신과학/철학
초심리학/잠재능력
UFO/신물리학
오컬티즘/미스터리

과학적, 비과학적 의학
동서양 대체의학

창조론/과학적 사실성
창조론/철학과 정치

스켑틱스/기타 주제
KOPSA 박물관

 

대중매체 모니터링
질문과 답

토론방법
토론사례

연구회원 게시판
연구위원 게시판

 

동서양 대체의학
   
  뇌졸중에서 침의 효과
  글쓴이 : 이병철     날짜 : 02-01-16 14:26     조회 : 5844    
뇌졸중에서 침의 효과 

뇌졸중환자에서 침의 효과가 확실히 인정되어 있지 않으나 우리 나라에서
는 아주 당연한 치료법으로 여겨져 국민적 호응(?)하에 정말 널리 시행되
고 있는 것 같다.

침의 효과를 밝히기 위한 임상적 연구에는 여러 어려움이 따른다. 우선은
이중 맹검 대조 연구가 가능하지 않을 것이며 침의 효과를 지지하는 측과
침의 효과를 인정하지 않으려는 측의 협력적이며 편견 없는 감시통제가 필
요할 것이나 현실적으로, 적어도 우리 나라에선, 그러하지 못한 실정이다.

뇌졸중 환자에서 침구요법은 우리 나라를 포함한, 동양 권 국가 뿐 아니라
서양에서도 시행되어 왔으나 아직까지 그 효과에 대해 확실히 입증할 자료
는 없다. 지금까지 뇌졸중에서 침의 효과를 지지하는 몇몇 연구가 있었으
나 대부분의 연구가 대상수가 적고, 대조 군이 없으며, 또한 무작위화되어
있지 않아 그 결과에 대해서는 신빙성이 적다.

국내에서는 뇌졸중에서 침의 효과에 대한 한의학계 연구결과를 쉽게 검색
하기 어려워 국내연구실적을 파악하기 어렵다.

최근 스웨덴에서 시행된, 비교적 잘 설계된 2개의 “뇌졸중환자에서 침의
효과”에 대한 연구가 있었고 그 결과, 뇌졸중 후 기능적 예후나 삶의 질
향상에 있어 대조 군에 비해 이점이 없음으로 결론지었다.

*아래 다음 두 편 논문의 초록이 있습니다. 

Acupuncture and Transcutaneous Nerve Stimulation in Stroke
Rehabilitation: A Randomized, Controlled Trial. Stroke 2001; 32:707-713.

Effects of Acupuncture Treatment on Daily Life Activities and Quality
of Life: A Controlled, Prospective, and Randomized Study of Acute
Stroke Patients. Stroke 1998; 29:2100-2108.
 
.........................................
Acupuncture and Transcutaneous Nerve Stimulation in Stroke
Rehabilitation, A Randomized, Controlled Trial

Barbro B. Johansson, MD, PhD; Eva Haker, PhD; Magnus von Arbin,
MD, PhD; Mona Britton, MD, PhD; Goran Langstrom, PhD; Andreas
Terent, MD, PhD; Dag Ursing, MD; Kjell Asplund, MD, PhD; for the
Swedish Collaboration on Sensory Stimulation After Stroke1

From the Department of Neurology (B.B.J.), Lund University Hospital,
Lund; Department of Physiotherapy (E.H.), Karolinska Institutet;
Department of Medicine at Danderyd Hospital (M. von A.), Stockholm;
Swedish Council for Technology Assessment in Health Care (M.B.),
Astra Hassle AB (G.L.), Molndal; Departments of Medicine at Uppsala
University Hospital (A.T.), Uppsala; Angelholm Hospital (D.U.),
Angelholm; and Umea University Hospital (K.A.), Umea, Sweden.

Correspondence to Prof Kjell Asplund, Department of Medicine,
University Hospital, SE-901 85 Umea, Sweden.
E-mail kjell.asplund@medicin.umu.se (Stroke 2001: 32-707)

Background and Purpose
In small trials with control groups that receive no intervention,
acupuncture has been reported to improve functional outcome after
stroke. We studied effects of acupuncture and transcutaneous electrical
nerve stimulation on functional outcome and quality of life after stroke
versus a control group that received subliminal electrostimulation.

Methods
In a multicenter randomized controlled trial involving 7 university and
district hospitals in Sweden, 150 patients with moderate or severe
functional impairment were included. At days 5 to 10 after acute stroke,
patients were randomized to 1 of 3 intervention groups: (a) acupuncture,
including electroacupuncture; (b) sensory stimulation with high-intensity,
low-frequency transcutaneous electrical nerve stimulation that induces
muscle contractions; and (c) low-intensity (subliminal) high-frequency
electrostimulation (control group). A total of 20 treatment sessions were
performed over a 10-week period. Outcome variables included motor
function, activities of daily living function, walking ability, social
activities, and life satisfaction at 3-month and 1-year follow-up.

Results
At baseline, patients in each group were closely similar in all important
prognostic variables. At 3-month and 1-year follow-ups, no clinically
important or statistically significant differences were observed between
groups for any of the outcome variables. The 3 treatment modalities
were all conducted without major adverse effects.

Conclusions
When compared with a control group that received subliminal
electrostimulation, treatment during the subacute phase of stroke with
acupuncture or transcutaneous electrical nerve stimulation with muscle
contractions had no beneficial effects on functional outcome or life
satisfaction.

Key Words: acupuncture  trancutaneous electric nerve stimulation 
activities of daily living  quality of life  outcome

..............................
Effects of Acupuncture Treatment on Daily Life Activities and Quality
of Life, A Controlled, Prospective, and Randomized Study of Acute
Stroke Patients
 
Gunilla Gosman-Hedstrom, OT, MSc; Lisbet Claesson, OT, MSc; Ulrika
Klingenstierna, RPT, MSc; Jane Carlsson, RPT, PhD; Bengt Olausson,
MD, PhD; Martin Frizell, MD, PhD; Bjorn Fagerberg, MD, PhD; 
Christian Blomstrand, MD, PhD

From the Department of Clinical Neuroscience, Section of Neurology
(G.G.-H., L.C., J.C., C.B., M.F.), Sahlgrenska University Hospital;
Goteborg College of Health Sciences, Department of Rehabilitation
(G.G.-H., L.C., U.K., J.C.); Department of Clinical Neuroscience, Section
of Psychiatry (B.O.), Molndal/Sahlgrenska University Hospital; and
Department of Medicine, Section of Internal Medicine (B.F.),
Sahlgrenska University Hospital, Goteborg, Sweden.

Correspondence to Associate Professor Christian Blomstrand, Department
of Clinical Neuroscience, Section of Neurology, Sahlgrenska University
Hospital, S-413 45 Goteborg, Sweden. E-mail cbl@neuro.gu.se  (Stroke
1998, 29:2100-2108) 

Background and Purpose
A number of studies have indicated that acupuncture might improve the
functional recovery of stroke patients. These studies vary in inclusion
criteria, sample size, and evaluation methods. The present study was
designed to investigate whether electroacupuncture treatment favorably
affects stroke patients' ability to perform daily life activities, their
health-related quality of life, and their use of health care and social
services.

Methods
One hundred four consecutive patients >40 years of age admitted to
hospital because of an acute stroke were randomized to 3 groups: deep,
superficial, and no acupuncture treatment. The acupuncture treatment
given by 4 physiotherapists started 4 to 10 days after randomization
and was given twice a week for 10 weeks. All patients underwent
conventional stroke rehabilitation as well. Two occupational therapists,
blinded regarding the patients' allocation, evaluated the treatment
effects. The assessments were performed 4 times during the first year
after randomization by means of interviews and observations.

Results
There were no differences between the groups with reference to
changes in the neurological score and the Barthel and Sunnaas activities
of daily living index scores after 3 and 12 months. Regarding the
Nottingham Health Profile, the no acupuncture group had somewhat
fewer mobility problems. No differences in health care and social
services were found between the groups.

Conclusions
The present study does not give support to the previous studies, which
indicates that acupuncture treatment may have a beneficial effect on
acute stroke patients' ability to perform daily life activities, their
health-related quality of life, and their use of health care and social
services.

Key Words: activities of daily living  acupuncture  cerebrovascular
disorders  quality of life  stroke outcome
----------------------