파킨슨병 환자를 대상으로 한 한방병원 단기 다학제 입원 치료 프로그램의 효과 : 9례 전후 비교 증례 연구

초록

Objectives: To evaluate the short-term clinical effects of a multidisciplinary inpatient program integrating Korean medicine with art- and movement-based nonpharmacological interventions in patients with advanced Parkinson’s disease (PD). Methods: We retrospectively analyzed nine patients with idiopathic PD (mean age, 60.2±5.8 years; mean disease duration, 10.1±3.5 years) admitted to a Korean medicine hospital. All patients received standard inpatient Korean medicine treatment (acupuncture, herbal medicine, temporomandibular balancing therapy, cupping, pharmacopuncture, herbal fumigation, and physiotherapy) in addition to their preexisting antiparkinsonian medications. A 6- or 14-day multidisciplinary program was added, including MARS-PD-based exercise, art therapy, psychotherapy, Tai Chi, the Goodball method, Danso classes, and patient education. Outcomes included objective gait parameters (10-Meter Walk Test, Timed Up and Go test, 360° turning test, and GAITRite gait analysis), patient-reported Parkinson’s Disease Questionnaire-39 (PDQ-39) and Parkinson’s Disease Sleep Scale (PDSS), and a patient-specific chief complaint Numerical Rating Scale (NRS) assessed at three time points. Results: All nine patients completed the program without falls or serious adverse events. GAITRite velocity (p=0.020), cadence (p=0.027), and 360° turning steps (p=0.023) improved significantly. NRS scores decreased significantly across the three time points (Friedman χ2 (df=2)=14.00, p=0.001), with significant improvement in both motor (p=0.001) and nonmotor domains (p=0.013). PDQ-39 and PDSS showed favorable but non-significant trends. One patient with a depleted deep brain stimulation pulse generator showed a reduction of 31.88 points in PDQ-39, approximately sixfold the minimal clinically important difference. Conclusions: A short-term multidisciplinary inpatient program integrating Korean medicine with art- and movement-based interventions was associated with significant improvements in objective gait parameters and chief complaint measures in advanced PD. Larger controlled trials are warranted.

키워드