봉침을 이용한 무작위배정 비교임상시험연구에서의 유해사례 보고에 대한 체계적 문헌고찰

이운섭 ( Woon Sup Yi ),김성수 ( Sung Soo Kim ) 한방재활의학과학회 2014 한방재활의학과학회지 Vol.24 No.4

ObjectivesBee venom acupuncture (BVA) is emerging as a potential therapeutic option for several conditions. However, evidence regarding accurate estimates of its adverse events are not available. Therefore, by combining occurrence rates of adverse events in rel-evant randomized controlled trials (RCTs), we have aimed to give an overall estimated rate of each adverse event following BVA intervention.MethodsA systematic search for adverse events of BVA in Pubmed, Cochrane Central Register of Controlled Trials, Embase, NDSL, KoreaMed, KISS, RISS, KISTI, and KMbase was performed. For the quality assessment of the trials, we applied the CONSORT harms reporting recommendations. The overall occurrence rate of each adverse event was as-sessed as the primary outcome. The overall drop-out rate due to adverse events was as-sessed as the secondary outcome. ResultsTen RCTs reported adverse events following BVA. Two RCTs were eligible of fur-ther synthesis. Adverse events of pruritus, localized edema, and erythema occurred sig-nificantly more frequently in the BVA group compared to the control group. Data of drop-outs were available in seven RCTs. However, no comparisons showed a significant difference.ConclusionsCurrently evidence of adverse events is far from sufficient for assessing a reliable, precise occurrence rate. Still, limited evidence shows a tendency that adverse events occur more frequently after the appliance of BVA compared to the control. Thus, we await well designed future studies of BVA with more proper and strict harms reporting methods. (J Korean Med Rehab 2014; 24(4):97-109)

전열침 시술에 호전되지 않는 요통환자에 대한 봉독약침 치료 증례보고 2례

연창호,박현건,이운섭,김종연,정석희,Yeon, Chang-Ho,Park, Hyun-Gun,Yi, Woon-Sup,Kim, Jong-Yeon,Chung, Seok-Hee 척추신경추나의학회 2012 척추신경추나의학회지 Vol.7 No.2

Objectives : According to previous reports, heating-conduction acupuncture treatment is very effective for sprain and strain of ligament. But there was no report about pain aggravation by heating-conduction acupuncture and relief from bee venom injection. In this article, we report two cases of pain aggravation by heating-conduction acupuncture treatment and relief from bee venom injection. Methods : We used heating-conduction acupuncture treatment on possible sprain of sacroiliac ligament diagnosed by physical examination. Outcomes were measured by Visual Analogue Scale(VAS), Range of Motion(ROM) and Belt test, Goldthwait test. Results : The patient has shown an aggravation on pain and ROM. And after we use subcutaneous bee venom injection, pain has relieved and ROM improved. Belt test, Goldthwait test also changed from positive to negative. Conclusions : In this report, we assured the effect of Bee venom injection. Further well-designed, controlled studies and more cases are needed to differentiate the indication of heating-conduction acupuncture and bee venom injection. 장요인대 염좌 환자 2명에게 전열침 치료를 시행하여 통증 강도가 증가하였지만 봉독약침 치료를 시행한 후 통증 강도와 요추 가동범위 및 이학적 검진상에서 호전되었음을 보고한다. 이와 같이 봉독약침에 의해 호전 될 수 있는, 염증성 병변을 내재하였거나 진행 될 가능성이 있는 환자에 대한 사전의 감별 진단에 대한 연구 및 전열침 치료의 효과 및 부작용에 대한 체계적인 연구가 추후에 필요할 것으로 사료된다.

한국의 5개 한의과대학 부속한방병원 재활의학과의 요통 입원 환자에 대한 후향적 기술통계분석 -입원 기간, 상병명, 치료 방법을 중심으로-

맹태호 ( Tae Ho Maeng ),김종연 ( Jong Yeon Kim ),이운섭 ( Woon Sup Yi ),정원석 ( Won Seok Chung ),고연석 ( Youn Seok Ko ),이정한 ( Jung Han Lee ),신병철 ( Byung Cheul Shin ),차윤엽 ( Yun Yeop Cha ),고호연 ( Ho Yeon Go ),선승호 ( S 한방재활의학과학회 2013 한방재활의학과학회지 Vol.23 No.4

ObjectivesLow back pain (LBP) is one of the most common reason for people in Korea to visit Korean medical institutions. To assess actual amounts of use in the treatment of LBP in Korean medicine and to provide objective base line data for policy decision making, research regarding the current state of LBP patients` treatment in Korean medical in-stitutions are in need.MethodsThe current study was designed as a retrospective chart review to investigate descriptive characteristics of LBP patients. The clinical records of 304 patients who were hospitalized for the treatment of LBP in Korean rehabilitation medicine inpatient clinics of five different Korean medicine hospitals were analyzed. The percentage of patient charac-teristics such as sex, age, average duration of admission, insurance type, diagnosed LBP related disease code, and rates of interventions applied were assessed. Results1. The female sex was significantly predominant among patients with LBP : 105 patients (34.5%) were male and 199 patients (65.5%) were female. Percentage of the pa-tients` age appeared as followed : 76 people (25.0%) were in their 50s, 64 people (21.1%)were in their 40s, 51 people (16.8%) were in their 30s, 37 people (12.2%) were in their 60s, and 33 people (10.9%) were in their 70s. Approximately half of the total LBP patients in-vestigated were older than 50. 2. The average duration of admission was 16.2 days. Approximately one third (30.3%) of the patients were hospitalized for 8 to 14 days. 3. Female patients tended to stay admitted in hospitals slightly longer than male patients. Elderly (age 60~79) patients stayed in hospitals longer (17.8 days) compared to younger (age 20~39) patients (13.5 days). 4. More than half of the patients (171 cases, 56.3%) had their hospital bills covered with automobile insurance. 40.1% (122 cases) of the patients had medical insurance to cover their hospital bills. The average duration of admission of patients who had automobile insurance was 14.2 days, while that of the patients who had medical insurance was 18.4 days. 5. "Sprain and strain of the lumbar spine and pelvis" was the most commonly used (195 cases, 64.1%) disease code in patients with LBP. Patients diagnosed as "lumbar and other intervertebral disc disorders with radiculopathy" required the longest admission duration (22.1 days). 6. Herbal medication was applied to all of the patients during admission. Acupuncture was applied to all of the patients except one case diagnosed as spinal stenosis. Physical therapy, cupping therapy, moxibustion therapy, chuna therapy, and pharmacopuncture therapy were applied to 94.7, 92.8, 85.2, 83.9, and 49.7% of the patients, respectively. 7. There were certain differences among Korean medicine hospitals in terms of the LBP patients` duration of admission, type of in-surance, frequency of the disease code use, type of intervention applied.ConclusionsIt is thought that the current study can be used as reference data in as-sessing the current state of LBP treatment in Korean rehabilitation medicine and a basis for future research. Provided improvements of certain limitations of the current study in fu-ture researches, such data would act as better base line data in policy decision making. (J Korean Med Rehab 2013;23(4):213-223)

심박변이도를 통한 폐경 전 한국인 비만 여성의 비만 관련 대사체 농도 예측을 위한 회귀분석

김종연 ( Jong Yeon Kim ),양요찬 ( Yo Chan Yang ),이운섭 ( Woon Sup Yi ),김제인 ( Je In Kim ),맹태호 ( Tae Ho Maeng ),유덕주 ( Duk Joo Yoo ),심재우 ( Jae Woo Shim ),조우영 ( Woo Young Cho ),송미연 ( Mi Yeon Song ),이종수 ( Jong Soo 한방재활의학과학회 2014 한방재활의학과학회지 Vol.24 No.4

ObjectivesAdvanced researches on the relationship between obesity and heart rate var-iability (HRV), heretofore, focused on characteristics of HRV depending on the state of obesity. However, the previous researches have not quantified predictive power of HRV to-ward the obesity-related variables, which is rather more meaningful for clinicians who regu-larly treat obese patients. Hence, we designed a research to investigate whether HRV could predict serum levels of obesity-related metabolites.MethodsNinety obese premenopausal women meeting the inclusion criteria were recruited. The HRV test, blood sampling, and measurement of physical traits were conducted. Multiple regression analysis of the measurement data was carried out, putting obesity-related metabolites (insulin, glucose, triglyceride, hs-CRP, HDL, LDL, total choles-terol) as outcome variables and the others as predictors. To select appropriate predictive variables, the Akaike``s Information Criterion (AIC) was applied. Normality and homo-skedasticity of residuals for each model were tested to identify if there were any violations of the regression analysis`s basic assumption. Logarithm transformation was used for the val-ues of the concentration of metabolites and the HRV. ResultsThe regression model including Total Power (TP) value and BMI had significant predictive power for serum insulin concentration (F(2, 88)=835.7, p<0.001, R2=0.95). The regression coefficient of ln (TP) was -0.1002. However, it was not sure if the HRV could pre-dict concentrations of other metabolites.ConclusionsThe results suggest that the Total Power (TP) value of the HRV can predict the level of serum insulin. If the BMI could be assumed as being constant, when the TP val-ue is multiplied by n, the predicted change of insulin could be drawn by multiplying n?0.1002. The uncertainty of this model can be assumed as approximately 5%. (J Korean Med Rehab 2014;24(4):155-162)

만성 요통 통증 완화에 대한 미세전류 테이프의 안전성 및 유효성 평가

박현건 ( Hyun Gun Park ),김종연 ( Jong Yeon Kim ),이운섭 ( Woon Sup Yi ),이신지 ( Sin Ji Lee ),정원석 ( Won Suk Chung ),김호준 ( Ho Jun Kim ),이종수 ( Jong Soo Lee ) 한방재활의학과학회 2013 한방재활의학과학회지 Vol.23 No.4

ObjectivesThe aim of this study was to evaluate the efficacy and safety of micro current taping therapy (MTT) on patients with chronic low back pain (CLBP).MethodsWe included 50 participants who met the inclusion criteria and 5 participants dropped out during the sessions due to the following reasons: 3 participants were personal reasons, 1 participant was taking medication, 1 participant was fore arm fracture. We at-tached “I” shaped 40 cm, 2 tapes along the erector muscles of the spine starting from both iliac crest and another “I” shaped 30 cm, 1 tape on the painful site horizontally. This proce-dure was done 8 times and participants visited a total of 9 times including a final visit for evaluation. We measured visual analog scale (VAS), range of motion (ROM) and schober’s test on every visit. Participants completed a questionnaire of oswestry disability index (ODI) and Beck’s depression inventory (BDI) on the first and last visits.ResultsIn VAS for pain intensity and bothersomeness, there were significant decreases after 1st, 6th treatments. In range of extension, there was significant increase after 3rd treatment at first. In range of flexion, there was significant increase after 2nd treatment at first. In range of left flexion, there was significant increase after 4th treatment at first. In range of right flexion, there was significant increase after 3rd treatment at first. in schober’s test, there was significant increase after 2nd treatment at first. In VAS, ROM, schober’s test, BDI, ODI, there were significant improvement after all treatments had done.ConclusionsThere was a significant effect of MTT on CLBP. And there was no adverse effect. (J Korean Med Rehab 2013;23(4):185-194)