• 제목/요약/키워드: Insomnia symptoms

검색결과 356건 처리시간 0.026초

우울증 환자의 주간기분변동과 수면 양상 (Diurnal Variation and Sleep Pattern in Depressive Patients)

  • 박영민;김린;서광윤;조숙행;강승걸;윤호경
    • 수면정신생리
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    • 제8권1호
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    • pp.30-36
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    • 2001
  • 배 경 : 주간기분변동은 주요 우울장애, 멜랑콜리아 형의 세부진단으로 포함되어 있다. 그러나 현재까지의 연구를 종합해 보면 주간기분변동은 우울증의 고유한 증상인지 수면 양상의 변화와 관련된 현상인지, 혹은 별개의 다른 기전을 갖는 현상인지에 대해서 서로 모순되는 주장들이 혼재되어 있다. 이에 본 연구에서는 우울증의 세부 진단에 따른 주간 기분변동의 유무를 조사하고, 주간기분변동의 유무에 따른 수면 양상의 차이를 비교함으로써 주간기분변동과 수면 양상 사이의 관계를 찾아 보고자 하였다. 방 법 : 입원 혹은 의뢰된 우울장애 환자 62명을 대상으로 하여 주간기분변동은 Visual Analogue Mood Scale로, 수면 양상은 Pittsburgh Sleep Quality Index, 우울증의 심각도는 Hamilton Depression Rating Scale을 이용하여 측정하였다. 주간기분변동이 있는 군과 없는 군으로 나누고 HDRS 총점과 소항목, 그리고 PSQI 총점과 소항목을 변수로 하여 통계적 분석을 시행하였다. 결 과 : 주간기분변동의 빈도는 각각의 진단별로 차이가 없었으며, 주간기분변동이 있는 군과 없는 군으로 나누었을 때 중기 불면증과 수면 시간에 있어서 유의한 차이가 있었다(p<0.05). 또한 멜랑콜리아 형만을 대상으로 주간기분변동이 있는 군과 없는 군을 비교하였을 때 중기 불면증, 수면 시간뿐만 아니라 PSQI 총점, 수면 잠복기, 수면 장애, 주간의 기능 면에서 유의한 차이를 보였다(p<0.05). 결 론 : 주간기분변동은 멜랑콜리아 형의 우울장애 뿐만 아니라, 다른 우울장애에서도 존재하기 때문에 주간기분변동이 멜랑콜리아 형 우울장애의 특유한 증상으로 보기는 어려웠다. 주간기분변동이 있는 군에서 수면의 질이 더 좋은 것으로 나타났는데 이는 수면과 관련될 가능성이 높으며 향후 심도있는 연구가 필요할 것이다. 주간 기분변동은 외부 환경의 영향을 받기 쉬움으로 신뢰성을 높이기 위해서는 측정 기간과 횟수 등의 방법론적 연구도 필요할 것으로 생각된다.

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담화(痰火)에 대한 형상의학적(刑象醫學的) 고찰 (HyungSang Medical Approach to Phlegm-Fire)

  • 김종원;전수형;지규용;김경철;이인선;이태식;김규곤;이용태
    • 동의생리병리학회지
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    • 제23권1호
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    • pp.1-6
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    • 2009
  • Many of our contemporaries suffer from the symptoms of phlegm-fire, which is caused by stress, processed food, heavy diet, and unseasonal fruits and vegetables. With consultations from 'Euihaklpmoon', 'DongeuiBogham', and 'Ji-San's clinical lectures' this research, which is mainly focused on phlegm-fire, concluded as following. Phlegm-fire is caused by congestion of seven emotions, congestion of qi, complication of phlegm on fire, depletion of body fluids after long periods of disease, heavy diet, or congenital unbalance of yin-yang and qi-hyul. Concentration of phlegm-fire on the head causes headache, dizziness, frontal headache, tinnitus, and auditory dysfunction. The patient usually complains breaking pain. Dhamhwabang of Yijin-tang, Chunghoonhwadham-tang, and Yijin-tang variation for right headache can be used. Concentration of phlegm-fire on the thorax causes insomnia, palpitation, and insanity. Samhoohndham-tang variation, Chungsimgondhanhwan can be used. Concentration of phlegm-fire on the gastric region causes reflux of gastric acid, eructation, vomiting, abdominal discomfort, dysmenorrhea, and fluor gentalis. Yijin-tang variation for abdominal discomfort, Yanghyulsamul-tang, Hwadhamchunghwa-tang can be used. Shin type or Gi type, female with prevalence of qi and tendency of fire, female with dark facial color, female with raised eye tails and large noses, female with pointed noses, and male or female with large noses and mouths are likely to possess phlegm-fire. Abdominal discomfort of male with thick eyebrow and headache of Gi type female is usually caused by phlegm-fire.

소아청소년 자폐성 스펙트럼 장애에서 SSRI 장기 사용에 대한 후향적 분석 (Retrospective Analyses of Long-Term Use of SSRI in Children and Adolescents with Autism Spectrum Disorder)

  • 구애진;박진박;이종일;진혜경;김예니
    • 생물정신의학
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    • 제19권4호
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    • pp.205-210
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    • 2012
  • Objectives The purpose of this study was to investigate clinical profile, efficacy, and safety of long-term treatment with selective serotonin reuptake inhibitors (SSRIs) in Korean autism spectrum disorders (ASDs) patients. Methods Effectiveness was assessed through a retrospective review of self-reported target symptom improvement at the last follow-up visit. Changes in illness severity and improvement were measured using the Clinical Global Impression-Severity (CGI-S) of illness and Clinical Global Impression-Improvement (CGI-I) Scales. Tolerability was assessed through a review of the reason for discontinuation of SSRI and documented adverse events. Results A total of 21 ASDs patients (aged 9 to 19 years) treated with SSRI during July 2010 to July 2011 in department of child and adolescent psychiatry of Seoul National Hospital were identified. The mean duration of SSRI treatment was 47.9 (standard deviation = 36.9) months (range 0.7-114.5), and the mean fluoxetine equivalent dosage of SSRIs was $27.1{\pm}10.8$ mg. Nineteen (90.5%) patients were using concomitant medication. We found that SSRIs were prescribed for symptoms of agitation, stereotyped behavior, aggression, depression, impulsivity and self-injury in ASDs. Ten patients (47.6%) reported improvement in their target symptom after SSRI treatment based on CGI-I scores (CGI-I ${\leq}$ 2). The side effects were reported in 5 patients (23.8%) ; vomiting (n = 2, 9.5%), excessive mood elevation (n = 1, 4.8%), insomnia (n = 1, 4.8%), somnolence (n = 1, 4.8%) and decreased appetite (n = 1, 4.8%). Self-injurious behavior was reported in one patient (4.8%). Conclusions The results of this study suggest that SSRIs may be used effectively in children and adolescents diagnosed with ASDs. However, safety issues need to be considered carefully when choosing SSRIs for treatment. Future controlled trials are needed to confirm these findings.

교통사고(交通事故)로 인한 편타성(鞭打性) 손상(損傷) 환자(患者) 37례(例)에 대한 임상연구(臨床硏究) (The clinical study on 37 cases of whiplash injury patients which caused by traffic accident)

  • 강재희;장석근;이현;이병렬
    • Journal of Acupuncture Research
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    • 제19권3호
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    • pp.180-191
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    • 2002
  • Objective : This study was performed to evaluate the effect of oriental medical treatment in whiplash injury patients which caused by traffic accident. Methods : The clinical study was carried out 37 cases of whiplash injury patients which had been admitted in Daejon university Cheon-an oriental hospital from June, 2001 to December, 2001. Results : l. In the distribution of sex distinction was female much more than male in the ratio of 3:2 and thirties was most in age distribution. 2. In situation of traffic accident, The most case was rear-ending(70.27%). 3. Except cervical pain or it's reffered pain, there were whole body symptoms as fallow, insomnia in 11cases(29.73%), night pain in 10 cases(27.03%), general body pain in 8cases(21.62), dizziness in 6cases(16.22%). 4. According to Meridian Muscle theory, a injured parts of patient were devided as follows. There were 22cases(59.46%) which have injury in Bladder, Small Intestine Meridian Muscle, 10cases(27.03%) in Gallblader, Triple Energizer Meridian Muscle, 5cases(13.51%) in Stomach, Large Intestine Meridian Muscle. 5. There were 6cases(16.22%) of the grade of complete recovery, 10cases(27.03%) of the grade of excellent, 12cases(32.43%) of the grade of improvement, 6cases(16.22%) of the grade of disimprovement and 3cases(8.11%) of the grade of poor. So 28cases(75.68%) were efficacious. 6. Generally Herb-meds that have efficacy of Geo-Eohyeol were most used(27cases, 72.97%) in early stage. Secondly Herb-med that have efficacy of Yiqi-sunqi were used(20case, 54,05%) in middle stage and Herb-med of Bo-Qiheol were used(l0cases, 27.03%) in latter term. The most used Herb-med was Hoisu-san, Oyaksungi-san(22cases, 54.96%). 7. In l5cases which have Aqua-Acupuncture treatment, There were 3cases of Complete recovery, 5cases of Excellent, 4cases of Improvement, 2cases of Disimprovement, 1cases of Poor. 8cases(53.33%) were above Excellent grade, so it is more efficatious Than simple treatment without Aqua-Acupuncture(36.37%). 8. The improvement of Bladder, Small Intestine Meridian Muscle was 77.27%, Gallblader, Triple Energizer Meridian Muscle was 70% and Stomach, Large Intestine Meridian Muscle was 80%. Additional Aqua-Acupuncture treatment improved to be effective in Bladder, Small Intestine Meridian Muscle(77.78%), in Gallblader, Triple Energizer Meridian Muscle(75%), in Stomach, Large Intestine Meridian Muscle(100%). Conclusions : In this study, Oriental treatment especially Aqua-Acupuncture was effective in whiplash injury patients which caused by traffic accident.

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兩義供辰丹을 倂用한 한방치료가 重症度의 통증 환자에 미치는 진통 효과 : 후향적 연구 (Analgesic Effect of a Traditional Korean Medicine Yang Eui Gongjin-dan on Severe Pain: A Retrospective Study)

  • 이동혁;이영은;이보윤;김연진;조승연;박성욱;정우상;문상관;고창남;조기호;박정미
    • 대한한방내과학회지
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    • 제36권3호
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    • pp.265-275
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    • 2015
  • Objectives: The aim of this study was to investigate the analgesic effect of Yang Eui Gongjin-dan (YEGJD), a traditional Korean medicine, on severe pain or numbness, including acute and chronic non-cancer pain. Methods: Records of patients visiting the Department of Traditional Korean Internal Medicine, Stroke and Neurological Disorders Center, from March 2011 to January 2015, were searched. Their chief complaint was severe numbness or pain (NRS≥7). We compared the NRS of pain pre- and post-YEGJD treatment in 34 patients; and analyzed changes in pain severity pre- and post-YEGJD treatment in 17 chronic non-cancer pain patients. We also investigated other accompanying symptoms, such as insomnia, anorexia, dyspepsia, fatigue, coldness, and excessive sweating, related to the deficiency state (虛症) in traditional Korean medicine. Results: The average pain NRS for the 34 patients significantly decreased from 8.04±1.08 to 3.75±2.54 after YEGJD treatment. The average pain NRS score in chronic non-cancer pain patients also significantly declined from 7.91±0.97 to 3.29±2.29. Conclusions: The traditional Korean medicine Yang Eui Gongjin-dan has an analgesic effect and is useful for treating severe pain or numbness. We recommend a randomized controlled trial using objective assessment scales and a large patient sample to further test the effects of Yang Eui Gongjin-dan.

당뇨병에 대한 옥천환(玉泉丸)의 효과에 관한 고찰 (Review of effect on Okchun-hwan for Diabetes Mellitus)

  • 김범준;배고은;최진용;조재현;박혜림;홍미나;김소연;권정남;윤영주;이인;최준용;한창우;홍진우;박성하
    • 동의생리병리학회지
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    • 제31권1호
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    • pp.20-24
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    • 2017
  • The aim of this study is to investigate the effect of Okchun-hwan on Diabetes Mellitus. We searched articles from Oasis and Chinese Academic Journals(CAJ) online databases. Searching keywords were '玉泉丸', '옥천환'. Among the articles published from January 2000 to September 2016, The 79 articles were found. After review the title, abstract and original, The five articles were selected finally to rule out a completely different prescriptions and an animal test articles. Okchun-hwan is effective in improving the symptoms(dry mouth and throat, fatigue, eat easy to hunger, shortness of breath, sweating, palpitation, cardiac heat, insomnia, and tongue)of a patient with deficiency of both qi and yin diagnosis(氣陰兩虛證) on Diabetes Mellitus, as well as act on protection of endothelial cells and regulation of insulin sensitivity, insulin resistance that cause the diabetic chronic vascular complications.

유방암 환자의 항암화학요법 후 한방병원 입원치료에 대한 일개 한방병원 환자 특성 및 치료 고찰 (Analysis of the Patients and Treatment of Korean Medicine Hospital after Chemotherapy in Patients with Breast Cancer)

  • 강수진;김선경;양금진;홍가경;조한백
    • 대한한방부인과학회지
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    • 제33권2호
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    • pp.77-89
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    • 2020
  • Objectives: The purpose of this study is to analyse current status and treatment of the Korean medicine hospital after chemotherapy in patients with breast cancer. Methods: We investigated the medical records of 21 patients who admitted to Korean medicine hospital after chemotherapy in patients with breast cacner from March 1, 2017 to December 31, 2019. We searched medical records retrospectively and analyzed current status and treatment of Korean medicine hospital. Results: The average age of 21 participants was 52.81±8.38 years and 40s and 50s accounted for 85.6% of the total. After receiving chemotherapy, the average time to hospitalization was 1.87±3.13days and average hospital stay was 9.78±4.14 days. The subjects were classified as 28.6% of stage I, 52.4% of stage II, 9.5% of stage III, and 9.5% of stage IV. The analysis according to the presence of metastasis was 57.1% without metastasis, 33.3% with axillary lymph node metastasis, and 9.5% with distant metastasis. The main symptoms complained when hospitalized by 21 subjects were nausea (54.2%), fatigue (54.2%), and anorexia (50.8%) in over 50%, pantalgia (47.5%), and insomnia (47.5%), dizziness (44.1%), cold sweating (42.4%), lower extremity pain (40.7%), 37.5~37.9℃ fever (39.0%), headache (37.3%), hot flush (37.3%), pruritus (30.5%) are 30% or more. Korean medicine treatment was performed in 87.4% of all hospitalizations and Gwakhyangjunggi-san-gami was the most administered prescription. Extracts of Korean medicine was performed in 100.0% of all patients and Eunkyo-san was most administered extracts medicine. Acupuncture, moxibustion, and cupping treatments were performed in all 21 study subjects. Other treatments was performed at a frequency of hyperthermia (90.5%), lymph massage (23.8%), air compression therapy (23.8%), and Interference current therapy (19.0%) Conclusion: Korean traditional medicine can be used as a countermeasure for side effects after chemotherapy in breast cancer patients.

암 환아 부모의 경험에 대한 질적 연구 (The Experience of Parents Whose Child is Dying with Cancer)

  • 조영숙;김수지
    • 대한간호학회지
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    • 제22권4호
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    • pp.491-505
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    • 1992
  • The purpose of this research was to understand the structure of the lived experience of parents of a child terminally ill with cancer The research question was “What is the structure of the experience of parents of a child terminally ill with cancer\ulcorner” The sample consisted of 17 parents of children admitted to the cancer units of two university hospitals in Seoul. The unstructured interviews were carried out from October 10, 1991 through January 10, 1992. They were audio-recorded and analysed using Van Kaam's method. Parents ascribed the cause of the cancer to the mother's emotional imbalance during pregnancy, the mother's stress, failure to observe religious rites, food, the parent's sin, misfortune and pollution. The theme clusters were tension, fear and depression experienced during pregnancy, stress that children suffer from abusive parents, failure to observe religious activites, bad luck, and sins committed during a previous life. When the child suffered a recurrence of cancer, the parents experienced negative emotions, nervousness, sorrow. depression and death. The theme clusters were feelings of despair, helplessness, regret, guilt, insecurity, emptyness and apathy. The long struggle with cancer resulted in the loss of economic security, loss of psychological and physical well being, and social withdrawal. The theme clusters were the economic burden of medical cost, giving up treatment, debt, limited medical insurance coverage and blood transfusion. The loss of psychological well being included stress, lack of support systems, inability to carry out responsibilities, lack of trust of the medical ten family breakdown, inappropriate expression of emotion and not disclosing the diagnosis to the child. Physically the parents suffered fatigue, insomnia, loss of appetite, loss of weight, dizzness, headache, psychosomatic symptoms, and increased consumption of liquor and cigarettes. Social withdrawal was manifested by taking time off from work to look after the child, decrease of outside social activities and feelings of isolation. Influences on family life were spousal conflicts, negative response of siblings, separation of the family members and economic hardship. The theme clusters were blaming a spouse for the cause of the illness and disagreements, maladjustment, lonliness, hostility and depression of siblings. The high price of medical care over the long period was a major factor influencing the life of the family. Positive experiences during the child's long illness were the strengthening of support systems and religious beliefs and financial help from social organizations. The support of one's spouse primarily helped to overcome the stress of the long illness. In addition, support was received from parents of other children with cancer and from nurses and religious leaders. The nurse, by providing empathetic support, should be a person with whom parents can express their feelings and share their experiences.

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조현병 환자에서 장기지속형 항정신병 주사제 팔리페리돈 팔미테이트의 효능과 안전 : 24주 개방형 연구 (Safety and Effectiveness of Long Acting Injectable Antipsychotic Paliperidone Palmitate Treatment in Schizophrenics : A 24-Week Open-Label Study)

  • 강현구;함웅;손인기;백인호
    • 생물정신의학
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    • 제20권3호
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    • pp.111-117
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    • 2013
  • Objectives We investigated the effectiveness and safety when treated in schizophrenics with paliperidone palmitate, a long acting injectable antipsychotic. Methods This was a 24-week open-label study, performed at one center in Korea. The eligible patients with schizophrenia diagnosed by Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision (DSM-IV-TR) criteria were enrolled. Patients received long-acting paliperidone palmitate injection (234 mg, baseline; 156 mg, week 1 ; then once 4 weeks flexible dosing). Effectiveness assessments were measured by the Positive and Negative Syndrome Scale (PANSS), The Clinical Global Impression Severity Scale (CGI-S), The Personal and Social Performance (PSP) at baseline, week 1, every 4 weeks untill 24 weeks or endpoint. Safety assessments were measured by The Extrapyramidal Symptom Rating Scale (ESRS), body weight (BW) and incidence of adverse events. Oral antipsychotics were stopped or tapered off within next 14 days. Results Of 20 patients recruited, 9 patients (45%) completed the study. Paliperidone palmitate produced a significant improvement in PANSS total score from baseline to endpoint. The response rate was 75% [mean change (${\pm}SD$) $-25.9{\pm}14.4$, all p < 0.001]. The CGI-S and PSP total scores significantly improved during 24 weeks (All p < 0.001). Eighty percent of patients reported adverse events and most common adverse events (${\geq}10%$) in paliperidone palmitate were anticholinergic adverse event, extrapyramidal symptoms, weight gain, akathisia, insomnia, headache, agitation, anxiety and GI trouble. ESRS score is not statistically significant, but tends to get better at the end of the study when compared to baseline. Conclusions Our study results demonstrated maintained effectiveness and safety of paliperidone palmitate treatment in schizophrenics. And provides both clinicians and patients with a new choice of treatment that can improve the outcome of long term therapy. Their potential effectiveness and safety should be better addressed by future randomized-controlled trials.

관중탕의 임상적 활용에 대한 연구 (The Study About the Clinical Use of Gwanjung-tang)

  • 임동환;김달래
    • 사상체질의학회지
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    • 제20권2호
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    • pp.30-42
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    • 2008
  • 1. Objectives This paper was tried to find out the clinical use of Gwanjung-tang by comparing patients' chief complain and natural symptom. 2. Methods The study was researched as clinically with medical records of 88 patients who visited a certain oriental medicine clinic which is in Seoul during January, 2000 and June, 2006. 3. Results 1) The male patient who was treated with Gwanjung-tang(寬中湯) is rare. The rate of patients who visited clinic in her forties is 27.3%, in fifties is 18.2%, in thirties is 15.9%, in sixties is 12.5%, in twenties is 10.3%. 2) Chief complain which made patients to visit clinic is a chest pain(19.3%), back pain and shoulder pain (15.9%), edema (12.5%), headache (9.1%), irregular menstruation (8.0%), dyspepsia (8.0%), fatigue (8.0%), insomnia (5.6%), menopausal disorder (4.5%), lumbago (4.5%), abnormal condition of stools (2.3%), and abnormal condition of urine (2.3%). 3) Natural symptom is classified into appetite, digestion, stools, urine, sweat, and sleep. The rate of patients who complained abnormal condition of digestion is 71.6%, of sleep is 59%, of stools is 52.3%, of urine is 47.7%, if sweat is 34.1%, and of appetite is 30.7%. 4) The rate of patients who is treated with Gwanjung-tang between thirty and forty packs is 43.2%, twenty packs is 39.7%, between fifty and sixty packs is 5.7%, between seventy and eighty packs is 2.3%, and between ninety and hundred packs is 3.4%. 5) The rate of patients who is treated with Gwanjung-tang during 15 days is 45.5%, between 16 and 30 days is 26.2%, between 31 and 60 days 7.9%, between 61 and 90 days 3.4%, between 91 and 120 days is 4.5%, and more than 120 days is 12.5%. 6) There are not many cases that chief complain was abnormal condition of digestion (8.0%), sleep (5.6%) stools (2.3%), and urine (2.3%). But the rate of patients who complained discomfort of digestion(71.6%), sleep(59%) stools (52.3%), and urine (47.7%) is significantly high. 7) According to "Sasang Sin Pyeon", Gwanjung-tang was used in To-sa-gwak-ran (吐瀉藿亂), Hae-su (咳嗽), Jeok-chui (積聚), Pyo-han -bu-jong (表寒浮腫), Chang-man (脹滿), Chil-gi (七氣), Dam-um (痰飮), Dam-goe (痰塊), Seom-jwa-yo-tong (閃挫腰痛), Bi-tong (臂痛) of Soeumin, and it is corresponds with clinical cases for various components. 4. Conclusions Gwanjung-tang is a medicine of reconciliation, and it makes Stomach to be warm and take down Yin Qi. The most important effect of Gwanjung-tang is Sun-qi(順氣). So it is considerable that Gyejibanhasenggang-tang (少陰人 桂枝半夏生薑湯), Hyangsayangwi-tang (少陰人 香砂養胃湯), and Gwakhyangjunggi-san (少陰人 藿香正氣散) is also effective to symptoms above, because these are medicines of reconciliatio.

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