Noninvasive Estimation of Moxibustion Effect on Peripheral Blood Flow by Doppler Ultrasound in Stroke Patients with Hemiplegia: Case Series

Transcription

1 31 4 (21 7 ) J Korean Oriental Med 21;31(4): Case Report 윤승규 이상훈 정우상 배영민 1 경희대학교한의과대학심계내과학교실 2 경희대학교한의과대학침구학교실 3 한국전기연구원 SOI-KOREA 센터 3 Noninvasive Estimation of Moxibustion Effect on Peripheral Blood Flow by Doppler Ultrasound in Stroke Patients with Hemiplegia: Case Series Seung-Kyou Yoon 1 Sang-Hoon Lee 2 Woo-Sang Jung 1 Young-Min Bae 3 1 Department of Internal Medicine College of Oriental Medicine Kyung Hee University 2 Department of Acupuncture & Moxibustion College of Oriental Medicine Kyung Hee University 3 SOI-KOREA Center Korea Electrotechnology Research Institute (KERI) Objectives: This study was to investigate the effect of on peripheral blood flow by Doppler ultrasound in post-stroke hemiplegia patients Methods:Moxibustion was applied on the points of LI4 TE3 TE5 and LI11 on the affected side and blood flow of the radial artery was measured using the Minimax-Doppler-K device Blood flow velocity and pulsation index were analyzed before during and after Results: The mean value of blood flow velocity in 13 patients showed a tendency of increase during but there was no significant difference in blood flow velocity before and after or pulsation index during and after In addition among the five patients who showed marked increase tendency on the blood velocity graph there was significant increase in blood velocity during and after compared with before Conclusions: This study suggests that has an effect on peripheral blood flow in stroke patients with hemiplegia Further validity tests with a larger scale sample are needed for the evidence of its practical use Key Words : Doppler ultrasound blood flow stroke hemiplegia 서론 ( ) pyramidal tract Received: 9 April 21 Revised: 2 July 21 Accepted: 5 July 21 Correspondence to : 이상훈(Sang-Hoon Lee) 서울동대문구회기동1 경희의료원한방병원침구과 Tel : Fax : shlee777@khuackr 178

2 3 : (661) 12) ) (Motor Grade ) 1215) 2 측정장비및측정방법 7-11) (Minimax-Doppler-K device Minimax Russia) 1 7mm 1mm 1 연구대상 연구방법 12) (linear) (volumetric) (pulsation index Gosling index) (peripheral resistance index Pourceleau index) (Fig 12) 5 ( 5cm ) 18 6 Fig 1 Fig 2 179

3 (662) 31 4 (21 7 ) Fig 3 Fig 4 (Fig 3) 3 뜸자극 91) ( 1cm 12cm - ) (Fig 3) 5 (Fig56) 4 관찰항목 PI(pulsatility index) : - / RI(resistivity index) : - / Table 1 1min 1min 1min stabilization Moxisbution(x 5) stabilization Measurement with the doppler ultrasound device 18

4 3 : (663) Fig 5 Fig 6 5 통계분석 결과 paired t-test (m/s) SPSS v12 5 (PI) Table 3 * ** before during after case1 114±13 121±45 98±86 case2 137±16 111±2 124±23 case3 177±16 16±23 166±18 case4 96±14 157±27 125±21 case5 96±22 136±56 136±39 case6 119±15 13±18 93±24 case7 126±19 14±56 119±2 case8 53±29 7±67 186±64 case9 56±27 18±64 146±3 case1 2±16 197±14 195±11 case11 163±43 143±67 28±41 case12 48±29 155±53 117±41 case13 92±48 446±12 246±121 Total 114±47 165±9 * 123±6 ** p=94 뜸자극전혈류속도와뜸자극중혈류속도의비교(paired t-test) p=717 뜸자극전혈류속도와뜸자극후혈류속도의비교(paired t-test) 181

5 (664) 31 4 (21 7 ) Table 4 * ** before during after case1 2436±82 248± ±24 case2 2676±66 292± ±135 case3 2463± ± ±85 case4 37±37 39±32 36±27 case5 242± ± ±129 case6 2128± ± ±1224 case7 2417± ± ±536 case8 1621± ± ±261 case9 279± ± ±165 case1 294± ± ±16 case11 55± ± ±1751 case ± ± ±322 case ± ± ±222 Total 2239± ±149 * 2249±943 ** p=27 뜸자극전맥동지수와뜸자극중맥동지수의비교(paired t-test) p=916 뜸자극전맥동지수와뜸자극후맥동지수의비교(paired t-test) case case Fig 7 Fig case case Fig 8 Fig 1 182

6 3 : (665) case case Fig 11 Fig case case Fig 12 Fig case case Fig 13 Fig case case Fig 14 Fig

7 (666) 31 4 (21 7 ) case 뜸자극전뜸자극중뜸자극후 case4 case5 case7 case9 case12 Fig 19 Fig case (Table 67)(Fig 78) Table 6 before during after * ** case4 96±14 157±27 125±21 case5 96±22 136±56 136±39 case7 126±19 14±56 119±2 case9 56±27 18±64 146±3 case12 48±29 155±53 117±41 Total 91±37 149±55 * 128±3 ** p<1 뜸자극전혈류속도와뜸자극중혈류속도의비교(paired t-test) p<1 뜸자극전혈류속도와뜸자극후혈류속도의비교(paired t-test) Table 7 ** * before during after case4 37±37 39±32 36±27 case5 242± ± ±129 case7 2417± ± ±536 case9 279± ± ±165 case ± ± ±322 Total 2159± ±13 * 194±1148 ** p=44 뜸자극전맥동지수와뜸자극중맥동지수의비교(paired t-test) p=348 뜸자극전맥동지수와뜸자극후맥동지수의비교(paired t-test) 184

8 3 : (667) Minimax-Doppler-K device 35 3 (Minimax Russia) 25 case4 2 case5 15 case7 (linear) (cm/s) case9 1 case12 5 (pulsation index Gosling index) 뜸자극전 뜸자극중 뜸자극후 (peripheral resistance index Pourceleau index) Fig 21 고 찰 16) 34) ICT5) TENS14) 16) ICT TENS 3514) 16) 7-11) ) 12) DITI ( ) 3-6) ( ) 185

9 (668) 31 4 (21 7 ) (B-94) 감사의글 (No K2513) 참고문헌 1 ParkYCChae JSEomJY SonSSChoeIS Thermographic Study on the Effects of Deep Acupuncture at Hapkok(LI4) in Cerebrovascular Hemiplegia The Journal of Korean Acupuncture & Moxibustion 23;2(4): Lee SH Lee YH Clinical Study with Thermography on Shoulder Hand Syndrome after Stroke The Journal of Korean Oriental Medical Society 1997:18(1); Han SM Lee SC The Change of Blood Flow Velocity of Radial Artery after Linear Polarized Infrared Light Radiation near the Stellate Ganglion: Comparing with the Stellate Ganglion Block The Korean Journal of Pain 21;14(1): Seo YS Flow Velocity Changes of Carotid Axillary Brachial and Radial Artery after Stellate Ganglion Block The Korean Journal of Pain 1995;8(1): Park JS Lee JH Effects of Interferential Current Stimulation on the Peripheral Blood Velocity in Healthy Subjects The Journal of Korean Society of Physical Theraphy 1999;11(2): KimHSAhnKHLeeJHKimEGYoonDH KimJSetalAssessmentofSoftTissueBlood Flow in Hemiplegic Patients with Type of Complex Regional Pain Syndrome by Power Doppler Sonography Department of Rehabilitation Medicine Kyung-Hee University College of Medicine 27;23(1): LeeSHKimJKSonYHJeongHYKimJH KwonJNetalAClinicalStudyofMoxibustion Therapy's Effect on Functional Recovery in Hemiplegia on Stroke Korean J Orient Int Med 28:29(1); LeeSHKimJKSonYHJeongHYKimYK Kwon JN The clinical study of Moxibustion Therapy effect on functional recovery in stroke patients Korean J Orient Int Med 28:fal; ChoiYSKimTKJungWSMoonSKLeeKS Effects of Moxibustion on the Edematous Hand in Hemiplegic Patients Korean J Orient Int Med 23:spr; ChoiYSKimTKJungWSMoonSKEffects of Moxibustion on the Hemiplegic Upper Extremity After Stroke 23:24(2); HwangWJYangKPTheStudyontheeffects of on peripheral blood circulation The Journal of Korean Oriental Medical Society 1997:18(1); SungKKHwangCYLeeSKLeeSYCheong SSKangSYetalTheClinicalEffectofHigh Voltage AC Field Therapy(HEALTHTRON) on Peripheral Circulatory Disturbance and Functional Outcome of Rehabilitaion in CVA Patients Korean Journal of Oriental Physiology & Pathology 22:16(3); Jeong YH Huh H Kim BM Measurement of blood flow during thermo-therapy Optical Society of Korea Summer Meeting 23:sum; Petrofsky J Schwab E LoE T Cuneo M LawsonDThethermaleffectonthebloodflow response to electriacl stimulation Med Sci Monit 27:13(11); Chen CC Johnson MI McDonough S Cramp F The effect of transcutaneous electrical nerve stimulation on local and distal cutaneous blood flow following a prolonged heat stimulus in healthy subjects Clin Physiol Funct Imaging 27:27; MoonSK WhangYK ParkSU KoCN Kim YS Bae HS et al Antispastic effect electroacupuncture and in stroke patients AJCM 31(3):23: