• Journal of Acupuncture Research
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• 제30권5호
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• pp.41-50
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• 2013

Objectives : This study was performed to compare the effects of Shinbaro pharmacopuncture therapy and bee venom pharmacopuncture therapy in lumbar disc herniation Methods : We compared treatment efficacy of 12 patients with Shinbaro pharmacopuncture therapy and 10 patients with bee venom pharmacopuncture therapy, all of whom were diagnosed with lumbar disc herniation using computed tomography(CT) or magnetic resonance imaging(MRI). We performed a retrospective comparison and analysis during the course of 21 days since admission. To evaluate the treatment efficacy, we recorded the temperatures of the opposite back, hip, and legs with visual analog scale(VAS, back and legs), pain rating scale(PRS), Oswestry disability index(ODI) and digital infrared thermal imaging(DITI) based on patients' medical records. Results : Both treatments were effective in reducing pain and improving functions for lumbar disc herniation patients in terms of VAS, PRS, ODI, DITI. Shinbaro pharmacopuncture group showed slightly better results than the bee venom pharmacopuncture group, but the difference was not significant. Conclusions : For the treatment of lumbar disc herniation, it is suggested that Shinbaro pharmacopuncture therapy is thought to be as effective as bee venom pharmacopuncture therapy without side effects, although further study would be necessary.

• Journal of Acupuncture Research
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• 제40권3호
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• pp.238-244
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• 2023

Background: Occipital neuralgia (ON) is an established risk factor for headaches in the posterior cervical region. Several conservative treatments by nerve decompression and pain relief are available for ON, but these treatments have limitations. Acupuncture treatment, which is known to demonstrate analgesic effects, involves various stimulation methods, and several studies have reported their clinical benefit. No recent systematic review (SR) has compared each acupuncture type for ON treatment. Thus, this SR aims to investigate the clinical effectiveness of each acupuncture type for treating ON. Methods: We will identify relevant studies using electronic databases, including EMBASE, MEDLINE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Korean Studies Information Service System (KISS), Korean Medical Database, KoreaMed, and National Digital Science Library (NDSL) from the inception until August 2023. The primary outcome will include the numerical change of pain symptoms (visual analog scale and numerical rating scale) and effective rate. Safety and secondary outcomes will include adverse events and quality of life. We will compare the conservative treatment with the acupuncture treatment using network meta-analysis. The Cochrane Collaboration "risk of bias" tools will be used to assess the quality of included trials. The Grades of Recommendation, Assessment, Development, and Evaluation will be used to examine the evidence level. Conclusion: This study will provide clinical evidence of several acupuncture types for ON and help clinicians decide on the best.

• Journal of Dental Anesthesia and Pain Medicine
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• 제23권4호
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• pp.213-220
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• 2023

Background: Third molar extraction is the most commonly performed minor oral surgical procedure in outpatient settings and requires regional anesthesia for pain control. Extraction of the maxillary molars commonly requires both posterior superior alveolar nerve block (PSANB) and greater palatine nerve block (GPNB), depending on the nerve innervations of the subject teeth. We aimed to study the effectiveness of PSANB alone in maxillary third molar (MTM) extraction. Methods: A sample size comprising 100 erupted and semi-erupted MTM was selected and subjected to study for extraction. Under strict aseptic conditions, the patients were subjected to the classical local anesthesia technique of PSANB alone with 2% lignocaine hydrochloride and adrenaline 1:80,000. After a latency period of 10 min, objective assessment of the buccal and palatal mucosa was performed. A numerical rating scale and visual analog scale were used. Results: In the post-latency period of 10 min, the depth of anesthesia obtained in our sample on the buccal side extended from the maxillary tuberosity posteriorly to the mesial of the first premolar (15%), second premolar (41%), and first molar (44%). This inferred that anesthesia was effectively high until the first molars and was less effective further anteriorly due to nerve innervation. The depth of anesthesia on the palatal aspect was up to the first molar (33%), second molar (67%), and lateromedially; 6% of the patients received anesthesia only to the alveolar region, whereas 66% received up to 1.5 cm to the mid-palatal raphe. In 5% of the cases, regional anesthesia was re-administered. An additional 1.8 ml PSANB was required in four patients, and another patient was administered a GPNB in addition to the PSANB during the time of extraction and elevation. Conclusion: The results of our study emphasize that PSANB alone is sufficient for the extraction of MTM in most cases, thereby obviating the need for poorly tolerated palatal injections.

• Journal of Acupuncture Research
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• 제28권5호
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• pp.135-142
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• 2011

Objectives : This study was to investigate on the hominis placenta pharmacopuncture of FBSS patient who were diagnosed as the cauda equina syndrome which has been described as a complex of low back pain, bilateral sciatica, saddle anesthesia and hypoesthesia in the lower extremity with bladder and bowel incontinence. Methods : The patient was treated with hominis placenta parmacopuncture at Samchosu($BL_{22}$), Shinsu($BL_{23}$), Sangryo($BL_{31}$), Charyo($BL_{32}$), Jungryo($BL_{33}$) and Haryo($BL_{34}$) with oriental medical conservative treatment. We estimated by visual analog scale and Oswestry disability index and nerve level dermatome test for evaluate the effect of Hominis Placenta Pharmacopuncture with oriental conservative treatment. Results : After treatment, patient's visual analogue scale score, Oswestry disability index score, bilateral sciatica, saddle anesthesia and hypoesthesia in the lower extremity with bladder and bowel incontinence were generally decreased. Conclusions : The hominis placenta pharmacopuncture with oriental medical conservative treatment might be an effective method to treat the FBSS patient who were diagnosed as the cauda equina syndrome.

• 한방재활의학과학회지
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• 제20권3호
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• pp.75-91
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• 2010

Objectives : Although the controversy surrounding the biomechanics of the sacroiliac joint remains unresolved at this time, the clinical importance of this joint in the cause of back pain has been established since 1930's. Recently, there has been renewed interest in the sacroiliac joint. This study was performed to evaluate the effects of pulsed electromagnetic therapy(PEMT) with acupuncture therapy for patients, who were suffering from sacroiliac joint syndrome, and to conduct more researches in the usage of acupuncture therapy for treating sacroiliac joint syndrome. Methods : 25 patients, who were diagnosed as sacroiliac joint syndrome were selected. They were treated twice a week during 3 weeks. They were measured after all the treatment and firs week and fourth week after termination of treatment by using visual analogue scale(VAS) and Roland Morris disability index(RMDI). The VAS and RMDI patterns were analyzed by using 'pared T-test' and 'Kruskal-Wallis' test. Results : 1. Each times of PEMT with acupuncture therapy, there were statistical significance in improvement of VAS(p<0.05) and each times of therapy except 1st one, there were statistical significance in improvement of RMDI(p<0.05). 2. After 4th therapy, there were most significant improvement of VAS with RMDI(p<0.001), when we compared the change in VAS and RMDI before and after the each therapy. 3. There was no statistical significance in VAS and RMDI by onset, sex and age. Conclusions : The results indicate that pulsed electromagnetic therapy and acupuncture therapy had good effect on sacroiliac joint syndrome.

• Journal of Korean Neurosurgical Society
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• 제65권4호
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• pp.539-548
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• 2022

Objective : Although full-endoscopic lumbar interbody fusion (Endo-LIF) has been tried as the latest alternative technique to minimally invasive transforaminal lumbar interobody fusion (MIS-TLIF) since mid-2010, the evidence is still lacking. We compared the clinical outcome and safety of Endo-LIF to MIS-TLIF for lumbar degenerative disease. Methods : We systematically searched electronic databases, including PubMed, EMBASE, and Cochrane Library to find literature comparing Endo-LIF to MIS-TLIF. The results retrieved were last updated on December 11, 2020. The perioperative outcome included the operation time, blood loss, complication, and hospital stay. The clinical outcomes included Visual analog scale (VAS) of low back pain and leg pain and Oswestry disability index (ODI), and the radiological outcome included pseudoarthosis rate with 12-month minimum follow-up. Results : Four retrospective observational studies and one prospective observational study comprising 423 patients (183 Endo-LIF and 241 MIS-TLIF) were included, and the pooled data analysis revealed low heterogeneity between studies in our review. Baseline characteristics including age and sex were not different between the two groups. Operation time was significantly longer in Endo-LIF (mean difference [MD], 23.220 minutes; 95% confidence interval [CI], 10.669-35.771; p=0.001). However, Endo-LIF resulted in less perioperative blood loss (MD, -144.710 mL; 95% CI, 247.941-41.478; p=0.023). Although VAS back pain at final (MD, -0.120; p=0.586), leg pain within 2 weeks (MD, 0.005; p=0.293), VAS leg pain at final (MD, 0.099; p=0.099), ODI at final (MD, 0.141; p=0.093) were not different, VAS back pain within 2 weeks was more favorable in the Endo-LIF (MD, -1.538; 95% CI, -2.044 to -1.032; p<0.001). On the other hand, no statistically significant group difference in complication rate (relative risk [RR], 0.709; p=0.774), hospital stay (MD, -2.399; p=0.151), and pseudoarthrosis rate (RR, 1.284; p=0.736) were found. Conclusion : Relative to MIS-TLIF, immediate outcomes were favorable in Endo-LIF in terms of blood loss and immediate VAS back pain, although complication rate, mid-term clinical outcomes, and fusion rate were not different. However, the challenges for Endo-LIF include longer operation time which means a difficult learning curve and limited surgical indication which means patient selection bias. Larger-scale, well-designed study with long-term follow-up and randomized controlled trials are needed to confirm and update the results of this systematic review.

• Asian Spine Journal
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• 제12권6호
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• pp.1043-1052
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• 2018

Study Design: Level III retrospective cross-sectional study. Purpose: To define and characterize the presentation, symptom duration, and patient/surgical risk factors associated with 'post-decompressive neuropathy (PDN).' Overview of Literature: PDN is characterized by lower extremity radicular pain that is 'different' from pre-surgical radiculopathy or claudication pain. Although it is a common constellation of postoperative symptoms, PDN is incompletely characterized and poorly understood. We hypothesize that PDN is caused by an intraoperative neuropraxic event and may develop early (within 30 days following the procedure) or late (after 30 days following the procedure) within the postoperative period. Methods: Patients who consented to undergo lumbar laminectomy with or without an instrumented fusion for degenerative lumbar spine disease were followed up prospectively from July 2013 to December 2014. Relevant data were extracted from the charts of the eligible patients. Patient demographics and surgical factors were identified. Patients completed postoperative questionnaires 3 weeks, 3 months, 6 months, and 1 year postoperatively. Questions were designed to characterize the postoperative pain that differed from preoperative pain. A diagnosis of PDN was established if the patient exhibited the following characteristics: pain different from preoperative pain, leg pain worse than back pain, a non-dermatomal pain pattern, and nocturnal pain that often disrupted sleep. A Visual Analog Scale was used to monitor the pain, and patients documented the effectiveness of the prescribed pain management modalities. Patients for whom more than one follow-up survey was missed were excluded from analysis. Results: Of the 164 eligible patients, 118 (72.0%) completed at least one follow-up survey at each time interval. Of these eligible patients, 91 (77.1%) described symptoms consistent with PDN. Additionally, 75 patients (82.4%) described early-onset symptoms, whereas 16 reported symptoms consistent with late-onset PDN. Significantly more female patients reported PDN symptoms (87% vs. 69%, p=0.03). Patients with both early and late development of PDN described their leg pain as an intermittent, constant, burning, sharp/stabbing, or dull ache. Early PDN was categorized more commonly as a dull ache than late-onset PDN (60% vs. 31%, p=0.052); however, the difference did not reach statistical significance. Opioids were significantly more effective for patients with early-onset PDN than for those with late-onset PDN (85% vs. 44%, p=0.001). Gabapentin was most commonly prescribed to patients who cited no resolution of symptoms (70% vs. 31%, p=0.003). Time to symptom resolution ranged from within 1 month to 1 year. Patients' symptoms were considered unresolved if symptoms persisted for more than 1 year postoperatively. In total, 81% of the patients with early-onset PDN reported complete symptom resolution 1 year postoperatively compared with 63% of patients with late-onset PDN (p=0.11). Conclusions: PDN is a discrete postoperative pain phenomenon that occurred in 77% of the patients who underwent lumbar laminectomy with or without instrumented fusion. Attention must be paid to the constellation and natural history of symptoms unique to PDN to effectively manage a self-limiting postoperative issue.

• Clinical Pain
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• 제18권1호
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• pp.1-7
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• 2019

Objective: To investigate the cortical disinhibition in diabetic patients with neuropathic pain and without pain. In addition, we assessed the cortical disinhibition and pain relief after repetitive transcranial magnetic stimulation (rTMS). Method: We recruited diabetic patients with neuropathic pain (n = 15) and without pain (n = 15). We compared the TMS parameters such as motor evoked potential (MEP) amplitude, cortical silent period (CSP), intracortical inhibition (ICI %) and intracortical facilitation (ICF %) between two groups. Moreover, we evaluated the changes of pain and TMS parameters after five consecutive high frequency (10 Hz) rTMS sessions in diabetic patients with neuropathic pain. The neuropathic pain intensity (visual analog scale) and TMS parameters were assessed on pre-rTMS, post-rTMS 1day, and post-rTMS 5 day. Results: The comparison of the CSP, ICI % revealed significant differences between two groups (p<0.01). After rTMS sessions, the decrease in pain intensity across the three time points revealed a pattern of significant differences (p<0.01). The change of CSP and ICI % across the three test points revealed a pattern of significant differences (p<0.01). The ICI % revealed immediate increase after first rTMS application and significant increase after five rTMS application (p<0.01) in diabetic patients with neuropathic pain. The MEP amplitude and ICF % did not reveal any significant changes. Conclusion: Our findings demonstrate that cortical inhibition was decreased in diabetic patients with neuropathic pain compared with patients without pain. Furthermore, we also identified that five daily rTMS sessions restored the defective intracortical inhibition which related to improvement of neuropathic pain in diabetic patients.

• 한국산학기술학회논문지
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• 제17권7호
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• pp.301-310
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• 2016

본 연구는 만성요통을 호소하는 여성노인을 대상으로 뜸 요법을 중재 방법으로 적용하여 일상생활기능장애 및 수면 양상을 효율적으로 관리 할 수 있는지 그 효과를 규명하기 위해 시도된 비동등성 대조군 전후 실험연구이다. G시에 거주하는 여성노인(실험군 30명, 대조군 30명)으로 2015년 3월 15일부터 5월 31일까지 뜸 요법을 12주간 주 1회 총 12회 뜸 요법을 적용하였고, 추후조사는 사후조사 2주후에 실시하였다. 뜸 요법은 요혈인 신수(腎諭)와 아시혈, 대장수(大腸兪), 요양관(腰陽關), 요수(腰兪)을 취혈하였다. 무극보양뜸 7혈인 족삼리(足三里) 곡지(谷地), 중완(中脘), 중극(中極)과 수도(水道), 폐수(肺愈), 고황과 천추(天樞), 위중(委中)부위에 각각 5장씩 뜸처치를 실시하였다. 연구도구는 요통정도를 사정하기 위해 Scott & Huskisson(1979)이 개발한 시각적 상사척도(Visual Analog Scale ; VAS)를 사용하였고, 일상생활기능장애 측정 도구는 Fairbank 등(1980)이 개발하고 임현술 등(1998)이 번역 수정한 Oswestry Disability Index를 이용하여 측정하였다. 수면양상 측정 도구는 오진주, 송미순, 김신미(1998)가 개발한 수면 측정 도구를 이용하였다. 자료분석은 SPSS/WIN 18.0을 사용하였으며 Chi-square test, t-test, repeated measures ANOVA를 실시하였다. 대조군에 비해 뜸 요법을 제공받은 여성노인의 통증점수(F=2510.32, p<.001), 일상생활기능장애 점수(F=1937.82, p<.001), 수면양상점수((F=15.54, p<.001)가 유의한 차이로 나타났다. 따라서 뜸요법은 통증과 일상생활기능장에를 감소시키고, 수면의 질을 향상시키는데 긍정적인 기여를 하는 것으로 나타나 향후 뜸요법이 만성요통을 호소하는 노인에게 간호중재로 활용할 필요가 있다.

• 대한소아치과학회지
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• 제38권1호
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• pp.1-8
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• 2011

이 연구의 목적은 도포마취제로서 5% EMLA cream과 20% Benzocaine gel의 구강 내 주사침 자입 및 마취제 주입시 전/구치부 전정부와 구개부에서의 작용시간과 동통 감소 효과를 평가하기 위함이다. 두 가지 도포마취제는 양측성 무작위 단일 맹검법 분할 디자인으로 평가되었다. Phase I은 전/구치부 전정부와 구개부에 도포마취제를 도포한 후 각각의 도포마취제의 작용시간을 평가하였다. Phase II는 Phase I에서 측정된 시간을 기초로 각각의 도포마취제를 부위별로 적용하여 주사침 자입 및 마취제 주입시 동통 감소 효과를 평가하였다. 평가를 위해 100-mm modified visual analog scale(VAS)를 이용하여 주관적인 동통 수치를 기록하였고, 맥박산소측정기(Pulse oximeter)를 사용하여 주사침 자입 및 마취제 주입 전후의 맥박수를 관찰하여 객관적인 동통 감소 효과를 비교하였다. Phase I 실험결과 두 가지 도포마취제는 전치부가 구치부보다, 구개부가 전정부보다 더 긴 작용시간을 보였다. 전치부 구개부를 제외한 모든 부위에서 EMLA cream이 Benzocaine gel보다 더 빠른 작용시간을 보였다. Phase II 실험결과 마취제주입시 부위별 그룹에 따른 VAS Score를 보면 전치부와 구치부 구개부에서 EMLA cream이 Benzocaine보다 동통 감소 효과에 있어 유의한 차이를 보였다(p<.05). 결론적으로 EMLA cream은 Benzocaine보다 전정부와 구개부 모두에서 빠른 작용시간과 더 좋은 유지력을 나타냈다. 또한 EMLA cream은 Benzocaine보다 주사침 자입시 전치부 구개부를 제외한 모든 부위에서, 마취제 주입시 전치부와 구치부 구개부에서 Benzocain 에 비해 더 좋은 동통 감소 효과를 보였다.