Choi Hee Seung, Lee Yoon Jae, Kim Me-Riong, Cho Jae-Heung, Kim Koh-Woon, Kim Eun-Jung, Ha In-Hyuk
Jaseng Hospital of Korean Medicine, Seoul, Republic of Korea.
Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, Seoul, Republic of Korea.
Evid Based Complement Alternat Med. 2019 Jul 31;2019:2345640. doi: 10.1155/2019/2345640. eCollection 2019.
A survey study was conducted in Korean medicine doctors who provide nonsurgical integrative treatment for cervical disc herniation (CDH) at spine-specialty hospitals to assess usual treatment practices, diagnosis and treatment methods, and related adverse events for CDH. The questionnaire was jointly developed by clinical experts and methodology experts and was administered to 197 Korean medicine doctors (response rate: 84.9% (n = 197/232)) practicing at spine-specialty Korean medicine hospitals for analysis of general sociodemographic information, practice patterns of CDH including diagnosis and treatment strategies, CDH prognosis, and treatment safety. The average clinical experience of respondents was 9.3±6.4 years, and 4.0±1.8 weeks were regarded to be needed for CDH pain to decrease by 50% and 9.1±3.4 weeks to decrease by 80%. Eight-Principle Pattern and Meridian System Identification were the most commonly used Korean medicine syndrome differentiation methods, and CDH was most often considered to be a result of Qi stagnation and Blood coagulation. The Spurling test was reported to be important in physical examination, and magnetic resonance (MR) images were mostly used for diagnosis and treatment of CDH of various diagnostic tools. Treatment mainly consisted of a nonsurgical, integrative multimodal approach comprising acupuncture, pharmacopuncture, herbal medicine, and Chuna manual therapy. Shinbaro pharmacopuncture and Chungpa-jun, which are well-established herbal treatments supported by evidence, were considered to be of high importance in CDH treatment. With regard to safety, acupuncture was considered to be the safest, while bee venom pharmacopuncture was of highest concern due to potential hypersensitivity. This study is the first report to investigate current practice patterns and approach of Korean medicine doctors to CDH treatment. This data may be of significance to Korean medicine doctors in drawing clinical guidelines and conducting randomized controlled trials (RCTs) to generate high-level evidence on the effectiveness of nonsurgical integrative medicine treatments for CDH.
一项调查研究在脊柱专科医院为颈椎间盘突出症（CDH）提供非手术综合治疗的韩医中开展，以评估CDH的常规治疗方法、诊断和治疗手段以及相关不良事件。该问卷由临床专家和方法学专家共同编制，发放给在脊柱专科医院执业的197名韩医（回复率：84.9%（n = 197/232）），用于分析一般社会人口学信息、CDH的治疗模式（包括诊断和治疗策略）、CDH预后以及治疗安全性。受访者的平均临床经验为9.3±6.4年，CDH疼痛减轻50%需要4.0±1.8周，减轻80%需要9.1±3.4周。八纲辨证和经络辨证是最常用的韩医辨证方法，CDH最常被认为是气滞血瘀所致。报告显示斯普林试验在体格检查中很重要，各种诊断工具中磁共振（MR）图像大多用于CDH的诊断和治疗。治疗主要包括非手术综合多模式方法，包括针灸、药针、草药和推拿手法治疗。新波洛药针和证据支持的成熟草药疗法仲巴君，在CDH治疗中被认为非常重要。在安全性方面，针灸被认为是最安全的，而蜂毒药针由于潜在的超敏反应最受关注。本研究是首篇调查韩医对CDH治疗的当前实践模式和方法的报告。这些数据对于韩医制定临床指南和开展随机对照试验（RCT）以产生关于非手术综合医学治疗CDH有效性的高级别证据可能具有重要意义。
