The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study

Sang Min Kim; Sun Ho Lee; You Bin Shin; Ji Hoon Choi; Ja Sung Koo; Hyung Jin Yoo; Dong Hyun Lee

doi:10.13045/acupunct.2015017

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Kim, Lee, Shin, Choi, Koo, Yoo, and Lee: The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study

Original Article

Acupuncture 2015; 32(2): 23-33.

DOI: https://doi.org/10.13045/acupunct.2015017

The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study

Sang Min Kim^1,^*, Sun Ho Lee¹, You Bin Shin¹, Ji Hoon Choi¹, Ja Sung Koo², Hyung Jin Yoo³, Dong Hyun Lee³

¹Department of Acupuncture & Moxibusion Medicine, Daejeon Jaseng Hospital of Korean Medicine

²Department of Oriental Internal Medicine, Daejeon Jaseng Hospital of Korean Medicine

³Department of Oriental Rehabilitation Medicine, Daejeon Jaseng Hospital of Korean Medicine

^*Corresponding author: Department of Acupuncture & Moxibusion Medicine, Daejeon Jaseng Hospital of Korean Medicine, 58, Munjeong-ro 48beon-gil, Seo-gu, Daejeon, 302-859, Republic of Korea,
Tel: +82-10-9407-6216, E-mail: goksmgo@naver.com

Received April 17, 2015 Revised May 21, 2015 Accepted May 26, 2015

See the Original "".

Abstract

Objectives:

This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation.

Methods:

This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments.

Results:

Average admission duration was 28.00±12.85 days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from 5.89±2.00 to 3.42± 1.87(p<0.001) and radiating pain from 5.96±2.12 to 3.38±1.83(p<0.001). ODI decreased from 46.69±19.25 to 35.69±16.67 (p<0.001), and EQ-5D index increased from 0.63±0.26 to 0.71±0.20(p<0.05) after treatment in lumbar disc patients.

Conclusions:

Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

Key Words: Intervertebral disc displacement; Observational study; Numeric rating scale(NRS); Oswestry disability index(ODI); EQ-5D; Korean medicine.

Fig. 1.

Flow Diagram of Included Patients

Table 1.

Distribution of Sex and Age

		N	%
Sex	Male	32	44.4
Sex	Female	40	55.6
Age	20~29	15	20.8
	30~39	19	26.4
	40~49	8	11.1
	50~59	17	23.6
	60~69	10	13.9
	70~	3	4.2
Total		72	100

Table 2.

Distribution of Causes

	N	%
Reason unknown	36	50
Lumbar strain	12	16.7
Same motion in long period	3	4.2
Overwork	9	12.5
Traffic accident	4	5.6
Slip down	7	9.7
Cough	1	1.4
Total	72	100

Table 3.

Distribution of Period of Illness

	N	%
Hyperacute stage	21	29.2
Acute stage	15	20.8
Subacute stage	14	19.4
Chronic stage	22	30.6
Total	72	100

Table 4.

Distribution of Admission Days

	N	%
0~5	1	1.4
6~10	3	4.2
11~15	11	15.3
16~20	9	12.5
21~25	8	11.1
26~30	11	15.3
31~35	9	12.5
36~40	5	6.9
41~45	7	9.7
46~50	6	8.3
51~	2	2.8
Total	72	100

Table 5.

Distribution of Numbers, Grade and Position of Herniation

		N	%
Numbers	1	16	22.2
	2	23	31.9
	3	25	34.7
	4	6	8.3
	5	2	2.8
Grade	Bulging	9	12.5
	Protrusion	35	48.6
	Extrusion	28	38.9
Position	L1 / 2	0	0
	L2 / 3	1	1.4
	L3 / 4	2	2.8
	L4 / 5	45	62.5
	L5 / S1	24	33.3
Total		72	100

Table 6.

Distribution of Pain Area

	N	%
Just lumbar pain	3	4.2
Lumbar and pelvis pain	5	6.9
From lumbar to thigh pain	0	0
Lumbar and whole leg pain	64	88.9
Total	72	100

Table 7.

Lumbar Pain NRS Difference before and after Treatment

		N	NRS		p-value
		N	Before	After	p-value
Sex	Male	32	5.53±2.21	2.81±1.47	p<0.001***
Sex	Female	40	6.18±1.78	3.90±2.02
Age	<40	34	5.56±2.06	2.85±1.28
Age	≥40	38	6.18±1.92	3.92±2.16
Period of disease	Hyperacute stage	21	6.71±2.22	3.43±2.04
	Acute stage	15	5.07±1.67	3.20±1.47
	Subacute stage	14	6.00±1.52	3.64±1.78
	Chronic stage	22	5.59±2.06	3.41±2.09
	Total	72	5.89±2.00	3.42±1.87

Average NRS values are means ± standard deviation. p-value by paired t-test in before and after NRS.

^*** p<0.001.

Table 8.

Radiating Pain NRS Difference before and after Treatment

		N	NRS		p-value
		N	Before	After	p-value
Pain area	Pelvis pain	5	6.60±2.19	2.80±1.30	0.012*
	Thigh pain	0	0	0
	Whole leg pain	64	5.91±2.13	3.42±1.87	p<0.001***
Sex	Male	29	5.90±2.34	2.76±1.43
Sex	Female	40	6.00±1.99	3.83±1.97
Age	<40	32	5.72±2.37	2.84±1.42
Age	≥40	37	6.16±1.89	3.84±2.03
Period of disease	Hyperacute stage	20	7.10±2.00	3.55±1.76
	Acute stage	15	5.47±1.88	3.33±1.54
	Subacute stage	14	6.14±1.23	3.43±1.74
	Chronic stage	20	5.05±2.46	3.20±2.24
	Total	69	5.96±2.12	3.38±1.83

Average NRS values are means ± standard deviation. p-value by paired t-test in before and after NRS.

^* p<0.05.

^*** p<0.001.

Table 9.

ODI Difference before and after Treatment

		N	ODI		p-value
		N	Before	After	p-value
Sex	Male	32	44.01±21.51	30.17±13.68	0.001**
Sex	Female	40	48.83±17.22	40.12±17.66	p<0.001***
Age	<40	34	42.20±20.53	29.89±14.18
Age	≥40	38	50.70±17.33	40.89±17.18
Period of disease	Hyperacute stage	21	60.35±21.47	38.48±21.97
	Acute stage	15	42.25±16.36	35.63±13.66	0.010**
	Subacute stage	14	44.56±12.97	34.83±13.10	p<0.001***
	Chronic stage	22	38.03±15.78	33.64±15.37	0.004**
	Total	72	46.69±19.25	35.69±16.67	p<0.001***

ODI values are means ± standard deviation. p-value by paired t-test in before and after ODI.

^** p<0.01.

^*** p<0.001.

Table 10.

EQ-5D Index Difference before and after Treatment

		N	EQ-5D index		p-value
		N	Before	After	p-value
Sex	Male	32	0.64±0.29	0.75±0.17	0.025*
Sex	Female	40	0.63±0.22	0.67±0.21	0.029*
Age	<40	34	0.67±0.26	0.75±0.16	0.041*
Age	≥40	38	0.60±0.25	0.67±0.22	0.029*
Period of disease	Hyperacute stage	21	0.42±0.33	0.63±0.27	0.013*
	Acute stage	15	0.74±0.10	0.77±0.06	0.140
	Subacute stage	14	0.67±0.25	0.70±0.25	0.067
	Chronic stage	22	0.73±0.09	0.74±0.10	0.029*
	Total	72	0.63±0.26	0.71±0.20	0.003**

EQ-5D index values are means ± standard deviation. p-value by paired t-test in before and after EQ-5D index.

^* p<0.05.

^** p<0.01.

VI.

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