소화불량증은 매우 흔한 질환으로 기존의 위장관계에 발생되는 기능성 소화불량증과 이에 대비되는 췌담관성 소화불량증이 있다. 그 중 담관계 소화불량증을 담즙성 소화 불량증이라 하며 심해지면 담관통도 유발할 수 있다. 비결석성 담관통은 기존 담도계 증상의 원인으로 잘 알려진 담석증, 담도 종양, 협착 등이 없이 발생되는 증상으로 복부 초음파나 CT로 진단되지 않은 미세담석증, 슬러지, 간디스토마 등의 기생충 질환, 그리고 기능성 담관계 질환 등이 있으며 감별을 위하여 내시경초음파 검사가 도움이 된다. 기능성 담관계 질환의 확진을 위하여 SOM 검사를 시행하고 있으나 현실적 실용성 및 검사 자체의 침습성 및 판독의 한계가 있으며 이에 대하여 최근 비침습적인 여러가지 검사에 대한 연구가 활발하다. 실제적으로 기능성 담관계 질환을 진단하기 위해서는 가장 임상적으로 쉽게 해 볼 수 있는 검사는 정량적 간담관 신티그라피 검사이며 담낭 운동이상, SOD 또는 복합형을 감별할 수 있다. 치료는 충분한 식이 조절과 약물 치료를 먼저 시행하되 증상이 악화되거나 자주 재발을 하는 경우는 담낭 운동이상만 있으면 복강경하 담낭절제술을 시행하고, 만약 SOD가 의심되거나 이에 합당한 소견이 관찰되는 경우는 추가적으로 SOM을 시행한 후 결과에 따라 EST를 고려해야 한다. SOM이 가용하지 않은 경우에는 자극 초음파 검사를 추가로 시행하여 판단을 해야 하며 SOD 2형은 EST를 시행할 수 있으며 SOD 제3형은 환자 선택에 신중을 기해야 할 것이다.

The purpose of the present study is to apply Maitland orthopedic manual physical therapy to patients to examine the effects of the therapy on the digestive system through serum gastrin tests that can identify the motility of the digestive system and dyspepsia symptoms and can provide basic data for internal medicinal physical therapy. Maitland orthopedic manual physical therapy was implemented on 20 subjects in total, with 10 in a dyspepsia group and 10 in a control group, for 20 minutes per day, three days per week for three weeks, and the following results were obtained. In the control group, serum gastrin values significantly decreased between before and after treatment(p<.01), and among questionnaire items regarding dyspepsia, those regarding epigastric pain and belching showed significant decreases in these symptoms(p<.05). In the dyspepsia group, serum gastrin values significantly decreased between before and after treatment(p<.01) and all questions regarding dyspepsia showed significant decreases in all symptoms(p<.01). According to the analysis, the dyspepsia group decreased significantly more than the control group in serum gastrin values and all dyspepsia symptoms, except for belching(p<.001). Through the present study, it was identified that Maitland orthopedic manual physical therapy can improve dyspepsia symptoms and is an effective treatment method for internal diseases, such as dyspepsia, by improving gastric motility to become close to the normal state.

This study aims to address the effect of interferential current therapy and thereby to provide basic resources to physical therapies for internal medicine by identifying symptoms for functional dyspepsia and serum gastrin level that shows gastric motility. Following results were obtained by performing interferential current therapy to 16 subjects composed of 8 for functional dyspepsia group and 8 for control group for 20 minutes a day, 3 days a week, for 6 weeks. In control group, serum gastrin level was significantly( p<.01), lowered after the therapy whereas there was no significant difference observed in all questions from questionnaire for symptoms of functional dyspepsia between before and after the therapy. In functional dyspepsia group, serum gastrin level was significantly(p<.01), lowered after the therapy and there was also significant(p<.01) reduction in every question from questionnaire for symptoms of functional dyspepsia between before and after the therapy. There was more significant decrease in serum gastrin level and reduction in questionnaire for symptoms of functional dyspepsia in the functional dyspepsia group compared to the control group(p<.01). This study confirms the interferential current therapy as an effective therapeutic method for internal diseases including functional dyspepsia since it not only improves the symptoms of functional dyspepsia but also allows the gastric motility close to normal.