한 이해가 필요하다. 표준주의 감염관리 원칙을 준수한다면 만성질환으로서의 보편적 호스피스 진료의 제공이 가능하겠다. 생의 말기 빠르고 적극적인 호스피스팀의 개입을 통해 환자들이 존엄하게 삶을 마무리하실 수 있도록 임상경험이 늘어나고, 제도가 마련되길 바란다.

• 한방재활의학과학회지
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• 제27권4호
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• pp.21-31
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• 2017

Objectives This study aimed to review manual therapies for mononeuropathies of upper limb through domestic and foreign studies designed for human body. Methods We searched databases (KMbase, OASIS, RISS, NDSL, KISS, KoreaMed, MEDLINE/Pubmed, CENTRAL, EMBASE) on the 1st to 31th of July 2017 to find related literatures that published after 2000. Results Twenty-eight studies were finally included. Of these, 13 articles were published after 2010. Twenty-two studies were clinical trials and 6 were observational studies. Carpal tunnel syndrome were the most researched type of diseases (85.7%). Most frequently used method of manual therapies was neurodynamic mobilization (35.7%). Pain scales and questionnaires were generally employed for evaluation. Significantly effective studies were 72.2% in controlled trials and 90% in the studies without control group. Conclusions In this study, we reviewed literatures concerning manual therapies on mononeuropathies of upper limb. Further studies are needed on the various diseases of mononeuropathies of upper limb to retain the evidence for the effectiveness of manual therapies.

• Journal of Acupuncture Research
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• 제32권4호
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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.

• 한국임상약학회지
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• 제22권4호
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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.

• Clinical and Experimental Pediatrics
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• 제46권11호
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• pp.1112-1117
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• 2003

목 적 : 소아의 악성 종양에 대한 새로운 치료법의 개발로 환아의 생존 기간이 증가하는 추세에 있으나 이로 인한 신경계 합병증의 발생도 증가하고 있다. 저자들은 항암 치료를 시행한 소아 종양 환아에서 나타난 중추 신경계 합병증에 대한 임상 양상을 알아보고자 하였다. 방 법 : 1995년 1월부터 2002년 11월까지 동산병원 소아과에서 항암치료를 시행한 환아 중 신경계 합병증이 동반되었던 15례의 환아를 대상으로 그 임상상을 후향적으로 검토하였다. 결 과 : 전체 15례 중에서 방사선학적 검사로 원인 질환을 밝힌 경우는 모두 13례로 백질뇌병증이 7례, 무기질화 미세혈관병증이 4례, 뇌경색이 3례, 뇌출혈이 1례, 저산소성 허혈성 뇌증이 1례, 2가지 이상의 합병증을 함께 나타낸 경우는 2례였으며, 혈액학적 방사선학적 검사상에서 이상 소견이 없이 MTX의 부작용으로 생각되는 경련성 질환이 2례였다. 뇌출혈과 뇌경색이 나타낸 경우는 예후가 나빴으며 전해질 불균형으로 인한 저산소성 허혈성 뇌증에서는 원인 교정 후 후유증 없이 회복되었다. 결 론 : 소아 종양 환아에서 치료 중 발생한 신경계 합병증은 질환의 예후에 큰 영향을 미치고 신경인지 발달에 장애를 남기므로 이들 합병증에 대한 예방, 진단 및 즉각적인 치료와 추적관찰이 필요할 것이다.

• 대한한방내과학회지
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• 제37권1호
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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.

• Clinical and Experimental Pediatrics
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• 제53권3호
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• pp.428-431
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• 2010

혈전저혈소판혈증자색반병은 혈관 내피 세포 손상에 의한 혈전미세혈관병증으로 미세혈관병용혈빈혈, 혈소판감소증과 미세혈관 혈전에 의한 다양한 정도의 신경 및 신장 침범을 보인다. 이는 소아에서는 드물게 발생하며 종종 치명적인 경과를 보일 수 있다. 혈전저혈소판혈증자색반병은 ADAMTS-13 유전자 변이에 의한 결핍을 보인 선천성 그리고 ADAMTS-13 항체들에 의해 발생하는 후천성인 경우로 분류할 수 있다. ADAMTS-13 활성도 및 순환 항체검사, 그리고 항 ADAMTS-13 IgG와 ADAMTS-13 염기서열분석은 이 질환의 진단에 중요하다. 후천성 환자에게는 혈장교환술이 주된 치료이며, 스테로이드제나 면역억제제도 사용된다. 저자들은 청소년기에 발생한 ADAMTS-13 활성도 저하와 항체 양성을 보인 후천성 혈전저혈소판혈증자색반병을 진단 후 혈장교환술로 효과적으로 치료하였던 1례를 보고하는 바이다.

• 임상간호연구
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• 제23권1호
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• pp.83-90
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• 2017

Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.