중풍휴유증으로 인한 편마비환자 견관절아탈구의 방사선학적 임상고찰

신병철 ( Shin Byung-Cheul ),권영달 ( Kwon Young-Dal ),송용선 대한한의학회 한방재활의학과학회 1998 한방재활의학과학회지 Vol.8 No.2

편마비 환자에서 견관절 아탈구에 대한 임상적 접근을 목적으로 편마비 환자 21을 대상으로 사진과 측정지수를 도입한 방사선학적 검사 및 수지 폭, 견관절 가동역, 통증의 정도, 근력평가 등의 이학적 검사를 시행하 고 그 결과들을 분석한 후 다음과 같은 결론을 얻었다. 1.총 21명의 환자중 남자가 10명, 여자가 11명이었으며, 연령별로는 50 대와 60대가 76.2%를 차지하였으며, 편마비 부위로는 좌측편마비가 13명 우측편마비가 8명이었다. 2. 발병원인으로는 Cerebral Infarction이 14명, Cerebral Hemorrhage 가 5명, SAH가 2명이었으며, 발병부위로는 B.G가 7명, MCA White matter 가 7명, Thalamus가 2명, Internal Capsule이 2명으로 주로 중대뇌동맥 의 침범이 가장 흔하였다. 3. 중풍발병후 입원까지의 기간은 1-10일이 9명으로 가장 많았고, 평균 입원 기간은 6-10주 사이가 9명으로 42.9%를 차지하였는데, 전 기간에 걸쳐 비교적 고른 분포를 나타냈다. 선행질환은 고혈압이 13명, 심장질 환이 7명, 당뇨병이 6명의 순이었으며, 평균 재활 치료시작시기는 5-25 일 사이에 61.9%의 환자가 재활치료를 시작하게 되었다. 4. 견관절 동통이 발생하는 국어통증정도 5이상이 된 시기는 주로 15-6 0일 사이가 76.2%로 나타나 대다수 환자가 주로 이 기간 사이에 견관절 동통이 발병함을 알 수 있었으며, Pain Scale은 국어통증정도 5-6이 12 명으로 57.2%를 나타내어 가장 많았다. 5. Painful shoulder의 원인으로는 강직성이 14명으로 66.7%, 견관절의 아탈구가 14명의 환자에서 66.7%, 어깨- 손 증후군은 7명에서 33.3%를 보였고, 어깨-손 증후군에 아탈구가 같이 있는 경우는 4명으로 19%를 나 타내었으며, 손의 Edema는 17명의 환자인 85.7%에 있었으며, 상완골두에 서 견봉까지의 수지폭 평균은 ½수지폭이 8명, ½ - 1 수지폭이 9명, 1 - 1½수지폭이 3명, 1½ - 2수지폭이 1명으로 나타났다. 6. Shoulde AP&Lat의 방사선학 소견에서 아탈구 판정은 11명, 퇴행성 변화는 2명, 골다공적 변화는 6명, 상완신경총 손상의 판정이 2명 있었 다. 7. 양측 견부의 방사선학적 측정지수를 고찰해 보면 편마비측이 정상측 보다 VD가 5.94±3.95㎜증가,HD가 3.21±4.00㎜증가, JD가 4.87±4.57㎜ 증가하여, 아탈구의 방사선학적 검사에서 JD와 VD, HD등의 측정이 임상 적 진단 및 치료효과를 판정하기 위한 객관적 지표로써 유용할 것으로 사료된다. 8. 능동적 견관절 움동범위의 변화에서 Fexion은 25.57±32.73。, Exte ntion은 13.81±9.99。, Internal Rotation은 34.29±35.72。, External Rotation은 7.90±15.38。, Abduction은 11.67±16.82。, Adduction은 2 9.33±29.42。의 향상을 보였으며, 주로 큰 폭의 향상을 보인 능동적 운 동은 Extention, External Rotation, Abduction의 신근운동이었으며, HD 값은 내전 기능의 회복과 유의한 상관관계(P〈0.05)를 나타내어 견관절 내전 기능의 회복에 측방 아탈구 거리가 중요한 요인임을 알 수 있었다. 9. 편마비 상지의 근력을 보면 발병 다시의 근력이 G0가 23.8%, G1이 5 2.8%로 나타나 G1이하의 근력을 가진 환자강 16명으로 76.2%이었는데, 퇴원시의 근력은 G4가 38.1%, G2가 28.6%, G3가 19.0%를 보여 85.7%에서 poor(G2)이상의 근력 회복을 보여주었으나 3명의 환자는 퇴원시까지 G1 의 근력으로 남아 있었다.

독활기생탕가미방(獨活寄生湯加味方)이 손상(損傷)된 배양척수감각신경세포(培養脊髓感覺神經細胞)에 미치는 영향(影響)

신병철 ( Byung Cheul Shin ),송용선 ( Yung Sun Song ),권영달 ( Young Dal Kwon ) 대한한의학회 한방재활의학과학회 2000 한방재활의학과학회지 Vol.10 No.2

중풍후유증으로 인한 편마비환자 견관절아탈구의 방사선학적 임상고찰

신병철 ( Shin Byung-Cheul ),권영달 ( Kwon Young-Dal ),송용선 ( Song Yung-Sun ) 대한한의학회 한방재활의학과학회 1998 한방재활의학과학회지 Vol.8 No.1

방풍통성산이 백서의 비만증 및 비만세포에 미치는 영향

신병철 ( Shin Byung-Cheul ),송용선 ( Song Yung-Sun ) 한방재활의학과학회 1997 한방재활의학과학회지 Vol.7 No.1

방풍통성산이 gold thioglucose와 고지방 식이로 유발한 비만 마우스에 미치는 효과와 전지방세포의 증식과 분화에 미치는 영향을 관찰한 결과 다음과 같은 결과를 보였다.1. 방풍통성산 추출액은 비만백서의 체중증가를 억제하는 효과를 나타냈다.2. 방풍통성산 추출액은 혈청 transaminase의 개선을 확인할 수 있었다.3. 방풍통성산 추출액은 간의 지질 및 간세포의 증가를 억제하는 효과를 나타냈다.4. 방풍통성산 추출물은 자궁주위 지방조직 및 간의 중량에서도 유의성있는 감소효과를 나타냈 다.5. 방풍통성산 추출액이 전지방세포인 미분화상태의 3T3-L1세포의 증식을 억제하는 효과를 나타냈다.6. 방풍통성산 추출물은 자연분화시 3T3-L1세포의 분화능에 유의성있는 영향을 미치지 못하였다.7. 방풍통성산 추출액은 유발분화시에는 3T3-L1세포의 지방세포분화를 억제하는 효과를 나타냈 다.이상의 효과로 미루어 보아 방풍통성산은 지방세포의 과다한 분화와 증식, 축적에 따른 비만증과 지방간 및 대사질환의 임상치료에 응용될 수 있을 것으로 사료된다.

중화중의약학회 정척분회 학술동향과『척추 상견병의 중의 정척 진료 가이드(中醫整脊科常見病診療指南), 2011』소개

신병철(Byung-Cheul Shin),황의형(Eui-Hyoung Hwang),조현우(Hyun-Woo Cho),양회천(Hui-Chun Yang),전종렬(Jong-Yul Chun),설재욱(Jae-Uk Sul),허광호(Kwang-Ho Hoe) 척추신경추나의학회 2012 척추신경추나의학회지 Vol.7 No.1

Objectives : The aims of this study were to introduce the theory of traditional Chinese orthopedic theory(整脊굊걩) and to analyze the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique(常見病中醫整脊指南). Methods : We have searched the web sites of traditional Chinese orthopedics association (整脊學會), a branch of the China academy of traditional Chinese medicine (TCM), and related articles. Additionally, we analyzed the guideline of diagnosis and treatment of common spinal disorders by treating Chinese spinal manipulation technique which was introduced by that association at 7th academic conference in China in 2011. Results : The guideline was prepared by 2 year project leaded by professor Yi-zhong Wei who was a person in charge of the spinal manipulation guideline of national standardization committee of TCM in China. It was a summary of the whole theory of China spinal manipulation therapy in TCM and contained 22 common spinal disorders by the treatment of traditional Chinese Tuina methods. Spinal manipulation theory was summarized by one doctrine, two theories, and two important view points. The treatment method was abstracted as 8 major Tuina techniques. Conclusions : The guideline will be a way of advance of Chinese spinal manipulation technique. This will be a good reference to Korea Chuna manipulation for improving their techniques.

경추 추나요법이 추골동맥과 기저동맥 혈류에 미치는 영향

신병철,김도환,김상돈,송용선,Shin, Byung-Cheul,Kim, Do-Hwan,Kim, Sang-Don,Song, Yung-Sun 척추신경추나의학회 2000 대한추나의학회지 Vol.1 No.1

Objectives : CHUNA therapy that removes compression of dislocated vertebral bones has positive effect, but sometimes improper CHUNA manual therapy may give rise to negative effect. The aim of this study is to make sure that cervical CHUNA manual therapy give positive effect or negative effect to the blood flow velocity of vertebral artery(VA) and basilar artery(BA) by Trancranial Doppler sonography(TCD). Methods : We performed TCD study on 20patients(male 5, female 15, mean ages 38.5 years) with diagnosis like cervical movement related disorder, headache or dizziness. After we measured mean blood flow velocity(Vm) of VA and BA before cervical CHUNA therapy(Pre-CCT) and after cervical CHUNA therapy(Post-CCT), statistically evaluated the results. Results: The patients received cervical CHUNA therapy for TA sequel, HIVD of cervical spine, headache, dizziness, neck stiffness etc. VA Vm was $31.9{\pm}8.0cm/sec$ before CHUNA therapy, but significantly increased $35.0{\pm}8.7cm/sec$ after CHUNA therapy (p < 0.05). But, there was no significant variation of BA Vm between $41.8{\pm}7.5cm/sec$ Pre-CCT and $41.2{\pm}8.5cm/sec$ Post-CCT(p>0.05). Though VA Vm slightly increased after CHUNA therapy in normal range group, there was no significant variation between VA Vm Pre-CCT and VA Vm Post~CCT. In VA Vm decrease group, VA Vm significantly increased after CHUNA therapy(p<0.05). But, there was no significant variation of BA Vm between Pre-CCT and Post-CCT in BA Vm normal range group and BA Vm decrease group(p>0.05). Conclusions: These findings suggest that cervical CHUNA manual therapy have positive effect on blood flow velocity of VA and BA.

백굴채(白屈菜)가 손상된 배양척수감각신경세포에 미치는 영향

신병철,송용선,Shin, Byung-Cheul,Song, Yung-Sun 척추신경추나의학회 2001 대한추나의학회지 Vol.2 No.1

Objectives and Methods : To evaluate the mechanism of oxidative damage by xanthine oxydase(XO) and hypoxanthine(HX)-induced oxygen radicals, MTT assay and NR assay were carried out after the cultured mouse spinal sensory neurons were preincubated for 4 hours with various concentrations of XO/HX. And the amount of total protein. neurofilament EIA. lipid peroxidation and LDH activity were measured, to evaluate the protective effect of Herbar Chelidonii(HC) water extract on cultured spinal sensory neurons damaged by XO/HX. after the cultured mouse spinal sensory neurons were preincubated with various concentrations of HC water extract for 3 hours prior to exposure of XO/HX. Results : XO/HX decreased significantly the survival rate of the cultured mouse sensory neurons by NR assay and MTT assay In proportion to concentration and exposed time. In proportion to concentration and exposed time on cultured spinal sensory neurons, XO/HX showed the quantitative decrease of neurofilament by EIA. the decrease of total protein amount by SRB assay and the Increase of lipid peroxidation as well as LDH. HC showed the quantitative increase of neurofilament and total protein, but showed the decrease of lipid peroxidation and LDH activity against the neurotoxicity of XO/HX. Conclusions : From the above results, it is concluded that XO/HX have a neurotoxic effect on cultured spinal sensory neurons and that the herbs extract, such as HC, prevent the toxicity of XO/HX effectively in that they decrease lipid peroxidation and LDH activity.

척추변위 명명체계에 대한 문헌 고찰

신병철,조현우,황의형,설재욱,신미숙,남항우,Shin, Byung-Cheul,Cho, Hyun-Woo,Hwang, Eui-Hyoung,Sul, Jae-Uk,Shin, Mi-Suk,Nam, Hang-Woo 척추신경추나의학회 2011 척추신경추나의학회지 Vol.6 No.1

Objectives : To introduce the medicare listing system for the clinicians that korean society of Chuna manual medicine for spine and nerves applies presently and wants to promote. Methods : Compare and analyse the differences, merits and demerits between Palmer-Gonstead listing system and medicare listing system using the publications and literatures of Chuna manual medicine and chiropractic. Results : It is easy to explain the movements and subluxations of spine when using medicare listing system. Also it has simple terminological system that can be applied when diagnosing the lesion of spinal joints with various palpations, Conclusion : Listing system used by Korean society of Chuna manual medicine for spine and nerves presently has very appropriate forms to indicate the movements and subluxations, However, it needs to spread to clinicians who still are using former listing system by continuous education.

경추추나치료 후 발생한 경막파열 환자 1례 보고

공재철,박태용,고연석,원재균,박단서,신병철,Kong, Jae-Cheol,Park, Tae-Yong,Ko, Youn-Seok,Won, Jae-Kyun,Park, Darn-Seo,Shin, Byung-Cheul 척추신경추나의학회 2006 척추신경추나의학회지 Vol.1 No.1

Objectives : A rare case of dural tear ensuing after a cervical Chuna Manipulation Treatment leading to cerebrospinal fluid (CSF) leakage in the lower cervical and upper thoracic spine was found, so we report it. Methods : A 32-year-old woman presented with back and neck pain in 1 days earlier. The patient undertook a cervical Chuna Manipulation Treatment. After this maneuver, the patient complained of an orthostatic headache with nausea. The patient's headache worsened, and lying down gave the only measure of limited relief. In Brain CT and MRI study, nonspecific finding was detected. In Cistemography study, CSF leakage at lower cervical or upper thoracic area was detected. Results and Conclusions : It is supposed that this patient suffered a dural tear and CSF leakage secondarily due to a cervical Chuna Manipulation Treatment. From this case, we can understand the etiology of dural tear to some extent and consider the complication of Chuna Manipulation Treatment. In the future, more study, research and prospective trial for complications of a cervical Chuna Manipulation Treatment is needed.

Total Body Modification(TBM) 기법에 관한 고찰

신병철,우영민,Shin, Byung-Cheul,Woo, Young-Min 척추신경추나의학회 2006 척추신경추나의학회지 Vol.1 No.1

Objectives : To introduce Total Body Modification(TBM) technique system developed by Dr. Victor Frank DC, DO, ND through combining chiropractic manipulation with osteopathy, acupuncture meridian system, and naturopathy based on his long-time clinical experiences and insights. Methods : After investigating the art, philosophy and science of TBM thechnique, and applying TBM practice under private clinical situation, we compared It with Chuna Korean manual medicine and oriental medicine system. Results : This system deals with correcting human body's functional physiology to potentiate in a favorable manner. TBM uses a neuromuscular reflex test and body access meridian points to tap into the body's biocomputer and read functional programs. Corrections are usually made by means of special respiratory spinal adjustment, cranial, soft tissue, or specific joint manipulation. Conclusions : We found similarities between TBM and Chuna system in the view of Korean Traditional meridian concept. The special combinations and sequences of various alarm points and associated points have clinical effects on the treatment of chronic spinal subluxation pattern. This suggests TBM has significance In the point of the future evolution of Chuna manual medicine in Korea.