Korean Medicine Clinic Research Articles

Mental Health and Medical Error among Nursing Staffs at Korean Medicine Clinics: a first survey in South Korea.

Nurses face mental health issues like emotional labor, stress, and depression, increasing the risk of medical errors. This study assesses the mental health and medical errors among nurses in Korean medicine clinics in South Korea. The cross-sectional analysis involved 83 nurses, examining relationships between emotional labor, stress, depression, cognitive failure, Hwa-byung (HB) (a syndrome of suppressed anger in Korean culture), and medical errors. It identified factors associated with HB and medical errors using multiple regression analysis, presenting their odds ratios (ORs) with 95% confidence intervals (CIs). The findings revealed a current HB prevalence of 19.28% and a 6-month medical error prevalence of 16.87% among participants. The regression analysis showed that higher levels of depression (OR = 1.368, 95% CI = 1.098 to 1.703, p = 0.005), cognitive failure (OR = 1.072, 95% CI = 1.011 to 1.136, p = 0.020), and HB trait (OR = 1.136, 95% CI = 1.005 to 1.284, p = 0.041) significantly correlated with HB presence. This groundbreaking study on this previously under-researched nurse workforce highlights the critical need for comprehensive mental health care, with the objective of significantly enhancing their mental well-being and improving their overall work environment.

Upgrading of Quality Control for Herbal Medicine Use in South Korea by Introducing an Accreditation System: a brief report.

This study aimed to present a government-led accreditation system for upgrading the quality control of herbal medicine by introducing the process and evaluation standard of external herbal dispensaries (EHDs) of traditional Korean medicine (TKM) clinics in South Korea 2018 to refer to other countries where herbal medicine were used similarly in Korea. We organized an EHD accreditation committee for the establishment of an accreditation system. The committee consisted of 9 experts an official of the Ministry of Health and Welfare (MoHW), a professor expert of TKM, a good manufacturing practice expert, a hazard analysis and critical control point expert, and an accreditation system expert. After 3 meetings, a draft of the evaluation standard and evaluation system was established in 2017. Based on the draft, a pilot test was conducted to determine the applicability of the evaluation standards in 2017. Two additional meeting was held to confirm the accreditation standards and was finalized in 2018. The evaluation standard for EHDs was developed. In the case of herbal medicine EHDs, the evaluation standard consisted of 9 evaluation categories, 25 evaluation parts, and 81 evaluation items were developed. The results of the evaluation of the pilot tests are as follows, and the results show that there is a deviation between the EHDs. As a world's first, Korea MoHW successfully launched the accreditation system for upgrading the quality control system of herbal medicine not approved by Korea's Ministry of Food and Drug Safety in 2018. Our report hope to provide a good reference to other countries where having similar herbal medicine system in South Korea hoping to make better quality control of herbal medicines.

Risk factors of passive suicidal ideation among outpatients in traditional medicine clinics: The case of Korean medicine in South Korea

Suicide is the leading cause of death worldwide, especially in South Korea. Individuals using Korean medicine (KM) clinics are common in this country, but KM doctor is not yet used in the country's suicide prevention policy. In this study, we investigated the prevalence and risk factors of passive suicidal ideation (SI) among outpatients at KM clinics, and attempted to develop a predictive model of SI through multivariate analysis. The Korea Health Panel Annual Data 2019, a nationally representative survey in South Korea, was analyzed. In this study, 1924 (weighted n:5,958,666) people aged 19 or older who used the KM outpatient service at least once in 2019 were set as study subjects. The authors calculated the weighted prevalence of passive SI and identified significant sociodemographic, physical, and mental factors using the Rao-Scott chi-square test and weighted logistic regression. A suicide risk scorecard was developed using the point to double the odds method to quantify individual risk, resulting in a score range of 0–100. We found high prevalence of passive SI among KM outpatients (7.5 %), and the annual prevalence of passive SI tended to be higher with increasing age (4.6 % in young adults, 6.7 % in middle-aged, and 12.4 % in old age). Also, the prevalence increased as stress worsened (2.0 % in hardly, 3.9 % in a little, 13.7 % in a lot, and 24.8 % in very much). By using multiple logistic regression analysis, SI risk prediction score model was developed, including basic livelihood security recipients, presence of chronic diseases, perceived stress, depression, and low quality of life. According to our findings, passive SI is not uncommon among KM outpatients. Based on current findings, the potential role of KMDs in the country's suicide prevention strategy can be discussed focusing on specific groups such as socioeconomically vulnerable groups, the elderly population, and those with physical illnesses.

A survey on the real-world clinical utilization of a traditional acupuncture in Republic of Korea: Sa-am acupuncture

ObjectiveThis study investigated the clinical details and usage of Sa-am acupuncture in Korean medicine clinics and explored how practicing Korean medicine doctors (KMDs) think about Sa-am acupuncture. MethodsWe conducted a questionnaire-based survey of KMDs who utilize Sa-am acupuncture in their practice. The study comprehensively investigated issues related to clinical application of Sa-am acupuncture, needling techniques used during treatment, training methods, and directions for its future improvement. ResultsWe analyzed 572 responses. An average of 50% of the patients visiting Korean medicine clinics were receiving Sa-am acupuncture. The most prevalent indication for Sa-am acupuncture use was digestive disorders. The patients’ appetite level and digestive function were most frequently used indicators for selecting acupuncture points. Regarding prescription compositions, Jung-Gyuk formulas were more frequently used than Seung-Gyuk formulas. Inserting the needle along the flow of the channel or against the flow of the channel was most popular. The acupuncture style most frequently used in combination with Sa-am acupuncture was Ashi point acupuncture. Strengths of Sa-am acupuncture included its versatility, easy application, and good outcomes. Limitations included the lack of rigorous education and training programs, difficulty in applying the principles for beginners, and insufficient clinical research evidence. ConclusionIn clinics where Sa-am acupuncture is available, KMDs were providing Sa-am acupuncture to about half of their patients. Practitioners were not using all of the tonification and sedation techniques which may be due to time constraints or simply a lack of necessity. Sa-am acupuncture demonstrated high utility in clinical practice and high satisfaction based on the efficacy and safety. More training programs and high-quality research are needed to help expand the use of Sa-am acupuncture.Please cite this article as: Park JY, Lee YS, Park HJ, Lee SK, Lee JW, Kim SY. A survey on the real-world clinical utilization of a traditional acupuncture in Republic of Korea: Sa-am acupuncture. J Integr Med. 2024; 22(5): 570–578.

Trends in the Study of Korean Medicine Education : Based on domestic and international research

Objectives: The purpose of this study is to review trends in Korean medical education research.Method: We searched Korean Medicine Education research in 4 domestic and 4 international datebases. The studies were analyzed with journal, year, keyword and detailed topic, word frequency in research context, divided into four categories: basic Korean medicine, clinical Korean medicine, medical humanities, education.Result: 128 Korean studies and 30 International studies, total 158 studies, published from 1993 to 2024 have been selected. Research on Korean medicine education has been consistently published every year since 2003, by 61 journals. The period when the most papers were published was 2020, with 16 papers. Journal of Physiology & Pathology in Korean Medicine published a relatively large number of studies, with 19. Among the keywords divided into 4 categories according to Institute of Korean Medicine Education & Evaluation, studies related to 'basic medicine' were the most with 45 cases. When classified into detailed topics, there were 40 papers related to 'subject', and 21 papers related to ‘awareness’.Discussion and Conclusion: The study suggests that Korean medicine education method and curriculum should be developed. As educational research and method progresses, the corresponding curriculum has to be improved and applied to the field. This study would contribute to the foundation of Korean medicine education.

Survey on the current usage of ultrasound-guided procedures in Korean Medicine Clinics and Hospitals.

Ultrasound-guidance is applied during the administration of Korean medicine (KM) interventions to improve the safety and effectiveness of the interventions. Although many case series and reports on the use of ultrasound-guided KM interventions have been reported, no study has investigated the current use of ultrasound-guidance in clinical practice by doctors of Korean medicine (KMDs). An online survey was conducted with questions examining the status of ultrasound-guidance usage among KMDs practicing in various KM clinical settings. Survey responses from 335 KMDs were collected. Ultrasound started to be widely used in the clinical practice of KM since 2022. The primary objective of using ultrasound-guidance was "To improve the accuracy and efficacy" by 54.6%. Ultrasound-guidance was most frequently applied for shoulder joint diseases, and pharmacopuncture was the most frequently used intervention (76.1% and 90.4%, respectively). The respondents reported that effectiveness could be enhanced the most in nerve entrapment syndromes and especially when used in shoulder joints. Over 90% of KMDs responded that the safety and efficacy of treatment, specialty, and patients' satisfaction were improved after adopting ultrasound-guidance. Moreover, 94.9% of KMDs agreed with the necessity for reimbursement of ultrasound-guidance in KM under national health insurance coverage. Most KMDs responded that they had positive perceptions regarding the clinical use of ultrasound-guidance in KM in terms of treatment effects, safety, and patient satisfaction, and the need for national health insurance coverage of the service. Our findings may provide practice-based evidence for conducting clinical studies.

Hip and Finger Degenerative Arthritis Case Series Protocol for Applying Korean Medicine Clinical Pathway

Hip and Finger Degenerative Arthritis Case Series Protocol for Applying Korean Medicine Clinical Pathway

The Potential of Yangdorak Diagnosis Application of Gallstone

Objectives: The aim of the study was to investigate the potential of Yangdorak diagnosis application against gallstone scanned by Ultrasound diagnosis.Method: For this aim, among 97 patients who had visited Julip Korean Medicine Clinic from July 2016 to June 2023, 30 patients with no gallstone as a control group and 67 patients with gallstone and diagnosed by ultrasonography, were subjected to Yangdorak diagnosis. Then, the changes in Gallbladder Meridian (GB) value as F5 AVE(average of left and right GB value) by Yangdorak were comparatively analyzed between gallstone and non-gallstone groups and statistical significance was evaluated by Tukey's multiple comparison test using Prism software.Results: After all subjects were evaluated by the Yangdorak and ultrasonography to assess the potential of the Yangdorak diagnosis for gallstone, it was noteworthy that the Yangdorak values relevant to F5 AVE of female gallstone group(N=36) were significantly (<i>p</i><0.001) decreased compared to the control group (N=30), while there was no significance in male gallstone group(N=31). Also, it was recognized significant difference between male and female groups.Conclusion: Based on these results, if the Yangdorak value can be estimated from a decrease with clinical symptom in female patient, it is recommended to follow up the ultrasonography test for diagnosing the gallstone.

Effectiveness analysis of herbal medicine for gastroesophageal reflux disease: A retrospective study.

This study aimed to identify the clinical features of gastroesophageal reflux disease (GERD) in primary clinics and the effectiveness and safety of herbal medicine (HM). Thirty-five patients with gastroesophageal-reflux symptom who visited the 16 Korean medicine (KM) primary clinics from June 2022 to October 2022 were included in the study. We retrospectively analyzed the charts of 35 patients and collected clinical characteristics, HM, and outcome variables such as the numerical rating scale, gastroesophageal reflux disease questionnaire, frequency scale for symptoms of gastroesophageal reflux disease, Euro-Quality Of Life-5 Dimension, and adverse events. Of the 35 patients, 12 (34.3%) were men, and the average age of all patients was 47.0 ± 14.3 years. HM was prescribed for all 35 patients; Pinelliae Tuber (n = 31, 88.57%), Zingiberis Rhizoma Recens (n = 30, 85.71%), and Poria Sclerotium (n = 28, 80%) were the most prescribed herbs. All scores including numerical rating scale, frequency scale for symptoms of gastroesophageal reflux disease, gastroesophageal reflux disease questionnaire, and Euro-Quality Of Life-5 Dimension after 30 and 60 days from baselines showed significant improvement, and there were only a few adverse events. This study supports the effectiveness and safety of HM in reducing GERD symptoms in primary Korean medicine clinics. The most frequently used herbs may play significant roles in GERD symptom management.

Combined Korean medicine therapies in children with allergic rhinitis: A prospective, multicenter, observational registry study at primary-care network clinics

IntroductionAllergic rhinitis (AR) causes symptoms such as hyper-rhinorrhea, sneezing, nasal congestion, itching, and pain by triggering inflammation in the nasal mucosa and an immune response caused by antigen-specific Immunoglobulin E (IgE). This prospective multicenter observational study aimed to evaluate the symptoms change and safety of combined Korean medicine (KM) therapy in patients with AR. MethodsThis study was conducted in HAMSOA Korean Medicine Clinics, a network specializing in treating pediatric patients in Korea, and 15 centers participated. The patients were divided into three groups (mild, moderate, and severe) according to their baseline total nasal symptom score. The patients were treated with herbal medicine, acupuncture, cupping therapy, and moxibustion therapy. ResultsThe study involved 72 subjects aged 6.47 ± 2.37 years. The average Numeric Rating Scale for allergic rhinitis symptoms at the baseline and final follow-up were 4.39 ± 2.14 to 3.47 ± 2.51, respectively, indicating a significant improvement over an average of 4 weeks. The Pediatric Allergic Disease Quality of Life Questionnaire scores at the final screening improved in all three groups. The mean difference was -10.44, with a 95 % confidence interval of -15.35 to -5.54 (p < 0.01.). Furthermore, no adverse events were reported in any patient in this study. ConclusionThe results provide preliminary evidence suggesting that KM treatment may be a safe and effective option for reducing symptoms associated with allergic rhinitis in children. Additional prospective studies are required to confirm the results of the present study.

체질 식이 이후에 발생한 소화불량에 대한 전신관절역학 치료 중 복부도인술과 림프순환기법의 효과: 증례보고

Objectives : This study aimed to report the effectiveness of abdominal Daoyin and lymphatic circulation technique in conjunction with whole-body articulation mechan- ics technique therapy in treating indigestion.&#x0D; Methods : Three patients who suffered from dyspepsia and abscess after consuming foods incompatible with their constitution, following a 10-year implementation of a constitutional diet at a local Korean Medicine clinic, visited a Korean Medicine Hospital. The patients underwent treatment with abdominal Daoyin and lymphatic circulation technique. The effects of these techniques were analyzed using a retrospective re- cord analysis method.&#x0D; Results : Following the implementation of abdominal Daoyin and lymphatic circulation technique for indigestion, the numeric rating scale scores improved significantly. Case 1 improved from 9 to 2, case 2 from 6 to 0, and case 3 from 5 to 1.&#x0D; Conclusions : While acknowledging the limitations of being a case report involving only three patients and the absence of specialized outcomes for digestive issues, this report may provide a preliminary basis for considering the efficacy of Chuna manual therapy in indigestion treatment.

Acupuncture for patients with insomnia and predictors of treatment response: a chart review.

Acupuncture is a potentially effective non-pharmacological treatment for insomnia. We observed the responses of patients with insomnia to acupuncture in routine clinical practice. In addition, we explored patient characteristics that might affect the treatment response to acupuncture for insomnia. Medical records of patients with insomnia in a Korean medicine clinic with baseline Insomnia Severity Index (ISI) scores ⩾8 and Pittsburgh Sleep Quality Index (PSQI) scores ⩾5 were reviewed. Acupuncture was applied at ST43, GB41, ST41, SI5, HT3, KI10, HT7 and ST3, for 1-2 months. The ISI and PSQI were measured monthly to assess insomnia severity. The effect of acupuncture over time was analyzed using a multilevel linear model for repeated measures. In addition, logistic regression was used to explore predictors of treatment response. A total of 91 patients with insomnia aged 59.2 ± 12.5 years (mean ± standard deviation (SD)) (90.1% female) were included in the analysis. After the acupuncture treatment, ISI scores were significantly reduced by -3.75 (95% confidence interval (CI) = -4.99, -2.50) and -4.69 (95% CI = -6.22, -3.16) after the first and second month, respectively. The PSQI global scores also improved, and sleep duration showed a tendency to increase by 0.35 h (95% CI = -0.17, 0.86) after acupuncture treatment. Three cases of mild fatigue were reported. In addition, higher baseline pain/discomfort predicted a greater likelihood of response after acupuncture treatment (odds ratio (OR) = 1.66, 95% CI = 1.10, 2.60). In a real-world setting, the insomnia of outpatients in a clinic was slightly alleviated after acupuncture treatment. These findings require validation by randomized controlled trials.

Herbal medicine Eunkyo-san (Yinqiao-san) for COVID-19: A telemedicine case series

Coronavirus disease 2019 (COVID-19) cases surged across South Korea during the omicron-variant wave. We aimed to report the effectiveness of herbal medicine administered through telemedicine consultations as an adjunctive therapy for COVID-19. Patients with confirmed COVID-19 who were self-isolating at home were provided telephone consultations through a Korean Medicine clinic between January and March 2022. On the basis of their dominant symptoms, the patients were prescribed Eunkyo-san for seven days. Patients were asked to evaluate the severity of their COVID-19 symptoms before and after treatment by numeric rating scale. Of ten patients, more than half of them reported cough, fever, headache, and sore throat on the first telephone consultation. Patients reported that all symptoms related to COVID-19 disappeared completely on the second consultation. No severe adverse events were identified. The results of this case series suggest that Eunkyo-san administration can be a beneficial adjunctive therapy for patients with COVID-19.

Analysis of Conservative Treatment Trends for Lumbar Disc Herniation with Radiculopathy in Korea: A Population-Based Cross-Sectional Study.

This study aimed to analyze the trends in conservative treatment and associated medical costs for lumbar intervertebral disc disorders with radiculopathy in Korea. This population-based cross-sectional study included patients aged ≥ 20 years with at least one "intervertebral disc disorder with radiculopathy" claim (Korean Standard Classification of Diseases (KCD)-7 code: M511) who sought treatment from tertiary, general, or Korean Medicine hospitals or clinics between 2010 and 2019 and whose data were extracted from the Korean Health Insurance Review and Assessment Service National Patients Sample database. Intervention frequency, ratio, and medical costs, including medication, were analyzed. The number of patients with lumbar intervertebral disc disorders and radiculopathy undergoing conservative treatment increased by >30%, and medical costs increased from USD 3,342,907 to USD 5,600,456 during the 10-year period. The non-surgical treatments mainly used were medication and physiotherapy, and the most commonly prescribed medication was non-opioid analgesics. Meanwhile, the number of patients who used nerve plexus and root and ganglion nerve blocks showed the most significant increase. In conclusion, the number of patients with radiculopathy who received nerve blocks, particularly nerve plexus and root and ganglion nerve blocks, and related expenditure increased, implying a gradual shift in medical decisions from systemic pain reduction to specific and targeted pain treatments. Future studies and clinical practice guidelines may require further inspection of real-world practice to advise optimal treatment choices for an effective treatment plan.

Korean Medicine Clinical Practice Guideline Update for Temporomandibular Disorders: An Evidence-Based Approach.

Many updated clinical research results have been published since the Korean Medicine Clinical Practice Guidelines (KMCPGs) for temporomandibular disorders (TMDs) were published in 2018. Therefore, it is necessary to update the existing clinical practice guidelines (CPGs). This study presents updated recommendations for TMD treatment based on current research data published up to February 2020. The draft version of the level of evidence and grade of recommendation was determined through an assessment of the risk of bias and a meta-analysis of selected literature based on the Grading of Recommendations Assessment, Development, and Evaluation (GRADE). The final guidelines were derived using the Delphi method. Eighteen recommendations were derived for eight items of Korean medicine treatment for TMDs. Compared with previous Korean medicine CPGs for TMDs, the grades of seven recommendations, including acupuncture, pharmacopuncture, and Chuna manual therapy, were increased. The grades of the two recommendations have been changed. Six new recommendations were added to fully reflect clinical reality. Acupuncture, pharmacopuncture, and Chuna manual therapy are recommended for TMD patients in clinical practice. Concurrent conventional conservative therapy with Korean medicine or a combination of Korean medicines should be considered in clinical practice in patients with temporomandibular disorders.

Development of Korean Medicine Clinical Pathways for Carpal Tunnel Syndrome

Development of Korean Medicine Clinical Pathways for Carpal Tunnel Syndrome

Clinical effectiveness of decoction form of herbal medicine in primary care treatment of allergic rhinitis: A retrospective cohort study

BackgroundThe decoction form of herbal medicine (D-HM) is mainly prescribed to patients with allergic rhinitis (AR) in Korean Medicine (KM) clinics in the Republic of Korea; however, it is difficult to conduct clinical trials of D-HM due to regulatory issues. This study investigated the clinical safety and effectiveness of D-HM combination therapy for the treatment of AR by analyzing the AR outpatient data from 17 KM clinics. MethodsThis retrospective cohort study included patients who visited KM clinics for AR treatment from January 1, 2021, to March 31, 2022. Cases were collated using structured case report forms and divided into the D-HM with KM usual care group (D-HM group) and the KM usual care group (UC group). Since D-HM therapy could not be randomly assigned to the study population, we used optimal propensity score (PS) matching to investigate the effectiveness and safety of D-HM combination therapy in the treatment of AR. ResultsData from 228 patients were collected. After PS matching, 144 patients were finally analyzed. The total nasal symptom score (TNSS) and mini-rhinoconjunctivitis quality of life questionnaire (mini-RQLQ) were significantly improved in the D-HM group compared with those in the UC group (TNSS: p=0.02; mini-RQLQ: p=0.04). Four patients in the D-HM group experienced minor adverse events that were mild and resolved within 15 days. ConclusionsD-HM combination therapy may be beneficial in the management of symptoms and rhinitis-associated quality of life and potentially useful in clinical practice. However, randomized placebo-controlled clinical trials are required to confirm their effectiveness. Study registrationThis study has been registered at Clinical Research Information Service (KCT0007242).

National Health Insurance Data Analysis for the Second-Wave Development of Korean Medicine Clinical Practice Guidelines in South Korea

National Health Insurance Data Analysis for the Second-Wave Development of Korean Medicine Clinical Practice Guidelines in South Korea

A Survey on Korean Medicine Doctors’ Recognition for Developing Korean Medicine Clinical Practice Guidelines for Gastric Cancer

Objective: The purpose of this study was to provide data for the development of Korean medicine (KM) clinical practice guidelines (CPG) for gastric cancer (GC) by identifying the awareness and knowledge needs of KM doctors (KMD) through an online survey.Methods: A survey questionnaire was produced by referring to the previous recognition survey studies for clinical KMDs. The survey questionnaire was composed of questions regarding the current status of clinical care for GC, the knowledge level of clinicians about GC, and other details that clinicians use during practice. The survey was conducted from September 20 to October 22, 2021. An online survey was conducted with 195 KMDs from the Society of Korean Medicine and the Korean Association of Traditional Oncology of KM.Results: A total of 195 respondents participated in the online survey regarding the current status of GC treatment. Of this number, 10.3% of the respondents specialize in GC, but even if they do not currently specialize in GC, they are more likely to treat patients with GC in the future. In terms of the specifics of KM treatment, there was a demand for information on comprehensive KM treatment methods, such as herbal medicine, acupuncture, moxibustion, cupping, and chuna, as well as on analyzing the effectiveness of combined treatment with chemotherapy and radiation.Conclusion: In this study, we were able to understand the clinical KMDs’ perception of GC, knowledge level, and requirements in the CPG. The results of this study will provide the basic data for the development of CPG for GC.

Development of Korean Medicine Clinical Pathways for Carpal Tunnel Syndrome

Development of Korean Medicine Clinical Pathways for Carpal Tunnel Syndrome