Korean medicine treatment including oral administration of Gyejibongnyeong-hwan and acupuncture therapy for calf edema and pain due to deep vein thrombosis of lower leg: A Case Report

Article information

J Korean Med. 2021;42(2):107-119

Publication date (electronic) : 2021 June 01

doi : https://doi.org/10.13048/jkm.21020

Department of Internal Medicine, College of Korean Medicine, Sangji University

Correspondence to: 김미경 (Mikyung Kim), Department of internal medicine, college of Korean medicine, Sangji university 83 Sangjidae-ro, Wonju, Gangwon-do, 26338, Republic of Korea, Tel:+82-33-741-9215, Fax:+82-33-732-2124, E-mail: 01mkkim@gmail.com

Received 2021 April 22; Revised 2021 May 6; Accepted 2021 May 14.

Abstract

Objectives

This study was aimed to report changes in clinical symptoms and signs after treatment with Korean medicine in patients who suffered from calf edema due to deep vein thrombosis (DVT).

Methods

A 46-year-old male patient, who discharged home after receiving standardized treatment for acute DVT in the right leg, suffered pain and heat sense due to edema of the affected calf. Oral administration of herbal medicine (Gyejibongnyeong-hwan 4 g, twice daily) and acupuncture therapy were given to him for 6 weeks. The change in chief complaints, Villalta score, the right and left side difference of the circumference and the skin surface temperature of both calves, and blood level of D-dimer were observed before and after treatment.

Results

The patient’s chief complaints began to significantly improve from 2 weeks after treatment, and disappeared completely within 4 weeks. At the end of the treatment, a substantial decrease in the difference between the right and left calves in the circumference and skin surface temperature was observed. This effect was maintained even at the time of follow-up 3 months after the end of treatment, and the patient completely recovered indoor and outdoor life to the level before onset.

Conclusions

This case suggests that Korean medicine treatment, including Gyejibongnyeong-hwan administration and acupuncture therapy, can be a viable option to improve edema and related clinical problems in the affected limbs due to DVT.

Keywords: acupuncture; deep vein thrombosis; Guizhifuling-wan; Gyejibongnyeong-hwan (桂枝茯笭丸); keishibukuryo-gan

Fig. 1

Change of verbal numeric rating scales for pain and heat sensation

Verbal numeric scale: 0–10 points, 10 = pain or heat sensation at week 0

Week 0 = initiation of Korean medicine treatment

Fig. 2

Change of digital infrared thermal imaging (DITI) of lower extremity

Left: original image, right: left-right symmetry

(A) Taken at week 0 (initiation of Korean medicine treatment)

(B) Taken at week 3

Table 1

The difference in the circumference of both calves and presence of non-pitting edema in right calf

Table 2

Change of Villalta score and D-dimer level

Notes

Conflicts of interest

이 논문은 이해관계 충돌의 여지가 없음.

Acknowledgement

증례 보고를 위한 자료 제공에 동의하고 적극적으로 협조해 주신 환자분께 감사드립니다.

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Article information Continued

Fig. 1

Change of verbal numeric rating scales for pain and heat sensation

Verbal numeric scale: 0–10 points, 10 = pain or heat sensation at week 0

Week 0 = initiation of Korean medicine treatment

Fig. 2

Change of digital infrared thermal imaging (DITI) of lower extremity

Left: original image, right: left-right symmetry

(A) Taken at week 0 (initiation of Korean medicine treatment)

(B) Taken at week 3

Table 1

The difference in the circumference of both calves and presence of non-pitting edema in right calf

Domain/week	0	1	2	3	4	5	6
Circumference 1 (fibular head)	1.5	1.5	1.0	0.5	0.5	0.2	0.2
Circumference 2 (maximal circumference)	1.5	1.7	1.0	0.8	0.5	0.5	0.5
Non-pitting edema, right calf	+	+	+/−	+/−	-	-	-

Circumference (right calf – left calf, cm)

Fibula head: The circumference was measured based on the acupoint GB34.

Maximal circumference: The circumference was measured based on the point where the calf was thickest.

Week 0 = initiation of Korean medicine treatment

Table 2

Change of Villalta score and D-dimer level

Outcome / week	−1	0	1	2	3	4	5	6	15
Villalta score (points)	-	10	11	7	5	3	1	1	-
D-dimer (mg/L)	8.7	-	-	2.4	-	-	-	-	0.4

Week 0 = initiation of the Korean medicine treatment

Villalta score (range: 0–33 points; the higher, the more severe)

D-dimer level (reference range < 0.65 mg/L)