• 제목/요약/키워드: Korean medicine clinical practice guidelines

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2009년 유행 신종인플루엔자 A(H1N1)의 한약 및 기타 비전형적 치료에 대한 고찰 (An Overview of the Herbal Remedies and other Non-conventional Therapies for 2009 Novel Influenza A(H1N1))

  • 선승호;장인수;백유상;배선재;한창호
    • 대한한방내과학회지
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    • 제30권3호
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    • pp.558-570
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    • 2009
  • Background : Since March 2009, when the first patient of novel influenza A (H1N1) was reported, many deaths have occurred in North and Central America. The start of the 2009 influenza pandemic was declared by WHO Director-General Dr. Margaret Chan on 11 June 2009, and the level of influenza pandemic alert raised from phase 5 to phase 6. There was no vaccine yet developed, and many experts worried that the novel H1N1 virus could kill as many or more as did the influenza pandemic in 1918-1919. Objective : To evaluate the possibility of treatment for 2009 novel influenza A (H1N1) using herbal remedies and other non-conventional therapies. Methods : We researched the clinical studies for novel H1N1 influenza virus-related herbal medicine or non-conventional medicine treatment using internet search engines including PubMed and CNKI. In addition, we reviewed many reports and clinical practice guidelines (CPG) for influenza A (H1N1). Results : Two case series were selected after reviewing 701 papers, and two CPG published by the Chinese government and Jilin province identified. They reported that the clinical symptoms were no more significant than seasonal influenza, and the condition of patients more than 45 years old was milder than those less than 45 years old. There are no patients with gastric problems, and oseltamivir has been used at the same time in all patients. Conclusion : The efficacy and effectiveness of herbal medicine and other non-conventional treatments for the novel influenza A (H1N1) is questionable, and more studies are needed to draw a firm conclusion. However, in the severe acute respiratory syndrome (SARS) experience in 2002/2003, it was demonstrated that herbal medicine can relieve all symptoms of SARS patients, promote absorption of lung inflammation, improve the degree of blood oxygen saturation, regulate immunological functions, reduce the required dosage of glucocorticoid and other medicines, and reduce case fatality rate. In light of the current situation that there is no vaccine or conventional treatment yet available, the study of herbal medicine and other non-conventional therapies are also necessary for appropriate evaluation.

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정신신체장애의 최면치료 (Hypnotherapy in Cases with Psychosomatic Disorders)

  • 최병무
    • 정신신체의학
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    • 제10권2호
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    • pp.176-180
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    • 2002
  • 최면치료는 오랜 역사를 가진 치료법으로 최근 들어 다양한 치료기법이 발달되어 적용되고 있다. 최면을 이용하는 치료는 다양한 정신과적, 의학적 장애에서 보조적인 치료기법으로 시용될 수 있으며, 그 효과가 많은 경험적 연구들을 통하여 증명되고 있다. 저자는 두통, 성기능 장애, 천식 등의 정신신체증상을 가진 환자의 치료과정에서 최면치료의 적용을 재검토 하였으며 각 환자에 대한 접근법과 최면의 적용지침, 그리고 치료 요인에 대한 가설 등을 제시하였다. 여타의 정신신체장애 환자의 치료에서도 최면을 적용한다면 그 장애를 치료하기 위한 임상가의 치료전략을 보다 확대할 수 있을 것이다. 향후 다양한 정신신체장애 각각에 부합하는 특이한 최면의 치료 요인과 치료 기법에 대해 보다 체계적인 연구가 필요할 것이다.

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안락사 (Euthanasia)

  • 홍영선;염창환;이경식
    • Journal of Hospice and Palliative Care
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    • 제2권1호
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    • pp.1-6
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    • 1999
  • 배경 : 안락사는 조절되지 않는 고통을 경감시킬 목적으로 한 사람의 생명을 끝낼 의도를 가지고 가해지는 중재를 말한다. 안락사를 합법화하고 규정을 만드는데 대한 논쟁이 의학 논문들을 통하여 계속되어 왔다. 방법 : 지난 수년간 발표된 안락사에 대한 논문들을 정리하였고 안락사를 시행하는 이유들을 알아보았다. 또한 네덜란드에서 안락사를 정책적으로 허용한 이후에 빚어진 결과를 문헌 고찰을 통하여 소개하였다. 결과 : 안락사가 아닌 행위가 종종 안락사로 불리어 왔으나 그 안에 내포된 윤리적 원칙들을 조사함으로써 구분이 가능하다. 네덜란드에서 안락사를 시행하는데 사용하였던 지침들은 부적절하였고 남용된 바가 컸는데도 렘멜링크 위원회의 보고서는 네덜란드에서는 안락사가 적절히 잘 이루어 졌다고 소개하였다. 결론 : 안락사를 합법화 해야할 임상상황은 어디에도 존재하지 않는다. 총괄적이고 여러 분야의 전문가가 협동하는 완화의학은 안락사를 시행해야 할 이유라고 불리는 말기환자들의 고통의 대부분을 효과적으로 조절해 줄 수 있다.

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MicroRNAs and periodontal disease: a qualitative systematic review of human studies

  • Mico-Martinez, Pablo;Alminana-Pastor, Pedro J.;Alpiste-Illueca, Francisco;Lopez-Roldan, Andres
    • Journal of Periodontal and Implant Science
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    • 제51권6호
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    • pp.386-397
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    • 2021
  • Purpose: MicroRNAs (miRNAs) are epigenetic post-transcriptional regulators that modulate gene expression and have been identified as biomarkers for several diseases, including cancer. This study aimed to systematically review the relationship between miRNAs and periodontal disease in humans, and to evaluate the potential of miRNAs as diagnostic and prognostic biomarkers of disease. Methods: The review was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines (reference number CRD42020180683). The MEDLINE, Scopus, Cochrane Library, Embase, Web of Science, and SciELO databases were searched for clinical studies conducted in humans investigating periodontal diseases and miRNAs. Expression levels of miRNAs across the different groups were analysed using the collected data. Results: A total of 1,299 references were identified in the initial literature search, and 23 articles were finally included in the review. The study designs were heterogeneous, which prevented a meta-analysis of the data. Most of the studies compared miRNA expression levels between patients with periodontitis and healthy controls. The most widely researched miRNA in periodontal diseases was miR-146a. Most studies reported higher expression levels of miR-146a in patients with periodontitis than in healthy controls. In addition, many studies also focused on identifying target genes of the differentially expressed miRNAs that were significantly related to periodontal inflammation. Conclusions: The results of the studies that we analysed are promising, but diagnostic tests are needed to confirm the use of miRNAs as biomarkers to monitor and aid in the early diagnosis of periodontitis in clinical practice.

한방의료기관에서의 감기 진료에 대한 일반인의 인식 조사 (A Survey in the General Population on the Perception of the Common Cold Treatment at the Korean Medical Clinic)

  • 김도형;조민경;홍미나;최준용
    • 대한한방내과학회지
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    • 제38권3호
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    • pp.336-352
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    • 2017
  • Objective: This study investigated the perception, utilization, and satisfaction (in the general population), of the common cold treatment at the Korean Medical Clinic, to provide basic information for the development of Korean medicine clinical practice guidelines for the common cold. Method: A questionnaire was developed that consisted of questions about the general perception, utilization status, degree of satisfaction, willingness to use, and the improvement of the common cold treatment at the Korean Medical Clinic. An online survey was conducted using this questionnaire. Results: Three-hundred subjects responded to the survey. The results of the analysis were as follows. 1. 73.7% of the subjects recognized the common cold treatment at the Korean Medical Clinic. 2. 72% of the subjects had a positive perception of Korean medicine for common cold treatment. The major reason for the positive perception was the expectation about improving immunity and preventing recurrence. 3. Only 20% of the subjects had visited the Korean Medical Clinic for common cold treatment. The expensive cost was the major reason for not visiting the Korean Medical Clinic for common cold treatment. 4. The ratio of subjects who were willing to visit the Korean Medical Clinic for common cold treatment was 70%. 5. The expansion of health insurance coverage (67.7%), the activation of public relations (54.7%), and the development of a new herb medicine preparation that was easy to take (43.3%) were found to be necessary for improving the Korean medical service for common cold treatment. Conclusion: In spite of high recognition and positive perception, actual utilization of common cold treatment at the Korean Medical Clinic was relatively low. Multifaceted efforts are necessary to enhance the competitiveness of Korean medical service for treatment of the common cold.

Clinical Practice Guideline for the Diagnosis and Treatment of Pediatric Obesity: Recommendations from the Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology Hepatology and Nutrition

  • Yi, Dae Yong;Kim, Soon Chul;Lee, Ji Hyuk;Lee, Eun Hye;Kim, Jae Young;Kim, Yong Joo;Kang, Ki Soo;Hong, Jeana;Shim, Jung Ok;Lee, Yoon;Kang, Ben;Lee, Yeoun Joo;Kim, Mi Jin;Moon, Jin Soo;Koh, Hong;You, JeongAe;Kwak, Young-Sook;Lim, Hyunjung;Yang, Hye Ran
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제22권1호
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    • pp.1-27
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    • 2019
  • The Committee on Pediatric Obesity of the Korean Society of Pediatric Gastroenterology, Hepatology and Nutrition newly developed the first Korean Guideline on the Diagnosis and Treatment of Obesity in Children and Adolescents to deliver an evidence-based systematic approach to childhood obesity in South Korea. The following areas were systematically reviewed, especially on the basis of all available references published in South Korea and worldwide, and new guidelines were established in each area with the strength of recommendations based on the levels of evidence: 1) definition and diagnosis of overweight and obesity in children and adolescents; 2) principles of treatment of pediatric obesity; 3) behavioral interventions for children and adolescents with obesity, including diet, exercise, lifestyle, and mental health; 4) pharmacotherapy; and 5) bariatric surgery.

주의력결핍 과잉행동장애 한국형 치료 권고안 개정안(II) - 진단 및 평가 - (The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (II) - Diagnosis and Assessment -)

  • 이문수;박수빈;김경미;김현진;박상원;김윤신;이영식;권용실;신동원
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제28권2호
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    • pp.58-69
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    • 2017
  • Attention-deficit hyperactivity disorder (ADHD) is a highly prevalent, impairing, and comorbid disorder that persists into adulthood. ADHD should be diagnosed in the same manner as other common adult mental health disorders. The three most important components in the comprehensive evaluation of patients with ADHD are the clinical interview, medical examination, and completion and scoring of behavior rating scales. The diagnostic evaluation of ADHD should include questions about the symptoms, family history, prior evaluation and treatment of ADHD, as well as other problems including alcohol and drug use. Screening interviews or rating scales, as well as interviews, should be used. When it is feasible, clinicians may wish to supplement these components of the evaluation with the objective assessments of the ADHD symptoms, such as through psychological tests. These tests are not essential to reaching a diagnosis, however, or to treatment planning, but may yield further information about the presence and severity of cognitive impairments that could be associated with some cases of ADHD. As comorbidity is the rule rather than the exception, clinicians should carefully screen for comorbid disorders as part of a comprehensive assessment of ADHD. To receive a diagnosis of ADHD, the person must be experiencing significant distress or impairment in his or her daily functioning, and must not meet the criteria for other mental disorders which might better account for the observed symptoms, such as mental retardation, autism or other pervasive developmental disorders, mood disorders and anxiety disorders. This report aims to suggest practice guidelines for the assessment and diagnosis of children, adolescents and adults with ADHD in Korea.

갱년기장애 사용처방과 변증분류에 관한 전문가 합의 연구 (A Study on the Experts' Agreement on the Patterns Classification of the Prescription for the Use of Menopausal Disorder)

  • 전수형;박영희;김종원;지규용;이지연;이인선
    • 대한한방부인과학회지
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    • 제35권2호
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    • pp.70-86
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    • 2022
  • Objectives: This study attempted to provide prescriptions that can be used according to the classification of menopausal disorders in order to increase the clinical utilization of CaPSPI (Diagnostic System for Climacteric and Postmenopausal Syndrome Pattern Identification). Methods: Delphi method survey was conducted for expert consensus on the Pattern Identification that could be used for each prescription by selecting frequent prescriptions based on the literature researched on the prescription of Korean medicine used for women with menopausal disorders. 11 experts participated in the questionnaire for posterity and 7 experts for sasang constitution. The survey was divided into the main prescription that can be mainly used for the patterns and the minor prescription that can be used although the suitability is somewhat low. Expert consensus was obtained through the second survey, and the pattern classification of prescriptions that were not confirmed here was confirmed through a face-to-face meeting. Results: There were 56 prescriptions mainly used for treatment for menopause, 45 for posterity and 11 for Sasang constitution. There were 69 identifications of 45 posterity prescriptions and 17 classifications of 11 Sasang constitutional prescriptions including major and minor patterns. By pattern identifications, the number of major/minor prescriptions was as follows. 肝鬱 14/5, 腎陰虛 8/2, 腎陽虛 4/1, 肝腎陰虛 2/7, 腎陰陽兩虛 3/1, 心腎不交 6/3, 心脾兩虛 15/2, 心火 7/6. Conclusions: In the future, by accumulating and analyzing the data on the diagnosis and treatment using CaPSPI, the clinical status of Korean medicine for menopausal disorders can be reviewed, and it can be used as the basis for the clinical practice guidelines for menopausal disorders. In addition, it is thought that analyzing the results of the diagnosis of pattern identifications and the prescription of Sasang constitution can be helpful in research on the posterity and Sasang constitution.

다기관 설문조사를 통한 국내 소아 음성질환 환자의 검사 및 치료 유형 연구 (Study on Assessment and Treatment Patterns of Speech-Language Pathologists in Pediatric Vocal Problem Through Multicenter Survey)

  • 이종근;방승환;전재민;이정규;김연;우정수;조재구
    • 대한후두음성언어의학회지
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    • 제30권1호
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    • pp.39-47
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    • 2019
  • Background and Objectives : Pediatric vocal health problems are relatively common. However, it is not yet well studied whether uniform diagnosis and treatment is done properly in South Korea. The purpose of this study was to investigate the methods that the Korean speech therapists use to diagnose and treat pediatric voice problem. Materials and Method : An anonymous online questionnaire was administered to 32 speech language therapists registered at the Korean laryngeal speech linguistics society detailing demographics, employment institution, general management of pediatric patients with vocal problem including assessment and treatment procedures. Results : Current practice patterns were analyzed on 32 speech language therapists providing services in South Korea mostly working at tertiary university hospital. One third of pediatric patients were assessed without proceeding to treatment. One fifth of patients were treated without assessment. Perceptual assessment was the main pretreatment assessment methods used. Treatment was done in the following order : Voice rest, SOVT, yawn-sigh and resonant voice. Post-treatment evaluation was used in the following order : Instrumental assessment, clinical judgment, and recording comparison. Conclusion : Speech language therapists practice in South Korea mostly follows the ASHA practice guidelines. However, there are still great amount of cases in which only the evaluation was done without appropriate treatment. Further research is needed to make SPLs more systematic and efficient for evaluating and treating pediatric vocal patients.

Korean Guidelines for Diagnosis and Management of Interstitial Lung Diseases: Part 2. Idiopathic Pulmonary Fibrosis

  • Lee, Sang Hoon;Yeo, Yoomi;Kim, Tae-Hyung;Lee, Hong Lyeol;Lee, Jin Hwa;Park, Yong Bum;Park, Jong Sun;Kim, Yee Hyung;Song, Jin Woo;Jhun, Byung Woo;Kim, Hyun Jung;Park, Jinkyeong;Uh, Soo-Taek;Kim, Young Whan;Kim, Dong Soon;Park, Moo Suk;Korean Interstitial Lung Diseases Study Group
    • Tuberculosis and Respiratory Diseases
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    • 제82권2호
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    • pp.102-117
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    • 2019
  • Idiopathic pulmonary fibrosis (IPF) is a chronic, progressive fibrosing interstitial pneumonia, which presents with a progressive worsening dyspnea, and thus a poor outcome. The members of the Korean Academy of Tuberculosis and Respiratory Diseases as well as the participating members of the Korea Interstitial Lung Disease Study Group drafted this clinical practice guideline for IPF management. This guideline includes a wide range of topics, including the epidemiology, pathogenesis, risk factors, clinical features, diagnosis, treatment, prognosis, and acute exacerbation of IPF in Korea. Additionally, we suggested the PICO for the use of pirfenidone and nintendanib and for lung transplantation for the treatment of patients with IPF through a systemic literature review using experts' help in conducting a meta-analysis. We recommend this guideline to physicians, other health care professionals, and government personnel in Korea, to facilitate the treatment of patients with IPF.