• Title/Summary/Keyword: stasis

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홍화 추출물이 치주인대세포, 조골세포 활성도에 미치는 영향 (The biologic effects of safflower(Carthamus tinctorius $Linn\acute{e}$) extract and Dipsasi Radix extract on periodontal ligament cells and osteoblastic cells)

  • 류인철;이용무;구영;배기환;정종평
    • Journal of Periodontal and Implant Science
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    • 제27권4호
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    • pp.867-882
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    • 1997
  • Safflower(Carthamus tinctorius $Linn\acute{e}$ has been traditionally used for the treatment of blood stasis, and Dipsasi Radix has been used as a drug for fracture in Chinese medicine. The purpose of present study was to examine the biologic effects of safflower extract and Disasi radix extracts on the periodontal. ligament cells and osteoblastic cells and on the wound healing of rat calvarial defect. The ethanolic extract of safflower blossom, safflower seed and Dipsasi Radix(125, 250, and 500 ${\mu}g/ml$) were prepared as test group, and PDGF-BB(lOng/ml) and unsafonifiable fraction of Zea Mays L.(125, 250, and 500 ${\mu}g/ml$) were employed as positive control. The effects of each agents on the growth and survival, ALPase activity, expression of PDGF-BB receptor, chemotactic response of PDL cell and ATCC human osteosarcoma MG63 cells in vitro were examined. The tissue regenerative effect of each extracts was evaluated by histomorphometric measuring of newly formed bone on the 8mm defect in rat calvaria after oral administration of 3 different dosages groups : 0.02, 0.1 and 0.35g/kg, per day. It was also employed the same dosages of unsaponifiable fraction of Zea Mays L. as positive controls. Safflower blossom extract, safflower seed extract, and Dipsasi Radix extract stimulate the cellular activity of MG63 cells in concentration range of $125-500{\mu}g/ml$, and safflower bolssom extract and safflower seed extract stimulate also the cellular activity of periodontal ligament cells in concentration range of $250-500{\mu}g/ml$. In activity of ALPase, $250-500{\mu}g/ml$ of safflower blossom extracts showed significant stimulating effects on MG63 cells, and the same concentration range of safflower seed extracts showed significant effect on periodontal ligament cells. In the recovery on PDGF-BB receptor expression which was depressed by $IL-1{\beta}$, $125-250{\mu}g/ml$ of safflower blossom extracts and $250-500{\mu}g/ml$ of safflower seed extracts showed significant increasing effect on MG63 cells, and $500{\mu}g/ml$ of safflower blossom extract and $250-500{\mu}g/ml$ of safflower seed extracts showed significant effect on periodontal ligament cells. In chemotactic response, among all tested group, safflower seed extracts only were chemotactic to MG63 cells and periodontal ligament cells in concentration range of $125-500{\mu}g/ml$. Also in the view of bone regeneration in rat calvarial defect model, the only group that was orally administrated 0.35g/kg, day of safflower seed extract showed significant new bone formation. These results suggested that safflower extracts might have a potential possibilities as an useful drug for adjunct to treatment for regeneration of periodontal defect.

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고려시대(高麗時代) 의학사관(醫學史觀) 질정(叱正)(1) - 고려초기(高麗初期) 의학(醫學)에 관한 김두종(金斗鍾)의 역사인식에 대한 비판 - (Berating on the Historical view in Korea dynasty's Medicine (1))

  • 김홍균
    • 한국한의학연구원논문집
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    • 제9권1호
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    • pp.1-33
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    • 2003
  • From the study on Doo-Jong Kims view of history about the early Korea$(Korea\;herewith\;stands\;for\;Korea\;dynasty\;A.D.918{\sim}1392)s$ Medicine, I came to a conclusion as follows. 1. Doo-Jong Kim is stressing on the fact that Early Koreas Medicine inherited from Shilla dynasty and seemingly expressing the pride of national medical science. But actually he distorted the Koreas independent growth with flunkeyism and insisted that Koreas medicine only took over Shilla dynastys which based on Chinese Tang dynastys medical science. As a result, Koreas medicine was blurred and evaluated as nothing but Tangs medicine. But, the reasons of Doo-Jong Kims viewpoints were not based on the fact, but on his speculation. 2. About the medical system, Doo-Jong Kim viewed that Korea copied Chinese Soo & Tangs medical system, But the fact is that Korea only borrowed a part of Chinese medical systems name, for examples, Tae-I-Gam, Sang-Yak-Kook, Sang-Sik-Kook, etc., and its actual functions were different and grew in Koreas own way, As a result, the titles or roles in the system were very different from those of Chinas. Especially, Korea saw much development in Science of Acupuncture and Moxibustion that there was a specialist on Acupuncture, called I-Chim-Sa, and even had much influences on Chinese Acupuncture and Moxibustions growth, exporting Hwang-Je-Ne-Kyong to Chinese Song dynasty. 3. About the education system of medicine, Doo-Jong Kim viewed that Koreas medicine was only a copy of Shilla dynastys which was based on Chinese Tang dynastys, taking the medical examination curriculum as an example. The fact is that Tangs medical curriculum was three, Bon-Cho, Kab-Ul, Maek-Kyong, Shilla had seven, Bon-Cho-Kyong, Kab-Ul-Kyong, So-Moon-Kyong, Chim-Kyong, Maek-Kyong, Myong-Dang-Kyong, Nan-Kyong, and Korea had ten, So-Moon-Kyong, Kab-Ul-Kyong, Bon-Cho-Kyong, Myong-Dang-Kyong, Maek-Kyong, Dae-Kyong-Chim-Kyong, Nan-Kyong, Ku-Kyong, Ryu-Yon-Ja-Bang, So-Kyong-Chang-Jeo-Ron. Simply considering this, it is so clear that Koreas medical curriculum was much more upgraded one than that of China. 4. About the examination system for civil service, Doo-Jong Kim expressed that Shilla dynasty did not have such system, and only expounded knowledge of Shilla medicine, In case of China, Tang danasty Hyang-Kong was only a qualification test for civil service, which the result was completely dependent on applicants social status, Song danasty examination system was composed of three steps of Hyang-Si, Sung-Si, Jeon-Si (See Note1), but it stuck to formality by having Jeon-Si of anti-fraudulence use. On the other hand, examination system for civil service in Korea dynasty started in 958 by an advice of Ssang-Ki, Chin-Si in 977 and K대-Ja-Si (See Note 1), a kind of Hyang-Si, in 1024., Three steps of examination system made employment for civil service strictly fair, Moreover, it was possible for offsprings of concubine to be an applicant. These easily explain that the examination system of Korea dynasty was more upgraded one than that of China, Tang & Song dynasty. Hyang-Si : Exam in local area Sung-Si : Exam in province for those who passed Hyang-Si Jeon-Si : Exam held with Koea Kings supervision for those who passed Hyang-Si Keo-Ja-Si : Selective exam in local area like Hyang-Si. From the reasons above, it is clear that Doo-Jong Kim was much biased by flunkeyism through Japanese colonialisam and expressed his view on Korea Medical History based on such theory of heteronomy and stasis. Moreover, without rigid historical evidence on records, he distored the fact by translating incorrectly on his purpose. Therefore, Doo-Jong Kims Korean Medical History must be reevaluated through rigid historical research and his mistranslation should be corrected.

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노인(老人) 저혈압(低血壓)에 대(對)한 문헌적(文獻的) 고찰(考察) (A Literature Review of The Senile Hypotension)

  • 곽익훈;김종대;정지천
    • 동국한의학연구소논문집
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    • 제4권
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    • pp.161-187
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    • 1995
  • This study was perfomed to investigate causes of the senile hypotension, pathogenic mechanism, symptoms, and therapies through medical literatures, recent chinese medical literatures and chinese medical journals. The results are as follows ; 1. The senile hypotension has major symptoms of dizziness, weakness, syncope, palpitation, shortness of breath, and deficiency of Qi. Additionally, it has minor symtoms of letharhy, isomnia, tinnitus, amnesia etc... 2. The prodromal symptoms of Kwul and Kwul are relating to the symptoms of tachycardia, facial pallor, sweating, anxietas, ambiguous consciousness, and fainting. Weakness and dizziness due to deficiency make the symptoms of exhaustion, fatigue, vertigo, lethargy, and brachycardia. 3. The most principal cause of the senile hypotension is deficiency of Shen due to aging, congenital deficiency, and chronic illness. The rest of causes are defciency of Qi and blood, phlegm of retention, stagnation of Qi, blood stasis, blood prostration etc... In the view of the occidental meicine, the causes of the senile hypotension came from the reduction of cardiac output, the decretion of cardiovascular system's extention due to aging, hereditary factor, secondary factor due to exsanguination, diabetes mellitus, C.V.A etc..., and factor of neurogenic system's degeneration. 4. The principal pathogenic mechanisms are the insufficiency of Xing-Yang, the deficiency of Qi in middle jiao, and deficiency of Shen-Qi. The rest of mechanisms are the deficiency of both Qi and blood, stagnation of the Gan-Qi, and the deficiency of Gan and Shen. Zang-Pu Organs have something to do with Xing, Bi, and Shen. 5. As principal therapies, there are warming and recuperation the Xing-Yang, strengthing the middle-jiao and replenishing Qi, replenishing vital essence to tonify the Shen, and warming and recuperation the Shen-Yang. Additionally, the therapies of invigorating the Bi and relieving mental stress, strengthning the Bi and tonifing the Shen, invigorating Qi and nourishing Yin, soothing the Gan and regulating the circulation of Qi, and tonifing the Shen and nourishing the Gan help the cure of the senile hypotension. In prescriptions there are Baohe Yuan Tang, Buzhong Yigi Tang, Zuoguei Yin, Yougui Yin, Guipi Tang, Zhu Fu Tang, Shengmai San, Sini San, and Qi Ju Dihuang Wan. The medical herbs of Astragali Radix, Codonopsitis Pilosulae Radix, Ginseng Radix, Aconiti Tuber, Ephedrae Herba, Cinnamomi Ramulus, Cinnamomi Corfex Spissus, Zingiberis Rhizoma, Polygalae Radix, Liriopis Tuber, Polygonati Sibirici Rhifoma, Lycii Fructus, Schizandrae Fructus, and Glycyrrhizae Radix can be treated. 6. According to the clinical report, the principal causes are the deficiency of Qi, and insufficiency of Yang which symptoms are dizziness, vitality fatigue and acratia, amnesia, body cold and alger of extremity, spontaneous perspiration, and therady and weak pulse. It was improved by taking WenYang YiQi Tang, Zhu Fu Tang about 20-30 days. The improvement was shown on disappearance of subjective symptoms or the ascending of blood pressure to normal figure, and the rate of improvement was over 70%. 7. As regimens, taking warming and recuperating food(a sheep mutton, juglans regia, chiness date, longan aril etc...) and pungent food(chinese green onion, fress ginger, pipers fructns etc...), doing physical training, not being ill in bed at a long time, and preventing descent of blood pressure coming from sudden change of posture are needed. Additionally, the usage of diuretic, abirritant, and depressor needs to be extra cautious.

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위암 수술 후 조기회복을 위한 임상진료 지침서의 활용이 가능한가? (Is a Fast-track Critical Pathway Possible in Gastric Cancer Surgery?)

  • 이정민;허훈;김성근;송교영;진형민;김욱;박조현;박승만;임근우;전해명
    • Journal of Gastric Cancer
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    • 제9권1호
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    • pp.18-25
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    • 2009
  • 목적: 위암 수술 후 회복을 위한 입원기간은 지금까지 대개 1주일 이상이었다. 이러한 회복기간을 요구하는 가장 큰 이유는 수술 후 3~4일간의 금식기간의 필요성과 합병증 발생 여부에 대한 관찰 때문이다. 본 연구진은 이번 연구를 통하여 수술 후 환자를 빠른 시일 내에 일상으로 복귀시키기 위한 임상진료 지침서를 만들고 이를 환자들에게 적용하여, 그 유용성과 안정성을 평가 하고자 하였다. 대상 및 방법: 2007년 10월부터 2008년 6월까지 성모병원에서 연속적으로 수술을 받은 103명의 환자를 수술 후 조기회복을 위한 임상진료 지침서의 적용대상으로 하였다. 임상진료 지침서에는 수술 전 최소한의 시술, 수술 후 적절한 통증관리 및 수액공급, 수술 후 조기 보행과 조기경구영양공급 등을 포함하고 있다. 진료지침 제외 기준을 수술 전, 수술 중 그리고 수술 후에 따라 마련하였다. 결과: 103명의 환자들 중 모두 19명의 환자가 각각 수술 전 5명, 수술 중 7명 그리고 수술 직후 7명의 제외 기준에 따라 제외되었다. 제외되지 않은 84명(81.6%)에 대하여 진료지침 시행 초기엔 수술 8일 후 퇴원을 계획하였으며, 최근엔 6일 후 퇴원을 계획하고 있다. 이들 중 22명(26.2%)의 환자에서 수술 후 합병증이 발생하였으며, 위장관 관련 합병증은 6명, 감염 관련 합병증은 8명에서 발생하였다. 환자들의 임상적, 수술적 특징에 따라서 합병증 발생률의 차이를 나타내지 않았다. 결론: 위암 수술 후 조기회복을 위한 임상진료 지침서는 제외 기준을 적용 후 대상 환자를 선정하고 활용한 결과, 환자들에게 유용하고 안전하게 사용되었다.

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위암 환자에서 위 절제술 후 결장 간치술 (Colon Interposition as a Gastric Substitute after Performing Gastrectomy in Patients with Gastric Cancer)

  • 이준현;허훈;전해명;김욱
    • Journal of Gastric Cancer
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    • 제8권4호
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    • pp.217-224
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    • 2008
  • 목적: 위암으로 위 절제 후 저장능 감소와 흡수장애 등의 단점을 보완하기 위해 소장 또는 결장을 이용한 간치술이 시행되고 있지만 술기상의 복잡성 등의 이유로 빈도가 높지 않다. 이에 저자들은 위 절제 후 결장 간치술의 경험을 분석하여 결과를 평가하고자 한다. 대상 및 방법: 2001년 3월부터 1년간 시행된 결장 간치술 30예를 대상으로 임상병리학적 특징, 수술 결과, 위 배출시간 및 몸무게 변화 등을 후향적으로 분석하였다. 결과: 상행결장이 25예, 횡행결장이 5예 간치되었고, 평균 수술 시간은 373분(204~600), 출혈양은 486 ml (200~1,000)였다. 평균 암종의 크기는 4.5 cm (1~10.5), 절제된 림프절수는 31개(17~48), 근위부 절제연은 3.8 cm (0.5~8), 재원기간은 18.2일(10~40)이었다. 수술 후 9예(30%)에서 합병증이 발생되었고, 췌장 농양으로 인한 패혈증으로 1명(3.3%)이 사망하였다. 추적 기간 중 문제가 된 자각 증상은 음식 저류로 인한 소화불량으로, 위 내시경 검사상 음식저류로 검사에 지장이 있었던 환자는 15명(50%)이었다. 체중 감소율은 전 절제, 근위부 절제, 원위부 절제로 나누었을 때 수술 후 6개월에 16.3%, 14.0%, 8.8%였으나 점자 회복되어 5년째에는 8.1%, 7.5%, 5.6%였다. 결론: 비록 대상수가 적지만 결장 간치술은 문합부가 많아 수술시간이 길고 복잡한 술식으로 30%의 이환율을 보였으며, 수술 후 음식저류가 흔하였고 환자들의 체중 회복도 만족스럽지 못하였다. 따라서 결장 간치술은 위암 환자에게 위 절제 후 적용될 수 있는 재건 술식인지는 좀 더 많은 연구가 필요할 것 같다.

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수족한(手足汗)의 원인(原因)과 치료법(治療法)에 대한 동(東).서의학적(西醫學的) 고찰(考察) (A Comparative Study of the Oriental and the Occidental Medical Literature on the Etiologies & Treatments for Palmoplantar Hyperhidrosis)

  • 고영철;신조영
    • 대한한방내과학회지
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    • 제18권2호
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    • pp.268-295
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    • 1997
  • Sweating is natural phenomenon necessary for the regulation of an individual's body-temperature. The secretion of sweat is mediated by a portion of our vegetative nervous system(the sympathetic nervous system). In some people, this system is working at a very high activity level, far higher than needed to keep a constant temperature. This condition is referred to as hyperhidrosis. Especially excessive sweating of the hands and the feet is palmoplantar hyperhidrosis or volar hyperhidrosis. This is by far the most distressing condition. It was founded that the first important cause of this was emotional factor. The hands are much more exposed in social and prefessional activities than any other part of our body. Many individuals with palmoplantar hyperhidrosis are limited in their choice of proffession, because unable to manipulate materials sensitive to humidity or reluctant to shake hands; some patients arrive to the point to avoid social contact. The occidental medical treatments for palmoplantar hyperhidrosis include application of topical agents(chemical antiperspirants such as aluminum chloride), iontophoresis(treatment with electrical current), or surgery(thoracic sympathectomy). It was reported that the most effective treatment was thoracic sympathectomy. So this study was started to find the easy and effective oriental medical treatments against the occidental medical treatments through the oriental medical literature. The occidental medical idea for palmoplantar hyperhidrosis is only limited in neurologic system, so surgery is the best treatment. But the oriental medical idea for palmoplantar hyperhidrosis is much wider, so the oriental medical causes and treatments for this are able to be veriety. And the oriental medical teatment is freely in treating the patients of palmoplantar hyperhidrosis, because entire idea including pulse, facial color, mental condition, constitution and other symptom exists in the oriental medicine. The results of a bibliographic study of causes and treatments for palmoplantar are as follows; 1. The main causes of pa1moplantar hyperhidrosis are heat in the stomach, damp-heat in the spleen and the stomach, insufficiency of the spleen-qi and the stomach-qi, deficiency of the spleen-yin and the stomach-yin, and the others are the stomach-cold syndrome, stasis of blood and dyspepsia in the stomach, disorder of the liver-qi, deficiency of the heart-yin and the kidney-yin, deficiency of the heart-yang and the kidney-yang, stagnated heat in the liver and the spleen, the lung channel-heat etc. 2. The main methods of medical treatments for palmoplantar hyperhidrosis are clearing out the stomach-heat, eliminating dampness and heat in the spleen and the stomach, invigorating the spleen-qi and the stomach-qi, reinforcing the spleen-yin and the stomach-yin, warming the stomach, relaxing the liver and alleviating of mental depression and tonifying the heart and the kidney etc. 3. The main prescriptions of palmoplantar hyperhidrosis are Taesihotang, Palmultang-kakam, Samyeongbaechusan, Chongbisan, Sasammaekmundongtang, the others are Leejungtang, Hwangkikonjungtang, Seungkitang, Boyumtang, Baekhotang, Chongsimyonjayum, Moyrosan, etc. 4. Local medicine for external use are liquid after boiling alum in water for about 1 or 2 hours, liquid after boiling alum and pueraria root in water and liquid after boiling stragalus root, pueraria root, ledebouriella root and schizonepeta in water, etc. 5. The methods of acupuncture therapy include invigorating Bokyru, Yumkuk and purgating Hapkouk, or invigorating Bokyru, Kihae and purgating Hapkouk, or steadying Hapkouk, Nokung.

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여드름의 동(東)·서의학적(西醫學的) 문헌(文獻) 고찰(考察) (A Literature Study about Comparison of Eastern-Western Medicine on the Acne)

  • 주현아;배현진;황충연
    • 한방안이비인후피부과학회지
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    • 제25권2호
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    • pp.1-19
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    • 2012
  • Objective : The purpose of this study is to investigate about comparison of Eastern-Western medicine on the acne. Methods : We searched Eastern and Western medicine books for acne. We analyzed these books and examined category, definition, etiology, classification, internal and external methods of treatment of acne. Results : The results were as follows. 1. In Eastern medicine, Acne belongs to the category of the Bunja(粉刺), Jwachang(痤瘡), Pyepungbunja(肺風粉刺). In Western medicine, the other name of Acne is acne vulgaris. 2. In Eastern medicine, the definition of Acne includes manual extraction of comedones and skin appearance. In Western medicine, Acne is a common skin disease during adolescence and a chronic inflammatory disease of pilosebaceous unit of self localization. It is characterized by noninflammatory, open or closed comedones and by inflammatory papules, pustules, and nodules and it affects the areas of skin with the densest population of sebaceous follicles, these areas include the face, neck, back, and the upper part of the chest. 3. In Eastern medicine, the cause and mechanism of Acne arose from the state of internal dampness-heat and spleen-stomach internal qi deficiency due to dietary irregularities and then invaded external pathogen such as wind-dampness-heat-cold-fire in lung meridian lead to qi and blood heat depression stagnation. So it appears in skin. In Western medicine, the etiology and pathogenesis of Acne is clearly not identified, but there are most significant pathogenic factors of blood heat depression stagnation. So it appears in skin. In Western medicine, the etiology and pathogenesis of Acne is clearly not identified, but there are most significant pathogenic factors of Acne; Androgen-stimulated production of sebum, hyperkeratinization and obstruction of sebaceous follicles, proliferation of Propionibacterium acnes and inflammation, abnormaility of skin barrier function, genetic aspects, environmental factors etc. 4. In Eastern medicine, differentiation of syndromes classifies clinical aspects, and cause and mechanism of disease; the former is papular, pustular, cystic, nodular, atrophic, comprehensive type; the latter is lung blood heat, intestine-stomach dampness-heat, phlegm-stasis depression, thoroughfare-conception disharmony, heat toxin type. In Western medicine, it divides into an etiology and invasion period, and clinical aspects; Acne neonatorum, Acne infantum, Acne in puberty and adulthood, Acne venenata; Acne vulgaris, Acne conglobata, Acne fulminans, Acne keloidalis. 5. In Eastern medicine, Internal methods of treatment of Acne are divided into five treatments; general treatments, the treatments of single-medicine and experiential description, the treatments depending on the cause and mechanism of disease, and clinical differentiation of syndromes, dietary treatments. In Western medicine, it is a basic principles that regulation on production of sebum, correction on hyperkeratinization of sebaceous follicles, decrease of Propionibacterium acnes colony and control of inflammation reaction. Internal methods of treatment of Acne are antibiotics, retinoids, hormone preparations etc. 6. In Eastern medicine, external methods of treatment of Acne are wet compress method, paste preparation method, powder preparation method, pill preparation method, acupuncture and moxibustion therapy, ear acupuncture therapy, prevention and notice, and so on. In Western medicine, external method of treatments of Acne are divided into topical therapy and other surgical therapies. Topical therapy is used such as antibiotics, sebum regulators, topical vitamin A medicines etc and other surgical therapies are used such as surgical treatments, intralesional injection of corticosteroids, skin dermabrasion, phototherapy, photodynamic therapy, and so on. Conclusions : Until now, there is no perfect, effective single treatment. We think that Eastern medicine approach and treatment can be helpful to overcome the limitations of acne cure.

복강경 보조 유문부보존 위절제술의 초기 경험: 복강경 보조 원위부 위절제술 후 Billroth-I 재건술과의 비교 (The Early Experience with a Laparoscopy-assisted Pylorus-preserving Gastrectomy: A Comparison with a Laparoscopy-assisted Distal Gastrectomy with Billroth-I Reconstruction)

  • 박종익;진성호;방호윤;채기봉;백남선;문난모;이종인
    • Journal of Gastric Cancer
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    • 제8권1호
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    • pp.20-26
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    • 2008
  • 목적: 유문부보존 위절제술(pylorus-preserving gastrectomy, PPG)은 유문륜을 보존하여 잔위의 배출기능을 보존하고 담즙 역류를 방지할 수 있는 기능 보존 수술법으로 조기위암 치료에 적용되고 있다. 저자들은 복강경 보조 유문부보존 위절제술(laparoscopy-assisted pylorus-preserving gastrectomy, LAPPG)의 초기 경험을 LADG 후 Billroth-I 재건술과 비교 분석하였다. 대상 및 방법: 2006년 11월부터 2007년 9월까지 원자력병원 외과에서 복강경 보조 위절제술을 시행 받은 39명의 조기위암 환자 중 LAPPG (n=9)와 LADG 후 Billroth-I 재건술(n=18)을 시행 받은 27명의 환자를 대상으로 하였고, 양 군간의 임상병리학적 변수를 비교하였다. 저자들은 LAPPG 시행 중 유문하동맥, 우위동맥, 미주신경 간지, 유문지 및 복강지를 보존하였으며, 림프절 절제술은 우위동맥 림프절(No. 5)을 제외한 D1+$\beta$술식을 시행하였고, 유문륜 상방 $3{\sim}4\;cm$에서 원위부 위절제를 시행하였다. 결과: LAPPG을 시행 받은 환자 9명의 평균 연령은 $59.9{\pm}9.4$세였으며 남녀 성비는 1.3 : 1.0 (남자 5명, 여자 4명)이었고, LADG 후 Billroth-I 재건술을 시행 받은 환자 18명의 평균 연령은 $64.1{\pm}10.0$세였으며 남녀 성비는 2.6 : 1.0 (남자 13명, 여자 5명)이었다. LAPPG 군과 LADG 후 Biliroth-I 재건술을 시행받은 군에서 절제된 림프절의 개수는 각각 $28.3{\pm}11.9$$28.1{\pm}8.9$개, 수술 시간은 각각 $269.0{\pm}34.4$분, $236.3{\pm}39.6$분, 술 중 출혈량은 각각 $191.1{\pm}85.7\;ml$, $218.3{\pm}156.6\;ml$, 술 후 첫 가스 배출은 각각 $3.6{\pm}0.9$일, $3.5{\pm}0.8$일에 있었고 술 후 첫 유동식은 각각 $5.1{\pm}0.9$일, $5.1{\pm}1.7$일에 섭취하였고 술 후 재원 기간은 각각 $10.1{\pm}4.0$일, $9.2{\pm}3.0$일로 모두 통계학적으로 유의한 차이가 없었다(P>0.05). 술 후 합병증은 LAPPG 군에서 위저류증 1예와 창상 장액종 1예가 발생하였고, LADG 후 Biliroth-I 재건술을 시행 받은 군에서는 좌외측간엽경색 1예가 발생하였다. 결론: 조기위암의 치료에 있어서 LAPPG는 기능 보존 수술 법으로 적용 가능하며, 적절한 적응증을 사용하면 임상종양학적 측면에서도 LADG 후 Billroth-I 재건술과 동등한 결과를 보일 것으로 기대된다.

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溫病學에서의 眼耳鼻咽喉科 疾患에 대한 文獻考察;臨證指南醫案을 중심으로 (A Literature Study of Ophthalmotolaryngologic Diseases from the Viewpoint of Onbyeong; On the Basis of Imjeungjinamuian)

  • 조재훈;채병윤;김윤범
    • 한방안이비인후피부과학회지
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    • 제15권1호
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    • pp.198-218
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    • 2002
  • On the basis of Imjeungjinamuian(臨證指南醫案), authors investigated the pathogenesis and treatment of ophthalmotolaryngobgic diseases from the viewpoint of Onbyeong(溫病). 1. The symptoms and diseases investigated according to department were as follows;. 1) Ophthalmology : blepharitis, blepharedema, lacrimal hypersecretion, hyperemia, ophthalmalgla, photopsia, visual disturbance, mydriasis 2) Otology : full-feeling, otorrhea, otalgla, mastoiditis, tinnitus, hearing disturbance, vertigo 3) Rhinology : rhinorrhea, nasal obstruction, sinusitis, epistaxis 4) Laryngology : sore throat, hoarseness 5) The Others : headache, cough, asthma 2. The pathogenesis and treatment of ophthalmotolaryngologic diseases were as follows. 1) When the pathogenesis of hyperemia, otorrhea, otalgia, mastoiditis, hearing disturhance. epistaxis, sore throat, headache and cough are wind-stagnanc(風鬱), wind-warm(風溫), wind-fire(風火), wind-dryness(風燥), dryness-heat(燥熱), the treatment of pungent-cool-evaporating(辛凉解表) with Dajosan(茶調散), Mori Folium(桑葉), Lonicerae Flos(金銀花), Forsythiae Fructus(連翹), Viticis Fructus(蔓荊子), Prunellae Spica(夏枯草), Arctii Fructus(牛蒡子), etc can be applied. 2) When the pathogenesis of hoarseness, cough and asthma are cold(寒), cold with endogenous heat(寒包熱, 外冷內熱), water retention(水邪), fluid retention(伏飮), impairment of YangKi by overexertion(勞傷陽氣), the treatment of pungent-warm-evaporating(辛溫解表) with Mahaenggamseoktang(麻杏甘石湯), Socheongryongtang(小靑龍湯), Jeongryeokdaejosapyetang(정력대조사폐탕), Gyejitang(桂枝湯), Armeniacae Amarum Semen(杏仁), etc can be applied. 3) When the pathogenesis of photopsia, otorrhea, otalgia, rhinorrhea, sinusitis, epistaxis, sore throat, hoarseness, headache and cough are stagnancy-induced heat(鬱熱), wind-dryness(風燥), wind-heat(風熱), summer heat(暑熱), summer wind(暑風), insidious summer heat(伏暑), autumn heat(秋暑), autumn wind(秋風), autumn dryness(秋燥), dryness-heat(燥熱), heat in Ki system(氣分熱), insidious warm(溫伏), brain discharge by fire in Ki system(氣火 腦熱), heat in stomach(胃熱), endogenous fire by deficiency of Yin(陰虛內火), deficiency of Yin in stomach(胃陰虛), the treatment of Ki-cooling(淸氣) with Bangpungtongseongsan(防風通聖散), Ikweonsan(益元散), Gyejibaekhotang(桂枝白虎湯), Geumgwemaekmundongtang(금궤맥문동탕), Gyeongokgo(瓊玉膏), Sojae Semen Praeparatum(두시), Scutellariae Radix(黃芩), Phyllostachys Folium(竹葉), Adenophorae Radix(沙參), Mori Cortex(桑白皮), Fritillariae Cirrhosae Bulbus(貝母), etc can be applied. 4) When the pathogenesis of blepharitis, hyperemia, ophthalmalgia, full-feeling, otorrhea, otalgia, tinnitus, hearing disturbance, sinusitis, hoarseness, headache and cough are fire in liver(肝火), fire in gallbladder(膽火), ministerial fire in Soyang system(少陽相火), wind-stagnancy(風鬱), stagnancy-induced fire(鬱火), brain discharge by phlegm-fire(痰火 腦熱), the treatment of mediation(和解) with Gardeniae Fructus(梔子), Moutan Cortex(牧丹皮), Saigae Tataricae Cornu(羚羊角), Artemisiae Annuae Herba(靑蒿), Cyperi Rhizoma(香附子), Poria(적복령), etc can be applied. 5) When the pathogenesis of blepharedema and cough are dampness in both spleen and lung(脾肺濕) damp-heat(濕熱), damp-phlegm(濕痰), the treatment of dampness-resolving(化濕) with Poria(백복령), Coicis Semen(薏苡仁), Tetrapanacis Medulla(通草), Armeniacae Amarum Semen(杏仁), Talcum(滑石), etc can be applied. 6) When the pathogenesis of vertigo and cough are deficiency of Yong(營虛), heat in Yong, system(營熱), the treatment of Yong-cooling(淸營) with Rehmanniae Radix(生地黃), Liriopis Tuber(麥門冬), Biotae Semen(柏子仁), Lilii Bulbus(百合), Phyllostachys Folium(竹葉), etc can be applied. 7) When the pathogenesis of epistaxis are heat in blood system of heart(心血熱), reversed flow of fire(火上逆), overexertion(努力), the treatment of blood-cooling(凉血) with Rhinoceri Cornu(犀角), Rehmanniae Radix(生地黃), Moutan Cortex(牧丹皮), Salviae Miltiorrhizae Radix(丹參), Scrophulariae Radix(玄蔘), etc can be applied. 8) When the pathogenesis of nasal obstruction is pathogen-stagnancy(邪鬱), the treatment of resuscitation(開竅) with Sosang(少商, LU11) acupuncture can be applied. When the pathogenesis of hoarseness is evil Ki(穢濁), the treatment of resuscitation(開竅) with Arctii Fructus(牛蒡子), Lasiosphaera Seu Calvatia(馬勃), Curcumae Radix(鬱金), etc can be applied. When the pathogenesis of headache is stasis of both Ki and blood(氣血瘀痺), the treatment of resuscitation(開竅) with Cnidii Rhizoma(川芎), Asari Herba Cum Radice(細辛), Scorpio(全蝎), moxibustion(灸), etc can be applied. 9) When the pathogenesis of lacrimal hypersecretion, visual disturbance, mydriasis, tinnitus, hearing disturbance, sinusitis, epistaxis, hoarseness and cough are deficiency of Yin(陰虛), deficiency of kidney(腎虛), deficiency of both liver and kidney(肝腎虛), deficiency of both heart and kidney(心腎虛), brain discharge by deficiency of Yin(陰虛 腦熱), exuberance of Yang in liver(肝陽上亢), overexertion(勞損), the treatment of Yin-replenishing(滋陰) with Yukmijihwanghwan(六味地黃丸), Hojamhwan(虎潛丸), Jeobutang(猪膚湯), Lycii Fructus(枸杞子), Polygoni Multiflori Radix(何首烏), Rehmanniae Radix(生地黃), Schizandrae Fructus(五味子), Liriopis Tuber(麥門冬), Asini Gelatinum(阿膠), etc can be applied. 10) When the pathogenesis of ophthalmalgia, mydriasis, vertigo and headache are deficiency of Yin in liver(肝陰虛), exuberance of Yang in liver(肝陽上亢), endogenous wind(內風), excess in upper and deficiency in lower part(上實下虛), the treatment of Yin-replenishing(滋陰) and endogenous wind-calming(熄風) with Rehmanniae Radix Preparat(熟地黃), Lycii Fructus(枸杞子), Polygoni Multiflori Radix(何首烏), Paeoniae Radix Alba(白芍藥), Ostreae Concha(牡蠣), Saigae Tataricae Cornu(羚羊角), Chrysanthemi Flos(菊花), etc be applied. 11) When the pathogenesis of mydriasis, sinusitis, hoarseness, headache, cough and asthma are exhaustion of vital essence(精氣無收藏), brain discharge(腦髓不固), floating Yang(陽虛浮), exsanguination(失血), deficiency of both Yin and Yang(陰陽不足), overexertion(勞損), deficiency of Yang in kidney(腎陽虛), the treatment of Yang-restoring and exhaustion-arresting(回陽固脫) with Yangyeongtang(養營湯), Cheonjinhwan(天眞丸), Bokmaektang(복맥탕), Geonjungtang(建中湯), Dogihwan(都氣丸), Singihwan(腎氣丸), Jinmutang(眞武湯), Ostreae Concha(牡蠣), Nelumbinis Semen(蓮子肉), etc can be applied. 12) When the pathogenesis of lacrimal hypersecretion, vertigo and headache are deficiency of stomach and endogenous wind(胃虛內風), endogenous wind with phlegm(內風挾痰), liver check of stomach(肝木橫擾), the treatment of concomitant-treating of both liver and stomach(肝胃同治) with Paeoniae Radix Alba(白芍藥), Uncariae Ramulus Et Uncus(釣鉤藤), Gastrodiae Rhizoma(天麻), Astragali Radix(황기), Pinelliae Rhizoma(半夏), etc can be applied. When the pathogenesis of asthma is failure of kidney to promote inspiration(腎不納氣), the treatment of kidney-tonifing and inspiration-promoting(補腎納氣) with Singihwan(腎氣丸), Psoraleae Fructus(補骨脂), Juglandis Semen(胡桃), Aquilariae Resinatum Lignum(沈香), etc can be applied. When the pathogenesis of asthma is deficiency of Ki(氣虛), the treatment of Ki-reinforcing(補氣) with Sagunjatang(四君子湯), Insamgeonjungtang(人參建中湯), etc can be applied.

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