• Title/Summary/Keyword: Practice of Korean Medicine

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A Survey on Clinical Practice Patterns of Patients with Cancer at Korean Medical Hospitals for Korean Medicine Cancer Registry (한의 암 레지스트리 연구를 위한 암 환자의 한방병원 진료현황에 대한 전문가집단 설문조사)

  • Yoon, Jee-Hyun;Park, Su Bin;Kim, Eun Hye;Lee, Jee Young;Yoon, Seong Woo
    • Journal of Korean Traditional Oncology
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    • v.26 no.1
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    • pp.17-27
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    • 2021
  • Objective: This study aimed to evaluate which information of cancer patients should be collected for the Korean medicine cancer registry in order to assess the efficacy and safety of Korean medicine (KM) treatment and to identify Korean medical prognostic predictors. Methods: A total of fifteen Korean medical specialists completed an online survey questionnaire including items about general characteristics of cancer patients and clinical practice patterns. Results: The four main types of cancer at Korean medical hospitals were breast, lung, stomach, and colorectal cancer. The majority of patients with cancer at Korean medical hospitals were in the advanced or metastatic stage (50.0%). The prominent purposes of KM treatment were to alleviate cancer-related symptoms, reduce the side effects of conventional therapy, and improve quality of life. The major options for treatment were traditional herbal medicine (THM), acupuncture, moxibustion, thermotherapy, pharmacoacupuncture, and meditation, with THM being the most frequently used (35.7%). Almost all Korean medical specialists (93.9%) used syndrome differentiation in clinical practice and identified over half the cancer patients as deficiency syndrome (57.2%). Conclusion: Physicians considered the primary goal of KM treatment for cancer patients to be symptom management since advanced or metastatic stage patients were the majority at Korean medical hospitals. THM were the most common treatment option and syndrome differentiation was used by almost all physicians. Further research is needed to monitor and ensure optimal KM treatment for patients with cancer.

Evidence-based Clinical Practice Guidelines On Kampo (Japanese Herbal) Medicine : The Current State of Kampo Clinical Practice Guidelines (근거 중심 Kampo medicine 임상진료지침의 현황)

  • Sasaki, Yui;Huang, Ching Wen;Kim, Kyeong Han;Park, Yu Lee;Shim, Ho Jong;Park, Dong Sun;Jeon, Yoon Jeong;Kim, Ji-Hwan;Jang, Bo-Hyoung;Shin, Yong-Cheol;Ko, Seong-Gyu
    • Journal of Society of Preventive Korean Medicine
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    • v.20 no.1
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    • pp.55-64
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    • 2016
  • Objectives : In 2007, a survey of how Kampo was regarded in Japanese clinical practice guidelines (CPGs) was first conducted by the Special Committee for Evidence Based Medicine (EBM), namely the Japan Society for Oriental Medicine (JSOM). A manual for CPG development was also published in 2007 by the Japan Council for Quality Health Care, and the revised edition came out in 2014. The purpose this study is to review the current state in CPGs applied to Kampo after 2007, while focusing on how Kampo products being regarded evidence based branch of medicine by CPG developers. Methods : Sources include the Kampo CPGs website of Japan Society for Oriental Medicine (JSOM) and MINDS (Medical Information Network Distribution Service) website of Japan Council for Quality Health Care. Results : Among the 784 CPGs existing by the end of 2015, 91 CPGs were considered containing descriptions of Kampo. Furthermore, 28 type A Kampo CPG (KCPG) which had quality of evidence and strength of recommendation with references were found. Also, most of type A KCPGs relied on the MINDS Handbook for Clinical Practice Guideline Development that was published in 2007. Conclusions : The number of KCPGs are increasing yearly. However, there is still not much Kampo evidence found in CPGs in Japan. Overall, it could be said that we need to not only make evidence vertically but preach it horizontally well.

A Re-discussion on the Characteristics of Medicine (의료행위의 특질 재론)

  • HeeTae Suk
    • The Korean Society of Law and Medicine
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    • v.25 no.1
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    • pp.3-58
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    • 2024
  • It has become a general idea today that the characteristics of medicine should be considered as a basis when discussing a medical personnel's duty of care and whether or not it has been violated, and when discussing its duty of explanation and whether or not it has been fulfilled in medical practice. However, in the discussion of its characteristics, some shortcomings still exist, so the need for a re-discussion has been raised. Firstly, existing discussions on characteristics have failed to comprehensively grasp and explain the characteristics of medical practice. Secondly, in some researchers' arguments, there are discrepancies between the terms used to express characteristics and their conceptual definitions or content. Thirdly, the lack of exemplified cases that reflect the characteristics of medicine - especially Supreme Court precedents - has led some to think negatively about the recognition and reflection of certain characteristics. In my early writings, I have described five characteristics of medical practice: 'conflict in medical goals', 'initiating appropriate medical actions (progression of illness)', 'dynamics of medical intervention (diversity of symptoms)', 'diversity of medical effects', 'inherent risk of medical treatment (invasiveness)'. In this paper, keeping in mind the reasons for the need for reconsideration, I aim to analyze the characteristics of medicine in detail and cite key parts of representative Korean Supreme Court precedents that reflect each characteristic. The characteristics of medicine extracted from this paper are; There are ten factors, including the legitimacy of the essence of medical practice, timeliness of medical execution, dynamics of medical progress, diversity of medical effects, risk of medical invasion, non-uniformity of medical methods, limitations of medical capabilities, intervention of the medical subject, high degree of medical standards, and maldistribution of medical data.

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Greater Yin Symptomatology (소음인체질병증 임상진료지침: 태음병)

  • Hwang, Min-Woo;Park, Hye-Seon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.45-54
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Greater Yin Symptomatology. This CPG was developed by the national-wide experts committee consisting of SCM professors. Methods First, it was performed that search and collection of literature related SCM such as "Dongeuisusebowon", Textbook of SCM, Clinical Guidebook of SCM and Fundamental research to standardize diagnosis of Sasang Constitutional Medicine. And journal search related clinical trial or Human complementary medicine of SCM was performed domestic and overseas. Finally, 1 article was selected and included in CPG for Greater Yin Symptomatology of Stomach Cold-based Interior Cold disease in Soeumin disease. Results & Conclusions CPG of Greater Yin symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Greater Yin symptomatology is classified into mild and moderate pattern by severity. Greater Yin Symptomatology Mild pattern is classified into Greater Yin Symptomatology accompanied abdominal pain and bowel irritability and Greater Yin pattern accompanied Epigastric stuffiness and fullness. And Greater Yin Symptomatology moderate pattern is classified into Greater Yin pattern accompanied Jaundice, Greater Yin pattern accompanied Edema and Greater Yin pattern by Yin toxin.

A Study on the KAP for Prevention of Hypertension and Diabetes in a Rural Area, Korea (농촌지역주민의 고혈압 및 당뇨병 예방을 위한 KAP 조사연구)

  • Kim, Young-Bok;Wie, Cha-Hyung
    • Journal of agricultural medicine and community health
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    • v.22 no.2
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    • pp.169-181
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    • 1997
  • The desirable change of KAP aimed at the prevention and early diagnosis of the disease. In Korea, Hypertension and Diabetes have been the major chronic disease. Especially, Hypertension and Diabetes are related to over-weight and diet behavior, which can be prevented through weight control and dietary treatment. Therefore this study the KAP for Hypertension and Diabetes in a rural area. The survey of the KAP were performed to a rural population of 288 in Namwon, Cheonbuk, Korea. The self-questionnaire was consisted of 15 questions of knowledge, 10 questions of attitude, and 15 questions of practice. To analyze the data, the score of knowledge was taken 1 when they were right. The scores of attitude and practice were taken from 4 to 1 by 4 scale. The results were as follows. 1. The mean of knowledge for Hypertension was 10.4(sd=3.28) and that of attitude was 31.5(sd=4.05), that of practice was 42.3(sd=6.14). In Diabetes, knowledge mean was 9.1(sd=3.51) and that of attitude was 31.2(sd=3.81), that of practice was 41.6(sd=6.21). The knowledge for Diabetes was lower than that for Hypertension. 2. To compare the scores by sex, the score of male's knowledge was higher than female's. However, in case of practice score, female's was higher than male's. And the scores of attitude were not different between male and female. This results were shown that the practice did not always derived from the knowledge. Although they have a little knowledge for disease, they are able to conduct the desirable practice when the importance for disease are increased. Therefore we thought that desirable practice derived from the combination of significance and knowledge for Hypertension and Diabetes.

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Development of a Clinical Practice Guideline : Benign Prostatic Hyperplasia (전립선비대증의 진료지침 개발)

  • Yu, Seung-Hum;Chai, Soo Eung;Kim, Chun-Bae;Kang, Myung Geun;Song, Jae Mann;Lee, Eun Sik;Lee, Jung Gu;Lee, Tchun Yong;Hong, Sung Joon
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.36-51
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    • 1997
  • Background : Clinical practice guidelines define "systematically developed statements to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances" and help to improve patient care. The purpose of this study is to develop a clinical practice guideline for the most effective diagnoses and treatments of benign prostatic hyperplasia based on patient preference and clinical need. Methods : For this research project, extensive literature searches (208 articles) were conducted. As well, critical reviews and syntheses (meta-analysis) were used to evaluate empirical evidence and significant outcomes of the BPH literature. Questionnaires about clinical practice for BPH patients were distributed and consensus meetings were undertaken to grasp variations in clinical practice and to reach agreement on the guideline's development. The guideline was promoted under the sponsorship of the Korean Medical Association and the Korean urological Cancer. Society. For the task, the Benign Prostatic Hyperplasia Guideline Panel was composed of multidisciplinary experts in the field. Results : BPH is a disease that affects a patient's quality of life. This Clinical Practice Guideline was developed for the typical man over age 50 with symptoms of prostatism, but with no significant medical morbidities such as diabetes or other known causes of voiding dysfunction, such as urethral stricture or neurogenic bladder. The guidelines detail the relative benefits and obstacles associated with all diagnostic and treatment approaches, including watchful waiting. Conclusion : This guideline provides a cornerstone for our medical association. It represents the most current scientific knowledge regarding the development, diagnosis, and treatment of BPH. It will be revised and updated as needed.

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Effect of practice guideline reminder and flow-sheet for improvement of quality in management of hypercholesterolemia (고콜레스테롤혈증 환자 진료의 질 향상을 위한 임상 지침 리마인더(Reminder)와 추적 관리지의 효과)

  • Cho, Han Kyu;Park, Hye Soon;Cho, Hong-Jun
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.230-240
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    • 1997
  • Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

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Clinical Practice Guideline for Soyangin Disease of Sasang Constitutional Medicine: Yin-Depletion (Mangeum) Symptomatology (소양인체질병증 임상진료지침: 망음병)

  • Shin, Mi-Ran;Joo, Jong-Cheon;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.3
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    • pp.251-261
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soyangin Disease of Sasang Constitutional Medicine(SCM): Yin-Depletion (Mangeum) Symptomatology. The CPG was developed by the national-wide experts committee consisting of SCM professors. Methods The CPG was developed by the national-wide experts committee considering of the society of Sasang Constitutional Medicine. It was performed by search and collection of literature related SCM, opinion of SCM experts and journal search and it was followed by CPG's guideline. Results & Conclusions The CPG of Yin-Depletion (Mangeum) Symptomatology in Soyangin Disease include classification, definition and standard symptoms of each pattern. Yin-Depletion (Mangeum) Symptomatology is classified into severe and critical pattern by severity. The severe pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum) and the advanced pattern of Heat-related diarrhea accompanied by headache (Sinyeol-dutong Mangeum). The critical pattern of Yin-Depletion (Mangeum) Symptomatology is classified into the pattern of Cold-related diarrhea accompanied by the abdominal pain (Sinhan-bocktong Mangeum) and the advanced pattern of Cold-related diarrhea accompanied by abdominal pain (Sinhan-bocktong Mangeum).

Clinical Practice Guideline for Soeumin Disease of Sasang Constitutional Medicine: Yang Depletion Symptomatology (소음인체질병증 임상진료지침: 망양병)

  • Joo, Jong-Cheon;Shin, Mi-Ran;Lee, Eui-Ju
    • Journal of Sasang Constitutional Medicine
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    • v.26 no.1
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    • pp.37-44
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    • 2014
  • Objectives This research was proposed to present Clinical Practice Guideline(CPG) for Soeumin Disease of Sasang Constitutional Medicine(SCM): Yang Depletion Symptomatology. Methods This CPG was developed by the national-wide experts committee consisting of the society of Sasang Constitutional Medicine. it was performed by search and collection of literature related SCM, opinion of SCM experts and journal search. And it was followed by CPG's guideline. Results & Conclusions No article was selected and included in CPG for Yang Depletion Symptomatology of Kidney Heat-based Exterior Heat disease in Soeumin disease. CPG of Yang Depletion symptomatology in Soeumin Disease include classification, definition and standard symptoms of each pattern. Yang Depletion symptomatology is classified into severe and critical pattern by severity. Yang Depletion Symptomatology severe pattern is classified into initial phase pattern and intermediate phase pattern. And Yang Depletion Symptomatology critical pattern is classified into advanced phase pattern.

Speculation of the Correlationship between Public Health Practice, Consumption and Fatigue in Patients who Complain Fatigue (피로를 주소로 내원한 환자의 생활섭생, 허손 및 피로의 상관성에 대한 고찰)

  • Kim, Se-Hoon;Lee, Jang-Hoon;Lee, Seung-Bo;Choi, Mi-Young;Kim, Young-Chul;Woo, Hong-Jung
    • The Journal of Internal Korean Medicine
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    • v.29 no.1
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    • pp.219-230
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    • 2008
  • Objectives : Consumption is a chronic wasting disease, in oriental medicine concept. Fatigue is a common symptom experienced by many people who have consumption. However, there has been little study about the relationship between consumption and fatigue in the Oriental medicine. For this reason, we attempted to investigate the present status of fatigue of outpatients, and its relation with consumption index, public health practice index, Chalder fatigue scale and Subjective Symptoms of Fatigue Test. Methods : The subjects were 149 outpatients who complain fatigue between Nov. 1, 2006 and Oct. 31, 2007. We measured degree of consumption by consumption index. We measured degree of fatigue by Chalder fatigue scale and Subjective Symptoms of Fatigue Test. Public health practice were investigated by "Breslow's 7 health practice". Results : Studies have shown that a group who disregard public health practices have higher numerical value, in part of $q\grave{i}-x\bar{u}$, $xu\grave{e}-x\bar{u}$, and Physical symptoms than a group more concerned with public health practice. A group who has fatigue for a period over 6 months are more likely to be $q\grave{i}-x\bar{u}$, $y\bar{i}n-x\bar{u}$, Chalder fatigue scale, neuro-sensory symptoms than a group fatigued for less than 6 months. Among the subjects, 81 (55.5%) were considered as 'fatigue patients' by the Chalder scale. Chalder fatigue scale, according to the Subjective Symptoms of Fatigue Test, consumption also, The more increase of Subjective symptoms of fatigue test, the more of consumption scale. Conclusions : This study has shown that there is a link between consumption and fatigue. Moreover, oriental medicine's consumption is more concrete than fatigue scale, so consumption index will have wide application to the study of fatigue.

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