내관(PC6),족삼리(ST36) 자침(刺鍼)이 심하통(心下痛)(심하만(心下滿)) 등 신경성질환에 미치는 영향

손인철 ( In Chul Sohn ) 대한경락경혈학회 2006 Korean Journal of Acupuncture Vol.23 No.1

Objectives: To test the therapeutic efficacy of acupuncture applied to PC6 and ST36 for the relief of fullness of epigastrium or epigastric pain. Subjects and Methods: We enrolled fifty patients in a case series study. The patients were mainly female (94 %) with an average age of 55 years (± 15.0); the average age of the male patients was 51 years (± 20.0). Twenty four percent of patients were in acute phase which epigastric pain had Lasted below 1 month. Twenty eight percent of patients were in chronic phase which the pain had Lasted over 6 month. The rest were in subacute phase. Acupuncture needles were inserted into PC6 and ST36 bilaterally. The acupuncture treatments were performed 2 times a week for 4 weeks. One treat session was Lasted for 30 min. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 4 scaled questionnaire. Results: After acupuncture treatment, a progressive improvement of pain intensity was reported in 46 of the 50 patients, including 23 of excellent and 23 of good. The progress of symptom was more superior in subacute phase to acute or chronic phase. The symptom of 22 of 24 patients in subacute phase was improved. No patient experienced minor side-effects during acupuncture treatment. Conclusion: These preliminary data suggest the acupuncture treatment provides good pain relief for most patients presenting with epigastric pain. Randomized trials with appropriate control groups are needed to validate the effectiveness of this therapy in the treatment of epigastric pain.

내관(PC6).족삼리(ST36) 자침(刺鍼)이 심하통(心下痛) 심하만(心下滿) 등 신경성질환에 미치는 영향

손인철,Sohn, In-Chul 경락경혈학회 2006 Korean Journal of Acupuncture Vol.23 No.1

Objectives : To test the therapeutic efficacy of acupuncture applied to PC6 and ST36 for the relief of fullness of epigastrium or epigastric pain. Subjects and Methods : We enrolled fifty patients in a case series study The patients were mainly female (94 %) with an average age of 55 years $({\pm}15.0)$; the average age of the male patients was 51 years $({\pm}20.0)$. Twenty four percent of patients were in acute phase which epigastric pain had lasted below 1 month. Twenty eight percent of patients were in chronic phase which the pain had lasted over 6 month. The rest were in subacute phase. Acupuncture needles were inserted into PC6 and ST36 bilaterally. The acupuncture treatments were performed 2 times a week for 4 weeks. One treat session was lasted for 30 min. At each visit, overall symptomatic improvement, frequency and intensity of symptoms were checked on a 4 scaled questionnaire. Results : After acupuncture treatment, a progressive improvement of pain intensity was reported in 46 of the 50 patients, including 23 of excellent and 23 of good. The progress of symptom was more superior in subacute phase to acute or chronic phase. The symptom of 22 of 24 patients in subacute phase was improved. No patient experienced minor side-effects during acupuncture treatment. Conclusion : These preliminary data suggest the acupuncture treatment provides good pain relief for most patients presenting with epigastric pain. Randomized trials with appropriate control groups are needed to validate the effectiveness of this therapy in the treatment of epigastric pain.

A Case of Rectus Sheath Hematoma with Spontaneous Inferior Epigastric Artery Injury Treated Successfully by Angioembolization

이동언,안재윤,문성배 대한응급의학회 2017 大韓應急醫學會誌 Vol.28 No.4

Rectus sheath hematoma with spontaneous inferior epigastric artery injury (IEAI) is rarely found and can often be mistaken for something else causing abdominal pain. We present the case of rectus sheath hematoma with spontaneous IEAI caused by coughing in a 61-year-old woman. She presented to our emergency department with a chief complaint of rightlower quadrant pain after severe coughing. An abdominal computed tomography scan with contrast enhancement demonstrated rectus sheath hematoma with active hemorrhage; angiography with selective embolization of the right inferior epigastric artery was performed successfully without complication. Even if a patient with nontraumatic abdominal pain had no anticoagulant therapy or coagulopathy, an abdominal contrast-enhanced computed tomography scan is essential for early diagnosis of spontaneous IEAI. Arteriography with selective embolization of the injured arteries is useful and highly effective in the control of ongoing hemorrhage owing to IEAI.

Efficacy of Acotiamide on Postprandial Distress Syndrome and Epigastric Pain Syndrome Depending on the Estimated Gastric Acid Secretion Level

( Toshiaki Suzuki ),( Reina Ohba ),( Ei Kataoka ),( Yui Kudo ),( Akira Zeniya ),( Daisuke Segawa ),( Keisuke Oikawa ),( Masaru Odashima ),( Taiji Saga ),( Tomoyuki Kuramitsu ),( Hideaki Sasahara ),( K 대한소화기기능성질환·운동학회 2022 Journal of Neurogastroenterology and Motility (JNM Vol.28 No.1

Background/Aims Gastric acid secretion is suspected to be a pivotal contributor to the pathogenesis of functional dyspepsia. The present study investigates the potential association of the gastric acid secretion estimated by measuring serum pepsinogen with therapeutic responsiveness to the prokinetic drug acotiamide. Methods Dyspeptic patients consulting participating clinics from October 2017 to March 2019 were prospectively enrolled in the study. The dyspeptic symptoms were classified into postprandial distress syndrome (PDS) and epigastric pain syndrome (EPS). Gastric acid secretion levels were estimated by the Helicobacter pylori infection status and serum pepsinogen using established criteria and classified into hypo-, normo-, and hyper-secretion. Each patient was then administered 100 mg acotiamide thrice daily for 4 weeks, and the response rate to the treatment was evaluated using the overall treatment efficacy scale. Results Of the 86 enrolled patients, 56 (65.1%) and 26 (30.2%) were classified into PDS and EPS, respectively. The estimated gastric acid secretion was not significantly different between PDS and EPS. The response rates were 66.0% for PDS and 73.1% for EPS, showing no significant difference. While the response rates were stable, ranging from 61.0% to 75.0% regardless of the estimated gastric acid secretion level among subjects with PDF, the rates were significantly lower in hyper-secretors than in non-hyper-secretors among subjects with EPS (42.0% vs 83.0%, P = 0.046). Conclusion Although acotiamide is effective for treating EPS as well as PDS overall, the efficacy is somewhat limited in EPS with gastric acid hypersecretion, with gastric acid suppressants, such as proton pump inhibitors, being more suitable. (J Neurogastroenterol Motil 2022;28:53-61)

인후부 이물감 및 상복부 통증과 수면불량을 호소하는 위절제술 후 증후군 환자의 한의 치험 1례

이지윤,조온유,박상민,최새롬,신재욱,백지훈 대한한방내과학회 2022 大韓韓方內科學會誌 Vol.43 No.6

Objective: The purpose of this case study was to report the effects of Korean medicine treatment on a patient diagnosed with postgastrectomy syndrome (PGS). Methods: The patient was treated with herbal medicine, acupuncture, and moxibustion in combination with Western medicine for 3 months. Results: Though abdominal tenderness was maintained at a similar level, other clinical symptoms (epigastric pain, globus pharyngis, and epigastric pain) were improved after Korean medicine treatment. Conclusions: These results suggest that the need to promote practical research on PGS, should receive greater attention in the Korean medical community.

Overlap Syndrome of Functional Dyspepsia and Irritable Bowel Syndrome -Are Both Diseases Mutually Exclusive?

( Hidekazu Suzuki ),( Toshifumi Hibi ) 대한소화기기능성질환·운동학회(구 대한소화관운동학회) 2011 Journal of Neurogastroenterology and Motility (JNM Vol.17 No.4

Among functional gastrointestinal (GI) disorders, functional dyspepsia (FD) and irritable bowel syndrome (IBS) are important to public health around the world and are frequently encountered in general practice. Upper GI symptoms such as heartburn, postprandial fullness, early satiety, epigastric pain or burning and lower GI symptoms such as constipation and diarrhea often coexist. Although the prevalence of FD-IBS overlap would be influenced by the selection of the study population, the overlap rate of FD-IBS could be in the range of 11%-27%. Specifically, FD-IBS overlap is associated with more severe symptoms than FD alone or IBS alone. Since clinical overlap, especially FD-IBS overlap, is very common, the 2 syndromes should not be treated in a mutually exclusive fashion. (J Neurogastroenterol Motil 2011;17:360-365)

Regional Brain Activity During Rest and Gastric Water Load in Subtypes of Functional Dyspepsia: A Preliminary Brain Functional Magnetic Resonance Imaging Study

Yanwen Chen,Ruifeng Wang,Bo Hou,Feng Feng,Xiucai Fang,Liming Zhu,Xiaohong Sun,Zhifeng Wang,Meiyun Ke 대한소화기 기능성질환∙운동학회 2018 Journal of Neurogastroenterology and Motility (JNM Vol.24 No.2

Background/Aims Functional dyspepsia (FD) remains a great clinical challenge since the FD subtypes, defined by Rome III classification, still have heterogeneous pathogenesis. Previous studies have shown notable differences in visceral sensation processing in the CNS in FD compared to healthy subjects (HS). However, the role of CNS in the pathogenesis of each FD subtype has not been recognized. Methods Twenty-eight FD patients, including 10 epigastric pain syndrome (EPS), 9 postprandial distress syndrome (PDS), and 9 mixed-type, and 10 HS, were enrolled. All subjects underwent a proximal gastric perfusion water load test and the regional brain activities during resting state and water load test were investigated by functional magnetic resonance imaging. Results For regional brain activities during the resting state and water load test, each FD subtype was significantly different from HS (P < 0.05). Focusing on EPS and PDS, the regional brain activities of EPS were stronger than PDS in the left paracentral lobule, right inferior frontal gyrus pars opercularis, postcentral gyrus, precuneus, insula, parahippocampal gyrus, caudate nucleus, and bilateral cingulate cortices at the resting state (P < 0.05), and stronger than PDS in the left inferior temporal and fusiform gyri during the water load test (P < 0.05). Conclusions Compared to HS, FD subtypes had different regional brain activities at rest and during water load test, whereby the differences displayed distinct manifestations for each subtype. Compared to PDS, EPS presented more significant differences from HS at rest, suggesting that the abnormality of central visceral pain processing could be one of the main pathogenesis mechanisms for EPS.

Association of the Extent of Atrophic Gastritis With Specific Dyspeptic Symptoms

( Sook Hee Chung ),( Kwang Jae Lee ),( Ja Yeon Kim ),( Seon Gyo Im ),( Eun Kyung Kim ),( Min Jae Yang ),( Seo Hee Ryu ) 대한소화기기능성질환·운동학회 2015 Journal of Neurogastroenterology and Motility (JNM Vol.21 No.4

Background/Aims It remains unclear whether atrophic gastritis can affect dyspeptic symptoms. We aimed to investigate whether the extent of atrophic gastritis is associated with specific dyspeptic symptoms. MethodsConsecutive adults in a routine health-checkup program were enrolled in the study. The extent of atrophic gastritis was classifiedinto 3 groups based on the Kimura-Takemoto criteria; the gastritis with no or little atrophy (group A: C0), the gastritis with atrophy mainly in the antrum (group B: C1 and C2), and the gastritis with atrophy in the large area of the corpus (group C: C3 and O). Upper gastrointestinal symptoms were categorized into “typical reflux symptoms,” “epigastric pain syndrome (EPS)-related symptoms,” and “postprandial distress syndrome (PDS)-related symptoms.” Results A total of 1827 patients (1009 males, mean age 45.1 years) were included in the analysis. The subgroups of atrophic gastritis were as follows: group A (n = 1218, 66.7%), group B (n = 392, 21.4%), and group C (n = 217, 11.9%). Typical reflux, EPS-related, and PDS-related symptoms were present in 10.5%, 19.8%, and 16.2% of the subjects, respectively. PDS-related and EPS-related symptoms were significantly more prevalent in the group C of male patients and the group B of female patients, respectively, compared with other groups. PDS-related and EPS-related symptoms were independently associated with the group C in males (OR, 2.123; 95% CI, 1.090-4.136) and the group B in females (OR, 2.571; 95% CI, 1.319-5.025), respectively. Conclusions The extent of atrophic gastritis appears to affect the generation of specific dyspeptic symptoms in a gender-dependent manner. (J Neurogastroenterol Motil 2015;21:528-536)

증례(證例) : 위완통(胃脘痛)을 수반한 만성위염 환자에 대한 독활지황탕(獨活地黃湯) 투여 1례

최빈혜 ( Bin Hye Choi ),변준석 ( Joon Seok Byun ) 濟韓東醫學術院 2009 東西醫學 Vol.34 No.2

Psychological Characteristics and Quality of Life of Patients With Functional Dyspepsia

Su-Woo Lee,Chan-Mo Yang,Han-Seung Ryu,Suck-Chei Choi,Sang-Yeol Lee,Seung-Ho Jang 대한신경정신의학회 2024 PSYCHIATRY INVESTIGATION Vol.21 No.6

Objective The objective of this study is to compare the psychosocial characteristics of functional dyspepsia (FD) with its subgroups, epigastric pain syndrome (EPS) and postprandial distress syndrome (PDS), against a healthy control group, and to investigate the quality of life (QoL). Methods All of the subjects were 210 adults, 131 patients with FD were diagnosed by gastroenterologist and 79 adults with no observable symptoms of FD were selected as the normal control group. Demographic factors were investigated. The Korean-Beck Depression Inventory-II, Korean-Beck Anxiety Inventory, Korean-Childhood Trauma Questionnaire, Multidimensional Scale of Perceived Social Support, Connor-Davidson Resilience Scale, and WHO Quality of Life Assessment Instrument Brief Form were used to assess psychological factors. A one-way analysis of variance was used to compare differences among the groups. Further, a stepwise regression analysis was conducted to determine factors affecting the QoL of the FD group. Results Between-group differences in demographic characteristics were not significant. Depression (F=37.166, p<0.001), anxiety (F= 30.261, p<0.001), and childhood trauma (F=6.591, p<0.01) were all significantly higher in FD group compared to the normal control. Among FD subgroups, EPS exhibited higher levels of both depression and anxiety than PDS. Social support (F=17.673, p<0.001) and resilience (F=8.425, p<0.001) were significantly lower in FD group than in other groups, and the values were higher in PDS than in EPS. Resilience (β=0.328, p<0.001) was the most important explanatory variable. The explained variance was 46.6%. Conclusion Significantly more symptoms of depression, anxiety, childhood trauma was observed for both FD sub-group. These groups also had less social support, resilience, and QoL than the control groups.