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J Acupunct Res > Volume 32(2); 2015 > Article
Kim, Lee, Shin, Choi, Koo, Yoo, and Lee: The Effect of Korean Medical Combination Treatment on 72 Cases of Herniated Intervertebral Lumbar Disc Patients: An Observational Study
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Abstract

Objectives:

This study was designed to assess the general distribution and clinical effectiveness of Korean medical treatment on lumbar disc herniation.

Methods:

This is an observational study. 72 patients admitted to Daejeon Jaseng Hospital of Korean Medicine with a diagnosis of herniated intervertebral disc(HIVD) by lumbar-CT of lumbar-MRI were observed from July, 2014 to April, 2015. They were analyzed according to sex, age, the period of disease, causal factors, symptoms on admission, admission day, disc herniation type and treatment efficacy. All patients received a combination of treatments during hospitalization, including acupuncture, Chuna, herbal medicines and physical therapy. A zero to ten numerating rating scale(NRS) assessing pain, Oswestry disability index(ODI) and EuroQol-5 dimension(EQ-5D) was used before and after treatments.

Results:

Average admission duration was 28.00±12.85 days in lumbar disc patients. For lumbar patients, lower back pain NRS decreased from 5.89±2.00 to 3.42± 1.87(p<0.001) and radiating pain from 5.96±2.12 to 3.38±1.83(p<0.001). ODI decreased from 46.69±19.25 to 35.69±16.67 (p<0.001), and EQ-5D index increased from 0.63±0.26 to 0.71±0.20(p<0.05) after treatment in lumbar disc patients.

Conclusions:

Korean medical combination treatment might be effective in reducing pain and improving quality of life for patients with lumbar disc herniation. This study further confirmed the efficacy of Korean medical treatment on HIVD.

Fig. 1.
Flow Diagram of Included Patients
acupunct-32-2-23f1.gif
Table 1.
Distribution of Sex and Age
N %
Sex Male 32 44.4
Female 40 55.6
Age 20~29 15 20.8
30~39 19 26.4
40~49 8 11.1
50~59 17 23.6
60~69 10 13.9
70~ 3 4.2
Total 72 100
Table 2.
Distribution of Causes
N %
Reason unknown 36 50
Lumbar strain 12 16.7
Same motion in long period 3 4.2
Overwork 9 12.5
Traffic accident 4 5.6
Slip down 7 9.7
Cough 1 1.4
Total 72 100
Table 3.
Distribution of Period of Illness
N %
Hyperacute stage 21 29.2
Acute stage 15 20.8
Subacute stage 14 19.4
Chronic stage 22 30.6
Total 72 100
Table 4.
Distribution of Admission Days
N %
0~5 1 1.4
6~10 3 4.2
11~15 11 15.3
16~20 9 12.5
21~25 8 11.1
26~30 11 15.3
31~35 9 12.5
36~40 5 6.9
41~45 7 9.7
46~50 6 8.3
51~ 2 2.8
Total 72 100
Table 5.
Distribution of Numbers, Grade and Position of Herniation
N %
Numbers 1 16 22.2
2 23 31.9
3 25 34.7
4 6 8.3
5 2 2.8
Grade Bulging 9 12.5
Protrusion 35 48.6
Extrusion 28 38.9
Position L1 / 2 0 0
L2 / 3 1 1.4
L3 / 4 2 2.8
L4 / 5 45 62.5
L5 / S1 24 33.3
Total 72 100
Table 6.
Distribution of Pain Area
N %
Just lumbar pain 3 4.2
Lumbar and pelvis pain 5 6.9
From lumbar to thigh pain 0 0
Lumbar and whole leg pain 64 88.9
Total 72 100
Table 7.
Lumbar Pain NRS Difference before and after Treatment
N NRS p-value
Before After
Sex Male 32 5.53±2.21 2.81±1.47 p<0.001***
Female 40 6.18±1.78 3.90±2.02
Age <40 34 5.56±2.06 2.85±1.28
≥40 38 6.18±1.92 3.92±2.16
Period of disease Hyperacute stage 21 6.71±2.22 3.43±2.04
Acute stage 15 5.07±1.67 3.20±1.47
Subacute stage 14 6.00±1.52 3.64±1.78
Chronic stage 22 5.59±2.06 3.41±2.09
Total 72 5.89±2.00 3.42±1.87

Average NRS values are means ± standard deviation. p-value by paired t-test in before and after NRS.

*** p<0.001.

Table 8.
Radiating Pain NRS Difference before and after Treatment
N NRS p-value
Before After
Pain area Pelvis pain 5 6.60±2.19 2.80±1.30 0.012*
Thigh pain 0 0 0
Whole leg pain 64 5.91±2.13 3.42±1.87 p<0.001***
Sex Male 29 5.90±2.34 2.76±1.43
Female 40 6.00±1.99 3.83±1.97
Age <40 32 5.72±2.37 2.84±1.42
≥40 37 6.16±1.89 3.84±2.03
Period of disease Hyperacute stage 20 7.10±2.00 3.55±1.76
Acute stage 15 5.47±1.88 3.33±1.54
Subacute stage 14 6.14±1.23 3.43±1.74
Chronic stage 20 5.05±2.46 3.20±2.24
Total 69 5.96±2.12 3.38±1.83

Average NRS values are means ± standard deviation. p-value by paired t-test in before and after NRS.

* p<0.05.

*** p<0.001.

Table 9.
ODI Difference before and after Treatment
N ODI p-value
Before After
Sex Male 32 44.01±21.51 30.17±13.68 0.001**
Female 40 48.83±17.22 40.12±17.66 p<0.001***
Age <40 34 42.20±20.53 29.89±14.18
≥40 38 50.70±17.33 40.89±17.18
Period of disease Hyperacute stage 21 60.35±21.47 38.48±21.97
Acute stage 15 42.25±16.36 35.63±13.66 0.010**
Subacute stage 14 44.56±12.97 34.83±13.10 p<0.001***
Chronic stage 22 38.03±15.78 33.64±15.37 0.004**
Total 72 46.69±19.25 35.69±16.67 p<0.001***

ODI values are means ± standard deviation. p-value by paired t-test in before and after ODI.

** p<0.01.

*** p<0.001.

Table 10.
EQ-5D Index Difference before and after Treatment
N EQ-5D index p-value
Before After
Sex Male 32 0.64±0.29 0.75±0.17 0.025*
Female 40 0.63±0.22 0.67±0.21 0.029*
Age <40 34 0.67±0.26 0.75±0.16 0.041*
≥40 38 0.60±0.25 0.67±0.22 0.029*
Period of disease Hyperacute stage 21 0.42±0.33 0.63±0.27 0.013*
Acute stage 15 0.74±0.10 0.77±0.06 0.140
Subacute stage 14 0.67±0.25 0.70±0.25 0.067
Chronic stage 22 0.73±0.09 0.74±0.10 0.029*
Total 72 0.63±0.26 0.71±0.20 0.003**

EQ-5D index values are means ± standard deviation. p-value by paired t-test in before and after EQ-5D index.

* p<0.05.

** p<0.01.

VI.
VI.

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