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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

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.

Fig. 1
Chest X-ray in case 1. [2019.07.12
jkm-41-3-162f1.gif
Fig. 2
Chest X-ray in case 2. [2019.10.21]
jkm-41-3-162f2.gif
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)
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)
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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