A clinical practice guideline for temporomandibular disorders in traditional Korean medicine: An evidence-based approach

Kim, Koh-Woon,Ha, In-Hyuk,Lee, Yoon Jae,Kim, Me-riong,Shin, Byung-Cheul,Song, Mi-Yeon,Cho, Jae-Heung ELSEVIER SCIENCE B.V. 2018 EUROPEAN JOURNAL OF INTEGRATIVE MEDICINE Vol.23 No.-

Anti-Osteoporotic Activity of Harpagoside by Upregulation of the BMP2 and Wnt Signaling Pathways in Osteoblasts and Suppression of Differentiation in Osteoclasts

Chung, Hwa-Jin,Kim, Won Kyung,Oh, Jedo,Kim, Me-riong,Shin, Joon-Shik,Lee, Jinho,Ha, In-Hyuk,Lee, Sang Kook American Chemical Society and American Society of 2017 Journal of natural products Vol.80 No.2

<P>Harpagoside (1) is an iridoid glycoside isolated from the radix of Harpagophytum procumbens var. sublobatum, commonly called Devil's claw. The anti-osteoporotic effect of 1 was investigated in both in vitro cell cultures and in vivo using an ovariectomized (OVX) mouse model. Compound 1 induced bone formation by stimulating osteoblast proliferation, alkaline phosphatase activity, and mineralization in osteoblastic MC3T3-E1 cells. Treatment with 1 increased the mRNA and protein expression of bone formation biomarkers through regulation of the BMP2 and Wnt signaling pathway in MC3T3-E1 cells. Compound 1 also suppressed the RANKL-induced osteoclastogenesis of cultured mouse bone marrow cells. Oral administration of 1 restored the OVX-induced destruction of trabecular bone. The bone mineral density of the femur was also increased significantly by 1. The elevated serum levels of osteocalcin, C-terminal telopeptide, and tartrate-resistant acid phosphatase in the OVX mice were decreased by treatment with 1. These findings suggest that compound 1 may protect against bone loss induced by OVX in mice by regulating stimulation of osteoblast differentiation and inhibition of osteoclast resorption. Therefore, harpagoside (1) is a potential candidate for management of postmenopausal osteoporosis.</P>

Comparison of the Ingredient Quantities, and Antioxidant and Anti-inflammatory Activities of Hwangryunhaedok Decoction Pharmacopuncture by Preparation Type

이진호,Min Jeong Kim,Jae Woong Lee,Me Riong Kim,In Hee Lee,Eun Jee Kim 대한침구의학회 2014 대한침구의학회지 Vol.31 No.4

Objectives : The main aim of this study was to assess the comparative efficiency of two preparation types of Hwangryunhaedok decoction(HRHD-D) using distilled and mixed extraction by measuring the index components and indicators of antioxidant and anti-inflammatory effects. Methods : The antioxidant activity was assessed by comparing distilled and mixed extractions of HRHD-D using an ELISA reader. The anti-inflammatory effect was determined by measuring NO amounts in RAW 264.7 cells. The contents were analyzed with high performance liquid chromatography-diode array detector(HPLC-DAD). Results : The electron donating ability of mixed and distilled extractions obtained with 500 ppm DPPH(1,1-diphenyl-2-picrylhydrazyl assay) solution were 57.8 % and 4.2 %, respectively. The total phenolic content of mixed extraction was 6.9 times that of distilled extraction and total flavonoid content was 51.5 times higher. The anti-inflammatory effect was assessed by NO measurement, and was found to increase significantly dependent on concentration in all mixed extract concentrations(25, 50, 100, 200, 400 μg/mL), but the difference in distilled extraction by concentration was only significant at 200 and 400 μg/mL. The HPLC analysis results of mixed extract of HRHD-D showed detection of all four main active constituents of HRHD-D. However, they were not detected in the distilled extract of HRHD-D. Conclusions : Mixed extraction with distillation added to decoction of HRHD-D showed better efficacy in antioxidant and anti-inflammatory effects, and ingredient quantities compared to distilled extraction. Further stability and clinical efficacy studies for standardization of mixed extractions are required.

Pain, disability, and MRI changes in lumbar disc herniation patients treated with integrative medicine: Ten-year results of an observational study

Lee Jin-Ho,Ha In-Hyuk,Kim Me-Riong,Cho Hyun-Woo,Seo Ji Yeon,Choi Hee-seung,Song Kwang Chan,Shin Byung-Cheul,Shin Joon-shik,Lee Yoon Jae 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.2

Background: To date, a 10-year follow-up study on complementary and alternative medical treatment of lumbar intervertebral disc herniation (LDH) has never been conducted. Therefore, we aimed to perform a prospective 10-year follow-up study on the integrated treatment of LDH in Korea. Methods: One hundred and fifty patients from the baseline study, who initially met the LDH diagnostic criteria with a chief complaint of radiating pain and received integrated treatment, were recruited for this follow-up study. The 10-year follow-up was conducted from February 2018 to March 2018 on pain, disability, satisfaction, quality of life, and changes in herniated disc, muscles, and fat through magnetic resonance imaging. Results: Sixty-five patients were included in this follow-up study. Visual analogue scale score for lower back pain and radiating leg pain were maintained at a significantly lower level than the baseline level. Significant improvements in Oswestry disability index and quality of life were consistently present. MRI confirmed that disc herniation size was reduced over the 10-year follow-up. In total, 95.38% of the patients were either “satisfied” or “extremely satisfied” with the treatment outcomes and 89.23% of the patients claimed their condition “improved” or “highly improved” at the 10-year follow-up. Conclusions: The reduced pain and improved disability was maintained over 10 years in patients with LDH who were treated with nonsurgical Korean medical treatment 10 years ago. Nonsurgical traditional Korean medical treatment for LDH produced beneficial long-term effects, but future large-scale randomized controlled trials for LDH are needed. Study registration: ClinicalTrials.gov, NCT03426215.

양혈거풍탕(養血風湯)을 투여한 두통을 동반한 경추 추간판 탈출증 환자 치험 2례

조남훈,김미령,정훈,양승희,Cho, Nam-Hoon,Kim, Me-Riong,Jeong, Hoon,Yang, Seung-Hee 척추신경추나의학회 2011 척추신경추나의학회지 Vol.6 No.2

양혈풍탕(養血風湯)을 처방하여 경추 추간판 탈출증으로 인한 극심한 통증 및 두통이 호전된 2례를 통하여 신경학적 결손이 없는 요추 방출성 골절에 대해 양혈풍탕(養血風湯)이 환자의 자각적인 증세 및 NRS, NDI 상으로 유효한 효과가 있었음을 확인하였다. 이에 저자는 두통이 동반된 경추 추간판 탈출증으로 입원하여 양혈풍탕(養血風湯)을 복용한 후 호전된 2케이스를 보고하는 바이다. Objectives : The purpose of this study is to investigate the clinical application of Yanghyeolgeopung-tang(yangxuequfeng-tang) to two patients with cervical disc herniation and headache. Methods : The patients were hopitalized at the Dept. of Oriental Rehabilitation Medicine, Jaseng Oriental Medicine Hospital, and diagnosed as cervical disc herniation and treated mainly with herbal medicine; Yanghyeolgeopung-tang(yangxuequfeng-tang). Additional acupuncture and pharmaco-puncture was provided. NRS(Numeric Rating Scale) and NDI(Neck Disability Index) scores were used as outcome measures. Results : After taking Yanghyeolgeopung-tang(yangxuequfeng-tang), the patients' pain was controlled and the patients slept well after treatment. NRS and NDI scores both decreased. Conclusions : As seen in these two cases of cervical disc herniation with headache, Yanghyeolgeopung-tang(yangxuequfeng-tang) has a positive effect in controlling neck pain and headahce due to cervical disc herniation.

The process of National Health Insurance coverage for Chuna Manual Therapy in Korea: A qualitative study

Yu Jieun,Shin Byung-Cheul,Kim Hyunmin,Hyun Eunhye,Lee Jin-Ho,Kim Me-Riong,Lim Byungmook 한국한의학연구원 2022 Integrative Medicine Research Vol.11 No.1

Background: Chuna Manual Therapy (CMT) has been widely used in Korea, and coverage in Korean National Health Insurance (NHI) was finally implemented in 2019. The objectives of this study were to analyze the process of NHI coverage for CMT qualitatively, and to summarize important roles, streams, and implications regarding its inclusion in the modern public health insurance system. Methods: Related literature was collected and 8 key personnel involved in the policy-making process were qualitatively interviewed, and Zahariadis’ version of the Multiple Streams Framework (MSF) was applied to analyze the policy agenda setting and the roles of stakeholders. Results: Through the collaborative efforts of various stakeholders, a pilot coverage project for CMT was implemented in 2017, and coverage was expanded nationwide in 2019. MSF showed that it was mainly achieved through three streams: governmental change (political stream), demand from the general public and KM doctors (problem stream), and strengthening/reinforcement of the feasibility and acceptability of the policy (policy steam). Also, the roles of policy entrepreneurs and resulting changes were shown to be significant for the overall process. Conclusion: NHI coverage for CMT was realized through collective policy and research efforts from the government and academic sectors. The roles of stakeholders were shown to be significant in the overall process, and documentation of their involvement is hoped to be of use of other countries that utilize traditional and/or manual medicine. Background: Chuna Manual Therapy (CMT) has been widely used in Korea, and coverage in Korean National Health Insurance (NHI) was finally implemented in 2019. The objectives of this study were to analyze the process of NHI coverage for CMT qualitatively, and to summarize important roles, streams, and implications regarding its inclusion in the modern public health insurance system. Methods: Related literature was collected and 8 key personnel involved in the policy-making process were qualitatively interviewed, and Zahariadis’ version of the Multiple Streams Framework (MSF) was applied to analyze the policy agenda setting and the roles of stakeholders. Results: Through the collaborative efforts of various stakeholders, a pilot coverage project for CMT was implemented in 2017, and coverage was expanded nationwide in 2019. MSF showed that it was mainly achieved through three streams: governmental change (political stream), demand from the general public and KM doctors (problem stream), and strengthening/reinforcement of the feasibility and acceptability of the policy (policy steam). Also, the roles of policy entrepreneurs and resulting changes were shown to be significant for the overall process. Conclusion: NHI coverage for CMT was realized through collective policy and research efforts from the government and academic sectors. The roles of stakeholders were shown to be significant in the overall process, and documentation of their involvement is hoped to be of use of other countries that utilize traditional and/or manual medicine.

A study on the classification system of herbology

Jang, Woo-Chang,Jeong, Chang-Hyun,Baik, Yoo-Sang,Mohk, In-Seok,Kim, Me-Riong,Kim, Yun-Ji Kyung Hee Oriental Medicine Research Center 2008 Oriental pharmacy and experimental medicine Vol.7 No.5

This paper reviews the historic origin and traits of the classification system used in current Korean herbology textbooks. By reassessing its value, it proposes the most relevant path for future revisions and supplementations. Through an evaluation of the history of the modern style of classification in terms of its efficacy and statistic analysis of the distribution of individual herbs in each category, this paper shows how the classification systems of Korean herbology textbooks were influenced by contemporary Chinese herbology, particularly that of the Cheong [淸] Dynasty. An examination of the academic background, strengths and weaknesses of each classification system demonstrates the need for future research on classification systems to concentrate on resolving the following issues: how well the setting and composition of each classification system reflects reality, and how closely it is connected to related sciences such as etiology and pathogenesis, prescriptionology, and diagnosis.

Current practice and usual care of major cervical disorders in Korea : A cross-sectional study of Korean health insurance review and assessment service national patient sample data

Choi, A Ryeon,Shin, Joon-Shik,Lee, Jinho,Lee, Yoon Jae,Kim, Me-riong,Oh, Min-seok,Lee, Eun-Jung,Kim, Sungchul,Kim, Mia,Ha, In-Hyuk Williams & Wilkins Co 2017 Medicine Vol.96 No.46

<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P>Neck pain is a highly common condition and is the 4th major cause of years lived with disability. Previous literature has focused on the effect of specific treatments, and observations of actual practice are lacking to date. This study examined Korean health insurance review and assessment service (HIRA) claims data to the aim of assessing prevalence and comparing current medical practice and costs of cervical disorders in Korea.</P><P>Current practice trends were determined through assessment of prevalence, total expenses, per-patient expense, average days in care, average days of visits, sociodemographic characteristics, distribution of medical costs, and frequency of treatment types of high frequency cervical disorders (cervical sprain/strain, cervical intervertebral disc displacement [IDD], and cervicalgia).</P><P>Although the number of cervical IDD patients was few, total expenses, per-patient expense, average days in care, and average days of visits were highest. The proportion of women was higher than men in all 3 groups with highest prevalence in the ≥50s middle-aged population for IDD compared to sprain/strain. Primary care settings were commonly used for ambulatory care, of which approximately 70% chose orthopedic specialist treatment. In analysis of medical expenditure distribution, costs of visit (consultation) (22%–34%) and physical therapy (14%–16%) were in the top 3 for all 3 disorders. Although heat and electrical therapies were the most frequently used physical therapies, traction use was high in the cervical IDD group. In nonnarcotics, aceclofenac and diclofenac were the most commonly used NSAIDs, and pethidine was their counterpart in narcotics.</P><P>This study investigated practice trends and cost distribution of treatment regimens for major cervical disorders, providing current usage patterns to healthcare policy decision makers, and the detailed treatment reports are expected to be of use to clinicians and researchers in understanding current usual care.</P></▼2>

Effectiveness of Acupuncture and Electroacupuncture for Chronic Neck Pain: A Systematic Review and Meta-Analysis

Seo, See Yoon,Lee, Ki-Beom,Shin, Joon-Shik,Lee, Jinho,Kim, Me-Riong,Ha, In-Hyuk,Ko, Youme,Lee, Yoon Jae World Scientific Publishing Company 2017 The American journal of Chinese medicine Vol.45 No.8

<P>The aim of this systematic review was to assess evidence from randomized controlled trials (RCTs) on the effectiveness and safety of acupuncture and electroacupuncture in patients with chronic neck pain. We searched nine databases including Chinese, Japanese and Korean databases through 30 July 2016. The participants were adults with chronic neck pain and were treated with acupuncture or electroacupuncture. Eligible trials were those with intervention groups receiving acupuncture and electroacupuncture with or without active control, and control groups receiving other conventional treatments such as physical therapy or medication. Outcomes included pain intensity, disability, quality of life (QoL) and adverse effects. For statistical pooling, the standardized mean difference (SMD) and its 95% confidence interval (CI) were calculated using a fixed-effects model. Sixteen RCTs were selected. The comparison of the sole acupuncture group and the active control group did not come out with a significant difference in pain (SMD 0.24, 95% CI <TEX>$ -$</TEX>0.27-0.75), disability (SMD 0.51, 95% CI <TEX>$ -$</TEX>0.01-1.02), or QoL (SMD <TEX>$ -$</TEX>0.37, 95% CI <TEX>$ -$</TEX>1.09-0.35), showing a similar effectiveness of acupuncture with active control. When acupuncture was added into the control group, the acupuncture add-on group showed significantly higher relief of pain in studies with unclear allocation concealment (SMD <TEX>$ -$</TEX>1.78, 95% CI <TEX>$ -$</TEX>2.08-<TEX>$ -$</TEX>1.48), but did not show significant relief of pain in studies with good allocation concealment (SMD <TEX>$ -$</TEX>0.07, 95% CI <TEX>$ -$</TEX>0.26-0.12). Significant relief of pain was observed when the sole electroacupuncture group was compared to the control group or electroacupuncture was added onto the active control group, but a lot of the results were evaluated to have low level of evidence, making it difficult to draw clear conclusions. In the result reporting adverse effects, no serious outcome of adverse event was confirmed. Acupuncture and conventional medicine for chronic neck pain have similar effectiveness on pain and disability when compared solely between the two of them. When acupuncture was added onto conventional treatment it relieved pain better, and electroacupuncture relieved pain even more. It is difficult to draw conclusion because the included studies have a high risk of bias and imprecision. Therefore better designed large-scale studies are needed in the future.</P>

Minimum Clinically Important Difference and Substantial Clinical Benefit in Pain, Functional, and Quality of Life Scales in Failed Back Surgery Syndrome Patients

Park, Ki Byung,Shin, Joon-Shik,Lee, Jinho,Lee, Yoon Jae,Kim, Me-riong,Lee, Jun-Hwan,Shin, Kyung-Min,Shin, Byung-Cheul,Cho, Jae-Heung,Ha, In-Hyuk Wolters Kluwer Health, Inc. All rights reserved. 2017 1528-1159) Vol.42 No.8

<P>Conclusion. LBP and leg pain VAS, ODI, and physical component summary of SF-36 may be used to measure responsiveness in FBSS patients.</P>