[논문]전신증상을 동반한 교통사고 입원환자에 대한 한방자동차보험 진료와 산삼비만약침 병행 치료: 환자군 연구

김덕현; 강미숙; 송호섭; 황지혜

doi:10.14406/acu.2019.004

전신증상을 동반한 교통사고 입원환자에 대한 한방자동차보험 진료와 산삼비만약침 병행 치료: 환자군 연구
Synergistic Effect of Wild Ginseng Complex Pharmacopuncture Combined with Korean Medicine Automobile Insurance Treatment on Two Obese Inpatients with Systemic Symptoms: Case Series 원문보기

Korean journal of acupuncture, v.36 no.1, 2019년, pp.81 - 91

김덕현 (가천대학교 한의과대학 침구의학과) , 강미숙 (가천대학교 한의과대학 침구의학과) , 송호섭 (가천대학교 한의과대학 침구의학과) , 황지혜 (가천대학교 한의과대학 침구의학과)

Abstract ▼ AI-Helper

Objectives : Symptoms caused by traffic accidents can be divided into localized pain and systemic symptoms. Edema and pain can be increased due to obesity. During hospitalization of obese patients after traffic accident injury, obesity and systemic symptoms such as edema, dizziness, abdominal fullness and heavy body feeling might increase more by decreased physical activity due to pain. Methods : This report details on two cases of obese female inpatients with systemic symptoms after a car accident who were treated with wild ginseng complex (WGC) pharmacopuncture combined with Korean Medicine (KM) automobile insurance treatment. The Numeric Rating Scale (NRS), Neck Disablility Index (NDI) and the Oswestry Disablility Index (ODI) were evaluated before and after treatment for comparison. Body composition was also measured. Results : Localized pain improved with a decrease in patients' NRS, NDI and ODI scores. Systemic symptoms increased during hospitalization were also improved with changes of body composition. Conclusions : Combining WGC pharmacopuncture with KM automobile insurance treatment may be synergistically effective for the treatment of obese patients with systemic symptoms such as edema, heavy body feeling and abdominal fullness.

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제안 방법

(1) KM automobile insurance treatment: Acupuncture was performed using a disposable stainless steel needle (0.30×40 mm for low back and buttocks and 0.25×0.30 mm for other parts) on GV4, GV3, BL23, BL24, BL25, BL26, GV30, GB20, GV14, EX-HN5, GB21, GV20, and ouch points, and electrical stimulation between BL23 and BL26, GB20 and GB21 by STN －330 (StraTek, KOREA), with tolerable intensity and infra-red irradiation therapy applied together during 15 minutes.
Several studies on the relationship between pain and obesity have reported that the improvement of pain is slow in the obese group and that body fat can be increased due to decreased activity due to chronic pain15,16). In this study, at first, Case 1 visited our hospital on the day of the accident with neck pain and U/Ex radiating pain, LBP, and headache and Case 2 visited our hospital two days after the accident with neck pain, left shoulder pain and headache. In Case 1, on the 5th day of hospitalization, the patient was treated WGC pharmacopuncture additionally.
, there have been few cases reported in relation to the degree of obesity or systemic symptoms such as edema, heavy body feeling, and abdominal fullness. In this study, we observed the synergistic effect of wild ginseng complex (WGC) pharmacopuncture combined with KM automobile insurance treatment on two obese female patients with an occurring heavy body feeling, edema, digestive discomfort, dizziness and abdominal fullness during hospitalization after traffic accident.
10: However, on the 4th day of admission, she complained about increased headache (NRS 4) with systemic symptoms such as edema, heavy body feeling, and abdominal fullness. On the 5th day, in a slightly increased state of overall symptoms, she was treated with WGC pharmacopuncture besides basic KM treatment. On the night of the procedure, her headache decreased and on the next day, her headache and both U/Ex radiating pain which when occurring felt like an electric shock in both the lower arms when one is seated for a long time, with the numbness disappearing and neck pain decreasing.

성능/효과

(4) F/U: Through the follow-up by phone, the symptoms of pain after discharge were slightly decreased with few systemic symptoms and decreased BW and the patient was satisfied with the treatment she received at our hospital. Due to her busy schedule, the patients were not able to receive any additional treatment and the symptoms seemed to be remained.
(5) F/U: As a result of F/U in outpatient clinic 1 week after discharge, the symptoms of pain were almost similar decreased with few systemic symptoms and the patient was satisfied with the treatment she received at our hospital. However, due to her busy schedule, she stated that she would not receive further treatment in the future.
In this study, the increase in systemic symptoms and discomfort of the inpatients was thought to be due to the abnormality of energy balance due to the decrease of the physical activity and circulatory disturbance by traffic accidents, in the state of decreased metabolism due to hormonal changes. Based on the results, WGC pharmacopuncture is thought to have helped relief of pain and systemic symptoms by the improvement of qi-blood circulation through promoting metabolism with fat cell degradation, and it can be thought to bring synergy effect on KM automobile treatment which can treat stagnant blood and inflammation.
In Case 1, on the 5th day of hospitalization, the patient was treated WGC pharmacopuncture additionally. From the day after the procedure, the headache began to disappear, U/Ex radiating pain decreased and disappeared, and all symptoms improved at discharge in NRS, NDI, and ODI scores compared with the condition before admission and there were changes in the composition of the body before and after WGC pharmacopuncture. In Case 2, on the 3rd, 6th and 9th day of hospitalization, the patient was treated WGC pharmacopuncture additionally.
In conclusion, in this study, despite the cost burden, based on the improvement of pain and other symptoms and the patient’s satisfaction with our treatment, it was thought that when accompanied by obesity and edema, with combined treatment, it could speed up the rate of improvement of a traffic accident’s aftermath.
However, there have been few reports of treatment outcomes considering other factors such as obesity, hormone change and edema. In this study, the improvement on pain and systemic symptoms with the combined treatment KM automobile insurance treatment and WGC pharmacopuncture for the obese patients with the hormone change due to the menopausal state in Case 1 or anti-breast cancer drug in Case 2 was confirmed.
On the other hand, when results before and 3 days after WGC pharmacopuncture were compared, it was found that her systemic symptoms including heavy body feeling, edema, and abdominal fullness almost disappeared and her body composition was improved from BW 69.1 kg to BFM 26.2, PBF 37.9%, WHR 0.97, BMI 26.0. SMM 23.
On the other hand, when results before and after 3 times treatments of WGC pharmacopuncture were compared, it was found that her systemic symptoms including heavy body feeling, edema, dizziness, digestive discomfort and abdominal fullness and hardening feeling almost disappeared and her body composition was improved from BW 62.5 kg, BFM 24.8, PBF 39.7%, WHR 0.94, BMI 26.7. SMM 20.

참고문헌 (25)

et al, . Survey of oriental medical care for traffic accident patients with automobile insurance;544 cases report. Journal of Korean Acupuncture & Moxibustion Society 2009;26:1-10. https://www.e-jar.org/upload/pdf/33701919.pdf
et al, . The Clinical Study on 197 Cases with Patients of Neck Pain Caused by Traffic Accident. Journal of Korean Acupuncture & Moxibustion Society 2010;27:143-54. https://www.e-jar.org/upload/pdf/33702039.pdf
10.3831/kpi.2007. 10.3.091
조희진, 권민수, 김정환, 조대현, 최지은, 한지선, 이승민, 이상훈, 남상수. 국내 교통사고 후유증 환자의 평가도구에 대한 임상연구 실태조사. The acupuncture = 대한침구의학회지, vol.33, no.4, 15-31.

원문보기 상세보기
The study relation of low back pain and obesity. Journal of Korean Acupuncture & Moxibustion Society 2002;20:102-13. https://www.e-jar.org/upload/pdf/33701063.pdf
Yoon JR, Sun SK, Han SW. A Study on Health Fitness and Correlations between Related Variables in Low Back Pain Patient's. Exercise Science 1999;8(1):105-19.
Melissas, John, Kontakis, George, Volakakis, Evaggelos, Tsepetis, Theodosis, Alegakis, Athanasios, Hadjipavlou, Alexander. The Effect of Surgical Weight Reduction on Functional Status in Morbidly Obese Patients with Low Back Pain. Obesity surgery : the official journal of the American Society for Bariatric Surgery and of the Obesity Surgery Society of Australia and New Zealand, vol.15, no.3, 378-381.

상세보기
Rejeski, W. Jack, Ip, Edward H., Marsh, Anthony P., Zhang, Qiang, Miller, Michael E.. Obesity Influences Transitional States of Disability in Older Adults With Knee Pain. Archives of physical medicine and rehabilitation, vol.89, no.11, 2102-2107.

상세보기
10.1136/bmj.2.5243.1
10.1136/bmj.2.5243.1
Kim SJ, Shin JA, Yun WS, Park HS. Effect of Office-Based Patient Education for Fat Distribution and Behavior Modification in Overweight Patients. Journal of the Korean Academy of Family Medicine 2002;23(6):778-86.
Stunkard W. Handbook of obesity treatment. Seoul :Daehan Co. 2005:4-10.
Jensen, Gordon L., Friedmann, Janet M.. Obesity Is Associated with Functional Decline in Community-Dwelling Rural Older Persons. Journal of the American Geriatrics Society, vol.50, no.5, 918-923.

상세보기
Obesity from the view point of metabolic rate. Journal of Korean Oriental Association for Study of Obesity 2003;3:95-105. http://www.ndsl.kr/ndsl/commons/util/ndslOriginalView.do?cn=JAKO200303039784042&dbt=JAKO&koi=KISTI1.1003%2FJNL.JAKO200303039784042
Kim GD, Han GS. Effects of Rehabilitation Exercise on the Body Composition, Lumbar Extension Strength, Ratio of Lumbar Flexion/Extension and VAS Change in Female Low Back Pain Patient of Abdominal Obesity. Journal of coaching development 2014;16(4):93-103.
10.35159/kjss.2017.06.26.3.967 Han GS, Han SH. The Effects of Obesity Standing Workers on Changes in Lower Extremity Edema, Body Stability and VAS. The Korea Journal of Sports Science 2017;26(3):967-76.

상세보기
Williamson, E., Williams, M., Gates, S., Lamb, S.E.. A systematic literature review of psychological factors and the development of late whiplash syndrome. Pain, vol.135, no.1, 20-30.

상세보기
O KW, Ryu IH, Kim JR, Kim HJ, Kang JA, Lee SJ et al. Case Series of Low Back Pain and Pelvic Pain Caused by Traffic Accident during Pregnancy. THE JOURNAL OF ORIENTAL OBSTETRICS &GYNECOLOGY 2009;22(4):194-204.
조민서, 한재경, 김윤희. 교통사고 소아환자 121례를 통한 임상적 고찰. 大韓韓方小兒科學會誌 = The journal of pediatrics of Korean medicine, vol.26, no.2, 35-46.

원문보기 상세보기
Jung C, Jung JH, Lee MS. A clinical study of immune pharmacopuncturology. Chungnam: Kyungrak medical publishing co. 2011.
Kim MW, Lim HH, Song YK. Anti-obesity effect of wild ginseng complex pharmacopuncture on adipocyte and high fat diet-induced obese C57BL/6J mice. J Oriental Rehab Med 2012;22(2):67-90.
Lim JY. Efficacy and safety of wild ginseng complex pharmacopuncture on the abdominal fat:randomized, double blinded, placebo-controlled trial. Doctorate thesis. Seongnam: Gachon Graduate School. 2013.
Shin MS. A Case Series:The Effects of Cultivated Wild Ginseng Pharmacopuncture and Thread Implantation Therapy on Abdominal Obesity. J Korean Med Obes Res 2013;13(1):46-50.
유정은. 온열요법을 결합한 산삼비만약침의 폐경기 복부비만 개선효과: 증례보고. 한방비만학회지 = Journal of Korean Medicine for Obesity Research, vol.16, no.2, 133-137.

원문보기 상세보기
The National College of Korean Medicine Pathology Classroom. Oriental Pathology. Yongin: Hanuimunhwasa. 2001.

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