• 제목/요약/키워드: Sleep insufficiency

검색결과 16건 처리시간 0.026초

양허(陽虛) 불면증(不眠症)환자 치험 1례 (A Clinical Report of Insomnia due to deficiency of Yang)

  • 김수연;김은정;이동원;김경화
    • 동의신경정신과학회지
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    • 제15권1호
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    • pp.121-126
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    • 2004
  • 본 증례(證例)는 local 한의원에 2003. 12. 19.부터 2004. 1. 20.일 까지 래원(來院)한 환자의 주소증이 부면심계(不眠心悸) 불안(不安) 이경(易驚) 외한(畏寒) 조잡(?雜) 증상을 호소하는 환자에게 한약 처방과 침구치료(鍼灸治療)만으로도 좋은 결과를 보여준 사례이다. 특별한 검사를 하지 않고도 한의학적(韓醫學的)이론에 입각하여 사진(四診)을 하고 그것을 토대로 변증을 한 것이 치료에 효과를 보여준 사례이다. 이러한 증례가 한 예에 불과하므로 앞으로도 많은 임상 증례가 나오기를 기대한다.

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불면환자의 수면의 질 척도, 우울척도, 한방진단시스템과의 연관성 연구(1) (Study on the Association of PSQI, IQ, BDI and DSOM in the Insomnia Patients(l))

  • 오경민;김보경
    • 동의신경정신과학회지
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    • 제20권3호
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    • pp.89-119
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    • 2009
  • Objectives : This study was to investigate the association of Pittsburgh Sleep Quality Index(PSQI), Insomnia Questionaire(IQ), Beck Depression Inventory(BDI) and Diagnos system of oriental medicine(DSOM) in the Insomnia Patients. Methods : For this study, we carried out PSQI, IQ, BDI and DSOM of 37 patients with insomnia who have come to Donguei oriental hospital of Donguei university from November 2008 to May 2009. And Using cross tabulation analysis, verified the association of PSQI, IQ, BDI and DSOM. Results : 1. The most Frequent Pathogenic Factor is blood-deficiency(血虛) in total patients. 2. The score of BDI has positive correlation with sc10 of deficiency of qi(氣虛), damp(濕), kdney(腎) in total patients. 3. The score of PSQI has positive correlation with zp of liver(肝) in total patients. 4. The score of PSQI has positive correlation with sc10 and zp of insufficiency of Yin(陰虛), and the score of BDI has positive correlation with sc10 of blood stasis(血瘀) and zp of liver(肝) in female patients. 5. The score of PSQI has positive correlation with sc10 of deficiency of qi(氣虛) and zp of heart(心), and the score of IQ has positive correlation with sc10 of liver(肝) in male patients. 6. The duration from onset in the group of 22-59years are longer than the group of 60-80 years and the duration of using hypnotics have positive correlation with total sleep time in 22-59years group. 7. The score of PSQI has positive correlation with zp of liver(肝) in 22-59years group. 8. The score of PSQI has positive correlation with the score of BDI in 60-80years group. 9. The score of BDI has positive correlation with sc10 of deficiency of qi(氣虛) and zp of blood-deficiency(血虛), and the score of IQ has positive correlation with zp of coldness(寒) in 60-80years group. 10. The score of IQ has positive correlation with sc10 and zp of dryness(燥) in below 6 Months Group. 11. The score of PSQI has positive correlation with the score of BDI in over 6 Months Group. 12. The score of PSQI has positive correlation with zp of liver(肝) in over 6 Months Group. 13. The score of IQ has positive correlation with sc10 of dryness(燥) in BDI 2nd Grade Group. 14. The score of BDI has positive correlation with sc10 of kidney(腎) and the age has positive correlation with zp of heart(心) in BDI 3rd Grade Group. 15. The age has positive correlation with sc10 of damp(濕) in BDI 4th Grade Group. Conclusions : This study provides insights into the complicated associations of the pattern of insomnia with depression and Diagnos system of oriental medicine. And especially this study showed apparent correlation between insomnia and depression in 60-80years group and over 6 months group.

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미숙아에서 발견된 부분형 DiGeorge 증후군 1례 (A Case of Partial DiGeorge Syndrome in Prematurity)

  • 성태정;고은영;김달현;오지은;권영세;임대현;손병관
    • Clinical and Experimental Pediatrics
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    • 제45권3호
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    • pp.383-389
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    • 2002
  • 저자들은 미숙아에서 청색증과 무호흡증으로 입원 치료 하던 중 저칼슘혈증으로 인한 경련이 나타난 환아에게서 흉부 X선 사진과 MRI상 흉선을 관찰할 수 없으면서 T 세포수의 감소와 부갑상선 홀몬수치 감소를 나타내고 소악증, 어구, 부리모양의 코 등의 안면 기형과 합지증, 코 역류증, 폐쇄성 수면 무호흡증, 구개 범인두 부전증 등의 증상을 보이며 염색체 22q11 극소결실이 FISH검사에서 확진된 부분형 DiGeorge 증후군 1예를 경험하였기에 문헌 고찰과 함께 보고하는 바이다.

구개인두성형술의 효과 및 합병증에 관한 장기추적관찰 (LONG TERM FOLLOW UP OF EFFECTIVENESS AND COMPLICATIONS OF PALATOPHARYNGOPLASTY)

  • 박재훈;이용배;남순열;김원일
    • 대한기관식도과학회:학술대회논문집
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    • 대한기관식도과학회 1993년도 제27차 학술대회 초록집
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    • pp.100-100
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    • 1993
  • 구개인두성형술은 만성 코골음 및 폐쇄성 수면 무호흡증의 치료를 위해 널리 이용되고 있는 수술이며 수술 직후의 치료 효과 및 합병증에 대한 연구는 많이 이루어져 있으나 5년 이상의 장기 추적 관찰에 관한 연구는 드물게 보고 되고 있다. 이에 저자들은 1985년부터 1987년까지 구개인두성형술을 시행한 총 37명의 환자중 추적관찰이 가능했던 25명의 환자(남:18명, 여:7명)를 대상으로 수술전, 수술후 8주 및 수술후 5년이 지난 환자의 주관적 증상을 비교 평가 하였으며 중상의 변화와 함께 체중의 증감도 같이 조사하여 다음과 같은 결과를 얻었다. (1) 수술후 5년된 25명의 환자에서 코골음은 10명(40%)에서 완전히 사라졌고 정도의 차이(Grade 1 - 3)는 있지만 3명을 제외한 나머지 모두에서 호전을 보였다. (2) 수술전 AI>20이었던 15명의 환자에서 발견된 수면 무호흡증은 추적 관찰용 수면 다원 검사상 13명의 환자에서 Grade 0 - 1 (Oxygen saturation 86%)로의 호전을 보였고 수술후 5년이 지난뒤에도 증상의 변화 및 체중 변화는 없었다. (3) 수술 5년후에도 문제가 되는 합병증으로는 물을 급히 마실 때에만 코끝에 물방울이 비치는 정도의 구개인두부전 3례, 인두 비대칭 1례, 인두 건조감이 5례에서 관찰되었다. 그외 비인두 협착, 미각 상실, 및 호흡 순환계의 장애 둥 심각한 합병증은 발견되지 않았다.

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Korean Society of Heart Failure Guidelines for the Management of Heart Failure: Management of the Underlying Etiologies and Comorbidities of Heart Failure

  • Sang Min Park;Soo Youn Lee;Mi-Hyang Jung;Jong-Chan Youn;Darae Kim;Jae Yeong Cho;Dong-Hyuk Cho;Junho Hyun;Hyun-Jai Cho;Seong-Mi Park;Jin-Oh Choi;Wook-Jin Chung;Seok-Min Kang;Byung-Su Yoo;Committee of Clinical Practice Guidelines, Korean Society of Heart Failure
    • Korean Circulation Journal
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    • 제53권7호
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    • pp.425-451
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    • 2023
  • Most patients with heart failure (HF) have multiple comorbidities, which impact their quality of life, aggravate HF, and increase mortality. Cardiovascular comorbidities include systemic and pulmonary hypertension, ischemic and valvular heart diseases, and atrial fibrillation. Non-cardiovascular comorbidities include diabetes mellitus (DM), chronic kidney and pulmonary diseases, iron deficiency and anemia, and sleep apnea. In patients with HF with hypertension and left ventricular hypertrophy, renin-angiotensin system inhibitors combined with calcium channel blockers and/or diuretics is an effective treatment regimen. Measurement of pulmonary vascular resistance via right heart catheterization is recommended for patients with HF considered suitable for implantation of mechanical circulatory support devices or as heart transplantation candidates. Coronary angiography remains the gold standard for the diagnosis and reperfusion in patients with HF and angina pectoris refractory to antianginal medications. In patients with HF and atrial fibrillation, longterm anticoagulants are recommended according to the CHA2DS2-VASc scores. Valvular heart diseases should be treated medically and/or surgically. In patients with HF and DM, metformin is relatively safer; thiazolidinediones cause fluid retention and should be avoided in patients with HF and dyspnea. In renal insufficiency, both volume status and cardiac performance are important for therapy guidance. In patients with HF and pulmonary disease, beta-blockers are underused, which may be related to increased mortality. In patients with HF and anemia, iron supplementation can help improve symptoms. In obstructive sleep apnea, continuous positive airway pressure therapy helps avoid severe nocturnal hypoxia. Appropriate management of comorbidities is important for improving clinical outcomes in patients with HF.

가정산소치료의 보험급여 실시 이후 처방 실태: 다기관 조사 -만성기도폐쇄성질환 임상연구센터 제3세부과제 만성기도폐쇄성질환 진료지침 개발/보급 연구- (Long-term Oxygen Therapy for Chronic Respiratory Insufficiency: the Situation in Korea after the Health Insurance Coverage: a Multi-center Korean Survey -Study for the Development and Dissemination of the COPD Guidelines, Clinical Research Center for Chronic Obstructive Airway Disease-)

  • 박명재;유지홍;최천웅;김영균;윤형규;강경호;이승룡;최혜숙;이관호;이진화;임성철;김유일;신동호;김태형;정기석;박용범
    • Tuberculosis and Respiratory Diseases
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    • 제67권2호
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    • pp.88-94
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    • 2009
  • Background: From November 2006, The national health insurance system in the Republic of Korea began to cover prescribed long-term oxygen therapy (LTOT) in patients with chronic respiratory insufficiency. This study examined the current status of LTOT after national health insurance coverage. Methods: Between November 1, 2006 and June 30, 2008, the medical records of patients who were prescribed LTOT by chest physicians were reviewed. The data was collected from 13 university hospitals. Results: 197 patients (131 male and 66 female) were prescribed LTOT. The mean age was 64.3${\pm}$13.0 years. The most common underlying disease was chronic obstructive pulmonary disease (n=103, 52.3%). Chest physicians prescribed LTOT using arterial blood gas analysis or a pulse oxymeter (74.6%), symptoms (14%), or a pulmonary function test (11.2%). The mean oxygen flow rate was 1.56${\pm}$0.68 L/min at rest, 2.08${\pm}$0.91 L/min during exercise or 1.51${\pm}$0.75 L/min during sleep. Most patients (98.3%) used oxygen concentrators. Only 19% of patients used ambulatory oxygen supplies. The oxygen saturation before and after LTOT was 83.18${\pm}$10.48% and 91.64${\pm}$7.1%, respectively. After LTOT, dyspnea improved in 81.2% of patients. The mean duration of LTOT was 16.85${\pm}$6.71 hours/day. The rental cost for the oxygen concentrator and related electricity charges were 48,414${\pm}$15,618 won/month and 40,352${\pm}$36,815 won/month, respectively. Approximately 75% of patients had a regular visit by the company. 5.8% of patients had personal pulse oxymetry. 54.9% of patients had their oxygen saturation checked on each visit hospital. 8% of patients were current smokers. The most common complaint with LTOT was the limitation of daily activity (53%). The most common complaint with oxygen concentrators was noise (41%). Conclusion: The patients showed good compliance with LTOT. However, only a few patients used an ambulatory oxygen device or had their oxygen saturation measured.