은화연교탕(銀花連翹湯)을 투여한 기침 환자에 대한 후향적 연구

백현정,이범준,정승기,정희재,Baek, Hyun-jung,Lee, Beom-joon,Jung, Sung-ki,Jung, Hee-jae 대한한방내과학회 2016 大韓韓方內科學會誌 Vol.37 No.6

Objectives: This study was designed to analyze the treatment effects of Eunhwayeongyo-tang through retrospective chart reviews. We also checked the correlation between each pair of variables of the symptoms and curative rates of patients with cough. Methods: Thirty-three patients with cough who had satisfied the selection criteria were retrospectively reviewed through their basic medical records, nasal endoscopy, and questionnaires about cough on their first and second visits. The questionnaires used were "The questionnaire on clinical symptoms of cough & sputum", Leicester Cough Questionnaire Korean Version (LCQ-K), Total Nasal Symptom Scores (TNSS), Visual Analog Scale (VAS), and "Cold-heat patterns". The improvement rate, calculated by "The questionnaire on clinical symptoms of cough & sputum" was considered to be clinically effective if reduction of symptoms scored more than 30%. The state of nasopharyngeal mucosa was assessed to categorize the cold-heat patterns of the upper respiratory tract and for diagnosis. Results: According to this study, cough and sputum improved by $57.22{\pm}37.76%$. Most patients (76%) improved significantly after $12.18{\pm}6.59days$ of taking Eunhwayeongyo-tang. The cure rates of 26 patients among the 33 patients were judged as effective. All the mean scores of the questionnaires and the anterior nasal cavity states were significantly improved on the patients' second visits. After $18.39{\pm}15.68days$, 30 patients were completely cured and ended treatment. The nasopharyngeal mucosa states of all patients were categorized as heat patterns. Conclusions: The conditions of the patients with nasopharyngitis significantly improved after taking Eunhwayeongyo-tang. All of the patients had pharyngitis or rhinitis. The cold-heat pattern of nasopharyngeal mucosa was a significant indicator of upper respiratory inflammation diagnosis.

청상보하탕(淸上補下湯)을 복용한 천식, COPD 등 만성호흡기환자에 대한 후향적 연구

백현정,방연희,김재효,김상진,김관일,이범준,정희재,정승기,Baek, Hyun-jung,Bhang, Yeon-hee,Kim, Jae-hyo,Kim, Sang-jin,Kim, Kwan-il,Lee, Beom-joon,Jung, Hee-jae,Jung, Sung-ki 대한한방내과학회 2016 大韓韓方內科學會誌 Vol.37 No.3

Objective: This study was designed to analyze the treatment effects of Chungsangboha-tang through retrospective chart reviews.Methods: Fifty-one outpatients who had visited the Allergy, Immune & Respiratory System Division at the Kyung Hee Korean Medicine Hospital and who had taken Chungsangboha-tang from February 1, 2006, to February 1, 2016, had their basic medical records and examinationsretrospectively reviewed with respect to IgE, eosinophil, AST, and ALT. The PFT results of 11 patients were also investigated with respect to FEV1, FVC, and FEV1/FVC.Results: The percentage of males and females was 49.02% and 50.98%, respectively. The past histories of patients included asthma (66.67%), unspecified cough (21.57%), COPD (9.80%), allergic rhinitis (7.84%), and others. The subjective symptoms included cough (82.35%), sputum (39.22%), dyspnea (37.25%), and others. The most numerous pattern identification was wheezing dyspnea. IgE was significantly reduced, and eosinophil had a reduced tendency after 116.76±160.40 days of taking Chungsangboha-tang. PFT results also significantly increased after 213.09±266.62 days, while AST and ALT results showed a reduced tendency. In the asthmatic group, IgE also showed a reduced tendency. In particular, IgE was significantly reduced in patient groups taking medicine for more than 12 weeks.Conclusions: The conditions of patients with chronic pulmonary disease such as asthma and COPD significantly improved with Chungsangboha-tang after more than 12 weeks.

한방병원 외래에 내원한 COPD환자 대한 후향적 임상 분석

백현정,방연희,김재효,김상진,김관일,이범준,정희재,정승기,Baek, Hyun-jung,Bhang, Yeon-hee,Kim, Jae-hyo,Kim, Sang-jin,Kim, Kwan-il,Lee, Beom-joon,Jung, Hee-jae,Jung, Sung-ki 대한한방내과학회 2016 大韓韓方內科學會誌 Vol.37 No.4

Objective: This study was designed to analyze the symptoms of chronic obstructive pulmonary disease (COPD) patients who attended a Korean medicine hospital and treatment effects through retrospective chart reviews.Methods: The medical records of 192 outpatients who had been diagnosed with COPD and visited the Allergy, Immune, and Respiratory System Department of Kyung Hee Korean Medicine Hospital from 1 February 2006 to 1 February, 2016 were retrospectively reviewed.Results: The study group consisted of 112 and 80 females. The median age of the patients was 59.80±15.46 y. Fifty of the patients had been diagnosed with chronic upper respiratory diseases, such as chronic rhinitis, nasopharyngitis, or sinusitis. The chief complaints were cough (n=136), sputum (n=124), and dyspnea (n=82). Other frequent symptoms were fatigue (n=11), hyperhidrosis (n=8), and a bad taste in the mouth (n=7). All the patients were prescribed Korean herbal medicine. In the study, 61 (31.77%) patients were treated with acupuncture, moxibustion, cupping therapy, or herbal steam therapy. Symptoms improved in 126 (65.63%) patients 141±272.82 d after the first treatment.Conclusions: Some of the COPD patients had chronic upper respiratory disease. The chief complains were cough, sputum, and dyspnea. Oher frequent symptoms related to body malfunction and pain. The symptoms improved in 126 (65.63%) patients 141.00±272.82 d post-treatment.

혈역학적으로 안정된 혈액투석환자에서 심장 질환 지표로서 B-type Natriuretic Peptide (BNP), N-terminal pro-BNP Cardiac Troponin T 측정

백현정 ( Hyun Jeong Baek ),김정아 ( Jung Ah Kim ),최소연 ( So Yeon Choi ),도연실 ( Yeon Sil Do ),장은희 ( Eun Hee Jang ),김정인 ( Jung In Kim ),도정호 ( Jung Ho Do ),최성철 ( Sung Chul Choi ),이정은 ( Jung Eun Lee ),허우성 ( Woo S 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.2

목적: 만성 신질환 환자들은 일반인에 비해서 관상 동맥질환과 좌심실 비대가 동반되는 경우가 많다. 일반인에서 Btype Natriuretic Peptide (BNP), N-terminal pro-BNP (NT-proBNP), Cardiac Troponin T (cTnT)가 심질환 진단과 예후 인자로 유용하게 사용되고 있다. 투석 환자에서도 표지자를 이용하여 심질환을 예측할 수 있는지 알아보고자 하였다. 방법: 2004년 9월부터 9개월간 삼성서울병원에서 6개월 이상 투석을 받고 있는 환자 중 급성 심혈관계 질환이 없는 27명을 대상으로 하였다. 같은 날 채혈과 심장초음파 검사를 시행하였다. 결과: BNP, NT-proBNP, cTnT 중앙값 (pg/mL)은 각각 433, 10,598, 0.021이었다. NT-proBNP는 BNP (r= 0.940, p=0.000), cTnT (r=0.504, p=0.009)와 뚜렷한 양의 상관관계를 보였다. BNP, NT-proBNP는 심박출 계수와는 음의 상관관계를 (각각 r=-0.502, p=0.008 vs. r=-0.556, p=0.003), 좌심실 질량 지수와는 양의 상관관계를 보였다 (각각 r=0.619, p=0.001 vs. r=0.718, p=0.000). cTnT는 심박출 계수와 음의 상관관계를 보였으나 (r=-0.513, p=0.007), 좌심실 질량 지수와는 상관관계를 보이지 않았다 (r=0.369, p=0.063). 심박출 계수에 독립적으로 영향을 미치는 인자는 albumin, cholesterol, LDL-cholesterol, NT-proBNP이었고 (R2=0.80), 좌심실 질량 지수에 영향을 미치는 인자는 나이, body mass index, LDL-cholesterol, NT-proBNP, cTnT이었다 (R2=0.78). 결론: 혈액투석을 받고 있는 환자에서도 표지자 측정이 심질환을 예측하는데 도움이 될 것으로 사료된다. Purpose: The prevalence of coronary artery disease and left ventricular hypertrophy (LVH) is higher in patients with chronic kidney disease (CKD) than in the general population. In the general population, BNP, NT-proBNP, and cTnT are useful markers of cardiac disease. Recently, studies on biomarkers in patients with CKD have been reported. However, the effect of renal disease on these markers is still uncertain particularly in hemodialysis patients. We investigated the potential of BNP, NT-proBNP, and cTnT as biomarkers of cardiac disease in hemodialysis patients. Methods: We prospectively studied 27 hemodialysis patients without cardiovascular event within the last 6 months. We performed an echocardiography and blood samples for plasma BNP, NT-proBNP and cTnT. Results: Median BNP, NT-proBNP, and cTnT level (pg/mL) were 433, 10,598, and 0.021, respectively. NT-proBNP was correlated with BNP (r=0.940, p=0.000) and cTnT (r=0.504, p=0.009). There was a negative correlation between BNP and left ventricular ejection fraction (LVEF) (r=-0.502, p=0.008), between NT-proBNP and LVEF (r=-0.556, p=0.003), and between cTnT and LVEF (r=-0.513, p=0.007). There was a positive correlation between BNP and LV mass index (LVMI) (g/m2) (r=0.619, p=0.001). Also, a positive correlation between NT-proBNP and LVMI was shown (r=0.718, p=0.000). There was an insignificant positive correlation between cTnT and LVMI (r=0.369, p=0.063). Albumin, cholesterol, LDL-cholesterol, and NT-proBNP had an independent effect on LVEF (R2=0.80). Age, body mass index, LDL-cholesterol, NT-proBNP, and cTnT had an independent effect on LVMI (R2=0.78). Conclusion: BNP, NT-proBNP, and cTnT may be as a noninvasive diagnostic or prognostic marker of cardiac disease in stable hemodialysis patients.

신동맥 스텐트 삽입술로 치료한 섬유근성 이형성증에 병발한 자발성 신동맥 박리

백현정 ( Hyun Jeong Baek ),김대중 ( Dae Joong Kim ),서현주 ( Hyun Joo Suh ),김민옥 ( Min Ok Kim ),여호명 ( Ho Myoung Yeo ),김정아 ( Jung Ah Kim ),김현진 ( Hyun Jin Kim ),강우헌 ( Woo Heon Kang ),김범 ( Beom Kim ),허우성 ( Woo Seo 대한신장학회 2004 Kidney Research and Clinical Practice Vol.23 No.5

두한증 및 수족다한증 환자의 비내시경, 체성분 검사를 통한 특성비교분석

박의근,백현정,김관일,이범준,정승기,정희재,Park, Eui-keun,Baek, Hyun-jung,Kim, Kwan-il,Lee, Beom-joon,Jung, Sung-ki,Jung, Hee-jae 대한한방내과학회 2015 大韓韓方內科學會誌 Vol.36 No.3

Objectives This study was designed to analyze the characteristics of craniofacial hyperhidrosis and palmar/plantar hyperhidrosis by nasal endoscopy and body composition test. Methods The study sample consisted of 20 and 22 patients with craniofacial hyperhidrosis and palmar/plantar hyperhidrosis, respectively, who answered questionnaires and underwent nasal endoscopy and body composition test. The questionnaires estimated the quality of life by Dermatology Life Quality Index score (DLQI), and the degree of obesity was evaluated using body mass index (BMI), percent body fat (PBF), and waist-hip ratio (WHR). The state of nasal cavity was evaluated by color, humidity, and swelling of the mucous membranes, and runny nose. Results BMI, PBF, and WHR were higher in patients with craniofacial hyperhidrosis than in patients with palmar/plantar hyperhidrosis. Rhinitis score was not significantly different between craniofacial hyperhidrosis and palmar/plantar hyperhidrosis. There was a positive correlation between rhinitis score and DLQI. Conclusions The degree of obesity was higher in patients with craniofacial hyperhidrosis than in those with palmar/plantar hyperhidrosis. The state of nasal cavity was not significantly different between craniofacial hyperhidrosis and palmar/plantar hyperhidrosis, but was associated with quality of life of hyperhidrosis patients.

복수가 동반된 간경변증을 가진 말기 신부전 환자에서 복막투석의 안정성

김정인 ( Jung In Kim ),이정은 ( Jung Eun Lee ),백현정 ( Hyun Jeong Baek ),최성철 ( Sung Chul Choi ),도정호 ( Jung Ho Do ),허우성 ( Woo Seong Huh ),김윤구 ( Yoon Goo Kim ),김대중 ( Dae Joong Kim ),오하영 ( Ha Young Oh ) 대한신장학회 2007 Kidney Research and Clinical Practice Vol.26 No.3

Purpose : When liver cirrhosis patients accompanying ascites need renal replacement therapy because of chronic renal failure (CRF), peritoneal dialysis (PD) can allow direct removal of ascites and prevent anticoagulants use. However, since PD might aggravate hypoalbuminemia and increase chances of peritonitis, clinicians tend to hesitate to apply it to those patients. The aim of the present study is to assess the outcome and stability of PD for the treatment of CRF patient with cirrhosis accompanying ascites. Methods : A retrospective study based on the clinical records was performed in cirrhotic patients with ascites in whom PD was performed for the treatment of CRF and who were followed up at Samsung Medical Center unit, between January 1995 and July 2005. Results : In our study, 15 patients were enrolled. Child-pugh class was worse in non-survival group than survival group (p<0.01). One-year patient survival was 40% in Class C and 75% in Class B, and patient survival differed between Class C and Class B (p=0.0014). Causes of death were terminal liver failure (n=6) and sepsis due to pneumonia (n=1). Total 27 episodes of peritonitis occurred, and the peritonitis rates were 0.91 episodes/patients-year. Conclusion : Although the peritonitis rates turned out somewhat high, the use of PD for the treatment of CRF in patients with liver cirrhosis accompanying ascites seems to be safe and effective. Main cause of death in our study seems to be related to liver disease.

지속성 외래 복막투석 환자에서 고용량(10,000 IU) Epoetin alfa의 효과에 대한 교차 연구

도정호 ( Jung Ho Do ),김대중 ( Dae Joong Kim ),최소연 ( So Yeon Choi ),도연실 ( Yeon Sil Do ),장은희 ( Eun Hee Jang ),백현정 ( Hyun Jeong Baek ),김정인 ( Jung In Kim ),여호명 ( Ho Myoung Yeo ),최성철 ( Sung Chul Choi ),이정은 ( Ju 대한내과학회 2006 대한내과학회지 Vol.71 No.5

목적: 유전자 재조합 인 에리스로포이에틴(rHuEPO)은 신성빈혈 치료에 필수 불가결한 약제이다. rHuEPO는 당화 폴리펩타이드로 피하 또는 정맥 내로 투여하여야 하며 이에 따른 불편함을 개선하기 위하여 최근에는 darbepoetin 또는 고용량의 epoetin beta로 투여 간격을 늘리는 방법이 소개되고 있다. 본 연구는 대상 환자간의 변이를 최소화 할 수 있는 교차 연구를 통하여 고용량 epoetin alfa 피하 투여의 빈혈 교정 효과를 볼 수 있는지 확인하고자 하였다. 방법: RHuEPO를 투여 중인 지속성 외래 복막투석환자 24명을 고용량-기존용량(n=12) 또는 기존용량-고용량(n=12) 피하투여군으로 무작위 분류하여 처음 6개월간은 총 10회 방문(스크리닝 1회, 이후 9회) 치료하였고(Period I), 이후 6개월간은 두 군을 교차시켜 4회 방문 치료(Period II)하였다. 고용량은 10,000 IU, 기존용량은 4,000 IU로 투여하였고, 헤마토크릿이 30~39% 범위를 유지하도록 투여 간격을 이전 투여 간격의 50% 이하 범위에서 조절하였다. 결과: 24명의 대상 환자 중 교차 연구를 완결한 환자는 고용량-기존용량군 8명, 기존용량-고용량군 7명이었고, 이들에 대하여 최종분석을 실시하였다. 투여 전, 12주, 24주, 36주, 48주에 혈색소는 고용량-기존용량군에서 10.8±1.1 (이하 평균±표준편차), 11.5±0.9, 11.5±1.5, 11.4±1.5, 11.5±0.8 g/dL이었으며, 기존용량-고용량군에서 11.2±0.8, 11.4±1.2, 11.2±0.9, 11.2±1.4, 11.4±0.9 g/dL로 차이가 없었다. 투여 전, 12주, 24주, 36주, 48주의 epoetin alfa의 평균 투여량은 고용량-기존용량군에서 83.6±38.1, 87.1±35.8, 89.4±34.2, 60.1±25.1, 62.8±30.7 IU/kg/week이었으며 기존용량-고용량군에서 69.8±31.6, 64.9±12.2, 69.9±46.1, 78.8±29.3, 75.9±16.4 IU/kg/week로 고용량 투여시 다소 많은 양상이었으나 유의한 차이는 없었다. 투여간격은 Period I, Period II에서 고용량-기존용량군은 13.3±5.3, 8.2±4.3일, 기존용량-고용량군은 7.0±2.5, 13.4±4.0일이었고, 고용량 투여시와 기존용량 투여시의 투여간격은 13.3±4.8, 7.5±3.4일로 유의한 차이를 보였다. 관찰 기간동안 양 군 모두 혈압의 변화와 요소 청소율(Kt/V)에는 차이가 없었고, 주사 부위 통증은 경미하였다. 결론: 지속성 외래 복막투석 환자에서 epoetin alfa 10,000 IU를 일시에 투여할 경우 4,000 IU 투여에 비하여 거의 비슷한 평균 용량으로 투여 횟수를 감소시킬 수 있었고, 부작용은 경미하였다. Background: Recombinant human erythropoietin (rHuEPO) is an essential and well-established treatment for renal anemia. Rcently, clinicians have moved toward administration of high dose rHuEPO to reduce the inconvenience and time efficient. We aimed to determine whether high dose subcutaneous (SC) epoetin alfa is as efficient and safe as the usual dose for treating anemia in continuous ambulatory peritoneal dialysis (CAPD) patients. Methods: Twenty-four patients on CAPD were randomly assigned to a high-usual dose group (n=12) and an usual-high dose group (n=12) with a variable interval for 48 weeks. Patients received 10 times treatments by scheduled visiting during Period I lasting 24 weeks and received 4 times treatments by scheduled visiting in Period II lasting 24 weeks by cross-over. The high dose was 10,000 IU and the usual dose was 4,000 IU epoetin alfa regimen. If hematocrit was out of the targeted range, 30~39%, the interval of epoetin alfa was changed within 50% of the previous interval. Results: Fifteen patients, out of 24, completed the study (8 patients in the high-usual dose group; 7 patients in the usual-high dose group). Mean hemoglobin levels at randomization and after 12, 24, 36 and 48 weeks were 10.8±1.1, 11.5±0.9, 11.5±1.5, 11.4±1.5, 11.5±0.8 g/dL, respectively, in high-usual dose group compared with 11.2±0.8, 11.4±1.2, 11.2±0.9, 11.2±1.4, 11.4±0.9 g/dL, respectively, in usual-high dose group. The mean weekly epoetin alfa dosages at randomization and after 12, 24, 36 and 48 weeks were 83.6±38.1, 87.1±35.8, 89.4±34.2, 60.1±25.1, 62.8±30.7 IU/kg/week, respectively, in high-usual dose group compared with 69.8±31.6, 64.9±12.2, 69.9±46.1, 78.8±29.3, 75.9±16.4 IU/kg/week, respectively, in usual-high dose group. No statistically significant differences between the two groups were apparent for hemoglobin levels or mean weekly epoetin alfa dosages. Treatment interval at Period I and Period II were 13.3±5.3, 8.2±4.3 days in high-usual dose group compared with 7.0±2.5, 13.4±4.0 days in usual-high dose group with statistically significant differences. Treatment interval in high dose was about two times as longer as usual dose. Adverse events were generally mild and transient, and pain on injection site following subcutaneous administration was rarely reported. Conclusions: This study demonstrates that epoetin alfa 10,000 IU is as efficient and safe as 4,000 IU with a similar weekly dose in CAPD patients. Epoetin alfa 10,000 IU administration can reduce frequency of injections by about one half.(Korean J Med 71:527-534, 2006)

노인성 폐렴 한방 치험 2례

방연희,백현정,김재효,김상진,김관일,이범준,정승기,정희재,Bhang, Yeon-hee,Baek, Hyun-jung,Kim, Jae-hyo,Kim, Sang-jin,Kim, Kwan-il,Lee, Beom-joon,Jung, Sung-ki,Jung, Hee-jae 대한한방내과학회 2016 大韓韓方內科學會誌 Vol.37 No.2

Objective: This study reports on traditional Korean medicine therapy used for pneumonia among elderly patients.Method: Two patients diagnosed with pneumonia were treated with herbal medicine and acupuncture, as well as cupping along the back. We checked chest X-rays, coughing and sputum on the visual analogue scale (VAS), and lab evaluations in order to evaluate the effectiveness of the treatment.Results: Following treatment with traditional Korean medicine therapy, VAS scores for coughing and sputum decreased and the chest X-rays and inflammation markers improved.Conclusion: Traditional Korean medicine therapy treatment appears to be effective for treating pneumonia in elderly patients.

한국인 기관지 천식 허증(虛證), 실증(實證) 환자와 CD46 유전자 다형성과의 관계

이매,백현정,박의근,김관일,이범준,김수강,정주호,김진주,김미아,정희재,정승기,Lee, Mei,Baek, Hyun-jung,Park, Eui-keun,Kim, Kwan-il,Lee, Beom-joon,Kim, Su-kang,Chung, Joo-ho,Kim, Jin-ju,Kim, Mi-a,Jung, Hee-jae,Jung, Sung-ki 대한한방내과학회 2015 大韓韓方內科學會誌 Vol.36 No.4

Objectives In this study, we divided Korean asthma patients into excess syndrome or deficiency syndrome groups according to clinical phenotype. Genetic analysis was conducted to investigate the association of exonic SNPs in the CD46 gene polymorphism with the clinical phenotype based on the differentiation syndrome of the bronchial asthma patients.Methods There were 95 healthy patients (control group) and 53 asthma patients. (The deficiency syndrome group included 24 and the excess syndrome group 29). We searched the exonic areas of the CD46 gene in the NCBI website SNPs with <0.01 minor allele frequency (MAF) and <0.01 heterozygosity. We finally selected two SNPs: rs138843816, Ser13Phe and rs7144, 3’-UTR. Hardy-Weinberg equilibrium was calculated using SNPStats.Results There were significant differences in the codominant 1 model and the dominant model between the healthy group and the asthma group. There were significant differences between deficiency syndrome group and the excess syndrome group in the genotype frequencies and in the codominant 1 model, the dominant model, and the log-additive model. The allele frequency of rs7144C showed a significant difference between the deficiency syndrome group and the excess syndrome group. Two-SNP haplotype analysis showed a significant difference in frequency in the deficiency syndrome group and in the excess syndrome group. There were significant differences between the healthy group and the excess syndrome group in the codominant 1 model, the dominant model, and the log-additive model. The frequency of the rs7144 C allele exhibited a significant difference in the demonstration. SNP haplotype analysis between the healthy group and the excess syndrome group showed a significant difference in the frequency of the CT haplotype and the CC haplotype.Conclusions The results indicate that two CD46 SNPs (rs138843816, Ser13Phe and rs7144, 3′–UTR) might be associated with the symptomatic excess syndrome in Korean asthma patients.