요각통 환자의 통증 평가에 있어서 수직, 수평선 Visual Analogue Scale 과 Numerical Rating Scale 간의 상관관계

하인혁 ( In Hyuk Ha ),박원상 ( Won Sang Park ),우인 ( In Woo ),김하늘 ( Ha Neul Kim ),고동현 ( Dong Hyen Koh ),윤유석 ( Yu Suk Yoon ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.4

Objective : We investigated which measurement is more useful and reliable between NRS, horizontal VAS, and vertical VAS in 110 hospitalized patients who complain LBP and low extremity pain. Also, we analyzed interrelation in each measurement. Methods : Before we began investigation, we informed the objective and method of this investigation to patients. Then we checked patient`s pain degree by using those three measurements(NRS, horizontal VAS, and vertical VAS). We evaluated that sensitivity, correlation and inter-individual variability of each measurement depended on analyzing values. Results : We included 108 patients because we excluded 8 patients who could not check VAS degree. Both of horizontal VAS and vertical VAS showed statically significant and high sensitivity appearing normal distribution shape. But NRS didn`t show normal distribution shape. The mean value of horizontal VAS and NRS was significantly higher than NRS. There was no sharp difference clinically between horizontal VAS and NRS in inter-individual variability. The interrelation of each measurement were very close. Conclusions : There was significant difference between horizontal VAS, vertical VAS and NRS in statistics , not in clinical aspect. However, We can use those measurements usefully in pain evaluation because their interrelation is very close.

자하거 약침의 지표물질 선정 및 분석법 벨리데이션

박상원 ( Sang Won Park ),이재웅 ( Jae Woong Lee ),이진호 ( Jin Ho Lee ),하인혁 ( In Hyuk Ha ),변장훈 ( Jang Hoon Byun ),정범환 ( Bum Hwan Jung ),정화진 ( Hwa Jin Jung ),이인희 ( In Hee Lee ),김민정 ( Min Jeong Kim ),김은지 ( Eun J 한방재활의학과학회 2016 한방재활의학과학회지 Vol.26 No.1

Objectives Despite the increasing use of Ja-ha-guh (Hominis-placenta ) pharmacopuncture in rehabilitative medicine field, its standard compound has yet to be investigated. The purpose of this study is to provide standardization for future studies and increase satisfaction of patients by utilizing standard pharmacopuncture. Methods Alanine and leucine were selected as potential standard compounds. LC/MS was used to devise an analytic method. This analytic method was subject to validation. According to validation guideline of Korea Food and Drug Administration, the specificity, linearity, precision, range, quantitative limits, detection limits and accuracy were measured. With this analysis, 3 lots of Ja-ha-guh pharmacopuncture were analyzed. Results Because the specificity, linearity, precision, range, quantitative limits, detection limits and accuracy meet criteria of the guideline, the analytic method was validated. It was found that Ja-ha-guh pharmacopuncture contained 211.02±7.28 ug/ml of alanine and 372.03±7.58 ug/ml of leucine. Conclusions Both alanine and leucine appear to be suitable standard compounds. These results are likely to contribute to further standardization of Ja-ha-guh for medical use. (J Korean Med Rehab 2016;26(1):33-40)

경항통에 대한 추나요법의 효과: 체계적 문헌고찰과 메타분석

이기범,하인혁,김호선,배영현,김노현,서창용,양규진,정유화,소민지,이윤재,Lee, Ki-Beom,Ha, In-Hyuk,Kim, Ho-Sun,Bae, Young-Hyun,Kim, No-Hyeon,Suh, Chang-Yong,Yang, Kyu-Jin,Jung, You-Hwa,So, Min-Ji,Lee, Yoon-Jae 척추신경추나의학회 2016 척추신경추나의학회지 Vol.11 No.2

Objectives : To determine the effectiveness of Chuna manual therapy for neck pain Methods : We searched 7 electronic databases(OASIS, NDSL, Ovid-MEDLINE, Ovid-EMBASE, Cochrane library, AMED, CNKI) to find all Randomized controlled trials that used Chuna manual therapy as a treatment for neck pain. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results : 7 RCTs met our inclusion criteria. The meta-analysis of 7 studies showed favorable results for the use of Chuna manual therapy. High risk of bias were observed for performance bias and detection bias. Conclusions : Our systematic review found favorable results using Chuna manual therapy for neck pain. But there are several limitations in our study due to lack of well-designed RCT. To obtain stronger evidence, further clinical trials would be needed.

편측 요통을 호소하는 환자에 있어서 척추 주위 근육의 지방량과 통증과의 관계

김하늘 ( Ha Neul Kim ),김경훈 ( Kyoung Hun Kim ),김주원 ( Joo Won Kim ),진은석 ( Eun Seok Jin ),하인혁 ( In Hyuk Ha ),고동현 ( Dong Hyun Koh ),홍순성 ( Soon Sung Hong ),권혁준 ( Hyeok Joon Kwon ) 한방재활의학과학회 2009 한방재활의학과학회지 Vol.19 No.1

목적: 요통은 임상에서 가장 흔하게 접할 수 있는 질환이며, 동시에 통증으로 인한 근무 결손도나 생활 불편감이 높은 질병이다. 그래서, 많은 연구들이 요통을 일으키는 원인 혹은 악화시키는 유발 인자를 밝혀내려는데 초점이 맞추어져 있다. 이번 연구의 목적은 편측 요통을 호소하는 환자에 있어서 MRI에서 조사된 척추 주위 근육의 지방량과 통증과의 관계에 대해서 알아보는데 있다. 방법: 2007년 11월부터 2008년 4월까지 본원에 요통으로 내원한 환자를 대상으로, 편측 요통을 호소하며, 체질량 지수가 25kg/㎡ 이하이며, 만 20세이상 40세미만인 환자 24명을 대상으로 연구를 진행하였다. MRI에서 조사되어진 L4-5 디스크 레벨의 척추 주위 근육의 지방량을 객관적인 pseudocoloring technique을 이용해 측정하고, paired t-test로 결과를 분석하여 요통이 유발된 측과 지방량의 관계에 대해서 연구하였다. 결과: 요통이 있는 측의 지방량과 요통이 없는 측의 지방량을 측정하여 데이터를 분석하였다. 양측의 지방량과 통증의 유무에 대한 관계는 통계적으로 유의한 수치를 나타냈다(P <0.05). 요통이 있는 측과 없는 측과의 성별, 나이, BMI의 통계적인 차이는 없었으며, 지방량 측정시 남자들이 여자들에 비해 지방량이 더 높게 측정되었다(남자 8.5±5.1%, 여자 6.5±3.6%). 결론: 이 연구를 통해 척추 주위 근육의 지방량과 요통에 대한 상관성의 증거를 제시하였다. 잘 선별되어진 환자의 MRI를 통해 객관적인 방법으로 지방량을 체크를 하였으며, 추후 더 많은 개체수를 이용해 보다 더 정확한 관련성을 파악하고, 나아가 지방량에 따른 통증 강도의 상관성에 대해서 연구가 필요하리라 생각된다. Objectives: Low back pain(LBP) is a common disabling disease in clinical practice and loss of working hours due to this condition is huge. The aim of this study was to determine if there was an association between fat deposit of paraspinal muscles as observed on MRI scans in patients presenting with unilateral LBP. Methods: 24 patients who visiting our hospital with a clinical presentation of unilateral LBP were recruited to the study. Patients were between 20 and 30 years and had a history of unilateral LBP within 12 months. After MRI scaning, the images were saved in DICOM file format for Picture Archiving and Communication System(PACS). The percentage of fat infiltrated area was measured using a pseudocoloring technique. Data were analyzed comparing the fat deposits of the muscles on the symptomatic and asymptomatic sides. Paired t-test was used to find the difference between the measurements of fat tissue in individual patients. Results: The amount of fat in the symptomatic side was 7.6±4.51%, asymptomatic side was 6.7±4.29%. There were increases, statistically significant, in the fat changes of the paraspinal muscles at the L4-5 disc level(P <0.05). Also, men were likely than women to have more fat deposit in symptomatic side(men 8.5±5.1%, women 6.5±3.6%). Conclusions: The amount of fat in the symptomatic side shows significantly increased than asymptomatic side in the paraspinal muscles at the L4-5 disc level. It suggested that fat infiltration in the muscles associated with LBP. Further studies will be needed to confirm the relationship between the muscle fatty changes and LBP in the large sample size. In addition, the correlation of pain severity with fat infiltration needs to be addressed.

보존적 치료를 통해 호전된 요추 추간판탈출증 환자의 자기공명영상으로 추적 관찰한 증례 4례 보고

박원상 ( Won Sang Park ),하인혁 ( In Hyuk Ha ),권혁준 ( Hyeok Joon Kwon ),우인 ( In Woo ),윤유석 ( You Suk Youn ),송주혀 ( Joo Hyun Song ) 한방재활의학과학회 2007 한방재활의학과학회지 Vol.17 No.4

Objectives :This study is designed to observe the effect of conservative oriental medicine treatment for HIVD of lumbar spine by MRI. Methods : 4 patients who were diagnosed as lumbar spine herniated intervertebral disc was evaluated after conservative oriental medicine treatment by Visual Analog Scale(VAS), Numeric Rating Scale(NRS), Oswestry Disability Index(ODI), Straight Leg Rasing Test(SLR) six times four week for 6 months. Results : 1. Visual Analog Scale(VAS), Numeric Rating Scale(NRS), Oswestry Disability Index(ODI), Straight Leg Rasing Test(SLR) was significantly improved after conservative oriental medicine treatment for six months.2. Also it was observed that herniated disc was decreased after six months by MRI reexamination. Conclusions : This study suggested that conservative oriental medicine treatment can be effective for decreasing pain and improving functional recovery also decreasing the volume of herniated disc

경추추간판탈출증과 경부통증에 대한 추나치료에 관한 해외연구동향분석 -Pubmed 검색중심으로-

박상원,변장훈,이종환,하인혁,이진호,Park, Sang-Won,Byun, Jang-Hun,Lee, Chong-Hwan,Ha, In-Hyuk,Lee, Jin-Ho 척추신경추나의학회 2013 척추신경추나의학회지 Vol.8 No.2

Objectives : The purpose of this study is to explore the trends of Chuna(manipulation) treatment on neck pain and cervical disc displacement. Methods : We set up the two searching strategies and investigated the latest clinical trials on Chuna(manipulation) therapy for Neck disorders and cervical disc herniation through PubMed search. The searched papers were analyzed and the year, journals, article types of literatures were examined. Of the articles, Randomized controlled trials(RCTs) are assessed by Jadad scale. Results : Studies on Chuna(manipulation) treatment to cervical disc herniation were very few. Articles on Chuna(manipulation) treatment to neck pain were relatively more than those of cervical disc herniation. The most frequently published journal was J Manipulative Physiol Ther. The main design of study was RCT. The limited quality assessment of RCT was conducted by Jadad scale and the average Jadad score was 1.73, which indicates low quality in terms of Jadad evaluation criteria. Conclusions : International trends of studies on Chuna therapy of cervical disease is increasingly reviewed. Although this review has several limitations, analyzing the latest trends of studies on Chuna(manipulation) treatment on neck pain and cervical disc displacement is necessary for further studies.

황련해독탕 약침의 장기보존시험에 관한 연구

이진호 ( Jin Ho Lee ),하인혁 ( In Hyuk Ha ),김미령 ( Me Riong Kim ),정화진 ( Hwa Jin Chung ),이재웅 ( Jae Woong Lee ),김민정 ( Min Jeong Kim ),김은지 ( Eun Jee Kim ),이인희 ( In Hee Lee ) 한방재활의학과학회 2016 한방재활의학과학회지 Vol.26 No.2

Objectives We studied long-term preservation in stability of a mixed preparation of distilled and 70% alcohol extracted Hwangnyunhaedok-tang pharmacopuncture to establish standards for expiration date and quality control. Methods Three lots of consecutively prepared Hwangnyunhaedok-tang pharmacopuncture were each tested in triplicate to a total 5 tests at 3 month intervals over a period of 12 months for analysis of appearance, pH, specific gravity, index component content, endotoxins, microbial sterility, residual organic solvents, heavy metals, and pesticides. Items with no difference by elapsed time were tested at the initial and final timepoints, and data of items with potential difference by elapsed time were analyzed for trends to establish individual quality control standards. Results All tested items were stable over the study period, and therefore the expiration date was set as 12 months. pH quality control standards were set as 3.66∼5.69, and that of specific gravity as 0.802∼1.203, respectively. In index component content standards, berberine was set at 4.96∼8.98 μg/vial, baicalin at 6.47∼10.31 μg/vial, and geniposide at 116.03∼189.55 μg/vial, respectively. Standards for other items with no difference by elapsed time were set according to general Korean herbal medicine standards in the Korean Pharmacopoeia. Conclusions Manageable expiration date and quality control standards were established through long-term preservation testing of Hwangnyunhaedok-tang pharmacopuncture, furthering standardization of Korean medicine pharmacopuncture. (J Korean Med Rehab 2016;26(2):51-59)

산양산삼복합약침의 표준화 및 급성독성시험

백상현,이인희,김민정,김은지,하인혁,이진호,이재웅,Baek, Sang-hyun,Lee, In-hee,Kim, Min-jeong,Kim, Eun-jee,Ha, In-hyuk,Lee, Jin-ho,Le, Jae-woong 대한한방내과학회 2015 大韓韓方內科學會誌 Vol.36 No.2

Objectives: The marker substances of cultivated wild ginseng pharmacopuncture that may not be detected during the process of steaming remain controversial. We developed a combined cultivated wild ginseng pharmacopuncture that contains all the marker substances. The aim of this experiment was to investigate the marker substances and test the toxicity of the combined cultivated wild ginseng pharmacopuncture. Methods: The marker substances were detected using HPLC. Intravenous injection toxicity studies were conducted at Medvill, an authorized institution for non-clinical studies, under the regulations of Good Laboratory Practice. We observed survival rates, abnormal behaviors, weight changes, gross findings in autopsy, blood biochemical properties, and histological abnormalities of organs such as the liver and kidney. Results: HPLC data showed that ginsenosides Rg1, Rb1, and Rg3 were detected at concentrations of 19.29, 47.64, and 3.02 μ g /ml, respectively. Administration of combined cultivated wild ginseng pharmacopuncture resulted in no dead animals or significant toxicological changes. Conclusions: The combined cultivated wild ginseng pharmacopuncture contains all the marker substances and is a relatively safe treatment medium. Further studies should be conducted to confirm the present findings.

건강보험심사평가원 데이터의 분석을 통한 체성기능부전 환자의 특성 및 M99 진단명의 사용현황 분석

신재권,주환수,이성엽,신예슬,고원일,박기병,김민규,하인혁,Shin, Jae-Kwon,Joo, Han-Soo,Lee, Seong-Yup,Shin, Ye-Sle,Ko, Won-Il,Park, Ki-Byung,Kim, Min-Kyu,Ha, In-Hyuk 척추신경추나의학회 2016 척추신경추나의학회지 Vol.11 No.1

Objectives : The aim of this study is to assess the usage of diagnosis codes for somatic dysfunctions and the general characteristics of patients diagnosed with the code, by analyzing health insurance data provided by the Health Insurance Review & Assessment Service(HIRA) of Korea. This investigation is intended to outline future and willing to contribute to further use of diagnosis code and the approach of Oriental Medicine to somatic dysfunction. Materials and Methods : By analyzing HIRA data, those diagnosed with M99 codes, a code attributed to somatic dysfunction, were selected for analysis. Patients included were assessed for the relevant general characteristics, and the specific diagnostic criteria. The current usage rates and noteworthy characteristics of diagnostic codes of somatic dysfunctions were assessed. A comparative analysis between clinical departments and subcategories, and a comparative analysis to data of 2014 was conducted. Results : Patients given M99 codes constituted a small minority of all patients diagnosed in 2011 as shown by HIRA data. The codes were more frequently to older patients, females, outpatients, and those who filed for Health Insurance compensation. Medical institutions participating in the diagnosis were mostly primary care facilities, usually specializing in orthopedic(Western medicine sector) and internal medicine (Oriental Medicine sector). The most registered code in 2011 and 2014 was M995. The same trend can be observed in Oriental/Western medicine institutions and Public health center, on the other hand, between them, have some different patterns both 2nd and 3rd. Conclusions : This investigation is that of current usage of diagnostic codes of somatic dysfunction. HIRA insurance claim data was analyzed. Based on the current results, more precise diagnostic standards of somatic dysfunction are warranted. This study will provide a foundation for future Oriental Medicine approach to somatic dysfunctions.

요통 환자의 요추 주변 근육 단면적과 신체안정성(Stability), 체중심(Center of Pressure)과의 관련성 : 동적평형검사(Tetrax)를 중심으로

성익현,이갑수,정재훈,김원우,조창영,최철우,하인혁,Seong, Ik-Hyun,Lee, Kap-Soo,Jung, Jae Hoon,Kim, Won-Woo,Cho, Chang-Young,Choi, Chul-Woo,Ha, In-Hyuk 척추신경추나의학회 2013 척추신경추나의학회지 Vol.8 No.2

Objectives : To identify the association between cross-sectional area of lumbar regional muscle and stability(ST), center of pressure(COP) assessed by tetrax. Methods : Patients(n=55) who had taken L-SPINE MRI and Tetrax(Sunlight, Israel) were analyzed retrospectively. To evaluate the cross-sectional area of lumbar regional muscle, L-SPINE MRI was used. Data of ST, COP were accumulated by using dynamic equilibrium analysis by Tetrax. Of the lumbar regional muscles, the Psoas muscles and the Paraspinalis muscles were examined. Using Pearson correlation, we analyzed COP, ST and the difference between the cross-sectional area of lumbar regional muscles. Results : The variance of cross-sectional area of both sides of Psoas muscle and COP had moderate positive correlation(r=0.621). Between variance of cross-sectional area of both sides of Paraspinalis and lumbar regional muscle and COP there was low positive correlation(r=0.287, r=0.329) ST also had low correlation with variance of cross-sectional area of both sides of Psoas muscle. Conclusion : The variance of cross-sectional area between both sides of Psoas muscle had moderate correlation with COP.