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급성(急性) 뇌경색환자(腦硬塞患者)에서 활혈화어(活血化瘀) 치법(治法)의 응용(應用)
김동웅,Kim Dong-Woung 대한예방한의학회 1999 대한예방한의학회지 Vol.3 No.1
In order to investigate the effect of circulating blood and extinguishing blood stasis method on acute ischemic stroke treatment, we compared muscle weakness in two groups. Dansamhwanotang was administered to experimental group and the Sopungtang was administered to comparison group. In prospective and consecutive study, 24 patients(male 14, female 10) were admitted to hospital within 6hours(median $4.21{\pm}2.45)$ after stroke attack. All of them were diagnosed computed tomography as acute cerebral infarction. We divided that patients into two groups. The experimental group was 13, took median $4.17{\pm}1.72hrs$ to admission after stroke attack and the comparison group 11, median $4.31{\pm}2.72hrs$ to admission after stroke attack. There was no statistical difference in time consumed from stroke onset to admission(P>0.05). Muscle weakness was measured on admission and 7 days later on AMA(American Medical Association) method. In the experimental group, muscle weakness on admission was $2.23{\pm}0.51$ and $2.79{\pm}0.72$ in upper and lower extremity, respectively. In comparison group, muscle weakness on admission was $2.17{\pm}0.43$ and $2.67{\pm}0.82$ in upper and lower extremity, respectively. There was no difference in muscle weakness(P〈0.05). In 7 days after, muscle weakness was $2.31{\pm}0.35$ in upper extremity and $3.15{\pm}0.12$ in lower extremity in experimental group, and $2.27{\pm}0.74$ in upper extremity and $3.45{\pm}0.48$, lower extremity in comparison group. There was no meaningful improvement statistically in upper extremity(p<0.05) but significant evolution in lower extremity(p<0.05). The muscle weakness comparison between admission time and 7 days later was as follows. Experimental group had improvement at the degree of $0.24{\pm}0.92$, $0.42{\pm}0.82$ in upper and lower extremity, respectively and comparison group, $0.12{\pm}0.82$, $0.27{\pm}0.97$ in same part(p<0.05). So, Dansamhwanotang administered group had more good muscle weakness improvement than Sopungtang administered group(P>0.05). From the above result, I suppose that circulating blood and extinguishing blood stasis method helps recover hemiparesis caused by acute ischemic cerabral disease, in acute stage at least.
김동웅,Kim Dong-Woung 대한예방한의학회 1999 대한예방한의학회지 Vol.3 No.1
From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was $10.05{\pm}2.75\;KAU$, $66.67{\pm}9.88\;IU/L$, $43.80{\pm}7.74\;IU/L$, $1.89{\pm}1.22\;mg/dl$ and $1.10{\pm}1.14\;mg/dl$ respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $11.01{\pm}3.16\;KAU$, $56.47{\pm}7.19\;IU/L$, $59.00{\pm}7.57\;IU/L$, $2.54{\pm}1.78\;mg/dl$, $1.64{\pm}1.59\;mg/dl$ respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.51{\pm}3.49\;KAU$, $77.85{\pm}7.17\;IU/L$, $58.00{\pm}9.09\;IU/L$, $2.54{\pm}1.97\;mg/dl$, and $1.80{\pm}1.81\;mg/dl$ respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.43{\pm}3.14\;KAU$, $41.13{\pm}6.49\;IU/L$, $50.40{\pm}7.17\;IU/L$, $1.66{\pm}1.90\;mg/dl$ and $1.14{\pm}1.50\;mg/dl$ respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was $12.30{\pm}3.25\;KAU$, $31.07{\pm}3.85\;IU/L$, $43.33{\pm}5.49\;IU/L$, $1.62{\pm}1.95\;mg/dl$, $1.17{\pm}1.71\;mg/dl$ respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was $28.73{\pm}5.19\;mg/dl$ and $1.82{\pm}1.27\;mg/dl$ respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was $32.12{\pm}5.65\;mg/dl$ and $2.31{\pm}0.45\;mg/dl$ respectively. From 4th day to 7th day, the mean BUN and Creatinine level was $31.07{\pm}5.47\;mg/dl$ and $1.92{\pm}0.79\;mg/dl$ respectively. From 7th day to 10th day, the mean BUN and Creatinine level was $17.47{\pm}3.57\;mg/dl$ and $1.33{\pm}0.59\;mg/dl$ respectively. From 11th day to 14th day, the mean BUN and Creatinine level was $11.93{\pm}3.16\;mg/dl$, $1.27{\pm}0.38\;mg/dl$ respectively.
천추(天樞) 및 상거허(上巨虛)의 침자극(針刺棘)이 대장(大腸) 통과시간(通過時間)에 미치는 영향(影響)
김동웅,이상용,이창현,Kim Dong-Woung,Lee Sang-Yung,Lee Chang-Hyun 대한침구의학회 1998 대한침구의학회지 Vol.15 No.2
Amis:ST25(Chonchu) and ST37(Sanggoho) are usually used acupoints to management several disease which induced to abnormal intestinal motility as diarrhea, constipation. Colonic transit time by radio opaque marker is able to study easily and useful method for evaluation of colonic motility. The aim of this study was to assess the effect on colonic transit time by manual acupuncture or electroacupuncture stimulation of ST25, ST37 in normal adult. Method: Colonic transit time, including Rt colon, Lt colon, rectosigmoid colon was measured by radio opaque marker in 11 normal adults. Colon transit time was measured before stimulation and after stimulation on ST25, ST37 by manual acupuncture and electroacupuncture. Each person was treated manual acupuncture or electroacupuncture stimulation for 3 days before colonic transit time measurement with 1 week interval. Result: Colon transit time before stimulation was measured $10.60{\pm}12.11$, $3.92{\pm}7.72$, $3.27{\pm}6.37$, $3.41{\pm}5.57$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Colon transit time after manual acupuncture is measured $10.48{\pm}12.35$, $3.72{\pm}7.52$, $3.37{\pm}6.76$, $3.39{\pm}5.84$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Colon transit time after electroacupuncture stimulation is measured $10.30{\pm}13.21$, $3.92{\pm}8.02$, $3.07{\pm} $, $3.31{\pm}5.49$ hours total colon, Rt colon, Lt colon, rectosigmoid colon, respectively. Significant change was observed Lt colon transit time after electroacupuncture as compared before acupuncture(P<0.05). Conclusion: Theses results suggest that manual acupuncture and electroacupuncture of ST25, ST37 in normal adults does not change colonic transit time.
뇌졸중으로 중환자실에서 집중치료한 환자들의 합병증에 관한 임상적 고찰
김동웅,한명아,Kim, Dong-Woung,Han, Myoung-Ah 대한한방내과학회 2000 大韓韓方內科學會誌 Vol.21 No.3
Purpose : Cerebrovascular disease is the most frequent cause of death in Korea and it remains severe disabilities disturbing normal life, According to the previous studies, mortality of the stroke in the first one week is up to the 20% and 95% of stroke patients in the acute stage are accompanied by more than one complications. These complications affect not only the acute stage mortality but also the late stage rehabilitations. In Korea the oriental medicine is preformed in the treatment of stroke. Therefore it is important to recognize thoroughly the complications in the acute stage of stroke and to prevent them. But studies about complications of acute stage stroke is rarely presented in the fields of oriental medicine. So this study is prepared for investigating the characteristics and frequency of complications in the acute stage of stroke. And we are to assess the importance of theses acute complications by systemic reviewing the previous studies. Methods : Fifty one patients are included who had been admitted to ICU(intensive care unit) of Chenju Hospital of Wonkwang Oriental Medicine. Twenty nine patients are diagnosed as ischemic stroke and twenty one patients are diagnosed hemorrhagic stroke. Medical and neurological complications were investigated retrospectively based on medical notes excluding primary symptoms of stroke Le. motor weakness, sensory disturbance and speech disorder. And risk factors of stroke such as D.M. or hypertension are excluded. Results : Medical complications are more frequent than neurological ones. Most frequent medical complication is dysuria(61%) and constipation(45%), fever(30%) and aspiration pneumonia(22%) are followed in order of frequency. In Neurological complication dysphagia(56%), the exacerbation of infarction due to increased intracranial pressure(24%), irritability or insomnia(21%) is most frequently complicated in order of frequency. Conclusions : These complications are mostly caused by bed rest state in acute stage stroke. It is supposed that more aggressive management can prevent theses ones. And it is possible to improve the medical and neurological conditions by sticking theses study results.