• Korean Journal of Clinical Pharmacy
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• v.20 no.3
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• pp.229-234
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• 2010

섬유근통 증후군은 만성 전신 통증을 나타내며 피곤, 두통, 우울증, 수면장애 등을 동반하는 질환이다. 주로 30-50대의 여성에게서 많이 나타나며 미국에서 2-4%, 한국에서 2%의 발병률을 보이고 있다. 정확한 원인과 기전이 밝혀져 있지 않아서 진단과 치료에 많은 논란과 어려움이 있다. 현재는 증상치료에 목표를 두고 삼환계항우울약을 많이 사용하고 있으나 심각한 부작용의 문제가 있다. 이러한 문제 때문에 최근에는 selective serotonin reuptake inhibitor (SSRI) 또는 serotonin-norepinephrine reuptake inhibitor (SNRI)를 빈번히 사용하고 있다. 본 연구는 SNRI의 하나인 milnacipran의 섬유근통 증후군 치료에 대한 효능 및 안정성을 알아보기 위해, MEDLINE에 등재된 논문을 기한없이 milnacipran과 fibromyalgia로 검색하여 무작위 배정 및 이중맹검 임상연구자료들을 선별하였다. 선별된 6개의 임상연구 결과, milnacipran를 사용했을 때 일관된 효능성과 안정성이 관찰되었고 섬유근통증후군 치료와 그에 수반되는 여러증상에 효과적인 것으로 나타났다.

• Journal of TMJ Balancing Medicine
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• v.10 no.1
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• pp.32-36
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• 2020

This case is witten for presenting the effect of the yin-yang balancing therapy using the TMJ balancing appliance which normalizes the yin and yang balance of the brain-nervous system including the Meridian system. The balancing appliance was used in patient with fibromyalgia syndrome, and clinical outcome measurements were performed through clinical observations in specific movement and actions. The patient displayed positive changes after the treatment and the effect was well-maintained during the treatment period. For the more precise evaluation, clinical and biological studies of temporomadibular balancing therapy (TBT) are needed.

• The Korean Journal of Pain
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• v.30 no.4
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• pp.250-257
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• 2017

Vitamin D is a cofactor responsible for autoimmune disorders. There is no agreement in the studies investigating the association between vitamin D and fibromyalgia. This study aims to combine the conflicting results of the primary studies which compared these patients with control groups regarding the serum concentration of vitamin D. This meta-analysis has been designed based on PRISMA guidelines. Relevant keywords were searched in PubMed, Science direct, Scopus, Cochrane, and Google scholar and primary studies were selected. After screening the eligible studies according to inclusion/exclusion criteria, we investigated the risk of bias in the selected studies and also the heterogeneity between the primary results using Cochrane (Q) and I-squared ($I^2$) indices. The primary results were combined using inverse variance method and Cohen statistics as well as a random effects model. Publication bias was assessed using Egger test. Sensitivity analysis was applied to investigate the influence of each primary study on the final result of the meta-analysis. Suspected factors in the heterogeneity were assessed using meta-regression models. We entered 12 eligible studies in the meta-analysis including 851 cases compared with 862 controls. The standardized mean difference of Vitamin D between the two groups was -0.56 (95% confidence interval: -1.05, -0.08). Our meta-analysis showed that vitamin D serum levels of patients with fibromyalgia was significantly lower than that of control group.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1268-1277
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• 2019

Objective: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of functional dyspepsia in a fibromyalgia patient with a history of long-term NSAIDs use. Methods: The patient was diagnosed as a Soeumin, one of the four constitution types in Korean medicine, and treated with herbal medicines such as Seungyangikgibuja-tang and Pyeongjinsunjeom-san. Acupuncture and moxibustion treatment were also performed. The severity of symptoms was assessed using the Numerical Rating Scale (NRS) of epigastric pain, daily oral intake changes, the Korean Gastrointestinal Symptom Rating Scale (KGSRS), the Gastrointestinal Symptom Score (GIS), and the Functional Dyspepsia-Quality of Life (FD-QOL) score. Results: After treatment for 48 days, the severity of epigastric pain decreased from NRS 8 to NRS 0, and daily oral intake was increased. The KGSRS score decreased from 55 to 43, the GIS score was reduced from 18 to 10, and the FD-QOL score also decreased from 69 to 55. Conclusions: This study suggests that Korean medical treatment could be an effective option for treating functional dyspepsia in fibromyalgia patients with a history of long-term NSAIDs use.

• The Journal of Internal Korean Medicine
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• v.38 no.5
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• pp.797-805
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• 2017

Objectives: The purpose of this clinical case is to evaluate the efficacy of traditional Korean medicine as a treatment for fibromyalgia. Methods: The patient was treated with Korean medicine therapy (herbal medicine, acupuncture, pharmacopuncture, and Chu-na therapy). We measured the status and progress of this patient using a numerical rating scale (NRS), EuroQol-5D, range of movement (ROM), and a special test. Results: After the treatments, the patient's pain was controlled and the NRS score decreased. The overall symptoms of the patient and the EQ-5D score were both improved. The ROM and special test score were also improved. Conclusions: Traditional Korean medicine may have positive effects as a treatment for fibromyalgia.

• The Korean Journal of Pain
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• v.32 no.2
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• pp.120-128
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• 2019

Background: We aimed to explore the American College of Rheumatology (ACR) 1990 and 2011 fibromyalgia (FM) classification criteria's items and the components of Fibromyalgia Impact Questionnaire (FIQ) to identify features best discriminating FM features. Finally, we developed a combined FM diagnostic (C-FM) model using the FM's key features. Methods: The means and frequency on tender points (TPs), ACR 2011 components and FIQ items were calculated in the FM and non-FM (osteoarthritis [OA] and non-OA) patients. Then, two-step multiple logistic regression analysis was performed to order these variables according to their maximal statistical contribution in predicting group membership. Partial correlations assessed their unique contribution, and two-group discriminant analysis provided a classification table. Using receiver operator characteristic analyses, we determined the sensitivity and specificity of the final model. Results: A total of 172 patients with FM, 75 with OA and 21 with periarthritis or regional pain syndromes were enrolled. Two steps multiple logistic regression analysis identified 8 key features of FM which accounted for 64.8% of variance associated with FM group membership: lateral epicondyle TP with variance percentages (36.9%), neck pain (14.5%), fatigue (4.7%), insomnia (3%), upper back pain (2.2%), shoulder pain (1.5%), gluteal TP (1.2%), and FIQ fatigue (0.9%). The C-FM model demonstrated a 91.4% correct classification rate, 91.9% for sensitivity and 91.7% for specificity. Conclusions: The C-FM model can accurately detect FM patients among other pain disorders. Re-inclusion of TPs along with saving of FM main symptoms in the C-FM model is a unique feature of this model.

• The Journal of Churna Manual Medicine for Spine and Nerves
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• v.15 no.2
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• pp.43-54
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• 2020

Objectives The purpose of this review was to analyze the trend of clinical research related to fibromyalgia and to suggest the direction of intervention Methods We reviewed the clinical research by searching seven Korean web databases and classified the studies by the year of publication, academic field, and study design. Results A total of 75 clinical studies were selected. Except for 2002, more than one study was annually published; however, the number was below 10. In the academic field, there were 34 in the medical field, 21 in the Korean medicine field, and 15 in the nursing science field. By study design, there were 62 observational studies, mostly case reports and case-control studies. There were 13 experimental studies, including non-random control studies and one group pre and post-test design studies. Conclusions Fibromyalgia-related clinical research requires a greater number of studies, and a study design with a high level of evidence should be conducted along with various observational and intervention studies. Additionally, multidisciplinary and integrated intervention plans and research are needed.

• The Journal of Internal Korean Medicine
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• v.42 no.2
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• pp.215-223
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• 2021

Objectives: The purpose of this study is to report the effects of Korean medicine treatment, including Onkyung-tang, on fibromyalgia. Methods: The patient was treated with herbal medicine, acupuncture, pharmacopuncture, and chuna manual therapy for 13 days. To evaluate the improvements, we used a numeric rating scale (NRS), the American College of Rheumatology Preliminary Diagnostic Criteria (ACR), the neck disability index (NDI), and the Oswestry disability index (ODI). Results: After treatment, the scores for the NRS, ACR, NDI, and ODI all decreased compared with baseline. Conclusion: This study suggests that Korean medicine treatment that includes Onkyung-tang can be effective in reducing pain and increasing ability to function in patients with fibromyalgia.

• The Korean Journal of Pain
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• v.35 no.3
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• pp.327-335
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• 2022

Background: The pathophysiology of fibromyalgia (FM) involves many mechanisms including central nervous system sensitization theory, autonomic nervous system (ANS) dysfunction, and recently small fiber neuropathy. While the small fiber neuropathy itself can cause ANS dysfunction and neuropathic pain (NP), it is still unknown whether ANS problems have an association with severity of disease and NP in patients with FM. The aim of this study was to evaluate ANS dysfunction in FM patients and to explore possible associations of ANS dysfunction with disease severity and NP. Methods: Twenty-nine FM patients and 20 healthy controls were included in this cross-sectional study. Participants were tested using sympathetic skin responses (SSR) and R-R interval variation analyses for sympathetic and parasympathetic ANS dysfunction, respectively. Disease severity and somatic symptoms of patients with FM were evaluated using the ACR-2010 scales and Fibromyalgia Impact Questionnaire, and NP symptoms were evaluated using the Pain Detect Questionnaire and Douleur Neuropathique questionnaire. Results: FM patients were found to have ANS dysfunction characterized by increased sympathetic response and decreased parasympathetic response. SSR amplitudes were found to be correlated with a more severe disease. Although nonsignificant, NP severity tended to be associated with a decrease in sympathetic and parasympathetic activities. Conclusions: ANS dysfunction may play a role in the pathophysiology of FM. The trend of decreased ANS functions in FM patients exhibiting NP contradicts the notion that FM is a sympathetically maintained NP and may be explained with small fiber involvement.

• The Journal of Internal Korean Medicine
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• v.45 no.2
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• pp.131-139
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• 2024

In this case report, we describe the effects of Korean Medicine therapies, including Bunshimgi-eum, on a patient hospitalized with insomnia due to fibromyalgia in a Korean Medicine Hospital. We treated the patient with Bunshimgi-eum for 21 of 27 hospital days. Post-treatment, we used the Insomnia Severity Index (ISI) to measure the severity of insomnia. To determine the severity of multiple pain, including neck, low back, Lt. shoulder, Lt. elbow, Rt. knee, and hand, we used the Numerical Rating Scale (NRS). For evaluation of generic health status, we used the European Quality of Life-5 Dimensions (EQ-5D) scale. After the treatment, the patient's clinical symptoms improved, according to the ISI, NRS, and EQ-5D. The results of this case study suggest that Korean Medicine therapies, including Bunshimgi-eum, may have positive effects as a treatment for insomnia related to fibromyalgia.