• Title/Summary/Keyword: 임상진료지침

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Clinical Practice Guidelines of Korean Medicine for Malignant Lymphoma (악성 림프종 치료에 대한 한의 임상진료지침)

  • Jung, Hyun-sik;Lee, Sang-hun;Yoo, Hwa-seung;Kim, Kyung-suk
    • The Journal of Internal Korean Medicine
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    • v.37 no.3
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    • pp.453-466
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    • 2016
  • Objective: The purpose of this study was to present the clinical practice guideline of Korean medicine for malignant lymphoma.Background: Malignant lymphoma is the tenth most common cancer in Korea. The two main types of lymphoma are Hodgkin’s disease and non-Hodgkin’s lymphoma. Non-Hodgkin’s lymphomas are more common, comprising nearly 95 percent of all lymphomas. In China, the traditional Chinese medicine clinical guidelines for malignant lymphoma were published in 2014. Therefore, there is growing need for a clinical practice guideline in Korea, which has not thus far existed. This clinical practice guideline was created by reviewing the Chinese clinical practice guideline and Korean clinical reports. This study will be helpful in understanding malignant lymphoma and in understanding its treatment in Korean medicine.Conclusion: Further clinical research on malignant lymphoma is needed to develop a more advanced clinical guideline.

Clinical Guidelines for Hwabyung III. (Diagnosis and Assessment of Hwabyung) (화병 임상진료지침 III. (화병의 진단과 평가))

  • Jung, In Chul;Choi, Woo Chang;Lee, Sang Ryong
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.23-36
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    • 2013
  • Objectives : The purpose of this guideline is to show the evidence-based guidelines of diagnosis and evaluation of Hwabyung by the synthesis and organization of existing research contents. Methods : We investigated the existing research on the concept of Hwabyung. Further, we investigated the diagnostic tools, self-diagnostic method, symptoms assessment tools, oriental medical diagnostic methods, treatment evaluation tools and other testing methods of Hwabyung. Results : There was a Hwabyung diagnostic interview schedule (HIBDS) in the standardized measure for the diagnosis of Hwabyung. In the symptoms assessment tools of Hwabyung, there was a self-report measurement tool of Hwabyung and measurement tool of Hwabyung to be evaluated by the interviewer. In the oriental medical diagnostic method, there was an instrument of pattern identification for Hwabyung. In the treatment assessment tool, there was an instrument of oriental medical evaluation for Hwabyung. In addition, MMPI, SCL-90R, Zung's self-rating anxiety scale (SAS), Zung's self-rating depression scale (SDS), State-Trait Anger Expression Inventory (STAXI) and etc. can be used for the diagnosis and assessment of Hwabyung. Conclusions : We expect 'Clinical Guidelines for the Treatment of Hwabyung' to be useful for the diagnosis and assessment of Hwabyung.

Clinical Guidelines for Hwabyung II. (Research on the Status of Hwabyung in Korea) (화병 임상진료지침 II. (화병의 실태))

  • Chung, Sun-Yong;Song, Seung-Yeon;Kim, Jong-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.15-22
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    • 2013
  • Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry attempted to produce clinical guidelines for doctors of Korean medicine for the treatment of Hwabyung. Methods : A standard guideline development process was followed. Relevant literature was identified by a review of bibliographies. The operational criteria were used to rate the quality of scientific evidence, and the line of treatment recommendations included a consensus clinical opinion. This section of "the status of Hwabyung in Korea" is 2 out of 5 articles drafted and reviewed by clinicians. Results : Hwabyung is changed depending on the time and have a risk of relapse. Like the previous studies, Female and lower socio-economic and educational level people suffers Hwabyung frequently. But recently number of Male Hwabyung patients increases. Recovery of Hwabyung is involved in depression, anxiety, stress. Hwabyung is related to Major depressive disorder, generalized anxiety disorder, somatoform disorder and diseases of the digestive system. Conclusions : This study was observed for the progression of Hwabyung. Hwabyung is a long-term disease associated with depression, anxiety and stress. Hwabyung is accompanied by physical and psychological symptoms and degrades the quality of life.

Development of Clinical Practice Guideline for Hwabyung (1) - Purpose, Development Strategy and Procedure - (화병 임상진료지침 개발 연구 (1) - 목적과 개발 전략 및 절차 -)

  • Kim, Jong-Woo;Chung, Sun-Yong;Cho, Seung-Hun;Whang, Wei-Wan;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.2
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    • pp.143-152
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    • 2009
  • Objectives : Hwabyung is one of well-known mental health problems like depression in Korea and it's concept is generated from oriental medicine. We suggest that clinical practice guideline should reflect the Hwabyung's characteristics, clinical environment and Oriental medical doctor's need. Methods : We use the general development method of clinical practice guideline and also apply the oriental medicine's properties. Results : We need to refer to the western psychiatric field, especially the clinical guideline of depression. And we should base on the clinical survey and trial with the selected core subject considering oriental medicine's character. Conclusions : From this development, we expect the application of proper clinical decision by medical team, the objectification of oriental medicine, and the improvement of medical quality in the clinical field of oriental medicine.

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Clinical Practice Guideline for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine: Diagnosis and Algorithm (태음인·태양인체질병증 임상진료지침: 진단 및 알고리즘)

  • Lee, Jun-Hee;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.13-41
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine(SCM): Diagnosis and Algorithm. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods We searched the literature and articles related to Taeeumin and Taeyangin Symptomatology diagnosis and algorithm. For developing diagnosis and algorithm, we searched the classification, ordinary symptom, present symptom of the Taeeumin and Taeyangin Symptomatology Results and Conclusions We classified the Taeeumin Symptomatology by 4 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern, initial-intermediate-advanced pattern. And we classified the Taeyangin Symptomatology by 3 steps: Exterior-Interior disease, favorable-unfavorable pattern, mild-moderate-severe-critical pattern. At the unfavorable pattern, ordinary symptom is very important. So doctors are considered to need to focus on the symptom of unfavorable's ordinary symptoms.

Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Yin-Depletion (Mangeum) Symptomatology (소양인체질병증 임상진료지침: 망음병)

  • Shin, Mi-Ran;Joo, Jong-Cheon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.251-261
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Yin-Depletion (Mangeum) Symptomatology. The CPG was developed by the national-wide experts committee consisting of SCM professors. Methods The CPG was developed by the national-wide experts committee considering of the society of Sasang Constitutional Medicine. It was performed by search and collection of literature related SCM, opinion of SCM experts and journal search and it was followed by CPG's guideline. Results & Conclusions The CPG of Yin-Depletion (Mangeum) Symptomatology in Soyangin Disease include classification, definition and standard symptoms of each pattern. Yin-Depletion (Mangeum) Symptomatology is classified into severe and critical pattern by severity. The severe pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum) and the advanced pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum). The critical pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Cold-related diarrhea accompanied by the abdominal pain (Sinhan-bocktong Mangeum) and the advanced pattern of Cold-related diarrhea accompanied by abdominal pain (Sinhan-bocktong Mangeum).

침치료에 대한 환자진료 평가 프로그램-독일 보험회사들의 침효과에 대한 검증-

  • Melchart, Dieter
    • Journal of Pharmacopuncture
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    • v.6 no.1
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    • pp.33-34
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    • 2003
  • 배경: 독일 의사와 보험회사 위원회 (The German Board of Physicians and Insurance Companies:Bundesausschuss der Arzte und Krankenkassen)가 앞으로 일부 적응증에 대한 침치료에 대해 공적 보험회사가 보험료를 지급해야 할 지에 대한 추가 결정을 하기 위해 침의 효과를 평가하기로 했다. 목적: 1) 침치료가 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염치료에 대조군 침치료보다 효과가 있는지 검증 2) 침치료가 편두통의 예방적 치료에 표준 약물 치료와 비슷하게 효과가 있는지 검증 3) 보건의료 서비스체계 안에서 주어진 조건에 대한 일상적 침치료의 질적인 부분을 서술하고, 안전성을 평가하며, 다른 침술학파간의 임상결과의 차이와 비용의 효용적 활용부분을 평가한다. 4) 위의 적응증에 해당하는 모든 임상실험연구를 찾아내어 기존의 고찰내용을 갱신한다. 방법: 1) 무작위 표본추출 임상 실험, 침치료, 거짓침 치료, 대기자 명단 대조군, 출발시점 4주, 28주 관찰 2) 무작위 표본추출 임상 실험, 침치료, 표준약물치료 대조군, 츨발시점 4주, 28주 관찰 3) 전향적 다중 의료기관 관찰 연구, 두 가지 다른 자료를 활용하여서, 치료 결과를 침 시술자에 의한 모든 환자 평가 자료와, 열 두 명의 환자 가운데 한 명의 환자로부터 직접 받은 평가 자료 (관찰 출발시점, 치료 출발 시점, 치료 시작 후 6 개월) 실험공간: 1) and 2) 높은 수준의 수련을 한 침 시술 의사가 시술하는 병원이나 일차 진료기관의 외래. 3) 보건 의료 서비스내 저급의 침 시술 의사 (140 시간 수강, 학점 이수 필수) 참가자: 1) $4{\times}320$ 편두통의 예방, 긴장성 두통, 요통, 무릎과 고관절의 골관절염 환자 2) 480 편두통 환자(긴장성 두통 환자 추가적) 3) 약 500,000 환자, 2년 반 동안: 대략 한 적응증 당 10,000 환자 치료법: 모든 침치료 자리는 체침만 허용함. 1) 진짜 침은 학파의 지침에 따른 심자, 거짓 침은 비특이적 자리의 표피만 찌르는 자침 (12-15회, 8주): 대기자 대조군은 12주 동안에 아무 치료도 받지 않는다. 2) Group 1(N=240): 최대 15회 치료, 12주 동안: Group II (N=240) 투약 Proponolol (80-240mg), Metoprolol (100-200mg) or Flunarizin (5-10mg) 하루, 16주 이상 3) 치료회수와 침자리의 선정은 참가자가 결정 주된 임상 결과 지표: 1) 군 간의 치료 전 및 치료 진행 도중 4주 마다의 두통을 느낀 날 수의 차이 (평균 혹은 이상의 편두통이나 긴장성 두통) 2) 요통환자 군간의 기능을 측정하는 FFbH-R (Funktionsfragebogen Hannover) 비교 3) 관절염 환자의 군간 WOMAC 지표 비교 4) 군 간의 24주 동안 두통을 느낀 날 수의 차이(평균 혹은 이상의 편두통이나 긴장성 두통) 5) 적응증, 부작용, 성공율에 대한 거시적 평가, 사용한 침수, 환자의 만족도, SES(?). ADS(?) 통증 장애 지표(PDI), 삶의 질 지표(SF36). 예비 결과 위의 결과가 큰 관찰 연구에 초점을 맞추면서 소개될 것임.

Proposals on Basic Data Based on Comparison of Changes in Clinical Laboratory Technologists' National Examination and Job Definition: Focused on Korea, Japan, and Taiwan (임상병리사국가시험 및 직무의 변천 비교를 중심으로 한 기초자료 제안: 한국, 일본, 대만을 중심으로)

  • Bon-Kyeong KOO;Myung Soo KIM;Yoon Sik KIM;Jun Ho LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.2
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    • pp.71-81
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    • 2023
  • This study examined the transition process of clinical laboratory technologists' national examination and job definition in Korea and compared the differences in the national examination between Korea and neighboring countries, such as Japan and Taiwan. In Korea, the number of questions made for it was 200 (1965), 200 (1977), 300 (1982), 250 (1992), 330 (2006), and 280 (2015). The practice of clinical physiology is important for real-time monitoring, given the characteristics of physiological testing. On the other hand, there are conflicts between other occupations in the working area. Clinical molecular biology needs to be established as a new major subject considering the diagnostic importance of molecular biological tests and the speed of science and technology development. Clinical laboratory operations provide policy and guidance recommendations to technologist staff. The proposed clinical laboratory technologists' national examination comprises major subjects: clinical biochemistry, clinical hematology, clinical transfusionology, clinical immunology, clinical microbiology, clinical molecular biology, clinical histology, clinical cytology, clinical physiology, and clinical laboratory operations. In addition, this study proposes the job definition of clinical laboratory technologists, revising various chemical or physiological testing to biomedical or physiological testing required for medical practice.

A Pilot Study on Effects of Critical Pathway Application for Hwa-Byung (화병 표준진료지침 적용효과에 대한 Pilot 분석)

  • Eom, Yoon-Ji;Kwon, Do-Hyung;Kim, Yun-Na;Lee, Hyun-Woo;Chung, Sun-Yong;Cho, Seung-Hun
    • Journal of Oriental Neuropsychiatry
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    • v.32 no.4
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    • pp.337-343
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    • 2021
  • Objectives: To investigate effectiveness and satisfaction of applying critical pathway (CP) to Hwa-byung outpatients. Methods: Subjects were 32 outpatients who were diagnosed with Hwa-byung between January 1 and 2021 to October 31, 2021. Among these patients, 18 patients were applied with CP and 14 patients received treatment without applying CP. Their medical records and administration records were retrospectively analyzed. Data were analyzed by mean, standard deviation, and t-test using SPSS 26.0 program. Results: Mean total treatment period significantly decreased in the CP group compared with the non-CP group. Medical expenses were classified by treatment period, per visit, and patient charges per type of visit. When analyzed specifically by detailed items, there was a decreasing tendency in total medical expenses, uncovered medical expenses, and patient charges but an increasing tendency in covered medical expenses, although some of these changes were not statistically significant. Satisfaction score increased in the CP group compared with the non-CP group in general, although not all increases were statistically significant. Conclusions: Applying CP may contribute to the reduction of medical expenses and improvement of medical service quality. Further research on the development of CP for various diseases and the application of CP under various circumstances is needed.

Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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