• 대한한방부인과학회지
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• 제29권1호
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• pp.92-101
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• 2016

Objectives: The purpose of this systematic review was to overview and evaluate the effectiveness of fumigation treatment for women with atrophic vaginitis. Methods: We searched articles from Pubmed, Chinese Academic Journals (CAJ) and Oasis online databases. Searching keywords were ‘fumigation’, ‘atrophic vaginitis’, ‘vaginitis’, ‘阴道炎’, ‘膣炎’, ‘老年性 阴道炎’, ‘坐熏’, ‘熏洗’, ‘熏浴’, ‘좌훈요법’, ‘질염’, ‘위축성질염’. After searching the articles, we performed quality assessment using Cochrane risk of bias (RoB) tool. Results: Among the 142 articles were searched, 5 randomized controlled clinical trials (RCTs) were finally selected. All of 5 studies showed that fumigation treatment has significant effect on atrophic vaginitis in terms of the effectiveness rate, but 3 studies were not statistically significant. Conclusions: Our systematic review found encouraging but limited evidence of fumigation therapy for atrophic vaginitis. We recommend clinical trials which obtain stronger evidence without the demerits of trial design.

• 대한한방부인과학회지
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• 제29권4호
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• pp.34-45
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• 2016

Objectives: Atrophic vaginitis is common disease in menopausal women. There are some studies about effective of the Korean medicine therapies to treat this disease, but cases are still deficiency. This study aims to report the effects of Korean medicine therapies on atrophic vaginitis in menopausal women. Methods: 2 menopausal women patients, who are suffered from atrophic vaginitis, were enrolled in this study. They received Korean medicine therapies such as herbal medicine, moxibustion, and acupuncture. Results: After Korean medicine therapies, severity of symptoms of atropic vaginitis were reduced. Conclusions: The present study suggests that Korean medicine therapies have a effect on atrophic vaginitis in menopausal women.

• 대한한방부인과학회지
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• 제28권3호
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• pp.11-20
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• 2015

Objectives This study is performed to recognize the relationship between atrophic vaginitis and stress that have an affect on autonomic nervous system. Methods We studied 47 patients who visited Kangnam Kyunghee Korean Hospital Medical Examination Center from November, 2013 to June, 2014. They were devided into two groups, atrophic vaginitis group (AV, n=18) and non-atrophic vaginitis group (NAV, n=29). We compared the result of HRV between the two groups. Results The mean of The standard deviation of NN intervals (SDNN), the square root of the mean squared difference of successive NNs (RMSSD) in AV group was lower than NAV group, but there was no significant difference between the two groups. Total power (TP), low frequency (LF) and very low frequency (VLF) of AV group was significantly lower than NAV group. There was no significant difference in high frequency (HF). Conclusions Women with atrophic vaginitis is expected to have low adaptive capacity against stress.

• 대한한방부인과학회지
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• 제32권3호
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• pp.227-244
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• 2019

Objectives: To evaluate the effectiveness and safety of application of Traditional East Asian Herbal Medicine (TEAM) in the treatment of Atrophic Vaginitis (AV). Methods: Randomized Controlled Trials (RCTs) were obtained from PubMed, Cochrane Library, Embase, CNKI, RISS, NDSL, and KISS. The risk of bias was assessed by using Cochrane's risk of bias tool, and RevMan 5.3 software was used. Results: 26 RCTs with 3,162 patients were identified and reviewed. Among them, 21 RCTs observe the effect of integrated traditional Chinese and Western medicine. 23 RCTs reported treatment groups was statistically effective than control groups in the study. Also, the recurrence rate was estimated in 10 RCTs and was lower than control groups. 12 studies observed adverse events (AEs) and severe AEs were not reported. Conclusions: This review suggested that TEAM was safe and effective in the treatment of AV. TEAM may also decrease the recurrence rate. However, this could not be proven conclusively. To ensure evidence-based clinical practice, well-designed trials with larger sample sizes are needed.

• 대한한방부인과학회지
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• 제32권3호
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• pp.245-262
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• 2019

Objectives: The purpose of this study is to review clinical studies of traditional Korean medicine treatment (herb medicine) on vaginal atrophy. Methods: Key words "Vaginal atrophy", "Vulvovaginal atrophy", "Vaginal dryness", "Atrophic vaginitis", "Herb medicine", "Acupuncture", "Moxibustion", "Catgut embedding" were searched on 11 database systems (PMC, CENTRAL, EMBASE, CNKI, KTKP, KISS, NDSL, OASIS, DBpia, KMBASE, RISS) on May 31th 2019. In all searches, limits were set for MeSH (human) and language (English, Chinese or Korean). Results: 18 controlled clinical trials were collected in accordance with the selection and exclusion criteria. The types of intervention were herbal medicine, and types of herbal medicine were decoction, cream, suppository, oil, ect. The study results and methods of intervention were analyzed. Conclusions: Among the 18 trials, 5 studies showed that herbal medicine with hormone or antiprotozoal therapy was more effective than hormone or antiprotozoal therapy alone. And 2 studies showed that herbal medicine treatment was more effective than oil treatment of topical use. There was no abnormal vaginal bleeding, breast swelling and pain in TCM group.

• 대한한방부인과학회지
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• 제34권2호
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• pp.62-81
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• 2021

Objectives: The purpose of this study is to review clinical studies and evaluate effectiveness of intravaginal administration of oriental medicine on vaginal atrophy in menopausal women. Methods: 'postmenopause', 'menopause', 'vaginal atrophy', 'atrophic vaginitis', 'vaginal cream', 'vaginal gel', 'pessary', 'suppository' were searched on 3 online databases (Pubmed, Cochrane Library, OASIS). The risk of bias was assessed by using Cochrane risk of bias (RoB) 2.0 tool. Results: 9 randominized controlled trials (RCTs) were selected among 489 articles. The types of intervention were intravaginal administration of oriental medicine. 6 studies showed that treatment group was better than placebo control group or both treatment group and western medicine control group improved similarly. 2 studies were not significant effective in some results and 1 study was not statistically significant. Conclusions: Intravaginal administration of oriental medicine can be an effective option in treating menopausal women with vaginal atrophy. but considering the small number and low quality of studies, further well-designed studies are needed to confirm the effectiveness of this treatment.

• 정신신체의학
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• 제31권2호
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• pp.63-71
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• 2023

요실금의 유병률은 전세계적으로 남성에서 3~11%, 여성에서 25~45%에 달할 정도로 매우 흔한 질환이며, 향후 고령화 진행에 따라 요실금은 더욱 증가할 것으로 예상된다. 요실금은 환자와 가족의 삶의 질을 현저히 떨어뜨리고, 우울감, 스트레스, 자존감 저하를 유발한다. 기존에 정신과 질환을 앓고있는 환자에서 요실금이 새로 발생할 때 정신과적 증상 악화, 치료 순응도 저하, 치료 효과 반감 등에 영향을 줄 수 있어 유의가 필요하다. 요실금은 대부분 방광 저장능력의 결함으로 일과성, 만성 요실금으로 구분된다. 일과성 요실금은 가역적인 요실금으로 delirium, infection, atrophic urethritis/vaginitis, psychological disorders, pharmaceuticals, excess urine output, restricted mobility, stool impaction (DIAPPERS)이 대표적인 원인이다. 만성 요실금은 복압성, 절박, 혼합, 일류성 또는 범람, 기능성, 그리고 지속성 요실금으로 구분된다. 약물 유발 요실금은 일과성 요실금의 한 종류로 임상에서 흔히 볼 수 있으며 여러 가지 정신과 약제에 의해서도 유발될 수 있다. 항정신병 약제가 가장 대표적으로 알려졌으며, 비정형 항정신병 약제의 알파 아드레날린성 차단효과로 인한 요도 괄약근 근긴장도 저하, 항콜린성작용에 의한 요폐, 세로토닌 길항 효과로 인한 pudendal nerve 반사 저하, 심한 진정효과, 약물유발 당뇨, 경련 등 여러가지 메커니즘이 작용하는 것으로 추정된다. 리튬은 요실금과 관련된 증례가 보고된 사례는 미미하나 신성 요붕증으로 인한 일류성 요실금과 연관될 수 있고, 발프로산도 명확하지 않은 기전으로 야뇨증을 유발할 수 있다. 항우울제의 경우 SSRI는 세로토닌 경로와 배뇨근 활성에 영향을 줌으로써, SNRI와 TCA는 요저류를 유발함으로써 요실금을 일으킬 수 있다. 부프로피온과 멀타자핀도 드물지만 요실금 사례가 보고된 바 있다. 벤조디아제핀의 경우 방광의 근이완으로 요저류와 요실금을 모두 유발할 수 있으며 항치매제로 쓰이는 아세틸콜린 분해효소 억제제는 말초의 아세틸콜린을 증가시켜 요실금을 유발한다. 이렇듯 요실금은 여러 정신과 약제로 인하여 발생될 수 있으므로, 요로 증상을 면밀히 확인하여 약물 선택과 조절에 주의해야 하며, 요실금이 약물로 인한 것임이 밝혀졌을 경우 원인 약물의 중단, 감량 또는 분복 변경이 필요하며 약물치료로는 desmopressin, oxybutynin, trihexyphenidyl, amitriptyline을 추가해볼 수 있다.