• 제목/요약/키워드: Herb-Acupuncture

검색결과 564건 처리시간 0.026초

농촌지역(農村地域)의 한방의료이용실태(韓方醫療利用實態) 일부(一部) 농촌지역(農村地域)의 군보건소이용자(群保建所利用者)를 중심(中心)으로- (Study on Utilization of Oriental Medicine by Residents in Rural Areas)

  • 김진순
    • 농촌의학ㆍ지역보건
    • /
    • 제15권2호
    • /
    • pp.118-129
    • /
    • 1990
  • Socioeconomic status in this county progressed rapidly, this has brought about many changes in health care fields, namely, pattern of disease prevalence and morbidity, increase of the aged people, and also availability of health care in rural areas. According to the utilization study of medical care, it showed that the oriental medicine is used for the treatment of lasted chronic disease not the minor and common diseases which is quick in its effect. Particularly, in rural areas. prevalence of chronic disease is higher than that in urban areas. Although the health cafe need of the oriental medicine is high in rural areas, the distribution of manpower and facilities is lower than that in urban areas. Therefore the government has planned to implement the demonstration project for the oriental medicine at the designated 3 health centers in rural areas. The purpose of this study was to collect the utilization level of oriental medical care of the people in rural areas. To meet the purpose of this study, patient interview were applied. 790 patients visited to health center in project areas were selected and analyzed by experienced interviewers from 2 April to 21 April 1990. The major findings of this study were as follows ; 1) Of the 790 patients, 32.6 percent of the respondents had experience of using the oriental medicine. As for the utilization by age and sex. 54.8% of those was female and 70.7% was 40 years of age and more. 2) Reaction to the question of educational achievement showed that on schooling and primary school graduates accounted for 63.1%. 3) The most user of oriental medicine resides in country level, where the health center is located, and 80 percent of those users resides within 10Km. 4) More than 50% of the total was the chronic diseases which lingered for more than 3months. 5) 32.6 percent of the total cases used the oriental medicine. 61.2% among those was treated by oriental medical care hospital and 38.8% by oriental drug dispensaries etc. 6) The contont of oriental medical care varied ; 50.1% for prescription of herb drugs for treatment, 25.1% for health maintenance and 23.9% for acupuncture, moxibustion etc. 7) As for the motivation for using the oriental medicine. 56.6% of the respondents was for treatment of diseases and 27.9% wes for strengthening the physical weakness. 8) As for the effectiveness of the oriental medicine. 70.3% of the total cases satisfied with that treatment and 84.2% of the total cases will use the oriental medicine when is provided by health center.

  • PDF

국내문헌(國內文獻)(35)에 나타난 항노화(抗老化) 및 항산화(抗酸化)의 실험적(實驗的) 연구(硏究)에 대(對)한 검색(檢索) (Search of Experimental Studies(35) on Anti aging and Anti oxidant in Korea)

  • 안상원;이철완
    • 대한한의학회지
    • /
    • 제19권2호
    • /
    • pp.373-390
    • /
    • 1998
  • 35 theses conducted in Korea on the topic of senescence or anti-oxidant were classified on the basis of research methods, animals used for the experiments, and research items. Evaluating these research works with respect to the Free Radical Theory, the following conclusions were reached. 1. Of the 17 theses written in the Oriental medicine aspect, three theses used a single herb, nine theses used a complex prescription, four theses concentrated on the usage of the medicinal acupuncture, and one research paper focused on using scientific components. Common objection of these papers were on the verification of the efficacy of herbs. 2. Of the 18 these written in the Western medicine aspect, five theses used a single drug, seven theses conducted a research on the changes due to senescence, and 6 papers were on variety of topics. The main focus of these works were on the mechanism and pathology related to the senescence rather than on the suppression of senescence. 3. Among the theses written in the Oriental medicine perspective, a total of 48 herbs were utilized. 26 of these herbs has a tonification function on the Kidney. Six out of nine complex prescription mentioned above has a function of tonifying the Kidney. 4. With respect to the research subjects used on the experiments, 8 theses have used Senescence-Accelerated mice, 13 theses have used Sprague-Dawley mice, and remaining 7 papers have used human or other animals. 5. These are the categorization of the research items used: the weight (11) and weight changes of the visceral organs (9), the measurement of the content of peroxide-disease (9), the measurement of enzyme vitality (21), the blood and urine test (10), the experiment concerning immune system (3), the influence on the hepatic capability of metabolizing foreign substance (3), the effect on hepatic cell protection (3), the measurement of both the suppression of Free Radical and ability to create Free Radical (2), the measurement of effect of suppresing MDA(malondialdehyde) (4), the effect of eliminating DPPH Radical (2), and experiements about the functions (2). 6. The rate of vitalization of well known anti-oxidants such as Superoxide dismutase (SOD), Protein-bound SH, Nonprotein-bound SH, Glutathione(GSH), Catalase, and etc. were tested in 17 theses. Considering the conclusions mentioned above, the theses related to the senescence published in Korea elected different animals used for experiments, research items and the methods of research, the end result seems to be a lack of objectivity. Thus, I would argue that research methods to overcome such a deficiency need to be developed systematically.

  • PDF

뇌경색 환자에게 실행한 한방음악치료 전후(前後)의 Ink foot print analysis 1례 (The Effectiveness of Ink Foot Print Analysis by Using Pre-post Oriental Medicine Music Therapy on Patient One Case with Cerebral Infarction)

  • 이승현;박경수;신현대
    • 한방재활의학과학회지
    • /
    • 제18권3호
    • /
    • pp.147-156
    • /
    • 2008
  • Objectives : Oriental Medicine Music Therapy is a new way of treating and preventing various diseases and promoting health by means of music specially picked and designed to produce Qi(氣) fitting to an individual person in the areas of the structure of human body, physiological function, pathological change, diagnosis and treatment. Therefore, it can facilitate the efficiency of the treatment much better and faster than only with herb or acupuncture. Equilibrium between body and mind is its originality. Methods : A 38-year old man came to hospital suffering from left side weakness, dysarthria because of cerebral infarction. After one week's medication in the part of neurology, he was sent to the oriental medicine music therapy center, and he took ten times' medical treatments once a day. Before and after the treatments, implementing 'Ink foot print analysis', as for the movement capacity and walking of left side weakness, these results are acquired. Results and Conclusions : 1. Before the oriental medicine music therapy, except the acceleration and deceleration section, within three meters, a right foot's step was measured 30.55 cm and a left foot was measured 15.2 cm, and the step distance was 15.2 cm. After the 10 times treatments, the right foot's step was 112.6 cm, the left foot's step was 113 cm, and the step distance improved to 51.8 cm. 2. The normal person's average step is about 38 cm, and it could be decreased owing to a decreptitude, pain, fatigue, and the weakness of the legs. In spite of all, from the increased 50 cm step measurement with the patient's body condition, it means that his movement capacity is recovered. 3. In the measurement of walking time, before 10 times treatments, it took 46.35 seconds within 6M, but after the treatments, it increased to 7.47 seconds as same as a normal person's walking speed. 4. In insomnia, and the abnormality of a facial muscle, it shows lots of improvement, and even the accuracy of a pronunciation, but despite of the 10 times treatments, the 'ㄹ(r)' sound placed under a vowel is unclear. 5. Before the 10 times' treatments, he can move the left side shoulder with pain and cannot move below the left elbow. After the treatments, the pain was disappeared, and he was able to move over 60 cm without pain. And improving of the movement of fingers, he can beat over 8 times with a drumstick.

한방병원(韓方病院)에 내원(來院)한 근위숙성(筋萎縮性) 측색경화증(側索硬化症)(ALS)환자(患者)의 임상적(臨床的) 관찰(觀察) - 한방병원(韓方病院)에 입원(入院)한 환자(患者) 17명(名)을 대상(對象)으로 - (Clinical study on the ALS(Amyotrophic Lateral Sclerosis) patients in the Department of Circulatory Internal Medicine of Kyung Hee Oriental Medical Hospital)

  • 전영완;문상관;고창남;조기호;김영석;배형섭;이경섭
    • 대한한방내과학회지
    • /
    • 제18권2호
    • /
    • pp.236-245
    • /
    • 1997
  • The subjects of this clinical study are 17 patients with ALS(Amyotrophic Lateral Sclerosis), who were diagnosed in other or our hospital from January 1987 to Nomember 1997. The age of onset, clinical signs, type of ALS, methods of treatment and outcomes, etc. were studied and analyzed. The data are summarized as follows ; 1) The mean age was $52.4{\pm}11.5$ years old, and the ratio of male to female was 2.4:1. There is increasing frequency with rising age. 2) Pseudopolyneuritic type(67%) is the most in male patients, bulbar type(60%) is the most in female patients, and totaly Pseudopolyneuritic type(54%) is the most. 3) In the period of hospitalization after onset, 1 year(11 cases, 64.8%) is the most frequent, and 2 year(2 cases, 11.7%), 1 month(2 cases, 11.7%), 4 years(1 case, 5.9%) and 6 months(1 case, 5.9%) in orders. 4) In the duration of admission, 10 days(8 cases, 47.2%) is the most frequent, and 30 days(4 cases 23.5%), 2 months(2 cases, 11.7%), 20 days(2 cases, 11.7%) and 3 months(1 case, 5.9%) in orders. 5) In the signs of patients, muscle weakness(17 cases, 100%), bulbar signs(14 cases, 82.4%), increased reflex of deep tendon(10 case, 58.8%), muscle atrophy (7 cases, 41.2%) and fasciculations(7 cases, 41.2%) were in orders. 6) In the methods of treatment, herb-medication(17 cases, 100%), acupuncture therapy(16 cases, 94.1%), physical therapy(7 cases, 41.2%), moxibustion therapy(5 cases, 29.4%), cupping therapy(4 case, 23.5%) and moxa-pack(1 case 5.9%) were administered in orders. 7) As to the outcome of treatment, 8(47.1%) were no changed, 4(23.5%) improved, 4(23.5%) aggravated, 1(5.9%) expired in orders.

  • PDF

비만인의 생활특성과 사상체질에 관한 연구 (A STUDY ON 4 TYPE CONSTITUTION AND SIFE CHARACTER OF OBESE PATIENTS)

  • 김달래
    • 사상체질의학회지
    • /
    • 제9권1호
    • /
    • pp.303-313
    • /
    • 1997
  • 질병의 발생은 병인, 숙주, 환경의 3가지 요소에 의해서 결정된다. 질병의 변천사를 보면 20세기 전반까지는 주요사망원인이 감염성 질환이었고, 20세기 후반기에 들어서면서 전염병이 관리되고 심장병, 당뇨병, 암 등 만성질환의 규모가 커지면서 만성질환의 관리가 현재까지의 관심사가 되고 있다. 식생활의 서구화와 고도 산업사회를 향한 시점에서 비만증은 근래에 발병률이 현저히 증가하면서 각종 성인병의 원인이 되고 있으며 만성질환의 이환율을 증가시키고 인간의 수영을 단축시키는 심각한 건강상의 문제를 일으키고 있다. 비만과 같은 만성질환은 대개 특정한 병원체가 없이 숙주와 환경의 상호작용에 의해서 결정된다. 한국 한의학에는 독특한 사상체질의학이론이 있다. 여기서는 모든 사람은 각자 체질적 특성을 갖고 체질마다 잘 걸리는 질병이 있다고 주장하고 있다. 비만도 일종의 질병이기 때문에 비만이 되기 쉬운 체질이 있을 것이다. 동양의학에서는 비만증의 치료 방법으로 약물요법, 침구요법 및 안마요법등을 사용하고 있다. 이에 상지대학교 부속 한방병원에 내원치료를 받고 있는 비만증환자들을 대상으로 하여 체질과 비만과의 관계를 연구한 결과는 다음과 같다. 1. 비만증 환자의 70.2%가 태음인, 26.9%가 소양인, 2.9%가 소음인이었다. 2. 비만인의 혈액 가운데 총 콜레스테롤, 저밀도 지방단백이 높은 사람보다 유리지방산과 중성지방이 높은 경우가 대부분을 차지했다. 지질분석과 체질간의 상관성에 관해서는 Triglyceride와 Free Fatty Acid가 상관성이 있는 것으로 인정되었다. 3. 비만과 유전은 밀접한 관련이 있는 것으로 사려된다. 4. 비만과 보약과는 관련성이 없었다. 5. 비만증은 분만, 피임, 수술후에 많이 발생하는 것으로 나타났다. 6. 대부분의 비만환자들은 간식, 특히 밀가루 음식을 즐기는 경향이 있었다. 7. 비만치료의 목적은 미용보다 건강을 위한 것이 많았다. 8. 태음인에게 태음조위탕으로 치료한 결과 4주에 2.2Kg이 감량되었다. 9. 비만인의 주된 원인은 육식보다는 당질과 지방질의 과다 섭취로 나타난 것이었다.

  • PDF

(${\ll}$속명의류안(續名醫類案)${\gg}$에 기재(記載)된 천(喘) 및 효천(哮喘)에 관(關)한 의안(醫案) 연구(硏究) (A Study of the Case Record on Dyspnea and Wheezing Asthma Recorded in Xu Ming Yi Lei An)

  • 이주일;서운교
    • 대한한의학방제학회지
    • /
    • 제15권1호
    • /
    • pp.49-105
    • /
    • 2007
  • Objectives : Select and analyze the case record of dyspnea and wheezing asthma recorded in Xu Ming Yi Lei An that is the most abundant and wide in contents in existing case records that are systematic, comprehending relatively modern Traditional Chinese Medicine to secure more deep and objective basis of Traditional Chinese Medicine approach for dyspnea and wheezing asthma to analyze and review possibility for clinical application in this study. Methods: The study was conducted with the case records of dyspnea and wheezing asthma in whole Xu Ming Yi Lei An. Pattern identify and classify selected case records and again classified with deficiency syndrome and excess syndrome. Also analyzed prescriptions and herbs used in the case records. Nature of herbs and properties and flavors that were used in the case records were classified and frequency of each nature of herbs were analyzed. Applicable case records were interpreted and suggested prescriptions, pulse feelings, pattern classification were analyzed and described. Results : Among the 5254 case records stated on the complete collection, it is researched that there are 63 case records for the symptom complex of dyspnea as 1.2% of the whole case records, and the case records on the symptom complex of wheezing asthma are 14 as the 0.27% of the total examples. 63 case record examples related with symptom complex of dyspnea were pattern identified and classified. As a result, deficiency syndrome of the Kidney(33 %), deficiency syndrome of the Spleen(26.0%), Wind-Cold(12.3%), phlegm turbidity(12.3%), Heat in the Lung(8.2%), asthenia of the Lung(8.2%) were investigated as above order. 14 case record examples related with wheezing asthma were pattern identified and classified. As a result, phlegm-Heat(26.3%), upper excess and lower deficiency(26.3%), external affections Wind-Cold(15.8%), Dampness-phlegm(10.5%), Lung asthenia(10.5%), Cold phlegm(5.3%), mutual deficiency and detriment of Heart and Kidneys(5.3%) were investigated as above order. Symptom complex of dyspnea has 67.1% of deficiency syndrome, 32.9% of excess syndrome resulting more deficiency syndrome than excess syndrome. Symptom complex of wheezing asthma has 42.1 % of deficiency syndrome and 57.9% of excess syndrome resulting more excess syndrome than deficiency syndrome. In case of symptom complex of dyspnea prescription used in the case record, the order of frequency is as following. Palmijihwang-tang, Bojung-ikgitang, Yungmijihwang-tang, Ijintang, Sojaganggitang, Igongsan. In case of symptom complex of wheezing asthma prescription in the case record, Yungmijihwang-tang, Ohotang, Dodamtang were mostly used. Herbs used in case records of symptom complex of dyspnea are Ginseng Radix, Poria, Glycyrrhizae Radix, Aconiti Iateralis Preparata Radix, Atractylodis Macrocephalae Rhizoma, Dioscoreae Rhizoma, Angelicae Gigantis Radix, Rehmanniae Radix Preparat, Pinelliae Rhizoma, Zingiberis Rhizoma Recens are mostly used. Nature of herb properties used for symptom complex of dyspnea and symptom complex of wheezing asthma are herbs that are warm properties. When the symptom complex of dyspnea and the symptom complex of wheezing asthma were treated. if the patient felt tenderness at Pyesu, doctors conducted pricking blood around the opposite Pyesu or Sipseon acupoint. when the patient didn't have tenderness at Pyesu by soft press, pricking blood was performed both sidees, right and left Pyesu. In case of the treatment of symptom complex of dyspnea and symptom complex of wheezing asthma, when they got treatment, when the symptom complex of disease is severe, a doctor cauterized the opposite Pyesu while the other Pyesu felt tenderness, and decided how the above treatment is performed whether the degree of the symptom compolex of disease is severe or not. In case of the treatment of symptom complex of dyspnea and symptom complex of wheezing asthma, if the person felt tenderness at Pyesu and is caught by the Wind-Cold pathogen, slight acupuncture is treated at relevant Pyesu with Fire needling. When patient with symptom complex of dyspnea and symptom complex of wheezing asthma cannot hawk sputum up from the oral and laryngopharynx, suction method is treated. Conclusion : With this study, actual traditional and clinical pattern identification form and characteristics of symptom complex of dyspnea and symptom complex of wheezing asthma were recognized. Modern case report utilizing in clinical application need to be secured and an incurable disease asthma need to be diagnosed and improvement for treatments have to be searched through other case records.

  • PDF

만성 질환을 가진 소아, 청소년에게 시행되는 보완대체요법의 실태 연구 (Complementary and Alternative Medical Therapies in Children and Adolescent with Chronic Disease : Utilizations and Patterns)

  • 김영빈;송준호;장명완;유황재;김철홍;이현희
    • Clinical and Experimental Pediatrics
    • /
    • 제48권9호
    • /
    • pp.929-934
    • /
    • 2005
  • 목 적 : 본 연구는 소아, 청소년에게 행해지는 보완대체요법 사용실태에 대한 구체적이고, 다각적인 연구의 필요성이 있었기에 보완대체요법을 접할 기회가 많은 만성질환을 가진 소아, 청소년에서 보완대체요법이 어느 정도 사용되고 있는지, 보완대체요법의 종류에 따른 사용실태를 알아보고, 보완대체요법 사용에 영향을 미치는 인자가 있는지 알아보고자 하였다. 방 법 : 2004년 3월부터 8월까지 관동의대 부속병원 소아과에서 지속적 추적관찰을 해오던 입원 경험이 있는 환아들 중에 만성질환(기관지 천식, 아토피, 간질, 뇌성마비 등)을 앓고 있는 환아(160명)를 대상으로 하였고, 환아와 동행한 보호자에게 설문양식에 따라 면담설문을 실시하였다. 결 과 : 설문 조사에 응답한 만성질환을 앓고 있는 환아는 252명이었고, 그 중 보완대체요법을 시행한 160명(63.5%)을 대상으로 삼았다. 각 질환별 보완대체요법 이용률은 선천성 근병증(100%), 아토피성 피부염(91.1%), 만성 반복성 복통(73.5%), 기관지 천식(72.5%), 만성 설사(50.0%), 뇌성 마비(42.1%), 만성 기관지염(37.5%), 간질(17.1%) 순으로 이용률의 차이를 보였다. 시행한 종류는 식이요법(31.1%), 생약요법(23.4%), 수치요법(16.3%), 마사지(14.2%), 방향요법(8.9%), 침술요법(4.6%), 동종요법(1.3%) 순이었다. 64명(40.0%)이 2가지 이상의 보완대체요법을 동시에 시행하였고, 보완대체요법을 권유받은 경로는 비의사처방에 의한 경우가 133명(83.1%)이었으며, 99명(61.9%)이 보완대체요법의 효과에 대해 긍정적으로 답변했다. 보완대체요법 시행군에 있어서 보완대체요법 사용에 영향을 미치는 인자들 중 부모 연령, 자녀 연령이 통계학적 의의가 있었으며, 부모의 연령이 높을수록 시행경험이 많았고(P=0.001), 자녀의 나이가 어릴수록 보완대체요법을 시행하지 않는 경향을(P=0.002) 보였다. 결 론 : 만성질환을 앓는 환아들은 치료에 있어서 현대의학에 의존하는 반면, 상당수가 보완대체요법을 이용하고 있었으며, 2가지 이상을 동시에 사용하는 경우가 많았고, 그 효과에 대해 긍정적으로 평가하고 있었다. 이와 같은 결과는 국내에서 보완대체요법의 접근성이 용이하고, 긍정적인 측면이 강조되고 있기 때문이므로 무분별한 보완대체요법의 사용을 피하기 위해서는 보완대체요법의 효과와 부작용에 대한 현대의학적인 연구가 더 필요할 것으로 사료된다.

Study on the Changes in the Blood Lipid Profile Levels of Patients with Metabolic Syndrome while Receiving Oriental Medicine Treatments for Various Diseases

  • Kim, Dong-Woung
    • 동의생리병리학회지
    • /
    • 제23권2호
    • /
    • pp.512-519
    • /
    • 2009
  • Among patients who visited each clinical department for oriental medical treatments, anthropometric measurement, blood pressure, fasting blood glucose and blood lipid profile level were measured at their first initial visit. 55 subject patients who were diagnosed as having metabolic syndrome and 150 mg/dL or more of triglyceride were selected as subjects whose fasting blood glucose, triglyceride, total cholesterol, HDL cholesterol and LDL cholesterol were measured after fasting. According to each patient's disease, the subject received treatments such as herb medicine, acupuncture, moxibustion, cupping therapy, physical therapy and rehabilitation therapy from each clinical department, and after an average of 4.10${\pm}$0.31 weeks, another test was performed yielding the following results. Serum triglyceride was 243.72${\pm}$13.05 mg/dL before the oriental medical treatment and 188.11${\pm}$12.17 mg/dL after the treatment where although it continued to show an abnormal value even after the treatment, there was statistically significant decrease compared to pre treatment(P<0.05). Serum total cholesterol was 207.50${\pm}$5.89 mg/dL before the oriental medical treatment and 192.37${\pm}$5.53 mg/dL after the treatment which was statistically insignificant compared to pre treatment(P>0.05). Serum HDL cholesterol was 51.19${\pm}$3.95 mg/dL before the oriental medical treatment and increased to 52.53${\pm}$1.49 mg/dL after the treatment although it was statistically insignificant compared to pre treatment(P>0.05). Serum LDL cholesterol was 110.66${\pm}$5.86 mg/dL before the oriental medical treatment and decreased to 106.12${\pm}$4.82 mg/dL after the treatment although it was statistically insignificant compared to pre treatment(P>0.05). In regards to the change of triglyceride for each sex, it was 221.84${\pm}$14.01 mg/dL before the treatment and 187.00${\pm}$15.47 mg/dL after the treatment for men, and it was 271.50${\pm}$22.78 mg/dL and 189.53${\pm}$19.76 mg/dL respectively for women where even though men and women showed the decrease of 34.84${\pm}$12.79 mg/dL and 81.96${\pm}$20.01 mg/dL respectively, both men and women continue to show abnormal values after the treatments. However, there was statistically significant decrease compared to pre treatment(P<0.05). In regards to the change of total cholesterol for each sex, with 198.24${\pm}$7.60 mg/dL for men before the treatment and 188.93${\pm}$7.45 mg/dL after the treatment, values for both before and after the treatment were within the normal range where the change value was 9.30${\pm}$5.86 mg/dL and statistically insignificant(P>0.05). For women, it was 219.26${\pm}$8.87 mg/dL and 196.73${\pm}$8.43 mg/dL respectively for women where with 22.53${\pm}$7.60 mg/dL, it decreased to the normal level after the treatment, and there was a statistically significant decrease compared to pre treatment(P<0.05). With such results, serum triglyceride and cholesterol levels of patients who have been diagnosed as having metabolic syndrome were observed to decrease after the oriental medical treatment. Especially, for both men and women, abnormally high triglyceride level decreased while the effect of lipid profile improvement for women was more significant compared to men.

뇌성마비아 조기발견과 관련된 모자인자 (Maternal and Child Factors Associated with Early Detection of Cerebral Palsy)

  • 배성수;박정한
    • Journal of Preventive Medicine and Public Health
    • /
    • 제20권2호
    • /
    • pp.312-321
    • /
    • 1987
  • 뇌성마비아의 조기 발견에 관련된 모자인자를 조사하기 위하여 1987년 2월부터 1987년 4월까지 대구 장애자 복지관, 대구대학교 부설재활원, 성바오로 어린이집, 그리고 부산 뇌성마비아복지회에 통원 또는 입원치료를 받고 있는 어린이 110명중 1980년 1월 1일 이후 출생자 74명 전원의 어머니를 대상으로 면담조사 하였다. 아버지의 학력과 이상 발견시기와는 아무런 상관관계가 없었으나 어머니의 학력이 대학졸업이상 일때가 고졸이하에 비해 어린이의 이상을 일찍 발견했고, 또 아버지의 직업이 전문직 또는 관리직일 때가 그 이외의 직업에 비해, 그리고 아버지의 월수입이 610,000원이상 일때가 600,000원 이하보다 더 일찍 발견하는 경향이었다. 첫째아이가 둘째아이 보다 그리고 부모의 나이가 34세 이하인 경우가 35세 이상인 경우에 비해 좀더 일찍 이상을 발견하는 경향을 보였다. 남아에서 여아에 비해 더 일찍 이상이 발견되었고 육아상담을 정기적으로 받은 어린이에서 정기적으로 받지 않은 어린이보다 더 일찍 이상이 발견되었는데 5% 유의수준에는 약간 못미쳤다. 연구대상아를 임신했을 때 산전관리를 7회이상 받았던 경우가 6회이하 받았던 경우에 비해 통계적으로 유의하게 일찍 어린이의 이상이 발견되었다. 처음으로 이상을 발견한 사람은 부모가 85.1%, 육아 상담을 정기적으로 받은 여부와는 관계없이 의사가 발견한 것은 2.7%였고 부모가 어린이의 이상을 발견하고 의사의 진단을 받았을때 36.5%에서 뇌성마비 진단을 받았고 나머지는관찰, 정상등으로 진단이 확실하지 않았다. 부모가 어린이의 이상을 발견하고 $2{\sim}3$개월 뒤에 의사의 진단을 받았고 진단후 전문적 치료를 시작할 때까지 방치했거나 물리치료, 한약, 침술 등을 받았다. 뇌성마비아의 조기 발견을 위해 의학교육과 임상수련과정에서 어린이의 발달을 평가하는 방법의 교육과 수련이 강화되어야 할 것이며 진단을 위한 전문인력의 양성이 필요한 것으로 생각된다. 또 부모들의 뇌성마비를 비롯한 각종 장애의 진단과 치료에 대한 인식을 높이기 위한 계몽교육이 필요하다.

  • PDF

견관절부 외상후 발생된 Shoulder-Hand Syndrome (A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder)

  • 전재수;이성근;송후빈;김선종;박욱;김성열
    • The Korean Journal of Pain
    • /
    • 제2권2호
    • /
    • pp.155-166
    • /
    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

  • PDF