당뇨를 동반한 외상성 뇌내출혈 이후 혈관성 치매 환자에 대한 한의복합치료 치험 1례
A Case Study of Combined Korean Medicine in Treating a Patient with Vascular Dementia after Traumatic Intracerebral Hemorrhage Accompanying Diabetes
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Objective: This study investigated Korean medicine in treating a case of cognition impairment after stroke with diabetes. Methods: A patient was treated with acupuncture, electroacupuncture, moxibustion, and herbal medicine (Yukmijihwang-tang (Liuweidihuang-wan)) for 69 days. Rehabilitation and speech therapy were also provided. Results: The degree of improvement in symptoms was evaluated using the Korea mini-mental state examination (K-MMSE), the Korean version of the modified Barthel index (K-MBI), the functional independence measure (FIM), the manual muscle test (MMT), HbA1c, average fasting blood sugar, glycated hemoglobin level (HbA1c), and changes in insulin usage. After 66 days of treatment, the MMSE-K increased from 8 to 18, the K-MBI score increased from 13 to 69, and the FIM score increased from 30 to 62. The MMT score increased from left upper extremity Gr.2+P and left lower extremity Gr.2P to left upper extremity Gr.3+F and left lower extremity Gr.3+F. HbA1c changed from 7.1% to 6.5%. Conclusion: This case report suggests that Korean medicine therapy can be effective in improving cognition following traumatic intracerebral hemorrhage and diabetes.
Abstract
Objective: This study investigated Korean medicine in treating a case of cognition impairment after stroke with diabetes. Methods: A patient was treated with acupuncture, electroacupuncture, moxibustion, and herbal medicine (Yukmijihwang-tang (Liuweidihuang-wan)) for 69 days. Rehabilitation and speech therapy were also provided. Results: The degree of improvement in symptoms was evaluated using the Korea mini-mental state examination (K-MMSE), the Korean version of the modified Barthel index (K-MBI), the functional independence measure (FIM), the manual muscle test (MMT), HbA1c, average fasting blood sugar, glycated hemoglobin level (HbA1c), and changes in insulin usage. After 66 days of treatment, the MMSE-K increased from 8 to 18, the K-MBI score increased from 13 to 69, and the FIM score increased from 30 to 62. The MMT score increased from left upper extremity Gr.2+P and left lower extremity Gr.2P to left upper extremity Gr.3+F and left lower extremity Gr.3+F. HbA1c changed from 7.1% to 6.5%. Conclusion: This case report suggests that Korean medicine therapy can be effective in improving cognition following traumatic intracerebral hemorrhage and diabetes.
참고문헌 (29)
- Korean stroke society, "stroke. 2nd impression", pp.521~535 (2017), Panmuneducation
- Gallucci L, "Post-stroke cognitive impairment remains highly prevalent and disabling despite state-of-the-art stroke treatment", Int J Stroke, 19(8), pp.888~897 (2024)
- Kitabchi AE, "Hyperglycemic Crises in Adult Patients With Diabetes", Diabetes Care, 32(7), pp.1335~1343 (2009)
- Musey VC, "Diabetes in urban African-Americans. I. Cessation of insulin therapy is the major precipitating cause of diabetic ketoacidosis", Diabetes Care, 18(4), pp.483~489 (1995)
- Ohara N, "Type 1 Diabetes Mellitus and Pernicious Anemia in an Elderly Japanese Patient : A Case Report and Literature Review", Intern Med Tokyo Jpn, 54(18), pp.2361~2365 (2015)
- Shin YJ, "Clinical and Biochemical Characteristics of Elderly Patients with Hyperglycemic Emergency State at a Single Institution", Annals of Geriatric Medicine and Research, 20(4), pp.185~189 (2016)
- Yang S, "Effect of Diabetes on Post-stroke Recovery : A Systematic Narrative Review", Front Neurol, 12, pp.747878~ (2021)
- Wei XL, "Studies on learning and memory function-related genes in the hippocampus and the relationship between the cognitive enhancing effect of liuwei dihuang decoction(LW)and gene expression", Sheng Li Ke Xue Jin Zhan, 31(3), pp.227~230 (2000)
- Lee JG, "Analysis of Studoes on Yukmijihwang-tang for Estabilishment of Evidence Based Medicine", Korean J Oriental Physiology and pathology, 23(1), pp.15~26 (2009)
- Park MS, "A Case Report of a Patient with Mild Cognitive Impairment Treated with Gugijihwang-tang", J Int Korean Med, 42(5), pp.1082~1093 (2021)
- Jung WS, "Case Report of Yukmijihwang-tang(Liuweidiguang-fang)on Diabetes Mellitus in Stroke Patients Diagnosed as Kidney-Yin Dificiency or Non Kidney-Yin Deficiency Synerome", The Korean journal of Joongpoong, 11(1), pp.82~88 (2010)
- Choi K, "A case of diabetic ketoacidosis", J Intern Korean Med, 23(1), pp.141~146 (2002)
- Jung HY, "Development of the Korean Version of Modified Barthel Index(K-MBI) : Multi-center Study for Subjects with Stroke", Journal of the Korean Academy of Rehabilitation Medicine, 31(3), pp.283~297 (2007)
- Stineman MG, "The Functional Independence Measure : tests of scaling assumptions, structure, and reliability across 20 diverse impairment categories", Arch Phys Med Rehabil, 77(11), pp.1101~1108 (1996)
- Kim JM, "Comparison of diagnostic validities between MMSE-K and K-MMSE for screening of dementia", Journal of the Korean Neuropsychiatric Association, 42(1), pp.124~130 (2003)
- Kang YW, "A validity study on the korean mini-mental state examination(K-MMSE)in dementia patients", Journal of the Korean Neurological Association, 15(2), pp.300~308 (1997)
- Yoo HY, "Relationship between diet, exercise, stress, and HbA1C among patients with Type 2 diabetes mellitus", Yonsei University Health System Repository, ~ (2004)
- Cho Y, "The Effects of Computerized Cognitive Rehabilitation on Cognitive Function in Elderly Post-stroke Patients", Journal of Special Education & Rehabilitation Science, 51(4), pp.261~278 (2012)
- Kim JW, "Cognitive-Language Testing Profiles of Diabete Mellitus Patients", Master, pp.2017
- Cho DH, "Effective Management of Diabetic Ketoacidosis", J Korean Diabetes, 19(4), pp.208~213 (2018)
- "antidementia drug" (2023)[URL]
- Colosimo C, "Non-motor symptoms in atypical and secondary parkinsonism : the PRIAMO study", J Neurol, 257(1), pp.5~14 (2010)
- Lee WS, "A Literatural Study on the YukMiGiHwang Tang", The Juornal of Dong Guk Oriental Medicine, 5, pp.149~166 (1996)
- Kim YH, "A literary test that is related to the disease-causing agent of the 消渴and the disease-causing disease", J Haehwa Med, 4(1), pp.269~285 (1995)
- Wu YC, "Increase of insulin sensitivity in diabetic rats received die-huang-wan, a herbal mixture used in Chinese traditional medicine", Acta pharmacologica Sinica, 23(12), pp.1181~1187 (2002)
- Xue YM, "Effects of liuwei dihuang pills on expressions of apoptosis-related genes bcl-2 and Bax in pancreas of OLETF rats", Zhong Xi Yi Jie He Xue Bao, 3(6), pp.455~458 (2005)
- Kim YJ, "Effects of Yukmijihwang-tang to Recover the Brain Damage of Mice", The Journal of Korean Oriental Internal Medicine, 23(2), pp.191~201 (2002)
- Rho SW, "Effects of Yukmijihwang-tang Derivatives(YMJd), a Memory Enhancing Herbal Extract, on the Gene-Expression Profile in the Rat Hippocampus", Biol Pharm Bull, 28(1), pp.87~93 (2005)
- Jin Sl, "A Study of Clinical Research Acupuncture Treatment on Post-stroke Cognitive Disorder", J Intern Korean Med, 39(3), pp.389~404 (2018)