파킨슨병 침치료 임상진료지침 개발을 위한 기초 연구 = Preliminary study for the development of medical guideline for parkinson's disease acupuncture treatment

다국어 초록 (Multilingual Abstract)

Background: Parkinson's disease is characterized by resting tremor, rigidity, bradykinesia and postural instability. It is the most common neurodegenerative disorder after Alzheimer's disease and is being newly recognized with the increase in elderly population and an increased interest in health. Symptomatic medication and operative methods have been unable to provide a complete recovery and complications arise with the progression of the disease. Over the years oriental medicine has treated and delayed the clinical progression of symptoms similar to Parkinson's disease. Recent studies have shown the potential of acupuncture treatment but the need for a medical guideline for Parkinson's disease acupuncture treatment is ever present.
Objective and Methods: This study is a preliminary study to develop a medical guideline for Parkinson's disease acupuncture treatment. Using evidence based development methods, a general literature review was done to arrange and understand knowledge on Parkinson's disease and a systematic review was done to search, evaluate and integrate 11 rct, 7 clinical trials, 7 case reports and 13 animal experiments from articles on Parkinson's disease acupuncture treatment released domestically and overseas. The following conclusions regarding the treatment regimen according to the degree of progression of Parkinson's disease, acupuncture treatment frequency, acupuncture treatment period, evaluation period and method, acupuncture stimulation method, acupoints were reached.
Conclusions: Treatment regimen according to the degree of progression of Parkinson's disease - If the patient is not experiencing difficulty living everyday life and has no problems maintaining a job, symptomatic medical treatment should be discontinued where possible and acupuncture treatment along with neuroprotective medication should be administered. If the patient has difficulty living everyday life or maintaining a job then symptomatic medical treatment together with acupuncture treatment was suggested. Acupuncture treatment frequency - Twice a week as an outpatient, seven times a week if hospitalized was suggested. Acupuncture treatment period - Since continuous management is required the improvement should be evaluated every 4 weeks and if there is improvement in the patients subjective symptoms, H-Y stage(Hoehn & Yahr Stage), ADL scale(Schwab and England activity of daily living) then acupuncture is considered to be significant and should be continued. Acupuncture stimulation method - Manual acupuncture and electroacupuncture can be administered together. Treatment acupoints - In addition to general standard acupoints GV20, LI4, LI11, LR3, ST36, GB34, acupoints can be selected according to symptom differentiation, and or sasang constitution. Additional acupoints can be supplemented according to chief motor symptoms, non-motor Parkinsonian symptoms, and complications from antiparkinsonian agents. With the conclusions stated above, a draft for the development of medical guideline for Parkinson's disease acupuncture treatment has been written up and suggested. Using this study as a foundation, if a medical guideline for parkinson's disease acupuncture treatment is developed by expert agreement, it will contribute greatly to Parkinson's disease treatment in a clinical setting and is expected to improve the quality of life of patients with Parkinson's disease. Additional studies should be continued to accumulate quality evidence.

Key Words : Parkinson's disease, Acupuncture, Medical guideline

목차 (Table of Contents)

• Ⅰ. 緖論 1
• Ⅱ. 파킨슨병에 대한 일반적 文獻考察 4
• 1. 파킨슨병의 특성 4
• 2. 역학 4
• 3. 분류 및 진단기준 5
• 4. 임상 평가 도구 6
• 5. 치료 7
• 6. 파킨슨병의 한의학적 고찰 15
• Ⅲ. 파킨슨병 침치료 논문의 체계적 고찰 方法 18
• 1. 국외 문헌 검색과 선정 과정 19
• 2. 국내 문헌 검색과 선정 과정 20
• Ⅳ. 結果 22
• 1. 논문의 종류 22
• 2. 파킨슨병 침치료 논문의 체계적 고찰 정리
• (파킨슨병 환자 대상) 22
• 3. 파킨슨병 침치료 논문의 체계적 고찰 정리
• (동물 모델 대상) 32
• 4. 파킨슨병 침치료 가이드라인(안) 36
• 5. 파킨슨병 침치료 혈위 알고리듬(안) 39
• Ⅴ. 考察 40
• Ⅵ. 結論 46
• 參考文獻 47
• ABSTRACT 55