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근골격계 초음파를 이용한 침도침술의 비골신경 마비 증례 보고 87
근골격계 초음파를 이용한 침도침술의 비골신경 마비 증례 보고
Case Study of Oriental Medicine Treatment with Acupotomy
Therapy of the Peroneal Nerve Palsy through Ultrasound
Case Report
Sungha Kim1, Man-young Park1, Sangmi Lee1, Sangkwan Lee2, Jinyoung Lim3, Sungchul Kim1*
1 Dept. of Acupuncture & Moxibustion, Gwang-Ju Oriental Medical, Hospital in WonKwang University
2 Dept. of Internal Medicine, Gwang-Ju Oriental Medical Hospital, WonKwang University
3 Dept. of Oriental Medicine, college of Oriental Medicine, WonKwang University
DOI : 10.3831/KPI.2011.14.1.087
ABSTRACT
Purpose : In order to estimate clinical effects of Oriental Medicine Treatment with acupotomy thera-
py of Peroneal nerve Palsy.
Methods : From 10th June, 2010 to 19th June, 2010, 1 female patient diagnosed as Peroneal nerve
Palsy(clinical diagnosed) was treated with general oriental medicine therapy (acupuncture, pharma-
copuncture, moxibustion, cupping, physical therapy, herbal medication) and acupotomy.
Results : The patient's left foot drop was remarkably improved.
Conclusions : This study demonstrates that oriental medical treatment with acuputomy therapy has
notable effect in improving symptoms of peroneal nerve palsy. as though we had not wide experience
in this treatment, more research is needed.
Corresponding author : Sungchul Kim, Dept. of Acupuncture &Moxibustion, Gwang-Ju Oriental Medical, Hospital inWonKwang University, 543-7, Juwal-dong, Nam-gu, Gwangju, Tel. 062-670-6442 E-mail :[email protected]
This study is supported by Wonkwang university 2010 project.
Key Words:acupotomy therapy,
peroneal nerve palsy,
foot drop, ultrasound
Received : 11. 02. 11
Revised : 11. 02. 23
Accepted : 11. 02. 28
I. 서론
(Foot drop)
(steppage gait)
(peroneal nerve)
L4,5 S1,2
1/3
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Journal of Pharmacopuncture 제14권 제1호(2011년 3월)
Togrol
1990
1
II. 증례
1
(F/16)
2.
2010 6 10 2010 6 18
3
Left foot drop
4
2010 6 9
5
peroneal nerve palsy
6
2007 8
2007 4
7
N/S
8
15
9
10 6 9 C/C developed
MRI of the brain C-spine L-spine
Hip non specific 10.6.10
(Babinski)
(extensor hallucis longus)
Compression test (lateral)
2010 6 10
10
88
087~96 근골격계.ps 2011.3.31 12:3 PM 페이지88 MAC-11
within nor-
mal limit
Chest PA& L-spine& Knee X-ray, MRI of the
brain & C-spine, L-spine & hip; non specific
11
1
4 (0.8) 1 2
4
(Fig.1
Fig.1 measuring depth of acupoint by ultraso-
noscope and gauging the insertion length
1
75%
0.5CC
0.05CC 0.1CC
(Fig. 2)
Fig. 2. insertion and exfoliation
5
2
0.30 40 1
0.5CC
3
8g
6g 6g 4g 4g 4g
4g 4g 4g 4g 4g 3g
1g 2g 2g 2g 2g
2g
4
Micro Wave ICT
6
12
1
Tinel's sign Motor test
Range of motor
50
2 Takakura rating scale
Takakura
10
8-9
6-7
5
13 STRICTA
근골격계 초음파를 이용한 침도침술의 비골신경 마비 증례 보고 89
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Journal of Pharmacopuncture 제14권 제1호(2011년 3월)
Item
1
2
3
4
5
6
Description
1992; 9-42
GB34 0.5
3~4
mm
0.5~ cm
4
0.8 1
2
3
8g 6g 6g 4g 4g 4g
4g 4g 4g 4g 4g 3g 1g
2g 2g 2g 2g 2g
Micro Wave ICT
6
21
TENS
90
STRICTA
Acupuncture rationale
Intervention
Needling details
Treatment regimen
Co-interventions
Practitioner background
Control intervention(s)
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III. 결과
1
Table 1.
Table 1. The changes of physical examination.
2 Takakura rating scale 9
Fig. 3
10.6.10 10.6.14 2
Fig. 3. The changes of rating scale.
IV. 고찰및결론
foot drop L4-5, S1-2
Peroneal nerve
L4,5 S1,2
Peroneous longus m.
4cm
foot drop
steppage gait
2-3
Krackow
3
12
MICHAEL
31
30 97%
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Journal of Pharmacopuncture 제14권 제1호(2011년 3월)
2
1 60% rating scale
Table
1.Figure 3.
5
V. 참고문헌
1. David J. Magee. Orthopedic Physical Therapy
Diagnostics. Seoul. Hyunmoon. 1998 : 805.
2. Society of Korean Orthopedic Surgery.
Orthopedic Surgery 6th : The latest mecicine.
2006 : 435-36
3. Togrol E. Bilateral peroneal nerve palsy
induced by prolonged squatting. Mil Med.
2000 Mar;165(3):240-2
4. Chu MG; Kim SJ; We J; Choi JB. A Clinical
Case Study of Foot Drop Caused by Common
Peroneal Neuropathy. J Oriental Rehab Med
2007;17(3):218, 227
5. Hwang JU, ,Lee JY, Won SH ,Kim DY ,Kim
SH, Park HS. Case Report of Foot Drop Patie-
nt Treated with Electroacupuncture. The jour-
nal of korean acupuncture & moxibustion soci-
ety. 2005 ; 22(05) : 161-66.
6. Lee SH, Choi SY, Lee SK, Gug YJ, Kim DJ.
Clinical Study on 1 Case of Patient with the F-
oot Drop Diagnosed as Peripheral Neuropathy.
The journal of korean acupuncture & moxibus-
tion society. 2006 ; 23(1) : 217-23
7. Jang WS. A case of foot drop treated with pla-
centa pharmacopuncture. The journal of phar-
macopuncture. 2009; 12(1): 99-102
8. Jeung HY, Kang SG, Koh HG. Review on The
XiaZhenDao Therapy. The journal of korean
acupuncture & moxibustion society.
2002; 19(1): 244-61
9. Kim SC, Seo GY, Lee SW, Parck SU, Kim JH,
Ahn SH, Hwang SY. Biological Activities of
Scolopendrid Pharmacopuncture. The journal
of pharmacopuncture. 2010; 13(3):5-13
10. Takakura Y, Kumai T, Takaoka T and Tamai S:
Peroneal nerve palsy caused by coalition asso-
ciated with a ganglion. J Bone Joint Surg, 80-B
: 130-33, 1998.
11. Kim Sm. Clinical Diagnostics of neuron.
Seoul: Jungdam. 1999 : 3,41,45
12. Kang SY, Park KH, Moon JL. Clinical and
Electromyography study of peroneal nerve pal-
sy. Korean academy of rehabilitation medicine.
1987;1(2):236-42
13. Meals RA. Peroneal nerve palsy complicating
92
087~96 근골격계.ps 2011.3.31 12:3 PM 페이지92 MAC-11
ankle sprain:Report of two cases and review of
the literature. J Bone Joint Surg.
1966;48:1484-95
14. Krackow KA, Maar DC, Mont MA, Carroll IV.
Surgical decompression for peroneal nerve pal-
sy after total knee arthroplasty. Clin Orthop.
1993;292:223-8
15. Cho SG, Chung BS, Yun HS, Lee JH, Lee SH,
Seo DM, Lee JD. Clinical study on a case of
axonotmesis of common peroneal mononero-
pathy by using 3 times EMG studies. The jour-
nal of pharmacopuncture. 2001; 4: 105-12
16. Michael A. Mont, A. Lee Dellon, Franklin
Chen, Marc W. Hungerford, Kenneth A.
Krackow and David S. Hungerford. The
Operative Treatment of Peroneal Nerve Palsy.
The Journal of bone & joint surgery.
1996; 78:863-9
17. Yang Yu Gul. The translation of Huangdi
Neijing Suwen. Seoul. Yiljong. 1991: 337-341
18. Hong Won Sik. Exquisite Huangdi Neijing
Suwen. Seoul. Institute of Oriental Medicine.
1985:14
19. Zhu Han Zhang. Therapy of Acupotomy.
Beijing: Chinese Medicine publishers.
1992; 9-42
20. W X P ng, Zh ng Ti n M n. Acupotomy of
low back & abdomen pain Beijing: Chinese
Medicine publishers. 2008; 156-62
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Journal of Pharmacopuncture 제14권 제1호(2011년 3월)94
Fig. 1. Measuring depth of acupoint by ultrasono and gauging the insertion length
Fig. 2. Insertion and exfoliation
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근골격계 초음파를 이용한 침도침술의 비골신경 마비 증례 보고 95
Fig. 3. The changes of rating scale.
Tinel's sign
Tibialis anterior muscle atrophy
Range of motion(Dorsi-flextion)
Motor test
Before treatment
-
-
-50
1
After treatment
-
-
20
5
Table 1. The changes of physical examination.
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