Ultrasound-Guided High-Dose Hwangryunhaedok-tang Pharmacopuncture Combined with Integrative Korean Medicine Treatment for Traumatic Rib Fracture: A Case Report

외상성 늑골 골절 환자에 대한 초음파 유도하 대용량 황련해독탕 약침 병행 한방통합치료 증례보고

This case report aimed to describe the clinical course and safety of integrative Korean medicine treatment combined with ultrasound-guided high-volume Hwangryunhaedok-tang (Huanglianjiedu-tang) pharmacopuncture in a patient with traumatic rib fracture. A 36-year-old male diagnosed with a left 10th rib fracture received 4 mL of Hwangryunhaedok-tang (Huanglianjiedu-tang) pharmacopuncture injected into the intercostal fascial plane under ultrasound guidance. Pain intensity, quality of life, inflammatory markers, and adverse events were evaluated. The rib pain score decreased from 7 to 2, and the EuroQol-5 dimension-5 level profile changed from 55555 at admission to 44444 on hospital day 7 and 11111 at discharge. Pre- and post-treatment numeric rating scale (NRS) scores were additionally recorded on pharmacopuncture days. In most sessions, the NRS score decreased by 2 to 3 points immediately after treatment, and pain relief lasted approximately 2 hours. No additional analgesics were used after the 5-day prescription from the first hospital. Inflammatory markers decreased, and no serious adverse events were observed. This case reports the clinical course of ultrasound-guided high-volume Hwangryunhaedok-tang (Huanglianjiedu-tang) pharmacopuncture applied to the intercostal fascial plane in a patient with traumatic rib fracture, with improvements in rib pain, sleep, gait function, and health-related quality of life without serious adverse events. However, comparative effectiveness and effects on fracture healing cannot be determined from a single case, and further studies are required.