• Journal of Acupuncture Research
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• 제25권4호
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• pp.95-103
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• 2008

Objectives : This study was to investigate the regulatory effect of electro-acupuncture on Jogsamni ($ST_{36}$) in bradygastric condition or gastroparesis which is a neuropathic complication of type 2 diabetes mellitus(T2DM), assessed using 4-channel electrogastrography (EGG). Methods : It was a case series study. Each patient was given electro-acupuncture(EA) one point, Jogsamni($ST_{36}$) or Gyeonu($LI_{15}$) bilaterally for thirty minutes with 2Hz bipolar square wave frequency and moderate intensity of stimulation. With attaching electrodes around stomach region throughout pre-acupuncture, acupuncture, and post-acupuncture session, these parameters were produced; percent rate of bradygastria power compared to sum of power in all kind of gastric rhythm(% bradygastria), dominant frequency(DF) and dominant power(DP). Parameter was analysed per each channel's variable change from pre-acupuncture session by paired t-test. Results : There was statistically significant decrease in % bradygastria parameters on one of the $ST_{36}$ treated patients from pre-acupuncture session and to post-acupuncture session(P=0.015, P=0.008 respectively). A marginal significant decrease of DP was shown in the other $ST_{36}$ treated patient from pre-acupuncture session through post-acupuncture session(P=0.049). Combined data of two $ST_{36}$ Treated patients showed that there was significant decrease of %bradygastria from pre-acupuncture session to acupuncture session(P=0.020), and was decrease of DP from pre-acupuncture session to post- acupuncture session(P=0.020). Conclusions : EA at $ST_{36}$ resulted in statistically significant decrease in %bradygastria and DP for dysrhythmic condition in T2DM gastroparesis patients. Considering this limited results, further study will be needed to elucidate the effect of multiple-acupuncture on gastric myoelectrical activities.

• Annals of Clinical Neurophysiology
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• 제3권1호
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• pp.43-46
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• 2001

Acute pandysautonomic neuropathy(APN) is an uncommon clinical entitiy involving vasomotor, sudomotor, pupilomotor, secretomotor and other autonomic systems. Both sympathetic or parasympathetic fibers are involved with relative preservation of somatic sensory and motor function. Although APN shares several clinical features with GBS, it is not clear whether APN is a subvariety of GBS. We report two young patients with APN. Patient 1 was a 18-year-old girl with recurrent fainting spells. Patient 2 was a 23-year-old man sufferring from unexplained nausea and vomiting. Both had a history of previous upper respiratory infection. They presented with gastroparesis, anhydrosis and orthostatic hypotension. Mild numbness and tingling sense was present, but motor power was intact. Neurologic examination showed bilateral tonic pupil, decreased pain and vibration sense, and absent tendon reflexes. Nerve conduction study indicated diffuse sensorimotor polyneuropathy. Nerve biopsy in patient 2 revealed axonal degeneration. After conservative management, gastrointestinal symptoms were improved in patient 2, however, patient 1 suffered from the symptoms lasting more than several months. These cases suggest that post-infectious dysautonomic symptoms in young patient may indicate the diagnosis of APN. Although the natural course is generally benign, accurate diagnosis and proper management may be mandatory for the better clinical outcome.

• 대한한방내과학회지
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• 제34권2호
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• pp.147-154
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• 2013

Objectives : The aims of this study was to find out whether Jichul-hwan (JCH) extract has an effect on gastric contractility in conscious rats by using a force transducer implanted in the body of the stomach. Methods : The force transducer (model: F-081S, Starmedical, JAPAN) was implanted to the exterior wall of the stomach body in rats. The gastric contractility was measured 30 minutes before and after administration of JCH (110.1 mg/kg). The control group was administrated with normal saline instead of JCH to compare the effect of JCH. The gastric contractility of the control group (normal saline: NS) was also measured 30 minutes before and after administration of NS. Results : The ratio of gastric contractility between before and after medication by JCH was $1.707{\pm}0.731$, and with NS was $0.701{\pm}0.541$. The gastric motility increased by JCH was significantly higher than NS. Conclusions : JCH extract increases gastric contractility in conscious rats. We could expect that this drug would be effective in the treatment of functional dyspepsia or post-surgical gastroparesis.

• 대한한방내과학회지
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• 제29권1호
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• pp.67-79
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• 2008

Backgrounds & Objectives : The aims of this study were to observe how morphology was changed and whether gastric motility was impaired in streptozotocin(STZ)-induced diabetic rats(DR), and whether Yijin-tang(YJT) was able to restore their impaired gastric motility. Methods : We investigated the change of body weight, feed intake and blood glucose between normal rats (NR) and DR for 12 weeks after induction of diabetes. At the time of 12 weeks after induction of diabetes, gastric surface area, gastric slow wave and gastric emptying rate were measured. Results : Decreased body weight, increased feed intake and increased gastric surface area were observed in DR, compared with NR. The percentage of normogastria decreased but that of bradygastria increased in DR, compared with NR. YJT 90mg/kg had no effect on the correction of gastric slow wave. YJT 90mg/kg and 270mg/kg had a significant effect on improvement of gastric emptying, more than normal saline (NS) in both NR and DR but the gastric emptying rate of DR was significantly lower than that of NR when YJT 90mg/kg and YJT 270mg/kg were administered. Conclusions : We can expect that administration of YJT would be effective on the improvement of gastric emptying and upper gastrointestinal symptoms as a juvantia.

• 혜화의학회지
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• 제10권1호
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• pp.157-166
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• 2001

Oryoungsan which first recorded in Sanghanron, the clinical medical book consists of treating acute febrile disease according to its change, is one of the frequently used oriental medicines. these days, it has been prescribed in symptoms accompanied by edema mostly. therefore it is easy to consider it as a type of diuretics. In Sanghanron it was originally used in the symptoms of perspiration, decreased urine volume, thirsty, flatulence. these symptoms indicate loss of body fluid and the prescription which orders "taking warm water sufficiently" supports this. On this background, it is supposed that Oryoungsan treats dehydration after providing water and electrolytes. To consider that herbal medicines consisted of Oryoungsan make electrolytes go out of the body, The healing mechanism of dehydration doesn't meet this. Because Oryoungsan was used in condition of fever or in similar condition, it is more resonable to understand that restoration of increasing blood flow to the subcutaneous venous plexus regulating body temperature in febrile condition into body circulation, resulting into maintaining main blood volume and into treating decreased urine volume and thirsty is Oryoungsan's function in the dehydration or febrile condition. That is, symptoms are decreased or disappeared through restoring unbalance of internal body fluid. The other target is pain controls, especially chronic headache, facial pain and trigeminal neuralgia. it is suggested that the function of pain control of Oryoungsan is related to 5-HT(5-hydroxytrypamine), nerve transmitter in the endogenous analgesic system. Moreover it is also suggested that Oryoungsan is relate to 5-HT, considering the fact that gastroparesis, a symptom of cyclic vomiting syndrome treated with 5-HT1D receptor agonist is similar to the 'bi', symptoms appeared in the Oryoungsan-related disease.

• 대한약리학회지
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• 제25권1호
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• pp.31-42
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• 1989

Metoclopramide (MCP)는 역류성식도염, 위하수증, 항암제에 의한 구토 증상을 치료하는데 사용되고 있는 dopamine수용체 차단제로 알려져 있다. 본 연구에서는 흰쥐의 적출 관류부신에서 catecholamine (CA)의 분비작용에 미치는 영향을 검토하여 다음과 같은 결과를 얻었다. MCP는 부신정맥내로 주입하였을때 용량의존적으로 CA 분비작용을 나타냈다. 이러한 MCP의 CA 분비작용은 atropine 전처치로 차단되었으나 chlorisondamine 처치에 의해서는 완전 차단되지 못하였다. MCP 분비작용은 physostigmine, adenosine, ouabain의 전처치로 현저히 증강되었다. 그러나 5mM-EGTA 함유 $Ca^{++}-free\;Krebs$ 액으로 관류하였을때 MCP의 CA 분비작용은 현저히 억제되었다. MCP (200 ug/30 min)를 관류한 실험에서는 KCI이나 acetylcholine의 CA 분비작용이 유의있게 감소되었다. 이상의 실험결과로 보아 MCP는 칼슘의존적기전에 의해 CA를 유리 시키며, 이러한 분비작용은 부신에서 nicotine수용체 보다도 muscarine수용체의 활성화에 더 기인 되는 것으로 생각되며, chromaffin cell에 대한 일분 직접작용도 개재되어 나타나는 것으로 사료된다.

• Journal of Hospice and Palliative Care
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• 제16권4호
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• pp.205-215
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• 2013

말기암환자들은 암의 진행으로 인한 여러 가지 육체적, 정신적 증상들로 고통 받고 있으며, 통증뿐만 아니라 피로감, 쇠약감, 식욕부진, 오심 구토, 호흡곤란 등은 말기암환자의 삶의 질 감소에 큰 영향을 미친다. 피로감은 여러 기전 및 원인에 의하여 발생하는데, 치료 가능한 원인으로는 약물부작용, 빈혈, 심한 통증, 수면장애, 우울증 또는 불안감, 영양부족, 내과적 동반질환 등이다. 피로감의 주 기전으로는 사이토카인의 조절이상 및 시상하부-뇌하수체-부신축의 기능부전, serotonin의 조절이상 생체리듬의 파괴, ATP에서의 변화 등이다. 치료는 치료 가능한 원인을 제거하고 환자의 에너지를 보존할 수 있게 하는 방향으로 활동을 계획하고, 교육해야 하며, 약물 치료로는 corticosteroid와 psychostimulants를 사용할 수 있다. 식욕부진과 악액질도 여러 가지 치료 가능한 원인이 있을 수 있는데, 구내염, 구강 캔디다증, 구강 herpes, 구강건조, 변비, 통증과 호흡곤란같이 조절이 안 되는 증상, 섬망, 오심 구토, 우울증, 위장관 운동기능 장애, 역류성 식도염, 내분비 장애가 포함 된다. 식욕부전의 기전은 음식섭취를 조절하는 뇌의 생리적 기전의 이상과 관련, serotonin 분비 증가, IL-$1{\alpha}$, IL-1, IL-6, IL-8 TNF-${\alpha}$와 관련이 있다. 악액질의 기전은 에너지와 기질(substrate metabolism)에서의 변화, 종양에서 생산된 지질분해요소와 단백질 분해요소, 호르몬 이상, 암세포로부터 세포성장에 필요한 영양분을 빼앗기는 것, 에너지 섭취의 감소 등이다. 치료는 정신과 상담 및 환자와 가족의 교육인데, 교육할 때는 환자와 그 가족에게 식욕부진과 악액질이 암으로 인한 임종과정 중 일어나는 자연적인 현상이라는 것을 알리며, 다른 행동으로 환자를 돌보는 방법 등을 교육한다. 약물치료로는 megestrol acetate와 dronabinol, steroid를 사용할 수 있다. 오심 구토의 원인 중 치료가 가능할 수도 있는 것으로는 약물, 요독증, 감염, 불안증, 변비, 상부위장관 폐쇄, 고칼슘혈증, 저나트륨증이 있고, 치료는 metoclopramide, haloperidol, olanzapine 또는 ondansetron 등을 사용해 볼 수 있다. 말기 암에서 호흡곤란의 증상은 폐의 특별한 병변이 없이도 환자가 호소할 수 있는데, 이 경우 opioids가 효과적이다. 말기 암환자에서 환자의 증상을 경감시켜주기 위한 완화치료는 매우 중요하며, 환자의 증상을 잘 평가하고 적절한 치료 및 관리를 해 줌으로써 환자의 삶의 질을 향상시킬 수 있다. 따라서 이들 환자의 증상 호소에 더욱 관심을 갖고 적극적으로 치료하고 관리하여야 할 것이다.