Hypothesis Proposal about Predictive Factors and Optimal Age for Response to Herbal Medicine Treatment for Height Gain in Children

Jungtae Leem,Jeeyeun Kim,Kyeungsuk Suh,Youngkwern Lim,Junhee Lee 대한한의학회 2018 대한한의학회지 Vol.39 No.4

Neurofeedback self-regulating training in patients with post traumatic stress disorder: a randomized controlled trial study protocol

Jungtae Leem,정문주,Sang-hoon Yoon,Hyunho Kim,Hee-Geun Jo,Hyeryun Lee,Jeesu Kim,Hyang Yi Kim,Geun-Woo Kim,Hyung Won Kang 한국한의학연구원 2020 Integrative Medicine Research Vol.9 No.4

Background: Post-traumatic stress disorder (PTSD) has become an important public health problem. However, the conventional therapeutic strategy, including pharmacotherapy and cognitive behavioral therapy, has limitations. Neurofeedback is a technique that utilizes electroencephalography (EEG) signaling to monitor human physiological functions and is widely used to treat patients with PTSD. The purpose of our study is to assess the efficacy and safety level of neurofeedback treatment in patients with PTSD using quantitative EEG. Methods: This is a randomized, waitlist-controlled, assessor-blinded, clinical trial. Forty-six patients with PTSD will be randomly assigned at a 1:1 ratio into two groups. The participants in the treatment group will receive neurofeedback treatment for 50 min, twice a week, for 8 weeks (16 sessions). Quantitative EEG will be utilized to monitor the physiological functions and brain waves of the participants. A four-week follow-up period is planned. The participants in the control group will wait for 12 weeks. The primary outcome is the Korean version of PTSD Checklist-5 (PCL-5-K) score. The PCL-5-K scores on week 8 will be compared between the two groups. Anxiety, depression, insomnia, emotions, EEG, quality-of-life, and safety level will be assessed as secondary outcomes. Discussion: This trial will describe a clinical research methodology for neurofeedback in patients with PTSD. The numerous subjective and objective secondary outcomes add to the value of this trial’s results. It will also suggest a therapeutic strategy for utilizing quantitative EEG in patients with PTSD. Our trial will provide basic evidence for the management of PTSD via an integrative treatment. Trial registration: Clinical Research Information Service (CRIS): KCT0003271.

Acupuncture for motor symptom improvement in Parkinson's disease and the potential identification of responders to acupuncture treatment

Jungtae Leem 한국한의학연구원 2016 Integrative Medicine Research Vol.5 No.4

Perception, attitude, and demand for Korean medicine and Western medicine collaborative treatment of medical occupational groups in Korea: A scoping review

Jungtae Leem,Kwanil Kim,Joo Hee Seo,Moon Joo Cheong,Inae Youn 한국한의학연구원 2021 Integrative Medicine Research Vol.10 No.1

Background: In Korea, there exists a dual medical license system whereby both traditional Korean medicine and Western medicine doctors practice independently. In 2009, via medical law revision, cross employment was allowed to activate Korean medicine and Western medicine collaborative treatment (KWCT). Despite its several advantages, there are several barriers to a well-organized KWCT. To activate KWCT, we investigated perception, attitude, demand of medical occupational groups and research gap via scoping review. Methods: Scoping review is an emerging methodology for knowledge synthesis adopting the Arksey and O’Malley framework. The research question was “What is known about perception, attitude, demand, and research gap on KWCT?” We searched articles published from 2009 to 2019 in 7 Korean and 4 English databases. We conducted descriptive and qualitative thematic analysis and presented the research gap. Results: From 1305 articles, 6 quantitative and 3 qualitative studies were included. In quantitative studies, perception and attitude of medical occupational groups did not change markedly. For better perception and attitude, experiencing, mutual understanding, and respect should precede. Academic exchange, education, supporting KWCT research and legal/institutional/administrative support is also important. In qualitative studies, education course, guidelines, trust, safety, academic integration, and scientification were also required. We found several research gaps about KWCT especially detailed on-site demand and activation strategy about KWCT. Conclusion: We investigated perception, attitude, and demand on KWCT. Based on research gap in our scoping review, quantitative studies using validated questionnaire and in-depth interview are needed to identify on-site demand to improve KWCT implementation. Protocol registration: https://www.researchregistry.com/ (reviewregistry830).

Efficacy and safety of thread embedding acupuncture combined with conventional acupuncture for chronic low back pain : A study protocol for a randomized, controlled, assessor-blinded, multicenter clinical trial

Leem, Jungtae,Kim, Hyunho,Jo, Hee-Geun,Jeon, Sae-rom,Hong, Yejin,Park, Yeoncheol,Seo, Byungkwan,Cho, Yeeun,Kang, Jung Won,Kim, Eun-Jung,Han, Ga Young,Kim, Jae Soo,Lee, Hyun-Jong,Kim, Tae-Hun,Nam, Dong Williams & Wilkins Co 2018 Medicine Vol.97 No.21

<P><B>Abstract</B></P><P><B>Background:</B></P><P>Back pain is one of the most common diseases, and many patients with recurrent pain seek alternative treatment strategies. Thread embedding acupuncture involves thread insertion at the acupuncture point for continuous physical and chemical stimulation. Although thread embedding is widely used in clinical practice, there is no sound evidence of its efficacy for chronic back pain. We describe the protocol for a randomized controlled trial for investigation of the efficacy and safety of thread embedding acupuncture combined with conventional acupuncture for chronic low back pain.</P><P><B>Methods:</B></P><P>This randomized, controlled, assessor-blinded, 2-armed, parallel, multicenter clinical trial will include 38 outpatients with chronic low back pain recruited from 4 traditional Korean Medicine hospitals. The patients will be randomly allocated to a treatment group (conventional acupuncture + thread embedding acupuncture) and a control group (only conventional acupuncture) in a 1:1 ratio. The treatment group patients will receive thread embedding acupuncture treatment at 10 acupuncture points (multifidus muscle, 4 points; spinal erector muscles, four points; lumbar quadrate muscle, 2 points) once a week for 8 weeks (8 sessions). In addition, all patients will receive conventional acupuncture treatment at 14 acupuncture points (GV3, EX-B5, and bilateral BL23, BL24, BL25, BL26, BL40, and BL60) twice a week for 8 weeks (16 sessions). The primary outcome will be the change in the visual analog scale score from visit 1 to visit 16, analyzed by independent <I>t</I> tests, in both groups. The groups will also be compared with regard to the clinical relevance (minimal clinically important difference), quality of life (3-level version of Euroqol-5D), disability level (Roland and Morris Disability Questionnaire), global assessment (patient global impression of change), and safety. Cost data for cost–benefit and cost-effectiveness analyses will be collected.</P><P><B>Discussion:</B></P><P>Our study results will provide evidence of the efficacy and safety of thread embedding acupuncture combined with conventional acupuncture for the management of chronic low back pain. Even though the assessors will be blinded, the patients will not be blinded to treatment because of the lack of a sham embedding acupuncture group; this is a limitation of our study.</P><P><B>Trial registration:</B></P><P>Clinical Research Information Service: KCT0002666</P>

Herbal medicine (Hyeolbuchukeo-tang or Xuefu Zhuyu decoction) for treating primary dysmenorrhea : A systematic review and meta-analysis of randomized controlled trials

Leem, Jungtae,Jo, Junyoung,Kwon, Chan-Young,Lee, Hojung,Park, Kyoung Sun,Lee, Jin Moo Williams & Wilkins Co 2019 Medicine Vol.98 No.5

<▼1><P>Supplemental Digital Content is available in the text</P></▼1><▼2><P><B>Abstract</B></P><P><B>Background:</B></P><P>Primary dysmenorrhea is a condition characterized by painful menstrual cramps that usually occurs in the absence of any identifiable pathological condition among menstruating women, with the prevalence estimates varying between 45% and 95%. Nonsteroidal anti-inflammatory drugs (NSAIDs) are considered as a standard treatment for primary dysmenorrhea; however, the failure rate of NSAIDs is often 20% to 25% and these drugs commonly cause adverse effects. In this review, we investigated the current evidence related to the effectiveness of Xuefu Zhuyu decoction (XZD) or Hyeolbuchukeo-tang, a traditional herbal formula, as a treatment for primary dysmenorrhea.</P><P><B>Methods:</B></P><P>Literature search was conducted about randomized controlled trials (RCTs) for XZD on primary dysmenorrhea. PubMed, Cochrane Library, Embase, China National Knowledge Infrastructure Database, Oriental Medicine Advanced Searching Integrated System, and other Chinese, Korean, Japanese databases were searched up to December 20, 2017. Two independent reviewers extracted and assessed the data. The main outcome domains were visual analogue scale (VAS) score and response rate.</P><P><B>Results:</B></P><P>Among 475 publications, 8 RCTs involving 1048 patients were finally included. Methodological quality of included RCTs was relatively low. In 4 add-on design studies, XZD plus western medication (WM) group showed better response rate as compared to the WM sole therapy (relative risk 1.18, 95% confidence interval [1.11, 1.25], <I>P</I> < .01). VAS score after the 3rd month of treatment in the XZD plus WM group was also lower than that in the WM group (mean difference –0.45, 95% confidence interval [–0.79, –0.12], <I>P</I> < .01). In 4 XZD versus WM design studies, XZD sole therapy showed better response rate than did WM sole therapy (relative risk 1.26, 95% confidence interval [1.06, 1.49], <I>P</I> < .01).</P><P><B>Conclusion:</B></P><P>The existing trials showed a favorable effect of XZD for the management of primary dysmenorrhea. However, the efficacy of XZD on primary dysmenorrhea is not conclusive owing to the small number of studies and the high risk of bias. Large-scale, long-term RCTs with rigorous methodological input are needed to clarify the role of XZD for the management of primary dysmenorrhea.</P><P><B>Trial registration number:</B></P><P>CRD42016050447 in PROSPERO 2016</P></▼2>

Experiences, perceptions and needs on the education of evidence-based medicine among Korean Medicine college students: A nationwide online survey

Leem, Jungtae,Kim, Yohwan,Heo, Jeongweon,Jung, Minwoo,Kim, Sihyun,Lee, Hojung,Park, Jeong Hwan,Kim, Tae-Hun ELSEVIER SCIENCE B.V.; AMSTERDAM 2017 EUROPEAN JOURNAL OF INTEGRATIVE MEDICINE Vol.15 No.-

<P><B>Abstract</B></P> <P><B>Introduction</B></P> <P>Evidence-based medicine (EBM) has become an important part of medical education. Students’ perception and demand are important in education. The aim of our study was to conduct a nationwide online survey about EBM in traditional Korean Medicine (KM) education.</P> <P><B>Methods</B></P> <P>An online questionnaire was developed, comprising categories about EBM education in KM. Student’s experience, achievement, satisfaction, understanding and expectation in EBM education were surveyed. Face validity of the developed questionnaire was tested before survey and online links were sent through SurveyMonkey to all KM college students in Korea.</P> <P><B>Results</B></P> <P>Among the total 4649 students nationwide, 1292 agreed to participate in the survey (response rate: 27.8%) within 10days. Self-appraisals about the achievement, satisfaction, and understanding of EBM were relatively low. In addition to this, 30% of students answered they did not learn about EBM in regular school curriculum. Expectation of extension of further EBM education curriculum was comparatively high. Most respondents agreed that EBM knowledge would be useful for clinical practice and the undergraduate curriculum. Barriers to enhance EBM education were perceived to be lack of resources and appropriate contents.</P> <P><B>Conclusion</B></P> <P>This first nationwide survey in Korea investigated the experience, perception, and demand for EBM education by KM college students. The importance of EBM education in the KM curriculum needs further improvement and curriculum development based on the students' experiences and perceptions. Additionally, online survey in smartphone environment, which was conducted thorough involvement of student’s representatives seems to be an eligible strategy for a survey of students.</P>

Fruit of Gardenia jasminoides Induces Mitochondrial Activation and Non-shivering Thermogenesis through Regulation of PPARγ

Woo Yong Park,Jungtae Leem,Jinbong Park,Jae-Young Um 한국식품영양과학회 2021 한국식품영양과학회 학술대회발표집 Vol.2021 No.10

The extract of the Gardenia jasminoides fruit (GJFE) can be consumed as an herbal tea or used as a yellow dye. We evaluated the thermogenic actions of GJFE by focusing on mitochondrial activation and studying the underlying mechanisms. To investigate the role of GJFE on thermogenesis in mice, we used an acute cold exposure model. After 2 weeks of feeding, the cold tolerance of GJFE-fed mice was notably increased compared to PBS-fed mice. Moreover, GJFE significantly increased thermogenic factors such as PPARγ, UCP1, and PGC1α in vitro as well. Factors related to mitochondrial abundance and functions were also induced by GJFE in white and beige adipocytes. However, the treatment of PPARγ inhibitor abolished the GJFE-induced changes, indicating that activation of PPAR γ is critical for the thermogenic effect of GJFE. In conclusion, GJFE induces thermogenic action by activating mitochondrial function via PPARγ activation. Through these findings, we suggest GJFE as a potential anti-obesity agent with a novel mechanism involving thermogenic action in white adipocytes.

Acupuncture for heart failure: A systematic review of clinical studies

Lee, Hojung,Kim, Tae-Hun,Leem, Jungtae Elsevier 2016 INTERNATIONAL JOURNAL OF CARDIOLOGY Vol.222 No.-

<P><B>Abstract</B></P> <P><B>Background</B></P> <P>Acupuncture has been used for treating heart failure mainly in combination with conventional treatments, but evidence for its effectiveness and safety has not been well established. Our aim was to review randomized controlled trials (RCTs) on acupuncture for heart failure and assess the clinical evidence.</P> <P><B>Methods</B></P> <P>Electronic databases such as Medline, EMBASE, Cochrane Central Register of Controlled Trials (CENTRAL) and certain Chinese & Korean databases were searched until October 2015. The main outcomes assessed were mortality, New York Heart Association (NYHA) function classifications, and acupuncture-related adverse events. The details of acupuncture intervention were also investigated.</P> <P><B>Results</B></P> <P>Among 4107 publications, seven RCTs were included; most of them showed considerable methodological flaws. We could not conduct a meta-analysis because of the heterogeneity of the included studies. In one acute heart failure study, acupuncture shortened intensive care unit (ICU) stay by 2.2days (95% CI 1.26, 3.14) and reduced the risk ratio of re-admission to 0.53 (95% CI 0.28, 0.99). However, mortality was not affected. Hemodynamic parameters also showed improvement. Another study reported an improved left ventricular ejection fraction by 9.95% (95% CI 3.24, 16.66). In five chronic heart failure studies, acupuncture improved exercise capacity, quality of life, hemodynamic parameters, and time domain heart rate variability parameters. Acupuncture decreased NT-pro BNP levels by 292.20 (95% CI −567.36, −17.04). No adverse effects were reported.</P> <P><B>Conclusions</B></P> <P>The effectiveness of acupuncture as a therapy for heart failure is currently inconclusive. Further large and rigorous clinical trials are needed to establish its clinical utility.</P>

Ephedrae Herba in combination with herbal medicine (Zhizichi decoction and Phellodendri Cortex) for weight reduction: a case series

Eunji Lee,Sang-Hoon Yoon,Hyunho Kim,Young Doo Kim,Jungtae Leem,Jinbong Park 한국한의학연구원 2020 Integrative Medicine Research Vol.9 No.2

Backgrounds: Ephedrae Herba is widely used to treat obesity. There is a concern for adverse events (AEs) using it and we need to develop strategies to attenuate it without its effectiveness for weight-reducing potential. We investigated the effects of a combination of Ephedra Herba with Zhizichi decoction and Phellodendri Cortex (Anmyungambi (AMGB) decoction) in reducing the incidence of Ephedra Herba-related AEs. Methods: We performed a retrospective chart review from a clinical case series of patients visiting the Jaonmi Korean Medicine Clinic (Seoul, Korea). The inclusion criteria was patients who were prescribed AMGB decoction, (containing Ephedrae Herba, Phellodendri Cortex, and Zhizichi decoction [Gardeniae Fructus, and Glycine Semen Preparata] in different proportions) for weight reduction. Exclusion of Phellodendri Cortex in the original AMGB preparation was allowed; conventional medications, acupuncture, and dietary supplements were not allowed. The primary outcome was absolute weight loss at the end of treatment. Results: Twenty-seven patients (6 men and 21 women), aged 18–75 years (mean age, 42.6 ± 11.1 years) and the average treatment duration was 39.4 days. Absolute weight loss at the end of treatment was 4.49 ± 2.40 kg. Fifteen patients lost more than 5% weight (55.6%). Treatment >45 days resulted in significantly greater weight loss compared to treatment <30 days (p < 0.001). Not severe AEs were reported in 16 patients including constipation, fatigue, etc. Conclusion: A combination of Ephedra Herba with Zhizichi decoction and Phellodendri Cortex may be a safe and effective treatment for weight reduction in obese and overweight patients.