두개천골요법과 이압요법이 중년여성의 갱년기 증상 완화에 미치는 영향

다국어 초록 (Multilingual Abstract)

The purpose of this study is to investigate the effects of combining Craniosacral Therapy and Auricular Acupressure on the alleviation of menopausal symptoms, as well as on psychological and physiological aspects in middle-aged women. To design the intervention program, a meta-analysis was conducted on 18 prior studies related to Craniosacral Therapy. Out of 33 initial participants, 4 dropped out due to health reasons, resulting in a final analysis of 29 participants.
The experimental intervention consisted of three groups: Experimental Group 1 received a combination of Craniosacral Therapy (CST) and Auricular Acupressure; Experimental Group 2 received only CST; and Experimental Group 3 received only Auricular Acupressure. The interventions were conducted once a week for a total of 10 weeks.
CST was applied for 50 minutes per session. For Auricular Acupressure, after an auricular massage, 'Shinbanseok' (press pellets) were attached to specific acupoints and maintained for 3 to 4 days.
To verify the efficacy of the interventions, the following variables were measured: menopausal symptoms, depression, sleep quality, psychological and physical stress, autonomic nervous system activity (HRV), salivary pH,
and brain function activity.
Data were analyzed using the SPSS 25.0 program. The reliability of the instruments measuring menopausal symptoms, depression, sleep quality, and stress was assessed using Cronbach’s $\alpha$.
Pre- and post-intervention changes were analyzed using paired t-tests, while changes over time in autonomic nervous system activity and salivary pH were examined using repeated measures ANOVA. Correlations among the major variables were determined using Pearson correlation analysis.
The results of the study are as follows:
First, comparative analysis of the three groups revealed that Experimental Group 1 demonstrated the greatest improvement in menopausal symptoms, depression, sleep quality, and both psychological and physical stress.
Second, regarding autonomic nervous system activity, the stress index and sympathetic nerve activity (LH) increased in all three groups; however, the interaction effect between measurement time and group was not statistically significant. Similarly, while changes were observed in parasympathetic nerve activity (HF) and autonomic balance (LF/HF ratio) across all groups, no significant interaction effects were found.
The increase in SDNN was more pronounced in Experimental Groups 1 and 2. Although salivary pH increased in all three groups, there were no significant differences among the groups.
Third, regarding brain function indices, the Basic Rhythm Quotient (BRQ), Self-Regulation Quotient (SRQ), Attention Quotient (ATQ), Activity Quotient (ACQ), and Anti-Stress Quotient (ASQ) showed pre- to post-intervention increases in all three groups, with the most significant effects observed in Experimental Group 1.
However, no significant changes were found in the Emotional Quotient (EQ), Correlation Quotient (CQ), or Brain Quotient (BQ).
Fourth, the correlation analysis between menopausal symptoms and key variables revealed the following results:
In Experimental Group 1, menopausal symptoms showed a positive correlation with psychological stress, while showing negative correlations with the Self-Regulation Quotient (Attention) and the Activity Quotient (Right).
In Experimental Group 2, positive correlations were observed between menopausal symptoms and depression, psychological and physical stress, and the Activity Quotient (Left).
However, in Experimental Group 3, no significant correlations were found between menopausal symptoms and the major variables.
"Based on the results of this study, it was confirmed that Craniosacral Therapy and Auricular Acupressure exert positive effects on the alleviation of menopausal symptoms in middle-aged women. In particular, the combined application of these therapies led to greater improvements in psychological and physiological indices.
This study is significant as it verified not only the individual effects of each therapy but also the synergistic effects of an integrative approach. Furthermore, by analyzing objective physiological indices-such as autonomic nervous system activity, brain function indices, and salivary pH-in addition to menopausal symptoms, this study provides scientific support for the mechanisms underlying the efficacy of manual therapies.
For future research, long-term follow-up studies and comparative studies involving an untreated control group are recommended.

목차 (Table of Contents)

• 목 차 ⅰ
• 표 목 차 ⅴ
• 그림목차 ⅷ
• Ⅰ. 서 론 1
• 1. 연구의 필요성 1
• 2. 연구 목적 5
• 3. 연구 가설 6
• 4. 용어의 정의 8
• 5. 연구의 제한점 11
• Ⅱ. 이론적 배경 12
• 1. 갱년기 중년여성의 생리적 변화 12
• 1) 갱년기 여성의 특성 12
• 2) 갱년기 여성의 우울 14
• 3) 갱년기 여성의 수면의 질 16
• 4) 갱년기 여성의 스트레스와 생리적 지표 18
• 2. 두개천골요법(Craniosacral Therapy)의 개념과 효과 20
• 1) 두개천골요법의 이론적 정립 20
• 2) 생리학적 기반과 작용기전 21
• 3. 이압요법(Auriculotherapy)의 개념과 효과 25
• 1) 이압요법의 이론적 정립 25
• 2) 생리학적 기반과 작용기전 26
• 4. 뇌파 지표와 정신건강과의 관계 29
• 1) 뇌파 주파수와 정신건강 29
• 2) 뇌기능 지수와 임상적 활용 30
• Ⅲ. 연구 방법 32
• 1. 연구 설계 32
• 2. 프로그램 구성을 위한 선행연구 고찰 33
• 1) 메타분석 33
• (1) 두개천골요법과 관련된 선행 연구 선정 33
• ① 자료의 수집 33
• ② 논문 선정 준거 34
• (2) 논문 선정 및 분석 35
• 2) 효과 크기 산출 38
• (1) 변수의 유목화 38
• (2) 자료처리 및 효과 크기의 해석 38
• 3) 두개천골요법 연구 동질성 검증 및 출판편향 39
• (1) 출판편향 39
• (2) 전체 효과 크기 39
• (3) 이질성 검증 40
• 4) 종속변인의 효과 크기 비교 41
• 5) 적용 횟수의 따른 효과 크기 42
• 6) 적용 시간에 따른 효과 크기 43
• 7) 적용 방법에 따른 효과 크기 44
• 3. 두개천골요법과 이압요법 프로토콜 구성 45
• 1) 두개천골요법 분석 45
• 2) 이압요법의 분석 46
• 3) 프로그램 적용방법 46
• (1) 두개천골요법과 이압요법 병행 적용방법 47
• (2) 두개천골요법 적용방법 47
• (3) 이압요법 적용방법 56
• 4. 연구 대상 61
• 1) 연구 대상자 61
• 2) 연구 대상자 배정 62
• 3) 연구 대상자 선정 기준과 제외 기준 62
• 5. 연구 도구 63
• 1) 심리적 측정 도구 63
• (1) 갱년기 증상척도(Menopause Sympton Index, MENSI) 63
• (2) 우울척도(Beck Depression Inventory, BDI) 63
• (3) 수면의 질(Pittsburgh Sleep Quality Index, PSQI) 63
• (4) 스트레스 척도(Stress Response Inventory, SRI) 64
• 2) 생리적 측정 도구 64
• (1) 뇌기능 분석(Brain Quotient, BQ) 64
• (2) 심박변이도(Heart Rate Variability, HRV) 65
• (3) 타액 pH 측정 67
• 6. 자료 분석 68
• Ⅳ. 연구 결과 69
• 1. 연구 대상자의 일반적 특성 69
• 2. 집단간 사전 동질성 검증 72
• 3. 갱년기 증상에 대한 효과 검증 82
• 4. 우울감에 대한 효과 검증 84
• 5. 수면의 질에 대한 효과 검증 86
• 6. 심리적, 신체적 스트레스에 대한 효과 검증 88
• 7. 자율신경계에 대한 효과 검증 91
• 8. 뇌기능지수에 대한 효과 검증 106
• 9. 갱년기 증상과 주요 변인과의 상관관계 127
• 10. 가설 검정 133
• Ⅴ. 고 찰 136
• Ⅵ. 결론 및 제언 142
• 참 고 문 헌 145
• 영 문 초 록 163
• 부 록 167
• 감 사 의 글 179