109 DOI : 10.3831/KPI.2010.13.3.109 Received : 10. 08. 13 Revised : 10. 09. 06 A Case Study Of Patients With Knee Joint Pain Treated With Rubiae Radix Pharmacopuncture Accepted : 10. 09. 07 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:82632208624, Tel:82632276234 Email:acudoctor@korea.com A Case Study Of Patients With Knee Joint Pain Treated With Rubiae Radix Pharmacopuncture
110 Journal of Pharmacopuncture 13 3 2010 9 3 II 1 McMurray (1) Apley's compression&distraction (2) McMurray McMurray (3) Drawer sign anterior posterior draw sign Drawer sign 3 2010 6 17 2010 7 1 3. 1) 2 1) Visual Analogue Scale VAS 10 0 1 2 2) 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 1 4 0.1mL 0.4mL (3) 3 2 2) 0.30mm 40mm(Stainless steel
111 Korea ST36 SP9 SP6 LI4 SI3 ST7 2 ST36 SP9 SP6 LI4 SI3 ST7 3) 2 3 1 3 2 1 4) Interferential current therapy Ultra sound Hot pack 1 1 2010.06.12 2010.05.21 MRI 2010.06.12 5) MRI of Lt. Knee 2010.05.21, Fig. 1 Horizontal tear in posterior horn of medial meniscus of Lt. knee 6) Table 1 ROM 100 120 VAS score 3 0 VAS score 8 6 Apley's compression Mcmurray 2 Apley's distraction Drawer sign KOOS 106 53 III 1 63 1) Lt 2) 2010 5 21 3) 2010.05.21 2010.06.12 4) 2010.05.21 2010.5.21 2 57 1) both knee joint pain (Rt>Lt) 2) 2010 2 3) 2010 2 2010 3 5 4) 2010.02.21 2010.06.10
112 Journal of Pharmacopuncture 13 3 2010 9 Apley's compression Mcmurray varus valgus stress Apley's distraction 5) MRI of Rt. Knee (2010.02.21, 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 100 130 VAS score 8 2 Apley's compression Mcmurray Apley's distraction Drawer sign KOOS 102 72 2010.05.30 MRI 2010.06.07 ROM 110 130 Apley's Compression Mcmurray Drawer sign 5) MRI of Rt. Knee (2010. 05. 30, 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 97 73 IV 3 1) 2) 2010 5 22 3) 2010.05.22 2010.06.07 4) 2010.05.22 2010.05.22 2010.06.07
113 3 1 ROM 100 120 VAS score 3 0 VAS score 8 6 Apley's compression Mcmurray 2 Apley's distraction Drawer sign KOOS 106 53 2 ROM 100 130 VAS score 8 2 Apley's compression Mcmurray Apley's distraction Drawer test KOOS 102 72 3 2 ROM 110 VAS score 10 1 Apley's compression Mcmurray test Apley's distraction 2 Drawer sign 2 KOOS 97 73 V 2010 6 17 2010 7 1 3
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115 17. The Korean Orthopaedic Association. Orthopedics 5th. Seoul:ChoiSin publishing company. 1999:195. 18. 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
116 Journal of Pharmacopuncture 13 3 2010 9 P1 P2 P3 P4 P5 P6 P7 P8 P9 Function, Daily living A1 A2
117 A3 A4 A5 A6 A7 A8 A9 A10 A11 A12 A13 A14 A15
118 Journal of Pharmacopuncture 13 3 2010 9 A16 A17 Function, Sports and Recreational Activities SP1 SP2 SP3 SP4 SP5 Q1 Q2 Q3 Q4
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)
120 Journal of Pharmacopuncture 13 3 2010 9 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 106 53 ROM : Flexion (135 ) 100 120 120 120 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 8 6 4 2 KOOS 102 72 ROM : Flexion (135 ) 100 130 130 130 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 10 8 6 1 KOOS 98 73 ROM : Flexion (135 ) 110 110 110 110 Apley's Compression Apley's Distraction Mcmurray test Drawer test(ant/post) / / / /