Hwang Ji Hye, Jung Hyo Won
Department of Acupuncture & Moxibustion Medicine, College of Korean Medicine, Gachon University, Seongnam.
College of Korean Medicine, Dongguk University, Gyeongju, Republic of Korea.
Medicine (Baltimore). 2018 Nov;97(45):e13123. doi: 10.1097/MD.0000000000013123.
Sprains, stretching or tearing of ligaments are common injuries. Clinicians should try to prevent acupuncture-associated vasovagal responses (AAVR) when treating patients with such injuries. In this study, we report the treatment of frequent sprains of various body parts in a patient with a history of AAVR using only TA (a 7-herb extract consisting of Scutellaria baicalensis, Phellodendron amurense, Pulsatilla koreana, Sophora tonkinensis, Aucklandia lappa, Aquilaria agallocha, and Carthamus tinctorius L.) pharmacopuncture.
The patient was a 47-year-old woman who was injured 23 times in 9 months. The injuries occurred in the knees, thumb, wrist, ankle, and low back region due to overextension during physical activity or frequent exercise. This patient had great fear of acupuncture after fainting due to her experience with a previous fire needling on an ankle sprain 18 years ago. Therefore, she did not want to undergo conventional acupuncture, including needle retention.
With the exception of the bruising and sprain of a knee occurring over 1 week after onset at the initial visit, the injuries were diagnosed as acute sprains of grade 1 with pain without range of movement limitation in various parts of the knee, ankle, thumb, and lower back. Time to onset of these injuries was within 3 days.
The patients received only TA pharmacopuncture at 4 to 6 ouch points (ashi points). The patient returned to work immediately after the conclusion of treatment without any posttreatment such as infrared and hot pack which can help absorbing the extract and calming the injection site.
The treatment was usually completed within 4 sessions, and led to a reduction in pain (visual analog scale [VAS] score of 1). In the absence of mild swelling and warmth or when there was mild pain (VAS score <3) in the affected area, the patient reported reduced pain and smoother joint movement immediately after 1 to 2 sessions.
Although our report is a single case study, our results indicate that TA pharmacopuncture can be effective in treating various acute sprains and is a potential acupuncture method for the treatment of patients with AAVR.
韧带扭伤、拉伸或撕裂是常见的损伤。临床医生在治疗此类损伤患者时应尽量预防针刺相关的血管迷走神经反应（AAVR）。在本研究中，我们报告了一名有AAVR病史的患者，仅使用TA（一种由黄芩、黄柏、白头翁、山豆根、木香、沉香和红花组成的七味草药提取物）药物穴位注射治疗身体各部位频繁扭伤的情况。
该患者为一名47岁女性，在9个月内受伤23次。这些损伤发生在膝盖、拇指、手腕、脚踝和下背部，原因是体育活动或频繁锻炼时过度伸展。由于18年前脚踝扭伤接受火针治疗后昏厥，该患者对针刺非常恐惧。因此，她不想接受包括留针在内的传统针刺治疗。
初诊时，除了初次就诊发病1周后出现的膝盖瘀伤和扭伤外，其他损伤被诊断为1级急性扭伤，膝盖、脚踝、拇指和下背部各部位疼痛但无活动范围受限。这些损伤的发病时间在3天内。
患者仅在4至6个阿是穴接受TA药物穴位注射。治疗结束后，患者立即返回工作岗位，未进行任何有助于吸收提取物和舒缓注射部位的后续治疗，如红外线和热敷。
治疗通常在4个疗程内完成，疼痛减轻（视觉模拟评分[VAS]降低1分）。在受影响区域无轻度肿胀和发热，或仅有轻度疼痛（VAS评分<3）时，患者在1至2个疗程后立即报告疼痛减轻且关节活动更顺畅。
尽管我们的报告是一项单病例研究，但我们的结果表明，TA药物穴位注射可有效治疗各种急性扭伤，是治疗AAVR患者的一种潜在针刺方法。
