서 론
30%
1-2)
, 16~26%
.
3-4)
,
5)
. Overview of Diabetic Peripheral Neuropathy and Need for
Therapeutic Strategy using Traditional Korean Medicine
Jin-Mi Kim
1, Sung-Sik Youn
1, So-Hyun An
1, Jeong-Sik Choi
1, Chung-Sik Cho
1, Chang-Gue Son
2, Chul-Jung Kim
1Internal Department of Oriental Medicine College, Daejeon University
Objective: This study aimed to analyze the current status of treatments and patients with diabetic peripheral neuropathy, and then map out of a strategy for development of generalized-treatments for diabetic peripheral neuropathy in Traditional Korean Medicine.
Methods: We selected research materials from various databases such as PubMed, Google, KStudy, KoreanTK, OIM, KOMS and books. Also, to understand current tendencies of medical examination and treatment related with diabetic peripheral neuropathy, we requested Health Insurance Review and Assessment Service clinical data from 2003 to 2007.
Results: It is reported that the incidence of diabetic peripheral neuropathy is increasing in an aging society. The medical fees of National Health Insurance related with diabetic peripheral neuropathy show a year-on-year increase.
There are no particularly effective therapies for diabetic peripheral neuropathy in Western medicine, and in some papers, it was reported that treatment of diabetic peripheral neuropathy using Traditional Korean Medicine was effective. However, patients usually visit on Western medical center rather than seek Traditional Korean Medicine.
To take charge of clinical fields related with diabetic peripheral neuropathy by Traditional Korean Medicine, we need more studies and experiments of diabetic peripheral neuropathy using Traditional Korean Medicine and should make a standardized protocol.
Conclusion: Various studies related with diabetic peripheral neuropathy using Traditional Korean Medicine will have to be undertaken hereafter. We expect that Traditional Korean Medicine will play a vital role in treating of diabetic peripheral neuropathy.
Key Words : Diabetic peripheral neuropathy, Traditional Korean Medicine, Western medicine 김진미
1, 윤성식
1, 안소현
1, 최정식
1, 조충식
1, 손창규
2, 김철중
11
대전대학교 한의과대학 신계내과학교실,
2대전대학교 한의과대학 간장면역학교실
Original Article
Received：29 June 2009 Revised：17 August 2009 Accepted：17 August 2009
Correspondence to：김철중(Chul-Jung Kim)
(301-724) 대전시 중구 대흥동 22-5번지 대전대학교 부속한방병원 신계내과학교실,
Tel：+82-42-229-6330, Fax：+82-42-254-3403, E-mail：[email protected].
(Table 1)
6).
Table 2 (Table 2)
7).
( , ) .
50%
, ,
8)
. 15~21%
8)
.
,
,
8)
.
9-14)
,
.
. ,
,
.
Polyneuropathy Mononeuropathy
Sensory Acute sensory Chronic sensorimotor
Isolated peripheral Mononeuritis multiplex Truncal
Motor Autonomic
Cardiovascular Gastrointestinal Genitouninary Other Proxmal Truncal Table 1.
Focal and multifocal painful neuropathy Cranial(e.g. N.Ⅲ mononeuropathic pain) Focal limb (e.g. entrapment neuropathic pain) Amyotrophy(proximal motor)
Truncal radiculo neuropathic pain General symmertrical painful neuropathy
Acute sensory(always painful) Chronic sensorimotor(DPNP) Chronic predominently sensory
key: DPNP = diabetic peripheral neuropathic pain
Table 2.
연구방법
1. 연구 설계
,
,
.
2. 자료 수집
Pubmed(http://www.pubmed.com/), Google(http://www.google.co.kr/),
(http://www.koreantk.com/), (http://
www.kstudy.com/), (http://www.oim.
or.kr/) (http://www.koms.or.kr/)
(Table 3).
, 2003 2007
. (2007),
E104(
), E104(
( )), E104 (
- ), E104
( ( )),
E105(
), E105(
( )), E114(
- ), E114(
II ( , , )),
E115( II
( , , )), E134(
), G632(
), M146( )
F765( ) ,
.
본론 및 고찰
1. 한국에서 당뇨병성 말초 신경병증의 유병률
분석
1798 Rollo
5% 60%
15)
, Pirat
25 50%
16)
. Bruyn Garland
100%
17)
.
검색 사이트 검색어 검색조건
Pubmed diabetic neuropathic pain/diabetic peripheral neuropathy Published in the Last 5years/English
Google 당뇨병성 말초 신경병증
한국전통지식포탈 당뇨병성 말초 신경병증
한국학술정보 당뇨병성 말초 신경병증
대한한방내과학회 당뇨병성 말초 신경병증
대한한의학회 당뇨병성 말초 신경병증
Table 3.
10~80% ,
2005
54%
5).
1 2 , 1
1/3, 2 1/2
18)
. 2
6% ( 3%)
10 20%
19).
, 2 5.3%(
1.4%)
20).
,
3.8%, 24%
(Fig. 1)
33).
2004 2007 60%
, 72%
(Fig 2).
.
, , 1 2
1 2
10% 2
.
2004 2005 2006 2007
1100
900 800
600 0 (억원)
medical cost claim number
3000 2700 (천건)
700 1000
2400 2100 1800 1500 0
Fig. 2.
2003 2004 2005 2006 2007
2000
1500
1000
500
0 (천명)
patients medical cost
6000 5000 4000 3000 2000 1000 0 (억원)
Fig. 1.
1 2
, 1 2
(Fig 3).
2. 당뇨병성 말초 신경병증의 한ㆍ양방적
병태에 대한 개괄 1)
,
. ,
poly pathway myoinositol
21-23)
.
advanced glycation endproducts (AGE)
,
24-26)
.
27-28)
.
“ (numbness)”
“ (tingling)”
.
“ ”, “
”, “
”
5).
, , ,
, ,
5)
.
, ,
.
. Epalrestant , Ruboxistaurin
5)
.
.
(억원)
2004 2005 2006 2007
1100 900
100
0
etc.
type2 type1
700 500 150
50
Fig. 3.
,
5)
.
2)
. , ,
29)
,
,
9)
.
. ,
, ,
.
,
9-13)
.
, , , , ,
,
, , , ,
,
. ‘
, , , ,
, , ,
’ ‘ ,
, , , ’
‘ , , ’ .
‘ , ’
‘ , , ’
13)
(Fig. 4).
,
.
.
Peripheral nerve injury 痛症 發生
(節疇) : 血痺, 痺證, 脚氣 證, 消渴, 痺症
消渴
陰虛 燥熱
氣滯
濕熱 瘀血
Reduction of Intracellular
Energy Metabolism Hyperglycemia
Poly pathway activation Myoinositol decrease
Oxygen deficiency of intemal nerve Oxidative stress increase Diabetes mellitus
Fig. 4.
.
3. 당뇨병성 말초 신경병증의 한 양방 진료패턴
.
F756 ,
. 2007 (Fig. 5),
.
, , , ,
.
0.035% .
(Fig. 5).
.
.
4. 당뇨병성 말초 신경병증에 대한 한의학적
연구의 필요성
30)
1 7%, 25
50% ,
31)
.
32)
.
9-14)
