DOI QR코드

DOI QR Code

슬관절 전치환술 후 재활 환자에게 시행한 한의 치료의 안전성: 후향적 차트 리뷰

The Safety of Korean Medicine on Patients after Total Knee Arthroplasty: A Retrospective Chart Review

  • 주성준 (원광대학교 대학원 한의학과 진단학교실) ;
  • 승혜빈 (동신한방병원 한방부인과) ;
  • 이정민 (동신한방병원 한방재활의학과) ;
  • 임정태 (원광대학교 대학원 한의학과 진단학교실)
  • Sungjun Joo (Department of Diagnostics, College of Korean Medicine, Wonkwang University) ;
  • Hyebin Seung (Department of Korean Gynecology Medicine, Dong-Shin Korean Medicine Hospital) ;
  • Jungmin Lee (Department of Korean Rehabilitation Medicine, Dong-Shin Korean Medicine Hospital) ;
  • Jungtae Leem (Department of Diagnostics, College of Korean Medicine, Wonkwang University)
  • 투고 : 2024.09.19
  • 심사 : 2024.09.27
  • 발행 : 2024.10.31

초록

Objectives This study aimed to evaluate the safety of Korean medicine treatments, including herbal medicine, for patients undergoing rehabilitation after total knee arthroplasty through a retrospective analysis of adverse events and blood test results. Methods Medical records of 22 patients who received Korean medicine treatments after total knee arthroplasty at a Koreanmedicine hospital between July 2017 and April 2022 were retrospectively reviewed. Adverse events were assessed using Common Terminology Criteria for Adverse Events and World Health Organization-Uppsala Monitoring Centre causality assessment system. Blood test results before and after herbal medicine administration were compared using the Wilcoxon signed-rank test. Results Among 41 adverse events reported during 623 days of hospitalization, 40 were mild or moderate. 4 adverse events were assessed as possibly related to Korean medicine treatments, all of which improved with appropriate management of Korean medicine. Blood tests showed no drug-induced liver injury or kidney damage caused by Korean medicine treatments, including herbal medicine. There were no significant internal medical adverse reactions observed in the blood tests. Conclusions Korean medicine treatments, including herbal medicine, appear to be relatively safe for rehabilitation after total knee arthroplasty when administered under proper medical supervision.

키워드

과제정보

This research was supported by the Bio&Medical Technology Development Program of the National Research Foundation (NRF) funded by the Korean government (MSIT) (No. RS-2023-00261934). This research was also supported by a grant of the Korea Health Technology Project through the Korea Health Industry Development Institute, funded by the Ministry of Health and Welfare, Republic of Korea (grant no. RS-2023-KH138802)

참고문헌

  1. Katz JN, Arant KR, Loeser RF. Diagnosis and treatment of hip and knee osteoarthritis: a review. JAMA. 2021;325(6):568-78.  https://doi.org/10.1001/jama.2020.22171
  2. Hong JW, Noh JH, Kim DJ. The prevalence of and demographic factors associated with radiographic knee osteoarthritis in Korean adults aged ≥ 50 years: The 2010-2013 Korea National Health and Nutrition Examination Survey. PLoS One. 2020;15(3):e0230613. 
  3. Park HR, Cho SK, Im SG, Jung SY, Kim D, Jang EJ, Sung YK. Treatment patterns of knee osteoarthritis patients in Korea. The Korean Journal of Internal Medicine. 2019;34(5):1145-53.  https://doi.org/10.3904/kjim.2017.304
  4. Bannuru RR, Osani MC, Vaysbrot EE, Arden NK, Bennell K, Bierma-Zeinstra SMA, Kraus VB, Lohmander LS, Abbott JH, Bhandari M, Blanco FJ, Espinosa R, Haugen IK, Lin J, Mandl LA, Moilanen E, Nakamura N, Snyder-Mackler L, Trojian T, Underwood M, McAlindon TE. OARSI guidelines for the non-surgical management of knee, hip, and polyarticular osteoarthritis. Osteoarthritis and Cartilage. 2019;27(11):1578-89.  https://doi.org/10.1016/j.joca.2019.06.011
  5. Kolasinski SL, Neogi T, Hochberg MC, Oatis C, Guyatt G, Block J, Callahan L, Copenhaver C, Dodge C, Felson D, Gellar K, Harvey WF, Hawker G, Herzig E, Kwoh CK, Nelson AE, Samuels J, Scanzello C, White D, Wise B, Altman RD, DiRenzo D, Fontanarosa J, Giradi G, Ishimori M, Misra D, Shah AA, Shmagel AK, Thoma LM, Turgunbaev M, Turner AS, Reston J. 2019 American college of rheumatology/arthritis foundation guideline for the management of osteoarthritis of the hand, hip, and knee. Arthritis Care & Research. 2020;72(2):149-62.  https://doi.org/10.1002/acr.24131
  6. Jevsevar DS, Brown GA, Jones DL, Matzkin EG, Manner PA, Mooar P, Schousboe JT, Stovitz S, Sanders JO, Bozic KJ, Goldberg MJ, Martin WR 3rd, Cummins DS, Donnelly P, Woznica A, Gross L; American Academy of Orthopaedic Surgeons. The American Academy of Orthopaedic Surgeons evidence-based guideline on: treatment of osteoarthritis of the knee, 2nd edition. The Journal of Bone and Joint Surgery. 2013;95(20):1885-6.  https://doi.org/10.2106/00004623-201310160-00010
  7. Jang S, Lee K, Ju JH. Recent updates of diagnosis, pathophysiology, and treatment on osteoarthritis of the knee. International Journal of Molecular Sciences. 2021;22(5):2619. 
  8. Mahomed NN, Barrett J, Katz JN, Baron JA, Wright J, Losina E. Epidemiology of total knee replacement in the United States medicare population. The Journal of Bone and Joint Surgery. 2005;87(6):1222-8.  https://doi.org/10.2106/00004623-200506000-00006
  9. Canovas F, Dagneaux L. Quality of life after total knee arthroplasty. Orthopaedics & Traumatology, Surgery & Research: OTSR. 2018;104(1S):S41-6.  https://doi.org/10.1016/j.otsr.2017.04.017
  10. Kim YB, Choi HS, Kang EM, Park S, Seo GW, Chun DI, Min TH. Trends of total knee arthroplasty according to age structural changes in Korea from 2011 to 2018. International Journal of Environmental Research and Public Health. 2021;18(24):13397. 
  11. Kim TW, Kang SB, Chang CB, Moon SY, Lee YK, Koo KH. Current trends and projected burden of primary and revision total knee arthroplasty in Korea between 2010 and 2030. The Journal of Arthroplasty. 2021;36(1):93-101.  https://doi.org/10.1016/j.arth.2020.06.064
  12. Oatis CA, Li W, DiRusso JM, Hoover MJ, Johnston KK, Butz MK, Phillips AL, Nanovic KM, Cummings EC, Rosal MC, Ayers DC, Franklin PD. Variations in delivery and exercise content of physical therapy rehabilitation following total knee replacement surgery: a cross-sectional observation study. International Journal of Physical Medicine & Rehabilitation. 2014;Suppl 5:002. 
  13. Konnyu KJ, Thoma LM, Cao W, Aaron RK, Panagiotou OA, Bhuma MR, Adam GP, Balk EM, Pinto D. Rehabilitation for total knee arthroplasty: a systematic review. American Journal of Physical Medicine & Rehabilitation. 2023;102(1):19-33.  https://doi.org/10.1097/PHM.0000000000002008
  14. Mistry JB, Elmallah RD, Bhave A, Chughtai M, Cherian JJ, McGinn T, Harwin SF, Mont MA. Rehabilitative guidelines after total knee arthroplasty: a review. The Journal of Knee Surgery. 2016;29(3):201-17.  https://doi.org/10.1055/s-0036-1579670
  15. Franklin PD, Li W, Ayers DC. The Chitranjan Ranawat award: functional outcome after total knee replacement varies with patient attributes. Clinical Orthopaedics and Related Research. 2008;466(11):2597-604.  https://doi.org/10.1007/s11999-008-0428-8
  16. The Society of Korean Medicine Rehabiliation. Korean medicine clinical practice guideline for post-operative treatment of total knee arthroplasty. Gyeongsan:National Institute for Korean Medicine Development. 2021. 
  17. Ha HJ, Oh MS. A systemic review of Korean medical treatment combined with continuous passive motion therapy on the knee joint postoperative rehabilitation. J Korean Med Rehabil. 2017;27(3):33-45.  https://doi.org/10.18325/jkmr.2017.27.3.33
  18. Zhu XF. Clinical observation on 60 cases of patients after total knee replacement treated with self-prepared Shujing Huoxue Tongluo decoction combined with CPM machine exercise. Chinese Journal of Traditional Medical Science and Technology. 2015;22(5):568. 
  19. Yang Y, Zhao LH, Huang J. Study on the clinical efficacy of knee replacement combined with traditional Chinese medicine therapy for knee osteoarthritis. Chinese Journal of Osteoporosis. 2016;22(7):837-42. 
  20. Guo ZZ, Zhang N, Cheng Y, Lu L, Duan XL. Effect of Yiqi Huoxue decoction on early recovery after total knee replacement. Chinese Journal of Clinical Rational Drug Use. 2016;9(10):67-8. 
  21. Jun Y, Zujian L, Tao J, Guihong L, Keyuan X. Effect of traditional Chinese medicine combined with multimodal analgesia on total knee arthroplasty pain. Journal of Hunan University of Chinese Medicine. 2017;37(10):1116-20. 
  22. Jin R, Liu Y, Yao Y, Liu Y, Tao HQ, Du SS, Chen H, Liu J. Rehabilitation satisfaction of Taohong Siwu decoction combined with acupoint moxibustion applied in older adults after total knee arthroplasty. Chinese Journal of Tissue Engineering Research. 2018;22(27):4271-6. 
  23. Lee SJ, Ko YM, Park JS, Park TY, Lee JH, Cho JH, Hwang EH, Kim KJ, Choi MY, Song YK. Effects of herbal medicine after total knee arthroplasty: a systematic review and meta-analysis. J Korean Med Rehabil. 2021;31(4):35-47.  https://doi.org/10.18325/jkmr.2021.31.4.35
  24. Ju CJ, Zhou X, Dong CC, Lin LQ, Liu HN, Hou Y. Clinical observation of warm moxibustion therapy to improve quadriceps weakness after total knee arthroplasty. Chinese Acupuncture & Moxibustion. 2019;39(3):276-9. 
  25. Chen CC, Yang CC, Hu CC, Shih HN, Chang YH, Hsieh PH. Acupuncture for pain relief after total knee arthroplasty: a randomized controlled trial. Regional Anesthesia & Pain Medicine. 2015;40(1):31-6.  https://doi.org/10.1097/AAP.0000000000000138
  26. Mayoral O, Salvat I, Martin MT, Martin S, Santiago J, Cotarelo J, Rodriguez C. Efficacy of myofascial trigger point dry needling in the prevention of pain after total knee arthroplasty: a randomized, double-blinded, placebo-controlled trial. Evidence Based Complementary and Alternative Medicine. 2013;2013:694941. 
  27. Yi J, Liang Z, Jiang T, Liang G, Xu K. Effect of traditional Chinese medicine combined with multimodal analgesia on total knee arthroplasty pain. Journal of Hubei University of Chinese Medicine. 2017;37(10):1116-20. 
  28. Xu H, Zhang HN, Wang CY, Lv CY, Yin ZY, Wang YZ. Local phonophoresis of traditional Chinese herbs: a good assistant for analgesia after total knee arthroplasty. International Journal of Clinical and Experimental Medicine. 2017;10(8):12426-32. 
  29. National Institutes of Health, National Cancer Institute. Common Terminology Criteria for Adverse Events (CTCAE) version 5.0 [Internet]. US Department of Health and Human Services; 2017 [cited 2024 Sep 19]. Available from: URL: https://ctep.cancer.gov/protocoldevelopment/electronic_applications/docs/CTCAE_v5_Quick_Reference_8.5x11.pdf. 
  30. World Health Organization (WHO)-Uppsala Monitoring Centre. The use of the WHO-UMC system for standardized case causality assessment [Internet]. Uppsala Monitoring Centre; 2018 [cited 2024 Sep 19]. Available from: URL: http://www.who-umc.org/Graphics/24734.pdf. 
  31. Verhamme KM, Sturkenboom MC, Stricker BH, Bosch R. Drug-induced urinary retention: incidence, management and prevention. Drug Safety. 2008;31(5):373-88.  https://doi.org/10.2165/00002018-200831050-00002
  32. Pitta M, Esposito CI, Li Z, Lee YY, Wright TM, Padgett DE. Failure after modern total knee arthroplasty: a prospective study of 18,065 knees. The Journal of Arthroplasty. 2018;33(2):407-14.  https://doi.org/10.1016/j.arth.2017.09.041
  33. Go TH, Kim HS, Kang DR, Jung JH, Kwon SW, Kim SC, Song JM, Chung HC, Kho SB. The benign prostatic hyperplasia incidence rate in Korea: using National Health Insurance Service data. Journal of Health Informatics and Statistics. 2018;43(3):217-22.  https://doi.org/10.21032/jhis.2018.43.3.217
  34. Selius BA, Subedi R. Urinary retention in adults: diagnosis and initial management. American Family Physician. 2008;77(5):643-50. 
  35. Lee J, Shin JS, Kim MR, Byun JH, Lee SY, Shin YS, Kim H, Byung Park K, Shin BC, Lee MS, Ha IH. Liver enzyme abnormalities in taking traditional herbal medicine in Korea: a retrospective large sample cohort study of musculoskeletal disorder patients. Journal of Ethnopharmacology. 2015;169:407-12.  https://doi.org/10.1016/j.jep.2015.04.048
  36. Zhu ZY, Xue JX, Yu LX, Bian WH, Zhang YF, Sohn KC, Shin IH, Yao C. Reducing postsurgical exudate in breast cancer patients by using San Huang decoction to ameliorate inflammatory status: a prospective clinical trial. Current Oncology. 2018;25(6):e507-15. https://doi.org/10.3747/co.25.4108
  37. Li J, Zheng C, Lin H, Yang C, Gu S, Wang Y, Duan H. Effect of Zhu-yuan decoction in patients with chronic rhinosinusitis after functional endoscopic sinus surgery. Journal of Traditional Chinese Medicine. 2018;38(1):83-8.  https://doi.org/10.1016/j.jtcm.2018.02.003
  38. Ye Q, Chen X, Hu Y, Zhou J, Gao C, Liu Z. Shudi Pingchan decoction combined with repetitive transcranial magnetic stimulation in the treatment of Parkinson's disease with sleep disorders. Traditional Medicine and Modern Medicine. 2020;3(2):85-92.  https://doi.org/10.1142/S2575900020500068
  39. Lee HG, Jeong H, Kwon CY, Kim KH, Sung SH, Han JE, Park M, Jang S. Adverse events of herbal decoction: a systematic review and meta-analysis over past 10 years. Complementary Therapies in Medicine. 2024;83:103057. 
  40. Naathan H, Ilo K, Berber R, Matar HE, Bloch B. Are postoperative blood tests always required after lower limb arthroplasty? Bone & Joint Open. 2023;4(5):357-62.  https://doi.org/10.1302/2633-1462.45.BJO-2022-0124.R1