Backgrounds : In 2017, National Health Insurance implemented the pilot insuring project for Chuna manual therapy(CMT). 65 Korean Medicine(KM) hospitals and clinics were selected in the project to monitor the provision of insured CMT. Objectives : This study aimed to evaluate the effectiveness of CMT for low back pain provided in the real world setting. Methods : Patients with low back pain who agreed to participated in the study were enrolled and requested to complete questionnaires. Patients who received CMT regardless of receiving other KM therapies were classified to Chuna group, and patient who received KM therapies without CMT to KM group. Pain(pain-VAS) and back function(KODI, Oswestry disability index-Korean version), quality of life were assessed at baseline, 4 weeks, and 8 weeks. Additionally, patients who received CMT twice and more, and who's pain-VAS 20 and over were included, and patients who used pain injection were excluded in the analysis. Results : Of 371 patients who completed all questionnaire (mean age=42.6years, SD=12.45; 61% female), 96 were excluded, 170 were in Chuna group, and 105 were in KM group. Proportions of patients who had low back pain for more than twelve weeks in the Chuna group and KM group were 57.7% and 24.8%, respectively. Pain and back function were significantly improved on 4weeks and 8weeks in both groups, but there was no difference between two groups. For the patients in the sub-acute and chronic stage(>=12 weeks), change of total KODI scores in the Chuna group was higher than KM group(p=0.013) at 4weeks. Conclusions : CMT with other KM therapies can improve back function in the sub-acute and chronic patients. For insurance policy decision, economic evaluation of CMT is needed.

Objectives : The aim of this study is to investigate the current research trend of herbal medicine based on the published articles in pharmacoepidemiologic journals. Methods : A total of 3 electronic journals, Pharmacoepidemiology and Drug Safety(PDS), Drug Safety and Journal of Pharmacoepidemiology and Risk Management(JPERM) from January 2013 to August 2018 were used for searching articles about herbal medicine. Selected articles were reviewed and classified under 5 categories-collection of adverse events in herbal medicine, statistical modeling and methodology, pharmaco-epidemiologic outcome study, drug utilization review(DUR), risk management system and regulation. Results : A total of 8 articles were finally included for analysis. 2 articles were categorized in collection of adverse events in herbal medicine, 1 was statistical modeling and methodology, 2 were pharmacoepidemiologic outcome study and 3 were risk management system and regulation. There was no article in DUR. And then pharmacoepidemiologic research trends of herbal medicine were summarized in classification of 5 categories. Conclusions : To sum up with these 8 articles of herbal medicine in pharmacoepidemiologic journals, herbal medicine was of interesting concern among researchers. The need for research on safety and risk management of herbal medicine is steadily increasing, pharmacoepidemiologic research about herbal medicine must be activated in Korea.

Objectives : The purpose of this study was to examine the lifestyle of korean medicine students based on their drinking patterns and eating attitudes. Methods : The survey was conducted on 101 korean medicine students to investigate their psychological characteristics. They were asked to complete Self-Administered Alcoholism Screening Test, Eating Attitude Test, and Minnesota Multiphasic Personality Inventory-2. Results : A total of 101 Korean medical students participated in the study. Non-drinker 19, drinker were 82. Unlikely to, possible and potential alcoholism 79(78.2%), 17(16.8%) and 5(5%) respectively. The mean and standard deviation of SAAST in the subjects were $3.88{\pm}3.33$ and the EAT score was $8.09{\pm}8.693$. There was a significant difference in the MMPI-2 items between non-drinker and drinker. The SAAST had an effect on the EAT score(${\beta}=0.319$). Conclusions : As a result of MMPI-2 test, in the potential alcoholism group, scale D, Mf, Si, INTR, TPA, SOD, Mt and GF were shown higher, and AAS and GM were shown lower than the normal group. In the bad eating attitude group, scale Hy, RC4, DISC and AA were shown higher than the good eating attitude group.

Objectives : The aim of this study was to investigate the Korean medicine doctor's perception of the extension and activation of herbal medicine preparations insurance benefits. Methods : The sample of Korean medicine doctors' panel pool which is extracted by examining the square root quota of city location of Korean medicine clinics was used. In case of a vacancy in some participants, the number of Korean medicine doctors were supplemented and placed for investigation. Results : It has 54.0% awareness of the separation of prescribing and dispensing herbal preparations, 87.0% agreed on the need to be insured, but the separation as a necessary condition for being insured was only 60.3% agreed. When a large number of herbal preparations are being insured, it was expected that 30% to 50% of patients(30.3%) will be prescribed herbal preparations and the number of new patients will increase by 5 to 15 for the purpose of prescriptions only(49.3%). Increase amount of medical expense(?3,000) as a result of the separation of prescribing and dispensing herbal preparations are insufficient(54.3%). Conclusions : From the results of this study, extension of national health insurance to cover herbal preparations must be needed to activate herbal medicine preparations and improve Korean medical services.

Background : There have been a variety of healthcare systems related to CAM practitioners developed in each country. However, the European cases have not been widely introduced in Korea so far. In the case of Germany, CAM practices have been developed in the frame of "Heilpraktiker" system. Objectives : The objectives of this study were to review the historical development and current situation of German Heilpraktiker system and its conflicting relationship with Western medical doctors, in order to utilize it as basic data for the conflict resolution between Western- and KM doctors in Korea. Methods : The historical development, current regulations and education system of Heilpraktiker were assessed. Research articles, reports, government publications and websites dealing with this issue were searched for and analyzed. Results : Heilpraktiker system was developed within German historical and cultural situation where naturopathic traditions were reilluminated in connection with modernization process of the state under the influence of romanticism formulating German nationalism. Between the concept of "Kurierverbot"(prohibition on medical treatment by non-physicians) and "Kurierfreiheit"(freedom of medical treatment), Heilpraktiker achieved a limited but legitimated right to conduct non-biomedical treatments from the state in the process of the formulation of modern German medical system. In this process, the conflicts between medical doctors and heilpraktikers have been also growing up to now. Conclusions : Heilpraktiker system, officially recognized with the legislation of Heilpraktiker law in 1939, stands at a crossroads between the continual development through strengthening its professionality, and abolition of the system due to its lack of quality control and medical evidence mostly argued by Western medical doctors, which has considerable implications for Korean situations in terms of the conflicting relationship between KM- and Western medical doctors. In this regard, it is necessary to discuss the debates on the concept "Kurierfreiheit"(freedom of medical treatment) developed within German tradition of medical pluralism.

Objectives : This study was conducted to review the research trends in Korean Medicine of pompholyx based on publications in Korea. Methods : Literature published after 2000 were collected using OASIS, NDSL, KISS, and key words searched were "한포진" "발한이상" "pompholyx" "dyshidrotic eczema". Results : 10 case reports and 4 patient studies were selected for study. Conclusions : Korean medicine treatments included acupuncture, pharmacopuncture, venesection therapy, herbal medicine, ointments and carbon arc lamp therapy. The most commonly used diagnostic method for pompholyx was inspection along with pulse diagnosis, abdominal diagnosis, tongue diagnosis, culture test, and KOH smear screening. The most frequently used treatment evaluation method was Likert scale while VAS(Visual Analog Scale) and Visual&Subjective symptoms were each used in 4 studies. Among 29 patients in 14 papers who showed clinical manifestations of pompholyx, there were 15 male patients (52%), 14 female patients (48%), and the male to female ratio showed 1.07:1. Symptoms were improved using Korean Medicine treatments including acupuncture and herbal medicine. Concurrent treatment using special treatments such as pharmacopuncture, jiyang-go, bojungikgi-tang(ex), external applications showed higher treatment effects. Korean medical treatment of pompholyx was effective in all studies, but the lack of numbers of research on Korean medicine of pompholyx was witnessed compared to other diseases such as psoriasis. Also considering the number of patients suffering from pompholyx, further studies should be conducted.

Objectives : 'Geumnaeng method'' is a well-known folk remedy, but It has not been studied in academia. This study was conducted to review the chinese published articles on Geumnaeg method (Jinleng method) of Chinese traditional medicine. Methods : The author searched Chinese published papers from 2000 to 2018 via CNKI(China National Knowledge Infrastructure) database by using keyword 'Jinleng', 'Jinleng method', and analyzed the papers covered Jinleng method health preservation, and classified them including periods, type of study, target symptoms, and comparison between countries. Results : 17 studies were reviewed. The study of Jinleng method in China began in 2005. 8 articles (47.1%) were review articles, 4 articles (23.5%) of the case report and case series, and 5 articles (29.4%) were clinical studies. Clinical studies have increased since 2008. Most of the studies related to genital disorders and sexual function were mainly performed. There were differences between Japan, Korea and China in Jinleng method. Conclusions : Various disease and symptoms was researched with Jinleng method in China. Research in China is more active than other country. We need to increase the level of evidence of Jinleng method's effectiveness through additional studies in the future.

Objectives : The aim of this study was to investigate expert opinions on the questions contained in a questionnaire for diagnosing blood stasis accompanying metabolic disorders. Methods : Two rounds of Delphi survey were conducted online targeting on one hundred Korean medicine doctors. Respondents rated the appropriateness of the 30 questions in diagnosing metabolic disorder on a five-point scale, anchored at '5 = very appropriate', '4 = appropriate', '3 = somewhat appropriate', '2 = inappropriate', and '1 = very inappropriate'. Results : The mean score on 30 questions of first and second Delphi survey was 3.26 points and 3.31 points, respectively. The ranking of the top 10 questions that were rated as appropriate for diagnosing blood stasis accompanying metabolic disorder were 'sublingual varices', 'reddish black tongue', 'reddish black gum', 'reddish black lips', ''dark purple palatal mucosa and venous edema', 'night pain, 'ecchymosis of the tongue', 'piercing pain', 'ecchymosis of the skin' and 'prolonged numbness'. Conclusions : The experts agreed that three of the most typical symptoms of blood stasis and the conditions of capillary vessels in the tongue or the oral cavity were highly associated with metabolic disorder, whereas the questions related to abdominal pain lacked an association with metabolic disorders.