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진정수면제를 음독한 노인 입원 환자에서 발생한 섬망에 대한 한의복합중재 증례보고

Korean Medicine Treatments for Delirium in an Elderly Patient Caused by Sedative-Hypnotics Overdose

김근우|조한별|구병수
대한한방신경정신과학회 (The Korean Society Of Oriental Neuropsychiatry)|2023.12|동의신경정신과학회지 (The Korean Society of Oriental Neuropsychiatry)|제34권 제4호|pp. 473-485|DOI 10.7231/jon.2023.34.4.473

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키워드

Elderly patientDeliriumKorean medicine treatmentOverdoseSedative-hypnotics
주제분류한의학

초록

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative- hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale- Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

Abstract

Objectives: The purpose of this study was to report the effectiveness of the combination of Korean medicine therapy on elderly patients with delirium due to overdose of sedative-hypnotics. Methods: The patient was diagnosed with delirium, which occurred after an overdose of sedative- hypnotics. The patient received Korean Medicine treatment, including herbal medicine, acupuncture, moxibustion and psychotherapy, and other treatments. The evaluation variables to check the effectiveness of the interventions were the Korean Version of the Delirium Rating Scale- Revised-98 (K-DRS-R-98) Mini-Mental State Examination-Korean (MMSE-K) Clinical Dementia Rating (CDR) and Manual Muscle Test (MMT). Results: During the hospitalization period, the K-DRS-R-98 score decreased from 31 to 4, MMSE-K score increased from 18 to 26. CDR score decreased from 2 to 0. MMT in the Right lower extremity was improved. Normal daily activities were possible. Conclusions: Combining Korean Medicine treatments, including herbal medicine, acupuncture, moxibustion, psychotherapy, and other treatments, may help alleviate delirium.

참고문헌 (23)

  1. American Psychiatric Association, "Diagnostic and statistical manual of mental disorders Fifth Edition(DSM-5®)" (2013), American Psychiatric Association
  2. 박재섭, "섬망 환자에서 항정신병약물 처방 유형에 따른 임상 경과의 차이", 정신신체의학, 25(2), pp.120~128 (2017), 한국정신신체의학회
  3. 임채성, "노인 입원 환자에서 섬망 발생과 결과에 대한 후향적 연구", 생물치료정신의학, 18(2), pp.186~193 (2012), 대한생물치료정신의학회
  4. 유상빈, "노인 입원 환자의 섬망 예방을 위한 비약물 중재에 대한 체계적 문헌고찰", 기본간호학회지, 28(2), pp.249~262 (2021), 기본간호학회[DOI]
  5. Shin JY, "Clinical Practice Guideline for Screening of Delirium in Hospitalized Older Adults", Korean J Fam Pract, 8, pp.645~653 (2018)
  6. 민성순, "？妄을 동반한 煩躁 환자의 치험 1례", 동의생리병리학회지, 19(6), pp.1715~1719 (2005), 한의병리학회
  7. 서명진, "《靈樞ㆍ癲狂篇》에 對한 硏究", 대한한의학원전학회지, 11(1), pp.360~394 (1998), 대한한의학원전학회
  8. The Korean Society of Oriental Neuropsychiatry, "Neuropsychiatry of Korean Medicine", pp.674~679 (2018), Maver Publishing
  9. Ku BD, "Clinical Approach to the Patients with Delirium in the Neurocritical Care", J Neurocrit Care, 3, pp.27~37 (2010)
  10. 이준, "한국판 섬망 평가 척도-98(K-DRS-98)을 이용한 섬망의 진단과 심각도 그리고 아형에 관한 연구", 생물치료정신의학, 14(1), pp.101~109 (2008), 대한생물치료정신의학회
  11. Folstein MF, "“Mini-Mental State”. A practical method for grading the cognitive state patients for the clinician", J Psychiatr Res, 12, pp.189~198 (1975)
  12. Kwon Y, "Standardization of Korean Version of the Mini-Mental State Examination(MMSE-K) in the Elderly", J Korean Neuropsychiatr Assoc, 28, pp.125~135 (1989)
  13. Park JH, "Standardization of Korean Version of Mini-Mental State Examination (MMSE-K) for use in the elderly. Part II. Diagnostic validity", J Korean Neuropsychiatr Assoc, 28, pp.508~513 (1989)
  14. 오병훈, "한국판 Neuropsychiatric Inventory로 본 치매 단계에 따른 행동 · 정신증상 특징", 신경정신의학, 43(5), pp.596~602 (2004), 대한신경정신의학회
  15. Choi IS, "Steps to internal medicine", pp.59~62 (2008), Jeongdam Publishing
  16. Trzepacz PT, "The neuropathogenesis of delirium. A need to focus our research", Psychosomatics, 35, pp.374~391 (1994)
  17. Jones RN, "Prevalence of delirium on admission to postacute care is associated with a higher number of nursing home deficiencies", J Am Med Dir Assoc, 11, pp.253~256 (2010)
  18. Abraha I, "Non-pharmacological interventions to prevent or treat delirium in older patients : clinical practice recommendations the SENATOR-ONTOP series", Journal of Nutrition, Health & Aging, 20, pp.927~936 (2016)
  19. 조하나, "한국의 노인환자에 대한 섬망 및 졸음 유발 약물의 사용평가", 한국임상약학회지, 22(1), pp.30~40 (2012), 한국임상약학회
  20. 김상균, "오령산 구성약재 성분의 Drug-likeness와 Oral bioavailability", 대한본초학회지, 33(5), pp.19~37 (2018), 대한본초학회[DOI]
  21. Kim BK, "Characteristics of elderly patients with acute poisoning", J Korean Soc Clin Toxicol, 8, pp.61~68 (2010)
  22. Tombaugh TN, "Test-retest reliable coefficients and 5-year change scores for the MMSE and 3MS", Arch Clin Neuropsychol, 20, pp.485~503 (2005)
  23. 김하늬, "정신건강의학과 입원환자에서 자살행동 관련 요인", 신경정신의학, 58(3), pp.202~208 (2019), 대한신경정신의학회[DOI]

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