원인불명의 극심한 食慾不振을 호소한 고령 환자 치험례
Case of an Old-Age Patient with Ill-defined Severe Anorexia
1
조회
0
다운로드
3
인용
0
참고문헌
키워드
초록
Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.
Abstract
Anorexia is a common symptom in the elderly patients. Causes of anorexia in the elderly are very diverse and multifactorial. Causes include physiological changes associated with aging, mental disorders such as depression, anorexia tardive, dementia, medical diseases such as cancer(lung and gastrointestinal cancer), benign gastrointestinal disorders, cardiac disorders, pulmonary disease, thyroid disorders, infection. Medications such as digoxin, theophylline have also been implicated in the problem. No cause is found in about one quarter of patients. Management is directing at treating causes and providing nutritional support. In Oriental medicine, the appetite has close relation to Biwi. The main cause of anorexia is the insufficiency of Biwi. The physiology of Biwi is that Bi sends clarity(food essence) upward and Wi sends digested food downward. Specially if the physiologic function of Wi is disordered by various factors, Wi cannot send digested food downward. As a result, the anorexia can present by the disorder of Wi function. We experienced a case of an 74 years old female patient with ill-defined severe anorexia differentiated as Wijoongheohan. The patient was managed with fluid therapy and Jeonghyangsiche-tang. The anorexia and other symptoms improved continuously during hospitalization.
참고문헌 (21)
- Morley, J.E., "Anorexia in the elderly", Neurobiol Aging, 9, pp.9~16 (1988)
- Marcus, E.L., "Refusal to eat in the elderly", Nutrition Reviews, 56(6), pp.163~171 (1998)
- Morley, J.E., "Anorexia, body composition, and ageing", The Current Opinion in Clinical Nutrition and Metabolic care, 4, pp.9~13 (2001)
- Huffman, G.B., "Evaluating and treating unintentional weight loss in the elderly", American Family Physician, 65(4), pp.640~650 (2002)
- Morley, J.E., "Anorexia and weight loss in older persons", The Journals of Gerontology, 58A(2), pp.131~137 (2003)
- Gazewood, J.D., "Diagnosis and management of weight loss in the elderly", The Journal of Family Practice, 47(1), pp.19~25 (1998)
- 신현기, "食慾不振에 對한 文獻的 考察", 대한한의학회지, 8(1), pp.82~87 (1987)
- 최수덕, "食慾不振에 對한 韓醫學的 考察 - 病因病理를 中心으로", 대한한의학회지, 19(2), pp.194~210 (1998)
- 박귀영, "神經性 食慾不振 患者 1例에 對한 臨床的 硏究", 동의신경정신과학회지, 6(1), pp.115~119 (1995)
- 유병찬, "신경성 식욕부진 유사 환자 1례에 대한 증례보고", 대한한방내과학회지, 25(3), pp.655~661 (2004), 대한한방내과학회
- Morley, J.E., "Decreased food intake with aging", The Journals of Gerontology, 56A, pp.81~88 (2001)
- Inagaki, T., "Late onset anorexia nervosa: Two cases reports", International Journal of Psychiatry in Medicine, 32, pp.91~95 (2002)
- Paquet, C., "Direct and indirect effects of everyday emotions on food intake of elderly patients in institutions", The Journal of Gerontology, 58A(2), pp.153~158 (2003)
- Spiller, R.C., "ABC of the upper gastrointestinal tract - Anorexia, nausea, vomiting, and pain", British Medical Journal, 323, pp.1354~1357 (2001)
- 박숙영, "脾胃와 七情에 관한 文獻的 考察-東西醫學의 比較-", 대한한의학회, 13(1), pp.140~151 (1992)
- 강형욱, "脾胃와 神志에 관한 文獻的 考察", 동의신경정신과학회지, 1(2), pp.100~108 (1990)
- 김현희, "脾主升淸 胃主降濁과 脾胃의 消化器能系統과의 關係", 동의생리학회지, 7(1), pp.173~176 (1992)
- 원진희, "脾胃의 氣機升降의 生理․病理․治法에 대한 考察 및 臨床例", 한국전통의학지, 7(2), pp.108~115 (1997)
- 대한한의사협회, "한국한의표준변증분류", pp.36~37 (2004), 대한한의사협회
- 전국한의과대학 병리학교실, "한방병리학", pp.359~364 (2001), 한의문화사
- Parker, B.A., "Relation between food intake and visual analogue scale ratings of appetite and other sensations in healthy older and young subjects", European Journal of Clinical Nutrition, 58, pp.212~218 (2004)
