Objective: The aim of this study was to provide a systematic review of the Korean literature on the influence of herbal medicine on liver function. Additionally, we tried to estimate the change in the data on liver function tests (LFTs) and the incidence of liver injury (LI) after taking herbal medicine. Methods: Systematic literature searches were performed on 6 major Korean databases (Research Information Sharing Service (RISS), Korea Institute of Science and Technology information (KISTI), National Assembly Electronic Library, Korean Medical database (KMBASE), Korean Traditional Portal, and Dongui University Electronic Library) from January 2010 to June 2020. No restrictions were placed on the types of publications, which included grey literature. Results: The data indicate that herbal medicine might be a minor cause of LI in Korea. However the results are not supported strongly enough to verify the safety issues because of the limitations of the original studies. Conclusions: Additional well-planned studies are still needed that can overcome the heterogeneity and the considerable methodological flaws in the analyzed studies.

Objectives: To investigate efficacy of Korean medicine for patients with Parkinson's Disease (PD) with pain. Methods: We performed a retrospective review of the medical records for patients diagnosed with PD between 2012 and 2019 at Gangdong Kyung Hee University Korean Medicine Hospital in South Korea. Results: Twenty-two patients with King's Parkinson's Disease Pain Scale(KPPS) scores at least twice were analyzed for evaluating the efficacy of Korean medicine for pain treatment in PD. The mean total scores before and after Korean medicine treatment were 15.23±1 .01 and 9.2±8.7, respectively, and the mean difference between the before/after total scores was 6.0±5.8 (P<0.001). Specifically, the score of radicular pain was significantly decreased (P=0.048). Conclusions: These findings suggest that Korean medicine could be beneficial for reducing pain associated with PD. Clinical efficacy should be confirmed by further studies, such as large-sample cohort studies and randomized controlled trials to clarify the pathological pain relief mechanism and the analgesic effect of Korean medicine.

Objectives: To examine the fundamental characteristics of interventional clinical trials registered in the CRIS (Clinical Research Information Service) database. Methods: We systematically analyzed the status of Korean medical interventions using the search function of the CRIS database. Results: From 2010 to January 2020, 267 Korean medicine-related clinical trials were registered with CRIS. The studies, which included many randomized trials (80.14%), focused primarily on demonstrating the effectiveness and safety of acupuncture and Korean herbal remedies. Most of these studies were government-sponsored and researcher-led clinical trials, but a few were company-sponsored trials. All trials were small and need improvement. Conclusion: This study reviews the current status of clinical trials in the field of Korean medicine and the basic data that can be used to create evidence-based Korean medicine.

Objective: This study was performed to investigate the effect of Acanthopanax sessiliflorum Cheonghyeol plus (ASCP) on NF-κB and MAPK signaling and vascular adhesion factors associated with dyslipidemia in human umbilical vein endothelial cells (HUVECs). Methods: We measured the scavenging activity of DPPH radical and ABTS radical by ASCP in HUVECs. We measured the protein expression levels of NF-κB, IκBα, ERK, JNK, and p38 after treatment of HUVECs with TNF-α. We measured the expression levels of MCP-1, ICAM-1, and VCAM-1 mRNA and of MCP-1, ICAM-1, and VCAM-1 biomarkers after treatment of HUVECs with TNF-α. Results: The DPPH and ABTS radical scavenging activity of ASCP increased in a concentration-dependent manner. NF-κB, IκB, ERK, p38 protein expression levels decreased following ASCP treatment at all concentrations compared to untreated control HUVECs. JNK protein expression levels decreased in ASCP-treated HUVECs compared to untreated controls at concentrations of 100 ㎍/mL. MCP-1 mRNA expression level decreased with ASCP treatment ≥200 ㎍/mL compared to the control. ICAM-1 and VCAM-1 mRNA expression levels decreased at all concentrations compared to the control. MCP-1 protein expression level was reduced compared to the control at concentrations ≥200 ㎍/mL, ICAM-1 protein expression level was reduced compared to the control at concentrations ≥100 ㎍/mL, and VCAM-1 protein expression level was reduced at all concentrations. Conclusions: These results suggest that ASCP has an antioxidative and hypolipidemic effect and that ASCP could treat and prevent dyslipidemia, atherosclerosis, and cardio-cerebrovascular diseases.

Objectives: This survey research was conducted to evaluate real-time non-face-to-face education in clinical Korean medicine conducted during the COVID-19 outbreak. Methods: This study was conducted with all 3rd and 4th grade students of the Department of Korean Medicine, Gachon University. The Korean Internal Medicine (Pulmonary) lecture course was held from April 1st to July 1st, 2020 for one semester. The lectures were conducted through real-time non-face-to-face education using the Cisco Webex program, and the lectures were mainly conducted by sharing a PowerPoint summarizing textbook. The questionnaire consisted of 3 parts and a total of 18 questions. The survey was conducted anonymously to ensure the confidentiality of all responses. Results: The overall score for real-time non-face-to-face education was 74.69±18.15 points. The efficiency of real-time non-face-to-face education was 2.12±0.78 points, and opinions on the expansion of future use were 2.08±0.91 points and were generally positive. The ratio of non-face-to-face education and face-to-face education in future clinical Korean medicine theory lectures was about 63:27, with a higher proportion of non-face-to-face education. Conclusions: Promoting clinical Korean medicine as a non-face-to-face education has generally been positively evaluated in terms of efficiency and overall, and its use should be expanded in the future. In particular, it will be necessary to use non-face-to-face education in the theory classes of clinical Korean medicine. However, technical problems involving internet, video, equipment, and communication tools will need to be improved in the future.

Objective: Parkinson's disease (PD) is the second most common neurodegenerative disease after Alzheimer's disease. Antioxidant stress and inflammatory reactions are important causes of neurodegenerative diseases and are major causes of PD. Many animal experiments have been aimed at treating PD using the antioxidant effects of various traditional medicines and dietary supplements. This review reports the research investigating the antioxidant effects of herbs in in vivo PD models. Methods: The study consisted of a database search for articles related to PD and herbal treatments using the OASIS, NDSL, KTKP, Korean KISS, PubMed, Science Direct, CNKI, Wanfang, and J-STAGE databases. The search period was limited from the start of the search engine application to November 14, 2019. Studies were selected to confirm the antioxidant effects of herbal medicines in an in vivo PD model. Results: Eighty-two studies were summarized for plant species, extracts (or compounds), animal models, neurotoxins, and functional results. The most frequently used herbal materials were Bacopa monnieri, Camellia sinensis, Centella asiatica, and Withania somnifera. MPTP and 6-OHDA were the most commonly used neurotoxins for inducing PD. Most studies confirmed an increased expression and activation of antioxidant enzymes and a decrease in oxidative stress. Herbal materials showed their antioxidant effects regardless of the order of treatment and confirmed their possible use as treatments for the prevention and treatment of neurodegeneration. Conclusion: Many herbal medicines have antioxidant effects and are likely to be effective in delaying neurodegenerative damage by inhibiting or reducing oxidative stress by expression of antioxidant enzymes.

Purpose: This study assessed the validity of a questionnaire (SEID-Q27) for diagnosis of chronic fatigue syndrome (CFS), designed based on the systematic exertion intolerance disorder (SEID) criteria. Methods: Two groups of participants were recruited: 1. a non-CFS control group: adult university personnel with a Chalder fatigue scale (CFQ) score ≥15, and 2. a CFS patient group: patients from an online CFS community diagnosed with CFS (diagnostic code of G93.3) with the symptoms present. The survey ran from September to October, 2020. The validity of the questionnaire was investigated by factor analysis and receiver operator characteristic (ROC) analysis. Results: Among the 35 adults surveyed, 30 (86%) participants had CFQ scores ≥15 (15 males and 15 females) and 5 (14%) had a CFS diagnosis (2 males and 3 females). The total mean score was significantly different between the two groups (CFS: 6.8±2.2 vs. control: 4.4±2.4, p<0.05). The area under the curve (AUC) was 0.827. With a cut-off point 62, the sensitivity was 60%, specificity 97%, and the discriminant ability of the survey was 79%. Conclusions: The SEID -Q27 appears to be a useful instrument for the diagnosis of CFS using SEID criteria. However, further large-scale studies are needed with greater numbers of participants.

Objective: This study investigated the measurement interval in the ultrasonographic gastric emptying test for patients with functional dyspepsia (FD) and the correlation between gastric emptying and the findings of various questionnaires. Methods: In total, 119 patients (59 patients with FD and 60 healthy controls) were recruited from July 2018 to June 2020. Gastric volume (GV) and gastric emptying half-time (T1/2) were measured by ultrasonography at fasting and again at 0, 5, 10, 15, 30, 45, 60, 90, and 120 min after meals (apple juice, 500 mL, 224 kcal), and the average half-time (average T1/2) was calculated. Questionnaires on food retention (FRQ), phlegm pattern e (PPQ), cold and heat (CHQ), deficiency and excess (DEQ), and spleen-qi deficiency (SQDQ), stomach qi deficiency pattern (SSDQ), visual analogue scale (VAS), and Nepean dyspepsia index-Korean version (NDI-K) were completed by all participants. The differences in GV and T1/2 were analyzed in participants whose maximal GV occurred at 0 min versus after 0 min. The correlation of the average T1/2 with the questionnaire scores was also analyzed after excluding erroneous data. Results: Patients with FD who took a certain amount of time to reach maximal GV after meals had a greater gastric volume up to about 30 minutes after meals, and the PPQ, DEQ, and NDI-K scores, especially for upper gastrointestinal symptoms and general weakness-related symptoms, showed statistically significant correlations with average T1/2. Conclusions: Ultrasonography can be a quantitative evaluation tool for FD. However, further studies on measurement methods based on FD physiopathology are required.

Objectives: To evaluate the reliability of a pattern identification tool for benign prostatic hyperplasia and to examine the relationship between pattern identification tool readings and IPSS and uroflowmetry. Methods: We analyzed 56 patients diagnosed with benign prostatic hyperplasia from December 27th, 2017 to December 26th, 2018 by two different Korean medical doctors and followed with a pattern identification tool and by IPSS and uroflowmetry. One week later, the patients were retested to analyze the reliability of the pattern identification tool, determined with the intraclass correlation coefficient (ICC) using the test-retest method. The correlation between IPSS and uroflowmetry was analyzed with the Pearson coefficient. Result: The reliability of the pattern identification tool for benign prostatic hyperplasia was evaluated as "poor agreement beyond chance" (ICC=0.349). The reliability of each pattern identification score was evaluated as "good" for Yang Deficiency of Kidney, Yin Deficiency of Kidney, Deficiency of Middle Qi, and Dampness-heat of Lower Energizer. The internal consistency was evaluated as "good" for Yang Deficiency of Kidney, Yin Deficiency of Kidney, and Dampness-heat of Lower Energizer, and as "excellent" for Deficiency of Middle Qi. The correlation between pattern identification and IPSS was evaluated as a "moderate positive correlation" for all pattern identifications. The average flow rate and maximum flow rate using uroflowmetry was evaluated with "moderate negative correlation" for Yang Deficiency of Kidney and Dampness-heat of Lower Energizer. Conclusion: The reliability of a pattern identification tool for benign prostatic hyperplasia was evaluated as "poor agreement beyond chance." Further research is needed.

Objective: This study was conducted to evaluate the effect of herbal medicine on blood glucose in diabetic patients. Methods: The subjects were patients with diabetes mellitus (DM) who had been admitted to Kyung Hee University Korean Medicine Hospital for more than 8 weeks for a primary diagnosis other than DM and who had taken herbal medicine for more than 8 weeks from January 2010 to February 2020. The medical records were analyzed retrospectively to confirm the characteristics of the subjects, and examination results included hemoglobin A1c (HbA1c), total cholesterol, triglyceride, low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), aspartate aminotransferase (AST), alanine aminotransferase (ALT), blood urea nitrogen (BUN), and creatinine. Changes in HbA1c before and after taking herbal medicine and changes according to subgroups were analyzed. Results: A total of 149 subjects with type 2 DM were selected as participants. After taking the herbal medicine, the HbA1c value was significantly decreased, and the statistical significance was maintained even when the effect of controlling antidiabetic agents was excluded. The decrease in HbA1c was higher in the poor glycemic control group. Liver and kidney functions did not show any significant changes after taking the herbal medicine. Conclusions: Administration of herbal medicine for a long period of 8 weeks or longer did not increase HbA1c in patients with DM complicated by other various diseases.

Objective: The purpose of this study was to investigate the effect of amorfrutin of licorice for Type2 diabetes mellitus. Method: The PubMed, CNKI, Wanfang, OASIS, NDSL, J-STAGE, and CiNii databases were searched from the beginning of the search to September 20, 2020, with no limits on language. Extractions and selections from the literature were made by two authors. The study included in vivo experiments with amorfrutins in high-fat diet-induced obesity C57BL/6 mice and leptin receptor-deficient db/db mice and in silico studies. Results & Conclusion: Four studies were finally selected. We confirmed that amorfrutin treatment considerably improved insulin sensitivity and glucose tolerance and reduced plasma insulin and glucose. Amorfrutins bind to and selectively activate Peroxisome Proliferator-Activated Receptor Gamma (PPARγ), which plays an important role in glucose metabolism. Amorfrutins also strongly bind to the glucagon receptor (GCGR) and work as antagonist. Using the amorfrutins from licorice could therefore be helpful in treating type2 diabetes mellitus.

Objective: The purpose of this study was to investigate the effect of cinnamon on the treatment of Parkinson's disease (PD) and to introduce its use in Korea. Method: We searched the experimental studies in electronic databases (PubMed, CNKI, Wanfang, CiNii, J-STAGE, Science ON, and OASIS) using the key search terms "cinnamic acid", "cinnamon", "cinnamomum", "Parkinson's disease", "Parkinson disease", "Parkinsonism", and "dopamine". This study only involved experimental studies (in vivo and in vitro) that adopted cinnamon as a single administration and measured indicators relating to Parkinson's disease, including parkin, tyrosine hydroxylase (TH), and dopamine. Results: A Total of 11 literature studies were selected, and they all showed that treatment with cinnamon has a neuroprotective effect. Cinnamon activated neuroprotective factors and restored neurotransmitters and it reduced the rate of oxidative stress and inflammation in neurons. As a result, cell viability was upregulated, while cell apoptosis and neurodegeneration were downregulated. Five in vivo studies, through behavioral tests, also confirmed that cinnamon recovers locomotor function in PD models. Conclusion: We identified that cinnamon is an effective neural protector and improves motor performance in behavioral testing in the experimental PD studies.

Objectives: The purpose of this study was to assess the effects of acupuncture as a treatment for allergic rhinitis (AR). We used a meta-analysis and systematic review to analyze the results of randomized controlled trials (RCTs) that applied acupuncture to AR patients. Methods: The key question assessed the effects of acupuncture on patients with AR, and we included only RCTs. We searched the KoreaMed, NDSL, KMBASE, Koreantk, OASIS, PubMed, EMBASE, and Cochrane databases, with no language restriction. We assessed risk of bias with the Cochrane Risk of Bias tool. The random effects model was used to adjust for the heterogeneity of the included studies, and the effect sizes between two groups were reported as mean differences (MD) and risk ratios (RR). Results: Twelve RCTs were analyzed, with a total of 1788 participants; 824 participants were in the treatment group (i.e., acupuncture) and 964 were in the control group (sham acupuncture, western medicine, or waitlist). The meta-analysis results of 7 RCTs comparing the therapeutic efficacy of acupuncture with that of sham acupuncture showed a statistically significant difference (p<0.05) in the Rhinoconjunctivitis Quality of Life Questionnaire (RQLQ) and the Change of Total Nasal Symptom Score (TNSS). The meta-analysis of 4 RCTs comparing the therapeutic efficacy of acupuncture with western medicine showed statistically significant differences (p<0.05) in the RQLQ but not in the changes in effective rate (p>0.05). Conclusions: Acupuncture can be an effective treatment for AR, but more studies are required to enhance the level of evidence and to confirm safety.

Objective: The purpose of this study was to review Chinese clinical studies of the treatment of gastroesophageal reflux disease (GERD) with herbal medicine including Pinellia ternata. Methods: We searched the China National Knowledge Infrastructure (CNKI) database for clinical studies on herbal treatments including Pinellia ternata for GERD, from January 1st, 2015 to September 30th, 2019. We evaluated the risk of bias using Cochrane's risk of bias to confirm the quality of the 37 selected documents. Results: The 37 papers included high-dose and middle-dose Pinellia ternata groups. The outcome measures included treatment effectiveness rate, symptom comparisons, and endoscopy effectiveness rates or scores. In both groups, most studies showed significant improvement in the treatment group compared with the control group. The meta-analysis revealed a higher treatment effectiveness rate and a lower recurrence rate in the treatment group than in the control group. Conclusions: Comparing the treatment effect between the two groups was difficult due to the low quality of most studies. However, the results suggest that herbal remedies including Pinellia ternata showed statistically significant improvement in GERD compared to control groups.

Objectives: Parkinson's disease (PD) is a neurodegenerative disease of the elderly characterized by impaired behavior from lack of dopamine secretion. However, no accurate quantitative diagnosis method has been established. The purpose of this study was to analyze the patent trends (PTs) of health examination and daily monitoring/healthcare technology for PD. Methods: For analyzing PTs, a search summary for classifying each analysis target technology was set, and a final search formula was constructed by collecting keywords. After constructing a database of related patents through the final search formula, noise was removed to extract valid patents. PTs by major countries were analyzed using the valid patents, and PTs and growth stages were analyzed by the detailed technologies. Results: The survey analysis showed that, despite the existence of unpublished patents between 2018 and 2020, patent activity has increased rapidly in the recent period, and this increasing trend was led by the USA. This technology is considered to be in its early- or mid-stage growth period, which means that the marketability is high and the barriers are low. Korea's market share is only about 25%, but it has a larger number of applications than those of Europe and Japan. Integrated monitoring and diagnosis technologies for PD have a share of 34%. Conclusion: The advances in diagnosis and healthcare technology for PD means that traditional Korean medicine must continue to pay attention to related technologies and to review plans that are applicable to clinical practice.

Objectives: The aim of this study was to determine the therapeutic effects of a traditional Korean treatment on the symptom improvement and loss of bile juice in cases of functional dyspepsia of gastric dysmotility complicated by bile juice reflux. Methods: Dyspeptic symptoms, gastric motility (electrogastrography and bowel sound analysis), and gastric mucosa (gastroendoscopy) were evaluated. The treatment consisted of Banwhasashim-tang (extract) used as a herbal drug. Both ST36 electrical stimulation and simple immersion stimulation of CV11, 12, and 13 in the abdomen were also applied. Results: Dyspeptic symptoms, including a foreign body sensation in the throat, indigestion, and upper abdominal pain, were all relieved by the treatment and gastric myoelectrical activity and gastric pyloric function were improved. Bile juice disappeared from the gastric mucosa. Conclusion: The traditional Korean treatment was effective at relieving dyspeptic symptoms and bile juice reflux by improving the pyloric sphincter function.

Introduction: In this case report, we addressed the effects of a Korean medicine treatment on recurrent pyelonephritis in a female patient with a duplicated collecting system. Case report: A 22-year-old female with acute pyelonephritis was treated with Korean medicine, including herbal medication, Insampaedok-san plus Oryeong-san, and with antibiotic therapy. We evaluated the improvements in her symptoms by measuring C-reactive protein, WBC count, body temperature, and a numeric rating scale for nausea. The symptoms of fever and nausea improved after two days of hospitalization. From the 4th day of taking the herbal medicine, the antibiotic IV infusion was changed to oral agents. Conclusions: This clinical case study suggests that modified Insampaedok-san might have shortened the duration of intravenous antibiotic infusion and hospitalization for recurrent pyelonephritis in a female patient with a bifid ureter.

The purpose of this case report is to describe the effect of Korean medicine therapy on patient with migraine. We treated migraine for 2 months using a Korean medical treatment and six-meridian pattern identification, including herbal medicine (Soshiho-tang), acupuncture, cupping, chuna, and pharmacopuncture. The measurements included a numerical rating scale (NRS), migraine disability assessment (MIDAS), headache impact test-6 (HIT-6), and migraine specific quality of life questionnaire (MSQoL) to confirm the effectiveness of the herbal medicine treatment. After treatment, the patient's complaints decreased, as shown by the results of the NRS, MIDAS, HIT-6, and MSQoL. For migraines, Korean medical treatment and six-meridian pattern identification, such as herbal medicine (Soshiho-tang), has beneficial effects for the control of migraine and improvement in the quality of life.

We studied the effect of Korean medicine treatment on the clearance of vancomycin-resistant enterococcus (VRE) colonization and on improvement in symptoms in a stroke patient. The patient was continuously followed up with stool VRE cultures while being treated with herbal medicine, Chunglijagam-tang, acupuncture, and oxygen therapy. We also checked the coccygeal pressure sore condition and the oxygen levels during therapy. No VRE colonization was found after treatment and the oxygen levels and pressure sores had improved. This study proved that Korean medicine treatment could be effective for the clearance of VRE colonization and improvement of symptoms.

Aphasia is a language disorder that results from brain damage and typically occurs after a stroke. The purpose of this case report was to describe the effects of Korean medical treatment on anomic aphasia after a putaminal hemorrhage. We used Korean medical treatment, including head acupuncture and herbal medicine (Hyungbangsabaek-san) therapy, on a patient who was admitted to the hospital for 19 days. The clinical symptoms were assessed with the Korean version of the Western Aphasia Battery (K-WAB), and quality of life was evaluated with Korean version of Stroke and Aphasia Quality of Life Scale-39 (K-SAQOL-39). After 19 days of treatment, the K-WAB scores were increased from 17 to 19 in the spontaneous speech score, from 7.55 to 9.85 in the comprehension score, from 9 to 9.4 in the speaking score, and from 5.8 to 9.7 in the naming score. The AQ score was increased from 78.7 to 95.9, and the K-SAQOL-3 score was increased from 2.64 to 3.26. In conclusion, the study findings suggested that Korean medical treatment could be an effective option for treating symptoms and improving quality of life in patients with aphasia after stroke.

Objective: The purpose of this study was to report the effect of acupuncture on the splenius muscle and the effect of combined Korean medicine treatment on acute dizziness in patients due to whiplash injury. Methods: Three patients with acute dizziness were treated with acupuncture of the splenius muscle and combined Korean medicine. A numeric rating scale (NRS) and the Korean dizziness handicap inventory (K-DHI) were checked every day from admission to discharge to confirm symptom improvements. Results: In the acute stage of dizziness caused by whiplash injury, acupuncture of the splenius muscle and combined Korean medicine improved the NRS and K-DHI scores. Conclusions: For patients with acute dizziness caused by whiplash injury, a combination of acupuncture on the splenius muscle and Korean medicine treatment may be a solution.

Objective: The purpose of this study was to report the effectiveness of Korean medicine (Beewha-eum) on the treatment of non-cardiac chest pain (NCCP) in a patient with non-erosive reflux disease (NERD). Methods: The patient was diagnosed with a spleen-stomach weakness pattern identified by Korean medicine and was treated with herbal medicine (Beewha-eum). The severity of symptoms was assessed with a numerical rating scale (NRS) for chest pain, self-reported dyspepsia degree (%), Korean gastrointestinal symptom rating scale (KGSRS), gastrointestinal symptom score (GIS), and Functional Dyspepsia-Quality of Life(FD-QOL) score. Results: After Beewha-eum treatment, the severity of chest pain was decreased from NRS 8 to NRS 0 and the self-reported dyspepsia degree also decreased from 100% to 65%. The KGSRS score was decreased from 49 to 35, the GIS score was also decreased from 16 to 9, and the FD-QOL score was increased from 20 to 25. Conclusions: The study findings suggested that Korean medical treatment with Beewha-eum could be an effective option for treating NCCP in patients with NERD.

Objective: This study was conducted to report the glucose-lowering effect and safety of herbal extracts in patients with type 2 diabetes mellitus. Methods: We investigated 21 patients with type 2 diabetes mellitus who were administered Daeshiho-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san at Kyung-Hee University Korean Medical Hospital from 2014 to 2019. The hypoglycemic effect of the herbal extracts was assessed by comparing blood glucose levels, including fasting blood sugar (FBS) and 2-hour postprandial glucose (PP2) levels. For safety assessment, the effects of herbal extracts on liver and kidney function were analyzed by liver function tests, including aspartate aminotransferase (AST), alanine aminotransferase (ALT), and γ-glutamyltransferase (GGT), and kidney function tests, including blood urea nitrogen (BUN) and creatinine (Cr). Patients were stratified according to their glycated hemoglobin (<6.5 or >6.5) levels and the kind of herbal extract used for treatment. Results: After administration of herbal extracts, FBS and PP2 significantly decreased to 20.24 mg/dL and 35.0 mg/dL respectively. Subgroup analysis revealed that, regardless of the glycated hemoglobin level, FBS and PP2 were significantly reduced in both groups. The safety profile showed no significant difference before and after taking herbal extracts. Conclusions: Daeshigo-tang, Bojungikgi-tang, Jowiseunggi-tang, and Hoechunyanggyeok-san may show the further glucose-lowering effects on patients with type 2 diabetes mellitus who have already treated with anti-hyperglycemic agents.

Introduction: The aim of this study was to report the effect of Korean medicine treatments on a stroke patient with acute cerebral infarction. Method: A 63-year-old male with anterior and middle cerebral artery infarction had symptoms of dizziness and disorientation. The patient was treated with Korean medicine therapy, including the herbal medicine "Sunghyuangjunggi-san-gamibang." Treatment progress was assessed using the Korean version of the Modified Barthel Index (K-MBI) and the Korean dizziness handicap inventory (K-DHI). Results: After 14 days of treatment, the K-DHI score decreased from 78 to 7 and the K-MBI score increased from 18 to 24. The patient's main symptoms were improved after the treatment, and no side effects were observed. Conclusion: Korean medicine treatment, including Sunghyuangjunggi-san, might be a recommended therapeutic option for dizziness and disorientation in stroke patients.

Objective: The purpose of this study was to report the effect of Korean medicine on a patient with non-small cell lung cancer with pleural metastasis who had been treated with afatinib. Method: A 61-year old female patient with non-small cell lung cancer with pleural metastasis was treated with acupuncture and herbal medicines, including Yijung-tang, Haengso-tang, Samchulkunbi-tang, Paeamju-bang (Feiai zhu fang), to control various symptoms caused by afatinib. The degree of pain was assessed by a numeric rating scale (NRS) and the quality of life was determined with the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire, Core 30 (EORTC QLQ-C30) and the EORTC 13-item lung cancer-specific module (EORTC LC-13). Results: After receiving acupuncture and herbal medicines, the patient showed improvement in her back and chest pain, according to the NRS score. Similarly, the Korean medicinal treatments significantly relieved her nausea, vomiting, diarrhea, hemoptysis, and alopecia. However, the EORTC QLQ-C30 assessment suggested that Korean medicinal treatments did not significantly improve the global health status of this patient. Conclusion: Korean medicine could be useful in relieving some of the symptoms occurring after conventional afatinib treatments.

Objectives: Patients with polycythemia vera can experience many symptoms, including dizziness, headache, and fatigue, caused by a high red blood cell mass and blood viscosity. Some symptoms persist even after appropriate treatment. The purpose of this study was to examine the effect of Korean medicine on dizziness following polycythemia vera treatment. Methods: A patient diagnosed with polycythemia vera was treated with Korean medicine, including pharmacopuncture, acupuncture, and herbal medicine. We used a numeral rating scale (NRS) and the Dizziness Handicap Inventory (DHI) to observe the effects of the treatment. Results: After treatment, the hematocrit and hemoglobin increased to within normal range, and the NRS scores for dizziness and fatigue, subjective discomfort, and DHI scores decreased compared with the preadmission values. Conclusions: This report shows that Korean medicine helped to relieve dizziness in a patient with polycythemia vera. However, we need further studies to establish treatment regimens for polycythemia vera symptoms.

Objective: This case report shows symptom improvements in stage IV metastatic colorectal cancer treated with a Korean medicine-based integrative cancer treatment (ICT). Methods: A 61-year-old male patient diagnosed with colorectal cancer in November 2017 and metastasis to the lung, peritoneum, and liver in September 2020 was treated with Integrative Cancer Treatment (ICT) for abdominal pain, abdominal discomfort, and anorexia for 1 month. Clinical outcomes were measured with the National Cancer Institute Common Terminology Criteria for Adverse Event (NCI-CTCAE), a numeral rating (NRS), the Eastern Cooperative Oncology Group (ECOG), and the Functional Assessment of Cancer Therapy-General (FACT-G) scales. Results: After treatment, the patient's abdominal pain was improved from NRS 8 to 1, and the ECOG score of the patient was improved from grade 3 to 2. Integrative Cancer Treatment. Also the score improved on the FACT-G test, and there were no serious side effects of grade 3 or higher according to the NCI-CTCAE. Conclusion: This case study suggests that Korean medicine-based ICT may help to improve abdominal pain and quality of life in patients with metastatic colorectal cancer.

Objective: The case study assessed the possibility of improving symptoms by external treatment in a patient complaining of night sweats who could not take oral herbal medicine. Methods: Chinensis galla, Ostreae concha, and Cinnabaris were mixed in a 2:1:1 ratio and applied to CV8 before the patient went to bed. The treatment was removed upon waking and repeated every night. If itchiness and skin redness occurred, the position was changed to 2-3 cm up or down from the navel or application was changed to once every two days. Results: The external treatment eliminated the symptoms of sweating in the arms, legs, chest, and abdomen and reduced sweating in the occipital and neck areas. The sweating was improved to the extent that it no longer interfered with daily life. Conclusions: This case study shows the possibility of using external treatments rather than herbal medicine to treat night sweats.

Background: Hemorrhoid surgery is a frequently performed surgery in Korea, second only to cataract surgery. However, it has serious complications, including bleeding, infection, anal stenosis, and urinary retention, so active conservative therapies are in need at an early stage. Case summary: Thirteen patients with anal disease complained of main symptoms of pain, bleeding, and prolapse, with additional complaints of itching and mucus discharge. An herbal medicine mixture of Eulja-tang and Hwangryeonhaedok-tang was administered twice daily, and dry cupping therapy, acupuncture, and hot pack placements were administered on pelvic and sacral regions once weekly for four weeks. The symptoms were evaluated before and each week after the treatments. The treatments had statistically significant therapeutic effects. Conclusion: Korean medicine treatment-effectively alleviating the symptoms of anal disease, such as pain, bleeding, and prolapse-may represent an alternative therapy for conservative treatments in the early stages of anal disease.

Background: The aim of this study was to determine the clinical effects of complex Korean medicine therapy for tinnitus associated with ear fullness, depression, and anxiety. Case Report: A 52-year-old female patient suffering from tinnitus with ear fullness, depression, and anxiety was treated with acupuncture, pharmacopuncture, and herbal medicine. We used the Tinnitus Handicap Inventory (THI), Beck Depression Inventory (BDI-II), Beck Anxiety Inventory (BAI), and a Verbal Numerical Rating Score (VNRS) to assess the patient's symptoms. The administration of the acupuncture, pharmacopuncture, and herbal medicine improved the ear fullness, depression and anxiety symptoms. No side effects were observed during the treatment. Conclusion: The study findings suggest that complex Korean medicine therapy, such as acupuncture, pharmacopuncture, and herbal medicine, may be effective for the treatment of tinnitus associated with ear fullness, depression, and anxiety.

This is a case report of Raynaud's disease improved by Korean medicine treatment. A patient suffering with redness of the hands for more than five years took Yanggyeoksanhwa-tang or Geopungcheonggi-san for 3 months. The change in symptoms was assessed with photographs and evaluating the subjective symptoms of patient. After the 25th treatment, the redness of the hands and the subjective symptoms showed improvement. These findings suggested that Korean medicine treatment could be an effective option for redness of the hands due to Raynaud's disease.