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J Acupunct Res > Volume 30(5); 2013 > Article
Kim, Kang, Cho, Kwak, and Lee: A Case Report of Undifferentiated Somatoform Disorder, Wei Symptom Patient
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Abstract

Objectives:

This is a case report about undifferentiated somatoform disorder, Wei symptom patient

Methods:

The patient was treated using acupuncture, electroacupuncture, pharmacopuncture, herbal medication and Korean medical physical therapy. The recovery of this patient had measured in physical examination, gait condition test, body surface temperature, body perimeter and sensory test by dermatome.

Results:

Through this treatment, the patient`s leg elevation angle, body surface tempreature, body perimeter was raised, Rt. lower limb numbness and gait condition had improved.

Conclusions:

Korean medical therapy including acupuncture, electroacupuncture, pharmacopuncture, herbal medication and Korean medical physical therapy was effective to improve undifferentiated somatoform disorder, Wei symptom patient.

Fig. 1.
Dermatome of lower extremity10)
acupunct-30-5-18-f1.gif
Fig. 2.
DITI of lower extremity, admission day
1st : front. 2nd : back. 3rd : plantar.
acupunct-30-5-18-f2.gif
Fig. 3.
DITI of lower extremity, admission 1 week
1st : front. 2nd : back. 3rd : plantar.
acupunct-30-5-18-f3.gif
Fig. 4.
DITI of lower extremity, outpatient department lweek
1st : front. 2nd : back. 3rd : plantar.
acupunct-30-5-18-f4.gif
Fig. 5.
DITI of lower extremity, outpatient department 3 weeks
1st : Front, 2nd : back, 3rd : plantar.
acupunct-30-5-18-f5.gif
Table 1.
Change of Herbal Medication
Date(month/day) Herbal medication
4. 3∼9 Yogaktong H
4. 10∼11 Jasinyanghyeolgunbo decoction
4. 12∼14 Samchulgunbi decoction
Discharge medication (4. 15∼29) Samchulgunbi decoction
Table 2.
Change of Physical Examination in Rt Lower Limb
Period Straight leg raise test(°) Against dorsi flexion Against plantar flexion Milgram test(sec)
A 0
1 week 90° + + 10
2 weeks 90° + + 10
OPD 1 week 90° + + 10
OPD 3 weeks 90° + + 10
OPD 5 weeks 90° + + 10
OPD 7 weeks 90° + + 10

A : admission. OPD : Outpatient department. + : weakness.

In against dorsi flexion, against plantar flexion, the grade was measured −, +, ++; − was paralysis, + was not paralysis, but was weakened, ++ was normal strength.

Table 3.
Change of Body Surface Temperature
Position ST36 (°C) ST41 (°C) BL40 (°C) BL56 (°C) K11 (°C)
Period Rt Lt Rt Lt Rt Lt Rt Lt Rt Lt
A 30.2 33.2 29.6 33.0 31.7 33.9 29.7 32.6 26.4 28.7
1wk 31.7 32.8 31.9 32.7 32.1 33.7 30.9 32.0 30.2 30.6
OPD 1wk 31.2 32.1 31.3 31.8 31.8 32.4 30.9 31.5 28.8 28.9
OPD 3wks 32.8 33.2 32.6 34.3 33.3 34.1 32.5 32.8 30.8 30.4

A : admission, OPD : outpatient department, wk : week.

Table 4.
Change of Body Surface Temperature; Substration Rt From Lt
Position ST36 (°C) ST41 (°C) BL40 (°C) BL56 (°C) K11 (°C)
Period
A 3 3.4 2.2 2.9 2.3
1 week 1.1 0.8 1.6 1.1 0.4
OPD 1 week 0.9 0.5 0.6 0.6 0.1
OPD 3 weeks 0.4 1.7 0.8 0.3 −0.4

A : admission. OPD : outpatient department.

Table 5.
Change of Body Perimeter in Rt Lower Limb
Position GB31 level (cm) ST34 level (cm) ST36 level (cm) BL57 level (cm)
Period
A 44 36 31.5 28.5
1 week 45.5 36.5 31.5 29
2 weeks 44 36 32.5 32
OPD 1 week 44 36.5 33 32.5
OPD 3 weeks 45 36.5 33 32
OPD 5 weeks 45 36 33 31.5
OPD 7 weeks 45 35.5 32.5 31

A : admission. OPD : outpatient department.

Table 6.
Change of Sensory Distribution in Rt Lower Limb
Position L4 L5 S1
Period
A 0 0 0
1 week 1 1 1
2 weeks 1 1 1
OPD 1 week 2 2 2
OPD 3 weeks 2 2 2
OPD 5 weeks 2 2 2
OPD 7 weeks 2 2 2

A : admission.

OPD : outpatient department.

The score was measured 0, 1, 2; 0 was numbness, 1 wasn’t numbness, but slightly dull sense, 2 was normal sense.

V. References

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6. Korean Acupuncture & moxibustion Society Textbook Compilation Committee. The Acupuncture and Moxibustion(Ha). Gyeonggi: Jipmoondang. 2008:198.

7. Kim JY, Seo JH, Kang HS, Sung WY, Jung DU. One Case Report of Somatoform Disorder Patient with Dyspnea, Dysarthria and Gait Disturbance. J of Oriental Neuropsychiatry. 2007;18(3):237–47.

8. Kang HC, Choi WJ, Jung MY, Lee SG. Clinical study on a case of somatoform disorder with chronic pelycalgia and hemiparesis. J of Oriental Neuropsychiatry. 2004;15(2):203–10.

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10. Korean Acupuncture & moxibustion Society Textbook Compilation Committee. The Acupuncture and Moxibustion(Jung). Gyeonggi: Jipmoondang. 2008:197.

11. Cheong SY, Kim CH, Sung EJ, et al. Primary Care Physicians Attitudes Toward Medically Unexplained Symptoms. Korean J Fam Med. 2005;26(1):15–21.

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13. American Psychiatry Association. Diagnostic and Statistical Manual of Mental Disorders. fourth edition. Seoul: Hanauihaksa. 1995:579–610.

14. Kim JY, Seo JH, Kang HS, Sung WY, Jeong DU. One Case Report of Somatoform Disorder Patient with Dyspnes, Dysarthria and Gait Disturbance. J of Oriental Neuropsychiatry. 2007;18(3):237–47.

15. Department of cardiology in national university of Korean Medicine. Simgye Internal Medicine. Seoul: Gunja publisher. 2006:353–8.

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17. Korean Acupuncture & moxibustion Society Textbook Compilation Committee. The Acupuncture and Moxibustion(Ha). Gyeonggi: Jipmoondang. 2008:199.

18. Kim HS, Kim LH, Wei TS. Three Cases of Radial Nerve Palsy with Bee Venom Therapy. J of Parmacopuncture. 2004;7(2):75–81.
crossref
19. Choi JH, Kim SY, Lee DW, Kim KS. A Case Report on Foot Drop Caused by Common Peroneal Nerve Palsy. J of Oriental Neuropsychiatry. 2004;15(1):149–53.

20. Kim MS, Kim HJ, Park YJ, Kim EH, Lee EY. The clinical research of the efficacy of bee venom aqua-acupuncture on peripheral facial paralysis. The J of Korean Acupuncture & Moxibustion Society. 2004;21(4):251–62.



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