This study is to report the usefulness of ultrasound in diagnosing rib fracture and the effectiveness of ultrasound-guided essential bee venom pharmacopuncture as a treatment of it. A 46-year-old unable to find a fracture by chest radiography was diagnosed it on ultrasound. The patient was applied integrative Korean medical treatments and ultrasound-guided essential bee venom pharmacopuncture at the fracture site for 4 weeks, 18 times total. Numeral rating scale (NRS) was used to evaluate the amount of pain. The chest pain when turning over the body was reduced from NRS 8 to 2 for 4 weeks. The remarkable aspect is that the pain was immediately relieved after phamacopuncture and its effect lasted for 3 hours. This report suggests ultrasound can be useful for diagnosing rib fracture and also helpful for safety and accuracy of pharmacopuncture. Additionally, essential bee venom can be considered one of the methods of treating rib fracture. (J Korean Med Rehabil 2019;29(3):157-163) Key words Rib fractures, Ultrasonography, Essential bee venom, Pharmacopuncture 서론»»» 늑골 골절은 전체 흉부 손상에서 35-40%를 차지하는 흔한 질환으로 대부분 직접적인 흉부 외상 때문에 발생 한다 1,2) . 드물게 외상력이 없어도 골프, 보디빌딩, 무거 운 물건 들기, 만성 기침으로도 발생할 수 있으며, 이는 늑간근의 격렬한 수축에 의한 것으로 보인다 3) . 늑골 골절은 임상적으로 심호흡, 기침, 돌아눕기 등 몸통을 움직일 때 흉통이 나타나고 골절 부위를 압진하 면 심한 통증을 호소한다 4) . 단 한 개의 늑골 골절만으 로도 심한 통증과 호흡 장애를 유발하며 결과적으로 폐 렴이나 무기폐 등의 합병증을 일으킬 수 있다. 특히 노 인 환자에서는 적절한 치료가 이뤄지지 않을 경우 치명 적인 결과를 가져올 수도 있다 5,6) . 늑골 골절 및 합병증의 진단은 흉부방사선촬영검사 가 가장 효과적인 초기 검사법으로 알려져 있지만 환자 상태나 골절 부위에 따라서 50-80%에서 골절을 발견하 지 못했다는 보고가 있다 7-9) . 보다 정확한 진단을 위해 안태석⋅문지현⋅박창영⋅오명진⋅최유민

Objectives:This experiment was conducted to examine the toxicity of Water soluble Carthmi-Flos herbal acupuncture (WCF) by administering a single intramuscular dose of WCF in 6-week-old, male and female Sprague-Dawley rats and to find the lethality dose for WCF.Methods:The experiment was conducted at Biotoxtech according to Good Laboratory Practices under a request by the Korean Pharmacopuncture Institute. This experiment was performed based on the testing standards of “Toxicity Test Standards for Drugs” by the Ministry of Food and Drug Safety. Subjects were divided into 4 groups: 1 control group in which normal saline was administered and 3 test groups in which 0.1, 0.5 or 1.0 mL of WCF was administered; a single intramuscular dose was injected into 5 males and 5 females in each group. General symptoms and body weights were observed/measured for 14 days after injection. At the end of the observation period, hematological and clinical chemistry tests were performed, followed by necropsy and histopathological examinations of the injected sections.Results:No mortalities were observed in any group. Also, symptoms, body weight, hematology, clinical chemistry and necropsy were not affected. However, histopathological examination of the injected part in one female in the 1.0-mL group showed infiltration of mononuclear cells and a multi-nucleated giant cell around eosinophilic material.Conclusion:Administration of single intramuscular doses of WCF in 3 groups of rats showed that the approximate lethal dose of WCF for all rats was in excess of 1.0 mL, as no mortalities were observed for injections up to and including 1.0 mL.

Objectives:The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease.Methods:This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were ‘pain on cervical spine’, ‘cervical pain’, ‘ruptured cervical disk’, ‘cervical disc disorder’, ‘stiffness of the neck’, ‘cervical disk’, ‘whiplash injury’, ‘cervicalgia’, ‘posterior cervical pain’, ‘neck disability’, ‘Herniated Nucleus Pulposus (HNP)’, and ‘Herniated Intervertebral Disc (HIVD)’.Results:Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy.Conclusion:The significant conclusions are as follows: (1) Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2) Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3) In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4) For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient’s condition.

Objectives:This study was performed to analyze the toxicity and to find the lethal dose of the test substance Water-soluble Carthami-flos pharmacopuncture (WCF) when used as a single intravenous-dose in 6-week-old, male and female Sprague-Dawley rats.Methods:The experiment was conducted at Biotoxtech according to Good Laboratory Practices. 20 female and 20 male Spague-Dawley rats were divided into 4 groups of 5 female and 5 male animals per group. The rats in the three experimental groups received single intravenous injections with 0.125-mL, 0.25-mL and 0.5-mL/animal doses of WCF, Groups 2, 3, and 4, respectively, and the control group, Group 1, received a single intravenous injection with a 0.5-mL dose of normal saline. Clinical signs were observed and body weight measurements were carried out for 14 days following the injections. At the end of the observation period, hematology, clinical chemistry, histopathological tests and necropsy were performed on the injected parts.Results:No deaths occurred in any of the groups. Also, no significant changes in body weight, hematological parameters or clinical chemistry test results between the control group and the experimental groups were observed. Visual inspection after necropsy showed no abnormalities. Histopathological tests on the injected parts showed no significant differences, except for Group 1 females; however, the result was spontaneous generation and had no toxicological meaning because it was not dose-dependent. Therefore, this study showed that WCF had no effect on the injected parts in terms of clinical signs, body weight, hematology, clinical chemistry, and necropsy.Conclusion:As a result of single intravenous-dose tests of the test substance WCF in 4 groups of rats, the lethal dose for both males and females exceeded 0.5 mL/animal. Therefore, WCF is a relatively safe pharmacopuncture that can be used for treatment, but further studies should be performed.