• 제목/요약/키워드: Oriental physical therapy

검색결과 561건 처리시간 0.026초

동종요법의 기본원리와 사상체질의학의 비교연구 (Study on Comarison of Homeopathy with Sa-sang constitutional Medicine in Basic Principles from the literature)

  • 안상우;조황성
    • 사상체질의학회지
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    • 제8권2호
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    • pp.165-190
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    • 1996
  • 동종요법은 1796년 독일인 의사인 S. 하네만에 의해 제창된, 서양의 현대의학과는 다른, 서양의 전통의학이며, 기본 이념은 유기체 내의 자연치유력의 존재를 전제로 하고 있다. 본 연구에서는 먼저 동종요법 기본이론을 서술하고 이에 상당하는 한의학의 기본원리를 비교 고찰함으로써 차후 여러 가지 종류의 자연요법연구에 기초자료를 제공하고, 하네만의 동종요법과 거의 비슷한 연대에 제창된 동무 이제마의 체질의학이 심신(心身), 즉 정신적 상태와 육체적 질병과의 상호 관계성을 언급한 질병관, 약제의 운용정신 등등의 여러 측면에서 그 유사점과 차이점을 비교 고찰하고자 하였다. 1. 동종요법은 생기론(生氣論)과 기계론(機械論)이라는 대립되는 학문적 전승구조로 부터 잉태된 전일의학으로서 서구 현대의학의 골간을 이루는 뉴튼물리학의 기계론적 패러다임과 상위(相違)되며, 그 이론적 성립과 성장배경에서 직 간접적으로 동양학문의 상적 배경과 한의학 이론이 변용된 상태로 흡수된 자연의학(自然醫學)의 일종이다. 2. 동종요법 약제체질론은 약제반응에 따라 질병증상과 개인의 체질적 특성을 직접 일대일 대응시킨 소략한 체질론으로 규율성을 갖춘 체계가 부족하나 심신상관론(心身相關論), 선천적인 체질결정론 등의 기본이론이 사상체질론과 동일하며, 단일 약물에 대한 세심한 개인특성의 연구는 중경입법과 사상의학의 정신에 부합된다고 할 수 있다. 3. 동종요법은 병증의 변화를 체질화하여 선택적 친화성에 따른 약제별로 다양한 유형으로 구분하고, 이에 비하여 사상의학은 병증의 변화를 자신의 체질적 조건하에서 발생하는 체질병증으로 설명하고 있어 차이가 있다.

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노인의 성별 만성동통 호소의 차이에 대한 조사연구 (Difference of Pain Description According to Gender in the Elderly)

  • 김명애;박경민;김효정
    • 대한간호학회지
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    • 제28권2호
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    • pp.369-379
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    • 1998
  • Despite acknowledgment that pain is likely to be a major problem for many older adults, it is difficult to estimate the frequency of pain problems for this population. The main purpose of this study was to identify the various characteristics of chronic pain in the elderly by gender. It examines by gender, pain frequency, pain intensity, number of chronic pain sites, localization of pain, impact on activities, methods of pain management, and effects of chronic pain management. The subjects were 189 elderly people(65 years and older) living in an urban area. They were surveyed at their homes. They were surveyed by interview using a closed-ended questionnaire. The survey was done from Nov. 6th. to Dec. 6th. 1997. Descriptive statistics were used to determine all of the reported pain variables. Chi-square tests were used to determine crude differences between pain intensity and gender. T-test was used to determine differences in number of pain sites between men and women. The findings are as follows ; Of the 189 subjects, 83.6% reported experiencing pain, and men reported a lower prevalence (69.5%) than women(89.2%). Women had significantly more severe pain than did men(p=.001). Lower back pain(20.2%) and leg pain(20.2%) were the most prevalent, followed by knee pain(17.4%), arm pain(13.3%), neck and shoulder pain(11.6%), and headache(9.9%). Women experienced more multiple localizations of pain(p=.0001), the greatest impact was on movement (83.5%) , followed by usual activities(60.8%), sleep(49.4%), visiting(29.1%), and hobbies and recreations(50.0%). No differences were observed between men and women in the proportion of subjects reporting a negative impact on each of these activities. The methods of pain management were hospital visit(70.9%), drug store medication(46.7%), oriental medicine clinic(32.9%), endurance(13.3%), self-management(6.3%). Drug therapy was the most effective pain management strategy(94%), followed by physical therapy(63%) and accupuncture.byssocausis(55%). The conclusion : Pain is a symptom of great clinical importance that is often associated with disability, loss of independence, and reduced quality of life. In this study chronic pain symptoms were common but unevenly distributed in men and women. The results further advance understanding of the experience and impact of pain by gender. Future studies should incorporate questions that gather systemic and more detailed information on the characteristics of pain, especially by gender and by age.

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흉(胸)·요추(腰椎) 압박골절(壓迫骨折) 환자(患者)에 대한 임상적(臨床的) 고찰(考察) (The clinical study on 44 cases of patient with Thoracolumbar Compression Fracture)

  • 임정은;김기현;황현서
    • Journal of Acupuncture Research
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    • 제17권2호
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    • pp.41-51
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    • 2000
  • Clinical observation was made on 44 cases of stable thoracolumbar compression fracture that were confirmed through simple x-ray and neurological examination. They were hospitalized and treated by acupuncture and moxibustion, bed rest, herb medicine and physical therapy. If necessary, patient was given an enema. The results obtained are as follows. 1. The patient distribution ratio, in regard to sex, was shown to be 1: 13.7 for males to females. In regard to age, it was shown that people in their 60's was the most predominant case, followed by people in their 70's, 80's, 50's and 40's, respectively. 2. In regard to contributing factors, it was observed that accidental falls were most frequent, followed by reasons unknown, repetitive lifting of heavy objects, overlaboring and bruise in that order. 3. In regard to duration of illness before treatment, it was found that treatment within 1 week was most predominant, followed by over 4 weeks, and 1-2 weeks, respectively. 4. With regard to the duration of hospitalization, hospitalization within 2 weeks was found to be most predominant, followed by 2-4 weeks. 5. In regard to the level of the affected vertebral body; The affected vertebral bodies distributed between T3 to L5 except for T7; T12 was found to be most predominant, followed in turn by L1 and L5. 6. In regard to the number of affected vertebral bodies, 2 was the most frequent followed by 1 and 3, in that order. The average of the number of affected vertebral bodies was observed to be 2.8 and single vertebral body compression fracture was shown to have no clinical and statistical difference as compared with multiple vertebral body compression fractures. 7. In regard to the grade of the seriousness of symptoms, it was found that Grade IV was most predominant, followed by Grade III. 8. With regard to signs at the first medical examination, low back pain was seen in the highest number, and followed in order by gait disturbance, flank pain, flexion-extension disturbance, disturbance of rotation to right or left, and bowel dysfunction. 9. Concerning the effect of treatment, good results were most predominantly seen, and 95.5% of total patients showed fair results. 10. The duration of admission treatment due to the grade of clinical symptoms was as follows; In the case of the Grade IV, it was observed that within 2 weeks was most predominant and for Grade III was 2-4 weeks. It was also found that the grade of clinical symptoms was not in proportion to the duration of admission treatment. 11. In regard to the result of treatment due to the grade of clinical symptoms; It was found that in the case of Grade IV, within 2 weeks was most predominant, and for Grade III, it was found to be 2-4 weeks. 12. Intestinal obstruction was shown in 50% of total patients; In the case of duration of constipation, more than 1 week was found to be most predominant, followed by 2 and 4 days respectively. 13. With regard to the treatment of intestinal obstruction, using acupuncture and moxibustion, herb - medicine and enema together were found to be most effective. 14. Intestinal obstruction was mostly seen in the case of Grade IV.

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치(齒)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Literature Study of the Teeth)

  • 곽익훈;윤철호;정지천
    • 대한한방내과학회지
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    • 제16권2호
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    • pp.146-177
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    • 1995
  • The purpose of this study was to investigate the relationship between the teeth and Zhang-Fu(臟腑), dental diseases, and the hygiene of the mouth through the literature of oriental medicine. First, the relatonship between the teeth and Zhang-Fu is reviewed as follows: The teeth are influenced by Shen(腎) because they are the end of bone and Biao(標) of Shen. Gingiva is related to Wei(胃) and Da-Chang(大腸) because it is passed by Yangming-Channel(陽明經). The growth and nutrition of teeth depends on Shen. The pathological condition of Shen causes the gingival atrophy, the loose of teeth, dedentition due to aging, withering of teeth, and tartar: whereas the pathological condition of Wei and Da-Chang causes toothache, gingivitis, inflamed gums, bad breath, and gingival hemorrhage. Second, the causes and therapies of dental diseases through the literature can be summarized as follows: The major causes of toothache are the pathogenic condition of wind-heat and wind-cold, the heat syndrome of Wei, the damp-heat of intestine, flaring-up of fire of deficiency type, rotten tooth, etc... The principal causes of dedentition and the shaking and loose of teeth are the deficiency of Shen, and the rest of causes are the damp-heat of Yangming. Gingival atrophy is caused by the deficiency of Shen, whereas the gingival hemorrhage comes from the factors in the pathogenic factor of wind-heat of Yangming-Channel, the heat syndrome of stomach, and the deficiency of Shen. The causes of grinding of teeth during sleeping are stomach-heat, and the delayed dentition and the withering result from the deficiency of Shen-Jing.(腎精) The principal therapies of toothache are removing wind and heat, clearing away heat and prompting diuresis, clearing away the stomach-heat, replenishing vital essence to tonify the Shen, relieving superficial syndrome by wind-cold, and alleviating pain by destroying parasites. For the prescription of the principal therapies, there are Xijio Dihuang Tang, Jiajian Ganlu Yin, Qufeng Wan, Qingwei San, Tiaowei Chenggi Tang Shengong Wan, Liangge San Qingwei Tang Yunu Jian, Liuwei Dihuang Wan Zuogui Yin Bawei Wan Wanshao Dan, Xixin San Badou Wan Gianghuo Fuzi Tang, Jiuzi Tang Badou Wan, etc... The therapies of dedentition and the shaking and loose of teeth are replenishing vital essence to tonify the Shen, and warming and recuperating the Shen-Yang: as the prescription, there are Liuwei Dihuang Wana Zuogui Yin, and Bawei Wan Anshen Wan Wanshao Dan Yougui Wan etc... The therapies of gingival hemorrhage are clearing away the stomach-heat, replenishing vital essence to tonify the Shen, warming and recuperating the Shen-Yang(腎陽), and moisturing and purging intence heat with the prescription of Tiaowei Chenggi Tang Xijiao Dihuang Tang, Liuwei Dihuang Wan Zuogui Yin, Bawei Wan Anshen Wan, and Yunu Jian. The therapy of gingival atrophy is replenishing vital essence to tonify the Shen in the prescription of Liuwei Wan Bawei Wan Ziyin Dabu Wan. The therapies of grinding of teeth during sleeping are clearing away the stomach-heat and purging intense heat, and invigorating the spleen through eliminating dampness in the prescription of Qingwei San, Wumei Wan, etc... The therapy of delaed dentition is replenishing vital essence to tonify the Shen with the prescription of Liuwei Wan Buyin Jian, etc... Third, clinical treatment reports of dental diseases are reviewed as follows: The toothache due to stomach-heat was treated by medical herbs like Gypsum, Natrir Sulfas, Rehmanniae, Schizonepetal Herba, Menthae Folium, Cimicifugae Rhizoma, and Scrophulariae Radix. The therapies of toothache due to flaring-up of fire in deficiency type from deficiency of Shen provided with replenishment of vital essence to tonify the Shen and clean ministerial fire, and the prescription was the kind of Liuwei Wan, which worked very well. The therapy of dedentition and loose of teeth due to deficiency of Shen was done to stablize the teeth as tonifing the Shen with the prescription of Guchi Wan. The rate of imrovement was over 90%. The destruction of periodontal tissue due to periodonititis was cured of dispelling wind, reducing heat, and alleviating pain, It was improved by taking Zizhi Xingiong Tang, Guchi Xiaotong San, Yunii Jian, and Qingwei San about 3-7 days, and the rate of improvement was over 80%. Fourth, the prevention and regimens are reviewed as follows: As a physical and breathing exercise of the teeth, tapping teeth which stimulates the circulation of Qi(氣) and Xue(血) had been used. The tapping time of 14, 17, 36, etc... has been reported, and it should be applied based on the body condition. The medical herbs for gargling and brushing teeth have been used. Specifically, Cimicifugae Rhizoma, Gypsum, Gypsum Fibrosum, and Indigo pulrelrata Lereis have been used to reduce heat, Coptidis Rhizama and Yang Jinggu to eliminate damp-heat, Amomi Semen, Cyperi Rhizoma, Flos Caryophylli, Asari Radix, Piperis Longi Fructus, Santali Albae Lignum, Meliae Fructus, Moschus, Aquillaiae Lignum, and Borneol to promote the circulation of Qi and to relieve pain, Ligustici Radix, Angelice Radix, Rhizoma Nardostachydis, Tribuli Semen to relieve superficial syndrome by means of diaphiresis, and Cnidii Rhizoma, Angelicae sinensis Radix, and Olibanum to promote blood circulation to stop pain.

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류마티스 관절염 환자의 치료행위 모형 검증을 위한 횡문화적 비교연구 (A Transcultural Study for Testing Models of the Treatment-seeking Behaviors in Patients with Rheumatoid Arthritis)

  • 이인숙;이은옥;은영
    • 근관절건강학회지
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    • 제6권2호
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    • pp.253-277
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    • 1999
  • Patients with chronic disease have various treatment patterns because it shows a progressive degenerative feature. Especially various physical and emotional problems of the rheumatoid arthritis patients leave them shopping around various types of treatment. According to previous studies, over 70% of patients with arthritis experienced the traditional oriental medicine or folk remedies simultaneously with medical treatment within one year after the onset of disease. The purposes of this study are 1) to compare the patterns of treatment-seeking behaviors between Korean arthritis patients and Americans ; and 2) test two models of treatment-seeking behaviors by path analysis, one for early treatment-seeking behavior model(ETBM) and the other is chronic treatment-seeking behavior model (CTBM) in Korean sample. The interview survey was performed to 133 RA patients with structured questionnaire at out-patient clinic or public health center. Patients characteristics such as age, duration of disease were similar in two countries except higher educational background in Americans. There were no patients using only alternative therapies or no medical treatment in the US. Most of the American patients have chosen both medical treatment and alternative therapy, while the Koreans less than American. In Korea, combined treatment group usually consists of the people who are younger, more educated and higher economic status than the characters of other groups in early or chronic stages. In early stage, they tend to have strong belief of curing from the disease, satisfy the relationship with their physicians and comply with direction of the medical professional. The paths of two models were explained by 70% in ETBM and 33% in CTBM. When the models were modified, almost all paths of the CTBM were the same as the previous one, but direct determinant factor was changed from the relationship with physicians to the lay referral system in chronic model. These two models' explanation powers became 94% and 88%, respectively. The attitude or perception of disease, lay referral system and the relationship with medical personnel are the main determinants of treatment-seeking behaviors.

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생쥐의 화상에 미치는 Squalene의 치료 효능 (Healing Effects of Squalene on the Epidermis in Burned Mouse)

  • 김종세;김정상;윤중식;최영복;조광필;김재성;정수만
    • Applied Microscopy
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    • 제29권2호
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    • pp.163-175
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    • 1999
  • 본 실험은 화상을 입은 생쥐에서 SQ의 치유 효과를 알아보기 위함에 있다. 실험군은 7개군으로 구분하였다; 대조군, 화상군, 그리고 화상을 입헌 후 SQ를 처치한 군. 대조군을 제외한 모든 군은 등 부위에 2도 화상을 입혔다. SQ를 처치한 모든 군은 하루에 한 번씩 10초 간격으로 순수한 SQ 3방울을 도포하였다. 화상 후 10일 동안 조직학적 및 미세구조적 변화를 광학 현미경과 전자현미경으로 관찰하였다. 광학현미경으로 관찰한 결과, 화상군의 표피층의 모든 부분은 SQ를 처치한 군보다 더 심한 상처를 입었다. SQ를 처치한 6째와 10일째 군에서, 기저층은 분화가 활발하였고, 가시층의 각화세포는 수적으로 매우 증가하였다. 전자현미경으로 관찰한 결과, SQ를 처치한 모든 군의 기저층에서 세포분열이 화상군에서보다 더 활발하게 나타났다. 특히, SQ를 처치한 10일군에서는 이상적인 결과를 얻을 수 있었다; 대조군보다 더 두꺼운 가시층과 많은 각화세포, 뚜렷한 세포간교, 그리고 멜라닌세포를 포함하는 튼튼한 기저층. 이와 같은 결과로 보아 SQ은 표피성장인자(EGF)를 활성화시키고, 유해산소의 제거 역할을 하며, 막계에 에너지원을 제공할 가능성이 있다. 이 실험의 결과는 SQ가 화상 치료에 특수한 효과가 있다고 사료된다.

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의료급여환자의 의료이용행태에 관한 질적 분석 (Qualitative Analysis of Medical Usage Patterns of Medical Aid Patients)

  • 박영희;이용재
    • 한국콘텐츠학회논문지
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    • 제17권9호
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    • pp.39-49
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    • 2017
  • 본 연구는 질적 연구를 통하여 의료급여환자들의 의료이용 경험을 이해함으로써 의료급여환자와 건강보험환자 간 의료이용량의 통계적 차이현상의 원인과 과정을 파악하기 위해 수행되었다. 주요 분석결과는 다음과 같다. 첫째, 의료급여환자의 과잉의료는 대체로 존재하지 않으며, 복합적 질병을 가지고 있어서 발생하는 것이다. 그러나 물리치료와 한방 침에 있어서 일부 과잉이용이 발생하고 있는 것으로 판단된다. 둘째, 의료급여환자들은 의료비를 마련하기 위하여 생계급여에서 일부를 활용하거나 주변 가족이나 이웃의 도움을 받고 있었다. 그러나 과도한 의료비 부담으로 비급여 의료서비스와 대형병원 의료이용은 실제 의료필요만큼 이용하지 못하고 있었다. 또한 일부 환자는 아파도 우선 참고 견디고 있었다. 한편, 일부 의료기관에서는 의료급여환자에 대한 차별적 진료행위를 여전히 하고 있었다. 셋째, 공무원과 의료기관 모두는 의료급여환자에게 의료비 지원정책에 대한 미흡한 정보 제공 등 충분한 도움을 주지 못하고 있었다. 넷째, 정부가 수행하고 있는 의료급여정책인 선택병의원제도, 의료급여사례관리제도, 진료연장승인제도 모두는 불필요한 의료이용을 감소시키는데 기여하고 있는 것으로 판단된다. 그러나 의료급여환자들에게 필요한 의료이용을 제한하는 문제를 초래할 수 있어 이에 대한 대책마련이 요구되었다. 이상의 연구결과를 살펴보면 건강보험환자와 의료급여환자의 의료이용량의 차이를 통계적으로 검증한 선행연구와는 달리 의료급여환자들은 의도적인 과잉이용을 하지 않고 있으며, 오히려 필요한 의료서비스 이용에 제한을 받는다고 생각하고 있었으므로, 이에 대한 대책마련이 요구된다.

한방공중보건서비스 만족도와 개선방안 (A Study on Satisfaction level with Herbal Public Health Services and its Improvement Plans)

  • 이재원;구진숙;서부일
    • 한국한의학연구원논문집
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    • 제18권2호
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    • pp.65-89
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    • 2012
  • Objective : In order to investigate and improve public Korean medical health service satisfaction level, this study was designed. Method : A questionnaire has been conducted on 212 patients who received treatments at six public health centers in the northern part of Gyeongbuk during 15 days between Sep. 24 and Oct. 8, 2011. Result : 1. An Investigation on the usage of herbal clinics in public health centers reveals that 63.7% have received three times or more medical treatments previously and 61.8% have had their illness treated at other medical institutions. In regard to illness 32.1% have had arthritis or muscle aches. 50.9% have taken insurance medication after having had treatments at the public health centers. 66% have assessed acupuncture and moxa cautery the most satisfying. 2. To a question regarding whether herbal health treatment costs higher than that of physician's, the highest response at 31.6% is 'No'. And to a question regarding whether herbal medicines administered at public health centers have more side effects than that of physician's, the highest response at 39.6% is 'No'. 3. To a question regarding whether herbal treatment of public health centers has little effect against acute disease, 48.1% of responses are 'Fair'. To a question regarding whether herbal treatments, when compared with physician's treatments, boost better recovery of patients, 48.1% of responses are 'Fair'. To a question regarding whether herbal medicine is unscientific, when compared with that of western medicine, 38.2% of responses are 'Fair', To a question regarding whether herbal medicine has faster effect on disease than western medicine, 41.0% of responses are 'Fair'. To a question regarding whether herbal medicine is more effective on disease prevention and promotion of health than disease treatment, 38.2% of responses are 'Fair'. And to a question regarding whether the lack of various types of physical therapy devices in herbal medicine, when compared with western medicine causes inconvenience in herbal treatment, 42.0% of responses are 'Fair'. Those responses take up highest portion at each questionnaire. 4. A comparative study between herbal treatments and physician's treatments has also been conducted. To questions regarding which one of the two considering types of disease is the better, responses are the latter accounted for 43.9% against 'Cancer', the latter accounted for 45.3% against 'Endocrine disorders', the former accounted for 30.7% against 'Psychiatric disorders', the latter accounted for 38.2% gainst 'Otolaryngological(ENT) disease', the former accounted for 47.6% against 'Post traumatic stress disorder', and the former accounted for 52.4% against 'Muscle-skeletal disease'. 5. An investigation on frequency of patients' visits via (p<0.05) of subjects show a statistically significant difference. 6. First, an investigation on frequency of reasons of medical treatments reveal that age, occupation, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects taking insurance medicines after herbal health treatments reveal that monthly income (p<0.05) of subject shows a statistically significant difference. 7. First, an investigation on frequency of a claim that herbal treatments of public health center does not have great effect on acute disease reveals that age, education, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of analysis that herbal treatments has faster effect on disease compared with western treatments reveals that education level, religion, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. 8. When herbal clinics of public health centers and general herbal medicine institutions are compared, a survey on additional treatments that herbal clinics need the most reveals that education level, monthly income, and insurance type (p<0.05) of subjects show a statistically significant difference. Secondly, an investigation on frequency of subjects who want various forms of herbal medicines reveals that occupation and insurance type (p<0.05) of subjects show a statistically significant difference. Conclusion : In order to improve efficiency of treatments and enhance patient's satisfaction level, this study suggests measures such as providing a differentiated acupuncture treatments as a whole, streamlining an reception procedure, adopting more elaborated computer system for a patient to get proper medical attention, standardizing a treatment duration in order for a maximum result, keeping regular office hours, and optimizing a consultation time for a patient.

A Role for Leu247 Residue within Transmembrane Domain 2 in Ginsenoside-Mediated α7 Nicotinic Acetylcholine Receptor Regulation

  • Lee, Byung-Hwan;Choi, Sun-Hye;Pyo, Mi Kyung;Shin, Tae-Joon;Hwang, Sung-Hee;Kim, Bo-Ra;Lee, Sang-MoK;Lee, Jun-Ho;Lee, Joon-Hee;Lee, Hui Sun;Choe, Han;Han, Kyou-Hoon;Kim, Hyoung-Chun;Rhim, Hyewhon;Yong, Joon-Hwan;Nah, Seung-Yeol
    • Molecules and Cells
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    • 제27권5호
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    • pp.591-599
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    • 2009
  • Nicotinic acetylcholine receptors (nAChRs) play important roles in nervous system functions and are involved in a variety of diseases. We previously demonstrated that ginsenosides, the active ingredients of Panax ginseng, inhibit subsets of nAChR channel currents, but not ${\alpha}7$, expressed in Xenopus laevis oocytes. Mutation of the highly conserved Leu247 to Thr247 in the transmembrane domain 2 (TM2) channel pore region of ${\alpha}7$ nAChR induces alterations in channel gating properties and converts ${\alpha}7$ nAChR antagonists into agonists. In the present study, we assessed how point mutations in the Leu247 residue leading to various amino acids affect 20(S)-ginsenoside $Rg_3$ ($Rg_3$) activity against the ${\alpha}7$ nAChR. Mutation of L247 to L247A, L247D, L247E, L247I, L247S, and L247T, but not L247K, rendered mutant receptors sensitive to $Rg_3$. We further characterized $Rg_3$ regulation of L247T receptors. We found that $Rg_3$ inhibition of mutant ${\alpha}7$ nAChR channel currents was reversible and concentration-dependent. $Rg_3$ inhibition was strongly voltage-dependent and noncompetitive manner. These results indicate that the interaction between $Rg_3$ and mutant receptors might differ from its interaction with the wild-type receptor. To identify differences in $Rg_3$ interactions between wild-type and L247T receptors, we utilized docked modeling. This modeling revealed that $Rg_3$ forms hydrogen bonds with amino acids, such as Ser240 of subunit I and Thr244 of subunit II and V at the channel pore, whereas $Rg_3$ localizes at the interface of the two wild-type receptor subunits. These results indicate that mutation of Leu247 to Thr247 induces conformational changes in the wild-type receptor and provides a binding pocket for $Rg_3$ at the channel pore.

구조화된 재활교육이 뇌졸중환자 가족의 스트레스에 미치는 영향 (A Study of the Effect of Structured Rehabilitation Education on the Stress of the Family with Stroke Patients)

  • 김병은;이정민;이향련
    • 동서간호학연구지
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    • 제1권1호
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    • pp.22-39
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    • 1997
  • Purpose: The purpose of this study is to evaluate the effect of rehabilitation education on the reduction of the stress of family members who have patients suffering from stroke and to find a new way to nurse the patients and their family. Subjects & Methods: The subjects were sixty-one family members with the patients who had been hospotalized in K hospital of oriental medicine from september the 9th, 1996 to september the fourteen, 1996. This study was performed by simulated control group pretest-posttest design; pretest was done on the control group through a questionnaire, counselling and observation while posttest was done on the experimental group 1-2 days after systemic rehabilitation education. To teach the patients and their family, the amended version of a book written by Lee Hae-jin was used as a tool for systemic rehabilitation education. As a method to estimate ADL score, modified Kang's method was applied and ADL score was measured by well-trained technician. As for the tool to estimate the degree of family stress, Choi's method adjusted to this study was applied. In the analysis of the data, social property of the patient and the characteristic of the disease were surveyed in $X^2$ examination to confirm the consistency between the experimental group and the control group. The diffrence in the degree of the stress, which is a dependent factor, was examined by t-test. The difference in ADL score between the experimental group and the control group was examined by t-test. The difference in the degree of the stress according to the general feature of the family with stroke patient, social property of the patients and the characteristic of the disease were surveyed by F examination. The difference in family stress according to the degree of ADL was surveyed by F examination. RESULTS: 1. After hypothetically-examined systemic rehabilitation education, the total of the score of family stress surveyed in 34 items of three domains was compared between the experimental group and the control group. There was no statistically significant difference between two groups; mean score of experimental group=2.28, that of control group=2.93(t=.17, df=59, p=. 66). 2. In the survey on family stress in 34 items, the items over mean score 3.0 were firstly the anxiety of possible disability and relapse of the disease and secondly to watch the patient's suffering without doing anything in the domain of the change of the disease and the difficulty in caring. And the items of the lowest stress with less than mean 2.0 score were little chance to meet the relative and friends, inconsistent treatment and attitude of the medical workers and the change of the attitude of the relative due to the patient orderly in the domain of social and personal relation and the responsibility as the family. The items which showed the difference between two groups were aggravation of neighboring patient(t=3.36, df= 59, p=.001) and the possibility of patient's death(t=2.19, df=58.38, p=.033) in the domain of the change of the disease and the difficulty in caring. 3. In the study on the stress difference according to general features of the family with the stroke patient, the score of family stress with the occupation was higher with mean 2.49 than that of the family stress without occupation with mean 2.16, but there was no significant difference. (F=5.21, df=1/59, p=.026). 4. In the study on the stress difference according to social property of the patient and the characteristic of the disease, there was significant difference in the age of the patients (F=2.98, df=3/57, p=.039). These results show that even if there is no statistically significant difference between two groups, sixteen of the experimental group are less than 3.0 in ADL score(standard 6 score)while eight of the control group are less than 3.0 and that ten of the experimental group are in the year range of 39-49 while four of the control group are in the year range of 39-49 which showed significant difference in family stress. These imply that there is a possibility that the experimental group have serious and fundamental stress resulting in high pretest stress compared with the control group. It might be due to the characteristic of simulated control group pretest-posttest design that the psychologic-supportive effect by the education was not observed. On the basis of these results, the followings are suggested. 1) A study on the nursing-mediated method to reduce the stress in the items which are not resolved by rehabilitation education, a study on nursing according to the patient's age and a study on the supportive nursing toward the family with occupation are required. 2) More than two times consecutive nursing-mediated rehabilitation education to measure the family stress is required. 3) Comprehensive and multilateral systemic education program including the instruction on western-eastern medicine, physical therapy, exercise and diet through collaboration of the experts in each field is required. 4) Family stress at home as well as in the hospital needs to be estimated and home rehabilitation and home-nursing needs to be continued.

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