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COVID-19 후각 이상에 대한 한의학적 고찰

Olfactory Dysfunction in COVID-19 from a Korean Medical Perspective

김종현|김상현
대한한의학원전학회|2022.05|대한한의학원전학회지 (The Journal Of Korean Medical Classics)|제35권 제2호|pp. 99-120

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참고문헌

키워드

COVID-19후각 이상후각 장애외감병미각 이상olfactory dysfunctionloss of smellexternal contraction diseaseloss of taste
주제분류한의학

초록

Objectives : COVID-19로 인해 발생하는 후각 이상에 대해 한의학적 관점에서 분석한다. Methods : COVID-19에 수반되는 후각 이상을 다룬 선행연구를 분석하여 대체적인 특징을 도출한 후 한의학 문헌에서 후각의 생리 및 병인병기에 관한 내용을 수집하고 분석한다. 이들을 바탕으로 COVID-19의 후각 이상을 한의학의 관점에서 고찰한다. Results : 후각 이상은 COVID-19 확진 초기에 높은 비율로 발현되며 코 막힘, 콧물 등 코 증상들과 별개로 나타나기도 한다. 높은 확률로 미각 이상을 겸하고 집중력 저하 등의 정신 이상과 함께 나타나는 경향이 보이며, 대부분의 경우 1~2주 내에 회복된다. 한의학적으로 볼 때 후각의 생리는 肺, 宗氣, 心과 밀접한 관련이 있고 風寒, 火鬱, 氣虛, 中風 등의 병기로 인해 정상생리가 저해되면 후각 이상이 나타날 수 있다. Conclusions : 외감병에서는 호흡에 관여하는 肺·胃나 냄새의 인지 및 분별에 관여하는 心의 문제로 인해 후각 이상이 유발될 수 있는데, COVID-19의 대체적인 특징은 心과의 깊은 관련성을 시사한다. 실제 치료에 있어서는 전반적인 증상을 기준으로 변증하여 치법을 구성해야 하며, 肺·胃의 문제나 心의 문제로 구분하여 접근할 수 있다.

Abstract

Objectives : To analyze symptoms of olfactory dysfunction caused by COVID-19 from a Korean Medical Perspective. Methods : Previous studies dealing with olfactory dysfunction accompanying COVID-19 were studied and analyzed for general characterization. Physiology and pathology of olfactory functions within the classical texts of Korean Medicine were collected and analyzed, through which symptoms of olfactory dysfunction in COVID-19 were examined. Results : Olfactory dysfunction manifested in high ratios in the early stages of confirmed COVID-19 cases, at times independent of other nasal symptoms such as blockage or discharge. There was a high chance of loss of taste being accompanied, while mental problems such as a tendency to have difficulty concentrating were present as well. In most cases, recovery took one to two weeks. From a Korean Medical perspective, physiology of olfactory function is closely linked to the Lungs, Ancetral Qi[宗氣], and the Heart, while its dysfunction could be explained by pathological factors such as Wind-Cold, Fire stagnation, Qi deficiency, Wind stroke, etc. Conclusions : In the context of external contraction disease[外感病], olfactory dysfunction could be caused by problems in the Lungs and Stomach that are responsible for breathing, or the Heart which is involved in recognizing and differentiating scent. General characteristics of COVID-19 imply it to be closely related to the Heart. In clinical application, overall symptoms need to be considered in diagnosis and treatment planning, after which further approaches could made to determine the problem to be of the Lung and Stomach, or of the Heart.

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