Search Results (193)

Background and Objectives: This study aimed to evaluate the clinical effectiveness and safety of ultrasound-guided pharmacopuncture (UGP) in comparison to non-guided pharmacopuncture (NGP) for the treatment of acute cervical myofascial pain syndrome (C-MPS) in primary care settings. Materials and Methods: This multi-center, prospective observational study included 97 patients diagnosed with acute C-MPS. Participants received a single session of either UGP or NGP at one of seven primary care institutions. Pain intensity was measured using the Numerical Rating Scale (NRS), and cervical function was assessed through active Range of Motion (ROM) tests conducted before and after treatment. We conducted follow-up interviews within 48 h after treatment to monitor adverse events. Results: Both groups showed significant improvements in pain levels and cervical ROM after treatment. The UGP group showed a greater reduction in NRS scores compared to the NGP group (p < 0.001). Notable enhancements in cervical extension and rotation on the affected side were also observed in the UGP group (p < 0.01), whereas changes in flexion and lateral flexion were similar between the two groups. No serious adverse events were reported. Conclusions: UGP has shown superior pain reduction and a greater improvement in specific cervical motions compared to non-guided treatments, indicating enhanced precision and therapeutic efficacy. Furthermore, no serious adverse events were reported, suggesting that UGP is a safe and effective non-surgical intervention for acute C-MPS in real-world primary care settings. Full article

Background and Objectives: Bell’s palsy, characterized by acute idiopathic facial nerve paralysis, exhibits variable recovery outcomes influenced by treatment timing, modality, and patient comorbidities. This study aimed to compare the effectiveness of corticosteroid-based treatment (Ear, Nose, and Throat [ENT]), nerve blocks/physical therapy (Pain Medicine), and acupuncture/herbal medicine (Traditional Korean Medicine [KM]) and identify predictors of recovery and recurrence. This retrospective cohort study leverages South Korea’s pluralistic healthcare system, where patients choose specialties, to provide novel insights into departmental treatment outcomes. Materials and Methods: We analyzed 600 patients treated within 72 h of Bell’s palsy onset (2010–2024) at Wonkwang University Hospital, South Korea, using propensity score matching (PSM) (1:1:1) for age, sex, comorbidities, and initial House–Brackmann (HB) grade. The primary outcome was complete recovery (HB grade I) at 6 months; secondary outcomes included recovery time, recurrence, complications, and patient satisfaction. Multivariate logistic regression identified predictors. Results: The ENT group achieved the highest complete recovery rate (87.5%, phi = 0.18) versus Pain Medicine (74.0%) and KM (69.5%) (p < 0.001), with the shortest recovery time (4 weeks, Cohen’s d = 0.65 vs. KM). Synkinesis was lowest in the ENT group (6.0%). ENT treatment (OR: 1.75; 95% CI: 1.29–2.37) and early corticosteroid application (OR: 1.95; 95% CI: 1.42–2.68) predicted recovery. Hypertension (OR: 4.40), hyperlipidemia (OR: 8.20), and diabetes (OR: 1.40) increased recurrence risk. Subgroup analyses showed that ENT treatment was most effective for severe cases (HB grade IV: 90% recovery vs. 65% in KM, p < 0.01). Conclusions: Corticosteroid-based treatment (ENT) yielded superior recovery outcomes. Comorbidity management is critical for recurrence prevention. Early ENT referral and integrated care models are recommended to optimize outcomes in diverse healthcare settings. Full article

Background and Objectives: The spontaneous reporting (SR) of adverse drug events (ADEs) is a cornerstone of pharmacovigilance and a critical mechanism for safeguarding patient safety. However, underreporting remains a persistent global challenge. In Korea, despite the widespread use of herbal medicines (HMs), adverse event reports from traditional Korean medicine doctors (KMDs) are remarkably scarce. This study aimed to assess the knowledge, attitudes, and experiences of KMDs regarding SR, identify key barriers, and suggest strategies to strengthen the safety culture within traditional Korean medicine. Materials and Methods: A cross-sectional, anonymous online survey was distributed to licensed KMDs registered with the Association of Korean Medicine. The questionnaire collected information on respondents’ sociodemographic characteristics and assessed their knowledge, attitudes, and experiences related to ADE reporting. Descriptive statistics and multivariate logistic regression were used to analyze the associations between the variables. Results: Of the 1021 KMDs who completed the survey, the vast majority acknowledged the importance of SR and recognized their role in pharmacovigilance. Nevertheless, only 5% had ever submitted an ADE report. A widespread lack of awareness about the national spontaneous reporting system (SRS), particularly its inclusion of licensed HMs, was evident. Although many respondents expressed support for expanding the scope of SR to cover all HMs, significant gaps in pharmacovigilance knowledge and limited access to relevant training were major barriers. KMDs affiliated with academic institutions or specialist groups showed higher levels of awareness, education, and reporting behavior. Conclusions: While KMDs exhibit positive attitudes toward patient safety and understand the importance of SR, their participation in it remains low due to knowledge deficits and insufficient training. Addressing these gaps through targeted education and expanding the national SRS to comprehensively include herbal medicines are essential steps toward enhancing pharmacovigilance and cultivating a proactive safety culture in Korean medicine. Full article

Luprops orientalis (Motschulsky, 1868) is an economically important pest in traditional Chinese medicines, widely distributed in East Asia. However, the primary limiting factors affecting its distribution, potential suitable areas, as well as its response to global warming, remain largely unknown. Utilizing 295 filtered distribution points and 10 environmental variables (9 climate variables and 1 land cover type), this study uses the MaxEnt model to predict the potential distribution of L. orientalis under near-current and future environmental change scenarios. The results indicated that precipitation of the warmest quarter (bio18), temperature seasonality (bio04), and precipitation of the wettest month (bio13) were the most significant environmental variables affecting the distribution of suitable habitats for L. orientalis, while the contribution of average variation in daytime temperature (bio2) was the smallest. Under the near-current climate, the areas of low, moderate, and high suitability for L. orientalis are approximately 1.02 × 10⁶ km², 1.65 × 10⁶ km², and 8.22 × 10⁵ km², respectively. The suitable areas are primarily located in North China, Central China, the Korean Peninsula, and Central and Southern Japan. Under future climate conditions, the potential suitable areas are expected to expand significantly, especially in Central China. However, the high-suitability areas in North China are predicted to experience a slight reduction. With the increase in carbon emission concentrations, the suitable area shows an increasing trend in the 2050s, followed by a declining trend in the 2090s. The centroids of suitable areas will shift to the northeast in the future. These findings enhance our understanding of how climate change affects the distribution of L. orientalis and will assist governments in formulating effective pest control strategies, including widespread monitoring and stringent quarantine measures. Full article

This comprehensive review focuses on Eleutherococcus senticosus (ES), examining the phytochemical composition, traditional medicinal roles, ecological traits, and pharmacological effects. Native to Northeast Asia, ES is used in traditional Chinese, Korean, and Japanese medicine. The rhizomes and bark are utilized medicinally and valued for their adaptogenic properties that enhance stress resistance, boost mental and physical endurance, and exhibit immunostimulatory effects that strengthen the immune system. Its pharmacological potential stems from a variety of bioactive compounds, including eleutherosides, lignans, saponins, flavonoids, and polysaccharides, which contribute to health benefits such as neuroprotective, antidiabetic, anticancer, and antioxidative activities. Neuroprotective properties may aid in the management of neurodegenerative conditions, such as Alzheimer’s and Parkinson’s disease, while antidiabetic effects support glucose regulation and insulin sensitivity. With increasing demands and conservation concerns, sustainable cultivation practices are essential, as ES is endangered in some areas. Plant biotechnology techniques offer solutions to enhance secondary metabolite yields while ensuring genetic stability and minimizing environmental impacts. ES is a promising natural resource for various industries because of its extensive benefits. Still, its conservation and sustainable production are critical and require ongoing research and innovative cultivation strategies. Full article

The pathogenesis of inflammatory bowel diseases (IBD), such as ulcerative colitis and Crohn’s disease, remains incompletely understood. Amomum villosum Lour. (Zingiberaceae) is a traditional herbal medicine used across Asia to treat digestive and inflammatory disorders. This study investigated the therapeutic effects of a water extract derived from the fruits of AV (referred to as AVE) in a mouse model of colitis induced by dextran sulfate sodium (DSS). The protective effects of AVE were evaluated by monitoring changes in body weight and colon length, as well as histological and molecular markers of inflammation. Neutrophil infiltration and levels of inflammatory cytokines in colon tissue and serum were assessed, and the integrity of the intestinal epithelial barrier was examined via Western blot analysis. Treatment with AVE significantly alleviated DSS-induced colitis, as evidenced by improved body weight, longer colon length, and reduced inflammatory responses. AVE administration restored tight junction protein expression (zonula occludens-1 [ZO-1] and occludin), suppressed phosphorylation of mitogen-activated protein kinases—specifically, extracellular signal-regulated kinase (ERK) and p38—and inhibited the expression of inflammatory mediators including tumor necrosis factor-alpha (TNF-α), cyclooxygenase-2 (COX-2), interleukin (IL)-6, IL-1β, and myeloperoxidase (MPO) activity. These findings suggest that oral AVE treatment effectively protects against experimental colitis by modulating inflammatory signaling and preserving epithelial barrier integrity. Further studies are warranted to explore the clinical potential and safety of AVE in the management of IBD. Full article

Background: Ultrasound guidance is widely used to enhance injection accuracy and safety. However, ultrasound-guided procedures require complex manipulation of both probe and needle. This simultaneous manipulation while maintaining sterility necessitates specific infection prevention protocols. This scoping review aimed to systematically investigate hygiene and safety procedures reported in clinical studies of ultrasound-guided injections. Methods: Following the Joanna Briggs Institute guideline, we conducted a systematic search of four databases (two English and two Korean) from inception to November 2023. Studies describing ultrasound-guided injection procedures with skin disinfection protocols were included. The extracted procedures were categorized and analyzed according to their timing (before, during, and after injection) and purpose. Results: Among 1728 studies identified, 86 met inclusion criteria. Notable variations were found in infection prevention practices, with only 5.81% reporting probe disinfection procedures and 27.91% documenting sterile probe cover use. Skin disinfection methods also varied, with iodophors (20.93%) and alcohol-based solutions (11.63%) being most common. Of studies describing ultrasound coupling agent procedures (26.74%), less than 20% specifically mentioned using sterile transmission agents. Documentation of temporal aspects of infection prevention was limited, with most studies not addressing precise timing of disinfection procedures or post-procedure probe reprocessing protocols. Conclusions: Our findings reveal considerable variation in infection prevention practices during ultrasound-guided injections and highlight gaps in documentation of hygiene protocols. These findings suggest the need for standardized, evidence-based protocols tailored to different anatomical sites and types of injections. Further research through expert consensus and real-world implementation is needed to develop and validate comprehensive guidelines for clinical practice. Full article

Background: Acupotomy is a modern acupuncture technique using a knife-shaped needle for pain treatment, combining traditional and anatomical knowledge. This study evaluates the diversity and safety of acupotomy procedures for lumbar spine disorders to aid in developing safety and reporting guidelines for clinical studies. Methods: A literature search was conducted on 30 October 2023 in PubMed, five Korean databases, and relevant journals with keywords like ‘low back pain’ and ‘acupotomy’. The search included clinical trial articles in English or Korean on lumbar spinal disorders treated by acupotomy. We reviewed 22 clinical studies involving 731 Korean patients published from 2008 to 2023. Data extracted included disease types, diagnosis methods, treatment specifics, needling factors, anesthesia, clinical outcomes, and safety reports. Results: Most studies focused on lumbar herniated discs and stenosis, with acupotomy performed on damaged tissue sites. Treatment frequency varied, and outcomes included pain scales and imaging assessments. Reporting gaps were found in needle size, insertion depth, and anesthesia status. Safety measures were poorly documented, with only six studies addressing safety and two reporting adverse events. Conclusions: There is a critical need for standardized clinical and reporting guidelines for acupotomy, akin to acupuncture’s existing guidelines, to enhance research consistency and quality. Future studies should develop guidelines covering target tissues, needle details, techniques, anesthesia, and adverse effects to improve acupotomy safety and effectiveness. Full article

‘Blood stasis’ (syndrome) (BSS) is a fundamental concept in Traditional Chinese Medicine (TCM), where it is known as Xue Yu (血瘀). Similar concepts exist in Traditional Korean Medicine (‘Eohyul’) and in Japanese Kampo medicine (Oketsu). Blood stasis is considered to underpin a large variety of inflammatory diseases, though an exact equivalent in Western systems medicine is yet to be described. Some time ago we discovered that blood can clot into an anomalous amyloid form, creating what we have referred to as fibrinaloid microclots. These microclots occur in a great many chronic, inflammatory diseases are comparatively resistant to fibrinolysis, and thus have the ability to block microcapillaries and hence lower oxygen transfer to tissues, with multiple pathological consequences. We here develop the idea that it is precisely the fibrinaloid microclots that relate to, and are largely mechanistically responsible for, the traditional concept of blood stasis (a term also used by Virchow). First, the diseases known to be associated with microclots are all associated with blood stasis. Secondly, by blocking red blood cell transport, fibrinaloid microclots provide a simple mechanistic explanation for the physical slowing down (‘stasis’) of blood flow. Thirdly, Chinese herbal medicine formulae proposed to treat these diseases, especially Xue Fu Zhu Yu and its derivatives, are known mechanistically to be anticoagulatory and anti-inflammatory, consistent with the idea that they are actually helping to lower the levels of fibrinaloid microclots, plausibly in part by blocking catalysis of the polymerization of fibrinogen into an amyloid form. We rehearse some of the known actions of the constituent herbs of Xue Fu Zhu Yu and specific bioactive molecules that they contain. Consequently, such herbal formulations (and some of their components), which are comparatively little known to Western science and medicine, would seem to offer the opportunity to provide novel, safe, and useful treatments for chronic inflammatory diseases that display fibrinaloid microclots, including Myalgic Encephalopathy/Chronic Fatigue Syndrome, long COVID, and even ischemic stroke. Full article

Background: Post-stroke equinovarus foot (EVF) impairs gait stability, increases the risk of secondary injuries, and contributes to elevated healthcare costs. However, effective targeted interventions for EVF remain limited. Patient concerns: Two patients with chronic EVF—a 63.5-year-old male (9.7 months post-stroke) and a 35.7-year-old female (24.5 months post-stroke)—presented with ankle deformity, gait asymmetry, and impaired balance, all of which interfered with daily activities. Intervention and outcomes: Both patients underwent ultrasound-guided acupotomy targeting spastic ankle muscles, administered over four sessions within two weeks. A quantitative gait analysis revealed substantial improvements in step length ratios (Case 1: 0.61 → 0.86; Case 2: 0.67 → 0.88), as well as enhancements in walking velocity, lateral symmetry, postural balance, and Modified Ashworth Scale scores. No adverse events were reported. Protocol proposal: Based on these observations, a prospective randomized controlled trial is planned to compare ultrasound-guided acupotomy plus conventional therapy versus conventional therapy alone. Outcomes will be assessed quantitatively using gait analysis. Lessons and implications: Ultrasound-guided acupotomy may offer a minimally invasive, targeted approach to releasing spastic muscles while preserving neurovascular structures, thereby improving gait function in patients with post-stroke EVF. Full article

Despite numerous advances in treatment, cancer still remains a leading cause of death worldwide. Given the significant health and economic burden this disease imposes, it is important to explore more effective treatment strategies. A major drawback of conventional cancer therapies is the persistence of drug resistance, adverse reactions to chemotherapy, digestive damage, reduced quality of life, and high treatment costs. To address these challenges, researchers have been investigating the utility of using complementary and alternative medicine (CAM) alongside conventional cancer treatments. Some of these CAM approaches have been reported to enhance patients’ quality of life and reduce the severity of adverse effects from conventional therapies. This review explores the utility of traditional Chinese, Korean, Indian, Japanese, and South African medicines as supportive therapies for conventional cancer treatments. We also discuss the concept of integrative oncology and its global relevance, as CAM approaches typically emphasize whole-person care, including diet, lifestyle, and mental/emotional well-being. In addition, we identify key active phytochemicals and herbal medicines used in these traditional systems for cancer treatment. Our discussion aims to provide a foundation for future research into integrative oncology, fostering an interdisciplinary and complementary approach to cancer management. Full article

Syndrome differentiation and disease diagnosis are central to Traditional Asian Medicine (TAM) because they guide personalized treatment. Yet, most TAM courses give students few structured opportunities to practise these paired skills. We developed Gen-SynDi, a knowledge-guided generative-AI framework that links syndrome differentiation with disease diagnosis to improve training. Using standardized patient files from the National Institute for Korean Medicine Development, we built a fatigue-focused dataset covering five Western-defined diseases and seven TAM syndromes. Carefully designed prompts and a large language model produced 28 virtual patient cases by joining compatible disease–syndrome pairs while preserving clinical realism. Inside an interactive web simulation, students conduct history-taking, receive free-text answers, and propose both syndrome and disease diagnoses; immediate feedback highlights missing questions, reasoning gaps, and overall accuracy. A built-in scoring module supplies quantitative measures of inquiry coverage and diagnostic precision, plus brief explanations of overlooked clues. A prompt-component role analysis confirmed that our prompt design improves response fidelity, and external experts endorsed the scenarios’ realism and educational value. Gen-SynDi therefore offers a scalable bridge between textbook knowledge and clinical practice, strengthening learners’ skills in differential diagnosis and syndrome differentiation. Full article

Background: Current research on healthcare-associated infection (HAI) surveillance in traditional Korean medicine (TKM) institutions is limited. Methods: We utilized the Delphi method to evaluate the validity and feasibility of implementing an HAI surveillance system in TKM hospitals. This involved conducting a systematic literature review and focus group interviews with three infection control experts and five TKM doctors experienced in infection control within TKM hospitals. Based on these findings, we developed a Delphi questionnaire. The survey included a total of fifteen participants: ten TKM doctors and TKM-related policy researchers with infection control expertise, two infection control nurses, and three infectious disease doctors. Results: The survey results indicated strong consensus on the necessity of introducing an HAI surveillance system tailored to TKM hospitals, as well as their integration into the Korean National Healthcare-associated Infections Surveillance (KONIS) system. Since infectious diseases do not differentiate between acute care hospitals and TKM hospitals, it is reasonable for TKM hospitals to participate in infection surveillance systems. However, the feasibility of implementing HAI surveillance in TKM hospitals remains low due to a lack of awareness regarding infection surveillance, insufficient surveillance personnel, inadequate diagnostic and surveillance infrastructure, and limited policy support for infection control. Therefore, this study proposes a phased approach in which hand hygiene surveillance and safe injection practice monitoring, which received relatively higher consensus on feasibility, should be prioritized to establish the necessary surveillance infrastructure. Subsequently, a stepwise implementation of HAI surveillance can be introduced. Conclusions: Although TKM hospitals generally have a lower risk of HAIs compared to acute care facilities, they lack robust infection control systems and support. To address this gap, TKM hospitals should join the KONIS system. Appointing and training dedicated infection control personnel will enable their participation and enhance overall infection management. Full article

Background/Objectives: Allergic rhinitis (AR) significantly affects patients’ quality of life and poses a substantial burden on healthcare systems worldwide, with its prevalence rising among pediatric populations. This study aimed to investigate the factors associated with the use of combination therapy involving traditional Korean medicine (KM) and conventional medicine in pediatric AR patients using large-scale health insurance data from South Korea. Methods: Data from 696,182 pediatric patients diagnosed with AR between 2018 and 2021 were analyzed. Multivariate logistic regression was employed to identify factors influencing KM therapy utilization. Results: Among these, 61,745 patients received KM combination therapy. The key predictors of KM combination therapy utilization included school-age children, the winter season, and comorbidities such as rhinitis and atopic dermatitis. Patients receiving KM combination therapy had longer treatment durations and incurred higher healthcare costs compared to those on conventional therapy alone. Additionally, seasonal variations and demographic factors, including a decline in KM use during the Coronavirus Disease 2019 (COVID-19) pandemic, were observed. Conclusions: The findings suggest that integrating KM into pediatric AR treatment may offer potential benefits, especially for children with comorbidities or during the winter months. These insights could guide the development of targeted healthcare policies and strategies to optimize treatment outcomes for pediatric AR patients. Full article

Bee venom acupuncture (BVA) is used in traditional Korean medicine (TKM) for various diseases, but its evaluation within clinical practice guidelines (CPGs) has not been comprehensively reviewed. This study aimed to review TKM-CPGs to characterize the range of conditions for which BVA is recommended, summarize the level of evidence and recommendation grades, and assess the factors influencing the grades. Eighteen TKM-CPGs, including 30 BVA-related recommendations, were identified. Data on targeted diseases/symptoms, treatment protocols, evidence levels, and recommendation grades were extracted. The CPGs recommended BVA for musculoskeletal and neurological disorders in standalone or combined therapy. Most of the evidence for BVA recommendations was evaluated with low to moderate levels based on randomized controlled trials. The grades of recommendations were mostly B or C, indicating that BVA is advisable or potentially beneficial. Although the CPGs offer some guidance on treatment protocols for BVA, there remains a lack of detailed specifications, and we need to conduct additional research to provide evidence. Also, the heterogeneity of recommendations across different CPGs presents a challenge in establishing consistent clinical guidelines. Future research should focus on generating high-quality evidence and standardizing treatment regimens to support more robust recommendations for BVA in TKM clinical practice. Full article