• Title/Summary/Keyword: 임상진료지침

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Clinical Guidelines for Hwabyung IV. (Medications & Acupuncture and Moxibustion) (화병 임상진료지침 IV. (약물치료와 침구치료))

  • Kang, Hyung-Won;Lee, Seung-Gi;Lee, Jae-Hyuk;Park, Bo-Ra;Lyu, Yeoung-Su
    • Journal of Oriental Neuropsychiatry
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    • v.24 no.spc1
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    • pp.37-46
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    • 2013
  • Objectives : The Hwabyung Research Center of The Korean Society Of Oriental Neuropsychiatry has attempted to develop the 'Clinical Guidelines for Hwabyung'. Methods : The Hwabyung Research Center constructed a committee of experts and advisory group. Relevant literature was collected and evaluated in order to find out effective Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping of Hwabyung. Results : We found some evidences that proved the effectiveness of Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, and cupping in the treatment of Hwabyung. 1) We recommend Pharmacotherapy (Herbal medicine), acupuncture and moxibustion, cupping, psychotherapy and management, other therapeutic approaches and education for Hwabyung. 2) Pharmacotherapy (Herbal medicine) should be determined according to the pattern identification of Korean medicine. Further, the prescription should be cost-effective, safe and have no side effects. Also, the interaction between Herbal and Western drugs should be considered carefully. 3) There are general acupuncture, scalp acupuncture, Pharmacopuncture, Sa-am acupuncture as well as acupuncture treatments for Hwabyung. 4) Moxibustion and cupping are useful, relieving various somatic symptoms of Hwabyung. Conclusions : Pharmacotherapy (Herbal medicine), Acupuncture and Moxibustion, Cupping for Hwabyung were studied. We hope that the 'Clinical Guidelines for the Treatment of Hwabyung' are helpful for oriental medical doctors and patients.

Consensus on definition and quality standard of clinical practice guideline using RAND method (RAND 방법으로 합의한 임상진료지침의 정의와 질 평가 기준)

  • Ji, Seon-Mi;Kim, Soo-Young;Sheen, Seung-Soo;Heo, Dae-Seog;Kim, Nam-Soon
    • Health Policy and Management
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    • v.20 no.2
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    • pp.1-16
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    • 2010
  • Background : Clinical practice guidelines are an increasingly familiar part of clinical practice. Moreover, rigorously developed evidence based guidelines has been widely used. However, in Korea, some of published documents as clinical practice guidelines have shown considerable disparity in structure, contents and quality. This is mainly because there is no consensus on the definition and quality standard of clinical practice guidelines. The purpose of this study was to draw consensus on the definition and the quality standard about clinical practice guidelines. Method : We developed a questionnaire about the definition of clinical practice guidelines with inclusion criteria(23 items) and the quality standard(30 items). We selected 9 experts who had prior experience in developing and implementing guidelines. Rating methods for appropriateness of items were adopted from the RAND method. Consensus was drawn in three rounds. Results : Of the 47 items agreed, 40 items were determined to be appropriate. Clinical practice guidelines were defined as "scientifically and systematically developed statements to assist practitioners and patients on making decisions about appropriate health care for specific clinical circumstances." Narrative reviews, systematic reviews or health technology assessment without recommendations, translation of foreign guidelines, guidelines for patients only and training manuals were not considered as clinical practice guidelines. For the quality standard of clinical practice guidelines, 27 items were deemed necessary. Conclusions : The consensus on the definition with inclusion criteria and the quality standard of clinical practice guidelines carries an important meaning as the first attempt to draw a general agreement in our society. The unique achievement of the consensus reflects the current status of clinical practice guidelines that there has been a high tendency to adapt foreign guidelines. We hope efforts of this kind will continue to bring improvement in clinical practice guidelines.

A Case Study on a Patient with Major Depressive Episode of Bipolar II Disorder Treated with a Combination of Interpersonal and Social Rhythm Therapy and Korean Medicine (제2형 양극성 장애의 주요우울 삽화에 대한 복합 한방 치료 사례보고: 대인관계 및 사회적 리듬 치료와 변증 치료를 중심으로)

  • Lee, Ji-Yoon;Kim, Ju-Yeon;Jeong, Jin-Hyung;Jung, In Chul
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.213-223
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    • 2020
  • Objectives: To determine treatment effects of a combination of interpersonal and social rhythm therapy and Korean medicine for a patient with major depressive episode of bipolar II disorder. Methods: A patient was treated with Korean medicine (acupuncture, herbal medicine, etc.) and interpersonal and social rhythm therapy (IPSRT) for four months. Pattern identification for depressive mood and sleep associated symptoms was evaluated using Patient Health Questionnaire-9 (PHQ-9) and Social rhythm metric II-5 (SRM II-5). Results: At the end of the treatment, depression and delayed sleep symptoms were improved and social rhythm was recovered to the regular range. The patient acquired an insight to his interpersonal tensions and conflicts. Conclusions: Korean medicine in combination with interpersonal and social rhythm therapy can be used to treat patients with major depressive episode of bipolar II disorder. More cases are needed to develop guidelines for treating bipolar disorder.

Evaluation of the Effect of Clinical Practice Guideline using Systematic Review (체계적 고찰 방법을 이용한 임상진료지침 정책효과 평가)

  • Lee, Sun-Hee;Ha, Gwi-Yeom;Kim, Ju-Hye;Seo, Ju-Hyun;Kim, Hyun-Mi
    • Korea Journal of Hospital Management
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    • v.14 no.1
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    • pp.62-98
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    • 2009
  • A systematic review of the literatures was conducted to evaluate the effect of clinical practice guideline. The 77 studies were identified from a computerized search of published research on MEDLINE, Science-Direct and Blackwell synergy from January, 1997 to October, 2007. The main search terms were "clinical practice guideline" and "effectiveness", "clinical practice guideline" and "impact", "clinical practice guideline" and "evaluation". These studies were assessed the Quality twice by one Qualified expert and converted into weighted scale. The 63 studies were eligible inclusion criteria and subdivided into type of effect. Final indicator using for policy effect of clinical practice guidelines were classified as 4 categories; "improvement of outcomes" in 81 studies, "betterment in practice patterns" in 68 studies, "rationalization in resource utilization" in 84 studies and "cost containment" in 31 studies. The vote-counting method, one of meta-analysis method, was applied to summarized the effect of clinical practice guidelines and test statistically. From results of meta analysis, all indices were statistically significant. In conclusion, this meta-analysis showed that introduction of clinical practice guidelines were resulted positive outcomes in health policy.

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Clinical Practice Guideline for Taeeumin Disease of Sasang Constitutional Medicine: Liver Heat-based Interior Heat (Gansuyeol-liyeol) disease (태음인체질병증 임상진료지침: 리병)

  • Jeon, Soo-Hyung;Yu, Jun-Sang;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.57-70
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    • 2015
  • Objectives This research was performed to present Clinical Practice Guideline(CPG) for Taeeumin Disease of Sasang Constitutional Medicine(SCM): Liver Heat-based Interior Heat (Gansuyeol-liyeol) disease. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related to SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and fundamental researches to standardize the diagnosis of Sasang Constitutional Medicine. And journal search related to clinical trials and case studies concerning SCM was performed domestic and overseas. Finally, 12 articles were selected and included in CPG for Liver Heat-based Interior Heat (Gansuyeol-liyeol) disease in Taeeumin Disease. Experts consensus was drawn through several meetings. Results & Conclusions CPG of Liver Heat-based Interior Heat (Gansuyeol-liyeol) disease in Taeeumin Disease include classification, definition and standard symptoms of each pattern. Liver Heat-based Interior Heat (Gansuyeol-liyeol) disease is classified into Liver-Heat (Ganyeol) symptomatology and Liver-Heat Lung-Dry (Ganyeol-paeJo) symptomatology. Depending on the severity of Liver Heat, Liver-Heat (Ganyeol) symptomatology is classified into mild pattern and moderate pattern. Mild pattern contains 1 disease, namely, Liver-Heat (Ganyeol) initial pattern. Moderate pattern classified into advanced pattern and intense pattern. Depending on the severity of the Lung-Dry, Liver-Heat Lung-Dry (Ganyeol-paeJo) symptomatology is classified into severe pattern and critical pattern. Severe pattern is classified into Dry-Heat (Joyeol) pattern and Dry-Heat (Joyeol) advanced pattern. Critical pattern contains 1 disease, namely, Dry-Heat (Joyeol) intense pattern (Eumhyeol-mogal yeolda pattern).

Clinical Practice Guideline for Taeyangin Disease of Sasang Constitutional Medicine (태양인체질병증 임상진료지침)

  • Park, Hye-Sun;Joo, Jong-Cheon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.71-81
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    • 2015
  • Objectives This research was proposed to present clinical practice guideline (CPG) for Taeyangin Disease of Sasang Constitutional Medicine (SCM). This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods This guideline was performed that search and collection of literature related SCM such as "Dongeuisusebowon", textbook of SCM, clinical guidebook of SCM and fundamental research to standardize diagnosis of Sasang Constitutional Medicine. Journal search related clinical trial or human complementary medicine of SCM was performed domestic and overseas. Finally, 1 article was selected and included in CPG for Taeyangin disease. Results & Conclusions The CPG of Taeyangin disease include classification, definition and standard symptoms of each pattern. Taeyangin disease is classified into exterior-origin lower back (EOLB) disease and interior-origin small intestine (IOSI) disease by region of symptom. EOLB can be replaced with Oegam-yocheok and IOSI can be replaced with Naechok-sojang that is Korean pronuncation. EOLB disease is classified into lower back favorable symptomatology (LBFS) and lower back unfavorable symptomatology (LBUS). Lower back is to say Yocheok, so LBFS can be called Yocheok favorable symptomatology and LBUS can be called Yocheok unfavorable symptomatology. LBUS is to say paraparesis symptomatology or Haeyeok, that is Korean pronunciation, symptomatology. IOSI disease is classified into small intestine favorable symptomatology (SIFS) and small intestine unfavorable symptomatology (SIUS). Small intestine is to say Sojang, so SIFS can be called Sojang favorable symptomatology and SIUS can be called Sojang unfavorable symptomatology. SIUS is to say regurgitation symptomatology or Yeolgeok, that is Korean pronunciation, symptomatology.

Clinical Practice Guideline for Sasang Constitutional Medicine: Prevention and Risk Fators of Sasangin Disease (사상체질병증 임상진료지침: 예방 및 위험인자)

  • Bae, Na-Young;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.82-109
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline (CPG) for Prevention of Sasangin disease pattern of Sasang Constitutional Medicine (SCM) and diseases closely related with Sasang constitution. Each CPG was developed by the national-wide experts committee consisting of SCM professors. Methods At first, we searched the literatures related to SCM such as "Dongeuisusebowon", Textbook of SCM and Clinical Guidebook of SCM. Also we searched the articles related to the studies about risk factors for Sasangin disease pattern of both at home and abroad. Finally, we selected leading risk factors of Sasangin disease pattern and developed CPG for prevention of Sasangin disease pattern of SCM. And then, we searched the literatures related SCM such as "Dongeuisusebowon" and the articles on the correlation between disease and Sasang constitution using case-control studies, observational studies or cross sectional studies of both at home and abroad. Next, we selected diseases closely related with Sasang constitution on the basis of articles including prevalence rate and odds ratio between disease and Sasang constitution and finally developed CPG for these diseases. Results and Conclusions We categorized risk factors of Sasang disease pattern into 2 types: non-modifiable and potentially modifiable. 3 items (age, sex and genetic factors) were classified as non-modifiable risk factors of Sasang disease pattern. 6 items (original symptom, stress, diet and nutrition, physical activity, alcohol and drug misuse) were classified as less well-documented or potentially modifiable risk factors of Sasangin disease pattern. We found out Sasang constitution is more likely to develop some diseases. It was proven that Sasang constitution increase the risk of hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. And there is high probability of Sasang constitution being potential risk factor for obesity, hyperlipidemia, allergy and cancer. Also, we found out Taeeumin is independent risk factor for hypertension, diabetes mellitus, metabolic syndrome, stroke, nonalcoholic fatty liver and obstructive sleep apnea. Therefore we recommend that Taeeumin need to prevent these disease by regular checkups and aggressive management.

Clinical Practice Guideline for Taeeumin Disease of Sasang Constitutional Medicine: Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease (태음인체질병증 임상진료지침: 표병)

  • Choi, Ae-Ryun;Shin, Mi-Ran;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.42-56
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    • 2015
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Taeeumin Disease of Sasang Constitutional Medicine(SCM): Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, collection and organization of literature related to SCM such as Donguisusebowon, Text book of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine was performed. Secondly, journals related to clinical trial or Human complementary medicine of SCM were searched. Finally, 7 articles were selected and included in CPG for Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease. Results & Conclusions The CPG of Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease in Taeeumin Disease include classification, definition and standard symptoms of each pattern. Esophagus Cold-based Exterior Cold (Wiwansuhan-pyohan) disease consists of two aspects : Esophagus-Cold (Wiwanhan) and Esophagus-Cold Lung-Dry (Wiwanhan-paejo) symptomatology. Esophagus-Cold (Wiwanhan) symptomatology is classified into mild and moderate pattern by severity. Mild pattern of Esophagus-Cold (Wiwanhan) symptomatology is classified into Supraspinal Exterior (Baechu-pyo) initial and Wheezing-Dyspnea (Hyocheon) pattern. Moderate pattern of Esophagus-Cold (Wiwanhan) symptomatology is classified into Cold-reversal (Hanguel) and Cold-reversal (Hanguel) advanced pattern. And Esophagus-Cold Lung-Dry (Wiwanhan-paejo) symptomatology is classified into severe and critical pattern by severity. Severe pattern of Esophagus-Cold Lung-Dry (Wiwanhan-paejo) is classified into Dry-Cold (Johan) pattern and Dry-Cold (Johan) advanced pattern. Critical pattern of Esophagus-Cold Lung-Dry (Wiwanhan-paejo) symptomatology consists of Dry-Cold (Johan) intense pattern (Eumhyeol-mogal handa pattern).

Clinical Practice Guideline for Taeeumin and Taeyangin Disease of Sasang Constitutional Medicine: Overview (태음인·태양인체질병증 임상진료지침: 총론)

  • Lee, Eui-Ju;Koh, Byung-Hee;Kim, Dal-Rae;Kim, Jong-Yeol;Kim, Jong-Won;Park, Seong-Sik;Song, Il-Byung;Song, Jeong-Mo;Ahn, Taek-Won;Jang, Hyun-Jin;Cho, Hwang-Sung
    • Journal of Sasang Constitutional Medicine
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    • v.27 no.1
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    • pp.1-12
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    • 2015
  • Objectives This study was aimed to develop the clinical practice guideline for Taeeumin, Taeyangin symptomatology. This was the second clinical practice guideline, which focuses on symptomatology. Methods Donguisusebowon and many articles were reviewed and examined for developing clinical practice guidelines. Among the previous guidelines, we assessed the guidelines by Appraisal of Guidelines for Research and Evaluation (AGREE II). After AGREE II assessment, we chose and revised the clinical practice guideline. Results and Conclusions By researching and discussing the Taeeumin, Taeyangin symptomatology, we make the principle of the clinical practice guideline, including classification, definition, algorithm, and treatment assessing tool.

Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Chest-Heat congested (Hyunggyeok-yeol) Symptomatology (소양인체질병증 임상진료지침: 흉격열병)

  • Park, Hye-Sun;Hwang, Min-Woo;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.262-271
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine (SCM) ; Chest-Heat congested(Hyunggyeok-yeol) Symptomatology. Methods This CPG was developed by the national-wide experts committee consisting of SCM professors. First, collection and organization of literature related to SCM such as Donguisusebowon, Text book of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine was performed. Secondly, journals related to clinical trial or Human complementary medicine of SCM were searched. Finally, 4 articles were selected and included in CPG for Chest-Heat congested(Hyunggyeok-yeol) Symptomatology of Stomach Heat-based Interior Heat disease in Soyangin disease. Results & Conclusions CPG of Chest-Heat congested(Hyunggyeok-yeol) symptomatology in Soyangin disease includes classification, definition and standard symptoms of each pattern. Chest-Heat congested(Hyunggyeok-yeol) symptomatology is classified into mild and moderate pattern by severity. Chest-Heat(Hyunggyeok-yeol) symptomatology Mild pattern is classified into Chest-Heat congested(Hyunggyeok-yeol) initial pattern and Chest-Heat congested(Hyunggyeok-yeol) advanced pattern. And Chest-Heat congested (Hyunggyeok-yeol) moderate pattern is classified into Clear Yang Failure of Stomach(Weguck-cheongyang Bulsagnseung) pattern (Upper wasting-thirst(Sangso) pattern), Clear Yang Failure of Large Intestine (Daejang-cheongyang Bulsangseung) pattern (Middle wasting-thirst (Jungso) pattern).