한방병원에 내원한 교통사고 외래환자에 있어서 사고규모와 치료기간 및 치료비용 간의 상관관계에 대한 연구

박지용 ( Ji Yong Park ),홍남중 ( Nam Jung Hong ),이민정 ( Min Jung Lee ),안지훈 ( Ji Hoon Ahn ),신유빈 ( You Bin Shin ),김병정 ( Byung Jung Kim ),신민근 ( Min Geun Shin ),하인혁 ( In Hyuk Ha ),이진호 ( Jin Ho Lee ) 한방재활의학과학회 2014 한방재활의학과학회지 Vol.24 No.1

ObjectivesThe purpose of this study is to investigate the corelation between traffic acci-dent severity and treatment period and cost by traffic accident.MethodsOutpatients who visited Jaseng Korean medicine hospital traffic accident clinic were investigated by hospital computer system about period and cost of treatment. And we requested for repair cost of car, a sort of car groups and agreement date with car in-surance company to insurance company. Therefore we could analysis statistical correlation of traffic accident severity (repair cost of car) with period of treatment, cost of treatment, number of treatment in same sort of car groups. For statistics, we used SPSS version 18.0 for windows.ResultsA significant positive correlation was found between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment in semi-midsize car, midsize car group. But, any significant correlation wasn`t found between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment in small car, full-sized car group. In SUV (sport utility vehicle) car group some significant correlation was found, but it isn`t between traffic accident severity (repair cost of car) with repair cost of car, cost of treatment and number of treatment.ConclusionsIt was found that traffic accident severity (repair cost of car) had an effect on cost of car, cost of treatment and number of treatment by statistical analysis. But, it was also suggested strongly that other factors like a cost of car and ages had an effect on them. (J Korean Med Rehab 2014;24(1):65-76)

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.

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.

염수초 포제법에 따른 두충의 항산화 및 항염증 활성 변화 비교연구

고원일 ( Wonil Koh ),이진호 ( Jinho Lee ),하인혁 ( In-hyuk Ha ),정화진 ( Hwa-jin Chung ),이인희 ( In-hee Lee ),이재웅 ( Jae-woong Lee ),김은지 ( Eun Jee Kim ),강병구 ( Byeong-gu Gang ),전세환 ( Se Hwan Jeon ),조용규 ( Yongkyu Cho 대한한의학회 한방재활의학과학회 2017 한방재활의학과학회지 Vol.27 No.2

Objectives The present study aimed to investigate the change in marker compounds, anti-oxidative and anti-inflammatory effects of salt-water processed Cortex Eucommiae. Methods To evaluate the influence of processing on anti-oxidant effect of Cortex Eucommiae, changes in total phenol, total flavonoid, 2,2-diphenyl-1-picrylhydrazyl (DPPH) free radical scavenging, 2,2`-azino-bis(3-ethylbenzothiazoline-6-sulphonic acid) (ABTS) free radical scavenging, and ferric reducing antioxidant power (FRAP) between processed and raw Cortex Eucommiae were assessed. In addition, nitrite assay was conducted to determine the influence of processing on anti-inflammatory effect of Cortex Eucommiae. Cell viability was also examined as to elucidate whether processing affects cytotoxicity of Cortex Eucommiae. Finally, high-performance liquid chromatography (HPLC) analysis was conducted to monitor changes in pinoresinol diglucoside amount of processed and raw Cortex Eucommiae. Results Salt-water processed Cortex Eucommiae showed higher total phenol and flavonoid amount, compared to raw Cortex Eucommiae. Furthermore, anti-oxidative activity of processed Cortex Eucommiae was improved as discovered in DPPH, ABTS, and FRAP assays. Anti-inflammatory effect of Cortex Eucommiae was also enhanced following salt-water processing, as evidenced in nitrite assay. HPLC analysis found that the amount of pinoresinol diglucoside, widely known as the marker compound of Cortex Eucommiae, increases through salt-water processing. All experiments were performed with non-toxic concentration of Cortex Eucommiae; processing did not affect the cytotoxicity of Cortex Eucommiae up to the currently adopted concentration. Conclusions The present results support that salt-water processing of Cortex Eucommiae is beneficial in terms of marker compound amount, anti-oxidative, and anti-inflammatory activities. Additional investigations are needed to standardize the processing method of Cortex Eucommiae. (J Korean Med Rehabil 2017;27(2):29-38)

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)

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)

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.

요추 추간판탈출증 환자의 발병시기에 따른 보존적 치료 결과 비교 연구

윤유석 ( You Suk Youn ),이종수 ( Jong Soo Lee ),하인혁 ( In Hyuk Ha ),김주원 ( Joo Won Kim ),권혁준 ( Hyeok Joon Kwon ) 한방재활의학과학회 2008 한방재활의학과학회지 Vol.18 No.4

Objectives : To investigate therapeutic outcomes of back pain modalities in patients with disc herniation according to the duration by treated with herbal medicine, chuna, acupuncture, bee-venom acupuncture. Methods : We separated 36 patients with disc herniation into three group according to duration; acute patients within 4 week, subacute patients within 5-12 week, and chronic group within 13-24 week. 36 patients with lumbar disc herniation were treated with chuna therapy, acupuncture, bee-venom acupuncture one times a week and took herbal medicine after a meal two times daily. The patients` symptoms were assessed 1 week, 2 week, 4 week, 8 week by Visual analogue scale(VAS), Oswestry disability index(ODI), 36-Item short-form health survey(SF-36). Results : 1. ODI of disability of daily activities showed significantly decreased in acute stage group compared to subacute and chronic stage groups(P<0.05). 2. Physical functioning(PF), bodily pain(BP), social functioning(SF) score of SF-36 showed significantly increased in acute stage group compared to subacute and chronic stage groups(P<0.05). Conclusions : This study suggests that acute stage group compared to subacute and chronic stage groups in patients with lumbar disc herniation is the more effective to improve symptoms treated with herbal medicine, chuna therapy, acupuncture, bee-venom acupuncture.

교통사고상해증후군 한의표준임상진료지침 개발을 위한 환자의 의료이용 경험과 의료체계 인식도 설문조사 연구

박선영 ( Sun-young Park ),이상현 ( Sang-hyun Lee ),허인 ( In Heo ),황만석 ( Man-suk Hwang ),김고운 ( Koh-woon Kim ),조재흥 ( Jae-heung Cho ),박경선 ( Kyoung Sun Park ),하인혁 ( In Hyuk Ha ),신병철 ( Byung-cheul Shin ) 한방재활의학과학회 2020 한방재활의학과학회지 Vol.30 No.2

Objectives To explore the traffic injury patients’ experience on health care utilization of Korean Medicine (KM) practice and perception of health care system for developing a Korean medicine clinical practice guideline (CPG) of traffic injuries by survey method. Methods Two hundred ten patients in suffering from traffic injuries were surveyed from September 1st, 2019 to January 31th, 2020 at 2 University Hospitals (Pusan National Korean Medicine Hospital and Kyung Hee Korean Medicine Hospital at Gangdong) and 1 Spine Specialty Hospital (Jaseng Hospital of Korean Medicine). A structured questionnaire of experience on health care utilization of KM practice and perception of health care system of was distributed to responders by visits and all data were statistically analysed. Results Survey results showed high satisfaction of patients with the experience of KM treatments in order of daoyin exercise (7.8±2.3), chuna manual therapy (7.7±4.0), pharmacoacupuncture (7.4±3.0) etc. Safety concerns were reported in 9.1% subjects and 205 (97.6%) patients answered that collaboration with KM and western medicine is necessary for patients with traffic injuries. For the patients’ requirement for extending insurance coverage, the most required therapy was chuna manual therapy (57.5%) and pharmacoacupuncture (42.0%). Conclusions This study presented the realistic patient-centered perception of KM practice and health care system in Korea. These results will provide basic data to be reflected in the process of adaptation for the revision of Korean Medicine CPG for traffic injuries. (J Korean Med Rehabil 2020;30(2):139-152)

두충의 건조법별 지표성분 및 항염증 활성 비교

도호정 ( Ho-jeong Do ),이진호 ( Jin-ho Lee ),하인혁 ( In-hyuk Ha ),정화진 ( Hwa-jin Chung ),이재웅 ( Jae-woong Lee ),김민정 ( Min-jeong Kim ),김은지 ( Eun-jee Kim ),이인희 ( In-hee Lee ) 대한한의학회 한방재활의학과학회 2017 한방재활의학과학회지 Vol.27 No.1

Objectives Eucommiae cortex is one of the frequently used herbs for musculoskeletal disorders, with well-known anti-inflammatory effect. Meanwhile, powdered form of herbal drugs is more advantageous than decoction form, in that storing and taking is more convenient. Thus, the authors aimed to investigate whether the drying method affects the index compound level and anti-inflammatory effect of eucommiae cortex water extract. Methods Eucommiae cortex was extracted in distilled water at 100℃ for 3 hours, filtered, and then evaporated under vacuum. One half of the sample was freeze-dried at -80℃. Another half of the sample was added with dextrin and then spray-dried at 180℃. To assess the possible change in index compound content, pinoresinol diglucoside was selected as the index marker. The content level of the index compound in various extract sample was quantified through high performance liquid chromatography. In addition, iNOS assay in LPS-induced RAW 264.7 cells was adopted to determine the anti-inflammatory effect of various extract samples. Furthermore, MTT assay was performed to confirm that the result of iNOS assay was not due to cytotoxicity. Results There was no significance difference in index compound content between extract samples obtained through two different drying methods. Anti-inflammatory activity of extract samples were similar at the matching concentration, regardless of the drying methods. Extract samples did not show any significant cytotoxicity. Conclusions Extract samples of eucommiae cortex were obtained through freeze-drying and spray-drying. Neither change in index compound content nor difference in anti-inflammatory activity was observed between drying methods. (J Korean Med Rehabil 2017;27(1):19-25)