The Effectiveness of Ultrasound-Guided Essential Bee Venom Pharmacopuncture Combined with Integrative Korean Medical Treatment for Rib Fracture: A Case Study

분리정제봉약침의 초음파 유도하 시술과 한의복합치료를 병행한 늑골 골절 증례 보고

  • Received : 2019.06.12
  • Accepted : 2019.07.04
  • Published : 2019.07.31


This study is to report the usefulness of ultrasound in diagnosing rib fracture and the effectiveness of ultrasound-guided essential bee venom pharmacopuncture as a treatment of it. A 46-year-old unable to find a fracture by chest radiography was diagnosed it on ultrasound. The patient was applied integrative Korean medical treatments and ultrasound-guided essential bee venom pharmacopuncture at the fracture site for 4 weeks, 18 times total. Numeral rating scale (NRS) was used to evaluate the amount of pain. The chest pain when turning over the body was reduced from NRS 8 to 2 for 4 weeks. The remarkable aspect is that the pain was immediately relieved after phamacopuncture and its effect lasted for 3 hours. This report suggests ultrasound can be useful for diagnosing rib fracture and also helpful for safety and accuracy of pharmacopuncture. Additionally, essential bee venom can be considered one of the methods of treating rib fracture.


  1. Calhoon JH, Grover FL, Trinkle JK. Chest trauma: approach and management. Clin Chest Med. 1992;13:55-67.
  2. Liman ST, Kuzucu A, Tastepe AI, Ulasan GN, Topcu S. Chest injury due to blunt trauma. European Journal of Cardio-Thoracic Surgery. 2003;23(3):374-82.
  3. Begley A, Wilson DS, Shaw J. Cough fracture of the first rib. injury. 1995;26:565-6.
  4. Ho HY, Chen CW, Li MC, Hsu YP, Kang SC, Liu EH, Lee KH. A novel and effective acupuncture modality as a complementary therapy to acute pain relief in inpatients with rib fractures. Biomed J. 2014;37:147-55.
  5. Cho YS, Baek CH, Lee KR, Shin YH, Whang YS, Jeong KY, Chung SH, Whang CH. Detection of rib fractures in minor chest injuries: a comparison between ultrasonography and radiography performed on the same day. Korean Journal of Radiology. 2007;56:349-54.
  6. Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48:1040-6.
  7. Bansidhar BJ, Lagares-Garcia JA, Miller SL. Clinical rib fractures: are follow-up chest Xrays a waste of resources? Am Surg. 2002;68:449-53.
  8. Griffith JF, Rainer TH, Ching ASC, Law KL, Cocks RA, Metreweli C. Sonography compared with radiography in revealing acute rib fracture. American Journal of Roentgenology. 1999;173:1603-9.
  9. Hurley ME, Keye GD, Hamilton S. Is ultrasound really helpful in the detection or rib fracture? Int J Care Injury. 2004;35:562-6.
  10. Kerr-Valentic MA, Arthur M, Mullins RJ, Pearson TE, Mayberry JC. Rib fracture pain and disability: can we do better? J Trauma. 2003;54:1058-64.
  11. Nakae H, Yokoi A, Kodama H, Horikawa A. Comparison of the effects on rib fracture between the traditional Japanese medicine jidabokuippo and nonsteroidal anti-inflammatory drugs: a randomized controlled trial. Evid Based Complement Alternat Med. 2012;2012:837958.
  12. Bae KJ, Jung JW, Jung MY, Kim SJ. Reviewing research on the treatment and study of fracture in Korean journals objective - focus on domestic thesis. J Korean Med Rehabi. 2015;25(3):27-36.
  13. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain. Arthritis Care & Research. 2011;63(11):240-52.
  14. Fabricant L, Ham B, Mullins R, Mayberry J. Prolonged pain and disability are common after rib fractures. The American Journal of Surgery. 2013;205:511-6.
  15. Choi WI. Case report of a simple rib fracture caused by coughing. J Trauma Inj. 2014;27:9-12.
  16. Koh DM, Burke S, Davies N, Padley SP. Transthoracic US of the chest wall: clinical uses and applications. Radiographics. 2002;22(1):e1.
  17. Kim BH, Yook TH, Song BY, Choi YM, Shin JH, Lee SH, Jeon YJ, Noh JH, Kim JU. Trends in Domestic and foreign clinical research on ultrasound-guided acupuncture. The Journal of Korean Acupuncture and Moxibustion Medicine. 2018;35(4):214-8.
  18. Kim SH, Lee SH, Ha WB, Lee JH, Jung HJ, Chu HM, Yang SB, Choi SM, Son MJ, Kim JH, Jeon YJ. Development of an ultrasound-imaging procedure and acquisition of ultrasound images of acupuncture points for safety and accuracy of needle insertion. Integrative Medicine Research. 2017;6:427-33.
  19. Kim HJ, Ji YS, Lee SM, Jeon JH, Kim YI. A systematic review of clinical study of bee venom acupuncture. Journal of Korean Acupuncture & Moxibustion Society. 2013;30(4):151-9.
  20. Park HJ, Lee HJ, Choi MS, Son DJ, Song HS, Song MJ, Lee JM, Han SB, Kim YS, Hong JT. JNK pathway is involved in the inhibition of inflammatory target gene expression and NF-kappaB activation by melittin. Journal of Inflammation. 2008;5:7.