[논문]경혈 전기 자극 전처치요법을 통해 치료한 치핵 통증: 증례보고

이승민

doi:10.14406/acu.2020.027

[국내논문] 경혈 전기 자극 전처치요법을 통해 치료한 치핵 통증: 증례보고
Acupoint Electrical Stimulation Preconditioning to Reduce Hemorrhoid Pain: A Case Report 원문보기

Korean journal of acupuncture, v.37 no.3, 2020년, pp.198 - 202

이승민 (부산대학교 한의과학연구소)

Abstract ▼ AI-Helper

A 30-year-old woman with Grade III hemorrhoid complained of excruciating pain that continued for several hours, especially with defecation. She was not able to frequent the clinic due to COVID-19 shutdowns, therefore additional treatment using acupoint electrical stimulation (AES) was self-administered. She administered AES bilaterally on BL57 and LR10 for fifteen minutes before each defecation as a preconditioning treatment. She assessed her pain using a Numerical Rating Scale (NRS) during defecation, and 3 hours later. The patient initially complained of pain rating 9 on the NRS. After the first session of AES, the pain dropped to 5. On one-month follow-up, the pain was at 3 and the patient was able to terminate all treatment. Self-administered AES preconditioning at BL57 and LR10 can be used to reduce extreme cases of hemorrhoid pain.

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문제 정의

To the best of the author’s knowledge, this is the first case report illustrating the use of self-administered AES to help increase and maintain treatment effects of regular acupuncture.

제안 방법

When she felt the first urge to have a bowel movement, the patient was taught to stick the rectangular carbon rubber surface pads (5 cm×5 cm) on bilateral BL57 and LR10 points for a duration of at least 15 minutes.
Gastroenterology offices were also not receiving new patients. Due to the unprecedented circumstances, the patient was taught how to self-administer electrical stimulation on acupuncture points to maintain acupuncture treatment effects while increasing treatment dosage.
In order to increase the effects and maintain the dosage, EAS was introduced as an adjunctive treatment method. The purpose was to increase the pain threshold to an optimal level before defecation, thereby reaching a preconditioned state before bowel movement.

대상 데이터

A 30-year-old Korean-American female presented with excruciating pain inside and around the anal area that worsened after each straining during defecation. Ten years ago, she had been diagnosed with asymptomatic Grade I hemorrhoids and three years back, the enlarged vascular channels had started to protrude when she released stool.

성능/효과

There was one report of patients being trained in self-needling to maintain acupuncture effects after therapist-delivered acupuncture, and another case of a patient being trained in applying selfelectroacupuncture as well^8,9). Both studies have reported positive results, concluding that self-application was a safe and cost-effective treatment method. Since puncturing the skin can expose the patient to unnecessary risks, AES was the choice of treatment in our case, especially during times of COV ID-19 as medical attention could not be immediately sought if there was an adverse event.

후속연구

Due to the extremity of the pain and condition, she was initially advised to visit a gastroenterologist, but the patient expressed concerns due to her insurance plan and opted to try acupuncture first. Therefore, further diagnostic testing could not be done.

참고문헌 (12)

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Yeo D, Tan KY. Hemorrhoidectomy - making sense of the surgical options. World J Gastroenterol. 2014 ; 20(45) : 16976-83. https://doi.org/10.3748/wjg.v20.i45.16976

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Chung S, Kim Y. Two cases of hemorrhoid treated with SaAhm acupuncture. J Korean Med Ophthalmol Otolaryngol Dermatol. 2003 ; 16(3) : 252-9.
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원문보기 상세보기
Wang X, Yin X, Guo X, Wang Y, Jin W, Mao A, et al. Effects of the pestle needle therapy, a type of acupoint stimulation, on posthemorrhoidectomy pain: a randomized controlled trial. J Integr Med. 2020 : S2095-4964(20)30079-0. https://doi.org/10.1016/j.joim.2020.08.001

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Molassiotis A, Bardy J, Finnegan-John J, Mackereth P, Ryder WD, Filshie J, et al. A randomized, controlled trial of acupuncture self-needling as maintenance therapy for cancer-related fatigue after therapist-delivered acupuncture. Ann Oncol. 2013 ; 24(6) : 1645-52. https://doi.org/10.1093/annonc/mdt034

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Wang K, Bugge J, Bugge S. A randomised, placebo-controlled trial of manual and electrical acupuncture for the treatment of tinnitus. Complement Ther Med. 2 010 ; 18(6) : 249-55. https://doi.org/10.1016/j.ctim.2010.09.005

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