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J Acupunct Res > Volume 32(1); 2015 > Article
Lee and Song: A Case Report on Patient with Trigger Thumb Improved by Complex Korean Medical Treatment※

Abstract

Objectives:

The purpose of this study was to report a case of patient with trigger thumb which improved by Meridian Tendino-musculature Acupuncture therapy, Moxubustion and Bee-Venom pharmacoacupuncture.

Methods:

In this study, we have conducted Meridian Tendi-musculature Acupuncture therapy, Bee-Venom Pharmacopuncture and Moxibustion treatment, on the basis of anatomical structure on the patient who was diagnosed of trigger thumb with pain, edema and motional restriction of the thumb. Furthermore, Electroacupuncture had been implemented with acupuncture therapy, and also passive exercise therapy had been conducted before and after the treatment to enhance the effect. The patient was assessed for trigger thumb-related symptoms by Visual Analogue Scale (VAS) score and Quinnell’s Classification of triggering.

Results:

Quinnell’s triggering grade & VAS score had decreased considerably after 18 sessions of treatment.

Conclusions:

It can be deducted that symptoms of Trigger thumb could be improved by Meridian Tendino-musculature Acupuncture therapy, Moxibustion and Bee Venom Pharmacopuncture treatment.

Notes

This research was supported by the Gachon University Research Fund in 2015

Fig. 1.
9)Anatomical location of thumb A1 pulley
The midline of the thumb interphalangeal(IP) crease, the hook of the hamate, and the pisiform.
Two longitudinal mark the possibility of locating of the A 1 pulley.
acupunct-32-1-141f1.gif
Fig. 2.
Acupuncture & bee venom pharmacopuncture treatment points for trigger thumb patient case
acupunct-32-1-141f2.gif
Fig. 3.
The changes of VAS score and triggering grade
acupunct-32-1-141f3.gif
Table 1.
Details of Acupuncture Technique Based on STRICTA1)
1. Acupuncture rationale
1a) Style of acupuncture Traditional Korean medicine
1b) Reasoning for treatment provided Based on historical context and anatomical information

2. Details of needling
2a) Number of needle insertions per subject per session 4–5
2b-1) Names of points used LU, etc 10
2b-2) Uni/bilateral Unilateral(affected side)
2c) Depth of insertion About 0.3~0.5 cm
2d) Response sought De-qi sensation
2e) Needle stimulation Eletroacupuncture
2f) Needle retention time 25~30 minutes
2g) Needle type 0.25 × 30 mm, Dong-bang stainless steel disposable acupuncture needle

3. Treatment regimen
3a) Number of treatment sessions 18 times
3b) Frequency and duration of treatment sessions Twice or 3 times a week

4. Other components of treatment
4a) Details of other interventions administered to the acupuncture group Passive exercise(after acupuncture treatment), bee benom pharmacopuncture, indirect moxibustion
4b) Setting and context of treatment, including instructions to practitioners, and information and explanations to patients None

5. Practitioner background
5) Description of participating acupuncturists Specialist of acupuncture and moxibustion medicine with more than 20 years of experience

6. Control or comparator
Interventions No control intervention
Table 2.
Grade of Triggering of the Digit (Thumb)
Grade Description
0: none Even movement during flexion / extension
1: mild Uneven movement during flexion / extension
2: moderate Actively correctable: Interferes with normal hand function
3: severe Passively correctable
4: locked Fixed in flexion
Table 3.
The Changes of VAS Score, Triggering Grade and Other Symptoms by Acupuncture & Bee Venom Pharmacopuncture
Treatment Month/day VAS score Triggering grade Trigger nodule ‘Click’ sound
1st 10. 23 5 3–4 + +
3rd 10. 27 3 3 + +
5th 11. 03 2~3 2 + +
8th 11. 12 2 2 + +
13th 11. 28 1~2 1 ±
15th 12. 03 0~1 1
18th 12. 12 0 0

References

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