• 대한한방내과학회지
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• 제42권5호
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• pp.1082-1093
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• 2021

Objective: Alzheimer's disease is characterized by progressive, irreversible brain damage and cognitive decline. Although the diagnosis and treatment of the prodromal symptoms of dementia are important, no treatment for mild cognitive impairment has been currently established. Herein, we report the case of an 80-year-old female patient with memory complaints treated with Gugijihwang-tang, a traditional Korean medicine herbal formula, as an add-on medication. Case Presentation: The patient was diagnosed with mild cognitive impairment based on clinical examinations using the Mini-Mental State Examination (MMSE), the Consortium to Establish a Registry for Alzheimer's Disease (CERAD), Activities of Daily Living (ADL) Scale, Global Deterioration (GDR) Scale, and Clinical Dementia Rating (CDR) Scale. She was treated with Gugijihwang-tang bis in die for 12 months while continuing her original medications, including 5-mg donepezil and 590-mg acetyl-l-carnitine. The MMSE score in the Korean Version of the CERAD Assessment Packet increased from 21 to 27 during the 12-month treatment period, and the CERAD 2 score increased from 33 to 62. The instrumental ADL scale score improved from 11 to 5. Other clinical examination results also showed improvement. The patient was satisfied and experienced no significant adverse events related to the Gugijihwang-tang treatment. Conclusion: This case suggests that Gugijihwang-tang could be considered as a treatment method for patients with mild cognitive impairment.

• 재활치료과학
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• 제2권1호
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• pp.66-76
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• 2013

목적 : 본 연구는 주간보호시설을 이용하는 치매노인의 욕구 및 제한점을 파악하고 목표 설정을 하고자 함이다. 연구방법 : 주간보호시설 이용 치매노인 1명을 대상으로 2012년 5월 1일부터 5주에 걸쳐 주 2회 정기적으로 30여 분간 심층 면담 및 평가를 실시하였다. 인간작업모델을 기반으로 한 작업질문지(Occupational Questionnaire; OQ)와 여가활동평가(Interest checklist; IC), 의욕조사표(Volitional Questionnaire; VQ), 의사소통과 상호작용기술평가(The Assessment of Communication and Interaction Skills ACIS), 작업수행 일생 면담II(Occupational Performance History Interview-II OPHI-II), 자가작업평가(Occupational Self Assessment OSA), 작업환경 평가면담과 등급화(The Occupational Circumstances Assessment Interview and Rating; OCAIR)를 대상자에게 실시하였다. 또한 대상자의 사례관리자와 보호자 각 1명씩을 대상으로 직 간접적인 면담을 시행하였다. 결과 : 인간작업모델을 적용하여 면담 및 평가를 실시한 결과 사회와 가족관계형성과 재 정 문제, 전반적인 행복에 제한이 있는 것으로 파악되었다. 결론 : 본 연구의 결과를 통해 치매노인을 대상으로 인간작업모델을 적용하여 전인적으로 판단 할 수 있었으며 대상자를 바라보는 새로운 관점과 해결방안을 제시가능 하였다. 이를 통해 작업치료의 질 향상과 서비스의 영역을 확대하는데 기여할 것이다.

• 동의신경정신과학회지
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• 제34권4호
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• pp.473-485
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• 2023

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative-hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale-Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

• 동의신경정신과학회지
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• 제32권2호
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• pp.81-93
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• 2021

Objectives: Mild cognitive impairment (MCI) is condition of cognitive decline shown in transition from normal aging to dementia. Hominis placenta pharmacopuncture (HPP) is a treatment that combines effects of medication and acupuncture by injecting Hominis placenta into acupoints. The objective of this study was to evaluate the efficacy and safety of HPP for MCI. Methods: This was a randomized, double-blind, placebo-controlled, two-center clinical trial. Eligible patients were randomly allocated to either the HPP group or the placebo group. HPP or saline as placebo was administered to participants for eight weeks. Changes in symptoms were observed. The primary outcome was difference in mean change of Korean Version of the Montreal Cognitive Assessment (MoCA-K) score between the HPP group and the placebo group. Cognitive function, overall status of mood and sleep, and quality of life (QoL) were also assessed. Safety assessment and economic analysis were then conducted. Results: Thirty participants were enrolled. One participant in the placebo group dropped out. The score of MoCA-K increased after treatment. Its mean change was smaller in the HPP group than in the control group. HPP ameliorated Global Deterioration Scale and Korean Dementia Rating Scale subtests for attention, organization, and memory compared to the placebo. However, none of them was significantly different between the two groups. Mood, sleep, and QoL all improved more in the HPP group than in the placebo group, although differences between the two groups were not statistically significant. There was no adverse event probably related to the drug. HPP treatment needed KRW 345,000 more than the placebo group in improving Geriatric Quality of Life scale-Dementia score by one point for one year. Conclusions: Although HPP treatment did not significantly improve cognition, it changed behavioral and psychological symptoms in MCI.

• 정신신체의학
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• 제22권1호
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• pp.23-30
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• 2014

연구목적 호모시스테인은 인지기능의 손상과 다양한 정신과 증상들과 연관되어 있다. 본 연구는 혈중 호모시스테인 농도와 치매의 행동심리증상 사이에 연관성을 검증하기 위해서 시행되었다. 방법 DSM-IV에 의해 알쯔하이머형 치매로 진단된 환자 41명의 혈중 호모시스테인, 엽산, 비타민 $B_{12}$ 농도를 측정하였다. 그리고 병력청취, 신체검사와 간이정신상태기능검사(MMSE), 전반적 퇴화척도(GDS), 임상치매 평가척도(CDR), 한국형 신경정신행동검사(K-NPI)를 수행하였다. 결과 호모시스테인 농도와 NPI 총 점수 사이에 통계적으로 유의한 양의 상관관계가 관찰되었고 망상, 초조/공격성, 우울/불쾌, 들뜸/흥분과 같은 여러 하위항목과도 양의 상관관계가 관찰되었다. 호모시스테인 농도와 MMSE, GDS, CDR 점수 사이에는 유의한 상관관계가 관찰되지 않았다. 결론 본 연구는 혈중 호모시스테인 농도가 치매의 행동심리증상과 연관되어 있음을 보여준다. 추가적인 연구를 통하여 이와 연관된 병태생리학적 기전을 밝히는 것이 필요하다.

• 대한간호학회지
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• 제29권4호
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• pp.766-779
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• 1999

The purpose of this study was to investigate the relationship between the burden on families who live with an elderly person suffering from senile dementia, and the degree of their depression. There were 400 participants in this study, staying in the Seoul and Kyonggi areas from August 1, 1997 to February 28, 1998. Among the group, 100 participants took care of their patient at home, and another 300 participants left 100 patient at a day-care center, 100 sanatorium for senile dementia(asylum for helpless elderly people), 100 an infirmary for elderly people. Eventually 242 subjects out of the 400 were selected for the data analysis. The Zarit (1980) tool was employed to measure the degree of burden and Zung's(1965) “Self-Rating Depression Scale” was employed for the data analysis. The data was analyzed, and the percentage, t-test, ANOVA and Person's Correlation Coefficient were calculated. The results are as follows : 1. The average degree of burden that care-giving families felt was 49.13, which is somewhat high. 2. The average degree of depression that care -giving families felt was 51.95, which is relatively high. 3. The degree of burden was directly affected by the relation with the patient(F＝2.48, P＜.05), and the socio-economic status of the family(F＝5.17, P＜.05). Its also affected by the patient's educational status(F＝2.17, P＜.05). 4. The degree of depression of the family was significantly dependent on sex(t＝-2.05, P＜.05), age (F＝2.99, P＜.05), the relationship with the patient(F＝3.65, P＜.01), socio-economic status (F＝7.74, P＜.001), occupation(t＝2.82, P＜.01), health status(F＝4.42, P＜.01), and the place of residence(F＝4.30, P＜.01), The patient characteristics was significantly dependent on his/her educational status(F＝3.85, P＜.01), the period of suffering from senile dementia(F＝2.47, P＜.05), and smoking habit(F＝6.17, P＜.001). 5. The relationship between the degree of burden and that of depression reads r＝0.43, which is statistically positive correlation in the high significant level. Upon analyzing the entire summation, most care-givers for elderly patients suffering from senile dementia lack time in caring for themselves. They also experience chronic fatigue and mental discomfort caused by the isolation from society, curtailment of certain activities, a sense of responsibility for their patients, and limits of their endurance in taking care of their patients over time. In conclusion, this study emphasizes the necessity for the following propositions : 1. In order to measure the degree of burden that Korean care-giving families undergo, a new tool must be developed on the basis of Korean culture. 2. An educational program based on the demands that care-giving families undergo must be developed, and its clinical effect also has to be examined.

• 정신신체의학
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• 제22권2호
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• pp.71-78
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• 2014

연구목적 알츠하이머병 환자들의 행동심리증상(BPSD)은 임상적인 문제들을 일으켜 결국 기능의 감퇴, 간병인 스트레스, 입원, 사망률의 증가를 가져온다. 최근의 연구는 성별차이가 BPSD에서 중요한 역할을 한다고 보고하고 있으나, BPSD와 성별 사이 연관에 대한 국내 연구는 시행된 적이 없었다. 이에 본 연구는 알츠하이머병 환자들의 BPSD가 성별 차이에 의해 영향을 받는 것인지를 검증해 보고자 실시하였다. 방 법 면담과 인지기능평가를 통해 DSM-IV 진단기준에 의하여 알츠하이머병으로 진단받은 98명의 환자들이 본 연구에 참가하였다. 간이정신상태검사(MMSE), 임상치매평가척도(CDR), 전반적 퇴화척도(GDS), 한국형 신경정신행동검사(K-NPI)를 사용하여 인지기능 및 BPSD를 평가하였다. 성별 차이를 확인하기 위해서 독립 t 검증을 사용하여 분석하였으며, MMSE, CDR, GDS와 NPI 사이의 관련성을 살펴보기 위해 피어슨 상관분석을 사용하였다. 결 과 알츠하이머병 환자들의 BPSD에서 통계적으로 유의미한 성별 차이는 관찰되지 않았다. MMSE와 NPI 총점, 그리고 NPI 하위영역인 환각과 유의한 상관관계를 보였으며, CDR의 경우 NPI 총점, 무감동/무관심, 과민/불안정과, GDS의 경우 NPI 하위영역인 환각과 유의한 상관관계를 나타내었다. 결 론 본 연구결과 우리나라 알츠하이머병 환자들의 BPSD에서 성별의 차이는 나타나지 않았지만, 추후 알츠하이머형 치매의 BPSD가 성별 차이에 의한 것인지 혹은 개인 차에 의한 것인지를 더 명확하게 밝혀내기 위한 광범위하고 지속적인 연구가 필요할 것으로 생각된다.

• 정신신체의학
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• 제24권1호
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• pp.94-101
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• 2016

연구목적 본빈혈은 노인 환자들에서 흔한 내과적 문제이다. 최근 연구는 빈혈이 인지기능 저하 및 알츠하이머병 치매와 연관성이 있다고 보고되고 있다. 본 연구는 한국 노인들에서 헤모글로빈 농도와 알츠하이머병 치매 및 경도 인지기능 장애와의 연관성에 대해 연구하기 위해 실시되었다. 방 법 116명의 대상자들이 본 연구에 참여하였다(평균 연령 : 74.67세, 여성 : 60.3%). 한국판 간이정신상태검사(MMSE-K), 임상치매평가척도(CDR), 전반적 퇴화척도(GDS)를 사용하여 대상자들을 평가하였고, 혈액학적 검사를 실시하였다. 결 과 알츠하이머병 치매 환자들이 경도인지장애군과 정상군에 비해서 유의미하게 낮은 헤모글로빈 농도와 적혈구 용적율을 가진다는 것이 관찰되었다. 헤모글로빈 농도는 MMSE-K와 양의 상관관계를 나타내었으며, overall CDR 및 GDS와는 음의 상관관계를 보였다. 결 론 한국 노인들에서 낮은 헤모글로빈 농도는 인지기능손상과 연관이 있는 것으로 나타났다. 본 연구 결과 알츠하이머병 치매는 빈혈과 연관이 있었으며, 이를 통해 낮은 헤모글로빈 농도가 알츠하이머병의 유용한 임상적 표지자로서 의미를 가지고 있다고 생각해 볼 수 있겠다. 치매에 대한 위험 요소는 더 광범위한 환자 군에서 전향적 종단 연구에 의해 확인하는 것이 필요하겠다.

• 대한한방내과학회지
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• 제44권2호
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• pp.187-196
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• 2023

Objective: This case study reported the effectiveness of adjuvant Korean therapy on gait disturbances induced by drug-induced Parkinsonism. Method: A patient suffering from frontotemporal lobe dementia was diagnosed with drug-induced Parkinsonism and treated with adjuvant Korean therapy, including herbal medicine and pharmaco-acupuncture. The evaluation was performed by monitoring the length of time and number of steps during an 8 m gait, using the Unified Parkinson's Disease Rating Scale (UPDRS). Results: After 17 days of adjuvant Korean therapy, the UPDRS score improved from 32 to 16. The length of time for the 8 m gait improved from 20 seconds to 14 seconds. The patient also showed a decrease in the number of steps during the 8 m gait from 43 to 22. Conclusion: This case suggests that adjuvant Korean therapy can be effective for drug-induced Parkinsonism.

• 동의신경정신과학회지
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• 제13권1호
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• pp.117-125
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• 2002

Objectives: The purpose of this study was to investigate the clinical application of oriental medical therapy to a patient with memory disorders and quadriparesis caused by traffic accident. Methods: This study was carried out on a patient who was admitted to the Sangji oriental medical hospital, from January 21st in 2002 to May 2nd in 2002. We used 4 kinds of diagnosis(watching, asking, hearing, and toughing) and treated the patient with herbal medication and acupuncture therapy. Then we estimated the effect of memory disorders through MMSE-K(Mini mental State Examination-Korea) and K-DRS(Korean-Dementia Rating Scale). The numerical effect demonstrated ability of movement through range of motion. Results: Following the treatment the patient's mental state and the ability of movement improved. Conclusions: The present results suggest that oriental medical therapy has the positive effects on a patient with memory disorders and quadriparesis which were caused by traffic accident.