A Clinical Case Study of Patient that Not Improved Thrombocytopenia after Intravenous Immunoglobulin Treatment at Idiopathic Thrombocytopenic Purpura as a Complication of Deep Vein Thrombosis

Article information

J Korean Acupunct Moxib Soc. 2013;30(4):203-210
Publication date (electronic) : 2013 September 20
doi : https://doi.org/10.13045/acupunct.2013038
1Department of Acupuncture & Moxibution Medicine, College of Oriental Medicine, Dong-Eui University
2Department of Oriental Rehabilitation Medicine, College of Oriental Medicine, Dong-Eui University
*Corresponding author : Department of Acupuncture & Moxibution Medicine, Oriental Medicine Hospital, Dong-Eui University, 62, Yangjeong-ro, Busanjin-gu, Busan, 614-851, Republic of Korea, Tel : +82-51-850-8752 E-mail : kjjang59@empal.com
Received 2013 August 16; Revised 2013 August 30; Accepted 2013 August 30.

Abstract

Objectives :

The purpose of this study is to report clinical effect of oriental medical for a not improved ITP patient, who developed complication from DVT, after intravenous immunoglobulin treatment.

Methods :

The patient was treated using Saam acupuncture, herbal medication, moxibustion and physical treatment. And we measured of systemic symptoms and platelet counts.

Results :

After treatment, systemic symptoms and platelet counts were improved in case.

Conclusions :

Oriental medical treatment showed significant effect on ITP patient that not improved platelet counts after intravenous immunoglobulin treatment.

Fig. 1.

The changes of platelet counts after oriental medical treatment

Main Treatment

The changes of severities of each symptoms after oriental medical treatment.

References

1. Kurt JI, Eugene B, Jean DW, Joseph BM, Anthony SF, Dennis LK. Harrison’s Principles of Internal Medicine. Jungdam 1997;:1230–1.
2. Kelman CW, Kortt MA, Becker NG, et al. Deep Vein Thrombosis and air travel. Record linkge study. BMJ 2003;327(7423):1072.
3. Karpatkin S. Autoimmune thrombocytopenic purpura. Blood 1980;304(19):329–43.
4. Mc Millan R. Chronic idiopathic thrombocytopenic purpura. N Engl J Med 1981;18(2):1135–47.
5. Ann GS, Lee JK, Kim JH, et al. A Case Report of the Herbal Medication Treatment and Counseling Therapy for the Chronic ITP Patient. J of Oriental Neuropsychiatry 2007;18(2):143–51.
6. Song YD, Lee KH, Hyun MS. Treatment Effect of Adult ITP. J of Korean Society Hematology 1999;34(1):62–70.
7. Samsung Seoul Hospital. News Letter 2007;14(4):1–4.
8. Han CH, Sin MS, Park SH, Choi SM. Research Trends on the Saam’s Acupuncture Method in Korea. Korean J of Oriental Medicine 2006;12(2):15–30.
9. Kim SY. Current practice in Cardiology. 2010;4(3):4–15.
10. Walker RW, Walker W. Idiopathic thrombocytopenia, initial illness and long term follow up. Arch Dis Child 1984;59(3):316–32.
11. Newton WA, Zuelzer WW. Idiopathic thrombocytopenic purpura in childhood. N Engl J Med 1951;245(8):879–85.
12. Gillis S. The Thrombocytopenic purpuras. Drugs 1996;51(6):942–53.
13. Harrington WJ, Ahn YS, Byrnes JJ, So AG, Mylvaganam R, Pall LM. Treatment of idiopathic thrombocytopenic purpura. Hosp pract 1983;18(3):205–20.
14. Ahn YS, Harrington WJ, Seelman RC, Eytel CS. Vincristine therapy of idiopathic and secondary thrombocytopenias. N Engl J Med 1974;291(12):376–80.
15. Department of Liver System Internal Medicine of Oriental Medical College. Liver System Internal Medicine Seoul: Research Institution of Oriental Medicine; 2001. p. 608–13.
16. Department of Acupuncture & Moxibustion of Oriental Medical College. Acupuncture & Moxibustion Seoul: Jipmoondang; 1994. p. 184–92. p. 1164–5.
17. Saam . Saamdoin Chimguyogeul Seoul: Hanglim; 1985. p. 221–6.
18. Lee IS. Kyogam Haesul Saamchimgu. Chorakdang 2007;:156–308.
19. Kim HK. Hwaltu Saamchimbub. Sinnongbaekcho 2001;67

Article information Continued

Fig. 1.

The changes of platelet counts after oriental medical treatment

Table 1.

Main Treatment

Date Acupuncture Herb medication Moxibustion Medication change
2011. 3. 21 (The first stage) Bee-jeonggyeok (SP10, SP6, KI3, KI10, LR8, GB39) Bojungikki Decoction Saengjihwang 8 g,
Jeokjakyak Ukag 6 g, Mokdanpi 4 g,
Chija Hwanglyun 3 g Add.(2 Chup 3 pack/day)
CV6, CV4 Nisolone tab
5 mg 4 T
Danazol 100 mg 3 c
2011. 3. 23 Blood transfusion
6 pack
2011. 3. 28 Bojungikki Decoction-Gami(2 Chup 3 pack/day)
Samul Decoction(1 Chup 2 pack/day)
2011. 3. 30 Nisolone tab
5 mg 2 T
Danazol remove
2011. 4. 6 (The middle stage) Bee-jeonggyeok
Add
Sojang-jeonggyeok
(KI10, KI3, LR8, GB39)
Bojungikki Decoction,
Saengjihwang 8g,
Jeokjakyak Ukag 6 g, Mokdanpi 4g,
Chija Hwanglyun 3 g,
Sunhakcho Baekhasuo 6 g,
Kukija 4 g
Add(2 Chup 3 pack/day)
Samul Decoction
(1 Chup 2 pack/day)
CV6, CV4, SP6, ST36 Nisolone tab
5 mg 1 T
2011. 4. 11 Nisolone tab 5 mg
remove
2011. 4. 19∼5. 15 (The last stage) Bee-jeonggyeok
Add
Sojang-jeonggyeok
(KI10, KI3, LR8, GB39, BL18, BL23)
Samul Decoction(2 Chup 3 pack/day)
Bojungikki Decoction Saengjihwang 8 g,
Jeokjakyak Ukag 6 g, Mokdanpi 4 g,
Chija Hwanglyun 3 g,
Sunhakcho Baekhasuo 6 g, Kukija 4 g
Add(1 Chup 2 pack/day)

Bojungikki Decoction : Daejo 7 g, Hwangki Saenggang 6 g, Baekchul Insam Gamcho 4 g, Jinpi Danggi 2 g, Sungma Siho 1.2 g(g/Chup).

Samul Decoction : Danggi 6 g, Baekjaktak Chengung 4 g, Sukjihwang 2 g(g/Chup).

Table 2.

The changes of severities of each symptoms after oriental medical treatment.

Date Lt* calf swelling (cm) Petec-hia Nose bleeding (/Week, bleeding amount) Pulse rate (/min) Palpit-ation Face acne
2011. 3. 23 48 ++++ 1∼2, ++ 110∼130 +++++ ++++
3. 23∼3. 28 48 ++++ 1∼2, ++ 90∼110 ++++ +++
3. 28∼4. 11 47 ++++ 1, ++ 90 +++ +++
4. 11∼4. 18 48 +++ 1, + 80∼90 +++ ++
4. 18∼4. 21 48 +++ 1, + 70∼85 +++ ++
4. 21∼4. 26 48.5 +++ 1, + 80∼90 +++ ++
4. 26∼5. 1 48 +++ 1, + 80∼90 +++ ++
5. 1∼5. 9 49 ++ 1, + 70∼80 +++ ++
5. 9∼5. 15 47.5 ++ 1, + 70∼80 ++ ++

Lt : left

Lt. calf swelling(cm) : measure around 5 cm under the inferior of patella.

It is a measurement instrument for clinical characteristics.

+++++:

the most severe clinical symptom that patient is experienced.

+:

20 % clinical symptom is reduced.

−:

10 % clinical symptom is reduced.