한방의료기관에서의 감기 진료에 대한 일반인의 인식 조사

김도형,조민경,홍미나,최준용,Kim, Do-hyung,Cho, Min-kyoung,Hong, Min-na,Choi, Jun-yong 대한한방내과학회 2017 大韓韓方內科學會誌 Vol.38 No.3

Objective: This study investigated the perception, utilization, and satisfaction (in the general population), of the common cold treatment at the Korean Medical Clinic, to provide basic information for the development of Korean medicine clinical practice guidelines for the common cold. Method: A questionnaire was developed that consisted of questions about the general perception, utilization status, degree of satisfaction, willingness to use, and the improvement of the common cold treatment at the Korean Medical Clinic. An online survey was conducted using this questionnaire. Results: Three-hundred subjects responded to the survey. The results of the analysis were as follows. 1. 73.7% of the subjects recognized the common cold treatment at the Korean Medical Clinic. 2. 72% of the subjects had a positive perception of Korean medicine for common cold treatment. The major reason for the positive perception was the expectation about improving immunity and preventing recurrence. 3. Only 20% of the subjects had visited the Korean Medical Clinic for common cold treatment. The expensive cost was the major reason for not visiting the Korean Medical Clinic for common cold treatment. 4. The ratio of subjects who were willing to visit the Korean Medical Clinic for common cold treatment was 70%. 5. The expansion of health insurance coverage (67.7%), the activation of public relations (54.7%), and the development of a new herb medicine preparation that was easy to take (43.3%) were found to be necessary for improving the Korean medical service for common cold treatment. Conclusion: In spite of high recognition and positive perception, actual utilization of common cold treatment at the Korean Medical Clinic was relatively low. Multifaceted efforts are necessary to enhance the competitiveness of Korean medical service for treatment of the common cold.

의료법상 “치과의료”의 범위 : 대법원 2013도7796판결을 중심으로

김영신 한국의료법학회 2018 한국의료법학회지 Vol.26 No.1

이 글은 치과의사가 피부 미용 목적으로 레이저를 사용한 시술을 한 것이 의료법이 규정하는 “치과의료” 즉 치과의사의 면허 범위를 벗어난 것인지에 관한 대법원 판결을 다룬다. 이 판결 이전에 대법원 전원합의체 판결로 치과의사가 피부 미용 목적으로 보톡스를 사용한 시술을 하는 것이 의료법상 허용된다는 취지의 결론이 내려진 바 있다. 대상판결은 나아가 레이저를 이용한 피부 미용 시술의 경우에도 치과의사의 면허 범위에 해당하는 것으로 보고 있다. 대상판결에서는 명확하게 근거를 밝히고 있지 않으나, 이전 대법원 전원합의체 판결에서는 첫째, 의료법상 “의료행위”와 “치과의료”의 구별이 불분명하고 일정한 행위는 중첩적으로 가능하다고 보아야 한다는 점, 둘째, 치과의사의 세부 전공 및 업무영역 가운데 하나인 구강악안면외과에서 안면 전반에 관한 교육이나 진료가 행하여지고 있고, 악안면에 관한 치과의료행위와 의료행위를 구분하기 어렵다는 점, 또한 치과의사의 수련이나 면허취득 과정에서 관련 교육이나 평가가 이루어지고 있다는 점, 셋째, 보톡스를 이용하여 눈가나 미간 등에 주름제거 시술을 하는 것이 비교적 간단하고 위험성이 크지 않다는 점 등을 근거로 보톡스를 이용한 주름제거시술이 치과의사의 면허 범위에 포함된다고 결론 내린 바 있다. 대상판결에서는 나아가 프락셀 레이저를 이용한 피부 미용 시술도 치과의사의 면허 범위에 포함되는 것으로 보고 있다. 이 글은 대상판결의 태도를 다음과 같은 근거로 비판한다. 첫째, 의사와 치과의사의 업무범위가 역사적, 사회적으로 결정된 것이라는 점에는 동의하나, 그렇다고 하여 치과의사가 안면과 관련된 모든 의료행위를 한다고 볼 수는 없다. 둘째, 치과의사의 교육과정이나 구강악안면외과의 연구 및 수련 범위, 치과 진료에 대한 국민건강보험공단 수가 지급 여부가 의료법상 치과의사의 업무 및 면허 범위를 확정하는데 참고가 될 수는 있으나, 이는 의료관행의 문제로 의료법 규정이 우선하여야 한다. 셋째, 의료법에서 치과의료를 일반의사의 의료행위와 별도로 규정하고 있다. “치과” 혹은 “구강”이라는 문언이 명백히 있음에도 불구하고 악안면 전반을 치과의사가 대상으로 하여 진료하는 것을 허용하는 것은 의료법 규정에 반하는 것으로 허용될 수 없다. 넷째, 그러한 점에서 보톡스를 이용하여 치과 진료와 직·간접적으로 관련 있는 악관절 질환치료, 혹은 악관절의 축소 등을 통한 미용 목적 시술 등을 하는 것은 치과의사 진료범위에 포함되나, 구강과 간접적 관련성을 가진다고 하기 어려운 눈가나 미간 등의 보톡스 시술까지 가능한 것으로 보는 것은 무리한 해석이다. 다섯째, 대상판결에서 다루는 피부에 대한 레이저 시술은 치과 진료와 연관성을 가진다고 하기 더욱 어렵다. 결론적으로 대상판결은 의료법상 의사와 치과의사의 업무 범위를 더욱 불분명하게 한 것이고, 이로 인하여 의료인 간의 업무 범위에 관한 분쟁이 더 증가할 것으로 생각된다. On this thesis, a judgment of Korean Supreme Court(an “Object Decision”) is reviewed if dentist’s. From the precedent for this case, Korean Supreme Court(entire department of justice) announced that it is not prohibited Botox injections of a dentist for the esthetic purpose under the Korean Medical Act. Futhermore, Korean Supreme Court announced that it is also permitted and lawful dentist to irradiate Fraxel laser for skin care under the Korean Medical Act. From the precedent for this case, it is supposed that Korean Supreme Court permit Botox injections of a dentist for the esthetic purpose on the following grounds: First, there is no clear standard to distinguish “Medical Treatment” from “Dental Treatment” under the Korean Medical Act. It can be overlapped in certain cases. Second, “Oral and Maxillofacial Surgery”, that is sub-area on dentistry, covers education and treatment on whole face. There are education and evaluation in the course of training and license acquisition of dentist. Third, it is –comparatively- easy and safe to operate facelift around or between eyes using Botox shot. More over, Korean Supreme Court decided that it is not illegal to irradiate Fraxel laser for skin care under the Korean Medical Act. On this thesis, author has opposite position to Supreme Court Decision; Dentist cannot perform all the medical treatment on whole face. There is no clear standard to distinguish “Medical Treatment” from “Dental Treatment” under the Korean Medical Act of course. But There IS classification between Medical Treatment” from “Dental Treatment”. On the contrary to the regulation “Dental” or “Oral”, it is not appropriate for dentist to treat whole face including Botox injection or Laser irradiation.

한방 난임 치료의 특성과 결과에 대한 분석 -2011년 주요 한의과대학 부속한방병원 및 연구 참여 한의원을 중심으로-

이동녕 ( Dong Nyung Lee ),최민선 ( Min Sun Choi ),김동일 ( Dong Il Kim ) 대한한방부인과학회 2014 大韓韓方婦人科學會誌 Vol.27 No.4

Objectives: We analyzed retrospective clinical data of Korean medical institutes for infertility care and investigated current status and outcome of the Korean medical treatment of infertility as a part of foundational research for verifying validity of constructing national support system and developing appropriate policy on Korean medical treatment of infertility. Methods: We investigated data uploaded on the homepage of The Society of Korean Medicine for Subfertility (http://www.okinfertility.org) by Korean medical institutes for infertility care to get informations such as patients’ age, body height, weight, methods of Korean medical treatment, cost and duration of treatment, success or failure of pregnancy and result of treatment. Results: The average age of patients was 33.1±3.8 and the average body height was 161.2±5.3 cm and the average body weight was 55.2±8.5 kg. The method of Korean medical treatment was Herbal medicine (97.5%), acupuncture (80.4%), moxibustion (57.7%), cupping (32.7%). The average cost of treatment was 1,160,625±882,499 won, and the average medical cost per visit was 357,845±241,602 won. The average duration of treatment was 11.26±10.58 weeks, and the average number of visits per patient was 4.78±6.10 times. The average duration of treatment was the longest in the group of infertile patients with the highest average medical cost per visit. The average pregnancy success rate was 30.9% overall, and that of the group of infertile patients was 25.8%. Conclusions: When we develop the standard project model with expectation for about 25% success rate of pregnancy and delivery in the group of patients who have idiopathic and ovulatory factors, it is desirable to perform acupuncture and moxibustion treatment 1-2 times a week with herbal medicine. The treatment period is set to at least 12 weeks. Average treatment fee maybe calculated by converting the averaged treatment cost of clinic’s one month worth of daily treatment fee and medical hospital’s ten day treatment fee into weekly treatment cost.

아토피피부염 온라인 커뮤니티를 통해 본 환자들의 경향과 한의학적 치료이용률을 높이기 위한 방안 연구

이명구,김상현,김안나,장현철,Lee, Myung-Ku,Kim, Sang-Hyun,Kim, An-Na,Jang, Hyun-Chul 대한한방안이비인후피부과학회 2016 한방안이비인후피부과학회지 Vol.29 No.4

Objectives : The purpose of this study is to understanding the patients thought of Korean Medical treatment and to suggest an improvement in utilization of Korean Medicine treatment about atopic dermatitis. Methods : We had investigate atopic dermatitis online community by classifying the post by treatment type, feature type of the information and by content to know the patients latest tendency. And then compare the result to understand the patients thought of Korean Medical treatment. Results : Most of the post was experiential information and about 67% of the post was about symptom and treatment. Especially there had lot of interest about there treatment information and self-treatment. By contrast Korean Medical treatment type has lower rate then other type of treatment about symptom and treatment and the information was not specific. This result may influence on utilization of Korean Medical treatment. Conclusions : To solve this problem patients needs easy access to Korean Medical treatment and more information about there treatment.

벨마비 환자의 한의학적 치료 시작시기에 따른 신경손상률 비교 : 후향적 관찰 연구

최지은,권민수,김정환,조대현,한지선,김지혜,김현호,강중원,남동우 대한침구의학회 2016 대한침구의학회지 Vol.33 No.2

Facial Nerve Damage in Bell’s Palsy according to When Korean Medical Treatment was Started : A Retrospective Study Ji Eun Choi1, Min Soo Kwon1, Jung Hwan Kim1, Dae Hyun Jo1, Ji Sun Han1, Hee Jin Jo1, Ji Hye Kim1, Hyun Ho Kim2, Jung Won Kang1 and Dong Woo Nam1,* 1Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Kyung Hee University 2Department of Biofunctional Medicine & Diagnostics, College of Korean Medicine, Kyung Hee University Objectives : Although integrative Korean medical treatments have been suggested to be effective for treating Bell’s palsy, the effect of Korean medical treatment according to when treatment was started is unknown in the clinical field. Therefore, this study was conducted to determine the results of treating Bell’s palsy according to different starting points of integrative Korean medical treatments. Methods : We screened patients who visited the Facial Palsy Center at Kyung Hee University Hospital for Korean and Western combined medical treatment from March 2011 to February 2016. A total of 821 out of 2086 patients were studied, including their basic characteristics and results of an electromyography. Patients who started Korean medical treatment within 3 days of onset were placed in group A, within 9 days of onset in group B, and patients who started treatment after 10 days of onset were placed in group C. We tried to compare the level of facial nerve damage by electromyography between groups. Results : The patients in group C had the highest axonal loss rates in all branches(frontal, oculi, nasal, oris). The post hoc analyses revealed the difference of axonal loss rates between group A and B was not statistically significant. Only group C showed statistically higher axonal loss rates in all branches. Conclusion : The study results showed that the patients who had delayed Korean medical treatments had a higher level of facial nerve damage by electromyography. According to the results of this study, early application of integrative Korean medical treatment is suggested.

한의학 관련 이미지 연구

김재익,명예슬,안수연,이영지,조충식,Kim, Jae-Ik,Myeong, Ye-Seul,Ahn, Soo-Yeon,Lee, Yeong-Ji,Cho, Chung-Sik 대한한방내과학회 2014 大韓韓方內科學會誌 Vol.35 No.3

Objectives: Recently, the utility rate of Korean-Medical service has been a 6 percent of the domestic market share in medical service, so there is a lot of effort to increase utility rate of Korean medical service. However, in spite of the importance of image to promotion, there are still few studies about image of Korean medicine. Thus, the purpose of this study was to suggest ways to increase utility rate of Korean medical service by surveying and analysing recognition of image of Korean Medicine. Methods: People aged between 20s and 40s were targets of investigation. We divided respondents into three groups depending on relation approximation with Korean medicine (weak-related group, normal-related group, strong-related group). The questionnaire consisted of questions about images of Korean medicine, conducted through online and personal interviews. Results: In total, 282 members responded to the survey and the results of the analysis were as follows. The more a person was related to Korean medicine, the greater the tendency to experience Korean medical service. The most associated taste about Korean medical institutions was Bitterness, smell was smell of Korean medicine, color was yellow, feeling was warm, sound (instrument) was drum, and treatment pattern was Acupuncture, respectively. The most associated image of acupuncture was painful, and the most associated age of Korean medical doctors was 40s. The most associated general term of Korean medicine was physical constitution, and most associated pathological term was extravasated blood. Conclusions: This study can be very useful for future image marketing of Korean medicine because there have been no other studies about image on Korean medicine before now. But this study has also some limits like area, respondent selection, etc., so a more detailed and comprehensive survey is needed.

연명의료결정법에서 무연고자 규정미비 등에 관한 법적 고찰

문상혁 대한의료법학회 2023 의료법학 Vol.24 No.4

현행 연명의료결정법에 따르면 연명의료를 시행하지 않거나 중단하는 결정은 임종과정에 있는 환자의 의사가 우선적으로 적용된다. 이러한 환자를 대상으로 하는 연명의료의 의사결정은 환자가 의식이 있는 경우에는 환자 본인이 연명의료에 대한 의사를 직접 서면이나 구두로 표시하거나 사전연명의료의향서와 연명의료계획서를 작성하는 것으로 자기결정을 행사할 수 있다. 반면에, 환자가 사전연명의료의향서나 연명의료계획서를 작성하지 않은 경우에는 환자 가족의 진술로 환자의 의사를 확인하거나 환자가족 전원의 동의로 연명의료중단등결정을 할 수 있다. 그러나 가족이 없거나 가족을 알 수 없는 무연고 환자인 경우에는 입원하기 전에 사전연명의료의향서와 연명의료계획서를 작성 하지 않은 상태에서 의사표현을 할 수 없는 의학적 상태로 되면 환자의 의사를 알 수가 없어 환자에 대한 연명의료를 지속해야 할지 중단해야 할지에 대한 결정을 해야 하는 상황이 발생한다. 본 연구는 무연고환자의 경우에 연명의료결정을 위한 정책적 방안을 제시하고자 현행법상 무연고 환자에 대한 논의와 방안 검토했다. 첫째로, 성년후견인제도의 적용을 살펴보았지만, 성년후견인은 신체를 침해하는 의료행위에 대한 동의를 대신할 수 있지만 의료행위의 직접적인 결과로 사망할 수 있는 경우에는 가정법원의 허가를 필요로 하기 때문에 임종과정에 있는 급박한 환자에게는 적절한 방안이라고 할 수 없다. 둘째로, 연명의료결정법 제14조에 따라 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정에 관한 심의에 대해 살펴보았다. 현행법상에서는 의료기관윤리위원회에서 무연고 환자에 대한 연명의료중단등결정을 할 수 없기 때문에, 개정을 통하여 무연고 환자에 대한 연명의료중단등결정에 대한 사항을 동법 제14조에 반영하거나 무연고 환자에 대한 규정을 따로 신설하여 개정하는 것이 필요하다. 또한 의료기관윤리위원회에서 무연고 환자에 대한 결정해야 하지만, 그런 결정을 하는 것에 대해서 해당 의료기관에서 할 수 없다면, 공용윤리위원회에서 무연고환자의 연명의료중단등결정을 할 수 있도록 법률을 개정할 필요가 있다. According to the current act of Decision-Marking in Life-Sustaining Medicine, the decision to withhold or discontinue life-sustaining treatment is primarily based on the wishes of a patient in the dying process. Decision-making regarding life- sustaining treatment for these patients is made by the patient, if he or she is conscious, directly expressing his/her intention for life-sustaining treatment in writing or verbally or by writing an advance medical directive and physician orders for life-sustaining treatment. It can be exercised. On the other hand, if the patient has not written an advance medical directive or physician orders for life- sustaining treatment, the patient's intention can be confirmed with a statement from the patient's family, or a decision to discontinue life-sustaining treatment can be made with the consent of all members of the patient's family. However, in the case of an unrelated patient who has no family or whose family is unknown, if an advance medical directive or physician orders for life- sustaining treatment are not written before hospitalization and a medical condition prevents the patient from expressing his or her opinion, the patient's will cannot be known and the patient cannot be informed. A situation arises where a decision must be made as to whether to continue or discontinue life-sustaining treatment. This study reviewed discussions and measures for unbefriended patients under the current law in order to suggest policy measures for deciding on life-sustaining treatment in the case of unbefriended patients. First, we looked at the application of the adult guardian system, but although an adult guardian can replace consent for medical treatment that infringes on the body, permission from the family court is required in cases where death may occur as a direct result of medical treatment. It cannot be said to be an appropriate solution for patients in the process of dying. Second, in accordance with Article 14 of the Life-Sustaining Treatment Decision Act, we looked at the deliberation of medical institution ethics committees on decisions to discontinue life-sustaining treatment for patients without family ties.Under the current law, the medical institution ethics committee cannot make decisions on discontinuation of life-sustaining treatment for unbefriended patients, so through revision, matters regarding decisions on discontinuation of life-sustaining treatment for unbefriended patients are reflected in Article 14 of the same Act or separate provisions for unbefriended patients are made. It is necessary to establish and amend new provisions. In addition, the medical institution ethics committee must make a decision on unbefriended patients, but if the medical institution cannot make such a decision, there is a need to revise the law so that the public ethics committee can make decisions, such as discontinuing life-sustaining treatment for unbefriended patients.

한방복합치료(韓方複合治療)가 STRESS로 유발된 말초성안면신경마비(末梢性顔面神經麻痺)에 미치는 영향

김경태,송호섭,Kim, Kyung-tae,Song, Ho-sueb 대한침구의학회 2004 대한침구의학회지 Vol.21 No.4

Objective: This study was to evaluate the influence of stress on Peripheral Facial Paralysis during the complex traditional korean medical treatment. Methods: We investigated 41 cases of patients with Peripheral Facial Paralysis who were given the complex traditional korean medical treatment. one group had stress as main factor, the other group didn't it. we evaluated the treatment effect of each group by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System. Results : 1. In age, sex, lesion, duration of disease, frequency of treatment, duration of treatment, we found that two groups have no significant differences. 2. Pain back of the ear showed the highest frequency in symptoms at onset. 3. Boyangwhanotang showed the highest frequency in oriental herb medicine treatment. 4. As a result of evaluation by using Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System, treatment score after 2weeks was marked more higher than score before treatment and treatment score after final treatment was more higher than treatment score after 2weeks on each groups. 5. After final treatment, Non-stress group had signficant result on Gross Grading System of House-Brackmann, Yanagihara's Unweighed Grading System compared with stress group. Conclusion : These results suggested that patient with Non-stress group should be get better than stress group.

악성 난소 생식세포 종양 환자의 항암 치료 후 발생한 부작용 증상에 대한 한방치료 증례 보고 1례

정소미,황덕상,이진무,이창훈,장준복 대한한방부인과학회 2019 大韓韓方婦人科學會誌 Vol.32 No.4

Objectives: The purpose of this study is to report the effect of Korean medical treatment in case of germ cell tumor patient treated by chemotherapy. Methods: The patient was treated with Korean medical treatment (herbal medicine, acupuncture) for 11 months. By taking computed tomography and laboratory testing, we could compare before and after. Results: The patient treated with combination of Korean medical treatment and Chemotherapy recovered after taking Korean medicine for 11 months. Panax ginseng, C.A. Meyer, Astragalus membranaceus, Rhus Verniciflua Stokes were main ingredient of the korean medical treatment. Conclusions: This report shows the Korean medical treatment is effective on Germ cell tumor patient. Korean medical treatment alleviates the side-effect of Chemotherapy such as nausea, vomiting, hot flush and anorexia. Also Blood test results prove long-term use of Korean medicine is safe for lung and kidney function.

A case report on the use of processed Glycyrrhiza uralensis extract and Korean medical treatment for a patient with Amyotrophic Lateral Sclerosis(ALS)

Cha, Eun Hye,Lee, Seong Jin,Lee, Ji In,Song, In Ja,Kim, Sung Chul Korean AcupunctureMoxibustion Medicine Society 2016 대한침구의학회지 Vol.19 No.2

Objectives : The serum creatine kinase(CK) level of Amyotrophic Lateral Sclerosis(ALS) patients suggests that it may be an independent prognostic factor for the survival of ALS. We report the changes of serum CK level of ALS patients treated by administering processed Glycyrrhiza uralensis extracts and Korean medical treatments. Methods : We provided an ALS patient with processed Glycyrrhiza uralensis extracts and Korean medical treatments including acupuncture, pharmacopuncture and herbal medicine. The serum CK level was checked every month. The changes of ALSFRS-R and MRC grade were checked every month for additional result. Results : The serum CK level as the prognostic factor for the survival of ALS gradually decreased for three months. However, ALSFRS-R decreased by two points at the second trial. MRC rate had no change for three months. Conclusion : Combined administration of processed Glycyrrhiza uralensis extracts and Korean medical treatment could be meaningful possibilities in the treatment of ALS. We should conduct further studies to solve the limitations of this case study.