Chronic Obstructive Pulmonary Disease Patients Treated with Korean Medicine Pulmonary Rehabilitation: Two case reports

Tae Hyun Kim; Su Won Lee; Yee Ran Lyu; Eun Jung Lee; In Chul Jung; Yang Chun Park; Kim, Tae Hyun; Lee, Su Won; Lyu, Yee Ran; Lee, Eun Jung; Jung, In Chul; Park, Yang Chun

doi:10.13048/jkm.20032

JKM > Volume 41(3); 2020 > Article

Kim, Lee, Lyu, Lee, Jung, and Park: Chronic Obstructive Pulmonary Disease Patients Treated with Korean Medicine Pulmonary Rehabilitation: Two case reports

Case Report

The Journal of Korean Medicine 2020; 41(3): 162-172.

Published online: September 01, 2020

DOI: https://doi.org/10.13048/jkm.20032

Chronic Obstructive Pulmonary Disease Patients Treated with Korean Medicine Pulmonary Rehabilitation: Two case reports

Tae Hyun Kim¹^{, †}

, Su Won Lee¹^{, †}

, Yee Ran Lyu¹

, Eun Jung Lee²

, In Chul Jung³

, Yang Chun Park¹

¹Division of Respiratory Medicine, Dep. of Internal Medicine, College of Korean Medicine, Daejeon University, Korea

²Department of Rehabilitation Medicine of Korean Medicine, College of Korean Medicine, Daejeon University, Korea

³Department of Neuropsychology, College of Korean Medicine, Daejeon University, Daejeon, Korea

Correspondence to: Yang-Chun Park Korean Internal Medicine, Daejeon Korean Medicine Hospital of Daejeon University 75, Daedeok-daero 176-beongil, Seo-gu, Daejeon, Republic of Korea 35235 Tel: +82-42-470-9126(clinic), +82-42-229-6763 (office, Munchang Campus), Fax: +82-42-470-9486

† These authors contributed equally to this work

Received July 17, 2020 Revised August 30, 2020 Accepted August 31, 2020

Abstract

Objectives

The purpose of study was to report the clinical improvement of Chronic Obstructive Pulmonary Disease (COPD) patients treated with Korean medicine pulmonary rehabilitation.

Methods

The patients were treated with Lung-conduction exercise, Chuna manual therapy, Exercise therapy. To assess the treatment outcomes, we used the pulmonary function test (PFT), modified medical research council scale (mMRC), 6-minute walk distance (6MWD), peak expiratory flow rate (PEFR), COPD assessment test (CAT), St. George respiratory questionnaire (SGRQ).

Results

After treatments, the patient’s clinical symptoms were improved with CAT, SGRQ’s significant decrease and PFT, mMRC, 6MWD and PEFR were maintained or improved slightly.

Conclusions

The Korean medicine pulmonary rehabilitation was effective in the treatment of COPD patients. This study suggested the possibility of Korean Medicine pulmonary rehabilitation program in the clinic.

Keywords: Cchronic obstructive pulmonary disease, Korean medicine, Pulmonary rehabilitation

Fig. 1

Chest X-ray in case 1. [2019.07.12

Fig. 2

Chest X-ray in case 2. [2019.10.21]

Table 1

The Korean Traditional Pulmonary Rehabilitation Program.

Method	Composition	Course description	Objective	Time
Lung-conduction exercise	Breathing technique (Jogigyeol, Taesikbeop)	Sit up comfortably and slowly while inhaling through the nose. After sufficient inhalation, hold breath while counting as high as you can tolerate. Then gently breathe out through the mouth	Respiratory efficiency (Ventilation-perfusion ratio)	Set 3 (5 min)
	Lung-doyinbeop	While sitting on the ground with both hands curled, inhale, swell your back, and raise your back up	Chest mobilizing	Set 5 (4 min)
		Hold your fists, bend your arms behind your back and tap your spine to the left and right	Secretion removal	Set 15 (4 min)
		Hold your breath for a while, close your eyes, hit your teeth several times, and swallow if the saliva is stuck in your mouth	Relaxing	Set 3 (2 min)
Chuna manual therapy	Fascia Chuna (Diaphragm)	The patient lies down and the operator places the thumb under the xiphoid process (central tendon), the front and rear rib attachment site respectively. Keep it in the inhalation, and press it slightly back in the the exhalation to maintain a tension until it relaxes	Respiratory efficiency (Reducing the use of breathing accessory muscle, Lowering respiratory load)	Set 3–4 (3 min)
Chuna manual therapy	Fascia Chuna (Breathing accessory muscle)	The patient lies down and makes isometric contraction in the inhalation; simultaneously the operator gives the opposite force. After 6–7 seconds, the patient exhales and relaxes the muscles		Set 3–4 (3 min)
Exercise therapy	Strength exercise	Upper limb and lower limbs strengthening training(1 set of 10–15 times of each muscle)	Muscle endurance (performance-enhancing)	Set 2–3 (15min)
Exercise therapy	Cardiovascular exercise	Using an ergometer or by treadmill	Cardiopulmonary function (increasing walking distance)	20min

Table 2

The Changes of Outcome measures in Cases.

Case	1		2

Evaluation time	2019.07.12	2019.09.10	2019.10.21	2019.11.09
mMRC*	2	2	4	3
6MWD(m)†	415	420	150
PEFR(L/min)‡	300	330	110	130
CAT§	13	9	34	20
SGRQ\|\|	27.9	23.5	43.5	40.6

* mMRC: modified medical research council scale,

† 6MWD: 6-minute walk distance,

‡ PEFR: Peak expiratory flow rate,

§ CAT: COPD assessment test,

|| SGRQ: St. George respiratory questionnaire.

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