Journal of Korean Medicine Rehabilitation (한방재활의학과학회지)

The society of Korean Medicine Rehabilitation (한방재활의학과학회)
권호 표지
DOI QR코드

DOI QR Code

The Study on Correlation between the Degree of Herniated Intervertebral Lumbar Disc at L4~5 Level and Improvement of Low Back Pain Treated by Korean Medicine Therapy

제 4~5번 요추 추간판 탈출 정도와 요통의 한의학적 치료 효과의 상관성 연구

  • Yoo, Hyung-jin (Department of Rehabilitation Medicine of Korean Medicine, Daejeon Jaseng of Korean Medicine Hospital) ;
  • Lee, Hyun-ho (Department of Rehabilitation Medicine of Korean Medicine, Daejeon Jaseng of Korean Medicine Hospital) ;
  • Jeong, Seong-hyun (Department of Rehabilitation Medicine of Korean Medicine, Daejeon Jaseng of Korean Medicine Hospital) ;
  • Jo, Kyeong-sang (Department of Rehabilitation Medicine of Korean Medicine, Daejeon Jaseng of Korean Medicine Hospital) ;
  • Lee, Gie-on (Department of Rehabilitation Medicine of Korean Medicine, Daejeon Jaseng of Korean Medicine Hospital) ;
  • Lee, Dong-hyun (Department of Rehabilitation Medicine of Korean Medicine, Daejeon Jaseng of Korean Medicine Hospital) ;
  • Kim, Sang-min (Department of Acupuncture & Moxibusion Medicine, Daejeon Jaseng of Korean Medicine Hospital)
  • 유형진 (대전자생한방병원 한방재활의학과) ;
  • 이현호 (대전자생한방병원 한방재활의학과) ;
  • 정성현 (대전자생한방병원 한방재활의학과) ;
  • 조경상 (대전자생한방병원 한방재활의학과) ;
  • 이기언 (대전자생한방병원 한방재활의학과) ;
  • 이동현 (대전자생한방병원 한방재활의학과) ;
  • 김상민 (대전자생한방병원 침구의학과)
  • Received : 2016.03.18
  • Accepted : 2016.04.14
  • Published : 2016.04.30
Download PDF
⟨ Previous Next ⟩

Abstract

Objectives The purpose of this study was to compare the effects between the degree of herniated intervertebral lumbar disc (HIVD) at L4-5 level and improvement of low back pain treated by Korean Medicine therapy. Methods 567 patients who received inpatient treatment from May 2014 to December 2015 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 6 groups by the degree of HIVD at L4-5 level confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, Normal stage on Intervertebral Lumbar Disc at L4-5 level group's Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) improvement was $1.30{\pm}1.62$, $4.52{\pm}11.82$ and $0.04{\pm}0.11$ respectively. Bulging group's improvement was $3.25{\pm}2.81$, $8.28{\pm}13.02$ and $0.09{\pm}0.17$ respectively. Spinal canal occupying ratio (SOR) less than 20 group's improvement was $2.15{\pm}1.92$, $11.79{\pm}17.81$ and $0.13{\pm}0.23$ respectively. SOR 20 to less than 40 stage group's improvement was $2.13{\pm}1.92$. $10.79{\pm}15.93$ and $0.10{\pm}0.26$ respectively. SOR 40 to less than 60 group's improvement was $2.16{\pm}2.24$, $9.80{\pm}16.62$ and $0.15{\pm}0.25$ respectively. Surgery group's improvement was $2.47{\pm}2.21$, $11.64{\pm}18.53$ and $0.15{\pm}0.27$ respectively (p<0.03). But there was no statistically significance between 6 group's improvement after treatment (p>0.05). Conclusions After inpatient treatment by Korean Medicine therapy, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically correlation between the degree of HIVD at L4-5 level and improvement of low back pain. So We think that future research of higher quality and correct statistics shall be necessary.

Keywords

References

  1. Korean Acupuncture & Moxibustion Society Textbook Compilation Committee. The Acupuncture and Moxibustion Medicine : 3rd vol. Seoul : Jipmoondang. 2008:72-84.
  2. The Korean Orthopaedic Association. Orthopedics : The 6th edition. Seoul : Choisin Medical Books. 2006:617-30.
  3. Suk SI. Textbook of Spinal Surgery : The 3rd edition. Seoul : Choisin Medical Books. 2011:300-43.
  4. Korean Spinal Neurosurgery Society. The Textbook of Spine : The 2nd edition. Seoul : Koonja Publisher. 2013:721-32.
  5. 金達鎬外. 黃帝內經素問. : Seoul : Eui Seong Dang. 2001:(上)233-959,(下)49-54.
  6. 李梴. 醫學入門 VI : Seoul : Namsandang. 1996:333-40.
  7. Jeong Sun-Hee, Lee Jae-Dong, Park Don-Suk. Literatural Study on the Cause of Lumbago, Aacupuncture, and Moxibustion. The Journal of Korean Acupuncture & Moxibustion Society. 1996;13(1):263-82.
  8. Kwak Hyun-Young, Nam Dong-Woo, Kang Jung-Won, Kim Eun-Jung, Kim Kap-Sung, Choi Do-Young, Lee Jae-Dong. A Bibliographic Study on Low Back Pain and Related General Symptoms in Classical Literatures - Standardization for Classification and Diagnosis of Low Back Pain-. The Journal of Korean Acupuncture & Moxibustion Society. 2010;27(1):31-41.
  9. Cho HJ, Sul JU, Shin MS. Research Trends on the Treatment of Lumbar Herniated Intervertebral Disc in Korean Medicine. Korean Journal of Acupuncture. 2012;29(4):501-18.
  10. Lee Ki-Ha, Kim Ki-Yuk, Kim Wo-Young, Kim Chang-Youn, Lee Hyun-Jong, Eom Tae-Woong. The clinical study on difference of sex, age, medical history, part, or type in patients with lumbar spine herniation of nucleus pulpous. The Journal of Korea CHUNA Manual Medicine for spine & nerves 2008;3(1):37-48.
  11. Jang Suk-Geun, Hwang Kyu-Jung, Lee Byung-Hyun, Lee Byung-Ryul. Clinical Reports on Correlation between the Different Herniated Type and Oriental Medical Treatment. The Journal of Korean Acupuncture & Moxibustion Society. 2001;18(4):68-81.
  12. Kim Seok-Joo, Lee Hyun. The Clinical Study on 193 Cases with Herniated Lumbar Disc. The Journal of Daejeon Oriental Medicine Research Institute of Korean Medicine. 2010;19(1):119-28.
  13. Jung Jae-Hoon, Kim Won-Woo, Seong Ik-Hyun, Lee Kap-Soo, Cho Chang-Young, Kum Chang-Jun, Kim Hee-Jung, Ha In-Hyuk. The Study on Effectiveness of Oriental Medicine Treatment for Lumbar Disc Herniation Inpatients on 208 Cases. Journal of Korean Medicine Rehabilitation. 2013;23(1):77-86.
  14. Ahn SG, Lee SR, Yang YS. The Treatise Research on Hua-Tuo-Jia-Ji-Xue. The Journal of Korean Acupuncture & Moxibustion Society. 2000;17(4):139-48.
  15. Korean Society of Chuna manual Medicine for Spine & Nerves complication. Chuna manual medicine : The 2nd edition. Seoul : The Journal of Korea CHUNA Manual Medicine for spine & nerves. 2014:309-10,324-6.
  16. Lee Eun-Kyoung, Choi Eun-Hee, Lee Ji-Eun, Lee Ji-Eun, Jeon Ju-Hyun, Lee Sung-Hwan, Lee Jae-Min, Kim Yeon-Mi, Kwak Byung-Min, Yang Gi-Young, Kim Young-Il. The Clinical Study on 137 Cases of Herniated Lumbar Disc Patients. The Journal of Korean Acupuncture & Moxibustion Society. 2008;25(3):127-38.
  17. Kim Sung-Nam, Kim Sung-Chul, Choi Hoi-Kang, So Ki-Suk, Lim Jeong-A, Moon Hyung-Cheol, Lee Jong-Deok, Choi Sung-Yong, Kim Hong-Hoon, Lee Ok-Ja. Clinical Study on Effect of Scolopendrid Aquacupuncture Classified by the Type of Lumbar Disc Herniation. The Journal of Korean Acupuncture & Moxibustion Society. 2004;21(5):79-99.
  18. Y. Matsubara, F. Kato, K. Mimatsu, G. Kajino, S. Nakamura, H. Nitta. Serial changes on MRI in lumbar disc herniations treated conservatively. Neuroradiology. 1995;37(5):378-83. https://doi.org/10.1007/BF00588017
  19. Hwang Jae-Sung. The Influence of the Degree of Lumbar Disc Degeneration and the Amount of Removed Disc on Clinical Outcomes [Master's thesis]. Busan : Dong-A University. 2009. Korean language.
  20. Wall PD, Mozack Ronald. Textbook of PAIN : Seoul : Jungdam Publication. 2002:483-4.
  21. Fairbank JC, Couper J, Davies JB, O'Brien JP. The Oswestry low back pain disability questionnaire. Physiotherapy. 1980;66(8):271-3.
  22. Sayed Javad Mousavi, Mohamad Parnianpour, Hossein Mehdian, Ali Montazeri, Bahram Mobini. The Oswestry Disability Index, the Roland-Morris Disability Questionnaire, and the Quebec Back Pain Disability Scale: translation and validation studies of the Iranian versions. Spine. 2006;31(14):454-459. https://doi.org/10.1097/01.brs.0000222141.61424.f7
  23. Kim GM, Park SY, Lee CH. A rasch analysis of the Korean version of oswestry disability questionnaire according to general characteristics of patients with low back pain. Phys Ther Korea. 2011;18(2):35-42.
  24. Kim Hye-Rang. The effect of intervention methods focused on stabilization excercises on low back pain [Master's thesis]. Chuncheon : Hallym University. 2014. Korean Language.
  25. Ha Sung-Suk. The affecting factor between chronic disease and quality life [Master's thesis]. Seoul : Inje Institute of Advanced Studies. 2015. Korean Language.
  26. Kim Tae-Hyup. Validity and reliability evaluation for EQ-5D in the general population of south Korea [Doctorate thesis]. Ulsan : University of Ulsan the Graduate School. 2012. Korean Language.
  27. Lee Yeon-Kyeng, Nam Hae-Sung, Chuang Ling-Hsiang, Kim Keon-Yeop, Yang Hae-Kyung, Kwon In-Sun, Kind Paul, Kweon Sun-Seog, Kim Young-Tack. South Korean Time Trade-Off Values for EQ-5D Health States: Modeling with Observed Values for 101 Health States. Value Health. 2009;12(8):1187-93. https://doi.org/10.1111/j.1524-4733.2009.00579.x
  28. Gang HS, Hong SH, Gang CH. Musculoskeletal radiology : 1st. ed. Seoul : Bummun Education. 2013:811-5.
  29. National Health Insurance Service. Health insurance statistics annual report The 6th edition Morbidity statistics. 2014:373-668.
  30. Kim Seh-Young, Park Han-Sol, Kim Min-Chul, Seo Young-Woo, Seo Young-Hoon, Lee Sang-Min, Kim Ki-Ok, Kim Tae-Hun. Effects of Korean Medical Combination Treatment for Herniated Intervertebral Lumbar Disc Patients: An Observational Study. The Acupuncture. 2014;31(4):21-8.
  31. Jang Sun-Jeong, Heo Dong-Seok. An Analysis of Hospital Cost on the Part of Lumbar HIVD Inpatients at Oriental Medicine Hospital. Journal of Korean Medicine Rehabilitation. 2012;22(2):119-32.
  32. Lee Kap-Soo, Kim Won-Woo, Seong Ik-Hyeon, Cho Chang-Young. The relationship between Width of Lumbar Disc Space and Severity of Herniated Intervertebral Disc in Patients Diagnosis Disc space narrowing. The Journal of Korea CHUNA Manual Medicine for spine & nerves. 2013;8(2):79-86.
  33. Raymond WJG. Clinically important outcomes in low back pain. Best Practice & Research Clinical Rheumatology. 2005;19(4):593-607. https://doi.org/10.1016/j.berh.2005.03.003