• 제목/요약/키워드: Oriental medical service

검색결과 296건 처리시간 0.03초

파킨슨병 변증 유형 및 지표 분포에 대한 전향적 다기관 관찰연구 프로토콜 (An Observational Multi-Center Study Protocol for Distribution of Pattern Identification and Clinical Index in Parkinson's Disease)

  • 조혜연;권오진;서복남;박성욱;유호룡;장정희
    • 대한한방내과학회지
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    • 제45권1호
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    • pp.1-10
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    • 2024
  • Objectives: This study investigated the pattern identification (PI) and clinical index of Parkinson's disease (PD) for personalized diagnosis and treatment. Methods: This prospective observational multi-center study recruited 100 patients diagnosed with PD from two Korean medicine hospitals. To cluster new subtypes of PD, items on a PI questionnaire (heat and cold, deficiency and excess, visceral PI) were evaluated along with pulse and tongue analysis. Gait analysis was performed and blood and feces molecular signature changes were assessed to explore biomarkers for new subtypes. In addition, unified PD rating scale II and III scores and the European quality of life 5-dimension questionnaire were assessed. Results: The clinical index obtained in this study analyzed the frequency statistics and hierarchical clustering analysis to classify new subtypes based on PI. Moreover, the biomarkers and current status of herbal medicine treatment were analyzed using the new subtypes. The results provide comprehensive data to investigate new subtypes and subtype-based biomarkers for the personalized diagnosis and treatment of PD patients. Ethical approval was obtained from the medical ethics committees of the two Korean medicine hospitals. All amendments to the research protocol were submitted and approved. Conclusions: An objective and standardized diagnostic tool is needed for the personalized treatment of PD by traditional Korean medicine. Therefore, we developed a clinical index as the basis for the PI clinical evaluation of PD. Trial Registration: This trial is registered with the Clinical Research Information Service (CRIS) (KCT0008677)

한 농촌지역 2개면 보건지소 통합전후 보건의료사업 변화 연구 (The Change of Health Service before and after the Unification of two Health Subcenters in a Rural Area)

  • 설수정;박향;손석준;박종;김기순
    • 농촌의학ㆍ지역보건
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    • 제25권2호
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    • pp.427-440
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    • 2000
  • 농어촌 의료서비스 개선사업의 일환으로 추진된 전라남도 장흥군 장동면과 장편면 2개면 보건지소를 통합하여 보다 수준 높은 통합보건지소를 설치하기 전인 1997년과 통합후인 1999년의 보건의료자원의 변화, 환자진료통계, 보건사업통계를 비교한 결과 다음과 같은 결과를 얻었다. 1. 통합전 보건지소의 시설은 진료실과 보건사업 사무실 등 극히 제한된 시설에 2개 보건지소를 합하여 일반의사 2인, 치과의사 1인, 간호조무사 4인, 치과위생사 1인 이상 8명의 직원이 근무하였으나 통합보건지소는 일반 진료실, 치과진료실 외에도 한방진료실, 소독실, X-선실, 임상병리실, 약국, 물리치료실, 보건사업 사무실이 갖추어진 지하 1층, 지상2층 총 건축면적이 $335m^2$이나 되는 시설을 갖추었고 전문의 l인, 일반의 1인, 치과의 1인, 한의 1인, 간호사 2인, 간호조무사 4인, 임상병리사 1인, 치과위생사 1인, 방사선사 1인, 물리치료사 1인 등 이상 다양한 전문직종이 포함된 14명의 직원이 근무하고 있었다. 2. 통합적인 1997년 1년동안 2개 보건지소의 수입을 합하여 78.815천원이어서 주민1인당 평균 14,000원이었던데 비하여 통합후인 1999년 1년동안 통합보건지소의 수입은 140,376천원으로 주민1인당 평균 25,000원에 해당하였다. 이러한 수입액은 인건비를 제외한 보건지소 운영비로 사용되었으며 의약품비가 가장 많은 비중을 차지하였다. 3. 통합전후 진료사업 통계를 비교한 결과 통합전에는 진료과목으로 일반진료 90.5%, 치과 9.5%이었고 초진 8.4%, 재진 91.6% 이었으나, 통합후에는 진료과목으로 일반진료 71.2%, 치과 10.8%, 한방 16.5%, 임상검사 1.5%의 분포를 보이고 초진 29.7%, 재진 70.3% 이었다. 통합전후 모두 치료받은 질환 종류는 근골격계 질환인 관절염이 가장 많은 빈도를 차지하였으며 한방진료도 요각통으로 가장많은 치료를 받았다. 통합전에는 치과진료로 매복치 및 매몰치가 가장 흔한 문제였으나 통합후는 치수염이 가장 빈도가 많은 문제이었다. 치료가 1인당 월평균 치료비는 통합전에는 9,363원이었으나 통합후에는 8,309원이었다. 6. 통합전후 대상인구당 보건사업 실시율을 분석한 결과 독거노인관리, 고혈압관리, 당뇨 환자관리, 임부등록에서는 통합후에 통합전보다 다소 감소하였지만 그 외 대부분의 만성질환자에 대한 방문보건사업, 모자보건사업, 예방접종 사업량은 정체되거나 약간 증가되는 경향을 보였다. 이상을 보면 통합전 2개 보건지소에 비하여 통합보건지소는 시설, 규모, 조직, 예산이 방대해져서 진료환자수는 증가하였으나 1인당 진료 단가는 다소 감소하였다. 예방 보건사업은 일부 사업량은 증가하였으나 일부 사업은 감소하였다. 통합보건지소가 소기의 목적을 달성하기 위해서는 2개면 전체주민을 위한 보건의료사업 활성화를 위한 보다 많은 노력이 요구되며 계속적인 평가도 필요하다.

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Evaluation of Atopy Dermatitis Information on the Internet in Korea

  • Seo, Min-Jun;Park, Jin-Han
    • Journal of Evidence-Based Herbal Medicine
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    • 제1권2호
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    • pp.1-6
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    • 2008
  • The internet is closely related to the lives of modern people in the 21st Century. Exchanging information with others over the internet in any place through is possible nowadays and such exchanging information has been developed at rapid speed also in the areas of medical care. The internet is an important and rapidly-evolving source of health-related information, and many patients with atopy dermatitis attempt to find information from the internet. This study was performed to investigate the current information available in atopy dermatitis on the internet in Korea. We chose three portal sites and two network communities to analyze the information in which the topic of 'atopy' could be found. Among the 2,024 web sites and 5,613 network communities, 98.2% of the web sites and 71.7% of the communities were related products or service advertisements, and some of them provided incorrect of exaggerated information. There were only 42 web sites and 75 available communities with genuine information, and most of these also presented unattested treatment methods, including alternative therapies. It is quite understandable that patients with atopy dermatitis want to seek information related to their disease and the internet has the potential to be a useful source of information. However, there are no regulations to control the accuracy and quality of information on the internet. We should take an active role in identifying the accuracy and evaluating the quality.

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소아 발작 질환에 대한 국내 임상논문 고찰 (A Review of Korean Medicine Treatment for Seizure Disease in Children)

  • 이신희;백정한;조연수
    • 대한한방소아과학회지
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    • 제34권3호
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    • pp.37-54
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    • 2020
  • Objectives The purpose of this study is to analyze the treatment and treatment's effect for seizures disease in children by reviewing Korean clinical studies. Methods 13 articles which were published from August, 2002 to August, 2016 were obtained from the National discovery for science leader (NDSL), Research information sharing service (RISS), Google Scholar, and Oriental medicine advanced searching integrated system (OASIS) by using keyword 'Seizure', 'Convulsion', and 'Epilepsy'. Results Most of the study cases were with epilepsy children. The most frequently used herbal medicine was Gwakhyangjeonggi-san gami, and the most commonly used acupoints were LI4 and LR3. Treatment periods range from 13 days to 14 months, and all of the seizures were completely cured or relieved after the treatments. Conclusions This study shows that there are common symptoms and treatments for seizures in children. The reported different treatments can be used in primary medical care. Developing guideline standards of the seizure treatments can be possible with further studies.

한방건강보험 약제 투약 실태 및 활성화 방안 연구 (A Study on the Current Status of Prescribed Drugs in Oriental Health Insurance and their Improvement)

  • 권용찬;유왕근;서부일
    • 대한본초학회지
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    • 제27권2호
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    • pp.1-16
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    • 2012
  • Objective : To investigate the current status of prescription drugs in Oriental medical institutes and to draw up a future plan for the revitalization of Oriental medical health insurance, this survey has been performed. Method : The survey has been made with 321 doctors working at Oriental medical institutes in Daegu and Kyungbuk areas for a period of 3 month from June 1, 2010 until September 1, 2010. Result : 1. When it comes to the current status of the use of herbal drugs in Oriental Health insurance, most of doctors surveyed prescribe insurance drugs, and they prescribe insurance drugs to patients, who are less than 20% of total patients visiting their clinics. 2. The awareness of Herbal Health Care Drugs is investigated. When it comes to the understanding of the difference between insurance drugs(powder type drugs) and granular type drugs, doctors admit that they differ only in one aspect, whether or not their being covered by health insurance. Based on the survey results on the understanding of insurance coverage of granular type drugs, doctors, even though they long for granular type drugs to be accepted as insurance drugs, are worrying whether the number of outpatients might dwindle due to increased insurance co-payments. They also point out that the biggest obstacles in the expansion of the granular type drugs as insurance drugs are the lack of understanding of the government and the objection of the Health Insurance Review and Assesment service (HIRA) for fear of increased insurance claims. 3. Upon investigation on Oriental medicine doctors' understandings of herbal pharmaceutical industry, it is found that doctors' responses on pharmaceutical industry are not all positive ones('new product development and neglect of R&D infrastructure' and 'smallness of industry'). When it is investigated what area needs the greatest improvement in herbal pharmaceutical industry, 'securing sufficient capital, good manufacturing, and strengthening quality control', is the highest. 4. When it is asked what are the most needed in order to improve herbal health insurance medicine, responses such as 'the increase in the accessibility to and the utilization of Oriental medical clinics through the diversification of the means of prescriptions', 'the improvement of insurance benefits(cap adjustments)', 'increase the proportion of high quality medicinal plants', 'the ceiling of co-payments(deductible) at 20,000 won or more', 'expansion of the choices of formulations', 'formulational expansions of tablets and pills', and finally 'admittance and expansion of granular type drug as insurance drug' are the highest. 5. Upon investigating the general characteristics of the current status of the usage of Oriental health care herbal drugs, the followings are observed. First, the frequency of use of health insurance drugs by the doctors who use health insurance with general characteristics shows similar differences in case of total monthly sales amount (p<0.001), average number of daily patients (p<0.05). Secondly, as to the willingness of the expanded usage of insurance drugs, similar differences are observed in case of total monthly sales amount (p<0.05). 6. Upon investigating the general characteristics of the perception of Herbal health care drugs, the followings are observed. First, inspecting general characteristics and insurance claims due to increased co-payments(deductible amount) reveals similar differences in case of working period (p<0.01) and in case of total monthly sales amount (p <0.01). Secondly, inspecting general characteristics and the obstacles that hinder granular type drugs from being accepted as health care insurance drugs shows similar differences in case of working period (p<0.05). 7. Upon investigating the general characteristics of the understanding of Oriental Herbal pharmaceutical companies, the followings are observed. First, opinions on the general characteristics of pharmaceutical companies, when examined with variance analysis, shows similar differences in case of total monthly sales amount (p<0.05). Secondly, when opinions are examined on general characteristics and the problems of herbal pharmaceutical companies, similar differences are found in case of working period (p<0.01) and in case of total monthly sales amount (p<0.001). Lastly, opinions on the general characteristics and reforms of pharmaceutical companies, similar differences are observed in case of working period (p<0.001). 8. Upon investigating the general characteristics of the improvement of insurance Herbal drugs, the followings are observed. First, regarding general characteristics and insurance benefits, similar differences are observed in case of working period (p<0.05), in case of total monthly sales amount (p<0.05), and in case of average number of daily patients (p<0.01). Secondly, opinions on the general characteristics and the needs for the improvement of Herbal insurance drugs are examined in 5 different aspects, which are the approval of granular type drugs as insurance drugs, the expanded practices of the number of prescription insurance drugs, the needs of a variety of formulations, the needs of TFT of which numbers of Oriental medical doctors are members for the revision of the existing system, and the needs of adjusting the current ceiling of the fixed amount and the fixed rate. When processed by the analysis of variance, the results show similar differences in case of average number of daily patients (p<0.01). Conclusion : From the results of this study the first measures to take are, to reform overall insurance benefit system, including insurance co-payment system(fixed rate cap adjustment), to expand the number of the herbal drugs to be prescribed matching with insurance benefit accordingly, and to revitalize herbal medicine insurance system through the change of various formulations. In addition, it is recommended to improve the effectiveness of herbal medicine by making plans to enhance the efficacy of herbal medicine and by enabling small pharmaceutical companies to outgrow themselves.

증자 둥굴레 추출물의 3T3-L1 지방세포에서 분화억제 및 지질강하 효과 (Effects of steamed Polygonatum odoratum extract on inhibition of adipocyte differentiation and lowing lipid in 3T3-L1 adipocytes)

  • 강병태;최원경;박동철;김종국;박모라;김성옥;김미려
    • 대한본초학회지
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    • 제29권2호
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    • pp.15-21
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    • 2014
  • Objectives : The purpose of this study was to investigate inhibitory effects of steamed Polygonatum odoratum extract (POE) on differentiation and adipogenesis in 3T3-L1 adipocytes. Methods : Polygonatum odoratum (P. odoratum) extract was extracted with ethyl acetate. Total phenolic and flavonoid contents in POE were measured for antioxidant activity. The spectrophotometric method was used to determine the DPPH and ABTS radical scavenging activity and ferric-reducing antioxidant potential (FRAP). MTT assay was examined for cell toxicity, oil red O staining was performed for intracelluar adipogenesis in differentiated 3T3-L1 adipocytes. Western blot analysis for measurement of CCAAT/enhancer-binding protein ${\alpha}$ ($C/EBP{\alpha}$), peroxisome proliferator-activated receptor${\gamma}$ ($PPAR{\gamma}$) and AMP-activated protein kinase (AMPK) expressions were performed. Results : The results revealed that POE has antioxidant activities. Contents of total polyphenolics and flavonoids were $50.83{\pm}1.52$ GAE mg/100g dry weight of POE and $17.05{\pm}2.47$ RE mg/100g dry weight of POE, respectively. DPPH radical scavenging activity, and FRAP in 10 mg/ml concentration were $92.1{\pm}0.6%$, $244.8{\pm}9.0{\mu}M$ Fe(II) and ABTS inhibition in 5 mg/ml concentration was $84.8{\pm}4.1%$. Treatment of POE in adipocytes inhibited the differentiation and adipogenesis of 3T3-L1 adipocytes compared to those of vehicle control. Additionally, protein expressions of $C/EBP{\alpha}$ and $PPAR{\gamma}$, major transcription factor for the adipogenic genes, were significantly decreased compared to those of vehicle control (p<0.05). Futhermore, phosphorylation of AMPK was increased in 3T3-L1 adipocytes treated with POE compared to that of vehicle control (p<0.05). Conclusions : we demonstrate that steamed P. odoratum extract (POE) has potentiating antioxidant activities, inhibits differentiation and lipid accumulation and also induces energy expenditure in adipocytes, which may contribute to antiobesity property.

최근 국내 한방 진료를 받은 소아·청소년 환자의 질환 진단명 분석 (A Study of the Recent Diseases in Korean Pediatrics and Adolescent Patients Treated with Oriental Medicine)

  • 김경리;이진화
    • 대한한방소아과학회지
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    • 제32권1호
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    • pp.54-74
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    • 2018
  • Objectives The purpose of this study is to investigate recent trend of diseases in Korean pediatrics and adolescent patients treated with oriental medicine. Methods Using data from the Korean statistical information service and healthcare bigdata hub, top 500 diseases pediatrics and adolescents that were treated with oriental medicine from 2012 to 2016 in admission and outpatient department was collected. Results From the inpatient study, majority of the subjects were between 15 to 19 years old (62.74%), followed by 10 to 14 years old, 5 to 9 years old and under 5 years old. In the outpatient department study, majority was 15 to 19 years old (36.51%), followed by 10 to 14 years old, under 5 years old, 5 to 9 years old. In systemic division of admission part, the most common disease was musculoskeletal related which was 72.32%, followed by brain, nerve, respiratory, dermatology and digestive related diseases. In systemic division of outpatient department, respiratory disease was the most common (41.81%), followed by digestive, dermatology, brain and nerve diseases. For under 5 years old patient group, respiratory disease was the most common, 29.86%, followed by dermatology, musculoskeletal, digestive related diseases. For 5 to 19 years old group of patients, musculoskeletal disease was most common. For the 5 to 14 years old patient group, respiratory related disease was the most common followed by dermatology and digestive diseases. For 15 to 19 years old patient group, digestive disease was the most common followed by respiratory and dermatology related diseases. For under 5 to 9 years old outpatient group, respiratory disease was the most common, and for under 5-year-old group, digestive, growth development, and dermatology disease were common. For the 5 to 9 years old group of patients, musculoskeletal related disease was the most common followed by digestive and dermatology related diseases. For the 10 to 19 years old patient group, musculoskeletal was the most common. For the 10 to 14 years old patient group, respiratory related disease was the most common followed by digestive, dermatology disease. For the 15 to 19 years old patient group, digestive related disease was the most common followed by respiratory, dermatology diseases. Musculoskeletal disease increased every year, in both inpatient and outpatient. Respiratory, brain, nerve, digestive related diseases were generally decreased. In outpatient, respiratory diseases were increased every year but brain, nerve, digestive related diseases were generally decreased. Conclusions More studies about the oriental medicine in chronic disease, such as allergy, metabolic syndrome, in Korean pediatrics and adolescents are needed.

노인 식이양생(食餌養生)을 위한 약선죽(藥膳粥)에 관한 연구 - "양노봉친서(養老奉親書)"를 중심으로 - (Studies of the Gruel as Medicated Diet for the RegimenYangSaeng of the Elderly - In Yang-lo-bong-chin-seo(養老奉親書) -)

  • 김정은;지명순
    • 대한한의학원전학회지
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    • 제26권1호
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    • pp.99-129
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    • 2013
  • Objective : Most disease of the aged comprise chronic illness, hence the diet is important. Yet, the study on diet methodology for the remedy of the aged folks' aliments is scarce. The diet for the aged must be easy to digest- in regard to the physiological features of the aged, delightfully chewable, while meeting the expectation and guaranteeing nutrition-supply and remedial efficacy. Material and Method : This study is designed to accomplish following things with the Yang-lo-bong-chin-seo, a text on maintaining and upbringing the health for the aged: (1) classify the food recorded in the text in terms of cooking methods, (2) then sort the main ingredients in remedial herbal rice porridge(Yak-sun-jook) in food material science manner, (3) evaluate the cooking methods of the porridge for each and various symptoms, and (4) assess the features of each ingredient of the porridge, the value of it both in oriental medicine's and nutrition's scope. Results : 1) Among 64 main dishes recorded in Yang-lo-bong-chin-seo, rice porridge composes the majority, which is 64%. Stew and soup account for 60% of side dishes. 2) In 15 food cures, 43 remedial herbal rice porridges(Yak-sun-jook) were recorded. 3) Yak-sun-jook utilizes most chinese herbs as its food material. 4) Yak-sun-jook is made more with vegetable ingredients than animal ingredients and consist highly of chinese herbs. 5) Main ingredients in the porridges are effective in disease cure in addition to sufficient, well-balanced nutrition. 6) Cooking method of the porridge is grinding chinese herbs into powder or boiling them for a long time. Conclusion: All forementioned steps build the informational foundation - for this purpose the information be utilized - for making possible the development and the devising of pragmatic and feasible Remedial herbal rice porridge(Yak-sun-jook).

한의사인력의 중장기 수급 추계 연구 (Future Demand and Supply of Physicians for Korean Medicine)

  • 김진현;배현지;이선동
    • 대한예방한의학회지
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    • 제17권1호
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    • pp.149-162
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    • 2013
  • Objectives : This study was conducted to estimate the future demand and supply of physicians for korean medicine from 2016 year to 2026 year in order to make an adequate manpower policy in a way of keeping a balance between demand and supply. Methods : Baseline projection method and trend analysis(a polynomial log power equation model) were used in the estimation of future supply and demand respectively. We used data about the amount of oriental doctors from Ministry of Health and Welfare Statistics Yearbook and the treatment days from HIRA Statistics Yearbook. Results : It was projected that the total number of physician of Korean medicine will be 25,178 registered and 18,967 available in clinical setting. According to polynomial equation model which explained the trend of demand and had the highest score of $R^2$ among the equation models, 3,800~5,600 physician in Korean medicine will be oversupplied in 2016 year, 9,000~10,700 physicians in 2021 year and 15,700~17,000 persons in 2026 year depends on annual working days which is 265days, 255days or 239days. Log equation model also showed that overall excess supply of physician manpower in Korean medicine. Conclusions : Alternative manpower policies for Korean medicine doctors should be implemented in a way of both dwindling supplies and growing demand in Korean medical service in terms of Korean medical services utilization and improving physician's productivity.

양.한방협진에 대한 지역주민의 인식 - 일부 보건소 이용자를 중심으로 - (Perceptions of Residents Visiting Local Health Centers on the Collaborating Care of Korean Traditional Medicine and Western Medicines)

  • 윤태형;박해모
    • 대한예방한의학회지
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    • 제14권1호
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    • pp.37-48
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    • 2010
  • Objective : The purpose of this research was to provide basic data for developing the collaborating care of Korean traditional medicine and western medicines by analyzing the perceptions of residents visiting local health centers on the collaborating care. Method : To this end, a self-administrated questionnaire was surveyed to 417 participants from March 10 to March 19, 2005. The questionnaires were regarding medical preferences, effectiveness, co-operative treatment types, and the demographic characteristics of the study population. The main statistical methods employed for analysis were frequency chi-square test analysis, using SPSS system 12.0 software for Windows. Result : First, the perceptions of collaborating care, such as preference and effectiveness, were better for residents who had experienced Korean traditional medicine(p < 0.05). Second, the most favorable collaborating care type was the neuromuscular disease and rehabilitation, and in particular, the preference of the patient who had experienced Korean traditional medicine was much higher than those who had not experienced it(p < 0.05). Third, as for recognizing the future of collaborating care, respondents insisted that collaboration care has to be conducted under evidence-based research. The reasons why collaborating care has not been active were reported as "difference in solving disease problems between oriental medicine and western medicine." The most important role of the Korean traditional medicines in the public sector was to provide specialized service for the elderly and low income households. Conclusion : Most respondents expected the positive effects of the collaborating care and wanted it to develop, particularly for neuromuscular diseases. As for the health promotion program in health centers, it was more popular than the home visiting program for the elderly and preventive rehabilitation for stroke. Now we must plan to balance between the need of the community and the medical provider on collaborating care.