Objectives: To evaluate the methodological quality of Korean Acupuncture Clinical trials Methods : Two independent researchers reviewed 12 protocols of Acupuncture clinical trials which were conducted in Korea 2006. Also, Survey Principal Investigator of those was conducted. We compare the results of protocol review with investigator reponses of actual practice. Quality assessment consisted of 5 items including random sequence generation, randomization method, allocation concealment, subject blinding, assessor blinding. Results : Randomization was performed using the proper procedure to insure that treatment assignment is unbiased and concealed from subjects in all clinical trials, According to protocols, 6(50%) of 12 clinical trials used computer-generated random numbers, 6(50%) remaining trials didn't describe the randomization method. Also all trials used appropriate randomization methods on the basis of the survey results: 8 trials used computer-generated random number, 2 used random table. Of 7 protocols in which allocation concealment was stated, 5(71%) reported appropriate method (Calling a central office or statisticians, Sealed opaque envelopes). However according to survey, 5(42%) of 12 trials used inappropriate allocation concealment (Keeping a master randomization list and referring to when subject entered the trial). In addition, the result of protocol review and survey response was not coincident in 5(42%) trials. Subject blinding was conducted in all except 1 clinical trials. Although 11(92%) of 12 trials were conducted using assessor blinding in actual practice, only 7(58%) reported that in protocol. Conclusion : Although randomization and blinding were conducted adequately, allocation concealment was used inadequately, Not only appropriate allocation concealment, but also every quality assessment item including randomization, blinding should be stated in more detail in protocol.
The purpose of this study aimed to know the association between seven health practices and self rated health by Sasang constitution. We recruited 367 subjects aged from 30 to 59. KS 15 questionnaire was used to classify Sasang constitution and visual analogue scale was used to estimate self rated health. Chi-square test was used to know the difference of occupation distribution by Sasang constitution. Anova test, T-test and Chi-square test also used to analyze the difference of self rated health between the health practice group and non-health group in individual Sasang constitution. SPSS 21.0K was used and significant p was <.05. Regular morning meal, non-snaking, good sleeping and sufficient exercise had higher self rated health score (p<.05). Regular morning meal, good sleeping and sufficient exercise had higher score in Tae-eumin (p<.05). Good sleeping had higher self rated health score in Soeumin and Soyangin (p<.05). These results suggest there is possibility that health practices for health promotion could be different according to Sasang constitution.
In the ancient times, the medical practice relied primarily upon human instincts and experiences at the same time, shaman's incantations were widely believed to cure diseases, the workings of evil spirits supposedly. For the period from the Old Chosun through Samhan(三韓), Chinese refugees brought a long medical knowledge and skills of the continent. New Chinese medicine, traditional practices and incantations were generally used at this time. In Samhan, however, the last was the most important, performed by a Chongoon(天君). Medicine and the medical system were arranged by the period of the Three Countries(三國時代). No definite record concerning Koguryo remains now. As for Paekje, however, history shows that they set up the system under the Chinese influence, assigning medical posts such as Euibaksa(醫博士, medical doctor), Chaeyaksa(採藥師, pharmacist), and Jukeumsa(呪禁師, medicine man) within Yakbu(藥部, department of medicine). Scientifically advanced, they sent experts to Japan, giving a tremendous influence on the development of the science in ancient Japan. After the unification of the three countries, Shilla(新羅) had theri own system after the model of Dang(唐). This system of the Unified Shilla was continued down to Koryo(高麗) and became the backbone of the future ones.
Objectives : To observe the effect of acupuncture treatment and western medical treatment on frozen shoulder patients. Methods : 39 voluntary patients were randomly assigned to the Eastern treatment group(E group, n=22) and the Western treatment group(W group, n=17). The E group received acupuncture treatment on LI15, TE14, GB21 and Master Dong's acupuncture points, Shin-gwan and Gyun-joong, twice a week for 4 weeks. The W group received suprascapular nerve block, subacromial injection and trigger point injection, twice a week for 4 weeks. Both groups were instructed to practice self exercise during their daily lives. Evaluations were made before treatment and after treatment using Constant Shoulder Assessment(CSA), Shoulder Pain and Disability Index(SPADI) and the patient's satisfaction concerning the treatment was measured by Visual Analogue Scale(VAS). The obtained data were analyzed and compared. Results : The E group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 5.67 on a scale of 10. The W group showed significant improvement(p<0.05) according to the CSA and SPADI. The patient's satisfaction scored 7.73. But the difference between the two groups were insignificant according to CSA and SPADI. Conclusion : Both acupuncture and nerve block treatment significantly improved frozen shoulder. But the difference of the two treatments was insignificant.
Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.
With sophisticated clinical skills and the effectiveness of Traditional Korean Medicine(TKM), many TKM doctors look forward to over seas expansion. About 450 TKM doctors had NCCAOM certificate, but only 40 TKM doctors arc in US now. Because The status of NCCAOM certificate in USA is not adequate enough for TKM doctors to perform medical treatments. In case of US, State medical boards depend to a large extent on the Educational Commission for Foreign Medical Graduates(ECFMG) for certification of international medical graduates (IMGs) seeking licensure in the United States. In addition to receiving certification that includes verification of education credentials, IMGs must pass Steps I and II of the USMLE. In order to obtain a license to practice in the United States, IMGs must successfully complete a residency in a program approved by the American Council of Graduate Medical Education(ACGME) and the complete Step III, the final step in the USMLE. TKM doctors, in the prospective of overseas expansion, applied to ECFMG and their applications have been rejected. This circumstance happened because Korea is unique country in the world with two different medical licensing system, Oriental and Western, both being physician workforce. Rejection by ECFMG occurred because of their minimal understanding of Korea's situation, while the responsibility to inform, propagate and protect TKM doctors own rights depend exclusively to Korean government, TKM doctor oneself and its related organizations, all the members should endeavor on it.
Objectives: The purpose of this study was to investigate the status of Korean medicine treatment, and to analyze problems and demands to provide basic data on Korean medicine in military medical services. Methods: This survey was completed by 30 volunteer Korean medicine military doctors on service via a web-based questionnaire system. The questionnaire was developed through in-depth interviews with Korean medicine military doctors and consisted of general information on the subject, overall characteristics of the medical environment, current status of Korean medicine care in each workplace, problems and needs, and related clinical evidence and education. Results: Korean medicine military doctors administered acupuncture treatment most frequently in clinical practice. The most common complaints were related to musculoskeletal diseases, which accounted for 86.5% of all diseases, including those of the respiratory, digestive, and nervous systems. Most of the problems in Korean medicine care were pointed out as being due to a lack of awareness of Korean medicine in the military. Many doctors were aware that it is necessary to establish clinical evidence for Korean medicine in the military, and were also positive about the possibility of performing clinical research in the military, but the experience of actual participation in clinical research or related education was uncommon. Conclusions: Korean medicine military treatment differs from private medical care due to the specificity of each workplace and the military medical system. In the future, it will be necessary to establish an appropriate Korean medicine treatment model in the military suitable for these characteristics and strategic plans for clinical evidence.
We have known that "Chimgudaeseong(鍼灸大成)" had been written by Yanggyeju(楊繼洲) in Myeong(明) Dynasty. And it had been the only text book of acupuncture & moxibustion for 300 years. This book is composed of 10 chapters dealing almost all the medical theories of that times. This book is so enormous that it is hard to understand essential ideas of author. The reading medical records is one of the best way to develop one's abilities of curing a disease without clinical practice. so we can't help dealing with medical records, because it is one of important method of understanding Oriental Medicine. On this study, we investigate a objective method on understanding medical records in "Chimgudaeseong(鍼灸大成)".
Park, Jong-Ku;Kang, Myung-Guen;Lee, Seong-Soo;Kim, Dal-Rae;Choi, Seo-Young;Han, Chang-Ho;Yoo, Jun-Sang;Kim, Min-Gi;Kim, Chun-Bae
The Journal of Internal Korean Medicine
/
v.22
no.4
/
pp.691-702
/
2001
Objectives : This study was done to assess the effects of the clinical interchange between the Western Medicine and the Oriental Medicine for ischemic stroke patients. The patient outcomes include changes in neurologic function by modified NIH stoke scale, stroke pattern identification scale, and patient satisfaction, Methods : For the assessment of effects, this study was performed with 178 inpatients who had undergone the stroke care at three hospitals (W Hospital adopted western therapy, S Oriental Hospital adopted Sasang constitution medicine therapy, and H Oriental Hospital adopted mixed therapy according to a joint protocol on Western Oriental medical care) from November 1997 to December 1998. Patients were interviewed or written with self-entered questionnaire forms, and clinical data were obtained, Physicians or oriental doctors wrote clinical questionnaire forms according to the care process. Results : The patient outcomes within three hospitals at 2 stages (at admission and discharge in the modified NIH stroke scale. at admission and second weeks during admission in the stroke pattern identification scale) were found to be decreased, Especially in the results of hierarchical multiple regression analysis, the degree of improvement of modified NIH stroke scale of the stroke patients at W Hospital was significant large than it at S Oriental Hospital. Also, the degree of improvement of stroke pattern identification scale at W Hospital was significantly large than it at other two hospitals. However, the patient's satisfaction score at three hospitals wasn't significantly different. Conclusions : The result of this study suggested that the joint clinical research of Western & Oriental medical practitioners was possible even if there was a conflict between Western Medicine and Oriental Medicine. Therefore Western & Oriental medical practitioners share a mutual responsibility to apply evidence-based practice, to seek scientific empirical proof through randomized clinical trials between the multicenter.
Objectives: This study aims to develop an educational program based on a manual for disaster medical support using Korean medicine (KM) for disaster survivors. Methods: We conducted a literature review on another educational program, a focus group interviews with experts, a survey of the academic needs of Korean medicine (KM) doctors, educational competency development, and an expert Delphi survey. Results: This program was designed using a hybrid method combining online (4 h) and offline (8 h) elements; the total time of the program is 12 h. The offline course consists of theory (4 h) and practice (4 h) lectures. The theory lecture covers herbal medicine, acupuncture, stabilizing technique, emotional freedom technique, and self-management, and the practice lecture covers stabilizing technique, emotional freedom technique, and clinical performance evaluation. Meanwhile, the online course covers a manual for disaster medical support using KM and an introductory course from the National Center for Disaster and Trauma. Conclusions: The results of this study are expected to be useful for enhancing training for KM doctors in trauma care for disaster survivors as well as evaluating and validating the program's effectiveness.
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