Objectives : The objective of this study is to discuss problems and potential improvements of national health insurance fees associated with miniscalpel acupuncture according to Korean medical doctors' workload, material cost and degree of risk. Methods : We researched the change of relative value points, national health insurance fees, the acupuncture process, and Korean medicine doctors' workload related to Miniscalpel acupuncture, as compared to general meridian point acupuncture. We also examined material cost by surveying pharmacies, internet shopping malls and medical appliance shops. Results : Relative value point for Miniscalpel acupuncture decreased from 2010 to 2012, and remained the same from 2012 to 2016. National health insurance fees for Miniscalpel acupuncture increased by a small margin annually for rise of equivalent index. There was no reporting on workload related to Miniscalpel acupuncture. Material cost of Miniscalpel acupuncture was 18.2~20.7 times higher than actual cost of procedure. There were few studies examining medical accidents related to Miniscalpel acupuncture, and thus we could not evaluate degree of risk. Conclusion : We suggest revaluating Korean medical doctors' workload related to including Miniscalpel acupuncture, to consider the material costs of Miniscalpel acupuncture, and investigate its degree of risk by researching medical accidents.
The present study examined that in Vivo/Vitro test is investigated in normotensive sham-operated rats (NSR) and aldosterone-analogue deoxycorticosterone acetate (DOCA)-salt hypertensive rats (ADHR) and that the antihypertensive effect was induced by silver spike point (SSP) electrical stimulation at meridian points(CV-3, -4, Ki-12, SP-6, LR-3, BL-25, -28, -32, -52), specifically, such as aldosterone in 24 hour urine analysis from healthy volunteer. The gross examination and morphometric-histological changes, such as hypertrophy, production of necrotic tissues, and the changes of cell arrangement on the kidney, and adrenal gland were markedly observed in aldosterone-analogue DOCA-salt hypertensive rats compared with those from normotensive sham-operated rats. The systolic blood pressure, weight of kidney and adrenal gland were significantly increased in ADHR than that in NSR. The required time of PSS-induced resting tone was significantly increased in ADHR than that in NSR. However, the voltage-dependent K+ (Kv) currents were significantly decreased in ADHR than that in NSR. The urine analysis showed that the concentration of aldosterone was significantly decreased in resting state from the elderly people compared with those from the adolescent healthy volunteer. The current of 1 Hz continue type of SSP electrical stimulation significantly decreased in the concentration of aldosterone of 24 hour urine from the elderly people. These results suggest that the development of aldosterone analogue-induced hypertension is associated with changed the weight of kidney and adrenal gland, blood pressure, resting tone and Kv currents, which directly affects blood pressure. Therefore, the hypertension is a risk factor on cerebrovascular disease. Moreover, these results suggest that the diminished responsiveness to SSP electrical stimulation, especially current of 1Hz continue type, in elderly people may be, in part, related by the increased of antihypertensive effects.
We implemented the Drug-Pad Moxibustion Method in order to improve the conventional moxibustion therapy. This method is aimed to eliminate burning wounds and smoke, which are the defects of conventional moxibustion therapy. And we performed to verify the efficiency by comparing the Drug-Pad Moxibustion Method with the conventional Indirect Moxibustion Therapy. We measured the body heat and the lasting time of blood circulation improvement using thermography. The moxibustion therapy has two kinds of effects: The formers are pharmacological effects of the Moxa's vasodilators and antioxidants. The latters are thermal effects which cause improvement of the blood circulation. To remove the demerits without omission of above therapeutic effects, we extracted the vasodilators and antioxidant compounds from the Moxa-$CH_2Cl_2$ fraction Moxa-EtOAc and composed the moxibustion kit with $(Ba_{0.8}\;Sr_{0.2})_{0.996}\;Y_{0.004}\;TiO_2+0.5_{WT}\;SiO_2%$ Positive Temperature Coefficients Thermistor. The experimental demonstrations have been made by the stimulating the spot which is CV4(Kwan-Won), CV8(Shin-Guel), CV12(Jung-Wan) acupuncture points of the conception vessel meridian(CV). And stimulating time was one hour. We divided the subjects into 5 groups such as no stimulation group, conventional Indirect Moxibustion group, only Drug-Pad stimulation group, only heat stimulation group, and Drug-Pad Moxibustion group. In the different cases, we have measured the body heat in pre-stimulation, just after stimulation, 2 hours after, and 4 hours after. The body heats of the group who were stimulated by the Drug-Pad Moxibustion Method were increased by over the $2^{\circ}C$. And the body heats of the group who were stimulated by the Indirect Moxibustion Method were increased by average the $1^{\circ}C$. We have evaluated that the Drug-Pad Moxibustion Method is improvement on the conventional Indirect Moxibustion Method by the heat-increasing rate is 200% and the lasting time is 150% with the body heat of the abdominal region. In the conclusions, We have implemented the Drug-Pad Moxibustion Method and evaluated the efficiency of the Drug-Pad Moxibustion Method comparing with the conventional Indirect Moxibustion Method.
목 적 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에서 전침 및 한약의 복합처치 치료가 이 두가지 면에서 각각 어떤 영향을 미치는지를 살펴보았다. 방 법 : 장음검사상 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 환자 10명을 대상으로 치료 전후의 장음 지표 변화를 비교하였다. 장음지표는 % of bowel sound (%BS)와 주 주파수(dominant frequency, DF)를 사용하였으며, %BS(6인 경우를 위 미주신경 활성저하 DF ratio(식후/식 전)<1를 유문부 기능장애로 평가하였다. 환자들에게 2주간 족삼리전 침과 체침이 매일 시술되었으며 평위산 전탕액이 하루 3회 투여되었다. 결 과 : 2주간의 치료 후 DF ratio는 $0.93\pm0.06$에서 $1.06\pm0.04$으로 유의성있게 증가했으며, 10명 중 9명의 환자가 DF ratio>1의 정상치로 회복되었다. %BS 역시 $2.97\pm1.17%$에서 4.27%로 증가했지만 통계적 유의성은 없었으며, 3명의 환자에서 %BS가 6이상으로 정상회복되었다. 결 론 : 위 미주신경 활성 저하와 유문부 기능 장애를 동시에 가지고 있는 기능성 소화불량증 환자에 대한 족삼리 전침과 일반 체침, 평위산의 치료는 미주신경 활성 저하보다는 유문부 기능 장애에 더 유의한 효과를 보였다.
Objectives : The purpose of this study is to review needling depth and location of LU7, BL62 and KI6 by the medical classics' records. Methods : 1. We researched the medical classics describing LU7, KI6 and BL62, and reorganized data about the location and needling depth. 2. We compared the medical classics' records on LU7, KI6 and BL62 with description of WHO standard acupuncture point location. 3. We reviewed different location and needling depth of LU7, BL62, and KI6 recorded in the medical classics with the anatomical structure. Results : 1. The common needling depth of LU7 is about 0.2 chon. But in some medical classics, the depth of LU7 is 0.8 chon. Needling depth of LU7 varied depending on the patient's hand posture. In the 'half-up' position with the thumb upward, it is possible to stimulate acupuncture on LU7 by 0.8 chon because there is a space between the tendons. 2. In WHO standard acupuncture point location, the locations of BL62 and KI6 are just below the lateral and medial malleolus. But in some medical classics, the locations of BL62 and KI6 are between the bones and muscles below the malleolus. In the locations between the bones and muscles below the malleolus, it is possible to stimulate acupuncture on BL62 and KI6 by penetrating acupuncture because there is no bone structure. Conclusions : 1. By the 'half-up' position with the thumb upward, it is possible to stimulate vertically acupuncture on LU7 by 0.8 chon. 2. By the locations of BL62 and KI6 between the bones and muscles below the malleolus, it is possible to stimulate on BL62 and KI6 by penetrating acupuncture.
Objectives : The purpose of this study was to evaluate the effectiveness and safety of acupuncture treatment for recovery of patients with vertebral compression fracture(VCF). Methods : We searched ten English and Chinese and seven Korean database up to April 2018. Randomised controlled trials(RCTs), quasi-RCTs, non-radomised Controlled Trials(CCTs) were eligible. Quasi-RCTs and CCTs were assessed only for safety assessment. Pain and adverse events were primary outcome of this review. Quality of life, dysfunction, patient satisfaction, incidence of new vertebral compression fracture were regarded as secondary outcomes. The risk of bias was assessed by two independent authors using the Cochrane risk of bias tool. Level of evidence was tabulated using the GRADE methods. Results : Of 1656 screened, 15 RCTs, 1 quasi-RCT and 3 CCTs were included. Number of participants per study ranged from 45 to 135. Most of the studies had unclear or high risk of bias and considerable heterogeneity in terms of type of intervention, comparison and time-points for outcome measurement. Compared to usual care alone, acupuncture combined with usual care showed short-term favorable results for pain relief in patients with VCF(5 studies, n=252, MD -1.05 point on a 0 to 10 point scale, 95% CI -1.45 to -0.65, $I^2=74%$). Four studies reported mild and temporary adverse events, and no serious adverse events were reported. One study descriptively reported that acupuncture was effective for improving quality of life without providing numerical outcomes. There were no reports of patient satisfaction and incidence of new VCF. Conclusions : Level of evidence is very low for the effectiveness and safety of acupuncture for pain, harms and other clinical outcomes in patients with VCF. Included studies suffered from incomplete reporting, high or unclear risk of bias and substantial heterogeneity between studies. Future high-quality RCTs are needed to assess whether acupuncture is beneficial for recovery of patients with VCF.
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.
In order to approach the nursing care of clients who are using oriental medicine and to understand the perception of the client who uses oriental medicine practices and the need to develop a model of nursing related to oriental medicine it is important to examine the major nursing concepts as they are found in oriental medicine and as they are differently defined according to the basic thought, theory and philosophical perspectives between East and West. Oriental medicine developed based on Sung Confucianism the teachings of Chut-zu, especially Tai-Chi-Tu Shuo and energy thought which are similar to traditional Korean Sasang Constitutional medicine. The basic theory on which oriental medicine is build is the theory of the five elements of Yin / Eum-Yang Theory(cosmic dual forces) and Meridian Theory. The most important attribute of Yin Yang is the concept of duality, confrontation and dependence, within Yin Yang but which do not exist separately. That is, the universe is a vast, indivisible entity within which all things exist in harmonious interdependence and balance. Harmony is achieved only when the two primorial forces, Yin and Yang, are brought into perfect balance. Each is contained within the other and there is a continuing interchange between the two. This also applies to the human body including human health which is defined as balanced harmony. The most universal connection of Yin and Yang is found in the universe where the five elements of life, fire, water, earth, wood and metal can be explained as having either Yin or Yang and therefore being in a state of connectedness but systematically circulating between the two, that is essentalilly one (the control of the unified ) or as coexistant poles of individual wholes (the pluralism of Yin Yang Theory) so that it is all unified(balanced) in the Great Absoulte. Human beings also maintain a balance of Yin and Yang in the five elements and this relationship is very important in approaching ·oriental medicine, The meridians are the channels in the body through which the life force flow throughout the body. In oriental medicine the meridians are seen as the railroad, the acupuncture points on the meridians as the stations and energy as the train. In the normal healthy organism, all are maintained in balance and in a contiuous circulation of energy. illness is the result of the energy flow becoming disarranged. Although practitioners of oriental medicine approach the client differently than do practitioners of Western medicine and their method of examining the patient is different, the basic objectives of the examination are the same for practitioners of both types of medicine. Therefore if each could be used to supplement the defiencies in the other and achieve a harmonious cooperation between the two, a higher level of care which is culturally appropriate to korean culture could be achieved. The traditional korean concept of health is a naturalistic view which emphasizes being in harmony with nature. Any manifestation of disease is considered a sign that the body is in a state of disequilibrium and is thus no longer in harmony with the universe. The wholistic view of the world held by practitioners of oriental medicine can be used by nursing in the development of a world view of nursing in which the human being is seen within the macrocosm as part of the natural phenomenon of the universe and but also as a microcosm of the universe, a universe which is a vast and indivisible entity within which all things exist in harmonious interdependence and balance. Interaction between human beings and their environment and the relationship of this interaction to health are concepts that are also found in nursing. Nursing views human brings, not as an accumulation of separate cells and organs but, as unified wholes interacted in very close relationship nth their environment. Nursing also maintains a view of human beings in which emphasis is placed on the role of the mind in explaining the concepts of harmony and balance in health. Although there are differences between oriental medicine and nursing in approaches to clients, the basic point of view and philosophy have many fundamental similarites. An understanding of the basic thought and philosophy of oriental medicine if applied to nursing, would allow for the development, not only of nursing related to oriental medicine, but of a nursing theory appropriate to the korean context.
Objectives : Acupuncture has been widely applied to rehabilitation after stroke by Oriental medical doctors in Korea. It has been reported that acupuncture increased cerebral blood supply and stimulated the functional activity of brain nerve cells. In addition, a correlation between activation of specific areas of brain cortices and corresponding acupuncture stimulation at the therapeutic points had been well illustrated. rill now, however, there were few studies which evaluated a correlation between activation of specific areas of brain and frequently-used acupuncture therapy for stroke, such as LI4-LI11 electro-acupuncture (EA) for paresis after stroke. This study was undertaken to evaluate the effect of LI4-LI11 EA on regional cerebral blood flow (rCBF) in normal volunteers using Single Photon Emission Computed Tomography (SPECT). Methods : In the resting state, $^{99m}Tc-ECD$ brain SPECT scans were performed on 10 normal volunteers (8 males, 2 females, mean age $25.6{\pm}2.3$years; age range from 24 to 31 years). 7 days after the resting examination, 15 minutes of electro-acupuncture were applied at LI 4 and LI 11 on the right side of the subjects. Immediately after LI4-LI11 EA, the second SPECT images were obtained in the same manner as the resting state. Significant increases and decreases of regional cerebral blood flow after LI4-LI11 EA were estimated by comparing their SPECT images with those of the resting state using paired t statistics at every voxel, which were analyzed by Statistical parametric mapping with a threshold of p=0.001, uncorrected (extent threshold: k=100 voxels). Results : EA applied at right LI4-LI11 increased rCBF in right frontopolar area (Brodmann area 10) and left middle frontal area (Brodmann area 46). Interestingly, all the areas showing increased rCBF corresponded to the territories of both anterior cerebral arteries. However, LI4-11 EA decreased rCBF in the left occipital lobe (peristriate area, Brodmann area 19). Conclusions : The results demonstrated a correlation between LI4-11 EA and rCBF increase in the frontal lobes. It is also suggested that there may be a correlation between LI meridian and the territory of the anterior cerebral arterties.
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