Efficacy of keishibukuryogan in muscle injury of lower extremity: Evaluation of therapeutic response and prediction of the outcome by magnetic resonance imaging

Abstract

We evaluated the outcome of 10 patients (age range: 13-62 years; 8 males and 2 females) with acute traumatic muscle injury of lower extremity who were treated with only Kampo medicine keishibukuryogan and no analgesic. The therapeutic response was determined by the influence on daily life and comparing local pain using a visual analogue scale (VAS). For a more objective evaluation of the therapeutic response, magnetic resonance imaging (MRI) findings were also used. The results showed to be markedly effective in 5 cases, effective in 2 cases, and ineffective in 3 cases. In the 7 cases in markedly effective or effective, pain relief was associated with attenuation of MRI signal intensities reflecting edema and hematoma of the injured area. In addition, the therapeutic outcome was analyzed in relation to the MRI findings obtained at first presentation; pain tended to be alleviated more rapidly in cases shown as having muscular contusion on the initial MRI, while pain and MRI high signal intensity areas tended to persist in cases shown as having injury of musculo-tendinous junction. In 2 of the 3 cases in ineffective, the initial MRI had shown rupture of muscle tissue. Keishibukuryogan was effective against traumatic muscle injury of lower extremity and MRI was useful for evaluating responses to the treatment and predicting the therapeutic outcome.