퇴행성 슬관절염 환자에서 근육 내 봉독약침과 피내 봉독약침의 효능 비교연구

Comparative Study of Effects of 'Intramuscular Bee Venom Herbal Acupuncture' and 'Intracutaneous Bee Venom Herbal Acupuncture' in Knee Osteoarthritis Patients

Objectives : This study was designed to compare the effects on Korean Western Ontario and McMaster Universities Osteoarthritis Index(KWOMAC), 36-ltems Short-Form Health Survey(SF-36), Visual Analog Scale(VAS) and Nine Point Scale between 'Intramuscular Bee Venom Herbal Acupuncture' and 'Intracutaneous Bee Venom Herbal Acupuncture' in knee osteoarthritis patients for 4weeks. Methods : All the voluntary subject were diagnosed as knee osteoarthritis. Patients were randomly assigned either to two groups : Intramuscular bee venom herbal acupuncture treatment group(IM-BV group) or Intracutaneous bee venom herbal acupuncture treatment group(IC-BV group). The IM-BV group received bee venom herbal acupuncture intramuscularly on muscles closest to the pathologic site on ultrasonography. The IC-BV group received bee venom herbal acupuncture intracutaneously on $LE_{110}$, $LE_{201}$, $ST_{35}$, $ST_{36}$ and $LR_8$. Bee venom herbal acupuncture was applied twice a week for 4 weeks by an oriental medical doctor at Kyung-hee Oriental Medical Hospital. Both groups were checked of pathologic site by ultrasonography before treatment and follow up after four-week treatment. The patients were assessed by KWOMAC and SF-36 before and after four-week treatment. The changes in patients' pain was measured by VAS before treatment and after one-, two-, three- and four-week treatment. The patients' overall treatment outcome assesment was measured by Nine Point Scale after four-week treatment. Results : The results were as follows ; 1. The IM-BV group showed significant improvement on total, pain, stiffness and physical function in KWOMAC, and the IC-BV group showed significant improvement on total and physical function in KWOMAC after 4weeks compared to the pre-treatment. In KWOMAC, the IM-BV group showed more improvement on average compared to the IC-BV group, but there were no significant difference between two groups. 2. The IM-BV group showed significant improvement on VAS after one-week treatment. The IC-BV group showed significant improvement on VAS after two-week treatment. But there were no significant difference between two groups. 3. The IM-BV group showed significant improvement on physical functioning(PF) and bodily pain(BP) in SF-36, and the IC-BV group showed significant improvement on vitality(VT) and bodily pain(BP) in SF-36 after 4weeks compared to the pre-treatment. But there were no significant difference between two groups. 4. 88.2% of IM-BV group and 93.3% of IC-BV group graded their improvement as 'Fair' or better on Nine Point Scale. But there were no significant difference between two groups. Conclusions : This study suggests that in the treatment of knee osteoarthtitis patients, effects of 'Intramuscular Bee Venom Herbal Acupuncture' were not different from 'Intracutaneous Bee Venom Herbal Acupuncture' statistically. But both treatment showed effects on pain and physical function in knee osteoarthtitis patients.