본문 바로가기
KERD
논문KCI 등재

뇌졸중 후 우울증과 한열허실 변증의 상관관계

Correlation between Post-Stroke Depression and Cold, Heat, Deficiency and Excess Patterns

송인자|이상관|홍해진|성강경|박기언|이일석
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2014.03|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제35권 제1호|pp. 50-58|DOI .

2

조회

0

다운로드

5

인용

0

참고문헌

키워드

Post-stroke depressioncortisol awakening responsedeficiency and excesscold and heat patterns
주제분류한의학

초록

Objectives : The aim of this study was to analyze relationship between post-stroke depression (PSD) and cold, heat, deficiency and excess patterns. Methods : Twenty-eight PSD patients were recruited from STROKE center and measured with questionnaires for cold, heat, deficiency and excess patternvalues and saliva for cortisol awakening response (CAR). Saliva samples were collected immediately, 15, 30 and 45 min after awakening. In addition, Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) were conducted for PSD severity. We conducted correlation analysis to find the relationship between cold, heat, deficiency and excess patterns and CAR or BDI and HDRS. Results : Deficiency and excess patterns werepositively correlated with area under the curve with respect to the increase (AUCi), but not with area under the curve with respect to the global (AUCg), in CAR. Furthermore, it was negatively correlated with BDI and HDRS, while cold and heat patterns were not correlated with CAR, BDI and HDRS. Conclusions : In terms of deficiency and excess patterns, the higher the PSD severity, the higher the deficiency and the lower the PSD severity, the higher the excess. However, there was not a significant relationship between PSD and cold and heat patterns.

Abstract

Objectives : The aim of this study was to analyze relationship between post-stroke depression (PSD) and cold, heat, deficiency and excess patterns. Methods : Twenty-eight PSD patients were recruited from STROKE center and measured with questionnaires for cold, heat, deficiency and excess patternvalues and saliva for cortisol awakening response (CAR). Saliva samples were collected immediately, 15, 30 and 45 min after awakening. In addition, Beck Depression Inventory (BDI) and Hamilton Depression Rating Scale (HDRS) were conducted for PSD severity. We conducted correlation analysis to find the relationship between cold, heat, deficiency and excess patterns and CAR or BDI and HDRS. Results : Deficiency and excess patterns werepositively correlated with area under the curve with respect to the increase (AUCi), but not with area under the curve with respect to the global (AUCg), in CAR. Furthermore, it was negatively correlated with BDI and HDRS, while cold and heat patterns were not correlated with CAR, BDI and HDRS. Conclusions : In terms of deficiency and excess patterns, the higher the PSD severity, the higher the deficiency and the lower the PSD severity, the higher the excess. However, there was not a significant relationship between PSD and cold and heat patterns.

참고문헌 (49)

  1. 김종성, "뇌졸중 후 발생하는 감정장애: 우울, 불안, 감정조절장애, 분노조절장애, 그리고 피로", 대한신경과학회지, 23(1), pp.1~8 (2005), 대한신경과학회
  2. Pohjasvaara T, "Depression is an independent predictor of poor long-term functional outcome post-stroke", Eur JNeurol, 8(4), pp.315~319 (2001)
  3. Robinson RG, "Poststroke depression: prevalence, diagnosis, treatment, and disease progression", Biol psychiatry, 54(3), pp.376~387 (2003)
  4. Kim P, "Quality of life of stroke survivors", Qual Life Res, 8(4), pp.293~301 (1999)
  5. King RB, "Quality of life after stroke", Stroke, 27(9), pp.1467~1472 (1996)
  6. Kauhanen M-L, "Poststroke depression correlates with cognitive impairment and neurological deficits", Stroke, 30(9), pp.1875~1880 (1999)
  7. Neau J-P, "Functional recovery and social outcome after cerebral infarction in young adults", Cerebrovasc Dis, 8(5), pp.296~302 (1998)
  8. 이정훈, "뇌졸중후 우울증의 정도와 운동기능의 회복과의 상관관계에 대한 연구", 동의신경정신과학회지, 13(2), pp.101~106 (2002)
  9. 한윤희, "뇌졸중 후 우울변화가 인지 및 상지기능회복에 미치는 영향", 대한작업치료학회지, 19(2), pp.39~51 (2011), 대한작업치료학회
  10. Born J, "Timing the end of nocturnal sleep", Nature, 397(6714), pp.29~30 (1999)
  11. Clow A, "The awakening cortisol response: methodological issues and significance", Stress, 7(1), pp.29~37 (2004)
  12. Pruessner J, "Free cortisol levels after awakening: a reliable biological marker for the assessment of adrenocortical activity", Life Sci, 61(26), pp.2539~2549 (1997)
  13. Neidert S, "Cortisol as a prognostic marker of outcome in acute ischemic cerebrovascular events", Endocrine Abstracts, 20, pp.OC3.6~ (2009)
  14. Marklund N, "Low and high circulating cortisol levels predict mortality and cognitive dysfunction early after stroke", J Intern Med, 256(1), pp.15~21 (2004)
  15. Reding M, "The dexamethasone suppression test: an indicator of depression in stroke but not a predictor of rehabilitation outcome", Arch Neurol, 42(3), pp.209~ (1985)
  16. Saban KL, "Depressive Symptoms and Diurnal Salivary Cortisol Patterns Among Female Caregivers of Stroke Survivors", Biol Res Nurs, 14(4), pp.396~404 (2012)
  17. 안규석, "논단 : 한의학의 변증체계와 그 내용", 동의병리학회지, 2, pp.6~11 (1987)
  18. 테라사와카츠토시, "증례로 배우는 동서의학", pp.141~150 (2005), 군자출판사
  19. 전국한의과대학 병리학교실, "한방병리학", pp.186~436 (2004), 일중사
  20. 강형원, "우울증(憂鬱症)의 한방적(韓方的) 이해(理解)에 관한 문헌고찰(文獻考察)", 동의신경정신과학회지, 12(2), pp.1~15 (2001)
  21. 최산호, "중풍 후 우울증의 변증안에 대한 전문가 델파이 조사", 동의생리병리학회지, 26(3), pp.367~375 (2012), 대한동의병리학회[DOI]
  22. Beck AT, "An inventory for measuring depression", Arch Gen Psychiatry, 4, pp.561~571 (1961)
  23. Hamilton M, "A rating scale for depression", J Neurol, Neurosurg, Psychiat, 23(1), pp.56~ (1960)
  24. Youn J-I, "Effects of Electro-Acupuncture Therapy on Post-Stroke Depression in Patients with Different Degrees of Motor Function Impairments: a Pilot Study", J Phys Ther Sci, 25(6), pp.725~ (2013)
  25. 안련섭, "Salivary Cortisol and DHEA Levels in the Korean Population: Age-Related Differences, Diurnal Rhythm, and Correlations with Serum Levels", Yonsei Medical Journal, 48(3), pp.379~388 (2007), 연세대학교의과대학
  26. Pruessner JC, "Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time- dependent change", Psychoneuroendocrinology, 28(7), pp.916~931 (2003)
  27. 이상관, "청소년의 성별에 따른 Cortisol 분비의 일주기 차이 : 반복측정에 따른 Area Under the Curve 분석법 사용", 대한한방내과학회지, 31(4), pp.829~836 (2010), 대한한방내과학회
  28. Stetler C, "Blunted cortisol response to awakening in mild to moderate depression: regulatory influences of sleep patterns and social contacts", J Abnorm Psychol, 114(4), pp.697~ (2005)
  29. Huber TJ, "The psychotherapy inpatients suffering from depression", Psychoneuroendocrinology, 31(7), pp.900~904 (2006)
  30. Roberts AD, "Salivary cortisol response to awakening in chronic fatigue syndrome", Br J Psychiatry, 184(2), pp.136~141 (2004)
  31. Kuehner C, "Decreased cortisol response to awakening is associated with cognitive vulnerability to depression in a nonclinical sample of young adults", Psychoneuroendocrinology, 32(2), pp.199~209 (2007)
  32. Schulz P, "Increased free cortisol secretion after awakening in chronically stressed individuals due to work overload", Stress Med, 14(2), pp.91~97 (1998)
  33. Lieb K, "Increased diurnal salivary cortisol in women with borderline personality disorder", J Psychiatr Res, 38(6), pp.559~565 (2004)
  34. Kirschbaum C, "‘Normal’ cigarette smoking increases free cortisol in habitual smokers", Life Sci, 50(6), pp.435~442 (1992)
  35. Balodis IM, "The other side of the curve: examining the relationship between pre-stressor physiological responses and stress reactivity", Psychoneuroendocrinology, 35(9), pp.1363~1373 (2010)
  36. Wirtz PH, "Perfectionism and the cortisol response to psychosocial stress in men", Psychosom Med, 69(3), pp.249~255 (2007)
  37. Wolf OT, "No morning cortisol response in patients with severe global amnesia", Psychoneuroendocrinology, 30(1), pp.101~105 (2005)
  38. 조혜숙, "寒熱虛實 辨證 診斷 설문지의 개발에 대한 연구", 동의생리병리학회지, 23(2), pp.288~293 (2009), 대한동의병리학회
  39. Fekedulegn DB, "Area under the curve and other summary indicators of repeated waking cortisol measurements", Psychosom Med, 69(7), pp.651~659 (2007)
  40. Edwards S, "Exploration of the awakening cortisol response in relation to diurnal cortisol secretory activity", Life Sci, 68(18), pp.2093~2103 (2001)
  41. Schmidt-Reinwald A, "The cortisol response to awakening in relation to different challenge tests and a 12-hour cortisol rhythm", Life Sci, 64(18), pp.1653~1660 (1999)
  42. Hellhammer J, "Several daily measurements are necessary to reliably assess the cortisol rise after awakening: state-and trait components", Psychoneuroendocrinology, 32(1), pp.80~86 (2007)
  43. 유현희, "한열 변증 설문지 개발에 관한 연구", 동의생리병리학회지, 22(6), pp.1410~1415 (2008), 대한동의병리학회
  44. 이정아, "뇌졸중 후 우울증과 일상생활 수행능력과의 상관관계", 동의신경정신과학회지, 11(2), pp.149~154 (2000)
  45. 나병조, "중풍후우울증에 대한 반하후박탕의 유효성 및 적응증 평가", 대한한방내과학회지, 26(3), pp.563~574 (2005), 대한한방내과학회
  46. 선종주, "중풍후우울증 환자에 대한 향기침요법의 임상적 연구", 대한한방내과학회지, 27(2), pp.480~487 (2006), 대한한방내과학회
  47. 제준태, "뇌졸중 후 우울증에 대한 황련해독탕 약침의 안전성 및 유효성 평가를 위한 임상 시험", Journal of Pharmacopuncture, 13(2), pp.67~74 (2010), 대한약침학회
  48. 최지혜, "뇌졸중후 우울증 침치료의 임상연구에 대한 고찰", 동의생리병리학회지, 25(6), pp.1119~1128 (2011), 대한동의병리학회
  49. Han H, "Characteristics of traditional Chinese medicine syndromes in post-stroke depression", Zhong Xi Yi Jie He Xue Bao, 8(5), pp.427~431 (2010)

관련 논문AI추천

중풍 후 우울증의 변증안에 대한 전문가 델파이 조사이인, 강형원, 김윤식, 문상관, 성강경, 오재건, 윤현자, 이상관, 임진영, 임형문, 최산호, 한창호한의병리학회 · 동의생리병리학회지2012 · 제26권 제3호뇌졸중 후 우울증 : 한방 치료에 대한 국내외 최신 문헌 고찰백경민, 이제원, 장우석, 황하연, 이보매나대한한방내과학회 · 대한한방내과학회지2012 · 제33권 제4호뇌졸중 후 우울증에 대한 침과 한약의 결합 치료 효과: 체계적 문헌 고찰 및 메타분석 연구김상호, 임수연, 정대규, 사공종원대한한방신경정신과학회 · 동의신경정신과학회지2020 · 제31권 제3호뇌졸중 후 우울증에 대한 황련해독탕 약침의 안전성 및 유효성 평가를 위한 임상 시험이상관, 제준태대한약침학회 · Journal of Pharmacopuncture2010 · 제13권 제2호한국형 중풍 변증 표준안 - Ⅱ와 한열허실 변증지표의 연관성 연구강병갑, 고미미, 권세혁, 김소연, 김정철, 방옥선, 오달석, 이정섭한의병리학회 · 동의생리병리학회지2010 · 제24권 제1호뇌졸중 후 우울증에 대한 감맥대조탕(甘麥大棗湯)의 효과: 체계적 문헌 고찰 및 메타 분석김경민, 김영균, 김예슬, 이영서대한한방내과학회 · 대한한방내과학회지2024 · 제45권 제3호

이 간행물의 다른 논문 (9건)

실시간 탄성초음파를 이용한 만성 뇌졸중 후 편마비 환자의 상지 강직에 대한 사암침 효과 연구박기영, 권동락, 백경민pp. 1-11파킨슨병의 침구치료 동향에 대한 고찰이은, 강세영, 김락형, 강기완, 장인수, 한창호, 선승호pp. 12-23중완(中脘)에 신기구 뜸시술이 뇌혈류 및 말초혈류 변화에 미치는 영향권정남, 김도형, 홍진우, 박승찬, 이인, 조민경pp. 24-36Mouse Single Oral Dose Toxicity Test of Chongmyung-tang Aqueous Extracts백경민, 황하연, 장우석pp. 37-49온열환경과 인삼(Panax Ginseng)이 Rat의 체온, 혈액학적 변화, 면역반응에 미치는 영향김민지, 류재환, 이인희, 이서라pp. 59-69
원문 보기