• Title/Summary/Keyword: quality of acupuncture

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An Analysis of the Existing Guidelines and Clinical Trials for the Development of the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD) (위식도역류질환 한약제제 임상시험 가이드라인 개발을 위한 관련 국내 가이드라인 분석 및 기존 한약임상시험과의 비교)

  • Han, Ga-jin;Leem, Jung-tae;Kim, Jin-sung;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.90-108
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    • 2016
  • Objectives: This study aimed to learn what should be considered in the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD) by analyzing the existing guidelines and clinical trials.Methods: The development committee searched the existing guidelines for herbal medicinal products or GERD. Then, clinical trials related to GERD using herbal medicine were selected. The chosen trials were analyzed in terms of their inclusion and exclusion of participants, intervention, comparators, outcome, and trial design. Then, we compared the results of the analysis according to the regulations and guidelines of the Ministry of Food and Drug Safety to suggest the issues that we will have to consider when developing the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD).Results: As a result, few guidelines for GERD and clinical trials with herbal medicinal products were located in the national institution homepage. In addition, 8 articles were found using the following combination of search terms: “Gastroesophageal reflux disease”, “GERD”, “herbal medicine”, “herbal therapy”, “Korean Medicine”, “Traditional Chinese Medicine”, and “TCM”. Even though all trials had their own unique research questions, all studies were performed using a randomization method. Most trials included participants with reflux esophagitis, but two trials targeted proton pump inhibitor-refractory GERD. The type of intervention varied, such as decoction, granules, and capsules. Additionally, individualized herbal medicines were used in two studies. Comparators were diverse, such as placebo, Western medicine, and electro-acupuncture. The most frequently used outcome for efficacy was the effectiveness rate. In addition, the outcome for evaluating quality of life, esophageal mucosa and pressure, esophageal acid reflux, and recurrence rates were used. Safety was investigated by recording adverse events and carrying out laboratory tests.Conclusions: We identified some issues by reviewing the existing guidelines and comparing them with clinical trials for GERD and herbal medicinal products. These results will be utilized for developing the Guidelines of Clinical Trials with Herbal Medicinal Products for Gastroesophageal Reflux Disease (GERD).

A Comparative Study of a Deeply-inserted Acupotomy Applied to Hyeopcheok Points and Usual Korean Medicine Treatments for Lumbosacral Radiculopathy: Safety, Effectiveness, Cost-effectiveness: A Study Protocol (요천추신경병증에 대한 심부협척 도침술과 한의통상치료의 효과 비교: 안전성, 유효성, 경제성평가: 연구 프로토콜)

  • Heo, In;Lee, Jin-Hyun;Ko, Youn-Suk;Jo, Dong Chan;Kim, Young Il;Lee, Sang-Hyun;Hwang, Eui-Hyoung;Park, Tae-Yong;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.69-77
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    • 2021
  • 연구 배경 최근 한국 및 중국에서 근골격계 질환에 대한 도침술의 활용이 늘고 있다. 하지만 현재까지의 임상연구는 대부분 증례보고 형태에 그치거나, 충분한 근거가 확보되지는 않은 실정이다. 우리는 요천추신경병증환자의 치료에 있어 도침치료와 통상한의치료와의 비교를 통해 도침치료의 유효성, 안전성, 경제성 평가를 시행하기 위해 본 연구를 기획하게 되었다. 연구 방법 본 연구는 예비임상 연구로, 다기관에서 진행되며, 무작위대조군, 활성 대조군을 통한 2개군 병행집단 연구로 평가자 맹검을 시행하게 된다. 이 연구에서는 총 50명의 요천추신경병증 환자를 대상으로 2개군으로 균등하게 분배하여 도침술 또는 통상한의치료를 시행하게 된다(각군당 25명). 도침술 그룹의 경우 협척혈에 도침치료를 시행 받게 되며, 통상 한의치료군은 연구자 판단하에 도침술을 제외한 적절한 한의치료를 시행 받게 된다. 두 개의 그룹은 주당 2회씩 총 3주간 치료를 받게 된다. 일차 유효성 평가는 요통으로 인한 기능장애를 평가하기 위한 Oswestry disability index를 통해 시행한다. 이차 유효성 평가지표로는 numeric rating scale, European Quality of Life 5-Dimension 5-Level, short-form McGill Pain Questionnaire, Roland-Morris Disability Questionnaire scores를 시행하게 된다. 고찰 본 예비임상연구의 결과는 추후 있을 요천추신경병증에 대한 도침치료 및 한의통상치료 비교효과 연구의 유효성, 경제성평가 본 임상연구를 위한 기초 정보 및 가능성을 확인하고 적절한 대상자수 산정에 도움이 될 것이다.

Long-Term Survival of Patients with Lung Cancer Treated by Traditional Korean Medicine Combined with Western Treatment: Report of Two Cases (양한방 복합투여로 장기간 생존을 보인 폐암 환자 2례)

  • Kang, Ji-young;Kim, Jun-young;Son, Chang-gue;Cho, Jung-hyo
    • The Journal of Internal Korean Medicine
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    • v.36 no.1
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    • pp.58-68
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    • 2015
  • Objectives : To evaluate the long-term survival effects of traditional Korean medicine (TKM) on refractory metastatic lung cancer and small cell lung cancer (SCLC), which have historically poor survival rates. Methods : A retrospective study was conducted using the medical records of two patients in Daejeon University hospital. The first patient, with SCLC, was treated from January 2000 to December 2009 and the other, with metastatic pulmonary cancer from primary hepatocellular carcinoma (HCC), was treated from September 2004 to February 2014. The patients were treated with herbal medicines at one-month intervals. During hospitalization, acupuncture and indirect moxibustion were performed concurrent with the administration of Western therapy. Treatment efficacy was assessed monthly using chest radiography, chest computed tomography, and laboratory examination data, and by measuring patient performance status. Results : Both patients exhibited a stable disease course for more than 9 years after the initial diagnosis of intractable lung cancer, suggesting that their disease status was controlled by TKM. Conclusions : We suggest that a combination of TKM with conventional Western therapy for refractory lung cancer patients is effective in controlling various symptoms related to lung cancer and improving quality of life, and may potentially prolong overall survival.

Effect of Peeling Blades and Abrasives on Mechanical Peeling of Cynanchum wilfordii Hemsley (박피(剝皮)날 및 연마재(硏磨材)가 백하수오(白何首烏) 기계박피(機械剝皮)에 미치는 영향(影響))

  • Kim Ju;Kim Chang-Soo;Song Yeung-Eun;Lee Yun-Suk;Shim Jin-Chan;Han Jong-Hyun;Kwak Joon-Soo
    • Korean Journal of Acupuncture
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    • v.18 no.1
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    • pp.165-170
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    • 2001
  • A rapid increasing in cultivation area due to favorable price temporarily and decreasing in consumer's demands caused by economic depressions recently, lead the price of Cynanchum wilfordii Hemsley to decline sharply. Thus, it may give rises to weakening of cultivation bases in Cynanchum wilfordii Hemsley. To investigate optimal mechanical peeling conditions of Cynanchum wilfordii Hemsley, protruded rubber, plastic pad, diamond shape's steel and palstic brush were introduced as blades and artificial stone, sand and small pebble were done as abrasives. The main results obtained were summarized as follows; 1. It took 2 minutes per 1kg in mechanical peeling of Cynanchum wilfordii Hemsley's raw root whereas 36 minutes in manual peeling and values of lightness showed more higher in manual peeling than in mechanical peeling. 2. Yield in combination of diamond shape's steel blade and sand abrasive showed the lowest at 89.9% among treatments and peeling rates in combination of diamond shape's steel blade and small pebble showed the highest at 71.3% in mechanical peeling. 3. Lightness, one of the most important factors in determining quality of Cynanchum wilfordii Hemsley, showed the highest in combination of diamond shape's steel blade and small pebble brasive at 61.90 in mechanical peeling. 4. As the speed of rotation gets faster, yields tend to lower in mechanical peeling. Peeling rates and lightness showed the highest at 66.8%, 57.96 respectively among treatments at 30 r.p.m. in mechanical peeling.

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The Study on Correlation between the Degree of Herniated Intervertebral Lumbar Disc at L4~5 Level and Improvement of Low Back Pain Treated by Korean Medicine Therapy (제 4~5번 요추 추간판 탈출 정도와 요통의 한의학적 치료 효과의 상관성 연구)

  • Yoo, Hyung-jin;Lee, Hyun-ho;Jeong, Seong-hyun;Jo, Kyeong-sang;Lee, Gie-on;Lee, Dong-hyun;Kim, Sang-min
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.2
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    • pp.105-121
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    • 2016
  • Objectives The purpose of this study was to compare the effects between the degree of herniated intervertebral lumbar disc (HIVD) at L4-5 level and improvement of low back pain treated by Korean Medicine therapy. Methods 567 patients who received inpatient treatment from May 2014 to December 2015 in the Daejeon-Jaseng of Korean Medicine Hospital were divided into 6 groups by the degree of HIVD at L4-5 level confirmed with a Lumbar spine magnetic resonance imaging. All patients received a combination of treatment including acupunture, chuna manual therapy, pharmacopunture, herbal medication. They were compared and analyzed on the basis of improvement between measuring Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) as they were hospitalized and as they were discharged. The statistically significance was evaluated by SPSS 23.0 for windows. Results After treatment, Normal stage on Intervertebral Lumbar Disc at L4-5 level group's Numeric Rating Scale (NRS), Oswestry Disability Index (ODI), EuroQol-5 Dimension Index (EQ5D Index) improvement was $1.30{\pm}1.62$, $4.52{\pm}11.82$ and $0.04{\pm}0.11$ respectively. Bulging group's improvement was $3.25{\pm}2.81$, $8.28{\pm}13.02$ and $0.09{\pm}0.17$ respectively. Spinal canal occupying ratio (SOR) less than 20 group's improvement was $2.15{\pm}1.92$, $11.79{\pm}17.81$ and $0.13{\pm}0.23$ respectively. SOR 20 to less than 40 stage group's improvement was $2.13{\pm}1.92$. $10.79{\pm}15.93$ and $0.10{\pm}0.26$ respectively. SOR 40 to less than 60 group's improvement was $2.16{\pm}2.24$, $9.80{\pm}16.62$ and $0.15{\pm}0.25$ respectively. Surgery group's improvement was $2.47{\pm}2.21$, $11.64{\pm}18.53$ and $0.15{\pm}0.27$ respectively (p<0.03). But there was no statistically significance between 6 group's improvement after treatment (p>0.05). Conclusions After inpatient treatment by Korean Medicine therapy, Most patient's pain, disability and Health Related Quality of Life was improved significantly. But there was no statistically correlation between the degree of HIVD at L4-5 level and improvement of low back pain. So We think that future research of higher quality and correct statistics shall be necessary.

A Case of the Shoulder-Hand Syndrome Caused by a Crush Injury of the Shoulder (견관절부 외상후 발생된 Shoulder-Hand Syndrome)

  • Jeon, Jae-Soo;Lee, Sung-Keun;Song, Hoo-Bin;Kim, Sun-Jong;Park, Wook;Kim, Sung-Yell
    • The Korean Journal of Pain
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    • v.2 no.2
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    • pp.155-166
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    • 1989
  • Bonica defined, that reflex sympathetic dystrophy (RSD) may develop pain, vasomotor abnoramalities, delayed functional recovery, and dystrophic changes on an affected area without major neurologic injury following trauma, surgery or one of several diseased states. This 45 year old male patient had been crushed on his left shoulder by a heavily laden rear car, during his job street cleaning about 10 years ago (1978). At first the pain was localizea only to the site of injury, but with time, it spreaded from the shoulder to the elbow and hand, with swelling. X-ray studies in the local clinic, showed no bone abnormalities of the affected site. During about 10 years following the injury, the had recieved several types of treatments such as nonsteroidal analgesics, steroid injections into the glenoidal cavity (10 times), physical therapy, some oriental herb medicines, and acupuncture over a period of 1~3 months annually. His shoulder pain and it's joint dysfunction persisted with recurrent paroxysmal aggrevation because of being mismanaged or neglected for a sufficiently long period these fore permiting progression of the sympathetic imbalance. On July 14 1988 when he visited our clinic. He complained of burning, aching and had a hyperpathic response or hyperesthesia in touch from the shoulder girdle to the elbow and the hand. Also the skin of the affected area was pale, cold, and there was much sweating of the axilla and palm, but no edema. The shoulder girdle was unable to move due to joint pain with marked weakness. We confirmed skin temperatures $5^{\circ}C$ lower than those of the unaffected axilla, elbow and palm of his hand, and his nails were slightly ridged with lateral arching and some were brittle. On X-ray findings of both the shoulder AP & lateral view, the left humerus and joint area showed diffuse post-traumatic osteoporosis and fibrous ankylozing with an osteoarthritis-like appearance. For evaluating the RSD and it's relief of pain, the left cervical sympathetic ganglion was blocked by injecting 0.5% bupivacaine 5 ml with normal saline 5 ml (=SGB). After 15 minutes following the SGB, the clinical efficacy of the block by the patients subjective score of pain intensity (=PSSPI), showed a 50% reduction of his shoulder and arm pain, which was burning in quality, and a hyperpathic response against palpation by the examiner. The skin temperatures of the axilla and palm rose to $4{\sim}5^{\circ}C$ more than those before the SGB. He felt that his left face and upper extremity became warmer than before the SGB, and that he had reduced sweating on his axilla and his palm. Horner's sign was also observed on his face and eyes. But his deep shoulder joint pain was not improved. For the control of the remaining shoulder joint pain, after 45 minutes following the SGB, a somatic sensory block was performed by injecting 0.5% bupivacaine 6 ml mixed with salmon calcitonin, $Tridol^{(R)}$, $Polydyn^{(R)}$ and triamcinolone into the fossa of the acromioclavicular joint region. The clinical effect of the somatic block showed an 80% releif of the deep joint pain by the PSSPI of the joint motion. Both blocks, as the above mentioned, were repeated a total of 28 times respectively, during 6 months, except the steroid was used just 3 times from the start. For maintaining the relieved pain level whilst using both blocks, we prescribed a low dose of clonazepam, prazocin, $Etravil^{(R)}$, codeine, etodolac micronized and antacids over 6 months. The result of the treatments were as follows; 1) The burning, aching and hyperpathic condition which accompanied with vaosmotor and pseudomotor dysfunction, disappeared gradually to almost nothing, within 3 weeks from the starting of the blocks every other day. 2) The joint disability of the affected area was improved little by little within 6 months. 3) The post-traumatic osteoporosis, fibrous ankylosis and marginal sclerosis with a narrowed joint, showed not much improvement on the X-ray findings (on April 25, 1989) 10 months later in the follow-up. 4) Now he has returned to his job as a street cleaner.

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Analysis of Components in the Different Parts of Lythrum salicaria L. (털부처꽃의 부위별 성분 분석)

  • Kim, Hee-Young;Park, Yea-Jin;Lee, Ju-Yeon;Kim, Ki-young;Shin, Su;Choi, Min-Woo;Hong, Eun-Jin;Kim, Min-jeong;Yeo, Sujung;Park, In-hwa;Jerng, Ui Min;An, Hyo-Jin;Cha, Yun-Yeop
    • The Korea Journal of Herbology
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    • v.37 no.5
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    • pp.89-96
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    • 2022
  • Objectives : This research was performed to analyze the components in the different parts of Lythrum salicaria L. and to compare which parts of L. salicaria L. are appropriate for food development. Methods : L. salicaria L. was extracted in 20% EtOH at 100 ℃ for 4 hours. Cytotoxicity was investigated in 3T3-L1 cells after treatment of 10-500 ㎍/ml L. salicaria L. for 24 hours. Total polyphenol content (TPC) was estimated using 1 N Folin-ciocateu reagent. 2,2-Diphenyl-1-picryhydrazyl (DPPH) radical scavenging activity was estimated using DPPH reagent and gallic acid. The chemical composition was analyzed by high-performance liquid chromatography (HPLC). 1) Results : The half maximal inhibitory concentration (IC50) in the extracts of the whole plant, aerial parts, and root parts was 350 ㎍/ml, over 500 ㎍/ml, and 150 ㎍/ml, respectively. The TPC in the extracts of the whole plant, aerial parts, and root parts was 527.1 mg/g, 422.6 mg/g, and 781.1 mg/g, respectively. The averages of vitexin contents in the aerial parts, and root parts were 256.7 ± 154.9 ㎍/g and 266.1 ± 63.2 ㎍/g, respectively. The averages of TPC in the leaves, roots, flower stalks and stems were 224.0 ± 53.7 tannin acid (TA) mg/g, 221.8 ± 70.2 TA mg/g, 249.8 ± 34.4 TA mg/g, and 67.7±8.9 TA mg/g, respectively. The averages of DPPH radical scavenging activity in the leaves, roots, flower stalks, and stems were 282.01 ± 43.3 gallic acid equivalent (GAE) 𝜇mole/g, 260.16 ± 44.1 GAE 𝜇mole/g, 288.0 ± 9.3 GAE 𝜇mole/g, and 97.6 ± 10.7 GAE 𝜇mole/g, respectively. Conclusions : There were no significant differences in the content of components or antioxidant activity in the aerial parts compared to those in the whole plant of L. salicaria L. Furthermore, the root parts had low extract yield, cytotoxicity, and quality control problems, therefore our results suggest that the use of the aerial part of L. salicaria L. would be the most appropriate for food development.

A Clinical Study of Hypersensitive rhinitis including Allergic rhinitis (알레르기성 비염을 포함하는 과민성 비염 환자에 관한 임상적 연구)

  • Choi, In-Hwa
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.15 no.2
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    • pp.169-182
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    • 2002
  • Background: Allergic rhinitis(AR) is a heterogeneous disorder that despite its high prevalence is often undiagnosed. It is characterized by one or more symptoms including sneezing, itching, nasal congestion, and rhinorrhea. And it is frequently accompanied by symptoms involving the eyes, ears, and throat, including postnasal drainage. There are many different causes of rhinitis in children and adults. Approximately 50$\%$ of all cases of rhinitis are caused by allergy. In the case of rhinitis caused by allergens, symptoms arise as a result of inflammation induced by a gamma globulin E-mediated immune response to specific allergens such as pollens, molds, animal dander, and dust mites. The immune response involves the release of inflammatory mediators and the activation and recruitment of cells to the nasal mucosa. AR is similar to 鼻?, hypersensitive rhinitis in Oriental Medicine. I think hypersensitive rhinitis is including of AR, vasomotor rhinitis and non-allergic rhinitis related with eosinophil increased and so on. Purpose: To perform a clinical analysis of hypersensitive rhinitis including allergic rhinitis and estimate the efficacy of Oriental Medical treatment. Objective: We studied 96 patients who had visited our hospital with complaints of nasal symptoms from March 2000 to February 2002; they had the signs more than 2 - nasal obstruction, watery discharge, sneezing and eye or nasal itching. Parameters Observed & Methods: We treated them with acupuncture & herb-medication. Sometime they used aroma oil or external medicine. 1) the distribution of sex & age groups 2) the clinical type based on duration & the severity of symptom 3) the breakdown of complication & pasl history of Otolaryngologic or allergic disease 4) the clinical assessment and classification of rhinitis(sneezers and runners & blockers) 5) the associated symptoms and signs 6) the classification of Byeonjeung 7) the classification of prescriptions and 8) the efficacy of treatment. Result: 1. In the clinical type of based on duration, the intermittent type was 42.7$\%$ and the persistent was 57.3$\%$. 2. We observed the severity of symptoms based on the quality of life. The mild type was 24.0$\%$ and the moderate-severe was 76.0$\%$. 3. In the clinical assessment and classification of rhinitis, the sneezers and runners type was 69.8$\%$ and the blockers was 30.2$\%$. 4. The most common family history with otolaryngologic or allergic disease were allergic rhinitis(17.7$\%$), urticaria, paranasal sinusitis and T.B.(3.1$\%$). 5. The most common past history with otolaryngologic or allergic disease were paranasal sinusitis(14.6$\%$), atopic dermatitis and asthma(8.3$\%$). It was 31.3$\%$ they had a family history and 44.8$\%$, past history. 6. The most common complication was paranasal sinusitis(15.6$\%$). In decreasing order the others were otitis media with effusion(9.4$\%$), GERD and headache(6.3$\%$), asthma, bronchitis, nasal bleeding and allergic dermatitis(5.2$\%$). 7. Classification through Byeonjeung : ⅰ) 39 cases(34.9$\%$) were classified as showing Deficiency syndrome. The insuffficiency of Qi was 17.7$\%$, deficiency of Kidney-Yang, 12.5$\%$ and Lung-Cold, 10.4$\%$. ⅱ) 57 cases(59.4$\%$) were classified as showing Excess syndrome. The Fever of YangMing-meridian was 35.4$\%$, Lung-Fever, 24.0$\%$. 8. The efficacy of treatments showed: an improvement in 22cases(22.9$\%$); an improvement partly in 24 cases(25.0$\%$); no real improvement or changes in 16 cases(16.7$\%$); and couldn't check the results 18cases(18.6$\%$). Conclusion: We suggest that this study could be utilized as a standard of clinical Oriental Medical treatment when we treat hypersensitive rhinitis including allergic rhinitis.

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The effects of Moxibustion Therapy on Chronic Low Back Pain, Daily Living Disability and Sleep Pattern in Elderly Women (뜸요법이 여성노인의 만성요통, 일상생활기능장애 및 수면양상에 미치는 효과)

  • Kim, Hye-Jeong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.17 no.7
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    • pp.301-310
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    • 2016
  • This is a nonequivalent control group non-synchronized experiment research to verify the effect of moxibustion therapy on efficient management of daily living disabilities and sleep patterns in elderly women with chronic low back pain. Total 12 sessions of moxibustion therapy were applied to elderly women(30 subjects in an experimental group and 30 subjects in a control group) in G City once a week for 12 weeks from March 15th to May $31^{st}$ 2015. Then the follow-up study was conducted 2 weeks after the post survey. For moxibustion, was applied to Shen-shu, Ashi point, Ta chang shu, Yang kuan and Yosu. 5 sheets of moxibustion were applied to 7 acupuncture points of Mugeukboyang moxibustion; Zu san li & Chu chi, Chung wan, Chung chi & Shui tao, Fei shu, Kao hung and Tien shu, Wijung respectively and experimental treatment was conducted. For assessing the degree of back pain, Visual Analog Scale(VAS) developed by Scott & Huskisson(1979) was used and for measuring the degree of daily living disability, Oswestry Disability Index, which was developed by Fairbank et al(1980) and translated and revised by Yim, Hyeon-sul et al.(1998), was used. For measuring sleep patterns, the sleep pattern measurement tool developed by Oh, Jin-su, Song, Mi-soon and Kim, Sin-mi(1998) was used. For data analysis, SPSS/WIN 18.0 was employed and Chi-square test, t-test and repeated measures ANOVA were performed. There were significant differences in pain score(F=2510.32, p<.001), daily living disability score(F=1937.82, p<.001) and sleep pattern score((F=15.54, p<.001) of elderly women that were provided with moxibustion therapy, compared to the control group. Therefore, it was found that moxibustion therapy made a positive contribution to reduction in pain and daily living disabilities and improvement in sleep quality. Based on this study finding, there is a need to apply moxibustion therapy to elderly people with chronic low back pain as a nursing intervention in future.