[논문]자율신경 기능 이상이 동반된 류마티즘 환자에 대한 온열-척추 마사지 치료 효과 : 증례 연구

최준현; 이정후; 윤용순

doi:10.15207/jkcs.2020.11.8.331

초록
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만성통증을 동반한 류마티즘 환자에서 자율신경계 이상(autonomic nervous system dysfunction)이 동반되기도 한다. 특히 만성통증 환자에서 자율신경계 이상은 국소 통증 강도 증가 및 통증 역치 감소를 발생하여 만성 근골격계 통증에 악영향을 미친다고 확인되었다. 이런 만성 근골격계 통증 환자에 온열-척추 마사지 치료를 실시한 실험에서 통증경감과 자율신경계 회복이 되었다고 보고되고 있다. 그래서 우리는 만성 통증과 자율신경계 이상이 동반된 류마티즘 환자에 온열-척추 마사지 치료를 적용하였고 자율신경기능의 회복과 통증의 감소를 경험한 사례가 있어 보고하고자 한다.

Abstract ▼ AI-Helper

Rheumatoid arthritis ("RA"), whose characteristics are chronic inflammation and chronic pain, accompanies autonomic nervous system(ANS) dysfunction. In particular, ANS dysfunction in patients with chronic musculoskeletal pain was found to have increased the local pain intensity while lowering the pa...

Rheumatoid arthritis ("RA"), whose characteristics are chronic inflammation and chronic pain, accompanies autonomic nervous system(ANS) dysfunction. In particular, ANS dysfunction in patients with chronic musculoskeletal pain was found to have increased the local pain intensity while lowering the pain threshold, thereby negatively influencing pain. It is reported that thermo-spinal massage affects relief of chronic pain and recovery of ANS in patients with chronic musculoskeletal pain. Therefore, we report a case of rheumatoid patients with chronic pain and ANS dysfunction, who experienced recovery of ANS dysfunction and pain reduction by applying thermo-spinal massage treatment.

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표/그림 (8)

그림 Fig. 1. (a) The result shows delayed onset latency. (b) Within 3 min of standing, a decrease in systolic blood pressure by ≥20 mmHg or diastolic blood pressure by ≥10 mmHg was observed (baseline blood pressure [BP], 105/58 mmHg and heart rate [HR], 71 beats per minute; head-up tilt BP, 82/48 mmHg and HR, 89 beats per minute; and head-down tilt BP, 135/77 mmHg and HR, 78 beats per minute)
그림 Fig. 2. Changes in mean visual analog scale (VAS) score and number of opioids used during the 20-week treatment period.
표 Table 1. Blood Sampling Test
그림 Fig. 3. Flowchart of the measurements
표 Table 2. Measure 1: Thermo-spinal massage treatment
표 Table 3. Measure 2: Bed rest treatment.
그림 Fig. 4. Measure 1: Thermo-spinal massage treatment. (a),(b),(c), and (d)
그림 Fig. 5. Measure 2: Bed rest treatment.

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문제 정의

, who reported the effects of simultaneous thermospinal massage treatment in patients with chronic pain. The result in this study is thus presumed to indicate an improvement in the parasympathetic activity during the simultaneous thermospinal massage treatment.

제안 방법

A 43-year-old female patient who had been diagnosed as having RA 14 years before was transferred from the division of rheumatology to our department for pain control. The patient complained of arthralgia caused by RA in the metacarpophalangeal and proximal interphalangeal joints from the first to the fourth fingers of both hands, shoulder pain on both sides, neck pain, tension-type headache, and intermittent dizziness. The shoulder pain on both sides, neck pain, and headache showed mean visual analog scale (VAS) scores of 5–6 in daily activities, with a pattern of aggravation to VAS scores of 7–9 several times during the day.
To ease the pain and increase the stability of the patient’s condition, a device for simultaneous thermospinal massage treatment was recommended. The patient used the thermospinal massage device (CGM MB-1401; Ceragem, South Korea) for 40 min twice a day during the 20-week treatment period.
This study thus applied thermospinal massage treatment with a reported effect on reduced pain via ANS regulation in patients with rheumatism who had autonomic dysfunction and reports the consequent positive effect on pain control in a single case.

대상 데이터

A 43-year-old female patient who had been diagnosed as having RA 14 years before was transferred from the division of rheumatology to our department for pain control. The patient complained of arthralgia caused by RA in the metacarpophalangeal and proximal interphalangeal joints from the first to the fourth fingers of both hands, shoulder pain on both sides, neck pain, tension-type headache, and intermittent dizziness.

성능/효과

After 12 weeks, the pain level was reduced to a VAS score of 1–3, without the previously observed pain increase during the day; thus, the opioid medication was withdrawn (as shown Fig. 2).
In addition, dizziness was reduced, and the sleep pattern was improved. After the 20 weeks of using the device for the simultaneous thermospinal massage treatment, heart rate variability (HRV) was analyzed to examine the continuous change of the ANS in relation to the use of the device, as the analysis has been reported to be a noninvasive method with high levels of reliability and reproducibility[7].
For Measurement 2, the SDNN and RMSSD increased during bed rest, while the LF decreased, HF increased, and LF/HF ratio decreased, but the levels of the changes were lower than those in Measurement 1 with simultaneous thermospinal massage treatment. In addition, the measurement after the treatment showed an increase in sympathetic activity as compared with that before the treatment (as shwon Fig.
The initial blood test results showed that the white blood cell count and C-reactive protein level in cerebrospinal fluid were normal, while the measurements of the levels of the RA factors, anti-CCP, and antistreptolysin O were higher than the normal levels (as shwon Table 1).

후속연구

Despite several limitations, including the fact that only a single case is reported, HRV was not measured prior to the initiation of the 20-week simultaneous thermo-spinal massage treatment, and HRV was measured two times, the findings of the present case imply the need for further research on the effects of simultaneous thermospinal massage treatment on other types of chronic pain in addition to that in rheumatism with autonomic dysfunction.

참고문헌 (16)

A. M. Adlan, G. Y. Lip, J. F. Paton, G. D. Kitas & J. P. Fisher. (2014). Autonomic function and rheumatoid arthritis-A systematic review. Seminars in Arthritis and Rheumatism, 44(3), 283-304. DOI : 10.1016/j.semarthrit.2014.06.003

상세보기
D. Hallman & E. Lyskov. (2012). Autonomic regulation in musculoskeletal pain. IntechOpen. 35-62. DOI :10.5772/51086
S. Inoue & M. Kabaya (1989). Biological activities caused by far-infrared radiation. International Journal of Biometeorology, 33(3), 145-150. DOI : 10.1007/BF01084598

상세보기
C. A. Moyer, J. Rounds & J. W. Hannum (2004). A meta-analysis of massage therapy research. Psychological bulletin, 130(1), 3-18. DOI : 10.1037/0033-2909.130.1.3

상세보기
Y. D. Kim, Y. S. Chang, D. H. Choi, H. J. Lee & K. S. Tae. (2010). Evaluation of immediate effects of an electrical massager on stress relaxation using the heart rate variability (HRV). Journal of the Korean Society for Precision Engineering, 27(6), 75-81.
D. W. Lee, J. H. Park, S. N. Eom, D. W. Kim, S. H. Cho, C. Y. Ko & H. S. Kim. (2012). Effects of Combined Stimulus on Stress Relief. Journal of Biomedical Engineering Research, 33(4), 194-201.

원문보기 상세보기
Electrophysiology, T. F. O. T. E. S. O. C. T. N. A. S. O. P. (1996). Heart rate variability: standards of measurement, physiological interpretation, and clinical use. Circulation, 93(5), 1043-1065. DOI : 10.1161/01.CIR.93.5.1043

상세보기
K. E. Speer, S. Semple, N. Naumovski & A. J. McKune. (2020). Measuring Heart Rate Variability Using Commercially Available Devices in Healthy Children: A Validity and Reliability Study. European Journal of Investigation in Health, Psychology and Education, 10(1), 390-404. DOI : 10.3390/ejihpe10010029

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M. V. Kamath & E. L. Fallen, (1993). Power spectral analysis of heart rate variability: a noninvasive signature of cardiac autonomic function. Critical reviews in biomedical engineering, 21(3), 245-311.

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L. A. De Luca Jr, J. V. Menani & A. K. Johnson. (2014). Circumventricular Organs: Integrators of Circulating Signals Controlling Hydration, Energy Balance, and Immune Function. Neurobiology of Body Fluid Homeostasis: Transduction and Integration. Boca Raton : CRC Press/Taylor & Francis.
A. M. Adlan, J. J. V. van Zanten, G. Y. Lip, J. F. Paton, G. D. Kitas & J. P. Fisher. (2017). Cardiovascular autonomic regulation, inflammation and pain in rheumatoid arthritis. Autonomic Neuroscience, 208, 137-145. DOI : 10.1016/j.autneu.2017.09.003

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K. J. Tracey. (2002). The inflammatory reflex. Nature, 420(6917), 853-859. DOI : 10.1038/nature01321

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T. Schlereth & F. Birklein. (2008). The sympathetic nervous system and pain. Neuromolecular medicine, 10(3), 141-147. DOI :10.1007/s12017-007-8018-6

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W. Janig. (2003). Relationship between pain and autonomic phenomena in headache and other pain conditions. Cephalalgia, 23(1 suppl), 43-48. DOI : 10.1046/j.1468-2982.2003.00573.x
T. A. Lovick (1991). Interactions between descending pathways from the dorsal and ventrolateral periaqueductal gray matter in the rat. In The midbrain periaqueductal gray matter. pp. 101-120. Boston : Springer.
M. N. Murphy, M. Mizuno, J. H. Mitchell & S. A. Smith. (2011). Cardiovascular regulation by skeletal muscle reflexes in health and disease. American Journal of Physiology-Heart and Circulatory Physiology, 301(4), H1191-H1204. DOI : 10.1152/ajpheart.00208.2011

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자율신경 기능 이상이 동반된 류마티즘 환자에 대한 온열-척추 마사지 치료 효과 : 증례 연구
Effects of Thermo-spinal massage treatment in a Patient with Rheumatism patient with Autonomic nervous system Dysfunction: A Case Report 원문보기

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자율신경 기능 이상이 동반된 류마티즘 환자에 대한 온열-척추 마사지 치료 효과 : 증례 연구 Effects of Thermo-spinal massage treatment in a Patient with Rheumatism patient with Autonomic nervous system Dysfunction: A Case Report 원문보기

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자율신경 기능 이상이 동반된 류마티즘 환자에 대한 온열-척추 마사지 치료 효과 : 증례 연구
Effects of Thermo-spinal massage treatment in a Patient with Rheumatism patient with Autonomic nervous system Dysfunction: A Case Report 원문보기

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