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1 109 DOI : /KPI Received : Revised : A Case Study Of Patients With Knee Joint Pain Treated With Rubiae Radix Pharmacopuncture Accepted : Key Words: Knee joint pain, Rubiae Radix, Pharmacopuncture, Korean medicine. Lee JinBok, Cho YiHyun, Im JeongGyun, Kim JongUk, Yook TaeHan, Song BeomYong Department of Acupuncture & Moxibustion, Woosuk University ABSTRACT Objective : This study was to investigate the clinical effect of Rubiae Radix pharmacopuncture on knee joint pain. Methods : The patients were treated by Rubiae Radix pharmacopuncture, Acupuncture, herbal medicine. To evaluate the effect of the treatment, The patient's symptoms were assessed by Visual Analogue Scale(VAS) Score, Knee injury and osteoarthritis outcome score(koos) and physical examinations. Results : In all cases, the pain was reduced significantly according to improvement of VAS score, KOOS and active Range Of Motion(ROM) of knee joint. VAS score and KOOS of all cases were decreased. In two cases, ROM of knee joint has improved. But in one case, ROM of knee joint has still been restricted. But there are no noticeable changes in physical examinations. Conclusion : These results suggest that Rubiae Radix pharmacopuncture might be an effective method to treat patients with knee joint pain. But, It's necessary to have more observations and experiments with Rubiae Radix pharmacopuncture. I Corresponding author : Beomyong Song, Dept. of Acupuncture & Moxibution, College of Oriental Medicine, Woosuk Univ. Tel: , Tel: A Case Study Of Patients With Knee Joint Pain Treated With Rubiae Radix Pharmacopuncture

2 110 Journal of Pharmacopuncture II 1 McMurray (1) Apley's compression&distraction (2) McMurray McMurray (3) Drawer sign anterior posterior draw sign Drawer sign ) 2 1) Visual Analogue Scale VAS ) Range Of Motion ROM ROM Goniometer 3) Knee injury and osteoarthritis outcome score KOOS (Appendix 1) 4) Apley's compression&distraction Drawer sign (1) (2) ST34 SP10 4 Sterile Hypodermic Syringe DM Medicrat 1.0mL, 30 Gauge Korea mL 0.4mL (3) 3 2 2) 0.30mm 40mm(Stainless steel

3 111 Korea ST36 SP9 SP6 LI4 SI3 ST7 2 ST36 SP9 SP6 LI4 SI3 ST7 3) ) Interferential current therapy Ultra sound Hot pack MRI ) MRI of Lt. Knee , Fig. 1 Horizontal tear in posterior horn of medial meniscus of Lt. knee 6) Table 1 ROM VAS score 3 0 VAS score 8 6 Apley's compression Mcmurray 2 Apley's distraction Drawer sign KOOS III ) Lt 2) ) ) ) both knee joint pain (Rt>Lt) 2) ) )

4 112 Journal of Pharmacopuncture Apley's compression Mcmurray varus valgus stress Apley's distraction 5) MRI of Rt. Knee ( , Fig. 2) Degenerative chondromalacia in inferior surface of medial femoral condyle with reactive subcortical marrow edema, Degenerative meniscal disease of posterior horn of medial meniscus 6) Table 2 ROM VAS score 8 2 Apley's compression Mcmurray Apley's distraction Drawer sign KOOS MRI ROM Apley's Compression Mcmurray Drawer sign 5) MRI of Rt. Knee ( , Fig. 3) Meniscal degenerations, mild to moderate, ant. horn of Lat. meniscus and post. horn of Med' meniscus, Rt. 6) Table 3 ROM 110 VAS score 10 1 Apley's compression&distraction Mcmurray Drawer sign KOOS IV 3 1) 2) ) )

5 ROM VAS score 3 0 VAS score 8 6 Apley's compression Mcmurray 2 Apley's distraction Drawer sign KOOS ROM VAS score 8 2 Apley's compression Mcmurray Apley's distraction Drawer test KOOS ROM 110 VAS score 10 1 Apley's compression Mcmurray test Apley's distraction 2 Drawer sign 2 KOOS V

6 114 Journal of Pharmacopuncture VAS 2. ROM 3. KOOS VI 1. KY Moon, SH Oh, BG Kang, YK Lee. The effect of closedneedle Irrigation of Knee in Patients with Osteoarthritis. Journal of Korean Academy of Rehabilitation Medicine. 1998;22(1): KH Kim, KW Kim, HJ Min, YS Yoon, HO Kim, JS Seo. Differences of Meniscus Injuries by Age Groups. Journal of Korean Knee Society. 2001;13(1): The National Medicine Association of China. Clinical Diagnostics of Oriental Medicine. Beijing:InMinWuiSang publishing company. 1987: KH Song, JS Lee, JH Jo, KB Park. Study on Clinical Effects of Homnis Placenta Herbal Acupuncture on Osteoarthritis of Knee Joint. The Jounal of Korean Acupuncture & Moxibustion Society. 2006;23(4): HS Yoo, JH Choi, JK Choi. Effects of Herbal Acupuncture(Soyeum) on Cancer Patients Accompanied by Pain. The Journal of Korean Pharmacopuncture Society. 2003;6(1): HY Shin, IA Chang, WJ Zhang, YC Kim, YG Yun, H Park. Immunemodulator Effect of Rubiae Radix Watet Extract. The Jounal of Korean Physiology & Pathology Society. 2008;22(2): HK Oh, JH Won, KM Jeong. Experimaental Study on the Effects of Rubiae Radix and Fagarae Mandshuricae Fructus. The Jounal of Korean Oriental Pediatrics. 1990;4(1): SS Kang. Dictionary of Oriental Herbology. Seoul:JungDam publishing company. 1998: JM Wang. Assessment of the Spinal Pain Using Visual Analogue Scale(VAS). Journal of Korean Spine Surgery. 1995;2(2): Roos EM, Lohmander LS. The Knee injury and Osteoarthritis Outcome Score (KOOS). from joint injury to oeteoarthritis. Health Qual Life Outcomes. 2003;1: The Korean Academy of Oriental Rehabilitation Medcine. Oriental Rehabilitation Medcine. Seoul:KoonJa publishing company. 2005:96, The National Medicine Association. The Clinical Diagnostics 4th. Seoul:HanMi publishing company. 2002: The National Oriental Medicine Acupuncture Association. Acupuncture and Moxibustion(the first part).seoul:jibmoondang publishing company. 2008:383,404,407,430, JJ Jin. Treatment and Prescription of Oriental Medicine. Seoul:JungDam publishing company. 2009: The Korean Association of Herbology. Herbology. Seoul:YoungRim Press Co. 2004: WS Hong. HwangJeNaeKyung. Seoul:Oriental Medicine Research publishing company. 1985:26,28,37,48,51,86.

7 The Korean Orthopaedic Association. Orthopedics 5th. Seoul:ChoiSin publishing company. 1999: The Korean Association of Oriental Medicine. Dictionary of Oriental Medicine. Seoul:YeoKang publishing company. Appendix 1. KOOS KOREAN KOOS KNEE SURVEY Symptoms S1 S2 S3 S4 S5 Stiffness S6 S7

8 116 Journal of Pharmacopuncture P1 P2 P3 P4 P5 P6 P7 P8 P9 Function, Daily living A1 A2

9 117 A3 A4 A5 A6 A7 A8 A9 A10 A11 A12 A13 A14 A15

10 118 Journal of Pharmacopuncture A16 A17 Function, Sports and Recreational Activities SP1 SP2 SP3 SP4 SP5 Q1 Q2 Q3 Q4

11 119 Fig. 1. MRI of Lt. Knee (Case 1, T1 weight sagittal view) Fig. 2. MRI of Rt. Knee (Case 2, T1 weight sagittal view) Fig. 3. MRI of Rt. Knee (Case 3, T1 weight sagittal view)

12 120 Journal of Pharmacopuncture Table 1. The treatment progress of Case1 6/19 6/23 6/27 7/1 VAS( ) 3/8 2/7 0/6 0/6 KOOS ROM : Flexion (135 ) Apley's Compression Apley's Distraction Mcmurray test Drawer test(ant/post) / / / / Table 2. The treatment progress of Case2 6/19 6/23 6/27 7/1 VAS KOOS ROM : Flexion (135 ) Apley's Compression Apley's Distraction Mcmurray test Drawer test(ant/post) / / / / Table 3. The treatment progress of Case3 6/19 6/23 6/27 7/1 VAS KOOS ROM : Flexion (135 ) Apley's Compression Apley's Distraction Mcmurray test Drawer test(ant/post) / / / /

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