Objectives: The aim of this study was to analyze the latest clinical studies on Korean medicine treatment of idiopathic thrombocytopenic purpura (ITP) in the Chinese National Knowledge Infrastructure (CNKI) database. Methods: We searched the last 6 years of clinical studies discussing Oriental medicine-based treatments for ITP in the CNKI database. A meta-analysis of 13 RCTs was performed by synthesizing the outcomes, including the measured platelet count and total effective rate. The quality of the studies was assessed using Cochrane's risk of bias (RoB) tool. RevMan 5.4.1 software was used for data analysis. Results: Of the 15 selected studies, 1 was a non-randomized controlled trial (nRCT), 2 were case series, and 12 were randomized controlled trials (RCTs). Treatments in all studies included oral herbal medicine. The most frequently used herbal decoction was the Liangxue Jiedu prescription (凉血解毒方), and the most commonly used herb was Agrimonia pilosa (仙鶴草), Astragali Radix (黃芪), Fossilia Glycyrrhizae Radix et Rhizoma (甘草), and Rehmannia glutinosa Liboschitz ex Steudel (地黃). The meta-analysis showed significantly better improvement in platelet counts and total effective rate for ITP in the treatment group than in the control group. Conclusion: Treatment with herbal medicine was effective in treating ITP. However, the significance of this conclusion is somewhat limited due to the low quality of the available studies. Multifaceted and scientifically designed clinical studies are required to develop treatments for ITP based on Korean medicine. The results of this study could be used as basic data for further ITP studies.

Objectives: The aim of this study was to investigate the differences in the prevalence of metabolic syndrome (MetS) according to the Sasang constitution (SC) and cold and heat pattern identification (CHPI). Methods: SC, CHPI, MetS, and component data were obtained from 2,561 participants in 26 Korean medical clinics from 2007 to 2013. SC, diagnosed by Korean medicine doctors, was confirmed by positive responses to herbal medicines administered according to that constitution. The CHPI was verified by a questionnaire about thermal sensitivity and drinking habits. The diagnosis criteria for MetS were: 1) waist circumference (WC) ≥90 cm (male) and ≥80 cm (female); 2) triglycerides ≥150 mg/dL; 3) high density lipoprotein cholesterol (HDL) <40 mg/dL (male) and <50 mg/dL (female); 4) blood pressure ≧130/85 mmHg; and 5) fasting blood glucose ≥100 mg/dL. Odds ratios (ORs) and differences in MetS and its components were compared using logistic regression and ANCOVA. Results: The MetS prevalence rates were 54.1%, 22.0%, and 33.3% for Taeeumin (TE), Soeumin (SE), and Soyangin (SY), respectively, and 30.5% and 44.5% for the cold and heat patterns, respectively. ANCOVA for MetS components showed significantly higher WC in TE than in SE or SY, and all components except HDL were higher in the heat pattern group than in the cold pattern group. Logistic regression for MetS prevalence showed a significant association between TE and the heat pattern group (OR=1.653) but not for non-TE and the cold pattern group. Conclusions: Considering SC and CHPI together may be more effective in managing MetS than considering SC alone.

Objectives: The aim of this study is to analyze cancer research trends in traditional Korean medical journals indexed in the Korea Citation Index since 2000. Methods: Cancer research papers published in traditional Korean medical journals were searched in databases from inception to October 2022. The numbers of publications by journal and by year were descriptively assessed. After natural language processing, topic modeling (based on Latent Dirichlet allocation) and keyword network analysis were conducted. Results: This research trend analysis involved 1,265 papers. Six topics were identified by topic modeling: case reports on symptom management, literature reviews, experiments on apoptosis, herbal extract treatments of breast carcinoma cell lines, anti-proliferative effects of herbal extracts, and anti-tumor effects. Keyword network analysis found that the effects of herbal medicine were assessed in clinical and experimental studies, while acupuncture was mainly mentioned in clinical reports. Conclusions: Cancer research papers in traditional Korean medical journals have contributed to evidence-based medicine. Further experimental studies are needed to elucidate the effects of on different hallmarks of cancer. Rigorous clinical studies are needed to support clinical guidelines.

Objective: The aim of this study was to identify the efficacy and underlying mechanism of cloves as an osteoarthritis (OA) treatment in a monosodium iodoacetate (MIA)-induced rat OA model. Osteoarthritis (OA) is nowadays one of the most prevalent degenerative joint diseases. Methods: Sprague-Dawley rats treated with MIA (50 μL; 80 mg/mL) were used as in vivo OA models. Cloves (100 and 200 mg/kg b.w.) were administered orally once daily for 2 weeks from 7 days after MIA injection. Changes in hindpaw weight distribution (HWD) were measured as a joint discomfort index. Activation markers related to inflammatory responses and cartilage degeneration in the right knee joints were evaluated by serum analysis and western blotting. Results: HWD decreased in the MIA control group but showed a dose-dependent elevation after clove treatment. Clove treatment inhibited inflammatory factors by PI3K/Akt/NF-κB signaling pathways, while also activating antioxidant factors through Sirt1/AMPK signaling pathways. Clove treatment also suppressed matrix metalloproteinase (MMP) overexpression and significantly increased the levels of tissue inhibitors of metalloproteinases (TIMPs). Conclusions: Treatment with cloves effectively reversed MIA-induced effects. Therefore, clove treatment could have the potential to protect against or treat OA.

Objectives: The purpose of this study is to explore the effectiveness and safety of frequently used clinical herbal medicines (Yijung-tang [Lizhong-tang, LJT], Pyeongwi-san [Pingwei-san, PWS], and Shihosogan-tang [Chaihu Shugan-tang, SST]) in patients with functional dyspepsia (FD) when administered according to herbal medicine and Korean medicine pattern identification. The results of this study will be used to standardize the diagnostic instrument used in Korean medicine and to investigate biomarkers of Korean medicine pattern identification. Methods: This study will be a randomized, assessor-blind, 3-arm, parallel, open-label, multi-center clinical trial. A total of 300 FD participants will be recruited from 3 Korean medical hospitals and assigned to the LJT (n=100), PWS (n=100), and SST (n=100) groups according to FD pattern identification. The patients will take the medication for 8 weeks, 3 times a day, before or between meals. The primary outcome will be total dyspepsia symptom (TDS) and the secondary outcomes will be adequate relief (AR) for dyspepsia, overall treatment effect (OTE), visual analogue scale (VAS), functional dyspepsia-related quality of life (FD-QoL), gastrointestinal symptom score (GIS), and pattern identification questionnaires. For the exploratory outcomes, we will analyze blood and fecal metabolome profiles, microbiota from fecal and saliva samples, single nucleotide polymorphism (SNP), and results of Korean medicine diagnosis device measurements (heart rate variability, and tongue, pulse, and abdominal diagnosis). Conclusions: The results of this study will prove objectivity for Korean medicine pattern identifications, and the effectiveness and safety of herbal medicines for the population with FD.

Objectives: The aim of this study was to retrospectively evaluate the efficacy and safety of Ongyeong-tang (OGT) in the treatment of insomnia in patients afflicted with neurological diseases, according to the medical records of one medical institution. OGT is a herbal prescription that originates from the "Synopsis of Prescriptions of the Golden Chamber" and has been used for menopausal symptoms, uterine diseases, skin diseases, insomnia, and other neuropsychiatric symptoms. Methods: Medical records of patients who visited Kyung Hee University Korean Medicine Hospital from January 1, 2021 to June 30, 2022, received outpatient or inpatient treatment, and met the inclusion criteria were used in this study. Results: Twenty-four patients satisfied the inclusion criteria and were included. The Pittsburgh Sleep Quality Index-Korean version (PSQI-K) score was used to evaluate the outcomes before and after treatment. After an average of 14.42±9.2 days of OGT extract intake, 20 patients (83.3%) experienced improvement. The remaining four (16.7%) had no change in their symptoms, but none demonstrated worsening of symptoms. The total PSQI-K score showed a statistically significant decrease from 13.08±4.54 to 10.42±4.58 (p<0.001). Sleep quality, sleep duration, sleep disturbance, use of sleeping medications, and daytime dysfunction also showed statistically significant improvements. Conclusions: Administration of OGT extract may be a relatively safe and effective therapeutic option for insomnia in patients with neurological diseases.

Purpose: We evaluated whether Spatholobus suberectus extract (SSE) can be used as a means of preventing and treating osteoporosis by measuring its effect on osteoclast differentiation, gene expression, and bone resorption. Methods: SSE was used to examine the effect on RAW 264.7 cells stimulated with RANKL to induce bone resorption. The inhibitory effect of TRAP formation and the expression of the bone resorption factors TRAP, cathepsin K, and MMP-9 during differentiation were measured. The effects on the differentiation-related factors NFATc and TRAIL and on the expression of OC-STAMP, DC-STAMP, ATP6v0d2, MITF, c-Fos, and inflammation-related factors were also evaluated. The effect on bone resorption was evaluated by culturing RANKL-treated osteoclasts on artificial bone fragments and observing the resulting resorption traces. The effect on bone damage in experimental animals was also measured. Results: SSE inhibited the differentiation of RANKL-stimulated osteoclasts into osteoclasts and suppressed the expression of cathepsin K, TRAP, MMP-9, NFATc1, TRAIL, MITF, OC-STAMP, DC-STAMP, ATP6v0d2, and c-Fos genes. Bone pore formation due to osteoclast action was also inhibited, and LPS-induced bone loss was suppressed in animal experiments. Conclusions: SSE could be useful for the prevention or treatment of osteoporosis by inhibiting osteoclast differentiation and bone resorption and suppressing bone loss induced in experimental animals. However, studies of larger populations are required.

Purpose: This systematic review was conducted to evaluate the clinical effects of Injinho-tang on hyperbilirubinemia in hepatobiliary disorders. Methods: We searched for randomized controlled clinical trials that had administered Injinho-tang as an intervention in the following medical databases: Public/Publisher MEDLINE (PubMed), Excerpta Medica dataBASE (EMBASE), Cochrane library, Research Information Sharing Service (RISS), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), and China National Knowledge Infrastructure (CNKI). Among the retrieved studies, only trials that met the inclusion criteria were selected, and serum total bilirubin values were extracted and analyzed from the finally selected trials. Results: The serum total bilirubin values of 1,302 patients with various hepatobiliary diseases were synthesized through a meta-analysis, which confirmed a decrease in serum total bilirubin of 21.03 𝜇mol/L (95% CI -29.58~-12.49, p<0.01) in the group administered with Injinho-tang compared with the control group. Conclusions: Injinho-tang is effective in alleviating hyperbilirubinemia in hepatobiliary diseases when administered with conventional treatment. However, the potential risk of bias, high heterogeneity among the included trials, and differences in herbal composition are limitations of the results of this meta-analysis.

Purpose: We examined the effects of Dansam (Salvia miltiorrhiza Bunge, SM) and Dansam-eum (DSE) on gastroesophageal reflux disease (GERD) and reflux esophagitis by comparing the inhibitory effects of SM and DSE with the representative treatment of PPI Omeprazole to determine if the effects of the prescription DSE based on Korean medicine are better than those of a single-use of SM. Methods: We performed experiments using both animal models and cancer cells. Results: Comparison of SM and DSE with PPI in the animal model tests revealed that the effects were superior for SM and DSE than for PPI in all categories (8-OHdG, p-IκB, PAR2, COX-1, cathelicidin, p-JNK, Caspase 3, ATP6V1B1, GRPR, serotonin, and NPY). In three categories (COX-1, serotonin, and NPY), SM and DSE showed superior results over the Controls. In the animal model tests, DSE was superior to SM in all categories except for serotonin. The anti-cancer effects observed in cancer cell tests revealed that SM and DSE had meaningful results in terms of cytotoxicity and cell movement rate, as well as in cancer cell apoptosis. Conclusions: We confirmed that SM and DSE can have effects on reflux esophagitis through the regulation of oxidative stress, inflammation, mucosal protection, apoptosis, proton pumping, and the enteroendocrine system in the stomach and esophagus. We also confirmed that SM and DSE have superior effects to those of PPI on all aspects, especially gastric mucosa protection and enteroendocrine system control. We also confirmed that SM and DSE have anti-cancer effects. Above all, we confirmed that DSE has superior effects on almost all aspects compared to using SM alone.

Objectives: A case study about the effectiveness of integrative Korean medicine treatment in a psychogenic tremor patient. Case presentation: A 36-year-old male diagnosed with psychogenic tremor with low back pain underwent 29 days of inpatient treatment and 4 weeks of outpatient treatment. His pattern identification was a psychogenic tremor of the weakness of the heart and gall bladder (SimDamHeoGup) type. The treatments were herbal medicine and acupuncture. He took Cheongshimondam-tang for 29 days and Chunwangbosim-dan for 6 weeks when he had symptoms. He also received acupuncture for 20 minutes twice a day at GB20 (Pungji), L14 (Hapgok), HT4 (Yeongdo), PC6 (Naegwan), HT7 (Sinmun), GB34 (Yangleungcheon), ST36 (Joksamni), SP6 (Sameumgyo), and LR3 (Taechung). After 8 weeks of treatment, the Fahn Tolosa Marin rating (FTM) scale of his tremor, at rest, dropped from Grade 4 on both upper extremities, trunk, and both lower extremities at the time of admission to Grade 2 in both upper extremities and trunk, and Grade 0 in both lower extremities at the time of discharge. His Beck Anxiety Inventory (BAI) score decreased from 38 to 7, and his numerical rating scale (NRS) decreased from 8 to 1 for low back pain and from 9 to 2 for tremor. A follow-up visit to the hospital 2 months after the end of treatment confirmed continued symptom improvements and no significant side effects. Conclusions: This study suggests the possibility of treating psychogenic tremor using only Korean medicine treatments. Further studies with control groups and long-term follow-up are needed.

Objectives: This study examined a case of an 80-year-old woman with extensive ascites and hypervolemic hyponatremia due to decompensated liver cirrhosis. Methods: The patient was first treated with a diuretic to treat her ascites. However, during hospitalization, she developed hypervolemic hyponatremia due to liver cirrhosis. Therefore, we discontinued the diuretic and treated her with Korean herbal medicine (Insamyangyoung-tang with Oryeong-san). We measured her abdominal circumference, followed by radiography, to evaluate the effect of Korean herbal medicine. Result: We treated the patient only with Korean medicine and without diuretics, and her ascites was successfully reduced. No recurrence was observed. Conclusion: Korean herbal medicine can be used as an adjuvant therapy for patients with ascites and hyponatremia.

Objective: The purpose of this study was to report three cases of post-COVID-19 dry cough that persisted even after taking Western medicine but was successfully treated with Maekmundong-tang. Methods: Three patients who were treated with Maekmundong-tang from March to June 2022 were selected from patients who visited Dong-Eui University Korean Medicine Hospital with post-Covid-19 dry cough. Jeil Maekmundong-tang Ext. granules were used to improve the cough. The effect of the treatment was evaluated using a visual analog scale, cough symptom score, and cough assessment test. Results: After the treatment, Cases 1, 2, and 3 showed decreases from 90 to 30, 65 to 0, and 70 to 20, respectively, for the visual analog scale score, decreases from 9 to 3, 5 to 0, and 5 to 3, respectively, for the cough symptom score, and decreases from 20 to 4, 9 to 1, and 8 to 3, respectively, for the cough assessment test score. Conclusion: Maekmundong-tang provided an effective improvement in the post-COVID-19 dry cough that persisted even after taking Western medicine.

Objectives: The aim of this study was to report a clinical case of decompensated liver cirrhosis in a patient with jaundice who showed improvement with Korean medicine treatment. Methods: A patient with decompensated liver cirrhosis with jaundice was treated with herbal medicine (Injinoryung-tang, Galgeunjowi-tang), acupuncture, cupping, and moxibustion. Changes in jaundice, fatigue, and dysuria were measured with subjective parameters. Liver function was checked by performing a blood test 8 times. The levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), gamma glutamyl transpeptidase (GGT), total bilirubin (TB), albumin, and platelets (Plt), prothrombin time (PT), and international normalized ratio (INR) were recorded. Results: The Korean medicine treatment improved jaundice, fatigue, and dysuria and lowered the AST, ALT, ALP, GGT, and TB levels. Conclusions: Korean medicine treatment containing Galgeunjowi-tang positively improves clinical symptoms and liver function.

Background: We present a case of asthma-chronic obstructive pulmonary disease syndrome (ACOS), which has features of both asthma and chronic obstructive pulmonary disease, in a 63-year-old man treated with Korean medicine. Methods: For four weeks of hospitalization, the patient received acupuncture, Guarujisil-tang decoction, and herbal steam therapy. The main symptoms of ACOS, which are dyspnea, chest discomfort, and throat discomfort, were treated with acupuncture. Guarujisil-tang decoction and herbal steam therapy were administered to relieve cough and smooth the expectoration of mucus. Results: By the end of hospitalization, no significant change was observed in lung function. However, the patient's subjective symptoms, including dyspnea, chest discomfort, sore throat, and sweating, were improved. The patient's objective sign of opaque yellow mucus changed to clear mucus after the treatment. His scores for the quality of life questionnaire for adult Korean asthmatics and the modified Borg scale also showed improvement from 42 to 62 and from 3 to 1, respectively. Conclusions: Although we reported only one ACOS case, this study is significant in that case reports of ACOS treated with Korean medicine are rare. Further study is needed to confirm the effectiveness of Korean medicine in patients with ACOS.

Objectives: The purpose of this study was to report the effectiveness of Korean medicine in the treatment of reflux esophagitis. Methods: A 62-year-old male patient had reflux esophagitis that occurred one year after a proximal gastrectomy for gastric ulcer in 2020. The patient underwent drug treatment in 2021 and inpatient treatment in 2022 at Mokpo Hankook Hospital, but he did not improve. We treated him with Korean medical treatments, including herbal medicines (Pyungjingunbi-tang-gami), acupuncture, and moxibustion. His symptom severity was assessed with a daily visual analog scale (VAS) for heartburn, upper abdomen pain, and acid reflux. Results: After treatment, the patient's symptoms were improved. The severity of heartburn and acid reflux was reduced from VAS 7 to VAS 1, and his upper abdomen pain was improved from VAS 6 to VAS 1. The symptom frequency was also reduced. Conclusion: Korean medicine treatment could be an effective and quick treatment for reflux esophagitis.

Objectives: The purpose of this study was to report the clinical effects of pharmacopuncture, acupuncture, and ohrimsan on prostatitis that was not improved by antibiotics. Methods: The patient underwent So-Yeom pharmacopuncture injection, acupuncture, and ohrimsan. A numerical rating scale (NRS) was used to obtain a sense of residual urine and the National Institute of Health Chronic Prostatitis Symptom Index (NIH-CPSI) was used to evaluate the treatment effects. Results: NRS for the sense of residual urine decreased from 70 before treatment to 0 after treatment. The NIH-CPSI was 19 on the first day of admission and decreased to 8 on the day of discharge. No side effects were observed after treatment. Conclusions: The traditional Korean medicine of pharmacopuncture, acupuncture, and ohrimsan is effective for treating prostatitis that is not improved by antibiotics.

Objective: To report a clinical case of Guillain-Barré syndrome-like neurological symptoms, including limb weakness, phantosmia, and nausea/vomiting after COVID-19 vaccination (AstraZeneca) that was improved by traditional Korean medicine (TKM) treatment. Methods: A 73-year-old male complained of extreme limb weakness, severe phantosmia, and nausea/vomiting after COVID-19 vaccination. No abnormalities had appeared in various radiological and laboratory tests, but the symptoms had continued to worsen for three months before visiting our clinic. Results: The patient was diagnosed with neurological complications suspicious of Guillain-Barré syndrome after COVID-19 vaccination. The patient was treated with acupuncture, moxibustion, herbal drugs (Banhabakchulchunma-tang), and nasal inhalation therapy with Aquilariae Lignum. Three weeks after Korean medicine treatment, his neurological symptoms had improved. Nausea/vomiting and phantosmia continued to show improvement, and muscle strength was gradually recovered in both lower limbs. Conclusion: Traditional Korean medicine could be a choice for the treatment of neurological complications after COVID-19 vaccination.

Posterior communicating artery aneurysms (PcomAAs) are the second most common type of aneurysm. Large cerebral aneurysms show various neurological symptoms, especially oculomotor nerve palsy (ONP), due to PcomAAs. Recent research has shown that stent-assisted coil embolization has many side effects. We report the effectiveness of Korean medicine in the treatment of ONP due to PcomAAs after stent-assisted coil embolization. A patient with ptosis and limitation of eye movement was treated with Korean medicine, including herbal medicine (Samlyeongbaegchul-san-byeonbang [參苓白朮散變方] and Uwhangchungsim-won [牛黃淸心元]), acupuncture, electroacupuncture, cupping, and moxibustion. Clinical symptoms were observed by images of the inter-palpebral fissure and eyeball movement. After the treatment, the inter-palpebral fissure and eyeball movement were noticeably improved. These findings suggest that treatment with Korean medicine can be an effective option for the treatment of ONP due to PcomAAs after stent-assisted coil embolization.

Objectives: The study investigated the effect of Korean medicine treatment on a hemiplegic patient with conscious and cognitive disorders due to hemorrhagic transformation after interventional reperfusion therapy of anterior circulation infarction. Case presentation: The patient was treated with acupuncture, moxibustion, cupping, and herbal medicine in combination with Western medicine and physical therapy. The effects on clinical symptoms were evaluated using the Manual Muscle Test (MMT), Glasgow Coma Scale (GCS), Korean Mini-Mental State Examination (K-MMSE), Korean Nursing Delirium Screening Scale (Korean Nu-DESC), and Modified Bathel Index (MBI). After the treatment, the MMT grade increased from Gr.0-1 to Gr.0-3, the GCS score increased from 10 to 15, the K-MMSE score increased from 8 to 15, the Korean Nu-DESC score decreased from 3 to 1, night delirium disappeared, and the MBI score increased from 13 to 26. Conclusions: Complex Korean medicine treatments were effective for improving the clinical symptoms of hemorrhagic transformation after interventional reperfusion therapy for anterior circulation infarction in a patient with hemiplegia and conscious and cognitive disorders. However, further studies are needed.

Background: The purpose of this study was to report the improvement of a patient with one-and-a-half syndrome, vertigo, and paresthesia caused by acute primary pontine hemorrhage (PPH) after a combination treatment of traditional Korean and Western medicine. Case report: A 51-year-old female with one-and-a-half syndrome, vertigo, and paresthesia after PPH was treated with Korean medicine, including herbal medication, acupuncture, and moxibustion, and Western medicine, including medication and rehabilitation therapy during hospitalization. Her progress was evaluated by checking for changes in symptoms with the extraocular muscle (EOM) function test, numeral rating scale (NRS), and follow-up brain computed tomography scans and magnetic resonance imaging (MRI). After 41 days of treatment, the EOM movement was improved, leaving limited abduction of the left eye. The NRS scores for vertigo and paresthesia decreased from 10 to 5 and from 10 to 3, respectively. Improvement was noted in hematoma in MRI, but a new ischemic lesion was also discovered. Conclusion: This case reports the clinical course of one-and-a-half syndrome and suggests that a combined therapy of traditional Korean and Western medicine can be useful for PPH patients with one-and-a-half syndrome, vertigo, and paresthesia. However, studies of larger populations are required.

Objective: The purpose of this case study was to report the effects of Korean medicine treatment on a patient diagnosed with postgastrectomy syndrome (PGS). Methods: The patient was treated with herbal medicine, acupuncture, and moxibustion in combination with Western medicine for 3 months. Results: Though abdominal tenderness was maintained at a similar level, other clinical symptoms (epigastric pain, globus pharyngis, and epigastric pain) were improved after Korean medicine treatment. Conclusions: These results suggest that the need to promote practical research on PGS, should receive greater attention in the Korean medical community.