• Korean Journal of Acupuncture
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• 제25권4호
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• pp.205-217
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• 2008

Background : One of the characteristics of acupuncture, a popular modality for treating musculoskeletal pain, is a plurality in diagnosis and treatment that can profoundly influence the treatment outcome. This multiplicity in treatment modality has to be considered in any research on the effectiveness of acupuncture. Many practitioners stress the necessity for individualized patient treatment, including acupuncture point selection and manipulation technique. However, the importance of individualization in acupuncture treatment, compared with standardization, has received little attention in clinical trials. The aim of the future study described here is therefore to compare the effectiveness of individualized acupuncture for knee osteoarthritis with standardized acupuncture and no acupuncture in patients with knee osteoarthritis. Methods : A total of 195 patients aged 50 years and over with knee pain, will be randomly divided into three treatment groups: individualized acupuncture, standardized acupuncture, and waiting list. Outcome data will be collected through patient.completed questionnaires before randomization, and at 4, 8 and 12 weeks after randomization. The questionnaires will be investigated demographic details as well as information on pain, movement and function of the affected knee, general health and quality of life. Discussion : This paper presents details on the rationale, design, and methods of the trial.

• Korean Journal of Acupuncture
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• 제23권2호
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• pp.19-27
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• 2006

Objectives: Although Korean Acupuncture (KA) in Korean Medicine (KM) shares its origins with Traditional Chinese Medicine (TCM), it has made its own contribution to the field of acupuncture and general medicine. This study reviews characteristics of KA. Methods: Representative theories of KA were reviewed in light of a constitutionally individualized and practically integrated approach. Individualized approach in KA is based on constitutional energy traits recognized in Saam, Taegeuk, and Eight Constitution acupuncture theories. New practically integrated therapeutic modalities, such as herbal, and bee venom acupunctures, have also been developed in KA. Results: As a form of natural medicine, KA along with KM put emphasis on the vitality and self-correcting mechanism of an individual, which led to the refinement of constitutional approach. KA along with KM theories features a summarized understanding and practical application of integrated therapeutics, which produced creative development of new modalities. Conclusions: KA is expected to make significant contributions to the individualized and practical medicine, based on basic research and clinical trials.

• 대한한의학회지
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• 제27권4호
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• pp.225-232
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• 2006

Objective : To test the hypotheses that individualized traditional Korean acupuncture improves pain and disability in patients with osteoarthritis of the knee and that benefits remain after stopping treatment more so than is the case for standardized minimal acupuncture. Design : Randomized single blind controlled trial with two intervention arms (individualized traditional Korean acupuncture, standardized minimal acupuncture) of six weeks' duration and three months follow-up. Setting : Acupuncture interventions were applied by two training doctors in the Department of Acupuncture and Moxibustion in a 1000-bed hospital. Assessment of the result was performed in a university-based laboratory. Participants : 50 patients with symptoms of knee osteoarthritis as diagnosed by an orthopedist. Intervention : Individualized traditional Korean acupuncture or standardized minimal acupuncture for six weeks. Main outcome measures: Primary outcome measure was pain as measured by the visual analogue scale. Secondary measures of pain and disability included the Western Ontario and McMaster Universities (WOMAC) index, Short Form-36 (SF-36), Lequesne Functional Index (LFI) score and Korean version of Health Assessment Questionnaire (KHAQ). Discussion : This paper presents detail on the rationale, design, methods and operational aspects of the trial.

• Journal of Acupuncture Research
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• 제22권4호
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• pp.197-204
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• 2005

Objectives : This survey was accomplished to find out how Korean medical doctors take acupuncture prescriptions for knee osteoarthritis in real clinical practice. Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. The questionnaires were distributed via e-mail to 3,306 members of Korea Oriental Medical Association from March 15th to March 23rd in 2005.84 members completed answers, and the computerized data were analyzed by ISP statistical program. Results : 1. 68 out of 84 Korean medical doctors used pattern diagnosis. 2. 61 out of 84 Korean medical doctors used both local and remote points, 20 doctors remote points only, and 3 doctors local acupuncture points only. 3. In case of doctors who use remote acupuncture points only, the acupuncture prescription principle was Saam or five element acupuncture (66%), along the meridian pathway (14%), Eight constitutional acupuncture (11%), Taegeuk acupuncture (2%), and miscellaneous (18%). Conclusion : In our e-mail survey, Korean medical doctors who experienced more than 10 year practice answered that they use five element acupuncture or Saam acupuncture according to meridian pathway theory as the most common principle of their acupuncture treatment prescription.

• Journal of Acupuncture Research
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• 제22권2호
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• pp.163-170
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• 2005

Background : Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are still controversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment. Objective : This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study. Method : Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form. Results & Suggestion : Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy. Conclusion : To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

• Journal of Acupuncture Research
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• 제22권5호
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• pp.141-150
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• 2005

Objectives : This study was accomplished in order to find out how Korean medical doctors take acupuncture prescription for knee osteoarthritis in clinical practice Methods : The survey questions were developed by the consensus from 4 professors and 10 residents who major in acupuncture & moxibustion for developing clinical trial protocol on individualized acupuncture treatment for knee osteoarthritis. 206 persons having more than 10 years experience were randomly selected from a list of Korean medical doctors. Telephone interviews with them were conducted by the well-trained interviewers between May 21 and May 27 in 2005. Results : 139 of 206 Korean medical doctors made an acupuncture prescription prior to treatment of knee osteoarthritis. 103 of 139 Korean medical doctors used both local and remote points, and 26 of them used remote points only, and 10 of them used local points only. In case of doctors who use remote points, the five element (45 of 129) or Saam (28 of 129) acupoints were used dominantly, and its was based on the pattern identification of the Jangbu organs related with the pain (56 of 129) or of the pain location (35 of 129). Conclusion : This study showed that Koran medical doctors prefer to use remote points such as five element or Saam acupoints based on the pattern identification of the Jangbu organs related with the pain or the pain location. These result may be useful for developing protocols for clinical trial on acupuncture on knee osteoarthritis.

• Journal of Acupuncture Research
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• 제24권4호
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• pp.183-195
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• 2007

Objectives : To determine whether individualized acupuncture (IA) provides greater pain relief and improved function compared with standardized acupuncture (SA) in patients with osteoarthritis of the knee. Methods: Design is a randomized single blind controlled trial with two intervention arms (IA vs SA) of 6 weeks' duration and 3 months follow up. An orthopedist diagnosed 50 patients' symptoms as knee osteoarthritis. Interventions were applied by 2 residents studying the acupuncture and moxibustion specially in Dongguk University International Hospital. Primary outcome measure is pain as measured by visual analogue scale (VAS). Secondary measures of pain and disability include WOMAC, SF-36, LFI and KHAQ. Results : The 50 participants were well matched for age, sex, bad side, VAS, WOMAC, SF-36, LFI and KHAQ scores at the baseline. 3 participants dropped out. There have not been any adverse events in both groups. Participants in both groups experienced great improvement in all measures except SF-36at 3 and 6 weeks. At 18 weeks, the IA group experienced significantly greater improvement than the SA group in VAS but not in WOMAC, SF-36, LFI and KHAQ. Conclusions : Manipulation of IA seems to provide pain relief longer for osteoarthritis of the knee when compared with SA.

• Journal of Acupuncture Research
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• 제23권6호
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• pp.239-254
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• 2006

The 3rd Japan-Korea Workshop on Acupuncture and EBM was held at Kanazawa on June $16^{th}$. From Korea team, 4 papers were presented. Dr. Hahn introduced a new approach of data analysis on series of n-of-1 trials using the Bayesian statistics. It offered important information for the future n-of-1 trials. Dr. Park clearly demonstrated the significance of various sham devices proposed and stressed the importance of research questions when we choose the control intervention in RCT. Dr. Lee reported the results of survey in Korean Medical Doctors (KMD) for their point selection and techniques to the distal and local points. Dr. Kim presented the results of face to face survey on the KMD with 28 items for acupuncture treatment on the knee OA. Finally, a draft of protocol was introduced by Dr. Kim. The title was "multi-center, a randomized, single blinded, two arms, parallel-group study to compare the effectiveness and safety of 'individualized acupuncture' and 'standardized minimal acupuncture' in Korean and Japanese patients with knee osteoarthritis (Phase IV)". From Japan team, 7 speakers presented their comments and proposals on the protocol. Dr. Takahashi introduced several issues regarding n-of-1 trials and pointed out the importance of obtaining generalizability from n-of-1 trials. Dr. Shichidou pointed the importance of research design, selection of outcome measures and reduction of biases. Dr. Itoh presented the results of point selection for the knee OA based on the literature survey. Dr. Sumiya introduced several differences between KMD and Japanese acupuncturists based on the questionnaire used in KMD survey. Dr. Furuya demonstrated a result of press tack needle and its sham device on shoulder stiffness. Dr. Yamashita introduced the results of literature survey regarding adverse events occurred by acupuncture on knee OA. Dr.Tsukayama stressed the importance of responsibility of Institutional Review Board (IRB) for the conduction of clinical trials. After several issues were discussed, the need of continued meeting for final protocol development was agreed, then the workshop was closed.

• Journal of Acupuncture Research
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• 제22권6호
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• pp.189-199
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• 2005

Objectives : This interview survey was carried out to identify how Korean medical doctors make acupuncture prescriptions for knee osteoarthritis in clinics. Methods : Survey questions were developed based on a consensus of acupuncture professors at Kyung Hee University, Dongguk University, Daegu Haany University. The interviews were conducted to 72 members of the Korea Oriental Medical Association who answered to prefer remote acupuncture prescription at previous telephone survey. Results : Korean medical doctors prefer to use five shu acupuncture points, especially 'hyung' or , 'shu' points, on the contralateral side of lesion and that the first target organ is liver. Five element points theory was mainly based on 'Nanjing' and 'Hwangdi Neijing'. The De-qi sensation of both doctor and patients was emphasized. Diagnosis and evaluation generally depend on subjective evaluation rather than objective scale. Conclusion : This study showed that Koran medical doctors prefer to follow the Korean traditional acupuncture methods respecting the old classic principles. And these results can guide us to develop advanced clinical trial protocols more close to our acupuncture practice.

• Korean Journal of Acupuncture
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• 제39권3호
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• pp.91-96
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• 2022

Objectives : The purpose of this study was to characterize the stimulation intensity in acupuncture manipulation techniques for tonification and sedation therapy. Methods : To describe the level of stimulation used in acupuncture manipulation techniques for tonification and sedation therapy, we reviewed the acupuncture manipulation techniques described in classical medical textbooks. Results : Based on the patients' conditions and pattern identification, acupuncture manipulation strategies for tonification and sedation therapy were chosen. For example, the excess condition was treated with sedative therapy, and the deficiency condition was treated with tonification therapy. For tonification therapy, weak to modest stimulation was applied in acupuncture manipulation techniques, whereas intense stimulation was applied for sedative therapy. Even though the intensity of acupuncture stimulation was chosen based on the clinical examination, deqi sensation is a crucial component of acupuncture treatment, and during acupuncture practice, the practitioner should choose the right intensity of acupuncture stimulation based on deqi response in each patient. Conclusions : We concluded that the tonifying and sedative effects of acupuncture treatment are related to the stimulation intensity of acupuncture manipulation techniques. For individualized medicine, the right amount of acupuncture stimulation should be administered based on the patients' conditions and responses, such as deqi responses.