• 대한한의학회지
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• 제24권1호
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• pp.181-189
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• 2003

Background : Patient, family, society and country are badly damaged by stroke (CVA : cerebrovascular accident). To reduce sequelae and return rapidly to society, treatment in the acute stage is very important. In many studies on purgation therapy (下法) used in acute stages of stroke, the changes of blood pressure, pulse and so on before and after purgation therapy were reported. However, the changes in the human body according to the day elapsed after defecation were not reported, so study was needed to confirm such changes. Methods : Seventy-six patients were studied. We observed forty-three patients at acute stroke and thirty-three patients at convalescent stroke. To confirm the importance of regular defecation in stroke patients, we analyzed blood pressure according to the day elapsed after defecation. Results : The following result were obtained. 1. In stroke group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute stroke group. 2. Especially in stroke and acute stroke groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. 3. In the infarction group, compared with the day after defecation, the mean blood pressure of the third day after defecation increased. It increased the most in the acute infarction group. 4. Especially, in the infarction and acute infarction groups, compared with the second day after defecation, the mean systolic blood pressure of the third day after defecation increased significantly. Conclusion : In stroke patients, regular defecation is important, so we think that purgation therapy (下法) is needed in stroke patients over the third day elapsed after defecation. We think that the bowel movement control in acute stroke patients is more important than in convalescent stroke patients.

• 대한한방내과학회지
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• 제31권3호
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• pp.612-619
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• 2010

Background : Low level laser therapy may be an effective method to protect tissue damage in acute stroke. Recently, series of clinical studies on the basis of animal experiments report efficacy and safety of laser therapy at early stages of acute stroke. Laser promotes mitochondrial ATP synthesis to reduce cell death by ischemic infarction. Objectives : To report possibility of non-invasive laser therapy for acute stroke by reviewing literature about its effectiveness, safety and mechanism. Methods : We searched papers using PubMed and 'Web of Knowledge' of Thomson ISI, using the keywords "Laser Therapy, Low-Level" and "Stroke". Limitations were last 10 years of publications and only in English. Search range includes RCTs, clinical reports, reviews and animal experiments. Papers not matched with inclusion criteria were excluded. Results : A total 223 studies were found, 203 excluded during title and extract screening. After scanning 20 papers the final 2 serial RCTs were selected and analyzed. They reported that transcranial laser therapy led in neuroprotective effect for acute stroke patents. Clinical evaluation factors showed favorable trend and initial safety. Conclusions : Non-invasive laser secured safety of clinical application. It may be a favorable choice for the acute stage of stroke.

• 대한한의학회지
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• 제25권1호
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• pp.111-116
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• 2004

Objective : To assess the clinical efficacy of Yangkyuksanwha-tang on acute stroke Methods : We prescribed Yangkyuksanwha-tang to 83 acute stroke patients without thrombolytic treatment. Results : The rate of progressive stroke type was 1.2%, it was remarkably lower than previous reports. 3.6% felt an itching sensation, 3.6% complained headache, dizziness and powerless, 2.4% complained indigestion and diarrhea, 1.2% appeared hematuria and G-I bleeding. Yangkyuksanwha-tang decreased Stroke-Pattern Identification and National Institute of Health Stroke Scale(NIHSS), and increased Modified Barthel Index(MBI). So we could suggest that this medicine have desirable effect to reduce the severity of stroke and improve functional recovery. As to the laboratory findings, all results were within the normal value, which showed no hepatic or renal toxicity. Conclusion : We could suggest that Yangkyuksanwha-tang is a useful medicine which has clinical efficacy for acute stroke, but further investigation for an administration of more than 2 weeks is necessary.

• 한국임상약학회지
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• 제34권2호
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• pp.79-99
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• 2024

Background: There was an important revision of the Korean Clinical Practice Guideline for Stroke (KCPGS) for antithrombotic therapy in patients with acute ischemic stroke in 2022. This review is to provide an updated information in this revision. Methods: The revision history by year after the first announcement was examined for each topic, focusing on antithrombotic therapy during acute phase which was revised in 2022. We compared before and after the revision, and investigated the clinical outcomes presented as evidence. It was also compared with the current U.S. guidelines. Results: The major changes about antiplatelet therapy are a clause stating that dual antiplatelet therapy with clopidogrel and aspirin initiated within 24 hours from the stroke onset and maintained for up to 21-30 days is recommended as an acute treatment, as well as the clause that antithrombotic therapy may be initiated within 24 hours after intravenous thrombolytics and that the use of glycoprotein IIb/IIIa receptor antagonists can be considered in highly selected patients as rescue therapy taking into account of benefit and risk. The change to the use of anticoagulants is that it may be reasonable to start oral anticoagulant between 4 and 14 days after stroke onset for patients with acute ischemic stroke and atrial fibrillation. Conclusions: It will be helpful in improving health outcomes for clinical pharmacists to be aware of the latest information for antithrombotic therapy and to actively use it in pharmaceutical care of stroke patients.

• 대한한방내과학회지
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• 제21권3호
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• pp.369-376
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• 2000

Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.

• 대한한의학회지
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• 제19권1호
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• pp.385-391
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• 1998

Stroke is badly demaged for patient, family, society and country. To reduce a sequelae and return rapidly to society, treatment at acute stages is very important. In the research on xiafa(下法;diarrhea technique) used at the acute stages of stroke, the results were as follows. On the treatment of stroke, we are to control qi(氣) For it, sweeting technique(汗法), vomitting technigue(吐法) and diarrhea technique(xiafa ;下法) are used. For treatment on biaoshizheng(標實 reyufushi, 熱鬱腑實) at acute stages, tongfuxiexiafa(通腑瀉下法) is in general use. At acute stages, mental state is very important. Therefore, Xiafa(下法) have to conduct by zangfu(臟腑)'s law. At the acute stages, xiafa(下法) improved a whole body problems by treatment on a constipation and dysuria. We think that xiafa(下法) clinically effect on the cerebral edema and increased intracranial pressure. In the future, experimental study is needed.

• 근관절건강학회지
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• 제19권2호
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• pp.107-119
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• 2012

Purpose: This study was conducted to extract international classification of functioning, disability, and health (ICF) core sets for measuring functional status in acute stroke patients, and to evaluate clinical applicability of the core sets. Methods: A set of 22 ICF items on functional status in acute stroke patients were extracted from the Korean general ICF core sets and ICF core sets for stroke patients. The extracted ICF functional items were assessed at the time of admission and discharge among 100 stroke patients who were admitted in a university hospital. Results: Comparing to functional status at admission of acute stroke patients, the overall functional status at discharge was improved. However, functions on defecation, skin protection, and relationship with immediate family at the time of discharge were not significantly changed. Conclusion: The set of ICF functional items identified in this study may be reliable and valid to assess acute stoke patients' body functions, activities and participation and environmental factors in the holistic and comprehensive nursing context. Nursing interventions on bowel elimination and skin protection for acute stroke patients need to be developed.

• 대한한방내과학회지
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• 제23권1호
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• pp.5-13
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• 2002

Purpose : Studies on stroke were conducted by using the scaling system to estimate, compare severity and to predict prognosis. National Institute of Health Stroke Scale is widely used for this purpose due to its accuracy in predicting clinical symptoms. According to previous studies, neurologic symptoms in acute stage of ischemic stroke did not disappear, and approximately 27% to 43% of them were aggravated, We conducted this study to define clinical aggravation and to improve ischemic stroke in its acute stage by using NIHSS. Methods and Subjects : Due to their acute ischemic stroke, twenty five patients visited Wonkwang Oriental Medicine in Cheonju within forty eight hours from its beginning stage. Two oriental medicine doctors checked NIHSS every six hours during the first ninety six hours and later every twenty four hours for twelve days from the beginning of the disease. Results : The Aggravated group consisted of nineteen out of twenty five cases, which is seventy six % and NIHSS on admissions were $5.88{\pm}0.63$ and it increased linearly over time by the equation of NIHSS on admissions was $8.50{\pm}2.02$ and it decreased linearly over time by the equation of NIHSS=-0.01 one hour+7.91. Conclusion : During the study, we defined the clinical courses of acute ischemic stroke. There have been no reports on this so far. Therefore, we hope that this study will be beneficial to expand the scope of oriental medicine in dealing with aggravating ischemic stroke in the acute stage.

• 한국간호교육학회지
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• 제24권2호
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• pp.149-159
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• 2018

Purpose: The purpose of this study was to explore the influencing factors on the family caregivers burden who have has inpatients with acute stroke. Methods: Subjects were 126 family caregivers who have has inpatients with acute stroke. Data were collected by questionnaires. The collected data were analyzed by t-test, ANOVA, Scheffe's test, Pearson's coefficients and multiple regression. Results: The Anxiety of family caregivers was identified as a determinant of family caregivers burden who have has inpatients with acute stroke by the multiple regression analysis (${\beta}=.58$, p<.001). Gender and low cognitive function of inpatients were significantly related to family caregivers burden. And knowledge about care (r=-.27, p=.002) was correlated with anxiety significantly. Conclusion: The family caregivers burden is not only an important issue for nursing but also major nursing problem to be addressed nurses. Family caregivers with acute stroke inpatients feel more anxiety than family caregivers with other illnesses. The anxiety of family caregivers is important especially to the family caregivers who have to care acute stroke inpatients to reduce their burden.

• 디지털융복합연구
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• 제11권6호
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• pp.221-233
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• 2013

본 연구는 뇌졸중 환자의 효율적인 재원일수 관리를 위해 행정자료를 이용하여 우리나라 의료기관을 이용한 뇌졸중 입원환자의 중증도 보정 적정 재원일수 예측 모형을 개발하고 이를 의료기관에서 활용할 수 있는 방안을 제시하고자 하였다. 이를 위해 2004-2009년 퇴원손상심층조사 자료 중 뇌졸중 입원환자 23,134명을 대상으로 데이터마이닝 기법을 이용하여 뇌졸중 입원환자의 적정 재원일수 예측모형을 개발하였다. 의사결정나무 모형에 따라 뇌졸중 입원환자의 평균재원일수에 가장 큰 영향을 미치는 변수는 뇌졸중 발생유형이었으며, 의사결정나무를 이용하여 개발된 뇌졸중 입원환자의 중증도 보정 재원일수 모형 결과, 적정 재원일수와 실제 재원일수의 차이는 진료비지불방법, 의료기관 소재지, 병상규모가 모두 통계적으로 유의하게 나타났다. 따라서 뇌졸중 입원환자의 재원일수 변이를 줄이고 효율적으로 관리하기 위해서는 개발된 모형을 의료기관의 의료정보시스템에 적용하고 관리하는 활동을 전개해야 할 것이다.