한국에서 비만치료에 쓰이는 한약에 대한 문헌 연구 -2000년 이후 발표된 논문을 중심으로

황미자 ( Mi Ja Hwang ),신현대 ( Hyun Sae Shin ),송미연 ( Mi Yeon Song ) 한방재활의학과학회 2006 한방재활의학과학회지 Vol.16 No.3

목적: 비만은 단지 용모 손상뿐만 아니라 당뇨나 고혈압과 같은 질환을 유발하고 지속시키는 만성적인 질환으로 인식되고 있다. 비만을 치료하기 위한 한약의 사용이 증가되고 있다. 2000년 이후에 나온 국내 한방 논문 및 pubmed 논문에 실린 비만 치료 한약을 분석함으로써 한국에서 비만에 주로 연구되는 한약에 대해 알고자 하였다. 방법: KSI 한국 학술정보 및 MEDLINE을 ‘비만`, ‘체중조절`, ‘체중감량`, ‘한약`으로 검색하고, 한방재활의학과학회지, 대한 한방비만학회지에 게재된 논문 중 비만에 한약을 사용한 논문을 대상으로 하여 빈도를 계산한 후, 처방에 포함된 한약을 참고하여 실제 한약물의 빈도를 계산하였다. 결과: 분석 대상 논문 총 72편, 이 중 한국어 논문 50편, pubmed 논문 22편 중 미국 14편 한국 3편 일본 5편이었다. 한국에서 가장 빈용되는 한약은 사상처방(太陰調胃湯 8회, 調胃升淸湯 5회) 및 體感薏苡仁湯(11회)이었으며, 방제구성을 고려할 때 빈용 약물은 薏苡仁, 當歸, 甘草, 蘿.子, 川芎, 麻黃, 桔梗, 熟地黃, 枸杞子, 黃. 순으로 나타났다. 단미로는 麻黃이 빈도가 제일 높았다. 미국에서는 주로 단미로 연구가 이뤄지고 있었으며, 麻黃이 제일 많고 人蔘, 枳實, 生薑 등이 연구되고 있었다. 결론: 한국에서 비만에 빈용되는 처방은 四象醫學에 기초한 처방으로 나타났다. 四象醫學은 사람을 네 체질로 나누고, 이 중 太陰人이 비만해지기 쉽고 체중감량은 어렵다고 하였으며, 태음인 처방에 麻黃이 포함된 것이 많았다. 이는 단미로써 사용될 때 문제시되는 麻黃의 부작용이 적절한 대상 선택과 적절한 한약 혼합을 통해 줄어들 수 있음을 시사한다.

한방재활의학과 관련 논문에 대한 조사연구

김도헌,이인선 ( Lee In-Seon ) 대한한의학회 한방재활의학과학회 1998 한방재활의학과학회지 Vol.8 No.2

1991년부터 1995년까지 발간된 5권의 한방물리요법과학회지 및 1996년 부터 1998년까지 발간된 4권의 한방재활의학과학회지에 발표된 논문 175 편의 내용을 조사, 분류한 바 다음과 같은 결론을 얻었다. 1. 175편의 논문 중 문헌논문은 92편(53%), 실험논문이 47편(27%), 임 상논문이 36편(20%)이었다. 2. 175편의 논문 중 경희대가 55편(31%)으로 가장 많은 논문을 발표하 였으며, 대전대가 47편(27%), 원광대가 21편(12%), 동국대가 17편(10%) 의 논문을 발표하였고, 1996년 이후에는 101편의 논문 중 대전대가 28편 (28%), 동국대가 17편(17%)의 논문을 발표하였다. 3. 특정 증상 및 질환을 중심으로 연구한 125편의 논문 중에서 관절염 및 비증(28%)에 관한 논문이 가장 많았고 비만(21%), 요통 및 척추 질환 (13%), 뇌졸중후유증(10%)에 관한 논문도 많았다. 4. 특정 치료방법을 중심으로 연구한 79편의 논문 중에서 약물을 제외 하고는 전기요법, 자기요법, 광선요법, 향기요법 등의 이학요법(35%)에 관한 논문이 가장 많았고 추나요법(27%), 식이요법(14%)에 관한 논문도 많았으며, 이학요법에 관한 논문은 28편 중 17편(82%)이 1996년 이후에 발표되었다. 5. 실험논문 중 가장 많이 연구한 증상 및 질환은 관절염 및 비증(34 %), 비만(19%), 근육피로(13%)등의 순이었다. 6. 실험방법에서 실험대상에게 취한 치료방법으로는 약물투여가 가장 많았으며(81%), 1996년 이후에는 자기요법, 광선요법, 식이요법, 부항요 법, 피내침, 약침, 오색조사, 외용약을 이용한 논문도 발표되었다. 7. 실험대상은 흰쥐가 가장 많았고(68%) 사람을 실험대상으로 한 논문 도 7편이 있었으며, 실험전 증상 및 질병을 유발한 논문은 44편(94%)이 었다. 8. 실험논문에서의 결과처리는 평균±표준오차가 가장 많았으며(66%), 유의성 검정을 한 논문은 45편(95%)이었다. 임상논문에서의 결과처리는 단순결과수치가 가장 많았으며(69%), 유의성 검정을 한 논문은 12편(3 1%)이었다. 9. 임상논문 중에서 가장 많이 연구한 증상 및 질환은 요통 및 척추질 환(28%), 비만(25%), 뇌졸중휴유증(19%)이었다. 10. 임상논문 중에서 약물외에 연구대상에게 취한 치료방법으로 식이요법, 전기요법, 추나, 초음파, 이침, 외용약이었고, 6편의 논문에서는 치 료방법의 혼용으로 특정 치료방법과 연구결과와의 인과관계를 추론하기 어려웠다. 11. 문헌논문 중에서 가장 많이 연구한 증상 및 질환은 관절염 및 비증 (33%), 비만(15%), 뇌졸중후유증(13%), 요통 및 척추질환(13%)이었다. 12. 문헌논문 중에서 수기요법에 관한 연구가 가장 많았으며(35%) 이학 요법, 식이요법과 양생법, 기공과 운동치료, 대체의학에 대한 연구가 있 었다. 이상의 결과로 보아 한방재활의학과와 관련된 증상 및 질환과 치료방법 에 관하여 다양한 연구방법과 연구형식에 의한 논문들이 발표되었으나, 앞으로는 문헌고찰, 실험연구 및 임상연구의 체계적인 연구가 시행되어 연구의 연계성을 살리고, 보다 발전된 연구방법에 의한 논문이 발표되어 한방재활의학과의 전문성을 발전시키며 의학논문의 가장 궁극적인 목적 인 건강유지의 향상에 직접적인 도움이 되어야 한다고 생각된다.

중풍후유증 환자 관리를 위한 프로그램 개발 연구 -한방 재활의학 및 간호를 중심으로-

오민석 ( Oh Min-Seok ),송태원 ( Song Tae-Won ),이철완,김태임 ( Kim Tae-Im ),이강이 ( Lee Kang-Yi ) 한방재활의학과학회 1997 한방재활의학과학회지 Vol.7 No.1

한방재활의학 및 간호를 중심으로 중풍후준증 환자관리에 대하여 연구한 결과 다음과 같은 결론을 얻었다.1.현행 실시되고 있는 재활치료의 대부분이 육체적인 재활치료 즉 운동치료에 중점을 두고 있는 현실에 비추어 볼때 심리적이고 정신적인 재활치료의 필요성을 느끼게 되었다.2.심리적이고 정신적인 중풍후유증 환자 관리에는 의사 뿐만 아니라 간호파트와의 협조체제가 절대적으로 필요한 것으로 사료된다.3.한방재활의학의 영역에서 음악·방향·향기·색깔·이미지·자석·소리·기공도인요법 등은 정신적인 재활파트부분으로써 매우 기대되는 치료방법들이다.4.음악·방향·향기·색깔 등 이학적 자극인자로 간호부분관리에 응용하면 보다 효과적인 간호관리 프로그램이 개발될 것으로 사료된다.5.한방재활의학과 간호파트와의 관계는 매우 밀접한 것으로 나타났으며 더욱 발전시키면 중풍후유증 환자 관리에 있어 새로운 프로그램이 보다 많이 제시될 수 있을 것으로 사료된다.

한방물리요법에 대한 문헌적 고찰

최보미 ( Bo Mi Choi ),홍서영 ( Seo Young Hong ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: The purpose of this study is to establish literatural evidence about traditional Korean medical physiotherapy through literatural review. Methods: Applicable paragraphs which were related to the traditional Korean medical physiotherapy were phrased from in 『Hwang-je-nae-gyung(黃帝內經)』, 『Yu-mun-sa-chin(儒門事親)』, 『Geum-guei-yo-ryack(金櫃要略)』, 『Eui-hack-ip-mun(醫學入門)』, 『Gyung-ack-jeon-seo(景岳全書)』, 『Eui-hack-gang-mock(醫學綱目)』, 『Dong-eui-bo-gam(東醫寶鑑)』 where were archiving of Oriental or Korean medicine literatures. Searched paragraphs were analysed for establishing historical and theoretical bases of Korean medical physiotherapy. Results:1. Theromtherapy is originated from yu(尉), hot hand, warm water bath, warm earth, fumigation, lamp, torchlight and brazier. Matching indications are various musculoskeletal pain and diseases, skin diseases such as chronic inflammation, frostbite, gynecological and urogenital diseases such as uterine myoma, lower abdominal pain, metrorrhagia, breast diseases, digestive tract diseases such as vomiting, diarrhea, stomachache and also it treats cardiovascular disease. Other matching indications are sunstroke, rhinorrhea, psycosis and anal pain. And it used helping acupuncture therapy. 2. Cryotherapy is originated from lengfu(冷敷), lengtie(冷貼), cold stone and cold water. Matching indications are various fever disease, skin diseases such as acute inflammation, wound, fever skin disease, otorhinolaryngological diseases such as acute sore throat, otitis, stomatitis, nasal bleeding and contusions, abrasions, burn and dysuria. In addition, it treats extremity coldness, chillness, stomachache caused to accumulate fever. 3. Physiotherapy by circulating meridian system is originated from manipulation such as pushing, massage and beating to therapy point. Matching indications are musculoskeletal diseases such as various muscular pain, heavy sensation, convulsion, urogenital diseases such as dysuria, lower abdomen pain, digestive tract diseases such as stomachache, and paralysis due to blocked meridian system. And other matching indications are psycosis, leprosy, hypoesthesia, acute stroke. In addition it helps other therapy methods. In addition, the power of manipulation classify to strengthen and reduce. 4. Physiotherapy by balancing meridian system is originated from sunshine, magnet, horn, bamboo and tube. Sunshine helps improving self`s care and cure inflammatory skin disease. Magnet`s matching indications are paralysis, various injuries, abscess, fever and eye disease. Cupping therapy treats to skin diseases and internal diseases such as tuberculosis. Conclusions: Traditional Korean medical physiotherapy was widely used in traditional Korean medicine since ancient time based on the traditional Korean medical principle and anatomical knowledge. With modern physiotherapy and traditional Korean medicine together, effects of treatment are enhanced. And traditional Korean medical physiotherapy is appropriated to world physiotherapy`s expectation.

경항통과 경추 만곡도의 상관성 고찰

정두영 ( Doo Young Jung ),김성수 ( Sung Soo Kim ),정석희 ( Seok Hee Chung ),이종수 ( Jong Soo Lee ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: To investigate and compare the curvature of the cervical spine for the neck pain patients and asymptomatic participants. Methods: Clinical study was carried out for 64 neck pain patients in Conmaul oriental hospital and 56 asymptomatic volunteers. Cervical spine curvature was measured by 7 types of measuring methods. Results: Curvature angles of the cervical spine were significantly lower in the patients group(p<0.05). In segmental analysis of curvature, segmental curvature of C3-C4 were significantly lower in the patients group. There is no significant relationship among the classifications by the types of cervical spine curvature in the 2 groups. Conclusions: The results suggest that the cervical spines of neck pain patients are straightened and kyphotic and most of cervical curvature decrease are occurred at middle cervical spine.

우슬 추출물이 흰쥐 좌골신경 손상 후 좌골신경의 기능회복에 미치는 영향

이마성 ( Ma Seong Lee ),송윤경 ( Yun Kyung Song ),임형호 ( Hyung Ho Lim ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: Peripheral nerve injuries are commonly encountered clinical problem and often result in severe functional deficits. The aim of this study is to evaluate the effects of aqueous extract of Achyranthes japonica(AJ) on functional recovery in sciatic nerve after crushed sciatic nerve injury. Methods: In the present study, the animals in the AJ-treated groups received the aqueous extract of AJ at the respective doses orally for 13 consecutive days. In order to assess the effects of the aqueous extract of AJ on function recovery in crushed sciatic nerve injury, sciatic functional index(SFI) was performed. c-Fos expression in the paraventricular nucleus(PVN) and ventrolateral periaqueductal gray(vlPAG), and neurofilament, and the expressions of brain-derived neurotrophic factor(BDNF), nerve growth factor(NGF) following crushed sciatic nerve injury in rats were investigated. For this, immunohistochemistry and western blot were performed. Results: In the present study, crushed sciatic nerve injury showed characteristic gait changes showing decrease of SFI value and treatment with the aqueous extract of AJ significantly enhanced the SFI value. Neurofilament expression in the sciatic nerve was decreased by crushed sciatic nerve injury and treatment with the AJ increased neurofilament expression. The expressions of BDNF and NGF in the sciatic nerve were increased following crushed sciatic nerve injury and treatment with the AJ significantly controlled the sciatic nerve injury-induced increment of BDNF and NGF expressions. c-Fos expressions in the PVN and vlPAG were increased following crushed sciatic nerve injury and treatment with the AJ significantly suppressed the sciatic nerve injury-induced increment of c-Fos expressions. Conclusions: These results suggest that AJ treatment after crushed sciatic nerve injury is effective in the functional recovery by enhancing axonal regeneration and suppressing of pain.

Wii-FitTM을 이용한 가상현실 운동프로그램이 뇌졸중 환자의 균형 및 보행능력에 미치는 영향

김정희 ( Jung Hee Kim ),이종수 ( Jong Soo Lee ),이수현 ( Su Hyun Lee ),김성식 ( Seong Sik Kim ),이병희 ( Byoung Hee Lee ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: This study was to investigate the effects on using Virtual reality exercise program Wii-Fit^(TM) for dynamic balance and walking ability in patients with stroke. Methods: The 22 subjects were randomly selected from the patients of the S hospital who met the study conditions. They were divided into a Wii-Fit^(TM)balance game group of 12 patients and a conventional physical therapy group of 10 patients. The Wii-Fit^(TM)balance game group received Wii-Fit^(TM)balance game and general physiotherapy for 5 days a weeks, 30 minutes a day, for a 4 weeks and the conventional physical therapy group received general physiotherapy for the same period. The subjects were measured and compared for Brunel balance assessment, functional gait assessment, 6 minute walk test, GAIT Rite system before and after the program. Results:The experimental group tend to improve more than control group in shifting the weight to the affected side(p=0.040) and tap test(p<0.001). The experimental group tend to improve more than control group in FGA (p=0.016). The experimental group improved significantly more than control group in 6MWT (p=0.008). The experimental group improved significantly more than control group in gait speed, cadence, stride length. Conclusions: Virtual Reality program (Wii-Fit^(TM)) with conventional physical therapy shows the benefits on dynamic balance and gait parameters in patients with stroke.

초오(草烏) 봉밀(蜂蜜) 혼합물(混合物)이 백서(白鼠)의 말초신경병증성 통증 억제에 미치는 영향

조희근 ( Hee Guen Jo ),박애련 ( Ae Ryeon Park ),최진봉 ( Jin Bong Choi ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: We have studied to know analgesic effects of the combination of Aconitum Cilliare Tuber with honey in the rat models of peripheral neuropathic pain. Methods: Neuropathic pain model was made by ligating left 5th lumbar spinal nerve. After 3 days, combination of Aconitum Ciliare Tuber and honey extract was administrated each alternate day. Administration was divided three groups, that is NP-OA1(0.06 mg/ml), NP-OA2(0.24 mg/ml), and NP-OA3(0.96 mg/ml). After that, we examined the with drawl response of neuropathic rats legs by von Frey filament and acetone stimulation. And also we examined c-Fos, glutamic oxaloacetic transaminase(GOT), glutamate-pyruvate transaminase(GPT) and change of weight. Results: Mechanical allodynia in NP-OA1 groups were significantly decreased compared with the control group. Cold allodynia in all experimental groups were no significant differences with the control group. c-Fos protein expression on the central grey, all experimental groups were lower than that of control groups. But, there were no statistically significant differences. Change of weight in all experimental groups were significantly increased compare with the control group. In blood serum GOT in NP-OA1, NP-OA2 groups were significantly decreased compare with the control group. In blood serum GPT in all experimental groups were no significant difference with the control group. Conclusions: We had noticed that the combination of Aconitum Ciliare Tuber and honey decreased mechanical allodynia in the model of neuropathic pain compared with the control group and it has not efficacy in elevation of GOT, GPT and weight loss etc., the element of which becomes damage to liver. This study can be proposed that Aconitum Ciliare with Honey may be applicable to neuropathic pain in clinic. But it is reliability not that cold allodynia and c-Fos expression have effectively to control pain. Therefore we have to follow up about that.

해인탕 추출물이 흰쥐 좌골신경 손상 모델에서 기능회복과 뇌의 c-Fos 발현에 미치는 영향

은영준 ( Young Joon Eun ),송윤경 ( Yun Kyung Song ),임형호 ( Hyung Ho Lim ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: Peripheral nerve injuries are commonly encountered clinical problems and often result in severe functional deficits. The purpose of this study was to evaluate the effects of Haein-tang(Hairen-tang) extract on functional recovery and pain release in the sciatic nerve after crushed sciatic nerve injury in rats. Methods: 1. Sciatic functional index(SFI) were performed on functional recovery. 2. c-Fos immunohistochemistry were performed on c-Fos expressions in the paraventricular nucleus(PVN) and ventrolateral periaqueductal gray(vlPAG). 3. Neurofilament immunohistochemistry were performed on neurofilament regeneration. 4. Western blot were performed on brain-derived neurotrophic factor(BDNF) and nerve growth factor(NGF) expression. Results: 1. Haein-tang(Hairen-tang) extract significantly enhanced the SFI value in the sciatic nerve injury and 100 mg/kg, 200 mg/kg Haein-tang(Hairen-tang)-treated group. 2. Haein-tang(Hairen-tang) extract significantly suppressed the sciatic nerve injury-induced increment of c-Fos expressions in the PVN and vlPAG in the sciatic nerve injury and 100 mg/kg, 200 mg/kg Haein-tang(Hairen-tang)-treated group. 3. Haein-tang(Hairen-tang) extract significantly increased neurofilament expression in the sciatic nerve injury and 50 mg/kg, 100 mg/kg, 200 mg/kg Haein-tang (Hairen-tang)-treated group. 4. Haein-tang(Hairen-tang) extract significantly controled the sciatic nerve injury-induced increment of BDNF and NGF expressions in the sciatic nerve injury and 100 mg/kg, 200 mg/kg Haein-tang(Hairen-tang)-treated group. Conclusions: These results suggest that Haein-tang(Hairen-tang) treatment after sciatic nerve injury is effective for the functional recovery by enhancing of axonal regeneration and suppressing of pain.

경피적외선요법의 경혈(經穴) 조사(照射) 치료법에 대한 고찰

황의형 ( Eui Hyoung Hwang ),신병철 ( Byung Cheul Shin ),신미숙 ( Mi Suk Shin ),조현우 ( Hyun Woo Cho ),정여름 ( Yeo Leum Jung ),설재욱 ( Jae Uk Sul ) 한방재활의학과학회 2011 한방재활의학과학회지 Vol.21 No.2

Objectives: The aim of this study is to establish evidence-based guideline on infrared therapy on acupoints. Methods: We investigated all the articles in websites including Pubmed, China national knowledge Infrastructure (CNKI) and medical journals authorized by national research foundation of Korea. The key words are acupoints and infrared. For the first time, we withdrew some papers no relationship to key words by reading titles and abstracts. In the second, we only selected randomized clinical trials (RCT) published from 2000 to 2010. Results: Out of 62 papers, only 2 RCT were analyzed. One (RCT 1) was about depression patients with insomnia (jadad score: 1). The other (RCT 2) was about urimic pruritus patients (jadad score: 5). In RCT 1, experimental group was significantly better than control group. In RCT 2, there was not statistical signification between two groups. Conclusions: In reality, there were not many papers on infrared therapy applications. Further study just like RCTs may be needed to establish evidenced-based guideline on infrared.