Successful treatment of Kampo medicine and acupuncture in resolving intractable wound pain after pulmonary cancer surgery with corpectomy: a case report

Abstract

A 69-year-old woman, who had a left pulmonary upper lobectomy with thoraco­scope, lymph nodes dissection, and corpectomy (Th3–5), had complained of in­trac­table wound pain. Daily administration of 15 mg of oxycodone hydro­chloride hydrate was not enough to resolve her pain. She visited our clinic 30 months after the surgery. She was prescribed with 7.5 g of goshyajinkigan (TJ-107), 2 g of the processing Aconite Tuber (TJ-3023), 7.5 g of kamikihito (TJ-137), and 5.0 g of tsudosan (TJ-105). Although these medicines improved the efficacy of oxycodone hydrochloride hydrate to a desired level, the side effect of REHMANNIAE RADIX, such as gastric discomfort was observed, resulting in her discontinuing goshyajinkigan. A new prescription consisting of the processing Aconite Tuber (TJ-3023) 1 g, kamikihito (TJ-137) 5.0 g, and tsudosan (TJ-105) 5.0 g was administered.

The intractable wound pain was relieved almost by 2 months, but, her left paravertebral wound pain returned 7 months later. Since she was reluctant to increase the medicine from the previous dose, acupuncture therapy was per­formed and it removed the pain to a satisfactory level．

Kampo medicine successfully reduced the pain in this case. However, a con­tinuous usage of goshyajinkigan became difficult, and it resulted in a poor control of pain. Since the paravertebral wound running along the bladder meridian of foot-taiyang, selecting and toning the acupuncture points in the above meridian in her legs led to a good pain control. A supplemental acupuncture treatment to Sanyinjiao (Saninko) improved the internal cold pattern. The combination of those acupuncture treatments to Kampo medicines resulted in controlling the pain further.

Selecting those points and applying the acupuncture technique performed is not complex. If used, they could contribute to controlling pain after spinal surgery.