[Show abstract][Hide abstract] ABSTRACT: The aim of this systematic review was to determine the effectiveness of acupuncture for the treatment of whiplash associated disorder (WAD). Twenty databases were searched from their inceptions to Oct. 2013. Randomised clinical trials (RCTs) of acupuncture (AT), electroacupuncture (EA), or dry needling (DN) for the treatment of WAD were considered eligible. The risk of bias was assessed using the Cochrane tool. Six RCTs met the inclusion criteria. Most of the included RCTs have serious methodological flaws. Four of the RCTs showed effectiveness of AT, AT in addition to usual care (UC), AT in addition to herbal medicine (HM) or EA was more effective than relaxation, sham EA, sham EA in addition to HM or UC for conditioned pain modulation (CPM) and alleviating pain. In one RCT, DN in addition to physiotherapy (PT) had no effect compared to sham-DN in addition to PT for the reduction of pain. None of the RCTs showed that AT/EA/DN was more effective than various types of control groups in reducing disability/function. One RCT did not report between-group comparisons of any outcome measures. The evidence for the effectiveness of AT/EA/DN for the treatment of WAD is limited. Therefore, more research in this area is warranted.
Evidence-based Complementary and Alternative Medicine 01/2014; 2014:870271. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The objectives of this study were to summarize the curriculum, history, and clinical researches of Chuna in Korea and to ultimately introduce Chuna to Western medicine. Information about the history and insurance coverage of Chuna was collected from Chuna-related institutions and papers. Data on Chuna education in all 12 Korean medicine (KM) colleges in Korea were reconstructed based on previously published papers. All available randomized controlled trials (RCTs) of Chuna in clinical research were searched using seven Korean databases and six KM journals. As a result, during the modern Chuna era, one of the three periods of Chuna, which also include the traditional Chuna era and the suppressed Chuna era, Chuna developed considerably because of a solid Korean academic system, partial insurance coverage, and the establishment of a Chuna association in Korea. All of the KM colleges offered courses on Chuna-related subjects (CRSs); however, the total number of hours dedicated to lectures on CRSs was insufficient to master Chuna completely. Overall, 17 RCTs were reviewed. Of the 14 RCTs of Chuna in musculoskeletal diseases, six reported Chuna was more effective than a control condition, and another six RCTs proposed Chuna had the same effect as a control condition. One of these 14 RCTs made the comparison impossible because of unreported statistical difference; the last RCT reported Chuna was less effective than a control condition. In addition, three RCTs of Chuna in neurological diseases reported Chuna was superior to a control condition. In conclusion, Chuna was not included in the regular curriculum in KM colleges until the modern Chuna era; Chuna became more popular as the result of it being covered by Korean insurance carriers and after the establishment of a Chuna association. Meanwhile, the currently available evidence is insufficient to characterize the effectiveness of Chuna in musculoskeletal and neurological diseases.
Integrative Medicine Research. 01/2014; 3(2):49–59.
[Show abstract][Hide abstract] ABSTRACT: PURPOSE: Managing cancer-related fatigue (CRF) is an important element of the palliative care of cancer patients. The aim of this systematic review was to critically evaluate the effectiveness of acupuncture (AT) or electroacupuncture (EA) for CRF. METHODS: Fourteen databases were searched from their respective inception to November 2012. Randomized clinical trials (RCTs) of AT or EA for the treatment of CRF were considered for inclusion. The risk of bias/methodological quality was assessed using the method suggested by the Cochrane Collaboration. RESULTS: Seven RCTs met the eligibility criteria. Most were small pilot studies with serious methodological flaws. Four of the RCTs showed effectiveness of AT or AT in addition to usual care (UC) over sham AT, UC, enhanced UC, or no intervention for alleviating CRF. Three RCTs showed no effect of AT/EA over sham treatment. CONCLUSION: Overall, the quantity and quality of RCTs included in the analysis were too low to draw meaningful conclusions. Even in the positive trials, it remained unclear whether the observed outcome was due to specific effects of AT/EA or nonspecific effects of care. Further research is required to investigate whether AT/EA demonstrates specific effects on CRF.
Supportive Care in Cancer 02/2013; · 2.09 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: BACKGROUND: Patients with stroke have various syndromes and symptoms. Through pattern identification (PI), traditional Korean medicine (TKM) classifies the several syndromes and symptoms of stroke patients into five categories: Fire-heat (FH), Dampness-phlegm (DP), Yin-deficiency (YD), Qi-deficiency (QD) and Blood-stasis (BS). DP has been associated with obesity and hyperlipidemia. Uncoupling protein-1 (UCP-1), which plays a major role in thermogenesis and energy expenditure can increase the risk of obesity and can be related metabolic disorders. In this study, we elucidated the association of three polymorphisms located in the UCP-1 promoter and coding region with DP among Korean stroke patients. METHODS: 1,593 patients with cerebral infarction (583/DP, 1,010/non-DP) and 587 normal subjects were enrolled. The genotypes A-3826G, G-1766A and Ala64Thr (G+1068A) for each subject were determined by polymerase chain reaction with TaqMan probes and five percent of subjects were re-genotyped by sequencing method to confirm the accuracy of genotyping. The results were analyzed using a multiple logistic regression model to evaluate the genetic associations: the UCP-1polymorphisms of normal versus those of DP subjects and those of normal versus those of non-DP subjects. RESULTS: A significantly higher percentage of subjects in the DP group possessed the A-3826G G allele than the A allele (OR=1.508, p=0.006). Furthermore, the number of subjects with the GG type of A-1766G was significantly lower in the non-DP group than the normal group in the recessive model (OR=0.606, p=0.042). In addition, an analysis of the relationship among 2 SNPs of UCP-1 and lipid serum concentration showed that the serum level of HDL cholesterol was significantly higher in subjects with the A-3826G G allele in the normal group (p=0.032). Serum triglyceride and HDL cholesterol were also associated with the A-1766G variant in the recessive model (p=0.002, p=0.046). CONCLUSIONS: These results suggest that that the A-3826G and A-1766G UCP-1 polymorphisms, which are related to obesity, might be candidate genetic markers for the DP pattern in the TKM diagnosis system.
BMC Complementary and Alternative Medicine 10/2012; 12(1):180. · 2.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: OBJECTIVE: To evaluate the effectiveness of Chuna for the treatment of musculoskeletal pain as reported in Korean literature. METHODS: We conducted an electronic literature search using seven Korean databases and manually searched six traditional Korean medicine journals. Risk of bias was assessed with the Cochrane criteria. RESULTS: Six randomized controlled trials (RCTs) were included in the study. Compared with standard care, three RCTs suggested favorable effects of Chuna on neck pain due to a hypolordotic cervical spine, low back pain caused by traffic accidents, and low back pain. In contrast, compared with standard care, three RCTs failed to show positive effects on temporomandibular joint disorder, mandibular movement, and neck pain caused by traffic accidents. CONCLUSIONS: Currently, the evidence of the effectiveness of Chuna for the treatment of musculoskeletal pain is not convincing. Further rigorously designed trials are warranted to determine its effectiveness.
Chinese Journal of Integrative Medicine 08/2012; · 1.06 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objective
The purpose of this article was to introduce our project, a Fundamental Study for the Standardization and Objectification of Pattern Identification in Traditional Korean Medicine (TKM) for Stroke.DesignThe total time period for this project is nine years from April 2005 to December 2013. These nine years are divided into three phases, with three years per phase. This article reports the first phase, which had three subprojects; the Korean Institute of Oriental Medicine was responsible for the first and the third subproject, and KyungHee University for the second subproject. The objective of this first phase was to standardize stroke diagnosis using pattern identification (PI), to create a standard clinical chart using a combination of TKM and Western medicine, and to construct a biobank and find biomarkers associated with patterns of stroke.ResultsAt the end of the first phase, we obtained five patterns (Fire-Heat, Dampness-Phlegm, Qi-Deficiency, Yin-Deficiency, and Blood Stasis), 60 pattern indicators and a unified clinical chart with a combination of 60 pattern indicators from TKM and 47 diagnostic indicators from Western medicine. In addition, 32 single nucleotide polymorphisms related with patterns were identified by genome-wide assay, and using proteomic analysis via the surface-enhanced laser desorption/ionization-TOF, we identified specific plasma proteins associated with varying patterns of stroke. We also developed a tool of PI for stroke and a prediction program for stroke risk ratio in Korean people.Conclusions
This study will advance the scientific knowledge of physicians, enhancing the accuracy of PI in TKM.
European Journal of Integrative Medicine 06/2012; 4(2):e125–e131. · 0.56 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The present study was conducted to examine the reliability and validity of the 'Korean Standard Pattern Identification for Stroke (K-SPI-Stroke)', which was developed and evaluated within the context of traditional Korean medicine (TKM).
Between September 2006 and December 2010, 2,905 patients from 11 Korean medical hospitals were asked to complete the K-SPI-Stroke questionnaire as a part of project ' Fundamental study for the standardization and objectification of pattern identification in traditional Korean medicine for stroke (SOPI-Stroke). Each patient was independently diagnosed by two TKM physicians from the same site according to one of four patterns, as suggested by the Korea Institute of Oriental Medicine: 1) a Qi deficiency pattern, 2) a Dampness-phlegm pattern, 3) a Yin deficiency pattern, or 4) a Fire-heat pattern. We estimated the internal consistency using Cronbach's α coefficient, the discriminant validity using the means score of patterns, and the predictive validity using the classification accuracy of the K-SPI-Stroke questionnaire.
The K-SPI-Stroke questionnaire had satisfactory internal consistency (α = 0.700) and validity, with significant differences in the mean of scores among the four patterns. The overall classification accuracy of this questionnaire was 65.2 %.
These results suggest that the K-SPI-Stroke questionnaire is a reliable and valid instrument for estimating the severity of the four patterns.
BMC Complementary and Alternative Medicine 04/2012; 12:55. · 2.08 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: The traditional Korean medical diagnoses employ pattern identification (PI), a diagnostic system that entails the comprehensive analysis of symptoms and signs. The PI needs to be standardized due to its ambiguity. Therefore, this study was performed to establish standard indicators of the PI for stroke through the traditional Korean medical literature, expert consensus and a clinical field test.
We sorted out stroke patterns with an expert committee organized by the Korean Institute of Oriental Medicine. The expert committee composed a document for a standardized pattern of identification for stroke based on the traditional Korean medical literature, and we evaluated the clinical significance of the document through a field test.
We established five stroke patterns from the traditional Korean medical literature and extracted 117 indicators required for diagnosis. The indicators were evaluated by a field test and verified by the expert committee.
This study sought to develop indicators of PI based on the traditional Korean medical literature. This process contributed to the standardization of traditional Korean medical diagnoses.
[Show abstract][Hide abstract] ABSTRACT: Uncoupling protein 2 (UCP2), a mitochondrial protein present in many organs and cell types, is known to dissipate the proton gradient formed by the electron transport chain. Its function is correlated with predictive parameters, such as obesity, diabetes, and metabolic syndromes. We analyzed the distribution of UCP2 polymorphisms in stroke patients diagnosed with one of the following four stroke subtypes based on the TKM standard pattern identification (PI): Qi-deficiency (QD), Dampness and Phlegm (D&P), Yin-deficiency (YD), and Fire and Heat (F&D). We studied a total of 1,786 stroke patients (397/QD, 645/D&P, 223/YD, and 522/F&D, 586/normal). Genotyping for the G-1957A, G-866A and A55V UCP2 polymorphisms was performed using the TaqMan. G-866A and A55V were significantly associated with the D&P and H&F subtypes. The frequency of subjects with the A allele of G-866A was significantly lower than the frequency of subjects with the GG type. The A55V polymorphism was also shown similar effect with G-866A in the dominant model. In contrast, no SNPs were shown to be associated with the QD or YD subtypes in this study. These results showed that the G-866A and A55V UCP2 polymorphisms may be genetic factors for specific PI types among Korean stroke patients.
Evidence-based Complementary and Alternative Medicine 01/2012; 2012:532078. · 1.72 Impact Factor
[Show abstract][Hide abstract] ABSTRACT: Objectives: The aim of this study was to verify the reliability of the 'Korean Standard Pattern Identification for Stroke (K-SPI-Stroke), by investigating the level of interobserver agreement. Methods: Interobserver agreement was studied among physicians from 11 Korean oriental medical hospitals from September 2006 to December 2010. Each patient was independently diagnosed by two physicians from the same site using Pattern Identification (PI). The interobserver agreement of PI for K-SPI-Stroke was assessed using simple percentage agreement and Cohen's kappa coefficient statistics. Results: A total of 4012 patients were included in the study. The interobserver agreement for PI in all subjects was considered as 'moderate to good' (k = 0.66). The interobserver agreement in each site ranged from 'moderate to good' to 'excellent' (k = 0.52-0.83). Five sites were rated as 'excellent' (k >= 0.75) with respect to their interobserver agreement. Conclusion: This article's results indicated a satisfactory interobserver agreement for PI in Korean stroke patients. The results of this study will help develop quantitative measures to evaluate and standardise the scientific criteria in traditional Korean medicine. (C) 2012 Elsevier GmbH. All rights reserved.
European Journal of Integrative Medicine 01/2012; 4(2):e133-e139. · 0.56 Impact Factor