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BMC Complementary Medicine and Therapies
Published in: BMC Complementary Medicine and Therapies 1/2015

Open Access 01-12-2015 | Research article

A survey among Korea Medicine doctors (KMDs) in Korea on patterns of integrative Korean Medicine practice for lumbar intervertebral disc displacement: Preliminary research for clinical practice guidelines

Authors: Ye-sle Shin, Joon-Shik Shin, Jinho Lee, Yoon Jae Lee, Me-riong Kim, Yong-jun Ahn, Ki Byung Park, Byung-Cheul Shin, Myeong Soo Lee, Joo-Hee Kim, Jae-Heung Cho, In-Hyuk Ha

Published in: BMC Complementary Medicine and Therapies | Issue 1/2015

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Abstract

Background

Patients seek Korean Medicine (KM) treatment for a broad range of complaints in Korea, but predominantly for musculoskeletal disorders. We investigated lumbar Intervertebral Disc Displacement (IDD) practice patterns of Korean Medicine doctors (KMDs) within a hospital/clinic network specializing in KM treatment of spinal disorders through survey of diagnosis and treatment methods.

Methods

Questionnaires on clinical practice patterns of KM treatment for lumbar IDD were distributed to 149 KMDs on January 25th, 2015. The questionnaire included items on sociodemographic characteristics, clinical practice patterns, and preferred method of lumbar IDD diagnosis and treatment. KMDs were asked to grade each treatment method for absolute and relative importance in treatment and prognosis, and safety.

Results

A total 79.19 % KMDs (n = 118/149) completed the survey, and results showed that integrative care mainly consisting of acupuncture, herbal medicine, Chuna manipulation, and pharmacopuncture was administered to IDD patients. The participant KMDs largely relied on radiological findings (MRI and X-ray) for diagnosis. ‘Eight principle pattern identification’, ‘Qi and Blood syndrome differentiation’ and ‘Meridian system syndrome differentiation’ theories were generally used for KM syndrome differentiation. The most frequently prescribed herbal medication was Chungpa-jun, and most commonly used Chuna technique was ‘sidelying lumbar extension displacement treatment’. IDD patients received 1.9 ± 0.3 treatment sessions/week, and KMDs estimated that an average 9.6 ± 3.5 weeks were needed for 80 % pain relief.

Conclusions

This is the first study to investigate expert opinion on KM treatment of IDD. Further randomized controlled trials and clinical guidelines based on clinical practice patterns of KM are called for.
Appendix
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Literature
1.
Manchikanti L. Epidemiology of low back pain. Pain Physician. 2000;3(2):167–92.PubMed
2.
Hoy D, March L, Brooks P, Blyth F, Woolf A, Bain C, et al. The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Ann Rheum Dis. 2014;73(6):968–74.CrossRefPubMed
3.
Kim JD, Son MS. National Health Insurance Statistical Yearbook. Seoul: Health Insurance Review and Assessment Service and National Health Insurance Service; 2014.
4.
Cho J, Kim N, Do S, Lee Y, Yoon G, Park J et al. 2011 National Survey on the use of Korean Medicine and Korean Herbal Medicine. Ministry of Health and Welfare, Korea Institute for Health and Social Affairs 2012, 11-1352000-000547-12:1–554.
5.
Shin B, Kong J, Park T, Yang C, Kang K, Choi S. Bee venom acupuncture for chronic low back pain: A randomised, sham-controlled, triple-blind clinical trial. Eur J Integr Med. 2012;4(3):e271–80.CrossRef
6.
Cho YJ, Song YK, Cha YY, Shin BC, Shin IH, Park HJ, et al. Acupuncture for chronic low back pain: a multicenter, randomized, patient-assessor blind, sham-controlled clinical trial. Spine (Phila Pa 1976). 2013;38(7):549–57.CrossRef
7.
Kim JI, Kim TH, Lee MS, Kang JW, Kim KH, Choi JY et al. Evaluation of wet-cupping therapy for persistent non-specific low back pain: a randomised, waiting-list controlled, open-label, parallel-group pilot trial. Trials 2011;12:146-6215-12-146.
8.
Institute of Medicine (US) Committee to Advise the Public Health Service on Clinical Practice Guidelines. Clinical Practice Guidelines: Directions for a New Program. Washington (DC): National Academies Press (US); 1990.
9.
Stevens L, Duarte H, Park J. Promising implications for integrative medicine for back pain: a profile of a Korean hospital. J Altern Complement Med. 2007;13(5):481–4.CrossRefPubMed
10.
Robinson N, Liu J. Oriental and traditional medicine - supporting the vision for integrated health. European Journal of Integrative Medicine. 2012;4(4):e363–5.CrossRef
11.
Shin JS, Lee JH, Kim MR, Shin BC, Lee MS, Ha IH. The long-term course of patients undergoing alternative and integrative therapy for lumbar disc herniation: 3-year results of a prospective observational study. BMJ Open. 2014;4(9), e005801.CrossRefPubMedCentral
12.
Lebude B, Wang D, Harrop JS, Maltenfort M, Anderson DG, Vaccaro AR, et al. Clinical survey: patterns of utilization of lumbar epidural steroid injections by a cohort of spinal surgeons. PM R. 2009;1(4):329–34.CrossRefPubMed
13.
Sepucha KR, Feibelmann S, Abdu WA, Clay CF, Cosenza C, Kearing S, et al. Psychometric evaluation of a decision quality instrument for treatment of lumbar herniated disc. Spine (Phila Pa 1976). 2012;37(18):1609–16.CrossRef
14.
Arts MP, Peul WC, Koes BW, Thomeer RT, Leiden-The Hague Spine Intervention Prognostic Study (SIPS) Group. Management of sciatica due to lumbar disc herniation in the Netherlands: a survey among spine surgeons. J Neurosurg Spine. 2008;9(1):32–9.CrossRefPubMed
15.
Willems P, de Bie R, Oner C, Castelein R, de Kleuver M. Clinical decision making in spinal fusion for chronic low back pain. Results of a nationwide survey among spine surgeons. BMJ Open 2011;1(2):e000391-2011-000391. Print 2011.
16.
Bishop FL, Zaman S, Lewith GT. Acupuncture for low back pain: a survey of clinical practice in the UK. Complement Ther Med. 2011;19(3):144–8.CrossRefPubMed
17.
Phaner V, Fayolle-Minon I, Lequang B, Valayer-Chaleat E, Calmels P. Are there indications (other than scoliosis) for rigid orthopaedic brace treatment in chronic, mechanical low back pain? Ann Phys Rehabil Med. 2009;52(5):382–93.CrossRefPubMed
18.
van Trijffel E, Oostendorp RA, Lindeboom R, Bossuyt PM, Lucas C. Perceptions and use of passive intervertebral motion assessment of the spine: a survey among physiotherapists specializing in manual therapy. Man Ther. 2009;14(3):243–51.CrossRefPubMed
19.
Sepucha KR, Levin CA, Uzogara EE, Barry MJ, O'Connor AM, Mulley AG. Developing instruments to measure the quality of decisions: early results for a set of symptom-driven decisions. Patient Educ Couns. 2008;73(3):504–10.CrossRefPubMed
20.
Molsberger AF, Zhou J, Arndt D, Teske W. Chinese acupuncture for chronic low back pain: an international expert survey. J Altern Complement Med. 2008;14(9):1089–95.CrossRefPubMed
21.
Liddle SD, David Baxter G, Gracey JH. Physiotherapists' use of advice and exercise for the management of chronic low back pain: a national survey. Man Ther. 2009;14(2):189–96.CrossRefPubMed
22.
Luijsterburg PA, Verhagen AP, Braak S, Oemraw A, Avezaat CJ, Koes BW. Neurosurgeons' management of lumbosacral radicular syndrome evaluated against a clinical guideline. Eur Spine J. 2004;13(8):719–23.CrossRefPubMedPubMedCentral
23.
Jackson A, Hettinga DM, Mead J, Mercer C. Using consensus methods in developing clinical guidelines for exercise in managing persistent low back pain. Physiotherapy. 2009;95(4):302–11.CrossRefPubMed
24.
Kreiner DS, Hwang SW, Easa JE, Resnick DK, Baisden JL, Bess S, et al. North American Spine Society: An evidence-based clinical guideline for the diagnosis and treatment of lumbar disc herniation with radiculopathy. Spine J. 2014;14(1):180–91.CrossRefPubMed
25.
Webster BS, Courtney TK, Huang YH, Matz S, Christiani DC. Physicians' initial management of acute low back pain versus evidence-based guidelines. Influence of sciatica. J Gen Intern Med. 2005;20(12):1132–5.CrossRefPubMedPubMedCentral
26.
Wilson JR, Barry S, Fischer DJ, Skelly AC, Arnold PM, Riew KD, et al. Frequency, timing, and predictors of neurological dysfunction in the nonmyelopathic patient with cervical spinal cord compression, canal stenosis, and/or ossification of the posterior longitudinal ligament. Spine (Phila Pa 1976). 2013;38(22 Suppl 1):S37–54.CrossRef
27.
Irwin ZN, Hilibrand A, Gustavel M, McLain R, Shaffer W, Myers M, et al. Variation in surgical decision making for degenerative spinal disorders. Part I: lumbar spine. Spine (Phila Pa 1976). 2005;30(19):2208–13.CrossRef
28.
Irwin ZN, Hilibrand A, Gustavel M, McLain R, Shaffer W, Myers M, et al. Variation in surgical decision making for degenerative spinal disorders. Part II: cervical spine. Spine (Phila Pa 1976). 2005;30(19):2214–9.CrossRef
29.
Lorio MP, Polly Jr DW, Ninkovic I, Ledonio CG, Hallas K, Andersson G. Utilization of minimally invasive surgical approach for sacroiliac joint fusion in surgeon population of ISASS and SMISS membership. Open Orthop J. 2014;8:1–6.CrossRefPubMedPubMedCentral
30.
Evidence-based Korean Medicine Clinical Practice Guideline Development Committee for Lumbar Herniated Intervertebral Disc (Korea Institute of Oriental Medicine and the Society of Korean Medicine Rehabilitation). Korean Medicine Clinical Practice Guideline for Lumbar Herniated Intervertebral Disc in Adults. Daejeon: Korea Institute of Oriental Medicine; 2014.
31.
The Society of Korean Rehabilitation. Oriental Rehabiliation Medicine. 3rd ed. Seoul: Koonja Publisher; 2011.
32.
Korean Society of Chuna Manual Medicine for Spine & Nerves. Chuna Medicine. Seoul: Korean Society of Chuna Manual Medicine for Spine & Nerves; 2014.
33.
Chou R, Qaseem A, Snow V, Casey D, Cross Jr JT, Shekelle P, et al. Diagnosis and treatment of low back pain: a joint clinical practice guideline from the American College of Physicians and the American Pain Society. Ann Intern Med. 2007;147(7):478–91.CrossRefPubMed
34.
National Collaborating Centre for Primary Care (UK). Medicines Adherence: involving patients in decisions about prescribed medicines and supporting adherence. London: Royal College of General Practitioners (UK); 2009.
35.
Chen R, Chen M, Su T, Zhou M, Sun J, Xiong J, et al. A 3-Arm, randomized, controlled trial of heat-sensitive moxibustion therapy to determine superior effect among patients with lumbar disc herniation. Evid Based Complement Alternat Med. 2014;2014:154941.PubMedPubMedCentral
36.
Saal JA, Saal JS. Nonoperative treatment of herniated lumbar intervertebral disc with radiculopathy. An outcome study. Spine (Phila Pa 1976). 1989;14(4):431–7.CrossRef
37.
Chung HJ, Lee HS, Shin JS, Lee SH, Park BM, Youn YS, et al. Modulation of acute and chronic inflammatory processes by a traditional medicine preparation GCSB-5 both in vitro and in vivo animal models. J Ethnopharmacol. 2010;130(3):450–9.CrossRefPubMed
38.
Kim TH, Yoon SJ, Lee WC, Kim JK, Shin J, Lee S, et al. Protective effect of GCSB-5, an herbal preparation, against peripheral nerve injury in rats. J Ethnopharmacol. 2011;136(2):297–304.CrossRefPubMed
39.
Kim JK, Park SW, Kang JW, Kim YJ, Lee SY, Shin J, et al. Effect of GCSB-5, a herbal formulation, on monosodium iodoacetate-induced osteoarthritis in rats. Evid Based Complement Alternat Med. 2012;2012:730907.PubMedPubMedCentral
40.
Park JJ, Shin J, Choi Y, Youn Y, Lee S, Kwon SR, et al. Integrative package for low back pain with leg pain in Korea: a prospective cohort study. Complement Ther Med. 2010;18(2):78–86.CrossRefPubMed
41.
Park YG, Ha CW, Han CD, Bin SI, Kim HC, Jung YB, et al. A prospective, randomized, double-blind, multicenter comparative study on the safety and efficacy of Celecoxib and GCSB-5, dried extracts of six herbs, for the treatment of osteoarthritis of knee joint. J Ethnopharmacol. 2013;149(3):816–24.CrossRefPubMed
42.
43.
Vroomen PC, de Krom MC, Wilmink JT, Kester AD, Knottnerus JA. Lack of effectiveness of bed rest for sciatica. N Engl J Med. 1999;340(6):418–23.CrossRefPubMed
44.
Bishop PB, Wing PC. Knowledge transfer in family physicians managing patients with acute low back pain: a prospective randomized control trial. Spine J. 2006;6(3):282–8.CrossRefPubMed
45.
Gonzalez-Urzelai V, Palacio-Elua L, Lopez-de-Munain J. Routine primary care management of acute low back pain: adherence to clinical guidelines. Eur Spine J. 2003;12(6):589–94.CrossRefPubMedPubMedCentral
46.
Hermoni D, Borkan JM, Pasternak S, Lahad A, Van-Ralte R, Biderman A, et al. Doctor-patient concordance and patient initiative during episodes of low back pain. Br J Gen Pract. 2000;50(459):809–10.PubMedPubMedCentral
47.
Ivanova JI, Birnbaum HG, Schiller M, Kantor E, Johnstone BM, Swindle RW. Real-world practice patterns, health-care utilization, and costs in patients with low back pain: the long road to guideline-concordant care. Spine J. 2011;11(7):622–32.CrossRefPubMed
48.
Williams CM, Maher CG, Hancock MJ, McAuley JH, McLachlan AJ, Britt H, et al. Low back pain and best practice care: A survey of general practice physicians. Arch Intern Med. 2010;170(3):271–7.CrossRefPubMed
Metadata
Title
A survey among Korea Medicine doctors (KMDs) in Korea on patterns of integrative Korean Medicine practice for lumbar intervertebral disc displacement: Preliminary research for clinical practice guidelines
Authors
Ye-sle Shin
Joon-Shik Shin
Jinho Lee
Yoon Jae Lee
Me-riong Kim
Yong-jun Ahn
Ki Byung Park
Byung-Cheul Shin
Myeong Soo Lee
Joo-Hee Kim
Jae-Heung Cho
In-Hyuk Ha
Publication date
01-12-2015
Publisher
BioMed Central
Published in
BMC Complementary Medicine and Therapies / Issue 1/2015
Electronic ISSN: 2662-7671
DOI
https://doi.org/10.1186/s12906-015-0956-1

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