• 제목/요약/키워드: lower abdominal pain

검색결과 264건 처리시간 0.031초

가미십전탕(加味十全湯)과 침구치료로 호전된 자궁내막종 2례 임상경과 보고 (Clinical Study for Two Cases of Endometrioma Treated by Gami-sibjeon-tang with Acupuncture and Moxa)

  • 박영애;성준호;박영선;김동철
    • 대한한방부인과학회지
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    • 제21권2호
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    • pp.273-283
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    • 2008
  • Purpose: The purpose of this study is to report the effect of Gami-sibjeon-tang with acupuncture and moxa on endometrioma. Methods: We treated two patients who had endometrioma. Western OB&GY doctors had recommended to operate or observe. But they refused the way western doctors cure the disease. Their chief complainment was severe pain during menstruation period. And they had lower abdominal or lower back pain and acnes on skin. We used Gami-sibjeon-tang on both patients with acupuncture and moxa. Results: After treated by Gami-sibjeon-tang with acupuncture and moxa, they experienced improvement of dysmenorrhea and pain of abdomen and back, and reduction of acnes on skin. And even the sizes of endometrioma had reduced or eliminated. Conclusion: We thought the dysmenorrhea of endometrioma was concerned with inflammation and adhension. So Gami-sibjeon-tang was used when the inflammation and adhension didn't healed because of deficiency of Qi and blood. We administerd Gami-sibjeon-tang with acupuncture and moxa and their dysmenorrhea and other symptoms was relieved.

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급성 비특이성 장간막 림프절염의 임상 소견과 급성 충수돌기염과의 감별 인자 (Clinical Features of Acute Nonspecific Mesenteric Lymphadenitis and Factors for Differential Diagnosis with Acute Appendicitis)

  • 신경화;김갑철;이정권;이영환;감신;황진복
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • 제7권1호
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    • pp.31-39
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    • 2004
  • 목 적: 급성 비특이성 장간막 림프절염(acute nonspecific mesenteric lymphadenitis, ANML)은 타 질환이 적절히 배제되었을 때 임상적 추정으로 진단하는 경우가 많아 그 실체에 대하여는 잘 알려져 있지 않다. 특히 급성 충수 돌기염(acute appendicitis, APPE)과의 감별에 혼란을 주어 복막염 등으로 이행되는 경우가 드물지 않다. ANML의 임상 소견을 보고하고, 특히 APPE와의 감별시 도움을 줄 수 있는 접근 방식을 연구하고자 한다. 방 법: 2000년 11월부터 2001년 5월까지 대구시 한영한마음연합소아과의원으로 급성 복통을 주소로 내원하여 ANML로 진단된 26명(남녀비 13:13)을, APPE 환자는 같은 기간 대구가톨릭대학병원을 방문하여 수술받은 21명(남녀비 12:9)을 대상으로 하였다. ANML 환자들은 복부 초음파 검사상 10 mm 이상, 5개 이상의 장간막 림프절이 관찰되면서 회장, 대장의 장벽 비후 소견이 5 mm를 넘지 않고 염증성 충수돌기가 관찰되지 않으며, 말초 혈액 검사, 소변 검사, 대변 검사상 타 질환을 의심할 소견이 없는 등을 진단기준으로 설정하였다. 결 과: 1) ANML군의 진단 당시 연령은 1~11세, $5.2{\pm}2.3$세였다. 2) ANML군의 복통 양상은 21례(80%)에서 야간 복통이 있었고, 위치는 배꼽 주위부 20례(76%), 우하복부 3례(11%), 하복부 3례(11%)였다. 2례(7%)에서 복부 강직이 있었고, 반발 압통은 전례에서 없었다. APPE군에서는 전례에서 야간 복통이 있었고, 17례(80%)에서 복부 강직이, 16례(76%)에서 반발 압통이 관찰되어 ANML군과 각각 유의한 차이를 보였다(p<0.05). 3) ANML군에서 복통의 회복까지 걸린 시간은 2~4일, $2.5{\pm}0.5$일이었다. 4) ANML군 10례(38%)에서 구토를 보였고 1~3회/일, $1.5{\pm}0.7$회/일이었다. 설사는 17례(65%)에서 있었고 1~4회/일, $1.6{\pm}0.8$회였다. APPE군 19례(90%)에서 구토가 있었으며 1~10회/일, $4.5{\pm}2.9$회로 ANML군과 유의한 차이를 보였다(p<0.05). APPE군의 설사는 6례(28%)에서 있었으며 1~5회/일, $2.1{\pm}1.6$회이었다. 5) ANML군에서 열은 19례(73%)에서 있었고, 말초혈액 백혈구 수는 $5,900{\sim}12,300/mm^3$이었으며 평균 $8,403{\pm}1,737/mm^3$이었다. APPE군에서는 열은 16례(76%)에서 관찰되었으며 백혈구 수는 $5,400{\sim}20,800/mm^3$으로 평균 $15,471{\pm}3,749/mm^3$이었으며 ANML군과는 유의한 차이를 보였다(p<0.05). 6) 판별분석을 이용하여 하루 구토의 강도와 백혈구 수를 독립변수로 하였을 때 ANML과 APPE는 95.7% 수준으로 분류되었다. 결 론: ANML과 APPE의 감별 시 복부강직, 반동압통 등 급성복증의 소견이 의심될 때 뿐만 아니라, 복통이 3일을 초과하여 지속되거나, 하루 구토가 3회를 초과하는 경우, 말초혈액검사상 백혈구 수가 $13,500/mm^3$ 이상을 보일 때에도 반드시 복부초음파 검사를 이용하여 APPE를 확인하여야 한다.

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경막외 진통법이 개흉술후 환자에게 미치는 영향 (Effect of Enidural Analgesia on the Post-thoracotomy Patient)

  • 이용재
    • Journal of Chest Surgery
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    • 제25권4호
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    • pp.391-397
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    • 1992
  • Postoperative hypoxemia in the absence of hypoventilation occurs more often after thoracic or upper abdominal surgery than lower abdominal operations or surgery on extremities. Although the factors which produce postoperative alveolar collapse have not been fully evaluated, the dominant factor of postoperative hypoxia is shunt of blood passing collapsed alveoli and the postoperative pain is associated with restriction of depth of breathing, sighing and movement. In 1979, the first successful clinical usage of epidurally administered morphine was done by Behar and associates for control of postoperative pain. This study was carried out for twenty patients who received posterolateral thoracostomy with Bled resection between May 1990 and May 1991 and who were primary spontaneous recurrent pneumothoraxes. We selected ten of twenty patients, one after the other and treated with epidural analgesia as study group and the remainder ten were grouped as control. Epidural catheters were inserted for study group before operation through T12-L1, 2 interspinous process at the pain clinic or operation room by anesthesiogist and then the drugs[0.25% Bupivacaine 15ml mixing with morphine 3mg] were instillated through the catheter before extubarion and once a day until 4th day, and the patients of control group were treated intermittently by Demerol 50mg intramuscularly for postoperative pain control. The epidural catheters were removed at postoperative 4th day. Observations were done about vital aigns, a-BGA, tidal volume, FVC and occurence of adverse effects during postoperative 2hr, 8hr, 1st day, 2nd day, 7th day in both groups. The results were as follows; [1] Tidal volume[85.1$\pm$29.8%R VS 60.8$\pm$20.5%R, p<0.05] and FVC[53.7$\pm$14.2%R, VS 35.5$\pm$9.l%R, p<0.01] were significantly improved in study group compared with control group during the first day of operation. [2] But the improvement of FVC was delayed after stopping of epidural analgesia[postoperative 7th day, 97.5$\pm$12.3%R VS 83.9$\pm$15.6%R, P <0.05]. [3] Others were statistically not significant. [4] The side effects of epidural analgesia were identified such as urinary retention[2 cases], itching sensation[1 case] and headache[1 case], but there was no need for active treatments.

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부인과 수술 후 한방 조기 회복 치료를 받은 입원 환자에 대한 후향적 분석 (Traditional Korea Medicine for Enhanced Recovery after Surgery (ERAS) in Inpatients after Gynecological Surgery: Retrospective Analysis)

  • 김혜원;유정은
    • 대한한방부인과학회지
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    • 제32권3호
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    • pp.142-161
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    • 2019
  • Objectives: The purpose of this study is to report the effect and safety of traditional Korean medicine (TKM) for enhanced recovery after surgery (ERAS) after gynecological surgery. Methods: The study is conducted by analyzing the medical records of the hospitalized patients in TKM hospital. Eighty-six patients were enrolled who received TKM for ERAS after gynecological surgery from January 2015 to April 2018. We performed statistical analysis by using SPSS ver. 25.0. To prove the effect and safety of TKM for ERAS, we analyzed symptoms and Hemoglobin (Hb), aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP) and serum creatinine (Cr) with glomerular filtration rate (GFR). In addition, we checked other adverse reactions that the patients complained to prove the safety of TKM for ERAS. Results: Among symptoms of pain, there was a statistically significant decrease in abdominal pain, lower back pain, and shoulder pain. Other symptoms showed statistically significant improvement in fatigue, abdominal tympanosis, operation-site discomfort, dizziness, urinary discomfort, throat discomfort, constipation, dyspepsia and colporrhagia. Anemia in both ferritin combination treatment group and herbal medicine only group showed significant improvement. There was no liver damage or renal damage by TKM. Conclusions: The result has shown that TKM for ERAS after gynecological surgery is effective and safe. The further study of TKM for ERAS with more patients is needed.

엘리트 남녀역도선수들의 등속성 허리 근기능 및 유연성과 요통과의 관계 (The Relationships between Isokinetic Muscular Function and Flexibility of the Lower Back Pain(LBP) in Elite Weight Lifter)

  • 김동현;주윤용
    • 한국임상보건과학회지
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    • 제3권2호
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    • pp.311-319
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    • 2015
  • Purpose. This study of purpose was to compare and analyze the relationship among the isokinetic trunk muscular functions, flexibility and low back pain of elite weight lifter with regard of sex. Methods. we measured the level of low back pain, isokinetic muscular functions according to gender, then analyzed the relationship between isokinetic functions and the level of low back pain, between flexibility and the level of pain, between Athletic Career and the level. Results. In this study, the gender, the VAS point was $2.6{\pm}2.3$ and the VRS point was $2.3{\pm}1.3$ in males. The other side, in females the VAS points was $3.6{\pm}1.7$ and the VRS was $3.2{\pm}1.1$. There was significant negative correlation(r=-0.826) between the VAS point and the maximal flexion muscular strength per kilogram of $30^{\circ}/sec$ isokinetic exercise in female. also there was negative correlation between the muscular flexion strength per kilogram and the VRS point in female, but there was no significant relationship in male. Conclusions. In current study, these results suggested that the higher muscular flexion strength per kilogram is, the lower the level of low back pain is in female athletes. this is caused by the imbalance between Abdominal Muscles and Back Extensor in weight lifter. Therefore, there is the need to apply the program to improve the balance of trunk.

제왕절개술후 통증치료시 지속적 경막외 국소마취제와 Tramadol의 병용투여의 효과 (Continuous Epidural Infusion of Bupivacaine with Tramadol for Post-Cesarean Analgesia)

  • 강포순;조재군
    • The Korean Journal of Pain
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    • 제11권1호
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    • pp.54-59
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    • 1998
  • Background: Tramadol administered epidurally is known to have one-thirtieth the potency of morphine for treatment of pain following abdominal surgery. We designed a prospective, randomized, controlled study to evaluate the analgesic efficacy and safety of combined epidural infusion of bupivacaine and tramadol with 2-day infusor as ompared to bupivacaine and morphine combined epidural infusion. Methods: Sixty healthy women scheduled for Cesarean delivery were assigned randomly in double- blind fashion: Group 1 (n=20) were given a mixture of morphine 10 mg(1 ml), 0.5% bupivacaine 40 ml and normal saline(NS) 40 ml; Group 2(n=20) a mixture of tramadol 300 mg(6 ml), 0.5% bupivacaine 40 ml and NS 54 ml; Group 3(n=20) or a mixture of tramadol 500 mg(10 ml), 0.5% bupivacaine 50 ml and NS 50 ml, of continuous dose via epidural route following 1% lidocaine 6 ml as bolus dose for 48 hours postoperatively. We evaluated the analgesic efficacy and side effects of these three groups using visual analogue pain scale (VAPS) and verbal rating scale (VRS). Results: VAPS of group 1 and 3 were lower than group 2, and VAPS of group 1 was lower than group 3(12, 24, 36, 48 hours). VRS of group 1 and 3 were lower than group 2 (12, 24, 36 hours). There were incidences of pruritus was 16 patients in group 1. Conclusions: Tramadol does possess the analgesia effect of morphine, but has the added analgesia following increment. Further research to determine the most effective administration method and reguired dosage of tramadol is further needed.

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병기(病機)19조(條)에 관하여 ≪의학심오(醫學心悟)≫가 ≪황제내경(黃帝內經)≫과 다른 세 가지 논점(論點)에 관한 고찰(考察) (A Discussion on Three Different Issues Between Huangdi Neijing 黃帝內經 and Yixuexinwu 醫學心悟 Regarding the 19 Mechanisms of Disease (病機十九條))

  • 전찬용
    • 대한한방내과학회지
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    • 제44권6호
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    • pp.1271-1278
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    • 2023
  • Objective: The 19 Mechanisms of Disease were first described in Huangdi Neijing. When examining Yixuexinwu, three descriptions that were different from Huangdi Neijing were found. Methods and Results: After examining the two books, three differences in the description of the 19 Mechanisms of Disease were discovered: 1) The upper and lower locations of dyspnea (喘症) are reversed. 2) The ratio of provisions for "fire (火)" and "cold (寒)" is different. 3) The organ affiliation for pain is different. Conclusion: 1) The upper and lower locations of dyspnea (喘症) are reversed. : Regarding external contraction dyspnea (外感喘), Yixuexinwu used the disease of the upper location (lung 上, 肺) in the same way as in Huangdi Neijing. In terms of internal damage (內傷喘), it was separately classified as a disease of the lower location (kidney 下, 腎). 2) The ratio of provisions for "fire (火)" and "cold (寒)" is different. : Arithmetically, if you round off the number after calculating the fraction, the difference between the two ratios becomes the same. Theoretically, five provisions of "fire" are replaced by four provisions of "heat (熱)", and the difference in ratios is exactly the same. Empirically, it emphasizes that there are more illnesses from fire and heat than from cold. 3) The organ affiliation for pain is different. : Huangdi Neijing described general inflammatory pain, while the Yixuexinwu described only stress-related abdominal pain (肝木乘脾 腹痛).

급성 림프구성 백혈병에 합병된 천공성 typhlitis (Two Cases of Perforated Typhlitis in Acute Lymphocytic Leukemia)

  • 박우현;안근수;최순옥
    • Advances in pediatric surgery
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    • 제7권1호
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    • pp.59-63
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    • 2001
  • 소아 ALL 환자 2례에서 천공성 맹장염을 경험하였다. 주요 증상으로 고열, 복통, 복부팽만 설사가 있었으며, 혈액 검사에서 백혈구 감소증 및 혈소판 감소증이 있었다. 진단은 초음파검사와 콤푸터 단층촬영으로 비정상적인 장벽 비후를 봄으로 가능하였다. 1예는 수술적 치료를 함으로 1예는 내과적 치료로 좋은 결과를 얻었다. 백혈병환자에서 항암 치료 중 고열, 하복부 동통이 있고 백혈구 감소증이 있을 경우는 맹장염의 기능성을 생각하고 조기에 초음파 검사 또는 컴퓨터 단층촬영을 하여 적절히 대처하여야 할 것으로 생각된다. 그리고 비록 천공성 맹장염이라도 증상이 국소적 일 때는 내과적 치료를 시도해 볼 필요가 있다고 생각된다.

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급성 신부전을 동반한 성인 Henoch-Sch$\ddot{o}$nlein 자반증 1예 (A Case of Adult onset Henoch-Sch$\ddot{o}$nlein Purpura with Acute Renal Failure)

  • 김석민;장경애;정선영;박찬서;박종원;도준영;김용진;윤경우
    • Journal of Yeungnam Medical Science
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    • 제25권1호
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    • pp.58-63
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    • 2008
  • Henoch-Sch$\ddot{o}$nlein purpura (HSP) is a leukocytoclastic vasculitis of small vessels with deposition of IgA, commonly resulting in skin, joint, gastrointestinal, and kidney involvement. HSP is an uncommon disorder in adults and accounts for 0.6% to 2% of adult nephropathy. We report a case of HSP with acute renal failure successfully treated with corticosteroid. In this case, the patient presented with vasculitic purpuric rash on lower extremity, arthralgia in the wrist, abdominal pain, hematochezia, oliguria and azotemia. Abdominal CT showed wall thickening of the small and large bowels. Skin biopsy revealed leukocytoclastic vasculitis. Percutaneous renal biopsy showed no crescent formation, but mesangial IgA and $C_3$ deposits were observed by immunofluorescence. The patient was treated with corticosteroid (1mg/kg per day) and hemodialysis. After treatment, renal function improved and purpuric lesion, arthralgia and abdominal pain disappeared. Thus, when adults present with purpuric rash and rapidly progressive glomerulonephritis (RPGN), HSP should be a diagnostic consideration.

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