The Journal of Internal Korean Medicine (대한한방내과학회지)

The Society of Internal Korean Medicine (대한한방내과학회)
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A Selective Effect of Combined Treatment of Electroacupuncture at Zusanli(ST36), Manual Acupuncture, and Pyengwi-san in Function Dyspepsia Patients with Pyloric Valve Disturbance and Hypoactivity of Gastric Vagus Nerve

한방치료가 위 미주신경 활성 저하와 유문부 기능 장애가 병발된 기능 소화불량중 환자에 미치는 선택적 효능

  • Kim, So-Yeon (3rd Dept. of Internal Medicine, College of Oriental Medicine, Kyung-hee University) ;
  • Yoon, Sang-Hyub (3rd Dept. of Internal Medicine, College of Oriental Medicine, Kyung-hee University)
  • 김소연 (경희대학교 한의과대학 비계내과학교실) ;
  • 윤상협 (경희대학교 한의과대학 비계내과학교실)
  • Published : 2009.03.31
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Abstract

Objectives : The aim of this study was to evaluate the therapeutic effect of acupuncture and herbal medicine in patients who had hvpoactivity of the gastric vagus nerve and pyloric valve disturbance simultaneously with function dyspepsia by bowel sounds analysis. Methods : Bowel sounds of 10 patients (male 1, female 9) were recorded and their % of bowel sound (%BS) and ratio of dominant frequency (DF) were analyzed before and after treatment. Hypoactivity of the gastric vagus nerve was considered if % BS was <6%. and pyloric valve disturbance was accepted if DF ratio (e.g.. postprandial DF/fasting DF) was <1. Electroacupuncture at Zusanli (ST36, 3Hz, 30 minutes) and manual acupuncture at other meridian points were applied daily for 2 weeks. Herbal medicine, Pyengwi-san. was administered to all patients (100cc, 3 times/day). Results : DF ratio significantly increased from $0.93\pm0.06$ to $1.06\pm0.04$ after treatment for 2 weeks (p=0.005). 9 of 10 patients were improved to DF ratio>1. %BS also increased from $2.97\pm1.17%$ to $4.49\pm4.27%$. not significantly. 3 patients showed a remarkable elevation, and their %BS reached >6% of normal value. Conclusions : Combined effect of electroacupuncture at Zusanli (ST36), manual acupuncture. and Pyengwi-san was shown effective in the improvement of pyloric valve disturbance more than hypoactivity of gastric vagus nerve on patients with functional dyspepsia.

목 적 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에서 전침 및 한약의 복합처치 치료가 이 두가지 면에서 각각 어떤 영향을 미치는지를 살펴보았다. 방 법 : 장음검사상 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 환자 10명을 대상으로 치료 전후의 장음 지표 변화를 비교하였다. 장음지표는 % of bowel sound (%BS)와 주 주파수(dominant frequency, DF)를 사용하였으며, %BS(6인 경우를 위 미주신경 활성저하 DF ratio(식후/식 전)<1를 유문부 기능장애로 평가하였다. 환자들에게 2주간 족삼리전 침과 체침이 매일 시술되었으며 평위산 전탕액이 하루 3회 투여되었다. 결 과 : 2주간의 치료 후 DF ratio는 $0.93\pm0.06$에서 $1.06\pm0.04$으로 유의성있게 증가했으며, 10명 중 9명의 환자가 DF ratio>1의 정상치로 회복되었다. %BS 역시 $2.97\pm1.17%$에서 4.27%로 증가했지만 통계적 유의성은 없었으며, 3명의 환자에서 %BS가 6이상으로 정상회복되었다. 결 론 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에 대한 족삼리 전침과 일반 체침, 평위산의 치료는 미주신경 활성 저하보다는 유문부 기능 장애에 더 유의한 효과를 보였다.

Keywords

References

  1. Geeraerts B, Tack J. Functional dyspepsia: past, present, and future. J Gastroenterol. 2008;43(4): 251-5. https://doi.org/10.1007/s00535-008-2167-8
  2. Tatsuta M, Iishi H. Effect of treatment with liu-jun-zi-tang (TJ-43) on gastric emptying and gastrointestinal symptoms in dyspeptic patients. Aliment Pharmacol Ther.1993;7(4):459-62. https://doi.org/10.1111/j.1365-2036.1993.tb00120.x
  3. Oikawa T, Ito G, Koyama H, Hanawa T. Prokinetic effect of a Kampo medicine, Hangekoboku- to (Banxia-houpo-tang), on patients with functional dyspepsia. Phytomedicine. 2005;12 (10):730-4. https://doi.org/10.1016/j.phymed.2005.03.001
  4. Xu S, Hou X, Zha H, Gao Z, Zhang Y, Chen JD. Electroacupuncture accelerates solid gastric emptying and improves dyspeptic symptoms in patients with functional dyspepsia. Dig Dis Sci. 2006;51(12):2154-9. https://doi.org/10.1007/s10620-006-9412-x
  5. Kim YS, Yoon SH. Combination Effects of Zusanli(ST36) Electroacupuncture and Manual Acupuncture of other Acupoints on Gastric Vagal Nerve Activity and Pyloric valve Function in Patients with Functional Dyspepsia. Korean J OrientInt Med. 2008;29(3):621-8.
  6. Yoon SH. Postprandial EpigastricFullness and Pyloric valve Disturbance in Patients with Function Dyspepsia-Analysis of Bowel Sounds and Electrogastrography. Korean J OrientInt Med. 2007;28(4):769-78.
  7. Cannon WB. Auscultation of the rhythmic sounds produced by the stomach and intestine. Am J Physiol. 1905;14:339-53.
  8. Arnbjornsson E, Bengmark S. The role of auscultation and registration of bowel sounds in the diagnosis of acute appendicitis. Ann Chir Gynaecol. 1983;72(6):324-8.
  9. Politzer JP, Devroede G, Vasseur C, Gerard J, Thibault R.The genesis of bowel sounds: influence of viscus and gastrointestinal content. Gastroenterology.1976;71(2):282-5.
  10. Yamaguchi K, Yamaguchi T, Odaka T, Saisho H. Evaluation of gastrointestinal motility by computerized analysis of abdominal auscultation findings. J Gastroenterol Hepatol. 2006;21(3):510-4. https://doi.org/10.1111/j.1440-1746.2005.03997.x
  11. Craine BL, Silpa ML, O'Toole CJ. Two-dimensional positional mapping of gastrointestinal sounds in control and functional bowel syndrome patients. Dig Dis Sci. 2002;47(6):1290-6. https://doi.org/10.1023/A:1015318413638
  12. Watson WC, Knox EC. Phonoenterography: the recording and analysis of bowel sounds. Gut. 1967;8(1):88-94. https://doi.org/10.1136/gut.8.1.88
  13. Tomomasa T, Takahashi A, Nako Y, Kaneko H, Tabata M, Tsuchida Y,et al. Analysis of gastrointestinal sounds in infants with pyloric stenosis before and after pyloromyotomy. Pediatrics. 1999;104(5):e60. https://doi.org/10.1542/peds.104.5.e60
  14. Tomomasa T, Morikawa A, Sandler RH, Mansy HA, Koneko H, Masahiko T, et al. Gastrointestinal sounds and migrating motor complex in fasted humans. Am J Gastroenterol. 1999;94(2):374-81. https://doi.org/10.1111/j.1572-0241.1999.00862.x
  15. Farrar JT, Ingelfinger FJ. Gastrointestinal motility as revealed by study of abdominal sounds. Gastroenterology.1955;29(5):789-802.
  16. Hong IA, Yoon SH. A Study of Gastrointestinal Parasympathetic Nerve Activity and Pyloric Valve Function, and Clinical Characteristerics in Patients with Functional Dyspepsia - Analysis of Bowel Sound. Korean J OrientInt Med. 2008;29(3):666-74.
  17. Locke GR, 3rd, Zinsmeister AR, Talley NJ, Fett SL, Melton LJ, 3rd. Familial association in adults with functional gastrointestinal disorders. Mayo Clin Proc. 2000;75(9):907-12. https://doi.org/10.4065/75.9.907
  18. van Lelyveld N, Linde JT, Schipper M, Samsom M. Candidate genotypes associated with functional dyspepsia. Neurogastroenterol Motil. 2008;20(7):767-73. https://doi.org/10.1111/j.1365-2982.2008.01102.x
  19. ArisawaT, TaharaT, ShibataT, Nagasaka M, Nakamura M, Kamiya Y et al. Genetic polymorphisms of cyclooxygenase-1 (COX-1) are associated with functional dyspepsia in Japanese women. J Womens Health (Larchmt). 2008;17(6):1039-43. https://doi.org/10.1089/jwh.2007.0720
  20. Noguchi E. Mechanism of reflex regulation of the gastroduodenal function by acupuncture. Evid Based Complement Alternat Med. 2008;5(3):251-6. https://doi.org/10.1093/ecam/nem077
  21. Takahashi T. Acupuncture for functional gastrointestinal disorders. J Gastroenterol. 2006;41(5):408-17. https://doi.org/10.1007/s00535-006-1773-6
  22. Kametani H, Sato A, Sato Y, Simpson A. Neural mechanisms of reflex facilitation and inhibition of gastric motility to stimulation of various skin areasin rats. J Physiol. 1979 ;294:407-18. https://doi.org/10.1113/jphysiol.1979.sp012937
  23. Qian LW, Lin YP. Effect of electroacupuncture at zusanli (ST36) point in regulating the pylorus peristaltic function. Zhongguo Zhong Xi Yi Jie He Za Zhi.1993;13(6):336-9.
  24. Allescher HD, Daniel EE, Dent J, Fox JE, Kostolanska F. Extrinsic and intrinsic neural control of pyloric sphincter pressure in the dog. J Physiol. 1988;401:17-38. https://doi.org/10.1113/jphysiol.1988.sp017149
  25. Hong JH, Yoon SH, Kim JS, Ryu BH.Effect of Sojukgunbihwan granule on Gastric Motility in Rats. Korean J Orient Int Med. 2006; 27(1):276-87.