• 대한한방내과학회지
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• 제40권3호
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• pp.295-311
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• 2019

Objectives: This research aimed to investigate Chinese clinical studies on the treatment of central post-stroke pain (CPSP) and thalamic syndrome after stroke with traditional herbal medicine (THM). Methods: Randomized controlled trials verifying the effects of herbal medicine on treating CPSP and thalamic syndrome after stroke were included in the study. Electrical and hand search were conducted in the China National Knowledge Infrastructure (CNKI), National Discovery for Science Leaders (NDSL), Research Information Sharing Service (RISS), Oriental Medicine Advanced Searching Integrated System (Oasis) for CPSP and thalamic syndrome after stroke. A literature search was performed in the Chinese and Korean databases for papers published from January 1, 2010 to October 1, 2018. The selected literature was assessed by Cochrane's risk of bias. Results: Twelve reports on randomized controlled trials met the inclusion criteria from the 227 identified reports. Effective rate, comparison of visual analogy scale, present pain intensity, pain grading index, recurrence rate, follow-up, and a 36-item short form survey instrument were used to evaluate the treatments. The effective rate of the treatment group was significantly higher than that of the control group in all papers. Side effects occurred less frequently in the treatment group than in the western medicine control group. Conclusions: The treatment of CPSP and thalamic syndrome after stroke with THM was shown to be highly effective. Additional well-designed clinical trials are needed. This study can be used as a basis for further research on the treatment of CPSP and thalamic syndrome after stroke.

• 대한물리의학회지
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• 제12권2호
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• pp.83-90
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• 2017

PURPOSE: Central post-stroke pain (CPSP), a chronic pain condition of stroke patients, can impair activities of daily living and worsen the quality of life (QOL), thereby negatively influencing the rehabilitation process. However, CPSP remains an underestimated complication of stroke. This study aimed to describe the prevalence and types of new-onset chronic pain and to identify the relation between pain and QOL in stroke patients. METHODS: All patients hospitalized because of a diagnosis of stroke were included. Questionnaire was used. Pain intensity was measured using Numerical rating scale (NRS), and pain characteristics were assessed using DN4. QOL was measured using SF-36. Descriptive statistics were used to analyze the characteristics and pain data, and chi-square test was used to compare QOL categorical data between the nociceptive and neurological pain groups. RESULTS: CPSP development was reported by 34% of the post-stroke pain patients. Perceived QOL was low in both groups, especially with respect to the physical functioning, bodily pain, physical-role functioning, emotional-role functioning, and mental health domains. However, no significant difference was observed in QOL between the nociceptive and neurological pain groups (p<.05). CONCLUSION: Our results indicated that CPSP is a common and disabling complication that is difficult to treat, often decreases QOL, and may negatively affect rehabilitation treatment.

• The Korean Journal of Pain
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• 제31권3호
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• pp.155-173
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• 2018

Chronic postsurgical pain (CPSP) is an unwanted adverse event in any operation. It leads to functional limitations and psychological trauma for patients, and leaves the operative team with feelings of failure and humiliation. Therefore, it is crucial that preventive strategies for CPSP are considered in high-risk operations. Various techniques have been implemented to reduce the risk with variable success. Identifying the risk factors for each patient and applying a timely preventive strategy may help patients avoid the distress of chronic pain. The preventive strategies include modification of the surgical technique, good pain control throughout the perioperative period, and preoperative psychological intervention focusing on the psychosocial and cognitive risk factors. Appropriate management of CPSP patients is also necessary to reduce their suffering. CPSP usually has a neuropathic pain component; therefore, the current recommendations are based on data on chronic neuropathic pain. Hence, voltage-dependent calcium channel antagonists, antidepressants, topical lidocaine and topical capsaicin are the main pharmacological treatments. Paracetamol, NSAIDs and weak opioids can be used according to symptom severity, but strong opioids should be used with great caution and are not recommended. Other drugs that may be helpful are ketamine, clonidine, and intravenous lidocaine infusion. For patients with failed pharmacological treatment, consideration should be given to pain interventions; examples include transcutaneous electrical nerve stimulation, botulinum toxin injections, pulsed radiofrequency, nerve blocks, nerve ablation, neuromodulation and surgical management. Physical therapy, cognitive behavioral therapy and lifestyle modifications are also useful for relieving the pain and distress experienced by CPSP patients.

• 한국음향학회:학술대회논문집
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• 한국음향학회 2004년도 추계학술발표대회논문집 제23권 2호
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• pp.35-38
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• 2004

In this paper, we investigate and analyze the problems encountered in frame-based estimation of TDOA(Time Difference of Arrival) using CPSP function. Spectral leakage occurring in framing of a speech signal by a rectangular window makes estimation of CPSP spectrum inaccurate. Framing with a Hamming window to reduce the spectral leakage effect distorts the signal due to the different weighting at temporally same sample, which make the TDOA estimation using CPSP function inaccurate. In this paper, we solve this problem by reducing the dynamic range of the spectrum of a speech signal with preemphasis. Experimental results confirm that the framing of pre-emphasized microphone output with a rectangular window shows higher success ratio of TDOA estimation than any other framing methods.

• 대한상한금궤의학회지
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• 제12권1호
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• pp.127-135
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• 2020

Objective: In this case report, we aimed to determine the effect of Kyejigadahuang-tang on central post-stroke pain (CPSP). Methods: A 42-year-old woman presented with whole-body neuralgia due to CPSP. According to the diagnostic system based on Shanghanlun provisions (DPIDS), the patient was treated with Kyejigadahuang-tang. The results were evaluated using the Numeric Rating Scale (NRS) and Korean Neuropathic Pain Questionnaire (KNPQ). Results: After administration of Kyejigadahuang-tang for 30 days, the NRS score decreased from 8.5 to 3 and the KNPQ score decreased from 151 to 51. Conclusions: The patient completely recovered from CPSP following treatment with Kyejigadahuang-tang according to DPIDS.

• 대한비뇨기종양학회지
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• 제16권3호
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• pp.126-134
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• 2018

Purpose: The purpose of this study is to compare the radiation therapy (RT) and radical prostatectomy (RP) of high-risk or locally advanced prostate cancer (PC) patients after neoadjuvant hormonal therapy (NHT). Materials and Methods: This retrospective study evaluated patients underwent RT (42 patients) or RP (152 patients) after NHT at a single center during 2003-2014. Times to biochemical recurrence (BCR), pelvic local recurrence (PLR), metastasis, clinical painful symptom progression (CPSP), castration-resistant PC (CRPC), and overall survival were compared between the RT and RP groups, after adjustment for TN stage, using the Kaplan-Meier method and log-rank test. Results: Significant inter-group differences were observed for age, Gleason score, initial PSA, and clinical and pathological T stages (all p<0.05). During a median follow-up of 71.7 months, the overall incidences of BCR, PLR, metastasis, CPSP, CRPC, and death were 49.5%, 16.5%, 8.3%, 7.7%, 7.7%, and 17.5%, respectively. The median times to BCR were 100 months for RT and 36.2 months for RP (p=0.004), although the median times were not reached for the other outcomes (all p>0.05). The independent predictor of CPSP was RP (hazard ratio, 0.291; p=0.013). Conclusions: Despite significantly different baseline parameters, RP provided better CPSP-free survival than RT among patients with localized high-risk or locally advanced PC.

• 대한한방내과학회지
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• 제42권5호
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• pp.893-903
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• 2021

Objectives: This study investigated the efficacy of Korean medical treatment for a headache (suspected CPSP) patient with a history of cerebral infarction. Methods: We treated the patient using Korean medical treatments (herbal medicines-Kamiseokyong-tang, acupuncture, pharmacopuncture, and chuna). The treatments were measured using the Numerical Rating Scale (NRS) and the Neck Disability Index (NDI) for headache and post neck pain. General health status was evaluated using the European Quality of Life Five Dimensions (EQ-5d) Scale. Results: We observed improvements in the NRS, NDI, and EQ-5d scores after the treatments. Conclusions: This study suggests that Korean medicine may effectively treat headaches (suspected CPSP) with accompanying cerebral infarction.

• Journal of Acupuncture Research
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• 제20권2호
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• pp.42-49
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• 2003

Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP patients who were treated with eletroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain form stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from $7.7{\pm}1.7$ to $4.4{\pm}2.0$ with pain treatment(p<0.05). In accordance with improvement of ain scores, RS and MBI scores ere also improved from $2.88{\pm}0.95$ to $2.13{\pm}1.01$ and from $83.0{\pm}16.9$ to $94.7{\pm}9.5$(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.

• 대한한방내과학회지
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• 제45권2호
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• pp.246-258
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• 2024

This case report describes a patient diagnosed with central post-stroke pain (CPSP) and hemiparesis due to anterior cerebral artery and middle cerebral artery infarction. The patient was treated with Korean medicines, including moxibustion, acupuncture, electroacupuncture, herbal medicine, Western medicine, and rehabilitation therapy for 67 days. CPSP improved based on scores on the Numeric Rating Scale (NRS) (from 8 to 0), paresthesia NRS (7 to 0), Manual Muscle Test (4/1 to 4+/4-),4+/4-), Korean version of the modified Barthel Index (24 to 73), National Institute of Health's Stroke Scale (7 to 0), Global Deterioration Scale (1 to 1), and Korean version of the Mini-Mental State Examination (27 to 29). No seizures, shocks, recurrent ischemic stroke, and liver dysfunction were recorded during the treatment. A moxibustion-induced burn healed within 7 days. This case suggests that moxibustion, combined with other treatments, has the potential to improve CPSP, without severe side effects.

• 대한약침학회지
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• 제4권2호
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• pp.95-103
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• 2001

Background : Central poststroke pain(CPSP) can occur as a result of lesion or dysfunction of the brain from stroke and may cause many difficulty in the social activities and daily life. In this study, we evaluate the clinical effectiveness of east-west medical management for CPSP through VAS(visual analogue scale), infrared themography, MBI(Moderfied Barthel Index) and Rankin scale. Methods : We treated thirty patients with oriental medical treatment method and western & oriental medical treatment method. Each group has fifteen patients of the CPSP. We evaluated their pain(characterizes tingling and burning sensation, aching, hyperalgesia, and allodynia) through VAS(visual analog scale) pain score, the skin temperature of pain site by infrared thermography and assessed their mobility & rehabilitation ability through MBI(Moderfied Barthel Index), Rankin scale before and after pain treatment. Results : The skin temperature of pain site was lower than non-pain site. The difference of skin temperature improved from $0.65{\pm}0.45^{\circ}C$ to $0.39{\pm}0.25^{\circ}C$ after oriental medical treatment and $0.68{\pm}0.54^{\circ}C$ to $0.27{\pm}0.24^{\circ}C$ after western & oriental medical treatment VAS scores improved from $7.9{\pm}1.4$ to $4.7{\pm}1.6$ after oriental medical treatment and $8.1{\pm}1.3$ to $4.6{\pm}1.2$ after western & oriental medical treatment. MBI scores improved from $61.40{\pm}13.58$ to $85.00{\pm}13.85$ after oriental medical treatment and $52.26{\pm}13.52$ to $77.13{\pm}12.04$ after western & oriental medical treatment. And Rankin scale scores improved from $3.33{\pm}0.72$ to $2.46{\pm}0.74$ after oriental medical treatment and $3.60{\pm}0.82$ to $2.66{\pm}0.81$ after western & oriental medical treatment Conclusion : The difference of skin temperature and Rankin scale scores more significantly improved after western & oriental medical treatment than oriental medical treatment. According to the results, we thought east-west medical management is very useful treatment for CPSP and rehabilitation of the patients with stroke.