PubMed | National Development Institute of Korean Medicine and Jaseng Spine and Joint Research Institute
Type: | Journal: Journal of ethnopharmacology | Year: 2016
While bee venom (BV) pharmacopuncture use is common in Asia, frequent occurrence of allergic reactions during the treatment process is burdensome for both practitioner and patient.This study compared efficacy and safety in isolated and purified essential BV (eBV) pharmacopuncture filtered for phospholipase A2 (PLA2) and histamine sections, and original BV to the aim of promoting safe BV pharmacopuncture use.In in vitro, we examined the effect of BV and eBV on nitric oxide (NO) production induced by lipopolysaccharide (LPS) in RAW 264.7 macrophages, and clinically, 20 healthy adults aged 20-40 years were randomly allocated and administered eBV 0.2mL and BV pharmacopuncture 0.2mL on left and right forearm, respectively, and physician, participant, and outcome assessor were blinded to treatment allocation. Local pain, swelling, itching, redness, wheals, and adverse reactions were recorded by timepoint.eBV and BV exhibited similar inhibitory effects on NO production. Also, in comparison between eBV and BV pharmacopuncture administration areas on each forearm, eBV displayed significantly lower local pain at 24h post-administration (P=0.0062), and less swelling at 30min (P=0.0198), 2 (P=0.0028), 24 (P=0.0068), and 48h post-administration (P=0.0253). eBV also showed significantly less itching at 24 (P=0.0119), 48 (P=0.0082), and 96h (P=0.0141), while redness was significantly less at 30min (P=0.0090), 6 (P=0.0005), and 24h (P<0.0001). Time-by-treatment interactions were statistically significant for itching and redness (P<0.001, and P<0.001, respectively), and all original BV pharmacopuncture administered regions showed a tendency toward more severe itching and redness in later measurements.eBV and BV displayed comparable anti-inflammatory effects, and eBV pharmacopuncture presented less local allergic reactions.
PubMed | Jaseng Spine and Joint Research Institute and Korea Promotion Institute for Traditional Medicine Industry
Type: Journal Article | Journal: BMC complementary and alternative medicine | Year: 2016
Pharmacopuncture is a relatively new acupuncture therapy combining acupuncture with herbal medicine. While pharmacopuncture is applied extensively in Korean medicine treatment, there are no clinical reports regarding what types of pharmacopuncture are used for which diseases.Data was extracted retrospectively from the electronic medical records of all inpatients and outpatients at 12 Korean medicine hospitals and clinics during the period of December 17, 2010 to October 2, 2014. Treatment patterns for acupuncture, electroacupuncture and pharmacopuncture were analyzed. Principle diagnosis codes, frequency of treatment, pharmacopuncture type and costs were investigated to assess pharmacopuncture use in clinical settings.During the study period, a total 33,415 inpatients and 373,755 outpatients visited the study sites, and most were musculoskeletal. Among inpatients and outpatients, 98.6% and 77.6% received pharmacopuncture, respectively. Administration rate of pharmacopuncture for the 10 most frequent principle diagnosis codes was 97.2-99.3% in inpatients, and that for outpatients was 73.0-91.5%. The average number of pharmacopuncture sessions in pharmacopuncture recipients was 8.212.3 for outpatients and 25.818.7 for inpatients. The mean total cost for pharmacopuncture per patient was $556.24174.62 among inpatients, and $149.16243.85 among outpatients. Estimated average cost per pharmacopuncture session was $23-24 for inpatients, and $17-18 for outpatients. Shinbaro1, bee venom, Hwangryunhaedok, and Shinbaro2 were the most frequently used pharmacopuncture types.This is the first analysis of treatment patterns of pharmacopuncture in a large-scale Korean medicine hospital/clinic patient population. We verified patterns of pharmacopuncture use for musculoskeletal disease treatment in Korea, and use of pharmacopuncture varied depending on disease or symptom severity. These results are expected to contribute to future clinical study design and standardization of pharmacopuncture.
PubMed | Jaseng Spine and Joint Research Institute and Seoul National University
Type: Journal Article | Journal: PloS one | Year: 2016
Bee venom (BV), a type of toxin extracted from honeybees (Apis mellifera), has been empirically and widely used to treat inflammatory diseases throughout Asia. Essential BV (eBV) was developed by removing phospholipase A2 (PLA2) and histamine to lower occurrence of allergic reaction. This study investigated the anti-allergic and anti-inflammatory activities of eBV in vitro and in vivo and its underlying mechanism of action.The anti-inflammatory potential of eBV was assessed in vivo using a carrageenan-induced paw edema model. To further investigate the mechanism by which eBV exerts anti-allergic and anti-inflammatory effects, compound 48/80-stimulated RBL-2H3 cells and lipopolysaccharide (LPS)-stimulated RAW 264.7 murine macrophage cells were studied in vitro.Release of -hexosaminidase and histamine was increased by eBV in a dose-dependent manner, but these levels were lower in eBV compared to original BV at the same concentration. In addition, eBV suppressed compound 48/80-induced expression of tumor necrosis factor- (TNF-) and interleukin-1 (IL-1) in RBL-2H3 cells. eBV was also shown to suppress nitric oxide (NO) production by down-regulating mRNA expression and subsequent protein expression of inflammatory mediators in LPS-induced RAW 264.7 cells. Phosphorylation of activators and signal transducers of transcription 1/interferon regulatory factor 3 (STAT1/IRF3) was attenuated by eBV treatment. eBV significantly inhibited carrageenan-induced acute edema in vivo. Serum levels of prostaglandin E2 (PGE2), TNF-, and IL-1 were also down-regulated by eBV.These results demonstrate that eBV inhibits allergic and inflammatory response by reducing inflammatory mediator production via regulation of the STAT1/IRF3 signaling pathway, suggesting that eBV is a feasible candidate for regulation of allergic-inflammatory response in complementary and alternative medicine.
PubMed | Jaseng Spine and Joint Research Institute and Seoul National University
Type: | Journal: Journal of ethnopharmacology | Year: 2016
Harpagide, an iridoid glucoside, is a constituent of the root of Harpagophytum procumbens var. sublobatum (Engl.) Stapf, Devils claw which has been used in patients with osteoarthritis (OA). In the present study, we investigated the anti-osteoporotic potential of harpagide and its underlying mechanism of action in in vitro cell culture and in vivo bone loss animal models.Harpagide was obtained from the alkalic hydrolysis of harpagoside, a major constituent of H. procumbens var. sublobatum Analysis of biomarkers for bone formation in osteoblastic MC3T3-E1 cells and bone resorption in osteoclast cells derived from mouse bone marrow cells was performed to evaluate the mechanism of action. The protective activity of harpagide against bone loss was also evaluated in ovariectomized (OVX) mouse model.Harpagide improved bone properties by stimulating the process of differentiation and maturation of osteoblast cells and suppressing the process of RANKL-induced differentiation of osteoclast cells. In OVX-induced bone loss mouse model, oral administration of harpagide significantly improved recovery of bone mineral density, trabecular bone volume, and trabecular number in the femur. Harpagide also prevented increase of trabecular separation and structure model index induced by OVX. Harpagide effectively inhibited the serum levels of biochemical markers of bone loss, including alkaline phosphatase, osteocalcin, C-terminal telopeptide, and tartrate-resistant acid phosphatase.Taken together, the present study demonstrates that harpagide has a potential for prevention of bone loss in OVX mice by regulating the stimulation of osteoblast differentiation and the suppression of osteoclast formation. Therefore, these findings suggest that harpagide might serve as a bioactive compound derived from H. procumbens var. sublobatum for improvement of age-dependent bone destruction disease.
PubMed | Korea University, Jaseng Spine and Joint Research Institute, Korea Institute of Oriental Medicine and Cedars Sinai Medical Center
Type: | Journal: Trials | Year: 2015
Lumbar disc herniation is a major cause of sciatica and low back pain and imposes a heavy burden on both individual and society. While use of pharmacopuncture, a combined form of acupuncture and herbal medicine, for lumbar disc herniation is widespread in Korea and China, there is a paucity of research.This study is the protocol for a three-armed, randomized, patient, physician, and assessor-blinded controlled pilot study. Sixty patients with severe non-acute sciatic pain diagnosed with lumbar disc herniation (NRS 5, onset between 4 weeks and 6 months) will be recruited and randomized 20 each to the Shinbaro pharmacopuncture (pharmacopuncture with acupuncture), acupuncture, and usual care groups, respectively. The 2 acupuncture groups will receive 2 sessions/week of acupuncture alone or with pharmacopuncture for 4 weeks (total 8 sessions), and the usual care group will receive conventional medication 2-3 times/day and physical therapy 2 sessions/week over 4 weeks (total 8 sessions). The initial acupuncture physician will administer acupuncture at 5 acupoints (GB30, BL40, BL25, BL23, GB34) in the 2 acupuncture groups, and mark an additional acupoint. A second acupuncture physician will administer pharmacopuncture to the marked acupoint in the pharmacopuncture group, and acupuncture in the acupuncture group during acupuncture needle retention. The second physician will administer acupuncture and pharmacopuncture in a similar manner in terms of advice and manual stimulation to maintain patient-blinding, treat the patient out of view of the initial physician, remove the additional acupuncture needle immediately, and cover the area with adhesive bandage to maintain physician-blinding. The primary endpoint will be at 5 weeks post-randomization, and the primary outcome will be Visual Analog Scale (VAS) of sciatic pain. Secondary outcomes will be VAS of low back pain, Numeric Rating Scale (NRS) of low back pain and sciatic pain, ODI, SF-36, EQ-5D, and PGIC. Post-treatment evaluations will take place 5, 7, 9, and 12 weeks after randomization.This trial will evaluate the comparative clinical effectiveness of pharmacopuncture for severe non-acute sciatic pain patients diagnosed with lumbar disc herniation with usual care of conventional medicine and that of Korean medicine (acupuncture), monitor its safety, and serve as basis for a large-scale, multicenter trial.ClinicalTrials.gov NCT02384928 , registered 27 February 2015.
Comparative effectiveness and cost-effectiveness of Chuna manual therapy versus conventional usual care for nonacute low back pain: study protocol for a pilot multicenter, pragmatic randomized controlled trial (pCRN study)
PubMed | Korea Institute of Oriental Medicine, Jaseng Spine and Joint Research Institute, Mokhuri Neck and Back Hospital, Kyung Hee University and Pusan National University
Type: Journal Article | Journal: Trials | Year: 2017
While Chuna manual therapy is a Korean manual therapy widely used primarily for low back pain (LBP)-related disorders in Korea, well-designed studies on the comparative effectiveness of Chuna manual therapy are scarce.This study is the protocol for a three-armed, multicenter, pragmatic randomized controlled pilot trial. Sixty severe nonacute LBP patients (pain duration of at least 3weeks, Numeric Rating Scale (NRS) 5) will be recruited at four Korean medicine hospitals. Participants will be randomly allocated to the Chuna group (n=20), usual care group (n=20), or Chuna plus usual care group (n=20) for 6weeks of treatment. Usual care will consist of orally administered conventional medicine, physical therapy, and back pain care education. The trial will be conducted with outcome assessor and statistician blinding. The primary endpoint will be NRS of LBP at week 7 post randomization. Secondary outcomes include NRS of leg pain, the Oswestry Disability Index (ODI), the Patient Global Impression of Change (PGIC), the Credibility and Expectancy Questionnaire, lumbar range of motion (ROM), the EuroQol-5 Dimension (EQ-5D) health survey, the Health Utility Index III (HUI-III), and economic evaluation and safety data. Post-treatment follow-ups will be conducted at 1, 4, and 10weeks after conclusion of treatment.This study will assess the comparative effectiveness of Chuna manual therapy compared to conventional usual care. Costs and effectiveness (utility) data will be analyzed for exploratory cost-effectiveness analysis. If this pilot study does not reach a definite conclusion due to its small sample size, these results will be used as preliminary results to calculate sample size for future large-scale clinical trials and contribute in the assessment of feasibility of a full-scale multicenter trial.Clinical Research Information Service (CRIS), KCT0001850 . Registered on 17 March 2016.
Demographic characteristics and medical service use of failed back surgery syndrome patients at an integrated treatment hospital focusing on complementary and alternative medicine: A retrospective review of electronic medical records
Choi H.S.,Jaseng Spine and Joint Research Institute |
Chi E.H.,Jaseng Spine and Joint Research Institute |
Kim M.-R.,Jaseng Spine and Joint Research Institute |
Jung J.,Jaseng Spine and Joint Research Institute |
And 3 more authors.
Evidence-based Complementary and Alternative Medicine | Year: 2014
Objective. To report the patient demographics and nonsurgical complementary and alternative medicine treatment used at a Korean medicine hospital for low back pain (LBP) and/or sciatica after surgery. Methods. Medical records of patients who visited a spine-specialized Korean medicine hospital at 2 separate sites for continuous or recurrent LBP or sciatica following back surgery were reviewed. The demographics, MRI and/or CT scans, and treatments were assessed. Results. Of the total 707 patients, 62% were male and the average age was 50.20 years. Ninety percent of patients presented with LBP and 67% with sciatica. Eighty-four percent were diagnosed with herniated nucleus pulposus at time of surgery. Of these patients, 70% had pain recurrence 6 months or later, but 19% experienced no relief or immediate aggravation of pain after surgery. Many patients selected traditional Korean medicine treatment as primary means of postsurgery care (47%). When time to pain recurrence was short or pain persisted after surgery, return of symptoms at the same disc level and side was frequent. Conclusion. An integrative treatment model focusing on Korean medicine and used in conjunction with radiological diagnostics and conventional medicine is currently used as a treatment option for patients with pain after lumbar spine surgery. © 2014 Hee Seung Choi et al.
PubMed | Michigan State University, Jaseng Spine and Joint Research Institute and Kyung Hee University
Type: | Journal: BMC public health | Year: 2015
Sleep duration holds considerable importance as an indicator of mental/physical health. The objective of this study was to investigate the association between sleep duration, mental health, and chronic disease prevalence in Koreans.Of 31,596 subjects eligible for the Korean National Health and Nutrition Examination Survey V (2010-2012), 17,638 participants who answered items on sleep duration (aged 19 yrs) were analyzed in a cross-sectional study. Association between sleep duration, mental health, and chronic disease prevalence was assessed using logistic regression, and adjusted for various socioeconomic and lifestyle characteristics.Short or long sleep duration showed correlations with mental health, and items of significance showed gender-specific patterns. Women displayed significant associations with stress and depressive symptoms, and men with stress, thoughts of suicide, and psychiatric counseling. While stress was related with short sleep duration in both genders, depressive symptoms showed a relationship with long duration in men, and short duration in women. Prevalence of any chronic disease was associated with 6 h sleep when adjusted for factors including mental health, and among chronic diseases, cancer and osteoarthritis showed associations with short sleep duration, while diabetes and dyslipidemia were associated with normal sleep duration.Mental health problems were associated with sleep duration with gender-specific patterns. Associations with osteoarthritis, cancer, diabetes, dyslipidemia and abnormal sleep duration persisted after adjustment for mental health.
PubMed | Jaseng Spine and Joint Research Institute
Type: Journal Article | Journal: BMJ open | Year: 2016
To assess the association between smoking patterns and knee and hip joint osteoarthritis (OA) prevalence in Koreans aged 50 years or older with focus on knee OA.Cross-sectional study using nationally representative data.Data were collected at portable Health Examination Centres in Korea.Data of 9064 participants of the 5th Korean National Health and Nutrition Examination Survey (2010-2012) aged 50 years or older who received knee or hip joint X-rays out of 31,596 total surveyees were analysed.OA prevalence by smoking behaviour (current smoking, past smoking, indirect smoking and non-smoking).Estimated risk of OA by smoking amount, period, pack-years and indirect smoking exposure time to assess the association between smoking-related factors and knee OA by calculating ORs and adjusting for covariates in a complex sampling design. A multinomial logistic regression analysis and backward elimination method was used.OA prevalence in Koreans aged 50 years or older was 13.9%, with prevalence about 3.5 times higher in women (men 5.7%, women 20.1%). ORs for knee and hip joint OA prevalence by smoking behaviour in male indirect-smokers were lower than those in non-smokers in age and sex (OR 0.271; 95% CI 0.088 to 0.828), and selective adjustments (OR 0.314; 95% CI 0.102 to 0.966). All other analyses for smoking behaviour and total OA prevalence, and knee OA prevalence were not significantly different. Associations between smoking amount, period, pack-years and knee OA prevalence were non-significant in ever-smokers. Associations between indirect smoking exposure time and knee OA prevalence were also non-significant.This study found that though direct and previous smoking and OA prevalence were not associated, there was a weak relationship between indirect smoking and OA.