암 환자에 대한 구법의 치료와 메커니즘에 대한 최신 국내외 연구 현황

윤해창,강지영,김준영,정진용,손창규,이남헌,조정효,Yoon, Hae-chang,Kang, Ji-young,Kim, Jun-young,Joung, Jin-yong,Son, Chang-gue,Lee, Nam-heon,Cho, Jung-hyo 대한한방내과학회 2015 大韓韓方內科學會誌 Vol.36 No.3

Objectives This study aims to review and summarize existing evidence on moxibustion treatment for cancer patients. Methods Literature published until May 2015 in international journals were searched on PubMed, CAJ (CNKI-Medicine), NDSL (National discovery for science leaders), Sage Journal, ScienceDirect, Taylor&Francis Online (HSS), and Wiley Interscience (including Blackwell); and articles in Korean journals were searched on Korean Studies Information Service System (KISS), DBPIA, E-Article, KSI e-book, New article, Korea Institute of Science and Technology Information (KISTI), and Kyobo scholar. Results We analyzed 65 relevant studies. The number of studies conducted annually has increased and most are conducted in Korea and China. Moxibustion decreases the side effects of palliative treatment, thereby synergizing with anticancer treatment; it also improves the immune system, reduces tumor factors, and relieves symptoms. The mechanism of moxibustion is multi-fold: thermo, chemo, aero and kinetic. Only the kinetic effect is not significant. It also needs a complement to moxibustion because of harmful smoke. Conclusions Thus, the effect and mechanism of moxibustion in cancer patients was reviewed. There is an unmet need to develop a model of moxibustion and test it based on Korean medicine.

호스피스·완화의료 발전사와 한의학 참여의 필요성

윤해창,손창규,이남헌,조정효,Yoon, Hae-chang,Son, Chang-gue,Lee, Nam-heon,Cho, Jung-hyo 대한한방내과학회 2018 大韓韓方內科學會誌 Vol.39 No.4

Objective: The aim of this study was to establish the developmental history of hospice palliative care (HPC) with Korean medicine (KM). Methods: We compared the developmental history of HPC in Korea with that of Britain, the United States, Taiwan, Japan, and China. The articles in English or Korean published until Feb. 2017 were searched using 'Hospice' or 'Palliative care' with the name of each nation in the PubMed, MEDLINE, ScienceDirect, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases for foreign articles and OASIS (Oriental Medicine Advanced Searching Integrated System) for domestic articles. Books and gray literature were searched on the same databases and websites of the Ministry of Health and Welfare and related organizations in each country. Results: Modern palliative care began with the hospice movement led by Dr. Cicely Saunders. HPC in Korea started earlier than in other countries but it took considerable time for social consensus, so Korean policies have only been published recently. In this process, KM was excluded from HPC. For this reason, western medicine in Korea does not fully accept the spirit of HPC, the government does not take an aggressive stance with KM, and the institutes of KM do not have any interest in HPC. The World Health Organization recommends the establishment of policies and programs connected with a country's own health care system. In 2015, the Korean government made the third comprehensive plan for the development of KM. It included critical pathway guidelines about cancer-related fatigue and anorexia. More effort is required to set up HPC than other care types because Korea has two medical systems. Conclusions: Each nation has been trying to improve systems of HPC. We need to overcome the problems and bring out the best by making our own model of HPC with KM.

한의치료를 받은 안면마비 환자의 진료비 특성 분석 - 건강보험통계연보를 중심으로

윤해창,Hae-chang Yoon 대한한의학회 2023 대한한의학회지 Vol.44 No.2

Objectives: This study aimed to find out the characteristics of patients with facial palsy based on the National Health Insurance(NHI) statistical yearbook and provide the information pertaining to supplement Coverage of NHI. Methods: Based on the data of NHI between 2004 to 2021 for facial palsy(G51) obtained from the Ministry of Health and Welfare, the analyses were carried out according to the distribution of gender and the number of patients, visits, reimbursed days, and medical expenses by using the SAS 9.4. Results: The crude rate of facial palsy was reported as 361.71(2021) comparable with 419.60(2004) and 534.11(2009). The rate of men increased from 293.96(2004) to 302.27(2021) but the rate of women decreased from 450.88(2014) to 420.80(2021). The number of patients maintained around 190,000, however, it declined for patients treated Korean medicine(KM) after 2010. As the medical expenses were elevated, especially Western medicine(WM), that of WM exceeded KM's since 2018. The expenses of women were higher than men's in KM. By contrast, there was no difference with gender in WM. For reimbursed days per visits, it has been increased in WM but there was no difference in KM. Conclusion: Although the rate of patients with facial palsy in KM was high with no difference in the whole number of patients and reimbursed days per visits in KM annually, the number of patients in KM decreased but medical expenses elevated. According to this, it is necessary for reinforcing Coverage of NHI to research other factors related to KM.

코로나19 유행 시 지역사회주민의 심리적 염려에 따른 건강행태 변화, 정신건강, 방역수칙 실천정도

김현우 ( Hyun-woo Kim ),김건엽 ( Keon-yeop Kim ),김세아 ( Se-a Kim ),윤해창 ( Hae-chang Yoon ),진수희 ( Soo-hee Jin ),장은화 ( Eun-hwa Jang ),추유진 ( Yoo-jin Choo ) 대한보건협회 2021 대한보건연구 Vol.47 No.4

배경 : 이 연구의 목적은 코로나19 발생으로 인한 대구지역사회 주민들의 심리적 염려에 따른 변화된 건강행태, 정신건강 및 방역수칙 실천 정도를 살펴보고 그 영향을 분석하고자 하는데 있다. 방법 : 2020년 지역사회건강조사 가운데 대구지역에서 수행된 7,307명을 대상으로 한 자료를 이용하였다. 분석은 대상자의 일반적 특성과 건강 관련 특성에 따른 코로나19로 인한 심리적 염려 정도의 차이, 코로나19로 인한 심리적 염려 정도에 따른 변화된 건강행태/정신건강 및 방역수칙 실천정도는 카이제곱검정을 시행하였다. 코로나19로 인한 심리적 염려가 변화된 건강행태/정신건강 및 방역수칙 실천에 미치는 영향을 알아보기 위해 다중로지스틱 회귀분석을 시행하였다. 결과 : 코로나19로 인한 지역사회주민들의 심리적 염려는 여성 및 노년층, 소득 및 교육수준이 낮을수록, 주관적 건강상태가 나쁘거나 만성질환이 있는 경우, 서비스직이나 농림어업에 종사하거나 기혼/사별/이혼/별거 상태에 있을수록 높게 나타났다(p<.01). 또한 심리적 염려가 낮은 군 대비 높은 군에서 인스턴트식품/탄산음료 섭취량(OR=1.40, 95% CI 1.190-1.654) 그리고 스트레스(OR=1.40, 95% CI 1.208-1.623)가 증가하였고 수면시간(OR=1.50, 95% CI 1.229-1.821)은 감소하였다. 게다가 심리적 염려가 높을수록 기침 예절(OR= 2.11, 95% CI 1.570-2.834), 환기(OR=1.88, 95% CI 1.256-2.813), 소독 실천율(OR=1.78, 95% CI 1.559-2.041)을 포함한 방역수칙 실천정도가 높게 나타났다. 결론 : 코로나19로 인하여 지역사회주민들의 심리적 염려가 높아지고 건강행태, 정신건강, 방역수칙 실천정도에 영향을 미치는 것을 알 수 있었다. 따라서 코로나19로 인한 대응책을 마련할 때 이를 고려하여 효과적인 중재를 마련해야 한다. Background : The purpose of this study is to examine the changed health behaviors, mental health, and the degree of practice of quarantine rules due to the psychological concerns of residents of the Daegu community in the outbreak of COVID-19 and to analyze the effects. Methods : A total of 7,307 people in Daegu were used in the 2020 Community Health Survey. The chi-square test was performed to determine the difference in the degree of psychological concerns due to COVID-19 according to the general characteristics and health-related characteristics of the subject, and the changed health behavior/mental health and the degree of practice of quarantine rules according to the psychological concerns level due to COVID-19. Multiple logistic regression analysis was performed to investigate the effect of psychological concerns due to COVID-19 on changed health behavior/mental health and practice of quarantine rules. Results : The psychological concerns of community residents due to COVID-19 are higher among women and the elderly, lower income, lower education level, poor subjective health status, chronic disease, service work, engaged in agriculture, forestry and fishing, or married, widowed, divorced and separated(p<.01). Consumption of instant food and carbonated beverages (OR=1.40, 95% CI 1.190-1.654) and stress (OR=1.40, 95% CI 1.208-1.623) were increased in the group with high psychological concerns compared to the group with low psychological concerns, and sleep time (OR=1.50, 95% CI 1.208-1.623) was decreased. The higher the psychological concern, the higher the level of practice of quarantine rules, including cough etiquette (OR=2.11, 95% CI 1.570-2.834), ventilation (OR=1.88, 95% CI 1.256-2.813), and disinfection practice rate (OR=1.78, 95% CI 1.559-2.041). Conclusions : Due to COVID-19, the psychological concerns of local residents are increasing, and psychological concerns have an effect on health behavior, mental health, prevention level practice. Therefore, when preparing countermeasures due to COVID-19, effective interventions should be prepared in consideration of them.