봉독약침이 류마티스 관절염 환자의 기능회복 및 삶의 질에 미치는 영향

이상훈,이현종,박상민,김수영,박재경,홍승재,양형인,이재동,최도영,김건식,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective: To evaluate the effects of bee venom acupuncture(BVA) on the rehabilitation and quality of life in rheumatoid arthritis(RA) patients Methods: Patients with RA were treated with the BVA therapy twice a week for 3 months. Tender joint counts, swollen joint counts, morning stiffness, Erythrocyte Sedimentation Rate(ESR), C-reactive protein(CRP), patient global assessment, physician global assessment, Korean health assessment questionnaire(KHAQ) were estimated and analyzed before and after BVA therapy. Results: Tender joint counts, swollen joint counts, morning stiffness showed significant decrease after BVA therapy. But, as acute inflammatory reactants, ESR showed no significant difference and CRP showed significant increase after BVA therapy. Patient global assessment physician global assessment, and KHAQ index showed significant improvement after BVA therapy. Conclusions: BVA therapy can improve rehabilitation and health-related quality of life RA patients as well as clinical symptom and signs. Further study is required in more population with large scale including acute inflammatory reaction of BVA therapy.

퇴행성 슬관절염 환자의 증상 중증도 측정을 위한 적외선 체열상의 유용성

이두익,김건식,김수영,최도영,이상훈,이재동,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 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 (LEI)), one generic instrument (Korean Health Assessment Questionnaire (KHAQ)), Visual Analogue Scale (VAS) pain intensities in order to assess the severity of disease, quality of life, and degree of pain and taken thermography in standardized environment before and after treatment, respectively. Results: The thermal differences between ipsilateral side and contralateral side in lateral aspect, medial aspect, patella region and suprapatella of both knees were correlated with pain lesion sites. Age, duration of disease, duration of morning stiffness, sex, and crepitus of knee were not correlated with the thermal differences of each regions. And also LFI, WOMAC, WOMAC pain subscale, WOMAC stiffness subscale, WOMAC physical function, KHAQ, were not correlated with the thermal differences of each region. But, the changes of VAS pain intensities were highly correlated with the thermal differences of each regions, especially in patelaa and suprapatella of knees after teratment. Conclusions: Although several specific evaluation indices for osteoarthritis of knee were not correlated with the degree of thermal differences between both knees, the differences of pain intensity (VAS) were quit correlated with thermal differences after treatment. And infrared thermography might be a very useful devices fot the evaluation of OA of knee and its treatment. Further study on the thermography on OA of the knee in more size of patients with appropriate severity grade and the standardization of analysis of thermographic data were recommended.

편두통 환자의 임상 양상 및 생체전기 자율반응과의 상관성 고찰

이현종,정인태,김수영,이두익,김건식,이재동,이윤호,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2004 東西醫學硏究所 論文集 Vol.2004 No.-

Objective : We had a clinical report in headache but didn't in migraine. We have planned this study in order to get the basic data of migraine in oriental medicine. Methods : The patient of 36 in migraine checked sec, age, onset, family history, severity of pain, influences of life, induced cause, clinical pain characteristics, associated symptom, treatment style, and paescription, frequency, using period of analgesics by a questionnaire and differentiated syndromes in migraine and evaluated autonomic bioelectric response recorder(ABR-2000). Results : There are 23.4% in prevalence rate of migraine. The ratio of sex is M: F=1:17. The age of an attack is the highest in thirties. The patient are the most in forties. The mean duration of illness is 12.0±9.9 years. 83.4% had a family history. 61.1% had a moderate grade in severity of pain. 77.8% selected fatigue in induced cause of migraine. 69.4% had tingling sense, nausea and vomiting in the associated symptoms. 91.7% used analgesics for treatment and 51.5% of them used analgesics voluntarily. 61.9% of them take analgesics less than once in a week. 33.6% had the phlegm syncope headache in differentiation of syndrome. In ABR-2000 results, item of graph showed low tendency mostly. Conclusions : We expected that this re port of clinical progress, differentiation of syndromes and ABR-2000 results in migraine would be used basic data by oriental medicine to treat migraine.

뇌졸중 후 중추성 통증 환자에 대한 동서협진이 진통과 재활에 미치는 영향

이현종,김수영,이상훈,서동민,이두익,김건식,이재동,이윤호,양형인,박재경,최도영 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Purpose : In order to study the effectiveness of East-West pain treatment on central poststroke pain(CPSP), we evaluated its effect on alleviation of pain and rehabilitation of CPSP Patients who were treated with electroacupuncture and west pain treatment for four weeks. Methods : Twenty four patients diagnosed by their pain characteristics of central pain from stroke were treated with sympathetic nerve block, gabapentin, amitriptyline, and electroacupuncture for four weeks. Pain intensity through the visual analogue scale(VAS), and improvements of mobility and rehabilitation through the modified Barthel index(MBI) and Rankin scale(RS), respectively, before and after pain treatment were also assessed. Results : VAS pain scores were significantly improved from 7.7±1.7 to 4.4±2.0 with pain treatment(p<0.05). In accordance with improvement of pain scores, RS and MBI scores were also improved from 2.88±0.95 to 2.13± 1.01 and from 83.0± 16.9 to 94.7±9.5(p<0.05), respectively, with pain treatment(p<0.05). Conclusions : It was suggested that the active pain treatment was contributed to the rehabilitation of CPSP patients, resulting in improvement of quality of life of CPSP patients. Futhermore, East pain treatment in combination with West pain treatment may be useful modality to alleviate CPSP.

무작위 대조 이중맹검 시험을 통한 봉독 약침의 류마티스 관절염 치료 효과 연구

이상훈,홍승재,김수영,양형인,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective : This study was performed in order to evaluate the effect of bee venom therapy on rheumatoid arthritis by randomized controlled double blind method. Method : RA patients were recruited and divided into an experiment group and a control group by random selection. As a double blind test, the experiment group was treated with bee venom injection on acupoints, and the control group was treated with normal saline injection on acupoints twice a week for 8 weeks. Tender joint count, swollen joint count, morning stiffness, pain, health assessment questionnaire, ESR. and CRP were estimated and analyzed at baseline, and at 1 month and 2 months after bee venom therapy Results : Compared to the control group, the experiment group showed significant decrease in tender joint count swollen joint count, morning stiffness, and health assessment questionnaire after 2 months. Pain, ESR and CRP showed significant decrease in the experiment group after 1 & 2 months. Conclusions : These results suggests that bee venom therapy could be an effective method in the treatment of patients with rheumatoid arthritis.

정신분열병에 대한 리스페리돈의 효과 및 안정성

이민수,김용구,김영훈,연병길,오병훈,윤도준,윤진상,이철,정희연,강병조,김광수,김동언,김명정,김상훈,김희철,나철,노승호,민경준,박기창,박두병,백기청,백인호,손봉기,손진욱,양병환,양창국,우행원,이정호,이종범,이홍식,임기영,전태연,정영조,정영철,정인과,정인원,지익성,채정호,한상익,한선호,한진희,서광윤 大韓神經精神醫學會 1998 신경정신의학 Vol.37 No.1

연구목적 : 본 시험의 목적은 임상시험 시작전에 연구자들을 대상으로 PANSS Workshop을 통하여 PANSS, ESRS에 대한 국내에서의 표준화 작업을 구축하고 새로운 정신병 치료제인 리스페리돈의 효과와 안정성을 재확인하여 리스페리돈 사용에 대한 적정화를 이루는데 있다. 연구방법 : 1996년 4월부터 1996년 9월까지 국내 39개 대학병원 정신과에 입원중인 혹은 증상이 악화되어 입원하는 정신분열병 환자 377명을 대상으로 다시설 개방 연구를 시행하였다. 1주일간의 약물 배설기간을 가진후, 리스페리돈을 8주간 투여하였고, 기준점, 1주, 2주, 4주, 그리고 8주후에 평가되었다. 용량은 제1일에는 리스페리돈 1mg씩 1일 2회, 제2일에는 2mg씩 1일 2회, 제3∼7일에는 3mg씩 1일 2회 투여하였다. 이후 환자의 임상상태에 따라 임의로 증량할 수 있으며, 최대 일일 16mg을 초과하지 않도록 하였다. 추체외로 증상을 조절하기 위한 투약을 허용하였다. 임상증상 및 부작용의 평가는 PANSS(Positive and Negative Syndrome Scale), CGI(Clinical Global Impression) 그리고 ESRS(Extrapyramidal Symptom Rating Scale)을 사용하였다. 연구결과 : 377명중 343명(91%)이 8주간의 연구를 완결하였다. 치료 종결시점인 8주후 PANSS 총점수가 20% 이상 호전된 경우를 약물 반응군으로 정의할때, 약물반응군은 81.3%였다. 리스페리돈에 반응하는 예측인자로는 발병연령, 이전의 입원 횟수, 유병기간이 관련 있었다. 리스페리돈은 1주후부터 PANSS양성, 음성, 및 일반정신병리 점수상에 유의한 호전을 보여 효과가 빨랐다. CGI의 경우도 기준점에 비해 1주후부터 유의한 감소를 나타내었다. ESRS의 경우, 파킨슨 평가점수는 기준점과 비교해 투여 1주, 2주, 4주후 유의하게 증가되었다가 8주후 기준점과 차이가 없었다. Dystonia 평가점수는 1주후만 유의한 증가를 보였으며, dyskinesia 평가점수는 유의한 차이가 없었다. 혈압, 맥박수의 생명징후 및 일반 혈액학 검사, 생화학적 검사, 심전도 검사에서 유의한 변화는 없었다. 결 론 : 이상의 다시설 개방 임상 연구를 통해 리스페리돈은 정신분열병 환자에서 양성증상뿐만 아니라 음성증상 및 전반적인 증상에도 효과적인 것으로 사료된다. 보다 명확한 평가를 위해서는 다른 항정신병약물과의 이중맹검 연구가 필요할 것으로 생각되며, 또한 장기적 치료에 대한 평가도 함께 이루어져야 하겠다. Objective : The purpose of this study was to investigate the efficacy and safety of risperidone in the treatment of Korean schizophrenic patients. Method : This multicenter open study included 377 schizophrenic patients drawn from 39 university hospitals. After a wash-out period of 1 week, the schizophrenic patients were treated with risperidone for 8 weeks and evaluated at 5 points ; at baseline, and 1, 2, 4 and 8 weeks of treatment. The dose was increased from 2mg/day(1mg twice daily) to 6mg/day(3mg twice daily) during the first week and adjusted to a maximum of 16mg/day over the next 7 weeks according to the patient's clinical response. Medication to control extrapyramidal symptoms was permitted. The psychiatric and neurological status of the patients was assessed by PANSS, CGI, and ESRS scales. Results : 343(91%) of 377 patients completed the 8-week trial period. Clinical improvement, as defined by a 20% or more reduction in total PANSS score at end point, was shown by 81.3% of patients. The predictors of response to risperidone were associated older age, shorter duration of illness, fewer previous hospitalization. Risperidone had rapid onset of action ; a significant decrease of the total PANSS and three PANSS factor(positive, negative, general), and CGI was already noticed at the end of first week. For the ESRS, parkinsonism rating scores were significantly increased until week 4 comparing with baseline. Dystonia rating scores were significantly increased until week 1, and dyskinesia rating scores were not significantly changed during the study. Laboratory parameters including vital sign, EKG, hematological, and biochemical values showed no significant changes during the trial. Conclusions : This study suggests that risperidone is generally safe and effective against both the positive and negative symptoms in our group of patients.

봉독약침이 류마티스 관절염 환자의 관절 통증, 종창 및 급성 염증 반응에 미치는 영향

이상훈,이현종,백용현,김수영,박재경,홍승재,양형인,김건식,이재동,최도영,이두익,이윤호 WHO COLLABORATING CENTRE FOR TRADITIONAL MEDICINE 2003 東西醫學硏究所 論文集 Vol.2003 No.-

Objective In order to study the effects of bee venom(BV) on the pain, edema, and acute inflammatory reactant of rheumatoid arthritis(RA) patients. Methods Patients with RA who met the ACR(American College of Rheumatology) 1987 revised criteria for the diagnosis of RA were treated with the BV therapy twice a week for 3 months. Tender Joint counts, swollen joint counts, Visual analog scale(VAS), morning stiffness, ESR. C-reactive protein(CRP) were analyzed before and after BV therapy. Results The results as follows. 1. Tender joint counts in patients after BV therapy were significantly lower than those before BV therapy(9.0±7.9 vs 15± 11.4, p=0.002). 2. Swollen joint counts of the patients after BV therapy were significantly lower than those before BV therapy(50±61 vs 15±23, p=0.001). 3. VAS in patients after BV therapy was significantly lower than those before BV therapy(608± 17.6 vs 380± 159, p=0.000). 4. Duration of morning stiffness in patients after BV therapy was significantly reduced compared with that before BV therapy(119.1± 112.6 min vs 59.0±89.7 min, p=0.009). 5. ESR and CRP were not significantly changed before and after BV therapy, suggesting BV itself could make inflammatory reaction as well as therapeutic effect. Conclusions BV therapy improved tender joint counts, swollen joint counts and duration of morning stiffness in this study, and further study is needed on long-term effect of BV therapy.

유착성 관절낭염 치료에 있어서 한방 치료와 양방 치료의 임상적 고찰 : 동서협진 모델 개발을 위한 기초 연구를 중심으로

남동우,정인태,김주희,박유선,임사비나,이두익,이재동,이윤호,최도영 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To observe the effect of acupuncture treatment and western medical treatment on frozen shoulder patients. Methods : 39 voluntary patients were randomly assigned to the Eastern treatment group(E group, n=22) and the Western treatment group(W group, n=17). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. Both groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment using Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 5.67 on a scale of 10. The W group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 7.73. But the difference between the two groups were insignificant according to CSA and SPADI. Conclusion : Both acupuncture and nerve block treatment significantly improved frozen shoulder. But the difference of the two treatments was insignificant.

동결견(凍結肩) 환자의 동서협진 치료의 임상효과 비교연구 : 견관절 가동운동범위(ROM) 변화를 중심으로

남동우,김행범,양동훈,임사비나,김건식,이두익,이재동,최도영,이윤호 경희대학교 동서의학연구소 2006 東西醫學硏究所 論文集 Vol.2006 No.-

Objectives : To establish an effective collaborate medicine treatment of acupuncture and western medicine for treating frozen shoulder patients. Methods : 59 voluntary patients were randomly assigned to Eastern treatment group(E group, n=22), Western treatment group(W group, n=17) and East-West treatment group(EW group, n=20). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. The EW group received acupuncture and injection treatment including nerve block. All groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment based on the change in shoulder Range of Motion(ROM) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The patient's satisfaction scores were E group 5.67, W group 7.73 and EW group 7.67. The E group and the EW group showed significant improvement in abbduction, adduction and flexion(p<0.05). The W group showed significant improvement in adduction(p<0.05). Abduction significantly improved(p<0.05) in the EW group compared to E group and W group. Flexion also showed improvement in the EW group, but the difference among the 3 groups was statistically insignificant. The three group's difference of change in extension and adduction was insignificant(p>0.05). Conclusion : Acupuncture and nerve block alone significantly improved ROM in frozen shoulder patients. Also collaborate treatment of acupuncture and nerve block significantly improved ROM in frozen shoulder patients. But the difference of the three treatments were significant only for improving abduction(p<0.05).

新聞에 揭載된 韓國人 自殺記事 內容 分析

박동철,이영식,박두병,곽동일,이길홍 중앙대학교 의과대학 의과학연구소 1991 中央醫大誌 Vol.16 No.4

To analyze the suicide patterns of Koreans, a research study was conducted from the suicide cases taken from the Dong-A Newspaper from 1981 to 1990. Four hundred and eleven cases were obtained from the collected data, which were composed of 275 cases of males and 136 cases of fe-males. The age groups were classified into 6 groups for convenience, 10's, 20's, 30's, 40's, 50's, and 60's. The group differences were then compared for analysis. The characteristics in relation to the socio-demographics and family environment were conpared for analysis. Suicide types compared and analyzed by gender and age group in terms of frequency, type, time, place, method, motivation, location and size of articles, and risk factors for suicide. Sta-tistical analysis used SPSS/PC^+ for cross-tabulation analysis. 1. In relation to the rate of Koreans' suicide, male suicide rate was at least double that of fe-male(2.02 : 1). The age group of the 20's(118 cases) and 30's(96 cases) accounted for a pre-dominant rate of 52.6% of the sample. 2. The distribution of occupation of suicides showed that most were students(22.5%), followed by the unemployed(17.8%) and housewives(12.7%), retrospectively. In relation to the residency of those that had committed suicide, residents who lived in large cities accounted for the greatest number as 70.3%, Especially, females and cases in their 40's were more likely to live in large cities. In the marital status, singles were in the lead(144 cases, 33.0%). With respect to marital status by age group, cases in their 40's(17.4%) tended to have an unstable status such as divorce, separation, co-habitation, remarriage, or widowed, In birth order, the first child were the highest ones as 22.1%. 3. In relationship to the family structure, data revealed that nuclear families were the most(163 cases). Especially, males and cases in their 40's were likely to be form a nuclear familiy, while those in their 60's were from and extended family. In relation to parental survival, data showed that both parents dead were at the highest frequency as 264 cases. In case of female, loss of both parents were more frequent. 4. With respect to the frequency of recurrent suicide, data presented that 6.3% of the cases ex-perienced recurrent suicide. In case of the recurrent suicide of male(8.0%), the rate was about 2.3 times higher than of female(2.9%) 5. For the relationships of homicide and suicide, data showed that 128cases(31.2%) hurt others and attempted suicide. Among them, 96 cases(23.4%) attempted co-suicide and 32 cases(7.8%) attempted homicide others. Analyzed by the characteristics of gender and age group, 10's males were more likely to commit solo-suicide, women in their 30's or 40's commit co-suicide, and 50's commit suicide after homicide. Among the victims of homicide, family members were the most(42 cases). Analysis by age difference between the suicide partners, the cases of 30's or 40's were with family members, 20's with lovers, and 10's with their peers. 6. In relation to the annual distribution of frequency of suicide, data revealed that most cases of suicide were reported in 1990(95 cases), 70 case in 1981, 45 cases in 1982, 44 in 1983, 30 in 1986, 1987, 1989, each, the fewest cases were in 1985(14 cases). In terms of the trend of sui-cide, recently the rate of male and old cohorts over 50's has been increasing. A great number of suicide were in 1981∼1982 and 1989∼1990, the period of a treat political-economical up-heaval. On the other hand, the number of suicide was low during the period of political-economical stability of 1985 and of political thawing in 1988. These fact demonstrated that there were some relationships between political-economical change and the rate of suicide. 7. For the month of suicide, data showed that the highest frequency of cases were in May and June(21.7%), followed by 44(10.7%) in September. For the season of suicide, the fewest cases were in winter(78 cases). The cases of 10's or 20's were more likely to suicide in May and June, and those of older aged group above 50's in fall, weekend, between 1 : 00∼6 : 00 A.M. 8. With respect to the place of suicide, data presented that in most cases suicide was attempted at home(210 cases). Compared by gender, the rate of femal's suicide at home(71.3%) was remarkably higher than that of male's(41.4%). On the other hand, the rate of male's suicide in indoors was much higher(36.4%) than that of female's(15.4%). Analyzed by age groups over 50's were more likely to attempt suicide at home, 30's in indoors, 20's in the office or outdoors. 9. For the methods of suicide, 31.9% resort to intoxication followed hanging(21.9%), jumping(13.1%), burning(10.2%), CO poisoning(6.1%), gunshot(3.9%) or drowning(2.9%), Compared by gender, while females were more likely to take such passive methods as intoxication or CO poisoning, males were more likely to take rather fatal methods such as hanging, burning, gunshot. 10. In relation to the general motives of suicide, data showed that economic poverty was the lead(20.9%), followed by emotional conflict(19.2%), marital conflict(16.1%), demonstration(8.5%), health problem (6.3%), school problems(5.8%), and job problems(5.6%). Analyzed by age group, in case of 10's adolescent conflicts such as school problems, scolding of parents of teachers, mockery, and frustration were the major motivations of their suicide, in the cases of 20's hetero-sexual problems, job and demonstration were their motivators. In case of 30's marital and legal problems were the motivators, economic problems in the age of 40's, loss of objects in 50's and health problems in 60's were their major motivations of suicide. 11. Analyzed by subtypes of suicide in the socio-psychological perspective, data showed that fatalistic suicide was the most frequent(30.2%), followed by anomic suicide(29.4%), egoistic suicide(21.7%), altruistic suicide(11.2%). Whereas in case of males altruistic and egoistic suicide were relatively more frequent, in case of females fatalistic and egoistic suicide were relatively more frequent. Analyzed by age group, fatalistic suicide in the 60's, anomic suicide in the 40's, egoistic suicide in the 10's adolescents and altruistic suicide in the 20's were more frequent. 12. For the psychodynamic factors of suicide, data revealed that most cases were escape from despair and loneliness(28.5%), followed by revenge toward the objects that hurt him or her(14.8%), inferiority(12.7%), escape from a conflict situation(11.4%), altruistic(7.8%), self-punishment for guilt(6.8%), pessimism(3.9%), reunion fantasy(1.0%), and other(13.1%). Whereas the psychodynamic factors of males were altruistic and inferiority, those of females were despair and revenge. Analyzed by age group, incase of old age groups over 50's despair and loneliness were the major fcators, revenge in the 30's and 40's, altruistic in the 20's inferiority and escape from a conflict situation in the 10's were more frequent psychodynamic factors. 13. With respect to the suicide risk rescue factors, data showed that as the helpers at the time of trying suicide, family members were the most(111 cases). Family members as helpers were more frequent in the case of females and in those of 10's or 60's. While passerbys were more frequent in the case of males and in those of 50's. For the suicide notes, 17.3% left the notes behind and those in their 60's males were more likely to have a relatively higher rate of leaving motes behind. 14. In relation to the experience rate of the suicide risk factors, data demonstrated that 16.8% had a history of depression which comprised the highest rate, followed by an alcoholism history(10.0%), unemployment and retirement(7.1%), recent death of intimates and separation(4.6%), health change(3.2%). Analyzed by gender and age groups, males were more likely to have an alcoholism or depression history, those in their 40's were more likely to have an alcoholism history than those of any other age group cohorts.