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A Review of the Korean Traditional Medicine Treatment for Meniscus Injury

Article information

J Korean Med. 2022;43(1):154-170
Publication date (electronic) : 2022 March 01
doi : https://doi.org/10.13048/jkm.22012
Sihoon Hanorcid_icon, Taeyoung Ohorcid_icon, Minseok Ohorcid_icon
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 2022 February 08; Revised 2022 February 21; Accepted 2022 February 22.

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.

Search Strategy Used in PubMed

Characteristics of 23 Studies

Composition of Herbal Medicine

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Article information Continued

Fig. 1

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

Fig. 2

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

Fig. 3

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