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1 pissn / eissn CASE REPORT Korean Journal of Acupuncture Vol.31, No.4, pp , 한방치료로호전된크론병치험 1 예 동신대학교한의과대학침구과교실 A Case Study of a Crohn's Disease Patient Treated with Oriental Medical Treatment Seon-wook Kim, Ook-jae Lee, Jeong-Cheol Shin Department of Acupuncture and Moxibustion, College of Oriental Medicine, Dongshin University Objectives : The purpose of this study is to report the effect of Oriental medical treatment on a patient with Crohn's disease. Methods : The patient was treated with acupuncture, herb remedy and moxibustion for about 2 weeks. We evaluated the results of the treatment by observing the patient's symptoms and through the Crohn's disease activity index(cdai) score. Results : After Oriental medical treatment the patient's symptoms such as emesis, heartburn and abdominal pain considerably reduced. The patients CDAI score decreased from to Conclusions : These results support that Oriental medical treatment can be a help in relieving symptoms of Crohn's disease. Key words : Crohn's disease, acupuncture, herb remedy, moxibustion 서론 염증성장질환은넓은의미에서장에발생하는염증성질환이며통상궤양성대장염과크론병으로지칭되고있다. 주로코카시안에게다발하는질환으로국내에서는흔한질환이아니었으나최근 10년사이한국에서도급증하여인구 10만명당 10명이상의유병률을보이고있다 1). 주로만성적인경과를보이는크론병은병변이일정치않고장전체에발생할수있으며협착, 천공등을유발시켜서복통, 설사, 체중감소등의증상을호소한다 2). 양방에서는크론병에대한원인및병리기전이정확히밝혀져있지않아근본적치료가어려우며증상에대한보조적인처치수준에머무르고있는데주로영양요법을중시하며약물요법, 내시경확장술, 외과적치료등이시행된다 3). 한의학에서의크론병은증상이다양한만큼腸澼, 腹痛, 泄瀉, 便血, 積聚등의범주로보고있다. 임상적으로虛實로나눌수있으며寒熱錯雜, 正虛邪變, 本虛標實등에해당되는경우가많아한방적으로원인과증상을고려하여진단을내린후치료를하게된다 4). 크론병관련연구를살펴보면크론병에대하여한의학적관점으로고찰한연구 5), 韓藥치료를통한크론병호전임상례 6-8), 鍼灸치료를통한크론병호전임상례 9), 韓藥및鍼치료를통한크론병호전임상례 10), 藥鍼요법이크론병에미치는효과를연구한실험 11,12), 電鍼요법이크론병에미치는효과를연구한실험 13) 등다양한범주에서결과를보여주었지만다른질환에비하여증례보고및연구가적다. 이는국내에서다른질환에비해유병률이낮으며양방치료에비해한방치료를받는환자수가적기때문으로사료된다. Received December 3, 2014, Revised December 12, 2014, Accepted December 13, 2014 Corresponding author: Jeong-Cheol Shin Department of Acupuncture & Moxibustion Medicine, Mokpo Oriental Hospital of Dongshin University, 313, Baengnyeon-daero, Mokpo , Korea Tel: , Fax: , fire-sjc@hanmail.net CC This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright 2014, SOCIETY FOR MERIDIAN AND ACUPOINT 247

2 본연구는특정치료에집중한이전의연구와달리韓藥, 鍼, 灸로구성된복합적인한방치료로양약투여없이크론병증상에유의한치료효과를보였다. 이에저자는복합적인한방치료가크론병의효과적인치료방법이될수있을거라사료되어보고하는바이다. 증례 1. 대상 1) 환자 : 김 / 여자 46세, HT/DM(-/-), 156 cm/38 kg 2) 발병일 : 2000년초부터 3) 치료기간 : 입원치료하심. 4) 진단명 : Crohn's disease 5) 주소증 (1) 嘔吐 : 하루 4 5 차례의구역감및토를동반 (2) 腹痛 : 주로속쓰림, 한번씩뒤틀릴듯한통증. (3) 腹滿 : 식후더부룩하며가스차는증상. (4) 食慾不振 : 입맛없음. 한공기의 1/4정도억지로드심. 증상 progress 이후 10 kg 감소 (5) 泄瀉 : 3회 /day. 풀어지는변 (6) 身體痛 : 항상피곤함과 general weakness 호소. 주로허리, 어깨주변으로통증호소 6) 초진소견 (1) 睡眠 : 예민하셔서자주깸. 깊은수면이어려움. (2) 小便 : 6 7 회 /1 day (3) 寒熱 : 추위를못참으며찬데서자면몸이쑤심. 상열감이한번씩있음. (4) 汗出 : 평소식은땀이남. (5) 大便 : 3회 /day, 풀어지는변, 후중감동반. 대변에음식물이보일때있음. (6) 生理 : 출산 3회. 주기 일. 가벼운생리통및백색냉 (7) 腹珍 : 심하부압통, 복직근긴장및압통. 하복부통증. 복부냉감. (8) 겉보기왜소하며피부가하얗다. 평소기운이없어쉽게지치며예민하여작은일에스트레스를많이받으시는편이다. 7) 과거력 : 없음 8) 가족력 : 父 - 뇌출혈 / 母 - 고혈압 9) 현병력 : 상기환자는평소복통및구토등의소화기증상으로 local 병원에서외래치료를받던중 2006 년서울대학교병원에서혈액, 방사선및내시경검사등을종합하여크론병으로진단을받 아증상에대한보존적치료로약물치료 (Azathioprine 50 mg 1회 /1 day, Trimebutine 300 mg 3회 /1 day, Pantoprazole 40 mg 3회 /1 day 경구복용 ) 를시작하였다. 약물치료에도효과는없었고 2014년부터증상이악화되자서울대학교병원에서수술을권유하였으나본인이수술보다는한방으로치료하고자하여 2014년 8월 18일동신대학교목포한방병원에입원하였다. 10) 검사소견 (1) 활력징후 : 혈압 140/90 mmhg, 맥박 68회 /min, 호흡 20회 /min, 체온 36.5 o C (2) Chest PA X-ray상別無, EKG normal (3) 임상병리 : RBC μl, HGB 9.5 g/dl, Hct 29.2%, LYM 7.5%, NETU 87%, ESR 6 mm/hr 2. 치료방법및임상경과 1) 치료방법 (1) 침치료 : 입원치료기간동안직경 0.2 mm, 길이 30 mm 인일회용 stainless 毫鍼 ( 동방침구제작소, 2014, 중국 ) 을사용하여 1 일 1 2 회시행하였다. 입원치료후 11일째까지크론병증상을판단하여曲地 (LI11), 天樞 (ST25), 足三里 (ST36), 合谷 (LI4) 및大腸兪 (BL25) 을양측에직자하고깊이는 mm로하였다. 虛證으로판단하여左轉으로捻轉하여得氣感이느껴지도록한후 분留鍼시켰다. 입원치료후 14일째까지위의경혈에中脘 (CV12), 氣海 (CV6), 太白 (SP3) 을추가하여위와같은방법으로시행하였다. (2) 한약치료 : 한약은동신대학교목포한방병원약제실에서조제한탕약을사용하였다. 1 桃花湯 ( ): 粳米 42 g, 赤石脂 16 g, 乾薑 8 g, 1일 1첩 3 pack(100 cc) 을 1일 3회식후 1시간복용 2 比和飮 ( ): 厚朴 8 g, 枳實 8 g, 大棗 6 g, 白茯笭 6 g, 白朮 6 g, 生薑 6 g, 神麯 6 g, 人蔘 6 g, 甘草 3 g, 藿香 3 g, 砂仁 3 g, 陳皮 3 g, 陣倉米 2 g, 1일 2첩 3 pack (120 cc) 을 1일 3회식후 1시간복용 (3) 뜸요법 : 간접구요법으로동방구관 ( 동방침구제작사, 2014, 중국 ) 을구관뜸판에 5개를꽃은후구관에불을붙여뜸판의가운데를中脘과關元 (CV4) 에해당하는위치로올려 15분정도유지하며하루 1회시행하였다. (4) 양약치료 : 환자에게한방치료를시행하면서호전양상에따라양약을줄이려고권유하였으나본인의의지로한방치료를시작하면서양약을복용하지않았다

3 한방치료로호전된크론병치험 1 예 2) 치료경과 (Table 1) (1) 嘔吐 : 입원당시 4 5 차례구역감에토를동반할때가많았지만입원치료를시작하면서부터토를하지않았고구역감횟수가줄어들더니입원치료후 9일째부터구역감도없어지게되었다. (2) 腹痛 : 입원치료후 8일째까지속쓰림의빈도가줄어들며속쓰림의강도가줄어들었으나 8월 26일육류과식후에속쓰림이심해졌다. 그후속쓰림증상은없었다. 뒤틀릴듯한腹痛은주로밤이나새벽에한차례씩있었는데발생의빈도가 2 3 일 1번씩으로줄어들었다. (3) 腹滿 : 입원치료후 11일째까지호전양상이크지않았으나침치료의추가및처방의변화를준시점부터복부에더부룩한느낌이경감되었다. 특히하복부압통감도경감되었다. (4) 食慾不振 : 입원치료후 5일째부터입맛이약간씩생겨식사량이 1/3정도를천천히먹게되었다. 8월 26일이후에는식욕은회복했으나환자분이과식을했을시에복만감에대한걱정으로 식사량을유지하였다. 퇴원일까지식사량은 1/2로늘었으며처음으로 40 kg이넘었다. (5) 泄瀉 : 입원치료후 5일째부터정상적인변을보기시작했고, 1회 /day로호전되었으나한번씩배변에어려움을겪었다. (6) 身體痛 : 주로환자분의컨디션과관련된부분으로치료후허리통증은거의느끼지못할정도로좋아졌으나어깨통증은큰차도가없었다. (7) Crohn's disease activity index(table 2): 입원당시 점이었으나추척관찰하여최근내원했을때 점으로감소하였다 ( 퇴원하였을때개인적인사정으로혈액검사를체크하지못하였다 ). Table 1. Change of Chief Complains Admission 4 days 8 days 12 days 16 days Vomiting ± ± ± Abdominal pain Abdominal discomfort Anorexia Diarrhea +++ ± ± ± ± Pantalgia Shoulder Lumbus ± *Symtoms grade : Severe +++ Moderate++ Mild+ Trace±. Table 2. Crohn's Disease Activity Index Items Factor Number of liquid or very soft stools* Abdominal pain*(0=none, 1=mild, 2=moderate, 3=severe) General well-being* (0=generally well, 1=slightly under par, 2=poor, 3=very poor, 4=terrible) Number of 6 listed categories patient now has: ) Arthritis/arthralgia 2) Iritis/uveitis 3) Erythema nodosum/pyoderma gangrenosum/aphthous stomatitis 4) Anal fissure, fistula, or abscess 5) Other fistula 6) Fever over 100 o F(37.8 o C) during past week 5. Taking lomotil/opiates for diarrhea(0=no,1=yes) Abnominal mass(0=none, 2=questionable, 5=define) Hematocrit Males:(47-hematocrit), Females:(42-hematocrit) Percent below standard weight(normogram) SUM *Sum of 7 days. *Adm. : Admission

4 고찰 WHO 에서크론병의개념은 원인이불명확하며젊은층에서호발하며섬유화나궤양을동반하는비특이적육아종성괴사및반흔성염증이특징인질환으로소화관의어느부위에서나발생할수있다 이다 3) 년 Dr. Crohn 이최초로돌창자말단이침범당한다고보고한이래다양한연구와실험이이루어졌으나병인과병리과정이밝혀지지않았다. 현재까지여러가지가설들이있는데자가면역성, 감염성인자, 유전적요인, 환경적요인등이관련성이높다고의심하고있다 14). 크론병은임상증상이다양하고병정이규칙적이지않고수시로변하여병변이활동성인지회복기인지구분하기어렵다. 이럴경우활성도에따른지표를설정하여분류하는데대표적인예가 Crohn's disease activity index(cdai) 이다. 일반적인실험및임상에서 CDAI 150 미만은비활동성 ( 관해 ), 150 이상은활동성인데 150 이상 220 미만은경증활동성, 220 이상 450 미만은중등도활동성, 450 이상은중증활동성이라한다. CDAI 가 150 이하이거나본래의수치가 100 이상감소하면회복기에접어든것으로판단할수있다 2). 다른질병에비해병인의정체를모르는크론병의치료는첫째는장내독성물을줄이고둘째는영양공급을통해조직손상을막고셋째염증성매개체의생산을억제시키도록하는것이다. 그러므로약물치료가우선이되어경증이나중등증일때 sulfasalazine 등이사용되며만성적일경우에는스테로이드를투여하게된다. 식이요법의경우적정한영양공급과동시에항원의감소및면역반응의시정등의효과를볼수있기에최근에많이사용되고있다. 그러나위의치료에도효과가없을시에는면역억제제가사용되기도한다 15). 상기환자의증상에맞춰크론병의한의학의범주를 嘔吐, 腹痛, 泄瀉 로보았으며세증후에공통되는치료혈을확인하고 16) 박 9) 의연구결과에서유효한효과를보았던曲地 (LI11), 天樞 (ST25), 足三里 (ST36), 合谷 (LI4) 및大腸兪 (GL25) 을시행하였다. 曲地는手陽明大藏經의合土穴로서疏邪熱, 利關節, 祛風濕, 調氣血의성질을가지며吐血, 腹痛, 吐瀉, 痢疾등主治한다. 合谷과配穴하여咽中閉塞과腹瀉를치료하며逆氣를泄함을주관하니大腸炎으로下利가일어났을때조절하는穴이다 17,18). 天樞는大腸의병을주관하는大腸의腹募穴로疏調大腸, 調中和胃, 理氣健脾등의성질을가지며急慢性胃炎, 腸炎, 腹痛, 泄瀉, 嘔吐, 腸鳴등에응용한다. 주로腹痛諸症을주치하며腹部의병에효과가있다 17,18). 문헌에서 甲乙經 에서는 腹脹腸鳴, 氣上冲胸, 不能久立, 腹中痛濯濯, 冬日重感于寒卽泄, 天樞之 라하였다. 足三里는理脾胃, 調中氣, 和腸消滯, 疏風化濕, 調和氣血, 强健脾胃등의성질을가지어대표적으로소화계통질환을치료하며호흡, 비뇨생식기계통의질환에도효과가있고全身强壯의要穴이다 17,18). 合谷은手陽明大腸經의原穴로써發表解熱, 疏風解表, 淸泄肺氣, 通降腸胃, 鎭痛安神등의성질을가지어消化不良, 吐瀉등에응용할수있다. 臨床에서는太衝과配穴하여소화기질환을치료할목적으로사용함에合谷과소화기의관계를알수있다 17,18). 大腸兪는大腸의邪氣가주입되는곳으로大腸經의募穴인天樞와배합하면소화기증상에효과가있다. 疏調二腸, 理氣化滯, 强健腰膝의성질을가지어腸炎, 腸出血, 腹痛, 泄瀉등에응용할수있다. 十四經發揮 에서 脊强, 腰痛, 腹中氣脹, 臍를감도는切痛, 膓鳴, 腹中雷鳴, 膓癖, 小腹絞痛, 大小便難을주관한다 라고효능을기술하고있다 17,18). 또한환자가가지고있는소증과증상에따라傷寒論의六經의 少陰病 제강의脈微細로판단하고크론병의양상으로桃花湯을처방하게되었다 19). 입원치료후 11일째까지복용한桃花湯은 傷寒雜病論 에서 少陰病下痢便膿血者桃花湯主之, 少陰病二三日至四五日腹痛小便不利下痢不止便膿血者桃花湯主之 라하여증상으로腹痛, 小便不利, 下痢, 便膿血이있는少陰病에사용하는처방이다. 桃花湯의적응증은下焦裏虛寒의下痢, 便膿血에있어서이미오래된병이되어서熱象은없고쇠약의경향이있어번번히下痢를하고便膿血을하나裏急後重없으며허리가약해진증상에사용할수있을것으로보인다. 桃花湯의처방은赤石脂, 乾薑, 粳米로구성되어있으며의가에서따라서湯또는丸으로사용하기도하며임상에서는大腸炎, 大腸潰瘍, 直腸炎, 肛門周圍炎, 肛門部潰瘍과같은하부소화성궤양혹은염증에응용되고있다 20). 桃花湯을구성하는약재들의效能과性味는다음과같다. 赤石脂는甘溫酸澁하여능히收濕止血而固下하고收口長肉하여腸癖泄痢, 癰痔潰瘍, 崩帶潰精을치료하는효능이있다. 乾薑은辛熱하여逐寒邪하고發表溫經, 燥脾濕, 定區消痰, 開胃扶脾하는효과가있어서反胃下痢, 腹痛을치료한다 21). 粳米는甘平하여平和五臟하고補益氣血하는효능이있고赤石脂와健康을補佐하여腸과胃를潤하게하는작용을한다 22). 그러므로裏寒증상이나타나는痢疾로써熱氣가退하고脈遲弱또는微弱하며腹痛下利不止便膿血하는자에게桃花湯을사용한다. 뜸요법은溫經散寒, 扶陽固脫, 豫防保健의작용을하는데, 주로溫經散寒의작용을통해병을치료한다. 침치료와같이생체의氣血運行과神氣의활동을강화하여치료효과를얻는데침치료와달리溫熱자극이있으므로氣溫하면血滑하여氣血의운행이강화 250

5 한방치료로호전된크론병치험 1 예 되고血脈과形및神이모두和利하고肌肉이解利하며피부는치밀해져건강한생리로도달한다 23). 특히이번뜸치료는任脈經의상ㆍ하복부에대해온열자극을하여胃腸질환에도움이되며전신강장작용을통해기운을올려주어병의회복에영향을끼친다 18). 환자가치료가시작한후로빠르게호전을보인부분은대변상태와구토이다. 치료가시작하면서입원치료후 3일만에변이정상적인상태를보였으며 1회 /day 로바뀌어치료가마무리되기까지유지가되었다. 치료중간에환자분이오히려排便難을 2차례호소하였지만그이후에는특별한불편감을없었다. 구토는식후구역감이심하고하루한차례이상의토를동반하여고형물의음식을피하는상태였고식욕이없었다. 치료이후속이편한느낌을가지며구역감이줄어들었으며토를하지않아서고형물의음식을약간씩섭취하게되었다. 크론병으로환자분의삶의質이많이깨진상태로특히睡眠의質이좋지않았다. 잦은腹痛과身體痛으로깊은잠에들지못하고자주깨는상태였다. 치료를받으면서증상의호전으로인해잠자는시간이 2시간에서 4시간으로증가하였으며중간에잠을깨는빈도도줄게되었다. 입원치료후 11일째까지쉽게호전되지않은부분이腹滿感이었다. 전반적으로증상에차도를보이는반면腹滿은입원치료후 5일째부터입원치료후 8일째까지약간의호전보이다가오히려트림의빈도가증가하면서상태를유지하여서침치료는中脘 (CV12), 氣海 (CV6), 太白 (SP3) 을추가하고처방을桃花湯에서比化飮으로변경하게되었다. 침치료에있어서환자가호소하는不食, 時脹時減, 無力感등을고려하여陰寒의邪氣로인한虛脹으로변증하여中脘과太白으로소화기관의기능을정상화하고, 氣海로복부의순환을돕고자기본혈위에추가하였다 16). 中脘은胃의募穴로써명치부위로배꼽중앙에서위로 4촌에위치한다. 和胃氣, 化濕滯, 理中焦, 調升降의성질을가지어腹脹, 胃炎, 消化不良, 嘔吐, 泄瀉, 呑酸등의질환에응용할수있다. 後天의氣를생성하는중심부, 즉脾胃에중요한혈자리로써脾胃질환에사용되는빈용취혈이다 17,18). 太白은脾經의原穴로써調脾和胃, 通經活絡의성질을가지어일반적으로소화기병일때취혈하며腹痛, 胃痛, 腹脹, 消化障碍등에응용할수있다 17,18). 氣海는元氣之海의의미로氣海穴을조정하는것이질병의치료에중요하다. 調氣益元, 溫下焦, 和營血理經帶등의성질을가지어腸炎, 胃炎, 腹腫脹, 眞氣不足, 四肢厥冷등에응용할수있다 17,18). 입원치료후 12일째부터입원치료후 14일째까지복용한比和飮은古今醫鑑에최초로수록되었으며健脾益氣의대표적인방제인四君子湯을중심으로하여消導開胃하는神麯, 砂仁, 利氣快氣하는藿香, 陳皮, 養胃하는陣倉米를가미하여구성된처방으로補脾健胃, 消食의효능을가지고있으며胃虛嘔吐, 久病人嘔吐및不思飮食의治療에사용해왔다 23). 임의연구 24) 에의하면비화음은소화기의평활근이완작용유도, 소화력증강, pepsin 의배출량억제, 구토억제등의효과를보여줬으며김의연구 25) 에서는위의수축력증가, 위산도감소및위액분비억제효과를보여줬다. 오랜기간동안病中에있으면서脾胃가虛하여발생하는트림및腹滿으로판단하여경혈과한약을사용했으며변경된치료가진행되는 5일동안증상은 vas 5로경감하게되었다. 이미桃花湯을사용하면서식욕이생겼지만식후생기는腹滿感으로식사량증가에두려움을갖고있었으나이부분이호전을보이면서식사량을 1/4공기에서 1/2공기로증량하게되었다. CDAI 상 점으로경증활동성으로판단하였으나퇴원하고추적관찰후최근내원한몸상태는 42 kg으로증가했고수면상태도좋아지고컨디션도좋아졌다. CDAI 상 134.2점을기록하여비활동성으로판단하였다. 입원기간동안에양약을복용하지않고한방치료만으로도크론병증상에호전을보였기에크론병에대한한방치료의가능성을보여주었다고사료된다. 결론 크론병진단으로嘔吐, 腹痛, 腹滿, 食慾不振, 泄瀉, 身體痛의증상을가진환자 1예에대한한방임상치료에서양방치료와병행하지않고증상에따른한방치료 ( 침, 한약, 뜸, 부항 ) 를통해주소증에대한호전을확인하였기에보고하는바이다. 다만크론병에적절한치료체계를세워지기위해다양한연구와검증및임상례가필요할것이라사료된다. References 1. Yang SK, Song IS, Kim JH, Kim HY, Kim KJ, Yang SH, et al. Epidemiology of Inflammatory Bowel Disease in the Songpa- Kangdong District, Seoul, Korea, : A KASID Study. Korean J Gastroenterol ; 14 :

6 2. Ye BD, Jang BI, Jeen YT, Lee KM, Kim JS, Yang SK, et al. Diagnostic Guideline of Crohn's Disease. Korean J Gastroenterol ; 53 : Lee YC. Steps to Internal Medicine, Gastrointestinal Internal Medicine. Jung-dam publishing inc ; 6 : Jin GJ. Practical Combination of China & West, Diagnosis and Therapeutics. Euiseongdang : Choi CW, Son CG, Jo JG. The Oriental-Western Literal Study of Crohn`s Disease. Daejeon University Oriental Medical LAB. Daejeon University Oriental Medical LAB Collection of Dissertations ; 9(2) : Seo SH, Jeong JW, Kim WI, Lee EH, Choi IS, Park SE. A Case Study of Suspected Crohn's Disease Treated with Bojanggunbitang. Korean J Oriental Int Med ; 25(3) : Lee MS, Hwang MW, Kim EH. A Case Study of a Soyangin Patient with Crohn's Disease who Reported Symptomatic Improvement after Being Treated with Dojeokgangki-tang. J Sasang Constitutional Medicine ; 24(2) : Na WG, Yang MR, Lee HJ, Park EJ, A Case Report of Crohn's Disease. Korean J Oriental Pediatrics ; 16(2) : Park JM, Kim HJ, Keum DH, Park YH, Lee MJ. The Effect of Oriental Medical Treatment on Crohn's Disease, 1 Case Report. The Journal of Korea CHUNA Manual Medicine for Spine & Nerves ; 5(1) : Lee SH, Park DS. Clinical Study on 1 Case of Soyangyin Patient Diagnosed as Crohn's Disease. Korean J Oriental Physiology & Pathology ; 21(5) : Song MY, Park SY, Kim JH, Ahn SH, Kim KS, Son IC. Effects of Moxi-tar Herbal Acupuncture of LI11 on Inflammatory Bowel Disease Induced by TNBS in Mices. Korean Journal of Acupuncture ; 25(2) : Kim YT, Ahn SH, Kim JH, Son IC. Effects of Moxi-tar Herbal Acupuncture at Cheonchu (ST25) on Crohn's Disease Induced by TNBS in Mices. Korean Journal of Acupuncture ; 25(2) : Choi YY, Ahn SH, Kwon OS, SEO SR, Son IC, Kin JH. Effects of Electroacupuncture on the Visceromotor Response to Colonic Distension in TNBS-Induced Colonic Inflammation in Rats. Korean Journal of Acupuncture ; 24(3) : Korean College of Oriental Medicine, Department of Spleen System Internal Medicine. Internal Medicine of Spleen System. Koonja publishing inc : Fazio VW, Wu JS. Surgical Therapy for Crohn's Disease of The Colon and Rectum. surg clin N Am ; 77 : The Korean Acupuncture & Moxibstion Medicine Society, The Textbook Compilation Committee. The Acupuncture and Moxibustion III. Jipmoon publishing inc : 294-6, 302-3, , Ahn YK. Meridianology Series. Seongbosa : 104-5, 116-7, 176-7, 196-7, 222-3, 366-7, 682-3, The Korean Acupuncture & Moxibstion Medicine Society, The textbook compilation committee. The Acupuncture and Moxibustion Ⅰ. Jipmoon publishing inc : 29, 24-5, 56-7, 63-4, 78, 138, 296-8, 301-2, Noh YH, Oh JH, Ryu HC. An Understanding of 'Mai' in Shanghanlun Based on Paleography and Clinical Application. Korean Medical Association of clinical Sanghan - Geumgwe : Lee JH, Essential Formulae in Oriental Medicine with Illustrations. Uibang Publishing company : Kim YJ, Ryu KW. A Study on the Effects of Soo Jeom San on Gastric Ulcer and Analgesic Action. J College of oriental medicine, Kyunghee University ; 29(9) : Wang-Ang. Yifangjijie. Seongbosa : The Korean Acupuncture & Moxibstion Medicine Society, The textbook compilation committee. The Acupuncture and Moxibustion II. Jipmoon publishing inc : Rim JW. Experimental Studies on efficacy of BEEWHAEUM. Dept. of Oriental Medicine Graduate School Kyunghee University Kim IS. Effect of Bihe-yin on Gastric Motility & Secretion of Gastric Juice. Dept. of Oriental Medicine Graduate School Wonkwang University

Lumbar spine

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