• Journal of Korean Medicine Rehabilitation
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• v.25 no.4
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• pp.113-121
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• 2015

Objectives Functional dyspepsia is a type of disease characterized by bothersome postprandial fullness, early satiation, epigastric pain and burning without structural gastrointestinal disorders. The aim of this study was to evaluate changes in symptoms, quality of life, HRV (Heart Rate Variability) before and after abdominal manipulation therapy in functional dyspepsia patients. Methods We recruited twenty functional dyspepsia patients from the volunteers who applied for this clinical trial. State of Patients were assessed by NDI-K (Nepean Dyspepsia Index Korean Version), HRV (Heart Rate Variability) before treatment. After 4 times of abdominal manipulation therapy for 2 weeks, state of patients were assessed by the same methods. Results Total symptom score and total quality of life score of NDI-K were significantly improved by the abdominal manipulation therapy. After the treatment, the number of subjects within normal range of LF/HF ratio was significantly increased. Although the median of LF/HF ratio did not significantly changed, interquartile range was reduced. Conclusions Abdominal manipulation therapy possibly can be an effective treatment for functional dyspepsia patients, but further studies are needed to demonstrate the effectiveness of abdominal manipulation therapy for functional dyspepsia patients.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1331-1340
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• 2021

A 42-year-old patient with functional dyspepsia had suffered from early satiation and postprandial fullness for 1 year despite Western medicine treatment. We treated her with the Spleen Daoyin method, along with acupuncture, moxibustion, and herbal medicine and scored her symptoms using a 4-point Functional Dyspepsia-related Quality of Life (4p-FD-QoL) questionnaire, the Gastrointestinal Symptom Rating Scale (GSRS), and a visual analogue scale (VAS). A 7-day Spleen Daoyin treatment decreased her 4p-FD-QoL score from 61 to 51, with a marked decrease in the emotional part (18 to 10). Her GSRS score did not change, but her bloating score decreased from 3 to 1. Her VAS score decreased from 6.6 to 4.3 for upper abdomen discomfort, but lower abdomen discomfort was unchanged. The patient showed high compliance and satisfaction with exercise therapy and reported no adverse events. Spleen Dayoin may be a useful therapy for functional dyspepsia, especially when accompanied by psychological problems.

• The Journal of Internal Korean Medicine
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• v.40 no.6
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• pp.1051-1062
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• 2019

Objectives: Chest pain presents diagnostic and therapeutic challenges because of its various etiologies. Many patients have chest pain from unknown causes and persistent chest pain in spite of standard treatment. The purpose of this study was to investigate the effectiveness of a Korean herbal medicine called Pyungjinsujeom-san (PSS) in relieving chest pain. Methods: We reviewed the electronic medical records of patients who visited the Korean Medical Clinic of Cardiology at Kyunghee University Hospital at Gangdong from January 2009 to July 2019, with the chief complaint of chest pain and who were treated with PSS. The mean severity of chest pain measured on the Numerical Rating Scale was compared before and after the administration of PSS. Results: The mean severity of chest pain of 20 patients decreased significantly from 6.80±1.61 to 1.35±0.9 after taking PSS (p<0.001). Most patients had symptoms of phlegm and food retention, including indigestion, postprandial fullness, and epigastric pain.Conclusions: These results suggest that PSS may be effective in relieving chest pain from various causes, particularly in patients with symptoms of phlegm and food retention.

• Biomolecules & Therapeutics
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• v.23 no.4
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• pp.350-356
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• 2015

Functional dyspepsia (FD) is a prevalent idiopathic upper gastrointestinal (GI) disorder characterized by diverse symptomatology including epigastric pain or discomfort, postprandial fullness, and early satiety. Although its pathophysiological mechanisms have not yet been fully established, the available studies suggest that the etiology of FD is invariably multifactorial. Benachio-F$^{(R)}$ (BF) is a proprietary liquid formulation of 7 herbal extracts that has been proposed to address this multifactorial etiology using multi-drug phytotherapy. The pharmacological effects of BF, in comparison with those of two other herbal products (Whalmyungsu$^{(R)}$; WM and Iberogast$^{(R)}$; IB) were evaluated in rats. In a laparotomy-induced rat model of delayed GI transit, BF significantly accelerated the delayed gastric emptying caused by morphine, apomorphine, and cisplatin, and also significantly increased mean gastric transit, as compared to the control animals. BF markedly increased gastric accommodation in rats and produced higher gastric volume values than did the control treatment. The effects of BF were generally comparable or superior to those of WM and IB in these models. Furthermore, BF significantly stimulated biliary flow, as compared to the control treatment. These results indicated that BF might have great potential as an effective phytotherapeutic agent capable of reducing GI symptoms and increasing quality of life in FD patients.

• The Journal of Internal Korean Medicine
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• v.26 no.4
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• pp.785-794
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• 2005

Little is known concerning the pathophysiology and symptomatology of gastric dysmotility of patients who have sought treatment in eastern traditional medicine. The aim of this study was to investigate gastric electrical activity and clinical characteristics between gastroparesis and non-gastroparetic functional dyspepsia(FD) and assess the necessity to distinguish them for eastern traditional medical treatment. 60 patients were surveyed by questionnaire. Gastric electrical activity was recorded and analyzed using electrogas-trography. Patients were divided into gastroparesis and non-gastroparetic FD by 1.0 of power ratio. Healthy persons were used as reference. Postprandial normogastria of gastroparesis decreased and that of non-gastroparetic functional dyspepsia increased compared before and after meals. Suggested causes of onset were the meat diets that most patients were on in the gastroparesis group, and that drugs that patients in the non-gastroparetic FD group were taking. Distribution of main symptom was equally regular in patients with gastroparesis, but patients with non-gastroparetic FD showed mainly upper abdominal pain and fullness. Values for the gastroparesis group were double those for the non-gastroparesis FD group in frequency of upper GI endosopic examination. Results suggest that effective application of eastern traditional medical treatment requires that first a clear distinction be made in state of gastric dysmotility and clinical characteristics of gastroparesis and non-gastroparesis FD when treating dyspepsia.

• Journal of Gastric Cancer
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• v.1 no.1
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• pp.38-43
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• 2001

Purpose: Roux stasis syndrome is the main complication of a Roux-en-Y gastrojejunostomy. The aim of this study was to compare the occurrence rate of Roux stasis syndrome with the passing of time in a conventional Roux-en-Y gastrojejunostomy and in an uncut Roux-en-Y gastrojejunostomy. Materials and Methods: 50 patients (31 men and 19 women) had a conventional Roux-en-Y reconstruction and 53 patients (35 men and 18 women) had an uncut Roux-en-Y reconstruction. The Roux stasis syndrome was defined by clinical criteria only. The criteria included one of the four following conditions at the time of follow-up: chronic upper abdominal pain, postprandial fullness, persistent nausea, and intermittent vomiting that are worsened by eating. Follow-up after surgery was done in all patients at $7\∼12,\;13\~18,\;19\~24,\;25\~30$, and $31\∼36$ months. Results: According to the criteria, the Roux stasis syndrome occurred in 40.0$\%$ of the patients at 7$\∼$12 months, 33.3$\%$ at $13\∼19$ months, $35.3\%$ at $19\∼24$ months, $32.0\%$ at $25\~30$ months, and $33.3\%$ at $31\∼36$ months after a conventional Roux-en-Y operation. The syndrome occurred in $22.6\%$ of the patients at $7\∼12$ months, $15.2\%$ at $13\∼18$ months, $17.1\%$ at $19\∼24$ months, $19.2\%$ at $25\∼30$ months, and $20\%$ at $31\∼36$ months after an uncut Roux-en-Y reconstruction. Conclusion: In terms of occurrence pattern, only a little variance existed one year after both procedures. Comparing the Roux stasis syndrome in both procedures, the uncut Roux operation had better results than the conventional Roux operation.

• Korean Journal of Psychosomatic Medicine
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• v.24 no.1
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• pp.3-8
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• 2016

Functional dyspepsia is one of the most common bowel disorders as prevalent of 7.7% Korean population. The cardinal manifestations include bothersome postprandial fullness, early satiation, epigastric burning or pain. These features are chronic and should be presented recurrently with no other compatible organic disease to explain the symptoms. Even though it is not life-shortening, functional dyspepsia usually make the health-related quality of life worse especially if other functional bowel disorder coexist. The coexistence of functional bowel disorders is called as 'overlap syndrome'. Anxiety, somatization and insomnia is more prevalent in overlap syndrome compared with sole functional bowel disorder. Therefore, it is worthwhile that physician interviews and elucidates whether the dyspeptic patient had other kinds of functional bowel disorders, and manages the underlying psychotic pathology. Placebo effect is large in functional dyspepsia, and there is only four kinds of prokinetics that is proven to be superior to placebo. Adverse events relating prolonged administration of prokinetics sometimes fatal or irreversible, physician willing to describe prokinetics should be familiar to the possible adverse effects and the relating risk factors. Pathologic acid reflux is not uncommon in functional dyspepsia, and acid-suppressant is equivalent to the prokientics in most of dyspeptic patients.

• Journal of agricultural medicine and community health
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• v.28 no.1
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• pp.79-92
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• 2003

Objectives: To investigate the reinfection rate of Helicobacter pylori and the factors related to reinfection of H. pylori, 86 persons were examined in April 2000 after 1 year follow-up period and 77 persons were examined in October 2001 after two and a half-year follow-up period in Gyeongju-si, Gyeongsangbuk-do, Korea. Methods: The subjects were confirmed as H. pylori negative by urea breath test(UBT), and asked to answer the questionnaire regarding demographic characteristics, dyspepsia symptoms, health-related behaviors and family history. Results: The reinfection rate on the first year of the eradication of H. pylori was 15.6%, when the 77 subjects have finished follow-up observation for one year. In the urea breath test performed after two and a half year, 13 out of 77 were positive, with the reinfection rate of 16.9%. Age, sex, socio-economical status, educational level and family history were not associated with the reinfection, while there was significant association between the reinfection and postprandial fullness and epigastric bloating in subjective dyspepsia that the subjects who were determined to be negative in the urea breath test for the following year. The treatment compliance and drinking were significant variables in univariate analysis. Meanwhile, the cases in which the dyspepsia symptom scores for the recent year were 2 to 3 points served as the only statistically significant variable in multiple logistic regression analysis, with the odds ratio of 4.5. The cases in which salt intake during meals was exceeded were 8.7 in the odds ratio, but statistically insignificant. Conclusions: Conclusively, the first-year reinfection rate was 15.6%, and the second-year reinfection rate was 16.9%. Thecomplaints of subjective dyspeptic symptoms and the treatment compliance, as the basis for predicting the H. pylori reinfection in communities, can be used as the basis to screen the subjects for follow-up examination to find out H. pylori infection.

• The Korean Journal of Gastroenterology
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• v.72 no.6
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• pp.325-328
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• 2018

위마비증(gastroparesis)이나 만성 구역 구토 증후군(chronic unexplained nausea and vomiting)으로 인한 구역과 구토에 대한 치료는 일반적으로 사용하는 위장관 촉진제에 만족스럽지 못한 경우가 많고, 여러 부작용으로 인하여 장기적으로 사용하기 어려워 보다 효과적인 치료 방법이 필요하다. 최근 미국에서 발표된 본 연구는 위마비증이나 연관 증후군 환자에서 구역과 구토 증상을 줄이기 위한 aprepitant(neurokinin-1 receptor antagonist) 치료의 효과를 분석한 것으로, 향후 일반적인 치료에 불응성 위마비증 환자에서 새로운 약제 사용을 시도해볼 수 있어 소개하고자 한다. 본 Aprepitant for the Relief of Nausea (APRON) 연구는 기질적 질환을 배제하기 위하여 최근 2년 이내 위내시경이 정상이며, 적어도 6개월 이상 조기 포만감(early satiety), 식후 만복감(postprandial fullness), 팽만감(bloating) 그리고 명치부 통증(epigastric pain)을 유발하는 증상과 함께 만성적인 구역이 있는 18세 이상의 성인 중 4시간의 위배출 검사를 시행받은 환자를 대상으로 하였다. 객관적인 지표로 0점에서 45점까지 보이는 9-증상 Gastroparesis Cardinal Symptom Index(GCSI)가 2주 이상 총 21점 이상이며, 0-100 mm의 visual analog scale (VAS)의 7일간의 구역 증상 평균 25 mm 이상인 환자를 대상으로 하였다. 일주일에 3일 이상 narcotics를 사용하였거나 와파린이나 pimozide, terfenadien, astemizole, cisapride를 복용하였던 환자, 2배 이상으로 간 효소 수치상승을 보이거나 Child-Pugh score 10점 이상, aprepitant에 알레르기를 보이는 환자는 제외되었다. 그렇지만 metoclopramide나 erythromycin을 안정적으로 사용 중인 환자는 제외되지 않았다. 위배출 검사는 2시간에서 60% 이상 남아 있거나 4시간에서 10% 이상 남아 있는 경우에 지연된 것으로 정의되었으며, 지연된 위배출 검사 결과 자체는 환자의 등록 기준에 포함되진 않았다. 등록 기준에 포함된 환자는 1:1로 무작위 배정되어 하루 한 번 125 mg의 aprepitant 복용군과 위약군으로 나누어져 연구가 진행되었으며, 약제 복용 4주간 2주 간격으로, 그리고 복용 후 2주 뒤까지 구역 증상의 호전 정도와 약제 안전성을 확인하였다. 이러한 효과를 판정하기 위하여 환자가 방문하는 동안 GCSI를 포함한 Patient Assessment of Upper GI Symptoms (PAGI-SYM), Gastrointestinal Symptom Rating Scale, daily VAS, daily diary version of the GCSI 그리고 정신 측정 도구와 삶의 질 도구인 Patient health Questionnaire 15와 Short Form 36 version이 측정되었다. 구역에 대한 aprepitant와 위약의 치료 효과의 일차적 판정은 이전 항암 요법에 대한 aprepitant 연구와 같이 28일 평균 VAS 25 mm 미만이거나 치료 전 7일간의 VAS와 비교하여 28일 치료 기간 동안 25 mm 이상 감소한 경우로 정의하였고, 이차 결과는 구역의 매일 시간, 치료 중 구역이 없는 날짜의 퍼센트, PAGI-SYM score의 개선 등으로 확인하였다. 2013년 4월부터 2015년 7월까지 총 126명의 환자가 등록되어 aprepitant군 63명, 위약군 63명으로 무작위 배정되었다. 전체의 57%인 72명에서 위배출 지연이 보였으며, 나머지 43%에서는 정상 또는 빠른 위배출 소견을 보여 만성적으로 설명할 수 없는 구역과 구토에 포함된 환자군으로 확인되었다. 또한 29%에서 당뇨를 가지고 있었으며, 8%에서 수면제를 사용하고 있었다. 최종적으로 aprepitant군은 59명, 위약군은 63명이 연구를 끝까지 종료하였다. 일차 결과에서 aprepitant 군 46%, 위약군 40%의 구역 호전을 보여 두 치료군 간에 통계적으로 의미 있는 차이는 보이지 않았다(상대 위험도 1.2, 95% CI: 0.8-1.7; p=0.43). 그러나 일차 분석의 두 가지 척도(28일 평균 VAS 25 mm 미만과 기저 VAS보다 평균 28일 VAS의 25 mm 이상 감소)를 모두 함께 고려한 민감도 분석에서는 aprepitant군이 37% (22/59)로 위약군의 17%(11/63)에 비하여 통계적으로 의미 있는 구역의 호전을 보였다(상대 위험도 2.1, 95% CI: 1.1-4.1; p=0.01). 또한 이차 분석을 살펴보면 aprepitant군에서 PAGI-SYM 중증도 지수로 확인하였을 때, 구역(1.8 vs. 1.0; p=0.005)과 구토(1.6 vs. 0.5; p=0.001)의 중증도 및 매일 구역 시간의 감소를 보였고, 28일 동안 구역이 없는 날짜의 퍼센트 증가 소견을 보였다. 다른 이차 결과 분석에서 aprepitant군이 PAGI-SYM 중증도 지수의 GCSI 종합 점수(1.3 vs. 0.7; p=0.001), 상당한 증상호전, 구역 구토의 세부 점수, 팽만감 세부 점수 그리고 위식도 역류 증상 점수에서 호전을 보였고, 매일 일기로 표현한 daily diary version of the GCSI에 상복부 통증 중증도, 전체 증상 그리고 Gastrointestinal Symptom Rating Scale의 종합 점수에서 호전을 보였다. 연구 중 발생한 부작용은 주로 경증과 중등도 정도의 부작용이 주로 발생하였지만, aprepitant군(35% vs. 17% 위약군, p=0.04)에서 더 많이 발생하였다. 결론적으로 위마비증 또는 위마비증 유사 증후군으로 인한 만성 구역 및 구토 환자의 무작위 시험에서 aprepitant는 VAS 점수를 통한 주요 결과를 분석하였을 때는 구역의 중증도를 호전시키지 못하였지만 다른 이차적 결과에 대해서는 위약군에 대하여 호전 소견을 보였다. 따라서 aprepitant에 효과적인 반응을 보이는 위마비증 환자를 감별하는 추가 임상시험이 필요할 것으로 판단된다.