A Review of the Korean Traditional Medicine Treatment for Meniscus Injury

Sihoon Han; Taeyoung Oh; Minseok Oh; Han, Sihoon; Oh, Taeyoung; Oh, Minseok

doi:10.13048/jkm.22012

JKM > Volume 43(1); 2022 > Article

Han, Oh, and Oh: A Review of the Korean Traditional Medicine Treatment for Meniscus Injury

Review Article

The Journal of Korean Medicine 2022; 43(1): 154-170.

Published online: March 01, 2022

DOI: https://doi.org/10.13048/jkm.22012

A Review of the Korean Traditional Medicine Treatment for Meniscus Injury

Sihoon Han

, Taeyoung Oh

, Minseok Oh^*

Department of Rehabilitation of Korean Medicine, College of Korean Medicine, DaeJeon University

Correspondence to: Minseok Oh, Department of Korean Medicine Rehabilitation, College of Korean Medicine, Daejeon University, 75, Daedeok-daero 176beon-gil, Seo-gu, Daejeon, 35235, Republic of Korea, Tel: +82-42-470-9136, Fax: +82-470-9005, E-mail: ohmin@dju.ac.kr

Received February 08, 2022 Revised February 21, 2022 Accepted February 22, 2022

Abstract

Objectives

The purpose of this study was review the current clinical studies about the effect of Korean traditional medicine treatment for meniscus injury.

Methods

Clinical studies on Korean traditional medicine treatment of meniscus injury were searched through 11 online databases. We analyzed the authors, publication year, country, study design, subjects, treatment methods, treatment effects, evaluation tools and adverse events of the selected studies.

Results

23 studies which included 9 randomized controlled trials, 8 case reports, 4 retrospective observational studies, 2 non-randomized controlled trials were selected through the databases. A total of 9 Korean traditional medicine treatments were used, among them, acupuncture treatment was the most used. The most commonly used outcome was effective rate.

Conclusions

Through this study, we could confirm that Korean traditional medicine is an effective treatment for meniscus injury. It was suggested that various clinical studies on the effects of Korean traditional medicine for meniscus injury are needed and it is necessary to establish more scientific evidence through studies with a high level of evidence.

Keywords: Meniscus, Korean Traditional Medicine, Acupuncture, Knee Injuries

Fig. 1

Flow diagram of the selection process. Twenty three studies were selected through the first and second exclusion.

CNKI: China National Knowledge Infrastructure, DB: database, RCT: randomized controlled trial.

Fig. 2

The number of clinical studies about korean traditional medicine for meniscus injury in the last 10 years.

Fig. 3

Proportion of included studies according to their methods. RCT is the most common type of study.

RCT: randomized controlled trial, nRCT: non-randomized controlled trial.

Table 1

Search Strategy Used in PubMed

No.	Search items	N
#1.	meniscus	16898
#2.	meniscal	8818
#3.	#1. or #2.	19327
#4.	tear	62482
#5.	injury	1645625
#6.	rupture	168232
#7.	lesion	901665
#8.	#4. or #5. or #6. or #7.	2572452
#9.	#3. and #8.	12525
#10.	acup*	37300
#11.	mox*	1198
#12.	korean traditional medicine	2804
#13.	traditional chinese medicine	101859
#14.	#10. or #11. or #12. or #13. or #14.	133580
#15.	#10 and #14	51

Table 2

Characteristics of 23 Studies

No.	Author (year/country)	Study design	Sample size (sex/age) or (M:n/F:n)	Treatment (E : Experimental group, C : Control group)	Number of patients in affected area (LK^*, RK^†, BK^‡ MM^‡, LM^§, BM^\|\|)	Main outcomes	Result
1	Lee, et al.12) (2018/Korea)	ROS^**	38 (M:9/F:29)	Acupuncture, Pharmacopuncture, Electro-acupuncture	Not Reported	NRS^††, EQ-5D^‡‡, WOMAC^§§	Improved (NRS, EQ-5D: P<0.001 WOMAC: P<0.05)
2	Lee, et al.13) (2017/Korea)	Case report	3 (M:1/F:2)	Acupuncture, Pharmacopuncture, Cupping, Herbal medicine, Physiotherapy	LK: 2, RK: 1, BK: 0 MM: 3, LM: 0, BM: 0	NRS, EQ-5D, ROM^¶¶, Special test	Improved
3	Heo, et al.14) (2015/Korea)	Case report	4 (M:2/F:2)	Acupuncture, Cupping, Moxibustion, Herbal medicine	LK: 2, RK: 2, BK: 0 MM: 2, LM: 1, BM: 1	VAS, ROM	Improved
4	Hong, et al.15) (2020/Korea)	Case report	5 (M:3/F:2)	Acupuncture, Pharmacopuncture, Herbal medicine,	LK: 2, RK: 3, BK: 0 MM: 4, LM: 0, BM: 1	NRS, ROM, WOMAC	Improved
5	Jeon, et al.16) (2019/Korea)	Case report	3 (F:3)	Acupuncture, Pharmacopuncture, Electro-acupuncture, Herbal medicine,	LK: 1, RK: 0, BK: 2 MM: 3, LM: 1, BM: 0	NRS, EQ-5D, WOMAC	Improved
6	Lee, et al.17) (2018/Korea)	Case report	4 (M:2/F:2)	Acupuncture, Pharmacopuncture, Electro-acupuncture, Herbal medicine, Physiotherapy	LK: 1, RK: 3, BK: 0 MM: 3, LM: 0, BM: 1	NRS, EQ-5D, WOMAC	Improved
7	Lee, et al.18) (2016/Korea)	Case report	1 (F/52)	Acupotomy	LK: 0, RK: 0, BK: 1 MM: 1, LM: 0, BM: 0	VAS, EQ-5D, WOMAC	Improved
8	Oh, et al.19) (2020/Korea)	Case report	1 (F/46)	Acupuncture, Pharmacopuncture, Electro-acupuncture, Cupping, Moxibustion, Herbal medicine	LK: 0, RK: 0, BK: 1 MM: 1, LM: 0, BM: 0	NRS, WOMAC, KOOS^\|\|\|\|	Improved
9	Lee, et al.20) (2020/Korea)	Case report	1 (M/51)	Acupuncture	LK: 1, RK: 0, BK: 0 MM: 1, LM: 0, BM: 0	NRS, WOMAC Pressure pain,	Improved
10	Du21) (2019/China)	nRCT	110 (M:63/F:47)	E: n=55, Rehabilitation exercise, Moxa-heated acupuncture, chuna C: n=55, Rehabilitation exercise	Not Reported	Effective rate, VAS, GQOLI-74 score^***, Lysholm score	All p<0.05
11	Cheng, et al.22) (2016/China)	ROS	100 (M:52/F:48)	Acupuncture, Chuna, Rehabilitation exercise	LK: 37, RK: 65, BK: 2 MM: 26, LM: 76, BM: 0	Effective rate	Improved
12	Luo, et al.23) (2019/China)	RCT	40 (M:22/F:18)	E: n=20, Rehabilitation exercise, Moxibustion, Herbal ointment C: n=20, Rehabilitation exercise	Not Reported	Effective rate, VAS, Barthel score, MMS^\|\|\|\|	All p<0.05
13	Lu, et al.24) (2016/China)	ROS	82 (M:33/F:49)	Chuna, Herbal ointment Rehabilitation exercise	LK: 41, RK:36, BK: 3 MM: 21, LM: 46, BM: 4	Lysholm score Barthel score	Improved (all p<0.005)
14	Liu25) (2018/China)	RCT	92 (M:49/F:43)	E: n=46, Rehabilitation exercise, Chuna, Herbal ointment C: n=46, Rehabilitation exercise	Not Reported	Lysholm score Barthel score	All p<0.05
15	Chen, et al.26) (2018/China)	RCT	102 (M:45/F:57)	E: n=51, Rehabilitation exercise, Chuna, Herbal ointment C: n=51, Rehabilitation exercise	Not Reported	Effective rate, ROM, Lysholm score, Barthel score	All p<0.05
16	Wan27) (2018/China)	RCT	100 (M:49/F:51)	E: n=50, Rehabilitation exercise, Herbal ointment C: n=50, Rehabilitation exercise	Not Reported	Lysholm score Barthel score	All p<0.05
17	Gan, et al.28) (2017/China)	nRCT	88 (M:58/F:30)	E: n=44, Rehabilitation exercise, Chuna, Herbal ointment C: n=44, Rehabilitation exercise	LK: 41, RK: 47, BK: 0 MM: 56, LM: 32, BM: 0	Effective rate, ROM, Lysholm score, Barthel score	All p<0.05
18	Wang29) (2018/China)	RCT	54 (M:29/F:25)	E: n=27, Rehabilitation exercise, Chuna, Electro-acupuncture, Herbal medicine, Herbal poultice C: n=27, Rehabilitation exercise	LK: 29, RK: 10, BK: 15 Not Reported	Lysholm score, ROM, MMS	All p<0.005
19	Jiang30) (2018/China)	RCT	50 (M:24/F:26)	E: n=25, Rehabilitation exercise, Chuna, Herbal medicine, Herbal poultice C: n=25, Rehabilitation exercise	Not Reported	Effective rate, ROM	Effective rate: P<0.005 ROM: P<0.05
20	Fan31) (2019/China)	RCT	72 (M:41/F:31)	E: n=36, Rehabilitation exercise, Chuna, Herbal medicine, Herbal poultice C: n=36, Rehabilitation exercise	Not Reported MM: 41, LM: 31, BM: 0	Effective rate, ROM, Lysholm score	Effective rate: P<0.05 ROM: P<0.005
21	Zhu32) (2017/China)	RCT	96 (M:56/F:40)	E: n=48, Rehabilitation exercise, Chuna, Electro-acupuncture, Herbal medicine, Herbal poultice C: n=48, Rehabilitation exercise	Not Reported MM: 42, LM: 54, BM: 0	Effective rate, Lysholm score, ROM, MMS	All p<0.05
22	Zhang, et al.33) (2021/China)	RCT	80 (M:46/F:34)	E: n=40, Rehabilitation exercise, Chuna C: n=40, Rehabilitation exercise	LK: 37, RK: 40, BK: 3 MM: 52, LM: 28, BM: 0	Effective rate, VAS, Lysholm score	All p<0.05
23	Wang34) (2013/China)	ROS	60 (M:33/F:49)	Chuna, Herbal ointment, Herbal medicine, Rehabilitation exercise	Not Reported	Effective rate	Improved

* LK : Left Knee,

† RK : Right Knee,

‡ BM : Both Knee,

§ MM : Medial Meniscus,

¶ LM : Lateral Meniscus,

|| BM : Both Meniscus,

** ROS: Retrospective bservational Study,

†† NRS : Numeral Rating Scale,

‡‡ EQ-5D: European Quality of Life - 5Dimensions,

§§ WOMAC : The Western Ontario and McMaster Universities Osteoarthritis Index,

¶¶ ROM : Range Of Motion,

|||| KOOS : the Knee injury and Osteoarthritis Outcome Score,

*** GQOLI-74 score : Generic Quality of Life Inventory-74 score,

††† MMS : Manual muscle strength

Table 3

Composition of Herbal Medicine

Herbal medicine	Composition of herbal medicine
Mabalgwanjeol-tang (馬勃關節湯)13,15–17)	Lasiosphaera Seu Calvatia(馬勃) 12g, Achyranthis Radix(牛膝) 8g, Ginseng Radix(人蔘) 8g, Glycyrrhizae Radix(甘草) 4g, Osterici Radix(羌活) 4g, Testudinis Plastrum(龜板) 4g, Angelicae Pubescentis Radix(獨活) 4g, Hordei Fructus Germinatus(麥芽) 4g, Saposhnikoviae Radix(防風) 4g, Amomi Fructus(砂仁) 4g, Astragali Radix (黃芪)4g, Aconiti Tuber(川烏) 2.8g
No name29–32)	Corydalis Tuber(延胡索) 20g, Angelicae Gigantis Radix(當歸) 15g, Cnidii Rhizoma(川芎) 15g, Persicae Semen(桃仁) 10g, Carthami Flo(紅花) 10g, Paeoniae Radix Rubra(赤芍藥) 10g, Hoele(茯笭) 10g, Lycopi Herba(澤蘭) 10g, Notoginseng Radix(三七) 6g
Keoseuphwalhyoljitong-tang (祛濕活血止痛湯)13,16)	Lonicerae Flos(金銀花) 8g, Akebiae Caulis(木通) 8g, Coicis Semen(薏苡仁) 8g, Atractylodis Rhizoma(白朮) 8g, Cinnamomi Ramulus(桂枝) 4g, Dianthi Herba(瞿麥) 4g, Angelicae Gigantis Radix(當歸) 4g, Persicae Semen(桃仁) 4g, Saposhnikoviae Radix(防風) 4g, Angelicae Dahuricae Radix(白芷) 4g, Rehmanniae Radix Crudus(生地黃) 4g, Linderae Radix(烏藥) 4g, Achyranthis Radix(牛膝) 4g, Clematidis Radix(威靈仙) 4g, Hoelen(茯苓) 4g, Paeoniae Radix(芍藥) 4g, Citri Unshii Pericarpium(陳皮) 4g, Cnidii Rhizoma(川芎) 4g, Gentianae scabrae Radix(龍膽) 4g, Polygoni Avicularis Herba(萹蓄) 4g, Caesalpiniae Lignum(蘇木) 2g, Carthami Flos(紅花) 2g
Cheongpa-jeon (靑波煎)13,17)	Chelidonium majus Linne var. asiaticum Ohwi(白屈菜), Achyranthes japonica Nakai(牛膝), Chaenomeles sinensis Koehne(木瓜), Acanthopanacis Cortex(五加皮), Corydalis Tuber(延胡索), Osterici Radix(羌活), Atractylodis Rhizoma(白朮), Angelicae Gigantis Radix(當歸), Rehmanniae Radix(生地黃), Paeoniae Radix Rubra(赤芍藥), Clematidis Radix(威靈仙), Araliae Continentalis Radix(獨活), Citri Unshii Pericarpium(陳皮), Carthami Flos(紅花), Amomi Fructus(砂仁), Glycyrrhizae Radix et Rhizoma(甘草), Zingiberis Rhizoma Crudus(生薑), Zizyphi Fructus(大棗)
Daeganghwal-tanggami (大羌活湯加味)19)	Lonicera Japonica(金銀花) 8g, Taraxacum Platycarpum(蒲公英) 8g, Ostericum Koreanum(羌活) 6g, Cimicifuga Heracleifolia(升麻) 6g, Bupleurum Falcatum(柴胡) 6g, Pinellia Ternata(半夏) 6g, Aralia Continentalis(獨活) 4g, Sinomenium Acutum(防己) 4g, Atractylodes Japonica(白朮) 4g, Clematis Mandshurica(威靈仙) 4g, Poria Cocos(茯笭) 4g, Alisma Canaliculatum(澤瀉) 4g, Amomi Fructus(砂仁) 4g, Machilus Thubergii(厚朴) 4g, Paeonia Suffruticosa(牡丹) 4g, Citrus Unshiu(橘皮) 3g, Zingiber Officinale(生薑) 3g
Dokhwalgisaeng-tang (獨活寄生湯)14)	Araliae Cordatae Radix(獨活) 3g, Loranthi Ramulus(桑寄生) 3g, Eucomiae Cortex(杜仲) 3g, Atractylodis Rhizoma alba(白朮) 2g, Bupleuri Radix(柴胡) 2g, Osterici Radix(羌活) 2g, Achyranthis Radix(牛膝) 2g, Glycyrrhizae Radix et Rhizoma(甘草) 2g, Cinnamomi Ramulus(桂枝)2g, Zingiberis Rhizoma Crudus(生薑) 2g, Angelicae Gigantis Radix(當歸) 2g, Astragali Radix(黃芪) 2g, Ginseng Radix(人蔘) 2g
Imyo-san(二妙散)14)	Atractylodis Rhizoma(蒼朮) 4g, Phellodendri Cortex(黃柏) 4g

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