• Korean Journal of Acupuncture
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• v.38 no.1
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• pp.16-31
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• 2021

Objectives : The purpose of this study was to investigate the current status of clinical practice for gout in Korean Medicine (KM). Methods : On-line survey was adopted for this study, targeted at KM Doctors who were registered in the Association of Korean Medicine. The questionnaire included the general status of treatment, pattern identification and treatment method according to three stages given: acute, chronic and asymptomatic hyperuricemia stage. Results : Data from a total of 384 respondents was analyzed. Participants who responded most were in their 40s, working in KM clinics located in Seoul. Acupuncture and herbal medicines were the top priority treatments in preparing recommendations in clinical practice guidelines for gout, and where clinical trials were considered essential. As of the past year, the average number of first visits per month was 86.7%, and the average treatment duration was less than 1 month, accounting for 72.9%. As for the diagnostic method used for gout patients, the "diagnosed by clinical pattern" response was the highest, and the "blood and urine test" response was the highest as the diagnostic equipment used. As for the evaluation scale being used, the "VAS/NRS" response was the highest. Regardless of the gout stage, acupuncture was the most commonly used treatment method for gout patients, and bee venom pharmacopuncture was the highest for the pharmacopuncture used. In the case of herbal medicine, it was found that a wider variety of herbal medication uninsured in health insurance and herbal prescription were used for the staged treatment of gout than herbal medication in national health insurance coverage. In clinical practice, "acupuncture treatment three times a week" was the most common, and the "acupoints in the limb" were the most frequently used; LR3 and SP3 were the most frequently used acupoints. Conclusions : It is suggested that this survey should be helpful to develop clinical practice guideline for gout that reflects actual clinical practice.

• Korean Journal of Acupuncture
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• v.38 no.4
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• pp.235-249
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• 2021

Objectives : Acupoint LU6 (Gongchoe) is known as an acupoint for the treatment of pain and bleeding caused by hemorrhoids. The purpose of this study was to critically review acupoint LU6 for treating hemorrhoids. Methods : We searched both ancient and modern literature of acupuncture and moxibustion using keywords "Gongchoe" and "hemorrhoids". We further performed an online ancient literature search for crosscheck. The searched literature was stratified by country (Korea, China, and Japan), and data were organized chronologically. Concerning literature related to hemorrhoids, data based on acupuncture treatment were compiled. Results : The bone proportional measurement of the forearm had been 12.5 cun until the Qing Dynasty but was recorded as 10 cun in "Shinkyushinzui," and the majority of modern Japanese and Korean literature indicated it as 10 cun. Gongchoe for treating hemorrhoids has been reported in the literature, including "Shinkyushinzui" (Japan, 1941), "Shiyoungzongguozhenjiujingxuexue" (Taiwan, 1963), "Gyeonghyeolhak" (Korea, 1971), and "Jinzhenmeihuashichao" (China, late Qing dynasty), but except "Jinzhenmeihuashichao", the location is different from the World Health Organization (WHO) standard acupoint location as it is 7 cun from the wrist out of 10 cun of the forearm bone proportional measurement. In addition, classical guides published until the Qing Dynasty did not report acupoint LU6 for the treatment of hemorrhoids. Conclusions : It is necessary to distinguish between Gongchoe in "Shinkyushinzui" and LU6 in WHO standard acupuncture point locations. Gongchoe (LU6)'s primary treatment for hemorrhoids has not been described in the classical literature, and further clinical evidence is needed to support it. When using Gongchoe for hemorrhoids, we should consider that the location of Gongchoe is closer to the LU5 than the standard acupuncture point locations and it is meaningful not only for treatment but also for diagnosis.

• Korean Journal of Acupuncture
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• v.38 no.4
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• pp.282-289
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• 2021

Objectives : The purpose of this study is to construct a model of the possible thermal runaway of electronic moxibustion and to implement an appropriate risk management method. Methods : To reproduce the system error situation of the electronic moxibustion circuit equipped with microcontroller unit, temperature sensor and heater, a code was set to disable the signal input to temperature sensor and maintain "high" heating signal to heater. The temperature change of electronic moxibustion was compared between 3 types of heater module; module 1 consisting of a combination of heater+0 ohm+0 ohm resistance, module 2 consisting of a combination of heater+Polymeric Positive Temperature Coefficient (PPTC)+0 ohm resistance, and module 3 consisting of a combination of heater+PPTC+10 ohm resistance. The temperature change was measured using a polydimethylsiloxane (PDMS) silicone phantom. After maintaining surface temperature of the phantom at 31~32℃ for 20 seconds, electronic moxibustion was applied. After operating electronic moxibustion, the temperature change was measured for 660 seconds on the surface and 900 seconds at 2 mm depth. Results : Regardless of the module type, the time-dependent change in temperature showed a rapid rise followed by a gentle curve, and a sharp drop in temperature after reaching the maximum temperature about 10 minutes after the switching the moxibustion on. Temperature measured at the depth of 2 mm below the surface increased slower and to a lesser extent. Module 1 reached highest peak temperature with largest change of temperature at both depths followed by module 2, and 3. Conclusions : Through the combination of PPTC+resistance with the heater of electronic moxibustion, it is possible to limit the rise in temperature even with the software error. Thus, this setting can be used as an independent safety measure for the electronic moxibustion control unit.

• The Korea Journal of Herbology
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• v.33 no.6
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• pp.35-42
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• 2018

Objectives : The aim of this study was to investigate whether the extract of Coptidis Rhizoma inhibits inflammation in chronic cold stress (CCS)-exposed mice or not. Methods : Coptidis Rhizoma extract (CRE) was made by reflux with distilled water. Male ICR mice (7 weeks old) were divided randomly into 5 groups: (1) control, (2) CCS, (3) CCS+CRE 100 mg/kg, (4) CCS+CRE 300 mg/kg, (5) CCS+CRE 1,000 mg/kg groups. Mice were orally administered once a day for 14 days starting from 1 day before CCS. Group (2)-(5) were exposed to CCS conditions that maintained at $4^{\circ}C$ for 2 h once a day for 14 days. The levels of serum cortisol and hypothalamic prostaglandin E1 (PGE1) and PGE2 were measured by enzyme-linked immunosorbent assay kit. The expression levels of several pro-inflammatory factors like heat shock protein 70 (HSP70), c-fos, and nuclear factor kappa-light-chain-enhancer of activated B cells (NF-kB) were measured by western blot analysis in mouse hypothalamus. Results : Oral administration of CRE 1,000 mg/kg significantly suppressed the increase of serum cortisol levels in mice exposed to CCS. CCS-exposed mice had significantly increased the expression of HSP70, c-fos, and NF-kB in hypothalamus, while CRE treatment significantly attenuated the elevation of these pro-inflammatory factors. The ratio of PGE2/PGE1 was also higher in CCS-exposed mice than control group. CRE treatment significantly reduced the increase of PGE2/PGE1 ratio induced by CCS. Conclusion : These findings suggest that Coptidis Rhizoma may work as a potential agent to modulate inflammatory responses under the condition of cold adaptation formed by CCS.

• Korean Journal of Acupuncture
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• v.39 no.2
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• pp.43-53
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• 2022

Objectives : Paeonia lactiflora Pallas (PLP) have been reported to have pharmacological effects such as anti-inflammatory and analgesic. However, it is not yet known whether PLP extract has anti-inflammatory effect on HaCaT cells, human keratinocyte. Methods : To confirm the anti-inflammatory effect of PLP on keratinocyte, TNF-𝛼/IFN-𝛾-stimulated HaCaT cells were used. HaCaT cells were pre-treated with PLP for 1h before stimulation with TNF-𝛼/IFN-𝛾. Then HaCaT cells were stimulated with TNF-𝛼/IFN-𝛾 for 24 h, the cells and media were harvested to measure the inflammatory cytokines levels. Granulocyte-macrophage colony stimulating factor (GM-CSF), monocyte chemoattractant protein-1 (MCP-1), interleukin 1 beta (IL-1𝛽), and TNF-𝛼 were analyzed by enzyme-linked immunosorbent assay (ELISA), and the mRNA expression of thymus and activation-regulated chemokines (TARC), IL-6, and IL-8 were measured by reverse transcription-polymerase chain reaction (RT-PCR). We also investigated the inhibitory mechanism of the mitogen-activated protein kinase (MAPKs) including ERK, JNK, and p38 and nuclear factor-kappaB (NF-𝜅B) by PLP using western blot. Results : PLP did not show cytotoxicity in HaCaT cells. In TNF-𝛼/IFN-𝛾-stimulated HaCaT cells, PLP significantly inhibited the expression of GM-CSF, MCP-1 IL-1𝛽, TNF-𝛼, TARC and IL-6. PLP inhibited the phosphorylation of ERK and translocation of NF-𝜅B into the nucleus. Conclusions : These results indicate that PLP could ameliorate the TNF-𝛼/IFN-𝛾-stimulated inflammatory response through inhibition of MAPK and NF-kB signal pathway. This suggests that PLP could be used beneficial agent to improve skin inflammation.

• The Journal of Korean Medicine
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• v.43 no.1
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• pp.6-17
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• 2022

Objectives: This study describes the implementation of a training course that aimed to increase the competency of undergraduate students of Korean medicine at a single college to obtain informed consent and perform bee venom acupuncture using an objective structured clinical examination (OSCE). Methods: We developed and implemented a short training course for 111 fourth-year students of Korean medicine during their clinical rotation at the Department of Acupuncture and Moxibustion Medicine. Lectures were conducted on the effects of and hypersensitivity reactions to bee venom acupuncture, obtaining informed consent, performing skin test and bee venom acupuncture. Due to the COVID-19 pandemic, some students were offered online lectures, and some could not experience the performance of OSCE in person. A survey with 16 closed and three open questions was used to investigate self-efficacy, opinions about the online lectures, and the OSCE. Results: Out of 111 questionnaires, 104 were completed (94%). Students were generally satisfied with the online lectures and OSCE. For the subjective questionnaire about what was helpful in the training of bee venom acupuncture techniques and OSCE, the authenticity of the teaching method was recorded the highest. Conclusions: This study showed that online lectures were effective in teaching clinical skills of Korean Medicine. It is necessary to produce standard educational materials for clinical skills of Korean Medicine, and studies to analyze the reliability and validity of OSCE are needed.

• Korean Journal of Acupuncture
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• v.40 no.1
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• pp.1-12
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• 2023

Objectives : This study aims to provide information regarding the status and quality of mobile applications (MAs) using self-acupressure by performing a systematic review. Methods : We conducted comprehensive searching on five international databases and two app markets from inception to July 31, 2022 to identify MAs using self-acupressure. We analyzed the characteristics of each MA regarding the name of the MA, registered app markets, target symptoms, developers, the year and country of development, cost, target age, media function, and expertise. We assessed the quality of each MA using Mobile Application Rating Scale (MARS). Results : We identified a total of 30 MAs using self-acupressure (25 MAs from the app market and 6 MAs from clinical studies, with 1 MA in common). 17 out of 24 MAs from the app market provided self-acupressure regimens for various symptoms and the others provided regimens for specific symptoms such as memory, anxiety, depression, asthma, allergy, low back pain, and headache. 14 developers were reported. 23 MAs were developed after 2013. The largest number of MAs were developed in the United States. The target age group of 12 MAs was above the age of 3, and that of 11 MAs was above the age of 12. 14 MAs provided multimedia functions such as videos. 13 MAs provided information of expertise. From clinical studies, only 3 out of 6 MAs were accessible through the app market. 4 MAs were developed by the researchers of the study. In terms of MARS, the score of MAs from the app market was higher than that of MAs from clinical studies in both objective and subjective evaluation areas. Conclusions : This study summarizes the characteristics of MAs using self-acupressure. More MAs using self-acupressure should be developed and further clinical research for MA on each symptom and disease is warranted for the diversification of MA fields using self-acupressure.

• Korean Journal of Acupuncture
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• v.39 no.4
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• pp.152-171
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• 2022

Objectives : This study was designed to investigate the effects of Sunbanghwalmyung-eum gamibang on Monosodium iodoacetate-induced osteoarthritis rats. Methods : Forty Sprague-Dawley (SD) rats were divided into 5 groups of 8 rats each. Osteoarthritis (OA) was induced by injecting MIA (2 mg/50 µl) into the joint cavity of the left knee of SD rats belonging to the experimental group, and normal saline was injected into the joint cavity of the left knee instead of MIA in the normal group. To the normal group and the controlled group (OA group), 2 ml of distilled water was orally administered. To the positive control group (Indomethacin group), indomethacin 2 ml at a concentration of 2 mg/kg, to the low concentration group of SHG (Low group), 2 ml of SHG at a concentration of 2 mg/kg, and to the high concentration group of SHG (High group), 2 ml of SHG at a concentration of 4 mg/kg ml was orally administered. The drug was administered for a total of 4 weeks, and histological changes were analyzed by Hematoxylin-Eosin staining and Safranin-O staining. In addition, inflammatory cytokines such as TNF-α, IL-1β, and IL-6, and MMP-13, TIMP-1, and GAGs were immunohistochemically analyzed. Finally, hematological examination, blood biochemical examination, and liver and kidney biopsy were performed. Results : SHG groups (Low and High) inhibited the matrix destruction and damage of the knee joint cartilage in SD rat model, and significantly prevented the reduction in cartilage thickness. In SHG groups, the expressions of TNF-α, IL-1β, IL-6 and MMP-13 were significantly decreased, and the expressions of TIMP-1, GAGs were significantly increased compared with OA group. The safety indicators had no significant differences among five groups. Conclusions : These results show that SHG has cartilage protection capacity, anti-inflammatory effect.

• Korean Journal of Acupuncture
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• v.40 no.3
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• pp.62-78
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• 2023

Objectives : This study aims to assess the impact of acupotomy on migraine through an examination of clinical studies conducted since 2015. Methods : We conducted a comprehensive search for randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) related to acupotomy treatment for migraine, utilizing five Korean online databases (OASIS, Science ON, DBPIA, KISS, RISS), as well as four foreign online databases (CNKI, PubMed, EMBASE, Cochrane Library). We identified a total of 10 relevant studies for analysis. Participants characteristics, treatment points, combination treatments, treatment cycles or frequencies, evaluation indices, efficacy, and adverse events were analyzed. The risk of bias in the 10 RCTs was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). Results : A total of 931 participants were included in 10 studies. In the intervention group, the average duration of migraine morbidity ranged from 15.5±4.5 months to 15.9±4.2 years. Six studies based their diagnoses on the International Classification of Headache Disorders (ICHD), while five studies relied on Chinese diagnostic criteria. All studies specified the treatment area as the region exhibiting tenderness or induration on the head and neck. Treatment cycles ranged from a minimum of 2 days to a maximum of 1 week, with the number of days per treatment course varied from 5 days to 4 weeks. The diameter of acupuncture needles used varied between 0.3 mm and 1 mm. Of the eight studies specifying needle length, the shortest was 20 mm, and the longest was 40 mm. A total of eight evaluation indices were employed, with total efficacy rate (TER) and visual analogue scale (VAS) being the most frequently used. Statistically, all intervention groups showed more significant results compared to the control groups. Adverse events were reported in only two studies within the intervention group. Overall, the risk of bias assessment for the selected RCTs ranged from 'some concerns' to 'high risk of bias.' Conclusions : This study showed that acupotomy treatments for migraine were effective.

• Korean Journal of Acupuncture
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• v.40 no.3
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• pp.79-89
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• 2023

Objectives : The purpose of this study is to investigate various application methods of focused ultrasound and apply them to clinical use in Korean medicine. Methods : Search was performed using the search engines of electronic databases, including PubMed, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), China National Knowledge Infrastructure (CNKI), Wanfang Data, Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii), from inception to July 2023 without language limitation. Inclusion criteria were clinical studies including randomized controlled trials (RCTs), and animal experimental studies related with focused ultrasound treatments for acupoints or meridian sinews. Results : Total 17 papers, 7 for RCT, 6 for in vivo animal studies, and other experimental studies, were finally selected. Indications used in studies were shoulder pain, back pain, chronic back pain, and degenerative knee arthritis. In experimental studies, studies on animal models of hypoxic ischemic brain damage and hyperlipidemia were also conducted. As for the acupoints, LR3, LI4, and ST36 were used in clinical studies and, in animal experimental studies, GV20, KI1, and ST36 were used. As for the dose, 4 studies below 3 W/cm² and 3 studies in the range of 0.625 to 5 W/cm² in clinical studies, and all studies did not exceed 5 W/cm². In animal experimental studies, 0.5 W/cm², 2 W/cm², 7.5 WW/cm², 15 W/cm², 10~20 W/cm² were used. In all three studies describing the penetration depth during irradiation, it was less than 1 cm. Conclusions : We suggest that focused ultrasound is an appropriate treatment tool for stimulating the acupoints to transfer heat energy. Future studies with rigorous and well-designed RCTs for various diseases will be required to ascertain the focused ultrasound stimulate acupoints or meridian sinews.