The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke.Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs.Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events.Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

Integrated Rehabilitation for Children with Cerebral palsy: A Prospective Observational Study

Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments.Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group.Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively).Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.

A pilot study of Korean Medical Examination

Objectives: This study aimed to evaluate the feasibility of the Korean medical examination protocol, which included 14 questionnaires and 20 medical examination devices.Methods: We conducted a pilot observational study of 90 subjects to measure the time required to fulfill each item of the Korean medical examination, to evaluate patient satisfaction, and to report improvements that can be made to the Korean medical examination protocol based on clinical coordinator and subject feedback.Results: Among the 90 subjects included in the study (59 women and 31 men; mean [standard deviation] age, 37.2 [12.3] years), over 80% intended to receive a Korean medical examination if hospitals provided it and would recommend a Korean medical examination to others. The average time spent on the overall Korean medical examination was approximately 88.0 (21.4) minutes. Three areas for improvements were reported: survey issues, including the number of items, understanding, and readability; error issues in device measurements; and environmental issues affecting the sequence of medical examinations and temperature.Conclusions: Most subjects were satisfied with the Korean medical examination. Future studies should be conducted with larger samples to collect data continuously.

A survey on the impact of a pharmacovigilance practice training course for future doctors of Korean medicine on their knowledge, attitudes, and perception

Objectives: This study aimed to evaluate the impact of a training course on pharmacovigilance for future doctors of Korean medicine (DKM).Methods: In 2020, a pharmacovigilance training course was conducted for 57 senior students of a Korean medicine (KM) college, and its impact to the students were assessed in terms of the knowledge, attitudes, and perceptions of these students at three-time points: pre-training, post-training, and 4-6 months after the end of the training.Results: A total of 38 students completed the survey. The average score from the knowledge test increased significantly after training compared to prior to the training (5.47±2.140, 6.61±1.001, respectively, p<0.001) and was maintained until the final survey (6.61±1.220). The rate of correct answers to most of the knowledge test questions increased after the training but decreased in the final survey. In terms of attitudes, self-confidence in causality assessment (2.63±1.025, 4.58±0.826, p<0.001) and spontaneous reporting (2.08±1.050, 4.74±0.446, p<0.001) significantly increased after the training and then slightly decreased (3.92±1.171, 4.40±0.755). The perception level was high prior to the training, and this pattern was maintained throughout the study period. Students responded that pharmacovigilance education was necessary for DKM after training, and for the undergraduates of KM colleges.Conclusions: This study shows that this pharmacovigilance training course is effective for students majoring in KM but that retraining is required at least 6 months after the initial training. Further follow-up studies are needed to ensure that students actively participate in spontaneous reporting after graduation, and continuous education should be provided to graduates.

The Association between Facial Morphology and Cold Pattern

Objectives: Facial diagnosis is an important part of clinical diagnosis in traditional East Asian Medicine. In this paper, using a fully automated facial shape analysis system, we show that facial morphological features are associated with cold pattern.Methods: The facial morphological features calculated from 68 facial landmarks included the angles, areas, and distances between the landmark points of each part of the face. Cold pattern severity was determined using a questionnaire and the cold pattern scores (CPS) were used for analysis. The association between facial features and CPS was calculated using Pearson's correlation coefficient and partial correlation coefficients.Results: The upper chin width and the lower chin width were negatively associated with CPS. The distance from the center point to the middle jaw and the distance from the center point to the lower jaw were negatively associated with CPS. The angle of the face outline near the ear and the angle of the chin line were positively associated with CPS. The area of the upper part of the face and the area of the face except the sensory organs were negatively associated with CPS. The number of facial morphological features that exhibited a statistically significant correlation with CPS was 37 (unadjusted).Conclusions: In this study of a Korean population, subjects with a high CPS had a more pointed chin, longer face, more angular jaw, higher eyes, and more upward corners of the mouth, and their facial sensory organs were relatively widespread.

Selection of Effective Herbal Medicines for Parkinson’s Disease Based on the Text Mining of the Classical Korean Medical Literature Donguibogam

Objectives: The prevalence of Parkinson’s disease is on an upward trend along with an increase in the aging population but there is no available treatment that halts the progression of neurodegeneration. This study reports a numerical analysis on Donguibogam and suggests novel herbal drugs, which have never been researched before but found to be deemed effective in this study.Methods: Referring to 71 Korean medicine symptom terms that represent the symptoms of Parkinson’s disease, 4170 prescriptions described in Donguibogam were classified into two groups based on whether their main effects were effective for Parkinson’s disease or not. Comparing the two groups, the chi-square test was performed to select statistically significant herbs, while the t-test, Wilcoxon test, and descriptive statistics were performed to determine the appropriate dose.Results: One hundred and twenty-seven prescriptions effective for Parkinson’s disease were identified. The chi-square test determined 17 herbs that are effective for symptomatic treatment. Among the medicinal herbs, the authors suggest Osterici seu Notopterygii Radix et Rhizoma, Ephedrae Herba, Aconiti Tuber, Myrrha, Sinomeni Caulis et Rhizoma, and Aconiti Kusnezoffii Tuber as herbal candidates that have never been studied for Parkinson’s disease. Through the statistical tests, it was judged that the mean value of the dose of the entire prescription was the appropriate dose for each herb.Conclusions: Seventeen herbs were selected for Parkinson’s disease and the appropriate daily dose were calculated. Furthermore, this study presented a new process that applies a statistical method to traditional medical literature and preselecting herbs deemed effective for specific diseases.

Treatment of Recalcitrant Plantar Wart Unresponsive to Cryotherapy with Acupuncture and Moxibustion: A Case Report

Objectives: Plantar wart is a common viral skin disease caused by human papillomavirus infection and poses a therapeutic challenge in the paediatric patient population. Acupuncture and moxibustion are effective treatments for a wide range of skin conditions.Case report: This study presents the case of a 9-year-old girl for whom complete resolution of recalcitrant warts was achieved with acupuncture and moxibustion treatment.Results: After 20-week treatment, the wart lesions and pain were completely resolved. At the 6-month follow-up, the lesions remained fully resolved.Conclusion: This result suggests that acupuncture and moxibustion could be effective therapeutic strategies for plantar warts.

Effects of LI11 Acupuncture on CO2 reactivity in the anterior and middle cerebral arteries during hyperventilation-induced hypocapnia in normal subjects: A before and after study

Objectives: The LI11 (Quchi) acupuncture point has always been included in the Seven acupoints for stroke; however, additional LI11 acupuncture research is needed. In this study, the effect of LI11 acupuncture on cerebral blood flow of the anterior cerebral arteries (ACA) and middle cerebral arteries (MCA) was investigated.Method: This study included 10 healthy young male subjects. Cerebral blood flow velocity and cerebrovascular reactivity were measured using transcranial Doppler sonography. Changes in hyperventilation-induced carbon dioxide (CO2) reactivity and modified ACA and MCA blood flow velocity at 40 mmHg (CV40), blood pressure, and heart rate were observed before and after LI11 acupuncture treatment.Results: A statistically significant increase in contralateral anterior cerebral artery CO2 reactivity (p=0.036) and decrease in contralateral middle cerebral artery CV40 (p=0.047) were observed. No significant difference in mean blood pressure was shown. A statistically significant increase in heart rate occurred after LI11 acupuncture; however, it was not clinically significant as there were negligible changes in the heart rhythm.Conclusions: LI11 acupuncture treatment could improve cerebral blood flow velocity. These results might be explained by regulating endothelium-dependent vessel dilation in the anterior cerebral artery region.Trial registration: This trial has been registered with Clinical Research Information Service, a service of the Korea Centers for Disease Control and Prevention: KCT0004494 (retrospectively registered). https://cris.nih.go.kr/cris/search/search_result_st01.jsp?seq=15359

Development of Mission and Vision of College of Korean Medicine Using the Delphi Techniques and Big-Data Analysis

Objectives: The purpose of this study is to introduce the procedures and methods for mission and vision development at a College of Korean Medicine (CKM), which established its mission and vision using Delphi techniques and big data analysis on various members and stakeholders.Methods: A total of 754 participated in the Delphi survey. A Delphi survey was conducted with professors, students, parents, and alumni stakeholders to establish Daegu Haany University CKM’s mission and vision. The data were analyzed through content analysis and big data analysis of keywords.Results: As a result of the study, the most important keywords to be included in the mission and vision were "professionalism" and "morality." Included in the mission were the concepts of "morality" and "professionalism," which were emphasized by the four groups. All surveyed stakeholders regarded "scientific," and "global" as important themes to be included in the vision.Conclusions: The present study confirmed that there were themes commonly prioritized by all stakeholders for college mission and vision, and a difference in demand for educational goals between professors and students was also affirmed. Therefore, institutions of higher learning should develop their mission and vision by appropriately reflecting the needs of the interest groups.

Anti-inflammatory Effects in LPS-treated RAW 264.7 Cells and the Influences on Drug Metabolizing Enzyme Activities by the Traditional Herbal Formulas, Yongdamsagan-Tang and Paljung-san

Objectives: Yongdamsagan-tang (YST) and Paljung-san (PJS) in traditional medicine and finasteride in modern medicine are used to treat benign prostatic hyperplasia (BPH). In recent, the use of combination herbal remedies with conventional drugs has been increasing. Therefore, we investigated the anti-inflammatory effects of these drugs to treat BPH and the influence of herbal formulas on finasteride metabolism.Methods: The inhibitory effects of the herbal formulas and finasteride on the production of inflammatory mediators and cytokines were determined in lipopolysaccharide (LPS)-treated RAW 264.7 cells. Additionally, the influence of herbal formulas on activities of human drug metabolizing enzymes (DMEs) was assessed using human microsomal enzymes.Results: We observed that YST, PJS and finasteride inhibited the production of nitric oxide (NO), prostaglandin E2 (PGE2) and interleukin-6 (IL-6) in RAW 264.7 cells. The half maximal inhibitory concentration (IC50) of YST on PGE2 production was calculated to be below 25 μg/mL. YST inhibited the activity of uridine diphosphateglucuronosyltransterase (UGT) 1A4 with an IC50 value of 49.35 μg/mL. The activities of cytochrome P450 (CYP) 1A2, CYP2B6, CYP2C19, CYP3A4, and UGT1A1 were inhibited by PJS (IC50 < 100 μg/mL, each). Although PJS and YST inhibited the activities of CYP3A4 and UGT1A4, respectively, these formulas may not influence the metabolism of finasteride because the IC50 values of herbal formulas on DMEs are too high to affect metabolism.Conclusions: Our results suggest that the combination of finasteride and YST or PJS might not influence their drug metabolism and that the drugs may have synergistic effects against BPH.