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중풍환자(中風患者)의 연하장애(嚥下障碍)에 전중혈 구치료(灸治療)가 미치는 효과(效果)
나병조,이준우,이차로,박영민,최창민,선종주,정우상,문상관,박성욱,조기호,김태훈,Na, Byong-Jo,Rhee, Jun-Woo,Lee, Cha-Ro,Park, Young-Min,Choi, Chang-Min,Sun, Jong-Joo,Jung, Woo-Sang,Moon, Sang-Kwan,Park, Sung-Wook,Cho, Ki-Ho,Kim, Tae-Hun 대한한방내과학회 2005 大韓韓方內科學會誌 Vol.26 No.2
Objectives: Dysphagia is a common in stroke patients. Dysphagia often affects the rehabilitation of stroke patients by increasing the risk of nutritional deficits and aspiration pneumonia. Despite the proliferation of physical therapies including swallowing training, much controversy remains regarding the application and benefit of them. Therefore, in this study, the clinical effect of moxibustion at Chonjung(CV17, Shanzhong) on post-stroke dysphagia were assessed using Swallowing Provocation Test(SPT). Methods: Dysphagia subjects were selected by Dysphagia Screening Test. Swallowing function was tested by Swallowing Provocation Test(sec). Direct moxibustion was applied to the acupoint, Chonjung, five times and Swallowing Provocation Test was performed before and after 30 minute. The Latency Time of Swallowing Reflex (LTSR) was checked by SPT. To find factors related with improving swallowing function, Cold-Heat and Excess-Deficiency Diagnosis were considered. Results: A total of 42 patient were included, but two of them were excluded due to severe coughing. Overall, the swallowing reflex improved significantly. In subgroup analysis on brain lesion, non-brain stem lesion patients significantly improved. Moxibustion was more effective in the cold group than in the heat group, but there were no differences between the Excess and the Deficiency groups. Conclusions: The result of this clinical study suggest that moxibustion at Chonjung(CV17, Shanzhong) is an effective treatment for the dysphagia patients after stroke, especially in non-brain stem lesion and the cold diagnosed patients.
공복혈당수치와 운동유발전위의 상관관계에 대한 후향적 분석 : 중추운동신경과 말초운동신경의 비교
나병조,박성욱,정우상,문상관,박정미,고창남,조기호,김영석,배형섭,홍진우,Na, Byung-Jo,Park, Seong-Uk,Jung, Woo-Sang,Moon, Sang-Kwan,Park, Jung-Mi,Ko, Chang-Nam,Cho, Ki-Ho,Kim, Young-Suk,Bae, Hyung-Sup,Hong, Jin-Woo 대한한방내과학회 2007 大韓韓方內科學會誌 Vol.28 No.3
Objectives : Peripheral neurodegeneration occurs in diabetes mellitus (DM), both sensory and motor nerve. but we don't know exactly if DM affects central nerve pathway for all studies. Electrophysiologic study is one of the most important diagnostic tools for diabetic neuropathy. Electroneurography and electromyography are usually used. but evoked potentials (EP) is more sensitive to small nerve fiber damages and useful for central nerve evaluation in addition to peripheral nerves. Most diabetic neuropathy studies by EP have been performed with somatosensory evoked potentials (SSEP). In contrast, the objective of this study is to investigate if DM targets central motor neurons by assessing the relation between fasting blood sugar (FBS) and motor evoked potentials (MEP) latency. Methods : We inspected the medical records of 34 patients who had MEP tests during admitting days. The latency from cervical portion to abductor pollicis brevis was used as peripheral motor conduction time (PMCT). and the latency from vertex to cervical portion was used as central motor conduction time (CMCT). Then, they were correlated to FBS using correlation analysis. Results : There was a significant linear relation between FBS and PMCT (Pearson's correlation coefficient r=0.487, p<0.01), but a poor linear relation between FBS and CMCT (Pearson's correlation coefficient r=-0.l97. p>0.05). Conclusions : This study suggests that prolonged latencies of MEP in DM may be due to peripheral neuropathy rather than dysfunction of central motor pathway. therefore the clinical use of MEP to diabetic neuropathy has to be divided segmentally.
죽력(竹瀝)이 흰쥐의 중대뇌동맥(中大腦動脈) 및 전뇌허혈(全腦虛血) 폐쇄 허혈모델에 미치는 영향
김재홍,홍진우,나병조,박성욱,정우상,문상관,박정미,고창남,조기호,김영석,배형섭,Kim, Jae-Hong,Hong, Jin-Woo,Na, Byung-Jo,Park, Seong-Uk,Jung, Woo-Sang,Moon, Sang-Kwan,Park, Jung-Mi,Ko, Cham-Nam,Cho, Ki-Ho,Kim, Young-Suk,Bae, Hyung-Sup 대한한방내과학회 2008 大韓韓方內科學會誌 Vol.29 No.3
Objective : The purpose of this study was to investigate the neuroprotective effect of Jukryuk on 4-vessel occlusion(4-VO) and middle cerebral artery (MCA) ischemia. Method : After administration of Jukryuk, we compared the Jukryuk-treated group, the control, and the sham groups, in view of several points as follows 1) We evaluated the damage characterized by coagulative cell change of pyramidal neurons and pronounced gliosis in each group 2) We counted the number of normal pyramidal shapes after ischemia in each group 3) Immunohistochemistry (cyclooxygenase-2) 4) In focal ischemic injury model, we measured the volume of ischemic area Results : In this experiment, the effect of Jukryuk was determined to be protecting neuron cell shape, reducing the number of neuron cells damaged by ischemia and the volume of the ischemic area. In immunohistochemistry, Jukryuk reduced cyclooxygenase-2 expression Conclusions : According to this study, Jukryuk can protect neuron cells from injury by cerebrovascular ischemia.
대사증후군 환자군과 정상군의 뇌혈류 측정 비교를 통한 뇌졸중 위험인자에 대한 TCD의 진단적 가치 고찰
엄은진,박우람,김주성,이범준,나병조 대한한의진단학회 2010 大韓韓醫診斷學會誌 Vol.14 No.2
Objectives The purpose of this study was to evaluate diagnostic value of Transcranial Doppler Ultrasound about risk factor of stroke by comparing blood flow between patients with metabolic syndrome(MS group) and Normal group. Methods 62 metabolic syndrome patients and 106 healthy adults were selected who had no cerebrovascular diseases, cardiovascular diseases and other systemic diseases. We measured the mean velocity(Vm), peak systolic velocity(Vs) and pulsatility index(PI) of MCA, ACA, PCA, VA, ICA in two groups using TCD. All subjects were divided by gender and age. Results In comparing Ms group with normal group, Vm in the MCA, ACA, PCA, ICA and Vs in the MCA, ICA were lower in MS group. In all vessels, PI of MS group were higher than that of Normal group. In all vessels, Vm and Vs revealed negative correlation with age and PI revealed positive correlation with age. In 20-39 year olds, there was decrease in the Vs and Vm and increase of PI of MS group in comparison with normal group. There was significant difference in the Vm of PCA, ICA, Vs of MCA, PCA, ICA and PI of MCA, ACA. In 40-59 year olds, Vm in the MCA, ACA, ICA and Vs in the MCA, ACA were lower in MS group. PI in the MCA, ACA, PCA, ICA were higher in MS group. In 60-79 year olds, Vm of MCA, PCA, ICA was decreased in MS group than Normal group with no statistical signification. Vs in the MCA was lower and PI in the PCA was higher in MS group. In male, Vm of PCA and Vs of MCA were lower and PI of MCA, ACA, PCA, ICA were higher in MS group. In female, Vm of MCA, PCA, ICA and Vs of MCA, ICA were lower and PI of ACA, PCA, VA, ICA were higher in MS group. Conclusions The significant difference in Vm, Vs, PI between MS group and normal group suggests hemodynamic disorder. Screening and prognosing high risk group can be done through TCD and this can be used to prevent stroke. More detailed study will be needed.
Pulse Wave Velocity(PWV)와 혈청지질수치를 포함한 심혈관 질환 위험 요인들과의 상관관계 연구
정승환,엄은진,박우람,이범준,나병조,Jeong, Seung-Hwan,Um, Eun-Jin,Park, Woo-Rham,Lee, Beom-Jun,Na, Byung-Jo 대한한방내과학회 2009 大韓韓方內科學會誌 Vol.30 No.3
Objectives : There are lots of reports that cardiovascular disease, including hypertension, cerebro-vascular accident, and coronary heart disease, is related to atherosclerotic changes. Increased serum levels of lipids could play a role in these changes. This study aimed to investigate the relationship between PWV and risk factors of cardiovascular disease, including serum lipid values. Methods : This study included 261 subjects ($49.32{\pm}11.79$ years, 112 male) who underwent PWV and serum lipid evaluation. We investigated the correlation between serum lipid values, blood pressure, body mass index (EMI) and PWV. Pearson's correlation and partial correlation analysis were applied to examine the relationship between PWV and risk factors of cardiovascular disease. Results : Serum triglyceride, total cholesterol, systolic blood pressure, and diastolic blood pressure were significantly correlated with PWV. Partial correlation coefficient adjusted by age yielded significant correlation between serum triglyceride, systolic blood pressure, diastolic blood pressure and PWV. Conclusion : In this study, it seems that there are significant relationships between PWV, triglyceride and blood pressure. We could suggest that PWV might have some relationships with Dam-eum and blood stasis in oriental theory.
소풍보심도담탕(疎風補心導痰湯) 합(合) 생맥산(生脈散) 투여 후 임상증상 및 심전도 상 심방조동이 호전된 환자 1례
김동현,임인환,유경환,나병조,이범준,Kim, Dong-Hyun,Im, In-Hwan,Rheu, Kyoung-Hwan,Na, Byong-Jo,Lee, Beom-Jun 대한한방내과학회 2006 大韓韓方內科學會誌 Vol.27 No.3
Most of the atrial flutter occurs in patients who have an organic disease of the heart. The symptoms of atrial flutter include anxiety with palpitation. sleep disorder and fatigue. For a long time, oriental medicine has clinically treated these symptoms, and the diagnosis has been usually based on the doctor's judgment on the subjective clinical symptoms. However, if oriental medicine includes new diagnostic aids like electrocardiogram or other various methods or combinations of techniques, the accuracy and objectivity of diagnosis and clinical data can be improved. In this case, a 65 year-old male patient who had anxiety with palpitation and abnormal P wave (atrial flutter) on the EKG was treated with Xiaofengbusindaotantang (疎風補心導痰湯) and Shengmaisan (生脈散). Significant improvement in the clinical symptoms and EKG results was observed. This result suggests that oriental medical treatment can be used for treatment of organic heart disease like an atrial flutter. In addition, subsequent studies should be followed to ensure the appropriateness of new diagnostic aids, such as EKG, and other various modalities.
기능성 소화불량증에 대한 적외선 체열검사(DITI)의 임상 지표적 의의 연구
정승환,임인환,엄은진,이범준,나병조,Jeong, Seung-Hwan,Im, In-Hwan,Um, Eun-Jin,Lee, Beom-Jun,Na, Byong-Jo 대한한방체열의학회 2008 대한한방체열의학회지 Vol.6 No.1
Objective: To investigate the significance of temperature differences on two different acupuncture points between functional dyspepsia(FD) group and non-functional dyspepsia(non-FD) group respectively. Methods: We performed this research on 40 patients who came and took D.I.T.I in Kang-nam korean hospital kyung-hee university. We analyzed the averaged temperature of Zhongwon(CV12), Indang(HN1) and, also, investigated the significance of subtraction from Indang to Zhongwon temperature statistically. Results: The temperature differences from Indang to Zhongwon between functional dyspepsia group and non-functional dyspepsia group was significant, it meant that patients who have functional dyspepsia have more significant temperature difference from Indang(HN1) to Zhongwon(CV12). The direct comparisons of mean temperature between Indang and Zhongwon in the FD group and non-FD group were not significant. Conclusion: The study provide hypothesis on the temperature difference from Indang(HN1) to Zhongwon(CV12) and its association with functional dyspepsia. This study can provide a foundation for future studies on the evaluation of functional dyspepsia by using D.I.T.I.
우황청심원(牛黃淸心元)이 정상인의 혈압(血壓), 맥박수(脈搏數), 뇌혈류(腦血流) 및 뇌혈관반응도(腦血管反應度)에 미치는 영향(影響)
윤상필,이상호,김은주,나병조,정동원,신원준,문상관,배형섭,김이동,Yun, Sang-Pil,Lee, Sang-Ho,Kim, Eun-Ju,Na, Byong-Jo,Jung, Dong-Won,Shin, Won-Jun,Moon, Sang-Kwan,Bae, Hyung-Sup,Kim, Lee-Dong 대한한방내과학회 2004 大韓韓方內科學會誌 Vol.25 No.3
Objectives: Uwhangchungsim-won(UC) has been used in the treatment of a wide variety of conditions including stroke, hypertension, arterosclerosis, autonomic imbalance, and mental instability, in Korean traditional hospitals. The aim of this study was to evaluate the effect of DC on cerebral hemodynamics and to determine the appropriate dosage. Methods: We studied changes in hyperventilation-induced cerebrovascular reactivity and mean blood flow velocity of the middle cerebral arteries(MCAs) were studied by means of transcranial Doppler ultrasound. Changes in mean blood pressure, pulse rate and expiratory CO2(PECO2) were observed using Cardiocap TM/5. Six healthy young volunteers who were administrated with full doses of DC for group A, and half doses for group B. Six other healthy subjects comprised the control group. The evaluation was performed during basal condition, and repeated at 20, 40, 60, 120, and 180 minutes after administration. Results: Increases of cerebrovascular reactivity and mean blood flow velocity in the middle cerebral artery in group A were significantly different compared with group B and the control group (p<0.1). Mean blood pressure, pulse rate and expiratory CO2 did not change during the observation and were not different among these three groups. We observed that in cerebrovascular reactivity induced hyperventilation, group A was most effective at 40 minutes after administration, and its effectiveness lasted for 120 minutes. Conclusions: This study provides evidence for UC, in full doses, as an agent for dilation of the cerebral arteriols to increase hyperventilation-induced cerebrovascular reactivity as a consequence of faster recovery of blood flow velocity.