기능성 소화불량증에서 위운동성 장애 진단을 위한 양도락 지표 연구
Study of Ryodoraku Parameters for Diagnosing Gastric Dysmotility in Functional Dyspepsia
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Objectives : The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku with gastric dysmotility in functional dyspepsia(FD).Methods : Subjects were 154 patients with FD and 18 patients with asthma. We calculated the average Ryodoraku score(RS, ㎂) and each variation from physiologic range of 12 Ryodoraku points, and investigated the incidence when left and right points were simultaneously below(bilateral deficiency) or above(bilateral excess) physiologic range. Postprandial regularity of normal slow waves, power ratio, and postprandial % of bowel sound were obtained by electrogastrography and enterotachography, and were used as gastric dysmotility index. Results : 1. Bilateral excess of H4, H5, F1, and F4 and bilateral deficiency of H4, H5, and H6 were characteristic in FD compared with asthma patients. 2. Incidence of gastric dysmotility in bilateral deficiency of H4, H5, and H6 was 100%, and was higher than in total FD patients(88.3%). 3. There was a positive correlation between the variation of H6 and % postprandial bowel sound. 4. Deficient tendency of H4, H5, and H6 was more evident when RS was above 40㎂ in FD.Conclusions : These findings suggest that gastric dysmotility in FD can be diagnosed when a pattern of H4, H5, H6 bilateral deficiency and F1, F4 bilateral excess is shown at the same time. We think this phenomenon is related to low activity of the vagus nerve rather than meridian pathway with result based on positive correlation between variation of H6 and postprandial % of bowel sound.
Abstract
Objectives : The aim of this study was to investigate the characteristics of Ryodoraku and association of Ryodoraku with gastric dysmotility in functional dyspepsia(FD).Methods : Subjects were 154 patients with FD and 18 patients with asthma. We calculated the average Ryodoraku score(RS, ㎂) and each variation from physiologic range of 12 Ryodoraku points, and investigated the incidence when left and right points were simultaneously below(bilateral deficiency) or above(bilateral excess) physiologic range. Postprandial regularity of normal slow waves, power ratio, and postprandial % of bowel sound were obtained by electrogastrography and enterotachography, and were used as gastric dysmotility index. Results : 1. Bilateral excess of H4, H5, F1, and F4 and bilateral deficiency of H4, H5, and H6 were characteristic in FD compared with asthma patients. 2. Incidence of gastric dysmotility in bilateral deficiency of H4, H5, and H6 was 100%, and was higher than in total FD patients(88.3%). 3. There was a positive correlation between the variation of H6 and % postprandial bowel sound. 4. Deficient tendency of H4, H5, and H6 was more evident when RS was above 40㎂ in FD.Conclusions : These findings suggest that gastric dysmotility in FD can be diagnosed when a pattern of H4, H5, H6 bilateral deficiency and F1, F4 bilateral excess is shown at the same time. We think this phenomenon is related to low activity of the vagus nerve rather than meridian pathway with result based on positive correlation between variation of H6 and postprandial % of bowel sound.
참고문헌 (32)
- Tack J, "Functional gastroduodenal disorders", Gastroenterology, 130(5), pp.1466~1479 (2006)
- 전국한의과대학 비계내과학교실, "비계내과학", pp.87~176 (2008), 군자출판사
- Talley NJ, "AGA technical review: evaluation of dyspepsia", Gastroenterology, 114(3), pp.582~595 (1998)
- El-Serag HB, "Systemic review : The prevalence and clinical course of functional dyspepsia", Aliment Pharmacol Ther, 19(6), pp.643~654 (2004)
- 정하덕, 류기원, 류봉하, 윤상협, 김진성, "기능성 소화불량증 환자의 辨證證候에 의한 건강상태와 위 운동성의 상관성에 대한 연구 (氣血水 辨證과 위전도 지표를 중심으로)", 대한한방내과학회지, 25(4), pp.158~166 (2004), 대한한방내과학회
- 대한소화관운동학회, "기능성 소화불량증 개정판", pp.43~ (2006), 진기획
- 이풍렬, "소화불량증 환자에서 적절한 기능검사", 소화기연관학회 합동학술대회, 10(2), pp.24~28 (2004)
- 박영배, "양도락의 원리와 임상적 활용", 제3의학, 1(2), pp.83~94 (1996)
- 전국한의과대학 진단․생기능의학교실, "양도락 In 생기능의학", pp.132~144 (2008), 군자출판사
- 김규태, "양도락 연구동향에 관한 문헌 고찰", 대한한의진단학회지, 9(1), pp.69~83 (2005)
- 김현경, 유종민, 장선영, 류기원, 엄국현, 이선령, 김진성, 류봉하, 윤상협, 이준석, "기능성 소화불량증 환자의 피로도에 대한 체표 교감신경 활성 및 심혈관 반응의 연계성(양도락과 맥진검사의 진단적 가치)", 대한한방내과학회지, 26(2), pp.390~397 (2005), 대한한방내과학회
- Eom GH, "The Correlation between Deviation Indexes of Ryodoraku and Acute Stress in Patients with Functional Dyspepsia", Kor J of Oriental Medicine, 27(4), pp.142~149 (2006)
- 이광재, "위전도 검사로 측정된 지표들의 재현성", 대한소화기학회지, 33, pp.735~740 (1999)
- Lu CL, "Impaired Postprandial Gastric Myoelectrical Activity in Chinese Patients with Nonulcer Dyspepsia", Digestive Diseases and Sciences, 46(2), pp.242~249 (2001)
- 윤상협, "機能性 消化不良症 患者의 食後 心下？滿과 pyloric valve의 機能障碍 - 장음과 위전도를 중심으로", 대한한방내과학회지, 28(4), pp.769~778 (2007), 대한한방내과학회
- Malagelada JR, "Gastrointestinal motor disturbances in functional dyspepsia", Scand J Gastroenterol, 182, pp.29~32 (1991)
- 한규언, "양도락 진단을 실시한 痞滿환자 1068례에 대한 임상적 고찰", 대한한의학회지, 13(2), pp.57~62 (1992)
- 金宇煥, "양도락기를 이용한 비위질환 환자의 변증판별에 대한 고찰", 동의대학교 동의논문집, 33, pp.127~146 (2000)
- 박재우, "기능성 소화불량증과 심박변이도 및 양도락과의 상관성 연구", 대한한의학회지, 28(2), pp.80~92 (2007), 대한한의학회
- 成樂箕, "양도락 진단법과 임상치료", pp.61~ (1984), 서원당
- Y. Nakatani, "Ryodoraku Acupuncture" (1997), Ryodoraku Research Institute
- 경희한의대 45기 졸업준비위원회, "한방진단의 실제적 접근", pp.201~225 (1997), 일중사
- Farrar JT, "Gastrointestinal motility as revealed by study of abdominal sounds", Gastroenterology, 29(5), pp.789~800 (1995)
- 남형신, "양도락상 소장, 삼초, 대장 허증으로 진단된 초진환자 29예에 대한 임상고찰", 혜화의학, 9(2), pp.50~58 (2000)
- John B, Furness, "The organisation of the autonomic nervous system : Peripheral connections", Auton Neurosci, 130(1-2), pp.1~5 (2006)
- 김지은, "심상군 외 11인. 기능성 소화불량증 환자에서 자율신경 기능 이상과 위배출시간의 연관성", 대한소화기학회지, 36, pp.573~582 (2000)
- Troncon LEA, "Relations between upper abdominal symptoms and gastric distension abnominalities in dysmotility-like functional dyspepsia: Insights on pathophysiological mechani는", Gut, 37, pp.17~22 (1995)
- Kristensson K, "Changes in the vagus nerve in diabetes mellitus", Acta Pathol Microbiol Scand, 79(6), pp.684~685 (1971)
- Feldman M, "Abnormal gastric function in longstanding, insulin-dependent diabetic patients", Gastroenterology, 77(1), pp.12~17 (1979)
- 박동일, "기능성 소화불량증 환자에서 자율신경 기능장애에 관한 연구", 대한소화관운동학회지, 6, pp.214~221 (2000)
- 장경선, "인체의 합곡, 곡지 침자에 관한 한방진단기기적 접근", 한국한의학연구소 논문집, 1(2), pp.173~ (1995)
- R.S. Choung, "Novel mechanisms in functional dyspepsia", World J Gastroenterol, 12(5), pp.673~677 (2006)