[논문]지체 장애인의 베체트병 약물치료 중 발생한 구강 건조증 치험 1례

강병수; 강덕; 김종한

doi:10.6114/jkood.2021.34.1.112

지체 장애인의 베체트병 약물치료 중 발생한 구강 건조증 치험 1례
A Case of Xerostomia that Occurred during Behcet's Disease Drug Treatment of a Person with Physical Disability 원문보기

韓方眼耳鼻咽喉皮膚科學會誌 = The journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology, v.34 no.1, 2021년, pp.112 - 135

강병수 (원주시 보건소 건강증진과) , 강덕 (모커리한방병원 한방재활의학과) , 김종한 (동신대학교 한의과대학 안이비인후피부과학교실)

초록
AI-Helper

2020년 7월부터 2020년 12월까지 일개 보건소 건강증진과에서 관할지역 거주 중증 장애인 중 뇌병변 장애와 지체 장애인을 대상으로 한의약 장애인 방문건강관리 표준프로그램을 진행하였고, 이 중 1명의 중증 지체 장애인이 구강 건조증을 앓고 있어, 한의 치료의 개입을 통한 통합적인 관리한 결과는 다음과 같다. 1. 팔물탕(八物湯) 연조엑스제를 포함한 한의 치료는 YDQ에 의해 음허(陰虛)로 변증된 지체 장애인의 약물 유발성 구강 건조를 완화시키고 삶의 질을 호전시켰다. 2. 건강 보험에 포함된 한의 치료를 제공하여 한·양방 통합적 개입으로 양약으로 발생한 구강 건조 증상을 관리할 수 있었다. 3. 6개월간 투약된 팔물탕(八物湯) 연조엑스로 인한 이상 반응은 없었다. 4. 팬데믹 상황에서 한의약 방문 진료와 전화 진료가 혼합된 형태의 공공보건기관의 한의약 건강증진사업으로 장애인의 SHCN를 충족하고 장애인의 만성 질환 관리가 가능한 부분을 확인할 수 있었다. 5. 본 연구는 한방안이비인후피부과 증상 및 질환도 보건소 한의약 건강증진사업으로 포함할 수 있는 가능성을 확인하였으며, 유관 학회의 협력 및 지원과 연구가 필요하다고 생각된다.

Abstract ▼ AI-Helper

Objectives : To report a case of drug-induced xerostomia treated with Integrative Korean Medicine Visiting Care Service of a Public Health Center. Methods : Home visit treatment and telemedicine were provided by public health doctor(Korean medicine doctor) for person with physical disability who were diagnosed with Behcet's Disease. Palmul-tang(PMT) soft extract was provided steadily 3 times a day for 6 months, and acupuncture, electro-acupuncture, and electro-moxibustion were provided irregularly 6 times for 6 months. Yin-deficiency questionnaire(YDQ), oral health impact profile-14(OHIP-14), oral pain visual analogue scale(VAS), and xerostomia inventory(XI) were used 3 times(baseline, intermediate and termination) to evaluate the changes. Results : YDQ decreased from 620 to 375, OHIP-14 decreased from 34 to 6, VAS decreased from 70 to 40, and XI decreased from 44 to 34. Four scales all gradually decreased. Conclusions : Integrative Korean Medicine Treatments in health insurance including PMT soft extract through home visit treatment can improve drug-induced xerostomia and Quality of life(QoL) of person with disabilities.

주제어

표/그림 (8)

표 Table 1. Prescription of Palmul-tang Soft Extract
표 Table 2. Korean Medicine Treatments for the Subject
표 Table 3. Existing Medications of Subject
그림 Fig. 1. Change of YDQ and OHIP-14 Scales about xerostomia gradually decreased. * YDQ, Yin-deficiency questionnaire; OHIP-14, Oral Health Impact Profile-14;
그림 Fig. 2. Change of XI and oral pain VAS Scales about xerostomia gradually decreased. * XI, Xerostomia Inventory; VAS, Visual Analog Scale;
표 Table 4. Changes of Scales
표 Table 5. Patient Satisfaction about the Program
표 Table 6. Patient Perspective

참고문헌 (23)

Guggenheimer J, Moore PA. Xerostomia: Etiology, recognition and treatment. The Journal of the American Dental Association. 2003;134(1):61-9.

상세보기
Villa A, Connell CL, Abati S. Diagnosis and management of xerostomia and hypo-salivation. Therapeutics and Clinical Risk Management. 2015;11:45-51.

상세보기
Devinsky O, Boyce D, Robbins M, Pressler M. Dental health in persons with disability. Epilepsy & Behavior. 2020;110:1-6.
Song YK, Shin BC, Cha YY, Hwang EH, Kang HW, Park TY, et al. Development of Visiting health care program for Korean Medicine for the disabled(Final report). Sejong:Ministry of Health and Welfare. 2018:54-111, 117, 121-6.
Shin DW, Choi YJ, Park JH, Park JH, Kim SY, Kim SH, et al. A study on the evaluation of a pilot project by the General Physician for the Disabled. Wonju:Health Insurance Review & Assessment Service. 2019:162, 209-10.
Jae LS, Bae PJ, Shil LS, Ho KK. Development of Yin-Deficiency Questionnaire and Examine the Reliability and Validity. Journal of Physiology & Pathology in Korean Medicine. 2004;18(2):376-80.
Jang SW, Kim JS. Development cut-off value for yin-deficiency questionnaire and diagnostic ability of yin-deficiency in xerostomia. The Journal of Internal Korean Medicine. 2014;35(4):483-97.
Bae KH, Kim HD, Jung SH, Park DY, Kim JB, Paik DI, et al. Validation of the Korean version of the oral health impact profile among the Korean elderly. Community dentistry and oral epidemiology. 2007; 35(1):73-9.

상세보기
Lee J, Koh JH, Kwok SK, Park SH. Translation and Validation of a Korean Version of the Xerostomia Inventory in Patients with Primary Sjogren's Syndrome. Journal of Korean Medical Science. 2016;31(5):724-8.

상세보기
Williamson A, Hoggart B. Pain: a review of three commonly used pain rating scales. Journal of Clinical Nursing. 2005;14(7):798-804.

상세보기
Atkinson TM, Ryan SJ, Bennett AV, Stover AM, Saracino RM, Rogak LJ, et al. The association between clinician-based common terminology criteria for adverse events (CTCAE) and patient-reported outcomes (PRO): a systematic review. Support Care Cancer. 2016;24(8):3669-76.

상세보기
Hwang BK, Lim SM, Park JH, Shin HI. Unmet Healthcare Needs in People with Disabilities: Comparison with the General Population in Korea. Annals of Rehabilitation Medicine. 2011;35(5):627-35.

상세보기
Lee MS, Choi TY, Jun JH, Lee HW, You SS, Jang SB. Behcet's Disease Intergrative Medicine Clinical Practice Guideline. Seoul:E-Tree Publishing. 2019:28-9, 32, 34-5, 41-2, 60-75.
Yong SI, Gu HG, Kim DH, Sohn KW, Yun YJ. Analysis of Clinical Researches on Traditional Medicine Treatment for Behcet's Disease in Korea, China, and Japan. Journal of Society of Preventive Korean Medicine. 2014;18(1):67-82.
Lim RJ, Nik Nabil WN, Chan SY, Wong YF, Han LX, Gong JY, et al. Effects of herbal medicine for xerostomia in head and neck cancer patients: an observational study in a tertiary cancer hospital. Support Care Cancer. 2019;27(9):3491-8.

상세보기
Dawidson I, Angmar-Mansson B, Blom M, Theodorsson E, Lundeberg T. The influence of sensory stimulation (acupuncture) on the release of neuropeptides in the saliva of healthy subjects. Life Science. 1998;63(8): 659-74.

상세보기
Korea Pharmaceutical Information Center [Internet]. 2018[cited 2021 JAN 16]. Available from: URL:http://www.health.kr/searchDrug/result_drug.asp?drug_cd2018050200033
Kim JY, Kim JS, Park JW, Ryu BH. Availability of Diagnosis of Yin-deficiency in Elderly People with Xerostomia and Factors Influencing Subjective Oral Dryness: A Prospective Cross-sectional Study. Journal of Korean Medicine. 2013;34(3):13-24.

원문보기 상세보기
Kim SH, Lee YH, Hwang JH, Oh MA, Yi MG, Oh DE, et al. National Survey of People with Disabilities in 2017. Sejong:Ministry of Health and Welfare;2017:245-6.
Yang MS, Kim KO, Jeong YS. A Pilot Study to Measure Patient Satisfaction with the Bojungikgi-tang Soft Extract. The Journal of Herbal Formula Science. 2016;24(4):301-9.
Filshie J, White A, Cummings M. Medical Acupuncture: A Western Scientific Approach. (korea translation) 2nd ed. Amsterdam:Elsevier. 2016:164-6, 508, 548-9,
Li L, Tian G, He J. The standardization of acupuncture treatment for radiation-induced xerostomia: A literature review. Chinese Journal of Integrative Medicine. 2016;22(7):549-54.

상세보기
Liu W, Liu B, Zheng H. Observation on therapeutic effect of acupuncture and moxibustion in 60 cases of Sjogren syndrome. Zhongguo Zhen Jiu. 2005;25(2): 101-2.

상세보기

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