• 대한한방내과학회지
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• 제28권4호
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• pp.769-778
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• 2007

Background & Object : Postprandial epigastric fullness is one of common symptoms in functional dyspepsia, but its pathophysiological mechanism has still been unknown. In this study, its association between postprandial epigastric fullness and pyloric valve disturbance was studied through analysis of bowel sounds and electrogastrography. Methods : Bowel sounds and electrogastrography were recorded together for fasting 15 min and postprandial 40 min. Parameters of bowel soundincluding motility index, sound to sound interval, standard deviation of sound to sound interval, sounds per minute, % of bowel sound, sound length, intensity, dominant frequency of sounds, and postprandial / fasting ratio of dominant frequency of sounds were analyzed with a specialized program. By electrogastrography, regularity of slow waves and power ratio were obtained. Results : Significances of bowel sounds appeared in motility index (p=0.046), dominant frequency of fasting (p=0.048), postprandial (p=0.003), and the ratio of postprandial/fasting (p=0.000); those of EGG parameters were shown in postprandial regularity of slow waves (p=0.006) and power ratio (p=0.011). Conclusion : Pyloric valve disturbance was a cause of postprandial epigastric fullness in patients with functional dyspepsia. Analysis of bowel sound might be useful in diagnosing its existence.

• 대한한방내과학회지
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• 제29권3호
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• pp.621-628
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• 2008

Objectives : The aim of this study was to investigate changes of gastric vagal nerve activity and pyloric valve function after execution of combination treatments of both electroacupuncture at Zusanli(ST36) and manual acupuncture at other acupoints in patient with functional dyspepsia. Methods : Bowel sounds of 49 patients (18 male, 31 female) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed. Postprandial %BS was used to indicate the gastric vagal activity after eating. Ratio of postprandial/fasting dominant frequency was used to present the degree of pyloric valve function. According to values of %BS and DF ratio, each patient was classified into normal or abnormal (<6 %BS, hypoactivity: <1 DF ratio, dysfunction) group. For 2 weeks, patients received a treatment consisting of both electroacupuncture stimulation at Zusanli (ST36) and acupuncture at other meridian points. Variation of parameters shifting normal to abnormal or abnormal to normal was observed, and total cure rate was calculated. Results : Total cure rate of %BS was 16%, and that of DF was 37%. Patients who improved to normal value from abnormal or aggravated to abnormal level showed both significant difference in both vagal nerve hypoactivity and pyloric valve dysfunction, respectively. Conclusions : Analysis of bowel sound might be useful to evaluate both gastric vagal nerve activity and pyloric valve function. Combination effects of Zusanli (ST36) electroacupuncture and manual acupuncture of other acupoints showed a bidirectional effect in which their activity and function were in general improved. sometimes from aggravated to abnormal level.

• 대한한방내과학회지
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• 제29권3호
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• pp.666-674
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• 2008

Objectives : The aim of this study was to evaluate gastrointestinal parasympathetic nerve activation and pyloric valve function in patients with functional dyspepsia through analysis of bowel sounds and to investigate clinical characteristics associated with the parameters of bowel sounds. Method : We surveyed clinical characteristics of patients by using a questionnaire about functional dyspepsia. Bowel sounds were recorded for 15 minutes during fasting state and for 40 minutes during postprandial state. We then classified the patients into 3 groups by abnormal states of bowel sounds, specifically by the percentage of B.S. and dominenet frequency, and studied clinical characteristics in each group. Results : Among the 182 subjects, patients who had low activity of parasympathetic nerve were 25.8% and showed a tendency of female-dominant, family history and more frequent abdominal pain. Those who had pyloric valve disturbance were 24.1% and showed no tendency by sex distribution, family history and complained of indigestion sensation. Patients who had both disorders were 10.9%, and their clinical characteristics were non-specific. Conclusion : Analysis of bowel sounds may be useful in evaluating pathophysiological factors of functional dyspepsia.

• 대한한방내과학회지
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• 제30권1호
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• pp.191-199
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• 2009

목 적 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에서 전침 및 한약의 복합처치 치료가 이 두가지 면에서 각각 어떤 영향을 미치는지를 살펴보았다. 방 법 : 장음검사상 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 환자 10명을 대상으로 치료 전후의 장음 지표 변화를 비교하였다. 장음지표는 % of bowel sound (%BS)와 주 주파수(dominant frequency, DF)를 사용하였으며, %BS(6인 경우를 위 미주신경 활성저하 DF ratio(식후/식 전)<1를 유문부 기능장애로 평가하였다. 환자들에게 2주간 족삼리전 침과 체침이 매일 시술되었으며 평위산 전탕액이 하루 3회 투여되었다. 결 과 : 2주간의 치료 후 DF ratio는 $0.93\pm0.06$에서 $1.06\pm0.04$으로 유의성있게 증가했으며, 10명 중 9명의 환자가 DF ratio>1의 정상치로 회복되었다. %BS 역시 $2.97\pm1.17%$에서 4.27%로 증가했지만 통계적 유의성은 없었으며, 3명의 환자에서 %BS가 6이상으로 정상회복되었다. 결 론 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에 대한 족삼리 전침과 일반 체침, 평위산의 치료는 미주신경 활성 저하보다는 유문부 기능 장애에 더 유의한 효과를 보였다.

• 대한한방내과학회지
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• 제33권1호
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• pp.26-38
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• 2012

Objectives : The aim of this study was to investigate the effect of partial pyloric obstruction on body weight, gastric juice, gastric surface area and gastric edema in normal intact and/or vagotomized rats. Methods : Partial pyloric obstruction was performed by wrapping a non-absorbable rubber ring (D:6 mm, W:4 mm, T:1 mm) around the 1st portion of the duodenum. Vagotomy was performed by resecting the branches around the esophagogastric junction. Pre-post body weight differential, fasting gastric juice volume, gastric surface area and gastric edema were measured at 8 weeks and 20 weeks. For the effect of pyloric reperfusion the rubber ring was removed after 8 weeks and then an additional 12 weeks of observation was performed to the end of the 20-week experimental period. Results : In the initial 8 weeks observation, the effect of pylorus obstruction and/or vagotomy was significantly remarkable in the pylorus obstructed and vagotomized group; slowdown of weight gain, increase of fasting gastric juice volume, dilatation of gastric surface area and severe gastric edema were shown. In the remaining 12 weeks observation, the effect of reperfusion was significantly remarkable in the ring-removed antral dilated group; recovery of weight gain, decrease of gastric surface area and decrease of gastric edema were shown. However, gastric juice volume was not significantly different from the other group. Conclusions : Partial pyloric obstruction plays a aggravating role and the vagus nerve plays a protective role in body weight, gastric juice, gastric surface area, and gastric edema. Furthermore, pyloric valve dysfunction as an aggravating factor strengthened in defect of the vagus nerve. These results suggest that patients with both functional pyloric outlet obstruction and hypofunction of vagus nerve need to be diagnosed in good time and treated properly.