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Case Report
Common Peroneal Nerve Entrapment Masked by Acute Lumbar Disc Herniation: Integrated Korean Medicine Treatment with Ultrasound-Guided Pharmacopuncture
Hyunsuk Park, Jinhyun Kim, Sungjae Yoo, Jung-Min Yun, Kwangchan Song
Perspect Integr Med. 2024;3(3):177-183.   Published online October 23, 2024
DOI: https://doi.org/10.56986/pim.2024.10.008
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AbstractAbstract PDF
The symptoms of common peroneal nerve (CPN) entrapment are similar to the symptoms of lumbar herniated intervertebral disc. We present the successful treatment of CPN entrapment masked by acute lumbar disc herniation. A 49-year-old man presented with low back pain and numbness in his left leg. Following admission, patient history, physical examination, and radiology findings, the patient received integrated Korean medicine (KM) treatment (acupuncture, pharmacopuncture, ultrasound-guided pharmacopuncture, moxibustion and cupping, herbal medicine, and chuna therapy) for lumbar disc herniation. Outcome measures included the numeric rating scale, the European quality of life five dimensions, and the Oswestry disability index. Symptoms persisted, and CPN compression was consequently suspected. On Day 12 of 23, in addition to KM treatment, an ultrasound-guided Shinbaro2 pharmacopuncture (4 mL) was performed on the CPN entrapment site. Significant symptom relief resulted after CPN treatment on Day 12. Improvement was particularly evident in the lower leg and ankle, areas where the pain had previously been misattributed to symptoms of lumbar disc herniation. His low back pain and radiating pain to the back of the left femur started to improve from Day 20 and were mild at discharge. This case highlights the importance of considering peripheral nerve entrapment in patients presenting with symptoms similar to lumbar disc herniation. It also suggests that combining traditional KM with modern diagnostic techniques such as ultrasonography, may be beneficial in the precise location for pharmacopuncture treatment. Further studies are recommended to validate these findings and explore the broader applicability of this approach.
Protocols
A Protocol for a Bibliometric Analysis of Traditional, Complementary, and Integrative Medicine Research Preprints
Jeremy Y. Ng, Brenda Lin, Sabrina Abdella, Magdalene Abebe, Isabella Tao, Holger Cramer
Perspect Integr Med. 2024;3(3):172-176.   Published online October 23, 2024
DOI: https://doi.org/10.56986/pim.2024.10.007
  • 151 View
  • 4 Download
AbstractAbstract PDF
Background
Traditional, complementary, and integrative medicine (TCIM) has witnessed significant growth in interest globally. Despite its popularity, TCIM research encounters numerous challenges including funding, methodological issues, and risk of bias. Preprints (scientific manuscripts openly accessible before formal peer review) present a potential solution, and understanding the characteristics and impact of TCIM preprints could offer valuable insights.
Methods
A bibliometric analysis will be conducted on all TCIM-related preprints, since inception, and posted on preprint servers with TCIM subject filters. Preprints will be sourced from servers listed in the Accelerating Science and Publication in Biology directory which allow filtering by TCIM-related categories. The preprint server and URLs, preprint server’s disciplinary scope, ownership type, screening processes, external content indexing, permanence of content, preservation of content, and comments will be extracted. The number of TCIM-related preprints yielded, and which TCIM-related term each preprint server uses will be noted. Data will be extracted from each eligible preprint: preprint server, title, DOI, preprint posted date, status of preprint, journal of final publication, final publication date, type of preprint, abstract of preprint, authors, author affiliation(s), country of corresponding author, funders, number of views, number of downloads, number of comments, number of citations, number of versions, and keywords. Descriptive statistics will be used to summarize the bibliometric characteristics, and trend analysis will identify publication patterns over time.
Conclusion
This protocol was developed for a study to identify trends in TCIM research dissemination, and contribute to a better understanding of how preprints are being used to advance the field
Protocol for a Scoping Review of Traditional and Complementary Medicine Governance Across Sub-Saharan Africa
Tendayi R. Chihaka, Nadine Ijaz, Ossy M.J. Kasilo, Peter B. James, Daniel F. Gallego Pérez, Jon Wardle, Razak M. Gyasi
Perspect Integr Med. 2024;3(2):123-128.   Published online June 21, 2024
DOI: https://doi.org/10.56986/pim.2024.06.008
  • 1,000 View
  • 23 Download
AbstractAbstract PDFSupplementary Material
Background
Since 1978, the World Health Organization (WHO) has repeatedly called on Member States to recognize the role of traditional and complementary medicine (T&CM) in primary healthcare, improve safety, and accessibility by governing T&CM. In the 2019 Global Report on T&CM, the WHO reported that 40 out of 47 (85%) Member States from African Region had enacted governance policies, and 20 out of 47 (43%) had regulatory policies on herbal medicines. The primary barriers to implementing T&CM policy were identified as an absence of data and inadequate financial support for research. The objective of this protocol was to detail how to perform a scoping review that will examine the policy, legislative, and regulatory landscape for T&CM practitioners and products in sub-Saharan Africa.
Methods
Databases will be searched (AMED, CINAHL Plus with Full Text, MEDLINE Plus with Full text, Web of Science, Scopus, PubMed, Google Scholar) for relevant articles. Searches will be limited to English, French, Portuguese, and Spanish language studies in peer-reviewed journals (1963-2023) that substantively report on legislation, bills, policies, governance approaches and regulations on T&CM (including successes and/or challenges in their design and implementation). Actual legislation, policies, and regulatory documents on T&CM and peer-reviewed studies with emphasis on integrating T&CM and biomedicine into healthcare systems will be excluded.
Expected Outcomes
This protocol has formulated the objectives for a scoping review to identify, map, and synthesize evidence on the governance of T&CM in sub-Saharan Africa.
Original Article
Evidence Map of Acupuncture: Where We Stand and Where We Should Go
Tae-Hun Kim, Jung Won Kang
Perspect Integr Med. 2024;3(2):106-113.   Published online June 21, 2024
DOI: https://doi.org/10.56986/pim.2024.06.006
  • 1,231 View
  • 40 Download
  • 1 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
Evidence mapping presents the current status of evidence on a specific field. The "Evidence Map of Acupuncture" published in 2014 gave an overall picture of the evidence on acupuncture treatments for various conditions/diseases. In this study, evidence in 2024 for the effect of acupuncture was reassessed.
Methods
The systematic reviews (SRs) on acupuncture for the 43 conditions/diseases where evidence was previously unclear or potentially effective in the "Evidence Map of Acupuncture" 2014 were searched in the PubMed and the Cochrane Library, and included SRs up to February, 2024. The Grading of Recommendations, Assessment, Development, and Evaluations assessment in the included SRs was used for assessing the confidence level in the evidence of each condition.
Results
When compared with the results of the "Evidence Map of Acupuncture" 2014, the average number of randomized controlled trials included in a SR increased from 11 to 19.5 by 2024. However, the confidence level showed an overall decrease. The reasons for unclear evidence were mainly methodological limitations such as poor research design, small sample size and small number of studies, and the results of the 2024 reassessment did not show a significant difference in the reasons compared with the "Evidence Map of Acupuncture" 2014.
Discussion
To improve clinical evidence for acupuncture, simple repetition and increasing the number of new randomized controlled trials does not seem to be effective. To reduce redundancy, large scaled studies should be conducted, and a new critical appraisal tool for acupuncture is needed to avoid unfair evaluation of risk of bias in acupuncture research.

Citations

Citations to this article as recorded by  
  • Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions
    Ye-Seul Lee, Myeong Soo Lee, David Moher, In-Hyuk Ha, Jian-Ping Liu, Terje Alræk, Stephen Birch, Tae-Hun Kim, Yoon Jae Lee, Juan V.A. Franco, Jeremy Y. Ng, Holger Cramer
    Perspectives on Integrative Medicine.2024; 3(3): 162.     CrossRef
Review Articles
Addressing the Challenges of Traditional, Complementary, and Integrative Medicine Research: An International Perspective and Proposed Strategies Moving Forward
Maheen Raja, Holger Cramer, Myeong Soo Lee, L. Susan Wieland, Jeremy Y. Ng
Perspect Integr Med. 2024;3(2):86-97.   Published online June 21, 2024
DOI: https://doi.org/10.56986/pim.2024.06.004
  • 1,922 View
  • 59 Download
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDF
Traditional, complementary, and integrative medicine (TCIM) encompasses a broad range of healthcare practices beyond conventional Western medicine. Despite its use globally and increased research, many TCIM research challenges persist impeding its progress and integration into clinical practice. Key challenges involve financial constraints, insufficient research training and educational support, and the methodological barriers which arise from a lack of standardization. Financial limitations hinder investment into crucial research limiting both the quantity and quality of TCIM research. Inadequate training in research and educational support limit the development of TCIM research, hindering growth and recognition of TCIM in academic and clinical settings. The inherent dynamic nature of TCIM therapies poses additional challenges for applying standardized biomedical research models. These challenges not only impede the advancement of TCIM research but also perpetuate negative attitudes and biases within the healthcare and research communities. To overcome these challenges, a comprehensive strategy is necessary to increase funding, improve literacy, and the promotion of open science practices in TCIM. Addressing these confounding factors will enable well-informed TCIM research literacy and the development of TCIM skills and facilitate the integration of evidence based TCIM therapies into a more inclusive healthcare domain, ultimately reducing negative attitudes and biases towards TCIM.

Citations

Citations to this article as recorded by  
  • A Protocol for a Bibliometric Analysis of Traditional, Complementary, and Integrative Medicine Research Preprints
    Jeremy Y. Ng, Brenda Lin, Sabrina Abdella, Magdalene Abebe, Isabella Tao, Holger Cramer
    Perspectives on Integrative Medicine.2024; 3(3): 172.     CrossRef
  • Robust Evidence in Integrative Medicine: Innovations, Challenges, and Future Directions
    Ye-Seul Lee, Myeong Soo Lee, David Moher, In-Hyuk Ha, Jian-Ping Liu, Terje Alræk, Stephen Birch, Tae-Hun Kim, Yoon Jae Lee, Juan V.A. Franco, Jeremy Y. Ng, Holger Cramer
    Perspectives on Integrative Medicine.2024; 3(3): 162.     CrossRef
Current Status and Challenges of the Evidence for Cupping Therapy in Clinical Practice Guidelines in Korea
Seungwon Shin
Perspect Integr Med. 2024;3(2):74-85.   Published online June 21, 2024
DOI: https://doi.org/10.56986/pim.2024.06.003
  • 821 View
  • 24 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Clinical practice guidelines (CPGs) published in Korea were reviewed to evaluate up-to-date evidence and the recommendations for cupping therapy (CT) to inform clinicians and researchers for future studies. There were 14 CPGs (allergic rhinitis, ankle sprain, cervical pain, chronic low back pain, cold hands and feet, facial nerve palsy, Hwabyung, knee osteoarthritis, lumbar herniated intervertebral disk, migraine, osteoporosis, postoperative syndrome, shoulder pain, and traffic accident injury) with 29 recommendations for CT determined from “low” to “moderate” rated evidence. The levels of evidence were mostly downgraded due to the risk of bias and imprecision. The majority of recommendations for CT were graded as B or C. This comprehensive analysis underscores the imperative need for robust clinical research, including randomized controlled trials and observational studies using real-world data to enhance the quality of the evidence for CT. In addition, recommendations providing definite phases or scope of the target conditions/diseases and treatment regimens should be employed. This work lays a foundational step towards integrating CT into evidence-based clinical practice, emphasizing strategic directions for future research to bridge the gap between evidence and practice.
A Modern Interpretation of Cold-Heat Pattern in Traditional Medicine with a Focus on Thermo-Regulation
Younggwang Kim, Jee Young Lee, Joongho Lee, Sanghun Lee
Perspect Integr Med. 2024;3(1):18-28.   Published online February 22, 2024
DOI: https://doi.org/10.56986/pim.2024.02.003
  • 1,564 View
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Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Cold-heat patterns (C-HPs) in Traditional East Asian Medicine are essential for individually diagnosing and treating patients. However, the concept of C-HPs and their biological mechanisms (thermoregulation) remains unclear. C-HPs studies published between January 2000 and May 2023 were retrieved from 5 databases (PubMed, Google Scholar, OASIS, Korean studies Information Service System, and Research Information Sharing Service). Among the 8,373 articles screened, 132 were included in the review and categorized. Nineteen articles were clinical studies related to traditional concept of C-HP identification, 14 studies investigated diseases affecting thermosensation or thermoregulation, and 99 studies identified candidate genes as potential markers for C-HP identification. Further analysis, including gene ontology, and gene set enrichment analysis of the candidate genes, revealed 3 primary biological processes closely associated with thermoregulation-related genes, including localization, responses to stimuli, and homeostatic processes. Notably there was a significant association between the candidate genes and inflammatory mediator regulation of transient receptor potential channels (p < 0.001). A significant association between C-HPs and inflammation-related pathways across thermosensation-related and thermoregulation-related clinical and preclinical studies was observed, suggesting that the traditional concept of C-HPs should be studied further from an immunological perspective.
Original Article
Contributing Factors in the Decision to Study Korean Medicine and Satisfaction with the College Experience: A Quantitative Nationwide Study
HyunSeok Kim, Hyunho Kim, Joohyun Lee, Hwimun Kim
Perspect Integr Med. 2023;2(3):173-181.   Published online October 23, 2023
DOI: https://doi.org/10.56986/pim.2023.10.005
  • 1,402 View
  • 36 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
The practice of Korean medicine (KM) taught at KM colleges has equal legal rights and responsibilities as Western medicine in South Korea. To date, no research has been conducted on the factors which influence college students in their choice to study KM and satisfaction with the course.
Methods
Content validity and face validity tests were conducted while developing the questionnaires. Research was conducted amongst all KM colleges in South Korea and of the 744 premedical KM 2nd year students, 420 participated. Analysis was performed on how much the mean values changed between the items and sub-items. Factors were also correlated with the students’ satisfaction and willingness to reenter KM colleges.
Results
The means of stable incumbency items were the highest of all the items, while items concerning experience of chronic disease had the lowest mean values. For enrollment, the latent value that most questionnaire items were changed positively by was interest in KM. Items related to students’ choice or KM doctor status were closely tied to students’ current satisfaction with their choice to enroll at a KM college, rather than their college entrance examination scores.
Conclusion
Identifying which factors are considered before entering KM college and during the course can help students to be more satisfied with their academic progress. To satisfy the KM students, educators should focus on providing both qualified clinical training and guidance to enter diverse career fields. This study highlights factors that can be applied to college curriculum or subject teaching.
Review Article
An Umbrella Review of Systematic Reviews for Chuna (or Tuina) Manual Therapy on Musculoskeletal Disorders
Doori Kim, Gil Geun Baek, Byung-Cheul Shin
Perspect Integr Med. 2023;2(3):142-154.   Published online October 23, 2023
DOI: https://doi.org/10.56986/pim.2023.10.002
  • 1,607 View
  • 39 Download
  • 2 Citations
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Background
To provide clinicians with reliable evidence an umbrella review of systematic reviews (SRs) on Chuna manual therapy (CMT) for musculoskeletal disorders was performed to synthesize important outcomes.
Methods
There were eight databases (Cochrane, EMBASE, MEDLINE, CNKI, KMBASE, KISS, Scienceon, and OASIS) searched as well as the international database Prospective Register of Systematic Reviews in health and social care until August 2023. SRs of randomized controlled trials involving patients with musculoskeletal conditions, limited to interventions explicitly labeled as “Chuna” or “Tuina” in English, Chinese, or Korean language were retrieved. Two reviewers independently conducted selection and data extraction, and SR quality was assessed using A Measurement Tool to Assess Systematic Reviews tool (low, medium, or high quality).
Results
This review included 32 SRs, categorized by cervical (n = 4), thoracolumbar (n = 7), upper extremity (n = 5), lower extremity (n = 9), and other musculoskeletal disorders (n = 7). Quality assessments determined that three SRs were of “high” quality, two were “low” quality, and the remaining SRs were of “medium” quality. CMT was consistently reported to demonstrate superior outcomes: an effective rate was observed in 17 of 19 SRs, CMT was effective at reducing pain in 12 of the 16 SRs, and functional outcomes of CMT were observed in 8 of 12 SRs. No serious adverse events were reported.
Conclusion
CMT may be a safe and effective treatment for various musculoskeletal disorders based on the limited number of studies and the low quality of included SRs.

Citations

Citations to this article as recorded by  
  • Reporting Overviews of Reviews: PRIORitizing a Reporting Guideline
    Lisa Hartling, David Moher
    Perspectives on Integrative Medicine.2024; 3(2): 65.     CrossRef
  • Effectiveness and Safety of Pharmacopuncture on Inpatients with Tension Headache Caused by Traffic Accidents: A Pragmatic Randomized Controlled Trial
    Ja-Yean Son, Kangmoo Goo, Na-young Kim, Seok-Gyu Yang, Dong Hwan Lee, Yu-Ra Im, Oh Bin Kwon, Hyun-Woo Cho, Sang Don Kim, Doori Kim, In-Hyuk Ha
    Journal of Clinical Medicine.2024; 13(15): 4457.     CrossRef
Editorial
Best Evidence for Best Care
Nicola Robinson
Perspect Integr Med. 2023;2(3):139-141.   Published online October 23, 2023
DOI: https://doi.org/10.56986/pim.2023.10.001
  • 1,314 View
  • 34 Download
Graphical AbstractGraphical Abstract PDF
Review Article
Proposal of a Case Reporting Draft Guideline for Pharmacopuncture: Literature Review of Pharmacopuncture Case Reports
Soohyun Jeong, Chaeyeon Son, Hyunjin Kim, Gapsik Yang, Hongmin Chu, Jungtae Leem
Perspect Integr Med. 2023;2(1):24-35.   Published online February 21, 2023
DOI: https://doi.org/10.56986/pim.2023.02.004
  • 1,906 View
  • 46 Download
Graphical AbstractGraphical Abstract AbstractAbstract PDFSupplementary Material
Pharmacopuncture is a popular treatment that combines the advantages of both herbal medicine and acupuncture. However, pharmacopuncture care reporting guidelines have not yet been developed. This study aimed to propose a reporting guideline draft for pharmacopuncture case reports. Pharmacopuncture case reports were retrieved from 4 databases (KCI, RISS, ScienceON, OASIS) to analyze the items reported and their fidelity. We analyzed 5 existing reporting guidelines related to Korean medicine case reporting to identify the items to be included in the extension of pharmacopuncture reporting guidelines. From 3,684 studies, 29 case reports were included and 4 items were identified as not reported in enough detail: “direction and depth of pharmacopuncture” (89.5%); “method of manufacturing the syringe needle” (82.8%); “posture of the patient during the therapy” (75.9%); and “pharmacopuncture recipe” (69.5%). As a result of analyzing moxibustion and acupuncture clinical trial reporting guidelines, it was determined that detailed reporting guidelines on the type of pharmacopuncture, manufacturing method, and treatment method were required and we propose that a pharmacopuncture reporting guideline draft should include these details. Further investigations are warranted using the Delphi technique to reach agreement with clinical practitioners and clinical research experts.
Editorial
Strategy for Integration
Nicola Robinson
Perspect Integr Med. 2023;2(1):1-2.   Published online February 21, 2023
DOI: https://doi.org/10.56986/pim.2023.02.001
  • 995 View
  • 27 Download
PDF
Original Article
Current Status of Korean Medicine Treatment for Post-acute COVID-19 Syndrome: A Survey of Korean Medicine Doctors
Doori Kim, Seo-Hyun Park, Won-Suk Sung, Eun-Jung Kim
Perspect Integr Med. 2022;1(1):34-44.   Published online September 22, 2022
DOI: https://doi.org/10.56986/pim.2022.09.006
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  • 46 Download
AbstractAbstract PDFSupplementary Material
Background
The applicability of Korean medicine (KM) treatments for post-acute COVID-19 syndrome were investigated.
Methods
A cross-sectional, web-based survey of Korean medical doctors (KMDs) was conducted in June 2022. The 25-item questionnaire comprised of five parts: basic characteristics, prescribed post-COVID-19 KM treatments, treatment effect in patients with post-acute COVID-19 syndrome, patient satisfaction, and awareness and utilization of the relevant KM Clinical Practice Guideline by the KMDs.
Results
In total, 1,063 completed questionnaires were collected, and 822 were analyzed. The most common symptoms in patients with post-acute COVID-19 syndrome treated by KMDs was weakness and fatigue (84.3%). Herbal decoctions (39.2%) and herbal powder (not covered by medical insurance; 25.8%) were primarily used. Among the KMDs, 95% (n = 781) responded that KM treatments, particularly herbal decoctions (82.6%) and herbal powder (not covered by medical insurance; 46.8%), were effective. Overall, 92.6% (n = 761) of KMD participants answered that the patients were satisfied with KM treatments, mostly due to symptomatic improvement (60.8%). The primary reason for dissatisfaction was the burden of cost for patients (78.4%). The main reasons for low uptake of KM services by patients with post-acute COVID-19 syndrome were lack of publicity and administrative issues such as no health insurance coverage.
Conclusion
KM is highly applicable for post-acute COVID-19 syndrome. Health policies supporting the use of KM for post-acute COVID-19 syndrome are recommended.

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