딸꾹질을 주소로 속섬유막뒷다리경색(Posterior limb of internal capsule infarction) 진단받은 환자에 대한 한방복합치험 1례
Combined Korean Medicine Treatment of a Patient Diagnosed with Posterior Limb of Internal Capsule Infarction Presenting with Hiccups as the Chief Complaint - A Case Report
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Objective: Hiccup is a sudden, involuntary contraction of the diaphragm and intercostal muscles, followed by laryngeal closure. Persistent hiccups can occur in the central nervous system following a cerebral infarction. While medications, for example chlorpromazine, are commonly used for treatment, they often fail to fully resolve the hiccups, showing little to no improvement in symptoms. The aim of this study was to present the treatment response of a patient diagnosed with posterior limb of internal capsule (PLIC) infarction, who was experiencing hiccups and was treated with combined Korean medicine after taking chlorpromazine. Case Presentation: A 71-year-old male diagnosed with left PLIC infarction was experiencing problems in daily life due to hiccups and dysarthria. During the 10-day hospitalization, he received treatment that included herbal medicine (modified Hyeolbuchugeo-tang, Xiěfǔzhúyūtāng), acupuncture (GV20, LI11, ST36, LI4, LR3, and submandibular area acupoint), moxibustion, cupping, and physical therapy. After 10 days of hospitalization, the patient’s hiccups disappeared, and he did not have to take any chlorpromazine. The score on the Numerical Rating Scale fell from 7-8 to 1-2. The 5-level EQ-5D version (EQ-5D-5L) fell from 11 to 7, and the EQ Visual Analogue Scale (EQ-VAS) rose from 20 to 80. The frequency (times per minute) of hiccups decreased and almost disappeared. During outpatient treatment, the patient stated that he did not experience hiccups for 7 months, and no significant side effects were observed. Conclusion: This study suggests that a patient with hiccups as a chief complaint can be effectively treated with combined Korean medicine. However, more studies with control groups are needed to confirm these findings.
Abstract
Objective: Hiccup is a sudden, involuntary contraction of the diaphragm and intercostal muscles, followed by laryngeal closure. Persistent hiccups can occur in the central nervous system following a cerebral infarction. While medications, for example chlorpromazine, are commonly used for treatment, they often fail to fully resolve the hiccups, showing little to no improvement in symptoms. The aim of this study was to present the treatment response of a patient diagnosed with posterior limb of internal capsule (PLIC) infarction, who was experiencing hiccups and was treated with combined Korean medicine after taking chlorpromazine. Case Presentation: A 71-year-old male diagnosed with left PLIC infarction was experiencing problems in daily life due to hiccups and dysarthria. During the 10-day hospitalization, he received treatment that included herbal medicine (modified Hyeolbuchugeo-tang, Xiěfǔzhúyūtāng), acupuncture (GV20, LI11, ST36, LI4, LR3, and submandibular area acupoint), moxibustion, cupping, and physical therapy. After 10 days of hospitalization, the patient’s hiccups disappeared, and he did not have to take any chlorpromazine. The score on the Numerical Rating Scale fell from 7-8 to 1-2. The 5-level EQ-5D version (EQ-5D-5L) fell from 11 to 7, and the EQ Visual Analogue Scale (EQ-VAS) rose from 20 to 80. The frequency (times per minute) of hiccups decreased and almost disappeared. During outpatient treatment, the patient stated that he did not experience hiccups for 7 months, and no significant side effects were observed. Conclusion: This study suggests that a patient with hiccups as a chief complaint can be effectively treated with combined Korean medicine. However, more studies with control groups are needed to confirm these findings.
참고문헌 (28)
- Lee AR, "Treatment of persistent postoperative hiccups with stellate ganglion block : Three case reports", Medicine, 97(48), pp.e13370~ (2018)
- Steger M, "Systemic review : the pathogenesis and pharmacological treatment of hiccups", Alimentary pharmacology & therapeutics, 42(9), pp.1037~1050 (2015)
- Chang FY, "Hiccup : mystery, nature and treatment", Journal of neurogastroenterology and motility, 18(2), pp.123~130 (2012)
- Korean Stroke Society, "Stroke", pp.645~646 (2024), Panmun education
- 전국한의과대학 심계내과학교실, "한방순환신경내과학", pp.252~ (2016), 군자출판사
- Lambert D, "A medication hiccup : chlorpromazine-induced agranulocytosis in a 72-year-old male", WMJ : Off Publ State Med Soc Wis, 121(3), pp.E60~E62 (2022)
- 전국한의과대학비계내과학교실, "비계내과학(脾系內科學)", pp.109~114 (2009), 군자출판사
- Kim MJ, "A Review of Recent Clinical Studies of Acupuncture Treatment for Hiccup-PubMed and Domestic Studies", The Journal of Internal Korean Medicine, 43(4), pp.567~581 (2022)
- Kang BG, "Case of Oriental Medicine Therapy on Intractable Hiccup Induced by Pontine Infarction", Journal of Physiology &Pathology in Korean Medicine, 22(1), pp.222~225 (2008)
- Moon JS, "A Case Report of Central Nervous System Disorder Induced Intractable Hiccups Treated with Korean Medicine", The Journal of Internal Korean Medicine, 43(2), pp.191~200 (2022)
- Lee SH, "Case of Persistent Hiccup that Ensued on Aspiration Pneumonia after Pontine Infarction", Journal of Physiology & Pathology in Korean Medicine, 22(6), pp.1621~1625 (2008)
- Kang EJ, "Review of Clinical Research about the Treatment of Hiccup After Stroke with Herbal Medicine-Based on Traditional Chinese Medicine Journals", The Journal of Internal Korean Medicine, 39(3), pp.323~337 (2018)
- Kim SH, "The EQ-5D-5L valuation study in Korea", Qual Life Res, 25(7), pp.1845~1852 (2016)
- Devlin N, "Value Sets for EQ-5D-5L:A Compendium, Comparative Review & User Guide Cham", pp.1~12 (2022), Springer
- Whitfield LR, "Chlorpromazine metabolism. IX. Pharmacokinetics of chlorpromazine following oral administration in man", Journal of Pharmacokinetics and Biopharmaceutics, 6(3), pp.187~196 (1978)
- Kim YS, "Successful Treatment of Intractable Hiccups with Benztropine", Journal of the Korean Child Neurology Society, 22(3), pp.165~168 (2014)
- Cheng Z, "Acute Anterior Choroidal Artery Territory Infarction : A Retrospective Study", Clin Neurol Neurosurg, 195, pp.105826~ (2020)
- Nodirovna AR, "Side Effects of Valproic Acid, Causes of Alopecia and Obesity", International Journal of Integrative and Modern Medicine, 2(9), pp.21~23 (2024)
- Naderi Y, "Compared to oxcarbazepine and carbamazepine, botulinum toxin type A is a useful therapeutic option for trigeminal neuralgia symptoms : A systematic review", Clinical and Experimental Dental Research, 10(2), pp.e882~ (2024)
- Nwankwo A, "A comprehensive review of the typical and atypical side effects of gabapentin", Pain Practice (2024)
- Zhang Y, "Ultrasound-guided phrenic nerve block for intraoperative persistent hiccups : a case report", BMC anesthesiology, 18(1), pp.123~ (2018)
- Sihn KW, "The Anatomical Revolution and the Transition of Anatomical Conception in Late Imperial China", Korean J Med Hist, 21(1), pp.67~99 (2012)
- 한의방제학 공동교재 편찬위원회, "한의방제학", pp.973~977 (2020), 군자출판사
- 전국한의과대학 공동교재편찬위원회, "본초학", pp.333~416 (2011), 영림사
- Seo HJ, "The Clinical Effectiveness of Frequently Used Herbal Medicines for Cerebrovascular Disease : A Retrospective Study", The Journal of Internal Korean Medicine, 40(6), pp.1063~1080 (2019)
- Lee MS, "Antithrombotic Activity and Protectice Effects of hexane fraction of Kamihyulbuchukeotang(KHBCT)on brain injury by KCN and MCA occlusion", Kor J Pharmacogn, 31(4), pp.373~382 (2000)
- Cho EH, "Neuroprotective Effects of Hyulbuchookau-tang(血府逐瘀湯)on Global Cerebral Ischemia of the Rats", The Journal of Korean Medicine, 28(2), pp.44~53 (2007)
- Kang SY, "Improvement in Balance and Walking in a Patient with Guillain-Barré Syndrome Treated with Acupuncture and Electroacupuncture : A Case Report", The Journal of Internal Korean Medicine, 45(2), pp.199~207 (2024)