Ultrasound-Guided High-Dose Hwangryunhaedok-tang Pharmacopuncture Combined with Integrative Korean Medicine Treatment for Traumatic Rib Fracture: A Case Report

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This case report aimed to describe the clinical course and safety of integrative Korean medicine treatment combined with ultrasound-guided high-volume Hwangryunhaedok-tang (Huanglianjiedu-tang) pharmacopuncture in a patient with traumatic rib fracture.A 36-year-old male diagnosed with a left 10th rib fracture received 4 mL of Hwangryunhaedok-tang (Huanglianjiedu-tang) pharmacopuncture injected into the intercostal fascial plane under ultrasound guidance.Pain intensity, quality of life, inflammatory markers, and adverse events were evaluated.The rib pain score decreased from 7 to 2, and the EuroQol-5 dimension-5 level profile changed from 55555 at admission to 44444 on hospital day 7 and 11111 at discharge.Pre-and post-treatment numeric rating scale (NRS) scores were additionally recorded on pharmacopuncture days.In most sessions, the NRS score decreased by 2 to 3 points immediately after treatment, and pain relief lasted approximately 2 hours.No additional analgesics were used after the 5-day prescription from the first hospital.Inflammatory markers decreased, and no serious adverse events were observed.This case reports the clinical course of ultrasound-guided high-volume Hwangryunhaedok-tang (Huanglianjiedu-tang) pharmacopuncture applied to the intercostal fascial plane in a patient with traumatic rib fracture, with improvements in rib pain, sleep, gait function, and health-related quality of life without serious adverse events.However, comparative effectiveness and effects on fracture healing cannot be determined from a single case, and further studies are required.(

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