• 제목/요약/키워드: Pain Rating Scale

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전신성 근긴장이상을 호소하는 환자에 대한 한의 치료 1례 (A Case Study of Korean Medicine Treatment in a Patient Complaining of Generalized Dystonia)

  • 이경화;허혜민;김동주;곽민제;황예채;조승연;박정미;고창남;박성욱
    • 대한한방내과학회지
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    • 제45권2호
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    • pp.208-218
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    • 2024
  • We report a case of generalized dystonia that developed from oromandibular dystonia and improved following Korean medicine treatment. The patient was hospitalized for 18 days and treated with herbal medicine, mainly Hyeongbangsabaek-san and Soyangbowi-tang, acupuncture, electroacupuncture, pharmacopuncture, cupping, and moxibustion. To evaluate the clinical effects of the treatment, we used the Unified Dystonia Rating Scale (UDRS) and Global Dystonia Severity Rating Scale (GDS) and checked dyskinesia occurrence in a diary recorded by the patient's guardian. After 18 days of hospitalization, the UDRS for the trunk, upper extremities, and lower face improved by more than 50%, and the GDS for the whole region, except the larynx and lower face, also improved. In addition, the maximum duration of dystonia decreased from 6 hours to 3 hours, and the pain and numbness associated with dystonia disappeared. This case suggests that Korean medicine treatment is effective in treating generalized dystonia.

혈액투석을 받는 만성신부전 환자에서 하지불안증후군과 삶의 질 (Restless Legs Syndrome and Quality of Life in Hemodialysis Patients)

  • 최현석;강승걸;부창수;이헌정;조원용;김형규;김린
    • 수면정신생리
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    • 제14권2호
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    • pp.99-106
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    • 2007
  • 목 적:혈액투석을 받고 있는 만성신부전 환자들에서 하지불안증후군(restless legs syndrome, RLS)의 발생빈도와 삶의 질과의 관계에 대한 연관성을 평가하는 것을 목적으로 하였다. 방 법:고대안암병원 인공신장실에서 만성신부전증으로 혈액투석 중인 83명의 환자들을 대상으로 직접 면담과 설문지를 통해 International Restless Legs Syndrome Study Group(IRLSSG) 진단기준에 합당한 지를 검사하였고 International Restless Legs Scale(IRLS), Athens insomnia scale(AIS), Epworth sleepiness scale(ESS), Medical Outcome Study Short Form-36(SF-36)을 설문지를 통해 측정하였다. 또한 각 환자들의 정신적 상태와 우울증에 대한 선별을 위해 Clinical Global Impression(CGI)와 Hamilton Depression Rating Scale(HDRS)을 시행하였다. 결 과:31명(37.3%)이 IRLSSG 진단기준에 합당한 RLS 환자로 판명이 되었고 RLS 증상을 가지는 환자들은 51.8%에 이르렀다. RLS로 판정된 경우에는 높은 AIS, ESS, HDRS, CGI 점수와 통계적으로 유의한 관련성이 있었다. 또한 RLS 환자로 판정된 경우 낮은 SF-36 총점, 신체적 정신적 요소 점수를 보였고 특히 세부항목으로는 낮은 신체적 역할 제한, 전반적인 건강상태, 신체적 역할제한, 정신적 역할제한, 정신건강 점수와 통계적으로 유의한 관련성이 있었다. 결 론:혈액투석을 하는 만성신부전 환자에서 높은 RLS 유병률을 보이고 있다. RLS를 동반한 경우는 동반하지 않은 경우보다 전반적인 삶의 질의 저하를 보였고 세부적으로는 역할의 제한, 전반적인 건강 및 정신건강 상태 항목에서의 저하가 뚜렷하게 나타났다.

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반복적 복통 환아의 정신과적 연구(反復的 腹痛 患兒의 精神科的 硏究) (A PSYCHIATRIC STUDY ON THE CHILDREN WITH RECURRENT ABDOMINAL PAIN)

  • 최진숙;홍강의;서정기
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • 제1권1호
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    • pp.117-129
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    • 1990
  • 반복적(反復的) 복통(腹痛)을 주소(主訴)로 1988년(年) 7월(月) 1일(日)부터 1989년(年) 2월(月) 28일(日)까지 서울대(大)병원 소아과(小兒科)를 방문하여 기질적(器質的) 원인(原因)이 배제(排除)된 후 소아정신과(小兒精神科)로 의뢰된 만 6재(才)~11재(才)의 아동(兒童) 35명(名)을 연구(硏究) 대상(對象)으로 하여 이들을 정상(正常) 아동(兒童)과 비교하여 반복적(反復的) 복통(腹痛) 환아(患兒)의 특징과 증상(症狀)의 발현(發現)및 유지(維持)에 영향을 줄 수 있는 가능한 요인(要因)들에 대하여 연구(硏究)하였다. 연구(硏究) 결과(結果) 반복적(反復的) 복통(腹痛) 환아(患兒)의 증상(症狀) 호소는 부모(父母)등 돌보아 주는 사람과의 접촉시간(時間)에 많았으며 가족중에 위장관기(胃腸官器) 질환의 병력이 많았다. 반복적(反復的) 복통(腹通) 환아중(患兒中) 정신과적(精神科的) 진단(診斷)이 가능(可能)하였던 경우는 16명(45.8%)이었는데, 적응 장애(適應 障碍) 4명, 과잉불안장애(過剩不安障碍)4명(名), 분리 불안장애(分離 不安障碍) 1명(名), 우울증(憂鬱症) 2명(名), 틱 장애(障碍) 2名, 주의력(注意力) 결함장애(缺陷障碍) 2명(名), 야요증(夜尿症) 1명(名) 등이었다. 행동조사표(行動調査表)에 의하면 반복적(反復的) 복통(腹通) 환아(息兒)는 대조군 아동에 비하여 주회적(柱會的) 수행(遂行) 능력(能力)과 활동(活動)영역의 점수가 유의하게 낮으며, 내향화(內向化) 척도(尺度)의 값이 유의하게 높았다. 가정(家庭) 환경(環境) 진단검사상(診斷檢査上)의 항목별 비교 결과 반복적(反複的) 복통(腹通) 환아(患兒)는 대조군 아동에 비하여 훈육상(訓育上) 부모(父母)와의 마찰이 심하고, 부모(父母)가 자녀(子女)에게 주는 훈육(訓育)이 보다 합리적(合理的)이지 못하고, 지시(指示)의 정도가 많으며, 감정적으로 냉철하지 못하였다. 반면 자녀의 복지에 대한 배려와 애정 표현(愛淸 表現)은 대조군 부모에 비해 높았다. 전반적으로 반복적(反復的) 복통(腹通) 환아(患兒)는 겁이많고 위축적이며 가족 성원 역시 사회적 적응도가 낮으면서 심리적(心理的)으로 불안(不安)한 경우가 많았으며 모(母)와 밀착된 관계를 지속하고 있었고 이러한 갈등의 신체적(身體的) 표현(表現)인 복통(腹通)은 환아(患兒) 자신 뿐 아니라 보다 신체화 증상을 갖고있는 부모(父母)에 의해 선택되어지고 강화되어 반복적(反復的)으로 지속되는것으로 보였다.

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회전개근 순수 관절경적 봉합술과 국소절개 구제봉합술 비교분석 : 2~6년 추시결과 분석 (Arthroscopic Versus Mini-Open Salvage Repair of the Rotator Cuff Tear : Outcome Analysis at Two to Six Years Follow-up)

  • 김승호;하권익;박종혁;강진석;오성균;오일빈;유재철
    • Clinics in Shoulder and Elbow
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    • 제5권2호
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    • pp.88-97
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    • 2002
  • The purpose of this study was to compare the outcomes between arthroscopir repair and mini-open repair of medium and large rotator cuff tears in which arthroscopic repair was technically unsuccessful. We evaluated 76 patients of full-thickness rotator cuff tears, among them 42 patients had all-arthroscopic and 34 patients had mini-open salvage repairs. Patients who had acromioclavicular arthritis, subscapularis tear, or instability were excluded. There were 39 males and 37 females with mean age of 56 years (range,42 to 75 years). At a mean follow-up of 39 months (range, 24 to 64 months), the results of both groups were compared with regard to the UCLA and ASES shoulder rating scale s. Shoulder scores improved in all ratings in both groups (p > 0.05). Overall, sixty-six patients showed excellent or gr)of and ten patients showed fair or poor scores by the UCLA scale. Seventy-two patients satisfactorily returned to prior activity. Four showed unsatisfactory return. The range of motion, strength, and patient's satisfaction were improved postoperatively. There were no difference in shoulder scores, pain, and activity return between the arthroscopic and mini-open salvage groups (p > 0.05). However, Patients with larger size tear showed lower shoulder scores and less predictive recovery of the strength and function (p < 0.05). Postoperative pain was not different with respect to the size of the tear (p : 0.251). Arthroscopic repair of medium and large full-thickness rotator cuff tears had iln equal outcome to technically unsuccessful arthroscopic repairs, which were salvaged by conversion to a mini- open repair technique. Surgical outcome depended on the size of the tear, rather than the method of repair.

척추수술 실패 증후군에 대한 국내 연구 동향: 정의, 치료 방법, 평가 도구를 중심으로 (The Domestic Trend of Failed Back Surgery Syndrome: Definition, Treatment Trials and Instruments for Assessment)

  • 최희승;차윤엽;박원형;신우석;정동훈;손슬기;김종수;김신웅;김세준
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.41-48
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    • 2014
  • Objectives The present study examines the domestic trend of Failed Back Surgery Syndrome (FBSS) in Korea. Methods The studies on FBSS were investigated via searching Korean web databases. As a result, 41 research papers were found and they were analyzed according to the year of publishment, the titles of journals which have the papers, the types of study, the definition of FBSS, employed treatment trials, and the instruments for assessment. Results The number of the research papers on FBSS published was increased since 2005. The studies on FBSS were mainly published in the Korean Journal of Pain. The most popular type of the studies were the case report and the most studies defined FBSS as persistent or recurring low back pain with or without sciatica after receiving spine surgeries. Various surgical and conservative treatments were employed in the studies and Visual Analogue Scale (VAS), Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) were used as primary means of assessments. Conclusions Reviewing the domestic trends of studies on FBSS and examining the definition of FBSS is essential for the future studies because there is no clear criteria for making diagnosis of FBSS. Therefore, the further studies on FBSS need to be more elaborate with the definition of FBSS, and it is also necessary to apply more assessment tools for the better understanding of FBSS from various aspects. Ultimately, this review is anticipated to benefit the future in-depth study on FBSS.

한방 복합치료로 호전된 경추성 현훈 환자의 증례보고 1례 (A Case Report on a Patient with Cervical Vertigo Who Improved with a Combination of Korean Medicine Treatments)

  • 황동규;김은지;최기훈;허승진;윤덕원
    • 대한한방내과학회지
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    • 제38권3호
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    • pp.392-400
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    • 2017
  • Objective: To report the case of a patient suffering from cervical vertigo who was treated with a combination of Korean medicine treatments (including acupuncture, pharmaco-acupuncture, and Chuna manual therapy). Method: An outpatient with cervical vertigo was given a combination of Korean medicine treatments five times, from December 5 to 16, 2016. All of the treatments, acupuncture with electric stimulation and pharmaco-acupuncture, were applied on the trigger points (TP) of the cervical muscles and the upper trapezoid muscles. Chuna manual therapy was then applied on the cervical area. The Numeric Rating Scale (NRS) - according to outpatient's statement on vertigo, neck pain and headache - and the Korean Dizziness Handicap Inventory (DHI), which is a self-evaluating scale of dizziness in daily life, were used to evaluate the effects of this treatment. Results: At the end of the treatment, the vertigo and the headache disappeared. The NRS decreased from 9 to 0 for vertigo and from 5 to 0 for headache. Although the neck pain also decreased, it did not disappear; this NRS decreased from 7 to 1. The DHI score also decreased significantly, from 64 to 4. Conclusion: Since the symptoms of the patient with cervical vertigo improved after the very first treatment and the improvement of the symptoms was observed as the treatment progressed, this case report is worth supporting the efficacy of combined Korean medical treatments. However, because there was only one subject, it is hard to say that this efficacy can be generalized. Moreover, this report cannot prove the individual efficacy since various treatments were combined. While there are many researches related to cervical vertigo in Western medicine, the studies in Korean medicine are comparably insufficient; therefore, follow-up research on more subjects is needed.

슬관절염에 대한 뜸 치료의 유효성 및 안전성 연구 : 무작위 대조 예비 임상연구 프로토콜 (Moxibustion for Knee Osteoarthritis : A Protocol for a Pilot Randomized Controlled Trial)

  • 이승훈;김건형;김태훈;김정은;김주희;강경원;정소영;김애란;박효주;신미숙;홍권의;최선미
    • Korean Journal of Acupuncture
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    • 제28권4호
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    • pp.1-15
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    • 2011
  • Objectives : The purpose of this study is to evaluate the feasibility of massive clinical research and to make a basic analysis on the effectiveness and safety of moxibustion treatment on knee osteoarthritis compared to usual care. Methods and Results : This study is a protocol for a pilot randomized controlled trial. Forty participants are assigned to the moxibustion group (n=20) and usual care group (n=20). Participants assigned to the moxibustion group receive moxibustion treatment on the affected knee(s) at six standard acupuncture points (ST36, ST35, ST34, SP9, Ex-LE04 and SP10) three times per week for four weeks (total of 12 sessions). Participants in the usual care group don't receive moxibustion treatment during the study period and follow-up are made on the 5th, 9th and 13th weeks after random allocation. Both groups are allowed to use any kind of treatment, including surgery, conventional medication, physical treatment, acupuncture, herbal medicine, over-the-counter drugs and other active treatments. Education material that explains knee osteoarthritis and current management options and self-exercise is provided for each group. The pain scale of the Korean Western Ontario and McMaster Universities Questionnaire (K-WOMAC) is the primary outcome measurement used in this study. Other subscales of the K-WOMAC, the Short-Form 36 Health Survey (SF-36), Beck Depression Inventory (BDI), Physical Function test, Patient Global Assessment, and Pain Numeric Rating Scale (NRS) are used as outcome variables to evaluate the effectiveness of acupuncture. Safety is assessed at every visit. Conclusions : The result of this trial will provide a basis for the effectiveness and safety of acupuncture treatment for knee osteoarthritis.

척추 해면상 혈관종 출혈로 인해 발생한 하지 강직감을 동반한 보행 장애에 대한 한의학 치료의 효과: 증례보고 (Korean Medicine for Gait Disturbance Accompanying Lower Limb Rigidity Caused by Bleeding of Spinal Cavernous Hemangioma: A Case Report)

  • 최현진;유승호;안상준;김세윤;신우철;조재흥;정원석;송미연;김형석
    • 한방재활의학과학회지
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    • 제33권4호
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    • pp.243-249
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    • 2023
  • 해면상 혈관종(cavernous hemangioma)은 인체 내 다양한 장기나 기관에서 발생할 수 있는 혈관기형으로, 순수 경막외 해면상 혈관종(pure epidural cavernous hemangioma)은 해면상 혈관종의 드문 경우에 속한다. 해면상 혈관종이 원인이 되어 발생한 증상에 한의학 치료를 적용한 연구가 드물게 보고되었으나, 순수 해면상 혈관종의 출혈로 인한 증상에 대한 것은 없었기에 관련 임상증례를 보고하고자 한다. 척추의 순수 해면상 혈관종으로 진단받은 51세 남성이 2022년도에 해면상 혈관종 출혈로 인해 발생한 보행장애에 대해 치료를 받기 위해 한방병원을 방문하였다. 척추의 순수해면상 혈관종 출혈로 인해 발생한 보행장애 환자는 침 치료, 전기 침 치료, 온침 치료, 한약, 추나, 뜸, 부항 치료를 시행 받았다. 평가지표는 25 foot walk test (25FW), timed up and go test (TUG), comfortable gait speed tests (CGS), 요통과 하지 통증에 대한 numeral rating scale (NRS), Berg balance score (BBS), Tinneti-score, manual muscle test (MMT), EuroQol-five dimension (EQ-5D), EQ-5D visual analog scale (EQ-5D VAS)이었으며, 25FW, TUG, CGS, NRS, BBS, EQ-5D (VAS)에서는 치료 후 호전을 보인 반면, Tinetti Score, MMT, EQ-5D의 지표는 치료 후에도 동일하게 유지되었다. 한의학은 척추 해면상 혈관종의 출혈로 인해 발생한 보행장애나 하지 강직감에 대한 치료의 한 방안으로 고려될 수 있다.

코로나 19 후 폐섬유화(Post COVID-19 pulmonary fibrosis)에 대한 복합 한의치험 1례 (Korean Medicine Treatment for a Patient with Post-COVID-19 Pulmonary Fibrosis: A Case Report)

  • 신정원;박지원;진수현;김관일;정희재;이범준
    • 대한한방내과학회지
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    • 제44권6호
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    • pp.1294-1317
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    • 2023
  • Background: Post-COVID-19 pulmonary fibrosis (PCPF) is a common complication in severe COVID-19 cases, often associated with acute respiratory distress syndrome or mechanical ventilation. Patients with PCPF frequently experience a decline in their quality of life due to persistent COVID-19 sequelae, including cough and chest pain. However, there is currently no established standard treatment, and the efficacy of existing medications remains uncertain. Case Report: A 65-year-old female patient presenting with cough, dyspnea, chest pain, and fatigue due to PCPF received Korean medicine treatment for 25 days. Symptom evaluation utilized the modified Medical Research Council scale, the Leicester Cough Questionnaire, and the Numeral Rating Scale. Quality of life and functional status were assessed using the Post-COVID-19 Functional Status and the EuroQol 5-Dimensional 5-Level. The extent of pulmonary fibrosis was assessed by comparing chest computed tomography (chest CT) scans before and after hospitalization. Following treatment, the patient demonstrated clinically meaningful improvement in clinical symptoms, enhanced quality of life, and decreased fibrotic lesions on CT scans. Conclusion: This case report suggests that Korean medicine treatment may be effective in improving clinical symptoms, such as cough and dyspnea caused by PCPF, while also enhancing post-COVID-19 quality of life and ameliorating pulmonary fibrotic lesions.

타액분비저하에 따른 구강작열감증후군 환자의 임상적 특징 비교 (Comparison of the Clinical Characteristics of Patients with Burning Mouth Syndrome due to Hyposalivation)

  • 이하늘;김동윤;백소영;정해인;이현진;조윤재;하나연;김진성
    • 대한한방내과학회지
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    • 제41권5호
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    • pp.838-847
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    • 2020
  • Objectives: The aim of this study was to investigate the clinical characteristics of patients with Burning Mouth Syndrome (BMS) due to hyposalivation (HS). Methods: We reviewed the clinical records of 39 BMS patients who visited the Department of Digestive Diseases of Kyunghee Korean Medicine Hospital from March 1st, 2020 to July 31st, 2020. The subjects were classified according to the presence or absence of hyposalivation and both groups were compared for the proportion of coated tongue, heart rate variability (HRV), Ryodoraku, and the numeral rating scale (NRS) score of tongue pain results. Results: The BMS with Hyposalivation (HS group) and the BMS without Hyposalivation (Non-HS group) showed a significant difference in the proportion of coated tongue and the NRS score for tongue pain. The NRS score was significantly higher in the Non-HS group and the proportion of coated tongue was lower. However, no significant differences were noted in several HRV parameters between the two groups. The most frequent accompanying symptoms were xerostomia and dyspepsia. Conclusions: The results of this study suggest that hyposalivation might be one of the main causes of tongue pain, the key complaint in BMS patients. Sympathetic/parasympathetic imbalance might not be a main contribution of hyposalivation in BMS. Instead, factors such as the number of medications taken seem to correlate with hyposalivation in BMS. This results could be useful in the management of BMS patients with hyposalivation in clinical practice.