[논문]급성 말초성 안면신경마비 환자의 안면신경 손상 정도에 영향을 미치는 요인에 대한 후향적 연구: 근전도검사를 이용하여

김필군; 성원석; 구본혁; 유희경; 석경환; 이주현; 김민정; 박연철; 서병관; 백용현; 박동석

doi:10.13045/acupunct.2013054

급성 말초성 안면신경마비 환자의 안면신경 손상 정도에 영향을 미치는 요인에 대한 후향적 연구: 근전도검사를 이용하여
Retrospective Study on Factors Influencing Facial Nerve Damage of Acute Peripheral Facial Palsy Patients: by Electromyography 원문보기

The acupuncture = 대한침구의학회지, v.30 no.5, 2013년, pp.155 - 167

Abstract ▼ AI-Helper

Objectives : This research was conducted to investigate the factors that affect the level of facial nerve damage. Methods : From October 2009 to September 2013, the total number of 581 patients of Bell's palsy and Ramsay-Hunt syndrome visited Facial Palsy Center in Kyung Hee University Hospital at Gangdong for Traditional Korean and Western combined medical treatment. Of these, 453 patients of peripheral facial nerve palsy were selected for the research. After reviewing the medical records that have details of age, gender, diagnosis(Bell's palsy and Ramsay-Hunt syndrome), onset, underlying diseases(DM, HTN), and HbAlc value, the analysis on the influence factors on the level of facial nerve damage was drew out. Results : The axonal loss rate of oris branch and nasal branch were significantly higher than the axonal loss rate of frontal branch and oculi branch. In addition, the frequency of becoming a major damaged branch was also high in the oris branch nasal branch. The factors by month, weather, smoking, and alcohol did not influence EMG axonal loss rate. Male rather than female and patient with Rasmay-Hut syndrome rather than Bell's palsy had a higher axonal loss rate in all branches. Of those, front of branch of male was remarkably higher than female. Patient with DM as P/H had high axonal loss rate in all branches. Patient with HTN as P/H had high axonal loss rate in all branches except for oris branches. Patients with DM and HTN group had significantly higher value from the average of axonal loss rate than patients who are only with HTN and without DM/HTN. DM alone group had significantly higher value than patients who are without DM/HTN. However, HTN alone was not significantly high. By analysing HbAlc of the patients who were hospitalised regardless DM, axonal loss rate was high in the order of DM group, preDM group, normal group. Nevertheless, only DM group showed higher axonal rate statistically than normal group. Considering DM and HbA1c value, the patients can be divided into 4 different groups of hkDM, lkDM, hfDM and nDM. By analysing those groups, the average damaged value of the groups with diagnosis followed by treatment(lkDM, hkDM) were higher than the average rate of hfDM and statistically higher than the rate of the nDM. Conclusions : The influential factors of increasing the level of EMG damage are male(only for the frontal branch), age above sixties, HTN, DM, and HbAlc value above 6.5. Besides, the negligible factors are month, season, diagnosis, alcohol, and smoking. Further research including clinical prognosis should be conducted.

주제어

질의응답

핵심어	질문	논문에서 추출한 답변
	2012년 The American Academy of Neurology의 Guideline에서 급성 특발성 안면신경마비에 관해 권고한 것은 무엇인가?	양방에서는 급성 안면마비에 corticosteroid를 복용하여 완치율을 높이고 연합운동 발병을 줄이는 데 유의한 효과가 있어 널리 사용되고 있다17). 2012년 The American Academy of Neurology의 Guideline에는 급성 특발성 안면마비에 스테로이드는 복용하되 항바이러스제제는 완치에 기여하는 효능이 입증된 것이 미미하여 최소한의 양만 투여하도록 권고하였다18). 한ㆍ양방 치료를 모두 시행하는 협진치료가 실제로도 널리 시행되는데 단독치료에 비한 협진치료의 우월성은 연구가 활발히 진행되고 있다19-22).
	안면신경마비란 무엇인가?	안면신경마비는 얼굴근육의 마비로 인하여 눈과 입 등이 한쪽으로 비뚤어지는 증상이 나타나는 것으로 ‘구안와사’라 한다. 원인이 뚜렷하지 않은 특발성 안면신경마비를 Bell’s palsy라 하고 무릎신경절이 대상포진에 침범당해 발생한 안면신경마비를 Ramsay-Hunt’s syndrome이라고 한다1).
	양방에서 급성 안면마비의 치료제로 사용하는 것은?	한방에서는 침2), 미소침3), 봉독약침4-8), 자하거약침9), 뜸10), 전침11-13), 매선14), 부항15), 괄법(括法)16) 등의 요법을 사용하고 위 치료의 효과를 입증하는 연구들이 발표되고 있다. 양방에서는 급성 안면마비에 corticosteroid를 복용하여 완치율을 높이고 연합운동 발병을 줄이는 데 유의한 효과가 있어 널리 사용되고 있다17). 2012년 The American Academy of Neurology의 Guideline에는 급성 특발성 안면마비에 스테로이드는 복용하되 항바이러스제제는 완치에 기여하는 효능이 입증된 것이 미미하여 최소한의 양만 투여하도록 권고하였다18).

참고문헌 (40)

Korean Acupuncture & Moxibustion Society. Acupuncture and Moxibustion. 2. Gyeonggi : Jipmoondang. 2008 : 186-90.
Lee CU, Park IB, Kim SU et al. The Effect of Acupuncture and Dong's Acupuncture about Bell's palsy. The J of Korean Acupuncture & Moxibustion Society. 2004 ; 21(2) : 287-300.
Lee SY, Ko JM, Kim JH, Kwon HJ et al. Case Reports : Case Study of Miso Facial Rejuvenation Acupuncture on Intractable Facial Palsy. The J of Korean Acupuncture & Moxibustion Society. 2009 ; 26(1) : 163-71.
Kim MS, Kim HJ, Park YJ, Kim EH, Lee EY. The Clinical Research of the Efficacy of Bee Venom Aqua-acupuncture on Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2004 ; 21(4) : 251-62.
Kang MS. A Clinical Study on the Case of Herpes Zoster Otiucus Occurred in Pregnancy Treated with Bee Venom Pharmarcopuncture. The J of Korean Acupuncture & Moxibustion Society. 2010 ; 27(2) : 155-60.
Yang KR, Song HS. Effect of Bee Venom Pharmacopuncture Complex Therapy on Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2009 ; 26(4) : 29-37.
Choi JY, Lee H, Kang JH et al. Comparative Study of General Oriental Medical Treatment and Bee Venom Pharmacopuncture on Acute Peripheral Facial Paralysis Patient with Postauricular Pain. The J of Korean Acupuncture & Moxibustion Society. 2009 ; 26(5) : 95-103.
Oh HJ, Song HS. Effect of Bee Venom Pharmacopuncture Complex Therapy at Yepung on Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2010 ; 27(4) : 179-85.
Lee EY, Yook TH, Kim EH, Lee JH. The Clinical Observation of Peripheral Facial Paralysis used Aqua-acupuncture Treatment. The J of Korean Acupuncture & Moxibustion Society. 2002 ; 19(1) : 11-23.
Kwon SJ, Song HS, Kim KH. The Influence of Moxibustion and Basic Compound Therapy on Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2000 ; 17(4) : 160-71.
Choi CH, Song HS. Effect of Electroacupunctrue Complex Therapy on Peripheral Facial Paralysis According to the Wave Forms. The J of Korean Acupuncture & Moxibustion Society. 2010 ; 27(5) : 43-50.
An BJ, Song HS. Effect of Electroacupuncture on Patients with Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2005 ; 22(4) : 121-9.
Hwang JH, Lee DG, Lee HJ, Cho HS, Kim KH, Kim KS. Effect of Combined Silver Spike Point Therapy and Electroacupuncture on Patients with Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2007 ; 24(4) : 69-80.
Lee CW, Lee SM, Jeon JH, Kim JI, Kim YI. Effects of Needle-Embedding Therapy on Sequelae of Peripheral Facial Palsy: A Case Series. The J of Korean Acupuncture & Moxibustion Society. 2011 ; 28(4) : 93-103.
Oh HJ, Song HS. Effect of Cupping Complex Therapy on Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2011 ; 28(4) : 119-25.
Oh MJ. Song HS. Effect of Scratching Method Complex Therapy on the Patients with Peripheral Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2011 ; 28(5) : 1-7.
Salinas RA, Alvarez G, Daly F, Ferreira J. Corticosteroids for Bell's Palsy(Idiopathic Facial Paralysis)(Review). The Cochrane Collaboration. 2010 : 1-21.
Gary S Gronseth, Remia Padua. Evidence-Based Guideline Update: Steroids and Antivirals for Bell Palsy: Report of the Guideline Development Subcommittee of The American Academy of Neurology. Neurology. 2012 ; (79) : 2209-13.
Kang MJ, Kim KH, Hwang HS. Comparative Clinical Study between Oriental Medicine and Oriental- Western Medicine Treatment on Facial Nerve Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2000 ; 17(1) : 55-66.
Kim NO, Chae SJ, Son SS. Comparative Clinical Study between Oriental Medicine and Oriental- Western Medicine Treatment on Bell's palsy. The J of Korean Acupuncture & Moxibustion Society. 2001 ; 18(5) : 99-108.
Park IB, Kim SW, Lee CW et al. Comparative Clinical Study between Oriental Medicine and Oriental-Western Medicine Treatment on Bell's Palsy. The J of Korean Acupuncture & Moxibustion Society. 2004 ; 21(5) : 191-203.
Kwon NH, Shin YJ, Kim CY et al. Comparative Clinical Study between Oriental Medical and Oriental-Western Medical Treatment on Bell's Palsy. The J of Korean Acupuncture & Moxibustion Society. 2008 ; 25(3) : 19-28.
Maria Grosheva, Claus Wittekindt, Orlando Guntinas- Lichius. Prognostic Value of Electroneurography and Electromyography in Facial Palsy. Rhinological and Otological Society. 2008 ; (3) : 394-97.
Fujiwara T, Hato N, Gyo K, Yanagihara N. Prognostic Factors of Bell's Palsy: Prospective Patient Collected Observational Study. Eur Arch Otorhinolaryngol. 2013 : 2-6.
Takemoto N, Horri A, Sakata Y, Inohaha H. Prognostic Factor of Peripheral Facial Palsy: Multivariate Analysis Followed by Receiver Operating Characteristic and Kaplan-Meier Anayses. Otol Neurotol Off Publ Am Otol Soc Am Neurotol Soc Eur Acad Otol Neurotol. 2011 ; 32(6) : 1031-6.

상세보기
Yeo SW, Lee DH, Jun BC, Chang KH, Park YS. Analysis of prognostic factors in Bell's palsy and Ramsay Hunt syndrome. Auris Nasus Larynx. 2007 ; 34(2) : 159-64.

상세보기
Lee DH, Jun BC, Lee DH, Hong SJ, Chang KH, Yeo SW. Analysis of Prognostic Factors in Bell's Palsy and Ramsay-Hunt's Syndrome. Korean J Otolaryngol-Head Neck Surg. 2005 ; 48(9) : 1081-5.
Morishima N, Yagi R, Shimizu K, Ota Susumu. Prognostic Factors of Synkinesis after Bell's Palsy and Ramsay Hunt Syndrome. Auris Nasus Larynx. 2013 ; 40(5) : 431-4.

상세보기
Katusic SK, Beard CM, Bergstralh EJ et al. Incidence, Clinical Features, and Prognosis in Bell's palsy. Annals of Neurology. 1986 ; 20(5) : 622-7.

상세보기
Ikeda M, Abiko Y, Kukimoto N, Omori H, Nakazato H, Ikeda K. Clinical Factors that Influence the Prognosis of Facial Nerve Paralysis and the Magnitudes of Influence. The Laryngoscope. 2005 ; 115(5) : 855-860.

상세보기
Ryu EW, Lee HY, Lee SY, Park MS, Yeo SG. Clinical Manifestations and Prognosis of Patients with Ramsay Hunt Syndrome. American Journal of Otolaryngology. 2012 ; 33(3) : 313-8.

상세보기
Riga M, Kefalidis G, Danielides V. The Role of Diabetes Mellitus in the Clinical Presentation and Prognosis of Bell Palsy. J Am Board Fam Med. 2013 ; 25(6) : 819-26.
Kanazawa A, Haginomori S, Takamaki A, Nonaka R, Araki M, Takenaka H. Prognosis for Bell's Palsy: A Comparison of Diabetic and Nondiabetic Patients. Acta Oto-Laryngologica. 2007 ; 127(8) : 888-91.

상세보기
Ahn CB, Yoon HM, Jang KJ et al. An Analysis of Clinical Prognosis Factros of Peripheral Facial Palsy and the Effects of Electrodiagnostic Test. The J of Korean Acupuncture & Moxibustion Society. 2007 ; 24(4) : 209-23.
SIllman JS, John K Niparko, Sharon S Lee, Paul R Kileny. Prognostic Value of Evoked and Standard Electromyography in Acute Facial Paralysis. Otolaryngol Head Neck Surg. 1992 ; 107(3) : 377-81.

상세보기
Sung WS, Goo BH, Ryu HK et al. Study on the Validity of Electromyography(EMG) And Earlyperformed Electroneurography(ENoG) as Predicting Factor for Facial Palsy-Based on Collaborative Treatment between Korean and Western Medicine. The J of Korean Acupuncture & Moxibustion Society. 2013 ; 30(4) : 115-23.
Meral EK, Derya U, Mehmet Y, Nurten U. Electrophysiological Findings of Acute Peripheral Facial Palsy in Diabetic and Non-diabetic Patients. Neuroscience Letters. 2007 ; 418(3) : 222-26.

상세보기
Grosheva M, Guntinas-Lichius O. Significance of Electromyography to Predict and Evaluate Facial Function Outcome after Acute Peripheral Facial Palsy. Eur Arch Otorhinolaryngol. 2007 : 264(12) ; 1491-5.

상세보기
Djordjevic G, Djuric S. Early Prognostic Value of Electrophysiological Tests in Bell's Palsy-Estimating the Duration of Clinical Recovery. Medicine and Biology. 2005 ; 12(1) : 47-54.
Kim MJ, Kim JH, Park SY et al. Retrospective Study on 100 Cases of Inpatients with Facial Paralysis. The J of Korean Acupuncture & Moxibustion Society. 2009 ; 22(2) : 128-38.

저자의 다른 논문 :

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증

Abstract ▼ AI-Helper

주제어

질의응답

참고문헌 (40)

이 논문을 인용한 문헌

저자의 다른 논문 :

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

연관된 기능

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트

연합인증

Abstract ▼ AI-Helper

주제어

질의응답

참고문헌 (40)

이 논문을 인용한 문헌

저자의 다른 논문 :

김필군 (4) 성원석 (4) 구본혁 (10) 유희경 (5) 석경환 (6) 이주현 (6) 박연철 (19) 서병관 (43) 백용현 (63) 박동석 (95)

관련 콘텐츠

원문 보기

원문 URL 링크

오픈액세스(OA) 유형

연관된 기능

이 논문과 함께 이용한 콘텐츠

AI-Helper ※ AI-Helper는 오픈소스 모델을 사용합니다.

선택된 텍스트