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 :kscndl@hanmail.net

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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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

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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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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

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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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Fig. 1. Measuring depth of acupoint by ultrasono and gauging the insertion length

Fig. 2. Insertion and exfoliation

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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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