Lee Jinho, Shin Joon-Shik, Lee Yoon Jae, Kim Me-Riong, Choi Areum, Lee Jun-Hwan, Shin Kyung-Min, Shin Byung-Cheul, Cho Jae-Heung, Ha In-Hyuk
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
Clinical Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea.
PLoS One. 2017 Jan 27;12(1):e0170972. doi: 10.1371/journal.pone.0170972. eCollection 2017.
With increase of spine surgeries, failed back surgery syndrome (FBSS) prevalence is also rising. While complementary and alternative medicine (CAM) is commonly used for low back pain (LBP), there are no studies reporting use of integrative Korean medicine in FBSS patients.
Patients with pain continuing after back surgery or recurring within 1 year and visual analogue scale (VAS) of LBP or leg pain of ≥6 (total n = 120) were recruited at 2 hospital sites from November 2011 to September 2014. Weekly sessions of integrative Korean medicine treatment were conducted for 16 weeks (herbal medicine, acupuncture/electroacupuncture, pharmacopuncture/bee venom pharmacopuncture, and Chuna manual therapy) with additional follow-ups at 24 weeks and 1 year. Outcome measures included VAS of LBP and leg pain (primary outcome), Oswestry Disability Index (ODI), Short-Form 36 (SF-36), medical use, and patient global impression of change (PGIC).
VAS of LBP and leg pain improved at 6 months (LBP from 6.1±2.0 at baseline to 2.9±2.3; and leg pain from 5.4±2.6 to 2.4±2.5, respectively). Eighty patients (66.7%) showed improvement of 50% or more in main pain of LBP or leg pain from baseline. Disability and quality of life also improved at 6 months (ODI from 41.3±12.3 at baseline to 23.6±13.6; and SF-36 from 42.8±14.5 to 62.7±16.8). At 1 year follow-up, conventional medical management use decreased, improvement in pain and disability was maintained, and 79.2% reported improvement of PGIC.
Despite limitations as an observational study, integrative Korean medicine treatment showed positive results in pain, function, and quality of life of FBSS patients.
随着脊柱手术数量的增加，失败的脊柱手术综合征（FBSS）的患病率也在上升。虽然补充和替代医学（CAM）常用于治疗腰痛（LBP），但尚无研究报道在FBSS患者中使用综合韩国医学的情况。
2011年11月至2014年9月期间，在2个医院招募了脊柱手术后疼痛持续或在1年内复发且腰痛或腿痛的视觉模拟量表（VAS）≥6分的患者（共120例）。进行为期16周的综合韩国医学治疗，每周一次（包括草药、针灸/电针、药针/蜂毒药针和推拿整复疗法），并在24周和1年时进行额外随访。结局指标包括腰痛和腿痛的VAS（主要结局）、Oswestry功能障碍指数（ODI）、简明健康调查问卷（SF-36）、医疗使用情况以及患者对变化的总体印象（PGIC）。
腰痛和腿痛的VAS在6个月时有所改善（腰痛从基线时的6.1±2.0降至2.9±2.3；腿痛从5.4±2.6降至2.4±2.5）。80例患者（66.7%）的腰痛或腿痛主要疼痛较基线改善了50%或更多。残疾和生活质量在6个月时也有所改善（ODI从基线时的41.3±12.3降至23.6±13.6；SF-36从42.8±14.5升至62.7±16.8）。在1年随访时，常规医疗管理的使用减少，疼痛和残疾的改善得以维持，79.2%的患者报告PGIC有所改善。
尽管作为一项观察性研究存在局限性，但综合韩国医学治疗在FBSS患者的疼痛、功能和生活质量方面显示出积极结果。
