• Journal of Preventive Medicine and Public Health
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• 제27권1호
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• pp.74-83
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• 1994

To investigate the sleeping patterns and gastrointestinal disorders of shift workers, the author studied 434 female workers who worked at textile industry ill Taejon city from September 1,1992 to September 31,1992. Shift pattern were divided into 3 categories ; 3 shift(shifts per 8 hours), 2 shift(day and night shift) and day work. The results obtained were as follows : 1 The average sleeping hours when adjusted for the education level of the total study subjects was 6.1 hours. That of 3 shift workers was 6.1 hours, 2 shift workers was 6.0 hours, but that of day workers was 6.5 hours. There were no significant difference among the shift workers. 2. For the 3 shift workers, the average physiologic adjusted duration in day shift (2.2 days) was shorter than that of night shift(2.7 days) and there were significant difference among the rotating shift works (p<0.001). The sleeping problems in day shift was less than those of night shift (p<0.001). 3. 44.9% of 3 shift workers, 39.3% of 2 shift workers and 33.1% of day workers complained gastrointestinal symptoms when adjusted for the age, education level, job tenure, work post. And the rates of gastrointestinal symptoms complained increase with job tenures (p<0.001). 4. The most frequent gastrointestinal diseases were gastitis and gastric ulcer with 14.2% , Irritable bowel syndrome with 3.1 %, duodenitis and duodenal ulcer with 2.1% and combined gastrointestinal disease with 2.1%. Age, eating habit, amount of coffee per day, job tenure, work post and shift pattern showed no significant difference with the gastrointestinal diseases when adjusted for the age. According to the above results, the author suggested that the shift pattern and job tenure can affect to the sleeping problem and gastrointestinal symptoms.

• 대한한방소아과학회지
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• 제15권1호
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• pp.59-70
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• 2001

Background : In recent years, pediatric chronic sinusitis patients who didn't respond with antibiotics were increasing, but there were a few reports on recurrence rate of the herbal medicine therapy treating pediatric chronic sinusitis, so this report was studied. Objective : To know the recurrence rate of herbal medicine therapy in the chronic sinusitis using follow-up investigation. Materials and methods : Thirty four patients(16 male and 18 female) treated in our hospital between December 1998 and August 1999 were studied. Ages ranged from 4 to 13 years (mean age :7.7 years). Twenty five patients(66%) had a underlying family history (allergy or sinusitis of family). In the past history, 32 patients (86%) had asthma, allergy of milk, atopic dermatitis, bronchiolitis and irritable bowel syndrome. Duration of treatment were from eleven to eighteen month (mean:14.3 month). Results : Of the 34 patients, 31 patients were improvement, 3 patients not. Of the 31 patients, thirty patients showed not recurrent (91%). Two patients showed no significant interval change(6%) and one patient was aggrevated(3%). The degree of the Health, thinking of protector for the herb medicine therapy and improvement of sinusitis were significant statistically. (significant <0.005) Conclusion : We know that herbal medicine therapy is the effective treatment of pediatric chronic sinusitis.

• Journal of Acupuncture Research
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• 제25권5호
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• pp.127-137
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• 2008

Objectives : These days, herbal acupuncture therapy is widely applied to many diseases and symptoms by Korean medical doctors in Korea. The aim of this study was to demonstrate the effect of Carthami-Semen herbal acupuncture(CSHA) on chronic constipation. Methods : This single-blind placebo-controlled randomized parellel study enrolled 24 adults with chronic constipation. After one week's run-in period, they were randomly assigned to receive CSHA therapy, or placebo therapy for 4 weeks by 2 times per week. After completing 4 week's therapy, 2 week's follow-up period was continued. During study, defecation frequency, consistency and ease of evacuation were checked before study, every week and follow-up periods. Also, the VAS of constipation, quality of life(QoL) and heart rate variability(HRV : low frequency, high frequency) were checked 3 times totally. Finally, 21 subjects completed the protocol and 20 subjects were analyzed.(1 subject is excluded for analysis because of not following the protocol.) Results : In CSHA group, defecation frequency(continued after 1 week), consistency and ease of evacuation(at 1 week after and follow-up) were increased significantly. The VAS of constipation in CSHA group was significantly decreased. There was no significant change at QoL and HRV. Conclusions : CSHA therapy was effective in treating adults with chronic constipation. Study that have larger case number and longer follow up will be needed in the future.

• 대한한방소아과학회지
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• 제35권3호
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• pp.67-88
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• 2021

Objectives The purpose of this study is to analyze randomized clinical trials (RCTs) on traditional Chinese medicine to summarize its efficacy and safety for the treatment of functional gastrointestinal disorders (FGIDs) in children. Methods We searched literatures published up to March 19, 2021 using two Chinese electronic databases. Data regarding patients, interventions, results, and adverse events were extracted from RCTs of herbal medicine for children with FGIDs. Results A total of 34 RCTs were included: 16 trials on functional dyspepsia, 7 trials on functional constipation, 6 trials on functional abdominal pain, 4 trials on irritable bowel syndrome, and 1 trial on functional diarrhea. 26 of 29 trials that reported total effective rate, the treatment group showed a significant improvement compared to the control group. Most of other evaluation indicators, such as symptom score, symptom disappearance time, and recurrence rate also demonstrated statistically significant improvement. Of the 16 studies which reported safety, 5 studies reported no adverse reactions in either group, and 4 studies reported no statistically significant differences in the incidence of adverse events between two groups. Also, reported adverse events were mostly mild. Conclusions Herbal medicine may help improve symptoms of FGIDs in children. However, due to limited types of studies on sub-diseases of FGIDs and small sample sizes in each study, additional large scale clinical studies on various other FGIDs are necessary.

• Journal of Neurogastroenterology and Motility
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• 제24권4호
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• pp.512-527
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• 2018

This review provides a comprehensive overview of brain imaging studies of the brain-gut interaction in functional gastrointestinal disorders (FGIDs). Functional neuroimaging studies during gut stimulation have shown enhanced brain responses in regions related to sensory processing of the homeostatic condition of the gut (homeostatic afferent) and responses to salience stimuli (salience network), as well as increased and decreased brain activity in the emotional response areas and reduced activation in areas associated with the top-down modulation of visceral afferent signals. Altered central regulation of the endocrine and autonomic nervous responses, the key mediators of the brain-gut axis, has been demonstrated. Studies using resting-state functional magnetic resonance imaging reported abnormal local and global connectivity in the areas related to pain processing and the default mode network (a physiological baseline of brain activity at rest associated with self-awareness and memory) in FGIDs. Structural imaging with brain morphometry and diffusion imaging demonstrated altered gray- and white-matter structures in areas that also showed changes in functional imaging studies, although this requires replication. Molecular imaging by magnetic resonance spectroscopy and positron emission tomography in FGIDs remains relatively sparse. Progress using analytical methods such as machine learning algorithms may shift neuroimaging studies from brain mapping to predicting clinical outcomes. Because several factors contribute to the pathophysiology of FGIDs and because its population is quite heterogeneous, a new model is needed in future studies to assess the importance of the factors and brain functions that are responsible for an optimal homeostatic state.

• Korean Journal of Acupuncture
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• 제36권2호
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• pp.93-103
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• 2019

Objectives : The aim of this study is to review the current trends in experimental studies on the acupuncture moxibustion treatment for visceral hypersensitivity. Methods : PubMed was searched for experimental studies about visceral hypersensitivity and acupuncture/moxibustion. Data were extracted and tabulated from the selected articles about experimental method, intervention, result and mechanism. Results : Total 23 articles were reviewed. Chronic visceral hypersensitivity animal model was applied in 17 studies (74%). Visceral hypersensitivity was measured by abdominal withdrawal reflex scoring or/and abdominal electromyogram. Acupoints like ST25, ST36, ST37, BL25, LI11, BL32 and PC6 were treated by electroacupuncture or moxibustion. All articles reported that electroacupuncture or moxibustion treatment is significantly effective in reducing visceral hypersensitivity. Treatment mechanisms were studied, related to mast cell, serotonin (5-HT) and receptor (5-HT3R and 5-HT4R), substance P (SP), vasoactive intestinal polypeptide (VIP), c-fos positive cell, corticotropin-releasing hormone (CRH), purinergic 2X (P2X)2, P2X3, P2X4, P2X7, N-methyl-D-aspartate (NMDA) receptor (NR1 and NR2B), prokinectin (PK) 1 and PK2. Conclusions : Evidences on acupuncture/moxibustion treatment for visceral hypersensitivity in animal studies warrant more research on effective acupoins, electro-acupuncture methods and treatment durations.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권6호
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• pp.500-509
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• 2022

Purpose: We compared the health-related quality of life (HRQOL) of children and adolescents with functional abdominal pain disorders (FAPDs) and organic abdominal pain disorders (ORGDs). Methods: This was a single-center, cross-sectional, observational study. The PedsQL 4.0 generic cores scales parent proxy-report was administered to parents/caregivers of 130 and 56 pediatric patients with FAPDs and ORGDs respectively on their first visit. The self-reported pain intensity in the patients was assessed using a visual analog scale (VAS) and facial affective scale (FAS). Results: Irritable bowel syndrome was the most prevalent FAPDs, and the most prevalent ORGDs were reflux esophagitis (41.1%) and gastritis associated with Helicobacter pylori (21.4%). There was no difference in HRQOL among patients diagnosed with ORGDs and FAPDs (p>0.05). Patients with ORGDs and FAPDs had lower HRQOL Scale scores than healthy Brazilian and American children's references, with a high proportion of children at risk for impaired HRQOL (p<0.0001). There was no difference in the VAS and the FAS scores between the ORGDs and the FAPDs. FAPDs had a higher prevalence of girls' and couples' disagreement (p<0.02), although poor school performance (p<0.0007) and bullying (p<0.01) were higher in patients with ORGD. Conclusion: This study revealed that there was a difference in impaired HRQOL between patients with ORGDs and FAPDs. Thus, considering the high prevalence of chronic abdominal pain in children, a well-founded treatment plan is necessary for a multidisciplinary cognitive-behavioral Pain management program.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제25권2호
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• pp.129-137
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• 2022

Purpose: The purpose of this study was to identify the risk factors for recurrent abdominal pain (RAP) in children who presented with nonorganic acute abdominal pain. Methods: A retrospective, single study was conducted on 2-15-year-old children diagnosed with nonorganic acute abdominal pain at the pediatric outpatient department of Vajira Hospital, Nawamindradhiraj University, between January 2015 and December 2019. The potential risk factors were analyzed using univariate and multivariate analyses. Results: Of the 367 patients with nonorganic acute abdominal pain, 94 (25.6%) experienced RAP within three months. In this group with RAP, 76 patients (80.8%) were diagnosed with functional gastrointestinal disorders, including functional dyspepsia, irritable bowel syndrome, functional abdominal pain-not otherwise specified, and functional constipation. History of gastrointestinal infection (p=0.011), mental health problems (p=0.022), abdominal pain lasting ≥7 days (p<0.001), and change in stool frequency (p=0.001) were the independent risk factors associated with RAP in children with nonorganic acute abdominal pain; their odds ratios and 95% confidence intervals were 3.364 (1.314-8.162), 3.052 (1.172-7.949), 3.706 (1.847-7.435), and 2.649 (1.477-4.750), respectively. Conclusion: RAP is a common problem among children who first present with nonorganic acute abdominal pain. The identification of risk factors may provide proper management, especially follow-up plans for this group in the future.

• 정신신체의학
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• 제26권1호
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• pp.1-8
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• 2018

연구목적 본 연구에서는 기능성 위장질환(Functional gastrointestinal disorder, 이하 FGID)이 동반된 정신질환자들의 정신사회적 특성을 알아보고자 하였다. 방 법 일 대학병원 정신건강의학과 외래를 방문한 환자를 대상으로 Rome III questionnaire - Korean version에 따라 FGID를 선별하여 144명의 자료를 분석하였다. 인구학적 요인을 조사하였으며, 정신사회적 요인을 평가하기 위해 Hospital Anxiety Depression Scale, Patient Health Questionnaire-15, Childhood Trauma Questionnaire-Korean, State-Trait Anger Expression Inventory를 사용하였다. 통계분석은 독립표본 t-검정(independent t-test)과 교차분석(chi-square test)을 사용하였다. 결 과 FGID에 따른 집단간 비교에서 학력에 따른 차이가 나타났다(${\chi}^2=10.139$, p=0.017). FGID 집단에 따른 정신질환의 차이에서는 과민성 대장증후군(Irritable bowel syndrome, 이하 IBS) 집단에서 유의한 차이가 있었다. (${\chi}^2=11.408$, p=0.022) IBS 집단은 불안(t=-3.106, p=0.002), 우울증상(t=-2.105, p=0.037), 신체증상(t=-3.565, p<0.001), 특성분노(t=-3.683, p<0.001), 분노-억제(t=-2.463, p=0.015), 분노-표출(t=-2.355, p=0.020)에서 높은 점수를 나타냈다. 기능성 소화불량(Functional dyspepsia) 집단에서는 불안(t=-4.893, p<0.001), 우울증상(t=-3.459, p<0.001), 신체증상(t=-7.906, p<0.001), 특성분노(t=-4.148, p<0.001), 상태분노(t=-2.181, p=0.031), 분노-억제(t=-2.684, p=0.008), 분노-표출(t=-3.005, p=0.003)지표가 유의하게 높았다. 비미란성 위식도 역류증(Nonerosive reflux disease) 집단에서는 불안(t=-4.286, p<0.001), 우울증상(t=-3.402, p<0.001), 신체증상(t=-7.162, p<0.001), 특성분노(t=-2.994, p=0.003), 상태분노(t=-2.259, p=0.025), 분노-억제(t=-2.772, p=0.006), 분노-표출(t=-2.958, p=0.004)에서 유의미하게 높은 수준을 나타냈다. 결 론 본 연구에서는 정신질환자에서 FGID의 유병률이 매우 높고, 다양한 정신사회적 변인들이 이에 영향을 미치는 것으로 나타났다. 따라서 이러한 정신의학적 접근은 FGID 환자를 더 잘 이해하고 치료하는데 있어서 도움이 될 것으로 생각된다.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• 제12권2호
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• pp.111-119
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• 2009

목 적: Rome III 기준을 적용하여 소아청소년 만성기능 복통 환아들을 진단하고 분류함으로써 각 아형 별특성에 대한 이해를 도모하여 임상적 적용에 도움을 주고자 하였다. 방 법: 2006년 7월부터 2007년 8월까지 만성 복통을 주소로 분당서울대학교병원 소아청소년과에 내원한 194명을 대상으로 소아청소년기 복통 설문지를 작성케 한 후 의료진이 문진과 진찰을 통해 설문답안을 수정하고 의학적 검사를 시행하여 기질적 질환을 배제한 후 전향적으로 시행하였다. 결 과: 전체 194명 중 복통 관련 기능 위장관 질환으로 확인된 환자는 167명(86.1%)이었으며, 평균 연령은 9.1${\pm}$3.2세, 복통의 유병기간은 2개월부터 85개월로 평균 17.6${\pm}$16.2개월이었고, 이 중 기능 소화불량이 49명 (29.3%)으로 가장 많았으며, 과민 대장증후군이 43명(25.7%), 복성 편두통이 13명(7.8%), 소아기 기능 복통이 45명(27.0%), 소아기 기능성 복통증후군이 21명(12.6%)이었다. 복통과 연관된 기능 위장관 질환의 진단 기준에 해당하지 않아 미분류된 환아는 17명(10.2%)이었다. 다른 아형들에 비해 소아기 기능 복통의 발병 연령이 상대적으로 낮고 진단 시까지의 유병기간이 짧았다(p<0.05). 결 론: Rome III 기준은 소아청소년 복통 관련 기능 위장관 질환의 평가에 좀더 포괄적이며 쉽게 적용할 수 있고 더 정확한 정보와 진단을 제공하여 임상적으로 유용할 것으로 생각된다.