The theory of "eccentric diseases are generally due to phlegm (怪病多屬痰)" means that phlegm is a major cause for intractable diseases including cerebrovascular accident, depression, insanity, and shock from strange things or evil sprint. It has been a key foundation for the diagnosis and treatment of phlegm in traditional Korean medicine. However, the origin of the theory is not clear and controversial. In this study, we critically reviewed the origin and developing process of the theory in the viewpoints of philology and pathology in Korean medicine. Wang Yin-Jun (王隱 君) did not claim that eccentric diseases are generally due to phlegm in Taidingyangshengzhu-lun (泰定養生主論). The miscitation by following medical literature caused the misunderstanding in the meaning of Taidingyangshengzhu-lun, that phlegm can cause variable symptoms and signs. In the Ming dynasty, some poor medical doctors had tended to diagnose any difficult case as phlegm syndrome and to use Kuntan-huan (滾痰丸) as a standard herbal formula for treating phlegm syndrome. However, the tendency to categorize delicate cases easily to phlegm syndrome is not desirable. Besides, the tendency to use Kuntan-huan as a basic formula for the phlegm syndrome might cause diverse and severe adverse effects. Thus, we cannot accept the theory of eccentric diseases is generally due to phlegm without a doubt. In conclusion, this theory might be a valuable aphorism in terms of considering the possibility of the secondary pathologic factors including phlegm and blood stasis which should be considered first in case of intractable diseases.

This study aimed to review clinical studies about Acupotomy used for Knee Osteoarthritis. We searched the following 12 online databases (KISS, NDSL, RISS, OASIS, Earticle, Kmbase, MEDLINE/Pubmed, Cochrane library, Ebscohost, Ovid, CNKI, Wanfang), to find randomized controlled trials that used Acupotomy for knee osteoarthritis. The methodological quality of randomized controlled trials were assessed by using the Cochrane risk of bias tool and meta-analyses were performed. 16 randomized controlled trials were included. Total number of patients was 1169. The average duration of treatment was 3.14 weeks and most of the patients were treated once a week. The major treatment sites were ligaments, muscles, and tender nodules and the most used evaluation tool was the efficiency. We selected 4 studies and meta-analyzed them. All of the studies performed Acupotomy+sodium hyaluronate injection as a treatment group, and sodium hyaluronate injection as a control group. Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of efficiency rate compared to sodium hyaluronate injection. Also Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of WOMAC (pain, stiffness, function) compared to sodium hyaluronate injection. In this study, we reviewed studies about Acupotomy used for knee osteoarthritis. The studies showed that Acupotomy can significantly effective on knee osteoarthritis. But according to Cochrane Risk of Bias (RoB) evaluation method, most of the study's risk of bias was unclear. Threrefore, more high-quality studies will be needed.

This study aimed to evaluate the effects of Chuna therapy for Sciatica. We searched the following 16 online databases without a language restriction (Pubmed, Cochrane, Embase, CINAHL, Ovid, Kmbase, RISS, NDSL, OASIS, KISS, KNAL, KTKP, DBpia, CNKI, Wangfang, J-stage) to find randomized controlled clinical trials that used Chuna therapy for Sciatica. The methodological quality of randomized controlled clinical trials (RCTs) were assessed using the Cochrane risk of bias tool and meta-analysis were performed. Among 496 articles that were searched, 15 RCTs were finally selected for systematic review. 14 studies showed that Chuna therapy has positive effect on sciatica. Two studies noted that there were side effects, and the difference between the intervention group and the control group was statistically insignificant. One study noted no side effects and the rest of the study, there was no mention of side effects. Meta-analysis showed positive results for Chuna single therapy in terms of efficiency rate compared to painkiller, herb medicine excepting acupuncture. When comparing Chuna therapy plus acupuncture and acupuncture, Chuna therapy plus acupuncture had a more positive result than acupuncture in terms of efficiency rate. Cochrane Risk of Bias (RoB)evaluation method, most of the studies's selection, performance, detection and reporting bias were unclear. The studies showed that Chuna therapy can significantly effective on sciatica. However, most of the studies's Risk of Bias included in the analysis were not low enough. In the future, to prove the level of evidence of Chuna therapy, more high-quality studies will be needed.

Besides respiratory infection, COVID-19 has many neurological symptoms not only loss of smell and taste but also fatigue and brain fog. But it is a challenge to treat the neurological symptoms especially of anosmia and ageusia. In order to search for the therapeutic methods, the geographical diversity and pathological mechanisms of the COVID-19 and two symptoms were investigated from the latest clinical studies. Because the environmental conditions of the monsoon climate zone of East Asia and the Mediterranean and Oceanic climate zone of Italy, Britain, United States and tropical Brazil are different, each of diverse etiology and internal milieu should be considered differently in the treatment. SARS-CoV-2 exhibits the dampness-like characteristics and the olfactory and gustatory disorders are particularly more common than other flu or cold. and it tends to show features of damaging the lung qi of olfaction and heart-spleen qi of gustation. The mechanisms of olfactory and gustatory loss are various according to precursory, inflammatory, non-inflammatory and sequelar forms, so the therapeutic method should be designed for each period and pathology. If the process of inflammation arises from nasal and respiratory, olfactory epithelium to the central nervous structure by way of blood brain barrier, the treatment should be corresponded with the stage and depth of pathogen place. And if the olfactory loss is asymptomatic or in the initial stage, it can be applied intranasal topical scent therapy to relieve temporary locking of qi movement, but maybe also used in parallel together with herbs of relieving dampness toxin latent in the lung parenchyma.

Mahwanghangingamchosukgo-tang (MH) is recorded as a treatment to treat exterior-related respiratory diseases in the Korean medicine. In this study, we examined the anti-inflammatory effects of MH, using MH water extract and lipopolysaccharide (LPS)-induced RAW 264.7 cells. First of all, we measured the amount of nitric oxide (NO) and prostaglandin E2 (PGE2), the products of inflammatory metabolism. Also, we measured enzymes such as inducible nitric oxide synthase (iNOS) and cyclooxygenase-2 (COX-2), as well as cytokines such as interleukin 6 (IL-6), interleukin 1 alpha (IL-1α), and interleukin 1 beta (IL-1β). MH suppressed the production of NO and PGE2 in a dose dependent manner and reduced the amount of protein and the mRNA expression of iNOS and COX-2. Also, MH reduced the mRNA expression of IL-6, IL-1α and IL-1β. In conclusion, MH decreased production of LPS-induced inflammatory factor, which could be a clinical basic subject for inflammatory diseases.

Nitrate-nitrite-nitric oxide (NO) pathway is a major alternative source of NO and is essential for NO - dependent physiological functions in body. Food supplements having nitrate/nitrite can improve metabolic syndromes including hypertension through antioxidant activity or vasodilation. The purpose of this study was to observe the effects of fermented garlic (F. garlic) having high concentration of NO2- on changes in blood flow and nitric oxide synthesis in the cerebral cortex of rodents. The generation of nitric oxide detected by a chemi-luminescence detector was higher in F. Garlic compared with NaNO2 solution under artificial gastric juice with pH 2.0. Ether F. garlic or NaNO2 diluted with artificial cerebrospinal fluid was directly applied into around the needle probe of laser Doppler flow meter that was located on epidural surface of the cortex. Direct application of F. garlic resulted in increase of cerebral blood flow detected by a laser Doppler flow meter with a dose-dependent manner. Compared with NaNO2 solution, F. garlic produced changes in cerebral blood flow at lower concentration of NO2-. Pretreatment of methylene blue, a guanylyl cyclase inhibitor prevented upregulation of cerebral blood flow by the treatment of F. garlic. In addition, the application of F. garlic with 250, 500ppm of NO2- caused significantly the production of NO in the cortical tissue but NaNO2 solution with 500ppm of NO2- did not. In summary, these results suggested that F. garlic with high content of NO2- induce increase in cerebral blood flow through nitric oxide-dependent signal pathway.

Nypa fruticans Wurmb. (NF) has been used as a folk remedy to treat inflammatory diseases in Asia. In this study, we aimed to investigate the protective effect of NF water extract on cerulein-induced acute pancreatitis (AP). To measure the protective effects of NF on AP, AP was induced via intraperitoneal injection of cerulein (50 ㎍/kg) hourly for 6 h in mice. NF water extract (100, 250, or 500 mg/kg) or saline was administrated to intraperitoneal injection 1 h before the first injection of cerulein. The mice were sacrificed at 6 h after the final injection of the cerulein. Pancreas, and blood sample were taken for further analysis. Administration of NF water extract inhibited the pancreatic injury, the elevation of pancreatic weight/ body weight ratio, and the elevation of serum digestive enzymes such as amylase and lipase during cerulein-induced AP in mice. Also, pancreas MPO activity, which represents neutrophil infiltration, was inhibited by administration of NF water extract. Taken together, administration of NF water extract reduces the severity of cerulein-induced AP, which suggests a clinical basis that NF could be a potential agent to prevent AP.

The purpose of this study was to investigate the possibility of herbal medicine complex extract (NI-01), which were prepared from 6 natural materials (Cinnamomum cassia Blume, Lonicerae Flos, Paeonia suffruticosa Andrews, Arctium lappa Linne, Schzandra chinesis Bailon, Elsholtzia ciliata Hylander), as a functional material for inhibition of atopic dermatitis. anti-oxidative activity was confirmed by measuring DPPH electron donating ability and ABTS+ radical scavenging ability. Cytotoxicity and NO inhibition were measured using RAW 264.7 cells to confirm anti-inflammatory efficacy. The test substance was orally administered to the pruritus-induced ICR mice to confirm the inhibition of pruritus. The bovine cornea opacity and permeability (BCOP) assay was performed to confirm safety for irritation. NI-01 showed high antioxidant activity in DPPH and ABTS+ methods. In the anti-inflammatory effect tests with RAW 264.7 cells, NO production was inhibited at NI-01 concentrations of 50 (14.9%) and 100 (4.2%) ㎍/mL, which indicated that the anti-inflammatory effect was increased in a concentration-dependent manner. NI-01 also showed anti-itching effect after inducing of itching by compound 48/80 in ICR mice. NI-01 was proved to be a non-irritant substance in BCOP assay. The results of this study suggested that the herbal medicine combined extract (NI-01) has high antioxidant, anti-inflammatory and anti-itching effects, and safety for irritation. Therefore, herbal medicine complex extract (NI-01) is thought to be highly applicable for the inhibitory ingredients of the atopic dermatitis.

Oryeong-san (ORS) is a traditional Korean herbal medicine widely used for renal associated diseases, composed of five medicine herbs; Atractylodes japonica Koidzumi, Cinnamomum cassia Presl, Polyporus umbellatus Fries, Poria cocos Wolf and Alisma orientale Juzepzuk. We studied to improve the convenience of intake and portability by developing modernized dosage forms, and examined the effect on anti-inflammation of ORS. In order to develop the tablet formulation of ORS (ORS-F), the tablets were evaluated on the basis of physical characteristics include diameter, thickness, weight variation, hardness, friability and disintegration. To analyze the marker components of ORS-F, eight index markers from five herbal medicines were chosen. And the method using high performance liquid chromatography (HPLC) with diode-array detector method was established for the simultaneous analysis. The biological activities were examined the effect of ORS-F on pro-inflammation mediated by LPS-stimulation. The production of nitric oxide (NO) and cytokines were determined by reacting cultured medium with griess reagent and enzyme-linked immunosorbent assay (ELISA). The expression of cyclooxygenase-2 (COX-2) and inducible NO synthase (iNOS) were investigated by Western blot and RT-PCR. The anti-oxidant activities of OJS-F increased markedly, in a dose-dependent manner. and, The total phenolic compound and flavonoids contents of OJS-F were 10.20±0.09 ㎍/㎎ and 12.86±0.86 ㎍/㎎. OJS-F which is LPS has diminished in the LPS-induced release of inflammatory mediators (NO, iNOS, COX2 and PGE2) and pro-inflammatory cytokines (TNF-α, IL-6 and IL-1β) from the RAW264.7 macrophages. Therefore, the developed formulation for tablet of ORS-F provide efficiency and usability, and indicated effect of anti-inflammation.

This study was designed to assess the toxicity of capsaicin-containing (CP) pharmacopunture using an in vitro chromosomal aberrations in Chinese hamster lung (CHL/IU) cells. In order to determine the high dose level in the main study of this study, a dose range finding study was conducted first. The high dose was selected at 10.0% of CP pharmacopuncture extract, and then diluted sequentially to produce lower dose levels of 5.00, 2.50, 1.25, 0.625 and 0.313% by applying a geometric ratio of 2. As a result, the cytotoxicity and precipitation of the CP pharmacopuncture as a test substance were not evident at any dose level during short-time treatment with and without metabolic activation and continuous treatment without metabolic activation. Therefore, the dose levels for this study were chosen as 10.0, 5.0, and 2.5%., and the treatment volume was 1.3 mL. In addition, negative and positive controls were set. In main study, the frequency of cells with chromosome aberrations in CP treated groups was less than 5% in short-time treatment with and without metabolic activation and continuous treatment without metabolic activation. In addition, there was no statistically significant difference when compared to the negative control group. The frequency of cells with structural chromosomal aberrations in the positive control group was more than 10% compared to the negative control group, and it increased statistically significantly. In conclusion, under the conditions of this study, CP pharmacopuncture did not show the possibility of causing chromosome aberrations.

In order to find out the relationship between the Eight Principle Pattern Identification of Yin-Yang, Exterior-Interior and the Sasang constitution, we analyzed the clinical data from 500 women with menstrual pain and women without menstrual pain. In the previous study, the subject's information of Typology Complexion Pulse and Symptom was collected, and Eight Principle Pattern Identification was executed based on this. Later, The relationship between the Sasang constitution and the Eight Principle Pattern Identification was statistically analyzed. The obvious difference between the experimental group and the control group in the patterns of Yin-Yang and Exterior-Interior is that patients who complain of menstrual pain do not maintain harmony with the yin-yang ratio, it can be said that the patterns of Yin-Yang and Exterior-Interior can be a identification standard that significantly obscures the condition of the disease. There was a significant difference between the Sasang constitution and the Eight Principle Pattern Identification of Yin-Yang. There was no significant difference between the Sasang constitution and the Eight Principle Pattern Identification of Exterior-Interior. It is assumed that the relationship between the Eight Principle Pattern Identification and the Sasang constitution has changed depending on the difference a view of emotional Qi and pathogenic Qi.