WHO 침구임상 지침서 개정을 위한 국제회의 보고

박히준,서정철,김세현,김상우,안경애,임사비나,김용석,최도영,강성길 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

The Working Group on the revision of Clinical Research Methodology for Acupuncture met in Seoul, Republic of Korea from 24 to 26 August 2005. The main objectives of the meeting were to review the regional publication guidelines for Clinical Research on Acupuncture, to make necessary revisions in the guidelines, to make recommendations on further collaboration and activities in the field of research on acupuncture, and to discuss scientific evidence-based approaches in the clinical research on acupuncture. Fourteen members from the eight Member States, one secretariat staff from the WHO Regional Office for the Western Pacific and ten observers from the Republic of Korea attended the meeting. The members presented their papers to review the current status of clinical research on acupuncture. The drafts of proposed revision to the previous guidelines for clinical research methodology on acupuncture were discussed extensively. The issues covered during the discussion included: the definition of the new terms; reorganization of clinical research design; revision and update of contents (e.g., control group); introduction of Institutional Review Board (IRB) on the section of ethical approval; additional outcomes including health-related quality of life (HRQOL), qualitative measures, etc. In the course of these discussions, the working group developed the revised guidelines for clinical research on acupuncture and made recommendations for promoting the dissemination of the revised guidelines.

퇴행성 슬관절염 환자의 증상 중증도 지표와 DITI의 상관성 연구

서병관,류성룡,강중원,안경애,이재동,최도영,김건식,이두익,이윤호,이상훈 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : To investigate the applicability of thermography as severity measurement in the patients with osteoarthritis (OA) of the knee. Methods : Data were obtained from 80 patiens with OA of the knee. They were asked to answer two disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index, Lequesne's Functional Index (LFI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), VAS in order to assess the severity of disease, quality of life, degree of pain and taken thermography in standardized environment. Results : The thermal difference between ipsilateral side and contralaterla side of lateral aspect of knee was correlated with that of medial aspect of knee, and the thermal difference of anterior thigh was correlated with that of lateral, medial aspect of knee and patella region. Age, duration of disease, duration of morning stiffness, sex, crepitus, and painful side of knee were not correlated with the thermal differences of each region. LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ,, VAS were not correlated with the thermal differences of each region. Conclusion : Further study on the thermography on OA of the knee in population with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

Anti-hypertensive Effect of Chunghyul-dan(Qingxue-dan) on Stroke Patients with Essential Hypertension

Yun, Sang-Pil,Jung, Woo-Sang,Park, Scong-Uk,Moon, Sang-Kwan,Ko, Chang-Nam,Cho, Ki-Ho,Kim, Young-Suk,Bac, Hyung-sup EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Hypertension is one of the modifiable risk factors for stroke. Lowering blood pressure is helpful for primary and secondary prevention of stroke. This study is aimed to assess the efficacy of Chunghyul-dan on stroke patients with stage I hypertension using 24 hours ambulatory blood pressure monitoring (24ABPM). Forty hospitalized stroke patients with stage I hypertension were included in the study and they were randomly assigned into two groups: group A was treated with Chunghyul-dan 1200 ㎎ once a day for 2 weeks, while group B was not. Twelve subjects were dropped out because of unexpected early discharge or data error, thus the remaining 28 subjects were included in the final analysis (15 in group A and 13 in group B). Blood pressure was monitored every 30 minutes for 24 hours at baseline and 2 weeks after medication. Blood pressure, pulse rate, trough/peak ratio (TPR) [the value calculated by dividing the blood pressure change at trough (22 to 24 hours after drug intake) by the change at peak (2 adjacent hours with a maximal blood pressure reduction between the second and eighth hour after drug intake)] and smoothness index (SI) (the value calculated as the ratio between the average of the 24 hours, treatment-induced blood pressure changes and its standard deviation) were compared to assess the efficacy of Chunghyul-dan. To assess the safety of Chunghyul-dan, any adverse effects during medication period were monitored. There was no significant difference in the baseline assessment between the two groups. Systolic blood pressure was lower in group A than in group B (141.37 ± 8.96 mmHg versus 132.28 ±9.46 mmHg, P=0.03), while diastolic blood pressure and pulse rate had no significant difference between the two groups. Systolic TPR and SI was 0.87 and 1.04 in group A, respectively. This suggests that Chunghyul-dan have antihypertensive effect on stroke patients with stage 1 hypertension.??

만성두통 환자의 성격유형 A 행태, 스트레스, 우울 및 두통영향정도의 관계 연구

차남현,임사비나,정인태,김수영,안경애,김건식,이재동,이상훈,최도영,이윤호,이두익 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

To examine an estimate factor and grasp the relation of difference for Ype A Behavior Pattern(TABP), Perceived Stress Questionnaire. Depression and HIT-6 in the Chronic headache client. Method: Data collected by self-reported questionnaires from 38 client in S city who were selected by criteria of IHS, from the 19^(th) of October to 10^(th) of December, 2004. Result: 1) Differences between biographical data by TABP was significant by SaSang constitutions, by Stress was significantly influenced by age, and by Depression were significantly influenced health status and SaSang constitutions. 2) Correlations Coefficients among Study Variables were Stress and Depression(r=.494, p=.002) and Depression and HIT-6(r=.432, p=.010). 3) In regression analysis, HIT-6 were significantly influenced by Depression and Type A Behavior Pattern(TABP). These variables explained 38% and 34% respectively. Conclusion: The result suggest that chronic headache management with psychological aspect, as well as physical aspect should be a focus to enhance the quality of life.

퇴행성 슬관절염 환자 평가 설문도구의 내적 신뢰도, 상관성에 관한 연구

류성룡,안경애,서병관,강중원,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : The aim of this study is to evaluate internal reliability and correlation among assessment instruments of knee OA. Methods : Data were obtained from 85 patients with knee OA. They were asked to answer VAS pain scale, two disease-specific questionnaires (WOMAC and LFI) and one instrument about health-related quality(KHAQ). Reliability was assessed using cronbach's alpha. Correlation was assessed by examining the pearson's correlation coefficients. Results : Cronbach's alpha of all Index except WOMAC stiffness subscale(.6679) exceeded the value of 0.70. A good correlation was obtained between WOMAC Subscale (especially Pain Subscale) and LFI (.726<cronbach's alpha<.791). Also, Correlation between KHAQ and two disease-specific questionnaires (WOMAC and LFI) was good(.612<cronbach's alpha<.662). Conclusions : All used instruments have good internal reliability. also, There are good correlation among them. The treatment of knee OA must be focused on health related quality. For this, we should use proper assessment instruments.

퇴행성 슬관절염에 대한 제통단의 안정성과 효능 임상연구

서병관,류성룡,강중원,안경애,이상훈,최도영,김건식,이두익,이윤호,이재동 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : In order to investigate the efficacy and safety of the newly developed herbal medicine Jetongdan, a placebo-controlled randomized clinical trial of patients with osteoarthriotis of the knee was undertaken. Methods : Data were obtained from 80 patients with OA of the knee. After the enrollment, they were asked to answer a disease-specific questionnaire (Western Ontario and McMaster Universities (WOMAC) OA index) and analyzed with the erythrocyte sedimentation rate (ESR) in order to evaluate the efficacy of Jetongdan, and analyzed for aspartate transaminase (AST) level, alanine transminase (ALT) level, blood urea mitrogen (BUN) level, and creatinine (Cr) level in order to evaluate the safety of Jetongdan. Results : The liver function and renal function did not deteriorate after treatment with Jetongdan. Composite WOMAC score and physical function subscale was improved, but pain subscale, stiffness subscale, and ESR were not improved by Jetongdan. This was possibly because the baseline characteristics of the two groups were not homogenized after randomization. Conclusions : Jetongdan could be a promising treatment option for osteoarthritis of the knee. Further study in a larger population with appropriate severity grades is recommended.

An Overview of Bee Venom Acupuncture in the Treatment of Arthritis

Lee, Jae-Dong,Park, Hi-Joon,Chae, Youn-Byoung,Lim, Sabina EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Bee venom acupuncture (BVA), as a kind of herbal acupuncture, exerts not only pharmacological actions from the bioactive compounds isolated from bee venom but also a mechanical function from acupuncture stimulation. BVA is growing in popularity, especially in Korea, and is used primarily for pain relief in many kinds of disease. We aimed to summarize and evaluate the available evidence of BVA for rheumatoid arthritis and osteoarthritis. Computerized literature searches for experimental studies and clinical trials of BVA for arthritis were performed on the databases from PUBMED, EMBASE and the Cochrane Library. In addition, two leading Korean journals (The Journal of Korean Society for Acupuncture and Moxibustion and the Journal of Korean Oriental Medicine) were searched for relevant studies. The search revealed 67 studies, 15 of which met our criteria. The anti-inflammation and analgesic actions of BVA were proved in various kinds of animal arthritic models. Two randomized controlled trials and three uncontrolled clinical trials showed that BVA was effective in the treatment of arthritis. It is highly likely that the effectiveness of BVA for arthritis is a promising area of future research. However, there is limited evidence demonstrating the efficacy of BVA in arthritis. Rigorous trials with large sample size and adequate design are needed to define the role of BVA for these indications. In addition, studies on the optimal dosage and concentration of BVA are recommended for future trials.

제통단이 퇴행성 슬관절염 환자의 삶의 질에 미치는 영향

서병관,류성룡,강중원,우현수,이상훈,이재동,최도영,김건식,이두익,이윤호 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objectives : to evaluate the effects of Jetongdan, the newly developed herbal medicine, on the quality of life in patients with osteoarthritis of knee Methods : Placebo-controlled, randomized clinical trial on the 80 patients with osteoarthritis of the knee was fulfilled. After enrollment, they took medication as they enrolled. And they were asked to answer the questionnaires (Korean Health Assessment Questionnaire (KHAQ), Lequesne's functional index (LF1), visual analogue scale (VAS)) and analysed with the erythrocyte sedimentation rate (ESR) at baseline, after 4 weeks and 8 weeks of medication. Results : Total KHAQ score, some categories of KHAQ like hygiene, activities were significantly improved after 8 weeks of medication. And the change of the KHAQ score was significantly correlated with the change of VAS. But LFI, VAS, ESR level was not significantly improved, and it was considered because of the short medication period and small size of study population. Conclusion : In conclusion, Jetongdan could improve the health-related quality of life in patients with osteoarthritis of knee. Further study in the large population, in long period were recommended.

만성두통환자에 대한 동서협진의 임상적 연구

정인태,이상훈,김수영,차남현,김건식,이두익,이재동,임사비나,이윤호,최도영 EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Objective : Because the cause and etiology of chronic headache are not yet fully explained, the treatment of this symptom is not simple. In order to study the effectiveness East-West pain treatment on chronic headache, we evaluated its effect of pain alleviation and quality of life improvement on chronic headache patients who were treated with nerve block and acupuncture, and only acupuncture for eight weeks. Methods : 92 clinical experiment participants were gathered and through a questionnaire patients who experienced headache for more than 4 hours a day and more than 15 days per month were qualified as chronic headache patients. The qualified patients were classified into two groups, nerve block and acupuncture group(EW group, n=49) and acupuncture group(E group, n=43). Treatment was applied 2 times a weeks for 8 weeks. The acupoints, GV20, HN23, ST8, HN46, TE17, GB20, LI20, LI11, LI14, ST36, and LR3 were stimulated for 20 minutes. The effects of two groups were analyzed using VAS scores and BPI(Brief Pain Inventory). Results : The VAS and BPI after four weeks of treatment showed significant improvement among two but differences between the three groups was statistically insignificant. The VAS and BPI of the EW group after eight weeks of treatment showed statistically significant improvement compared to the other two groups. Conclusion : The pain treatment for chronic headache might be contributed to improvement of quality of life as well as alleviation of pain of chronic headache patients. It was suggested that the West pain treatment in combination with East pain treatment might be an useful modality to improve the pain and quality of life in chronic headache patients.

Efficacy and Safety of Chunghyul-dan(Qingwie-dan) in Patients with Hypercholesterolemia

Cho, Ki-Ho,Kang, Heung-Sun,Jung, Woo-Sang,Park, Seong-Uk,Moon, Sang Kwan EAST-WEST MEDICAL RESEARCH INSTITUTE KYUNG HEE UNI 2005 東西醫學硏究所 論文集 Vol.2005 No.-

Chunghyul-dan has inhibitory effects on HMG-CoA reductase and pancreatic lipase. We investigated whether Chunghyul-dan has therapeutic effects on humans with hypercholesterolemia. This study was a case-control, open-labeled clinical study. Subjects were treated with Chunghyul-dan (600 ㎎/day) or Atorvastatin (10 ㎎/day) for 8 weeks. Serum lipids were checked at baseline after 4 and 8 weeks of medication. While, Chunghyul-dan showed significant lipid-lowering effects, it was less effective than Atorvastatin. In comparison with the histological controls, Chunghyul-dan's effects were superior to placebo. On safety assessment, there was no adverse effect with the use of Chunghyul-dan in hepatic or renal toxicity. In conclusion, we suggest that Chunghyul-dan is a useful herbal medicine for hypercholesterolemia.