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Evaluating the Effectiveness of Chuna Manual Therapy for low back pain in the Pilot Insuring Project of the National Health Insurance

건강보험 시범사업 기관에 내원한 요통환자에 대한 추나요법 유효성 평가 연구

  • Ryu, Jiseon (Research Institute for Korean Medicine, Pusan National University) ;
  • Kim, Dongsu (KM Policy Research Center, Korea Institute of Oriental Medicine) ;
  • Shin, Byung-Cheul (Department of Korean Rehabilitation Medicine, Pusan National University Korean Medicine Hospital) ;
  • Lim, Byungmook (Research Institute for Korean Medicine, Pusan National University)
  • 류지선 (부산대학교 한의과학연구소) ;
  • 김동수 (한국한의학연구원 정책표준기획팀) ;
  • 신병철 (부산대학교 한방병원 한방재활의학과) ;
  • 임병묵 (부산대학교 한의과학연구소)
  • Received : 2018.12.08
  • Accepted : 2018.12.17
  • Published : 2018.12.31

Abstract

Backgrounds : In 2017, National Health Insurance implemented the pilot insuring project for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the project to monitor the provision of insured CMT. Objectives : This study aimed to evaluate the effectiveness of CMT for low back pain provided in the real world setting. Methods : Patients with low back pain who agreed to participated in the study were enrolled and requested to complete questionnaires. Patients who received CMT regardless of receiving other KM therapies were classified to Chuna group, and patient who received KM therapies without CMT to KM group. Pain(pain-VAS) and back function(KODI, Oswestry disability index-Korean version), quality of life were assessed at baseline, 4 weeks, and 8 weeks. Additionally, patients who received CMT twice and more, and who's pain-VAS 20 and over were included, and patients who used pain injection were excluded in the analysis. Results : Of 371 patients who completed all questionnaire (mean age=42.6years, SD=12.45; 61% female), 96 were excluded, 170 were in Chuna group, and 105 were in KM group. Proportions of patients who had low back pain for more than twelve weeks in the Chuna group and KM group were 57.7% and 24.8%, respectively. Pain and back function were significantly improved on 4weeks and 8weeks in both groups, but there was no difference between two groups. For the patients in the sub-acute and chronic stage(>=12 weeks), change of total KODI scores in the Chuna group was higher than KM group(p=0.013) at 4weeks. Conclusions : CMT with other KM therapies can improve back function in the sub-acute and chronic patients. For insurance policy decision, economic evaluation of CMT is needed.

Keywords

References

  1. Korean Society of Chuna-Manual Medicine for Spine & Nerves. Study on the clinical efficacy of Chuna therapy. 2015
  2. Korea Institute for Health and Social Affairs. 2016 Health Insurance Statistical Yearbook. 2016
  3. Korea Health Industry Development Institute. Report on Usage and Consumption of Korean Medicine. 2014.
  4. Park DS, Pi CH, Lee SJ, Kon SC, Baek DG, Song YS, Kwon YM. Survey of Satisfaction with Oriental Medical Care for Traffic Accident Patients; 35 Case Report. Journal of Oriental Rehabilitation Medicine 2008:18(3):99-118.
  5. Ko YS, Lee JH, Hwang EH, Heo KH, Yun JM, Park TY, Kong JC, Sul JU, Jung TG, Kim KB, Yang HC, Shin BC. A Study to Provide of Health Insurance for Chuna Manual Therapy. The Journal of Korea Chuna Manual Medicine for Spine & Nerves 2012;7(2):1-14
  6. Hwang MS, Cho HW, Lee HY, Heo KH, Hwang EH, Shin MS, Shin BC. Research Trends on Chuna Treatment in Korean Medicine - Focused on Type of Clinical Trails, Published Year, Academic Journals and Treatment Technique for Each Used Parts. The Journal of Korea Chuna Manual Medicine for Spine & Nerves 2013;8(1):49-61
  7. Ministry of Health & Welfare. 2014-2018 Mid-term Health Insurance Plan. 2015
  8. Ministry of Health & Welfare. 3rd Promotion & Development plan for Korean medicine 2016-2020. 2016
  9. Ministry of Health & Welfare. 'Assigned 65 Clinics to participate in the project on health insurance for Chuna Manual Therapy' Press release. 2107.2.9
  10. Jeon CH, Kim DJ, Kim DJ, Lee HM, Park HJ. Cross-cultural Adaptation of the Korean Version Of the Oswestry Disability Index (ODI). Journal of Korean Spine surg. 2005;12(2):146-152. https://doi.org/10.4184/jkss.2005.12.2.146
  11. Lee NW, Kim GH, Heo I, Kim KW, Ha IH, Lee JH, Hwang EH, Shin BC. Chuna (Tuina) Manual Therapy for Musculoskeletal Disorder: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. Evidence-Based Complementary and Alternative Medicine. Volume 2017, Article ID 8218139, 22pages https://doi.org/10.1155/2017/8218139
  12. Shin BJ, KimTK, Baik JS, Shim DM. Comparison The Safety and The Efficacy between the Group of using Pelubiprofen Tab. and the Group of using Aceclofenac Tab. on Back Pain Patients - Multi Institution, Double Blind, Random Sample -. J Korean Soc Spine Surg 2012 Jun;19(2):38-46. https://doi.org/10.4184/jkss.2012.19.2.38
  13. Jeon CH, Kim DJ, Kim DJ, Lee HM, Park HJ, Kim HS, Shin DE, Min HT. Comparative Study of the Safety and Effectiveness of Tramadol 37.5 mg/Acetaminophen 325 mg Combined Tablets and Cyclo-Oxygenase-2 (Celecoxib) Inhibitor for the Treatment of Chronic Low Back Pain- A Multicenter, Randomized, Comparative Clinical Study -. J Korean Soc Spine Surg 2005;12(4):299-309. https://doi.org/10.4184/jkss.2005.12.4.299