Clinical Research Trends and Evidence Level of Saam Acupuncture : A Systematic Review = 사암침법에 대한 기존 연구 동향 및 근거 수준 분석: 체계적 문헌 고찰

다국어 초록 (Multilingual Abstract)

Objectives: This study aimed to systematically review several works of literature on Saam acupuncture by analyzing the research trends and objectifying the level of evidence, thus providing a basis for its clinical use.

Methods (Design): Using eight search engines (RISS, OASIS, KTKP, KISS, ScienceON, PubMed, Cochrane Library, and Embase), 6,648 studies on the clinical use of Saam acupuncture published from January 1st, 2000, to December 31st, 2020 were retrieved. Among the articles collected, the followings were excluded from the screening process: studies that were duplicates and unrelated to the topics, studies that did not use Saam acupuncture for a therapeutic purpose, studies that did not specify the main symptom or acupuncture method used, studies with acupoints constituting Saam acupuncture were partly modified, in vivo studies, in vitro studies, systematic reviews, dissertations, theses, protocols, and abstracts.
The selected papers were classified into case reports and clinical trials, and research trends analysis on disease and symptom classification, main symptom, acupuncture method, and intervention type for each study was conducted. A network analysis using Gephi version 0.9.7 was also conducted to identify the association between Saam acupuncture with the main symptoms.
A systematic review of clinical trials on bibliographic information, main symptom, the number of study subjects, acupuncture method, intervention type, randomization, statistical analysis, experimental group, comparative group, rating, and study result was conducted. The evidence level and risk of bias in the clinical trials were analyzed using the Scottish Intercollegiate Guideline Network and the Risk of Bias.

Results: Among the 148 analyzed research papers, there were 122 case reports and 26 clinical trials. Studies using Saam acupuncture in combination with other types of interventions were the most common with 109 cases, and the number of studies on 'Diseases of the Nervous System' was the highest, with 24 cases. Warts, tremors, amyotrophic lateral sclerosis, tension-type headaches, insomnia, dyskinesia, low back pain, hearing loss, postpartum diseases, oculomotor nerve palsy, nummular eczema, allergic dermatitis, atopic dermatitis, psoriasis, calcific tendonitis of supraspinatus, shoulder pain, and dysmenorrhea were the main symptoms mentioned in at least two related case reports. Small Intestine Jeonggyeok, Liver Jeonggyeok, Lung Jeonggyeok, Gall Bladder Jeonggyeok, Bladder Jeonggyeok, and Large Intestine Jeonggyeok were used for the treatments of these symptoms. In the network analysis of case reports, the use of Stomach Jeonggyeok, Small Intestine Jeonggyeok, Kidney Jeonggyeok, Liver Jeonggyeok, Lung Jeonggyeok, Liver Seunggyeok, Spleen Jeonggyeok, and Large Intestine Jeonggyeok accounted for the largest proportion among the acupuncture methods used in case reports.
A clinical trial was conducted on a wart, temporomandibular disorder, tension-type headache, amyotrophic lateral sclerosis, stroke, bell's palsy, insomnia, low back pain, fatigue, post-traumatic stress disorder, Hwa-Byung, obesity, diabetes mellitus, myopia, knee osteoarthritis, dysmenorrhea, and hypertension. In the 12 clinical trials, Saam acupuncture was used in combination with other types of interventions. Warts, amyotrophic lateral sclerosis, low back pain, and Hwa-Byung were the main symptoms for which there were two or more related clinical trials. Small Intestine Jeonggyeok, Lung Jeonggyeok, Bladder Jeonggyeok, Kidney Jeonggyeok, and Pericardium Jeonggyeok were used to treat these symptoms. In the network analysis of clinical trials, tension-type headaches, amyotrophic lateral sclerosis, knee osteoarthritis, low back pain, Hwa-Byung, Small Intestine Jeonggyeok, Gall Bladder Jeonggyeok, Liver Jeonggyeok, Bladder Jeonggyeok, and Spleen Jeonggyeok accounted for the largest proportion.
In the clinical trials, 20 studies had at least one comparative group, and randomization was done in 15 studies. The level of evidence for most clinical trials evaluated by the Scottish Intercollegiate Guideline Network was 1+ to 1- (8 cases). In the Risk of Bias evaluation, 'Uncertainty' was the most checked item. Lack of study methods and results description (random sequence generation, allocation concealment, blinding, and dropout or exclusion) and the simultaneous use of multiple interventions were major factors that increased the risk of bias.
Among all the papers, the articles that showed the most substantial evidence (1++ ~ 1+) were the studies using Pericardium Jeonggyeok for Hwa-Byung. In clinical trials, studies on fatigue (Spleen Jeonggyeok, Kidney Yeolgyeok), low back pain (Kidney Jeonggyeok), and knee osteoarthritis (Spleen Jeonggyeok, Liver Jeonggyeok, Gall Bladder Jeonggyeok, Bladder Jeonggyeok) had a relatively high level of evidence (1+ ~ 1-).
In case reports, studies on warts (Small Intestine Jeonggyeok), oral leukoplakia (Gall Bladder Jeonggyeok), glossitis (Heart Hangyeok), hemorrhoids (Large Intestine Hangyeok), low back pain (Lung Seunggyeok), muscle cramp (Liver Jeonggyeok), blepharospasm (Stomach Seunghangyeok), and cystitis (Kidney Jeonggyeok) using only one type of Saam acupuncture, and studies on warts (Small Intestine Jeonggyeok), tremors (Liver Jeonggyeok), amyotrophic lateral sclerosis (Liver Jeonggyeok, Lung Jeonggyeok), insomnia (Gall Bladder Jeonggyeok), low back pain (Gall Bladder Jeonggyeok, Bladder Jeonggyeok), nummular eczema (Large Intestine Jeonggyeok, Lung Jeonggyeok), allergic dermatitis (Large Intestine Jeonggyeok, Lung Jeonggyeok), atopic dermatitis (Large Intestine Jeonggyeok, Lung Jeonggyeok), and dysmenorrhea (Small Intestine Joenggyeok) with two or more related case reports were considered to be more reproducible

Conclusions: Studies judged to have a high level of evidence and high reproducibility in this study can be referred primarily when using Saam acupuncture for the treatment. However, various biases, such as lack of study method description, simultaneous use of multiple interventions, unclear target symptoms, and reason for using Saam acupuncture may be inherent in the related studies. To clearly understand the clinical use range of Saam acupuncture, additional follow-up studies are required.

국문 초록 (Abstract)

연구 목적: 본 연구는 사암침법에 대한 기존 연구 동향을 분석하고 근거 수준의 객관화를 탐색하여, 임상 활용의 기초가 되는 체계적 문헌 고찰을 시행하고자 하였다

연구 방법: 검색 엔진인 RISS, OASIS, KTKP, KISS, ScienceON, PubMed, Cochrane Library, Embase를 사용해 2000년 1월 1일부터 2020년 12월 31일까지 발표된 사암침법 관련 임상 연구 6,648편을 검색하였다. 이 중 중복에 해당하는 논문, 주제와 관련이 적은 논문, 사암침법을 치료 목적으로 사용하지 않은 논문, 주요 질환이나 사용된 침법을 확인할 수 없는 논문, 침법의 혈자리를 임의로 변경해 사용한 논문, 실험 논문, 체계적 문헌 고찰 논문, 학위 논문, 프로토콜이나 초록만 제시한 논문을 분석에서 제외하였다
선별된 논문을 증례 보고와 임상시험으로 분류해 질병 분류, 주요 증상, 사용 침법, 중재 유형에 대한 연구 동향 분석을 시행하였으며, Gephi를 통한 네트워크 분석을 통해 사압침법과 주요 증상 사이의 관계를 파악하였다.
임상시험 논문의 서지 정보, 주요 증상, 연구 대상자 수, 사용 침법, 중재 유형, 무작위화 여부, 통계 분석 여부, 실험군, 비교군, 평가 척도, 연구 결과에 대한 체계적 문헌 고찰을 시행하였으며, Scottish Intercollegiate Guideline Network와 Risk of Bias 척도를 사용해 임상시험 논문의 근거 수준 및 편향 위험을 분석하였다.

연구 결과: 분석 대상으로 148편이 선정되었으며, 증례 보고는 122편, 임상시험은 26편이었다. 증례 보고 중에서는 사암침법과 다른 치료법을 함께 사용한 연구가 109편으로 가장 많았으며, 국제 질병 분류 상으로는 'Diseases of the Nervous System'에 해당하는 연구가 24편으로 가장 높은 비중을 차지했다. 사마귀, 떨림, 근위축성 측삭경화증, 긴장형 두통, 불면증, 운동이상증, 요통, 난청, 산후병, 동안신경마비, 화폐상 습진, 알레르기 피부염, 아토피 피부염, 건선, 극상근 석회화 건염, 어깨 통증, 월경통에 대한 증례 보고는 2편 이상 존재하였으며, 치료 중재로는 소장정격, 간정격, 폐정격, 담정격, 방광정격, 대장정격이 주로 사용되었다. 네트워크 분석에서는 위정격, 소장정격, 신정격, 간정격, 폐정격, 간승격, 비정격, 대장정격이 증례 보고에 사용된 치료 중재 중 높은 비중을 차지함을 확인할 수 있었다.
임상시험은 사마귀, 측두하악장애, 긴장형 두통, 근위축성 측삭경화증, 뇌졸중, 벨마비, 불면증, 요통, 피로, 외상 후 스트레스 장애, 화병, 비만, 당뇨, 근시, 무릎 관절염, 월경통, 고혈압을 대상으로 시행되었으며. 그 중 12편이 사암침법과 다른 치료법을 함께 사용한 연구였다. 사마귀, 근위축성 측삭경화증, 요통, 화병에 대한 임상시험 논문은 2편 이상 존재하였으며, 치료 중재로는 소장정격, 폐정격, 방광정격, 신정격, 심포정격 등이 활용되었다. 네트워크 분석 결과, 질환 중에서는 긴장형 두통, 근위축성 측삭경화증, 무릎 관절염, 요통, 화병이, 치료 중재로는 소장정격, 담정격, 간정격, 방광정격, 비정격의 활용이 임상시험 논문 중 높은 비중을 차지함을 확인할 수 있었다.
임상시험 논문 중 비교군이 존재하는 연구는 20편, 무작위화가 이루어진 연구는 15편이었으며, 연구별 근거 수준의 경우 Scottish Intercollegiate Guideline Network 기준 중 1+ ~ 1-에 해당하는 논문의 수가 8편으로 가장 많았다. Risk of Bias 척도를 사용한 편향 위험 평가에서는 '불확실' 항목에 해당되는 경우가 가장 많았으며, 무작위 배정 순서 생성, 배정 순서 은폐, 눈가림, 탈락 혹은 배제 관련 정보와 같은 연구 방법 및 결과에 대한 서술 부족, 여러 중재의 혼용 등이 편향 위험을 높이는 주된 원인에 해당하였다.
분석 대상 중 화병에 심포정격을 사용한 연구가 가장 높은 근거 수준(1++ ~ 1+)을 보였으며, 임상시험의 경우 피로(비정격, 신열격), 요통(신정격), 무릎 관절염(비정격, 간정격, 담정격, 방광정격)에 대한 연구가 상대적으로 높은(1+ ~ 1-) 근거 수준을 나타냈다.
증레 보고의 경우, 단독 중재를 활용한 사마귀 (소장정격), 구강백반증 (담정격), 설염 (심한격), 치질 (대장한격), 요통 (폐승격), 전근 (간정격), 안검경련 (위승한격), 방광염 (신정격)에 대한 보고와, 관련 연구가 2편 이상 존재하는 사마귀(소장정격), 떨림(간정격), 근위축성 측삭경화증(간정격, 폐정격), 불면(담정격), 요통(담정격, 방광정격), 화폐상 습진(대장정격, 폐정격), 알레르기 피부염(대장정격, 폐정격), 아토피 피부염(대장정격, 폐정격), 월경통(소장정격)에 대한 보고가 다른 증례 보고 논문에 비해 상대적으로 높은 재현성을 나타냈다.

결론: 사암침법을 치료 목적으로 사용할 경우, 본 연구에서 근거 수준과 재현성이 높다고 판단된 논문들을 우선적으로 참고해볼 수 있을 것이다. 다만 연구 설계 방법에 대한 서술 부족, 여러 중재의 혼용, 불명확한 주증상 및 침법 사용 근거 등 다양한 편향이 관련 연구에 내제되어 있을 수 있으며, 사암침법의 임상 활용 범위를 보다 명확하게 파악하기 위해서는 상기한 부분이 보완된 추가적 후속 연구의 진행이 필요할 것으로 사료된다. 

목차 (Table of Contents)

• I. Introduction 1
• II. Methods 3
• 1. Data Sources and Eligibility Criteria 3
• 2. Data Collection 6
• 3. Data Analysis and Quality Assessment 8
• III. Results 13
• 1. Research Trends of Saam Acupuncture 13
• 2. Evidence Level of Saam Acupuncture 27
• IV. Discussion 41
• V. Conclusion 48

참고문헌 (Reference)

1. A case report of breast cancer, Kim S , Yoo D., 14 ( 2 ) :189-95 ., , 2005

2. A case report of verruca plana, Lee H , Lee BH, 41 ( 3 ) :7-17 ., , 2016

3. A case report of Sanghanhaehu Yeolgyeog, Kim DJ, 32 ( 3 ) :31-43 ., , 2007

4. A clinical report of seborrheic dermatitis, Bae HJ , Jo GW , Choi YJ , Heo ES , Hwang CY, 27 ( 4 ) :200-8. http : //doi.org/10.6114/jkood.2014.27.4.200 ., , 2014

5. A case of postpartum syndrome with coccygodynia, Lee DN , Kim HJ , Moon YC , Lim EM ., 15 ( 1 ) :231-9 ., , 2002

6. A case report about iatrogenic Cushing syndrome, Lee BR , Kang YG , Jeong HR , Kim KM , Cho SW , Kim WI, 23 ( 1 ) :133-40. http : //doi.org/10.14374/HFS.2015.23.1.133 ., , 2015

7. A case study of Soyangin hyperthyroidism patient, Yi JW , Choi JS , Jang MH , Ahn TW, 21 ( 2 ) :149-56 ., , 2013

8. Glossitis treated with acupuncture : Case series, Noh HM , Park SG , Park HJ , Jung HM , Kim JW , Jo EH , et al, 29 ( 3 ) :197-207. http : //doi.org/10.6114/jkood.2016.29.3.197 ., , 2016

9. One case treated degenerated HIVD by Bunsimki-um, Kim DW , Ahn KP , Lee SS , Song KS, 6 ( 1 ) :33-8 ., , 2000

10. A clinical study on primary dysmenorrheic patient, Park H , Hong K , Lee B, 13 ( 1 ) :255-60 ., , 2004

11. A clinical study on 3 cases in submaxillary tremor, Yang HS , Kim JH , Guk YJ , Baek DG , Kim TH , Kang HW et al, 15 ( 1 ) :187-96 ., , 2004

12. A case report of proteinuria with Sjogren 's syndrome, Jeong J , Kim S , Sun S , Kim B ., 11 ( 4 ) :95-9 ., , 2008

13. Two cases of atopic dermatitis treated with Huini-san, Jo SH , Jo EH , Kim SJ , Park IH , Park MC, 27 ( 3 ) :180-90. http : //doi.org/10.6114/jkood.2014.27.3.180 ., , 2014

14. A case of nummular dermatitis with allergic dermatitis, Lim KM , Choi JH , Park SY , Kim JH , Kim SJ , Shin JC , et al, 28 ( 3 ) :135-44. http : //doi.org/10.6114/jkood.2015.28.3.135 ., , 2015

15. A case report of chronic insomnia diagnosed Blood Stasis, Kim DH , Lee YC , Kim BK, 28 ( 2 ) :137-43. http : //doi.org/10.7231/jon.2017.28.2.137 ., , 2017

16. Case report of two cases of the oculomotor nerve palsy ., Noh HM , Park SG , Jo EH , Park MC, 34 ( 3 ) :156-63. http : //doi.org/10.14406/acu.2017.013 ., , 2017

17. The clinical observation on 1 case of multiple sclerosis, Knag SI , Park WT , Koo CM , Kim YS, 8 ( 1 ) :34-45 ., , 2002

18. The effect of Sa-am acupuncture on knee osteoarthritis ., Min MH , Choi YG , Kim YJ , Park HJ , Lee SC , Joo HN , et al, 26 ( 4 ) : 53-66 ., , 2009

19. Two cases of hemorrhoid treated with SaAhm acupuncture ., Chung S , Kim Y ., 16 ( 3 ) :252-9 ., , 2003

20. A clinical study on a case of arrhythmia after stillbirth, Kim JH , Kang NH , Park KI , Park YK , Hwang DS , Lee JM , et al, 29 ( 1 ) :127-34. http : //doi.org/10.15204/jkobgy.2016.29.1.127 ., , 2016

21. A case report of benign paroxymal positional vertigo patient, Jeong DL , Hong SU, 21 ( 2 ) :198-205 ., , 2008

22. A report on the insomnia treated successfully by acupuncture ., Lee HS , Lim SC , Kim JS , Lee YK , Lee HJ , Han CH , et al ., 31 ( 4 ) :234-9. http : //doi.org/10.14406/acu.2014.033 ., , 2014

23. Report on a ankle pain by contusion treated with acupuncture ., Bae HY , Lee BH, 42 ( 2 ) :43-9 ., , 2017

24. The study of a case about dermatitis exfoliativa by drug eruption, Jun SK , Kim JH , Kim MH , Shin SH , Yoon HJ , Ko WS , et al, 19 ( 1 ) :145-54 ., , 2006

25. A case of prurigo nodularis with improvement of intestinal bacillus, Weon YH , Cho YC, 30 ( 3 ) :250-7. http : //doi.org/10.6114/jkood.2017.30.3.250 ., , 2017

26. Clinical study on Sa-am acupuncture of insomnia in traffic accident, Shin K , Lee S , Park K , Cho J, 10 ( 2 ) :51-60, , 2004

27. End stage renal disease caused by IgA nephropathy : One case report, Jeong JJ , Sun SH, 27 ( 6 ) :823-6 ., , 2013

28. Korean acupuncture : The individualized and practical acupuncture ., Yin CS , Park HJ , Chae Y , Ha E , Park HK , Lee HS , et al, 29 ( 1 ) :10-5. http : //doi.org/10.1179/016164107X172301 ., , 2007

29. A case of allergic contact dermatitis aggravated by steroid ointment, Song MS , Yoon HJ , Ko WS, 31 ( 3 ) :107-15. http : //doi.org/10.6114/jkood.2018.31.3.107 ., , 2018

30. The clinical study on spinocerebellar ataxia with cerebellar atrophy, Lee JL , Ha KS , Kim SM , Ha SY , Song IS, 19 ( 2 ) :41-50, , 2005

31. 6 Case series of the chronic pelvic pain by Korean medicine therapies, Kim JH , Kang NH , Chae MS , Hwang DS , Lee JM , Lee CH , et al, 28 ( 2 ) :143-55. http : //doi.org/10.15204/jkobgy.2015.28.2.143 ., , 2015

32. A case study of a Taeyangin patient with amyotrophic lateral sclerosis, Kim SH , Lee MS , Park YG , Bae NY ., 28 ( 3 ) :300-8. http : //doi.org/10.7730/JSCM.2016.28.3.300 ., , 2016

33. Disappearance of an adnexal mass with Saam acupuncture : A case report, Seo JC , Kwon OC , Kwon HJ , Chung DK , Cho YJ , Lee GH, 32 ( 1 ) :81-3. http : //doi.org/10.1136/acupmed-2013- 010397 ., , 2014

34. Acupuncture for refractory cases of sudden sensorineural hearing loss ., Yin CS , Park HJ , Nam HJ, 16 ( 9 ) :973-8. http : //doi.org/10.1089/acm.2009.0542 ., , 2010

35. The clinical study on 2 cases of atrophic vaginitis in menopausal women, Kang NH , Kim JH , Park NC , Yoo ES , Lee JM , Lee CH , et al, 29 ( 4 ) :34-45. http : //doi.org/10.15204/jkobgy.2016.29.4.034 ., , 2016

36. A case of acute allergic contact dermatitis with multiple nummular eczema, Jang IW , Jang JH , Yoon HJ , Ko WS, 27 ( 4 ) :243-50. http : //doi.org/10.6114/jkood.2014.27.4.243 ., , 2014

37. A case report on the CVA patient with the sense disorder of equilibrium ., Lim HS , Kim JB, 17 ( 5 ) :1339-42 ., , 2003

38. A case of nummular eczema treated by Chijageongangtang and Korean medicine, Jin HS , Yoon HJ, 33 ( 1 ) :89-97. http : //doi.org/10.6114/jkood.2020.33.1.089 ., , 2020

39. A clinical review of Chunghunwhadam-tang in dizziness and vertigo patients, Lee SH , Kim SG , Ra SY , Kim MS , Yoon KB, 7 ( 1 ) :92-9 ., , 2001

40. Two different cases of psoriasis patients treated with 2 different Kobangs, Moon YH , Oh JS , Kim SJ, 28 ( 6 ) :650-6, , 2014

41. A case report of postpartum disease induced by inadequate postpartum care ., Kim ES , Lee JM , Lee CH , Cho JH , Jang JB , Lee KS ., 20 ( 3 ) :238-45 ., , 2007

42. A case study of Sa-Am acupuncture in knee pain caused by traffic accident ., Lee S , Lim S , Lee S., 5 ( 1 ) :35-44 ., , 2008

43. Clinical study on 1 case of Soyangyin patient diagnosed as Crohn 's disease, Lee SH , Park DS, 21 ( 5 ) :1346- 51, , 2007

44. A casuistics of two Whabyong cases by Simseunggyok of the Saam acupuncture ., Ahn BS , Lee BR ., 11 ( 1 ) :151-62 ., , 2002

45. A clinical study of two patients suffering from normal pressure hydrocephalus, Cho BH , Yu BC , Kim YS , Seol IC, 22 ( 1 ) :43-53 ., , 2005

46. Treatment of influenza A virus infection in a Soeumin patient ; a single case, Jeon H , Lee S., 30 ( 2 ) :55-63. http : //doi.org/10.7730/JSCM.2018.30.2.55 ., , 2018

47. A case report on secondary dysmenorrhea with herlyn-werner-wunderlich syndrome, Kim PW , Im JY , Jeon YT , Lee EH, 29 ( 4 ) :69-79. http : //doi.org/10.15204/jkobgy.2016.29.4.069 ., , 2016

48. 3 Case reports of tension-type headache Taeeumin patients using Melonis Pedicus, Kim JS , Oh HW , Lee JH , Koh BH , Lee EJ, 26 ( 4 ) :409-21. http : //doi.org/10.7730/JSCM.2014.26.4.409 ., , 2014

49. Clinical study on the remedial effect of oriental medicine used EAV ( Meridian ), Chang B , Jin K , Kim J , Yang M , Kim I , Mun H , et al, 19 ( 6 ) :80-96 ., , 2002

50. Korean medicinal in-patient treatments for chronic renal disease : 2 Case report, Oh JM , Jung ES , Choi KE , Heo JW , Kim HT , Ryu JY , et al, 30 ( 4 ) :289-99. http : //doi.org/10.15188/kjopp.2016.08.30.4.289 ., , 2016

51. A case report of Damyum back pain , the treatment Saam acupuncture ( Damyumbang ), Yang C , Song H., 3 ( 1 ) :59-61 ., , 2006

52. A case study on steroid rebound phenomenon after steroids treatment for pompholyx, Shin SH , Yun JM , Heo JE , Ko WS , Yoon HJ, 27 ( 3 ) :155-61. http : //doi.org/10.6114/jkood.2014.27.3.155 ., , 2014

53. Effects of local and Sa-am acupuncture on Hypoadrenia and chronic low back pain ., Kim SM , Kim HJ , Lee MJ , Shin YJ, 30:104-16, , 2009

54. A case report of interstitial cystitis treated with Sa-am acupuncture treatments ., Im Y , Hwang W., 29 ( 2 ) :107-13 ., , 2012

55. A case reports of a patient with Sjogren 's syndrome treated with Gami-onchung-eum, Jeong Y , Park C , Kim J ., 38 ( 5 ) :763-8. http : //doi.org/10.22246/jikm.2017.38.5.763 ., , 2017

56. A clinical study on the case of ankylosing spondylitis treated by oriental therapy, Jin KS , Chang BS , Hwang WJ, 8 ( 2 ) :1-10, , 2002

57. Clinical study of oriental medical treatment 1 case of patient with oral dyskinesia, Hwang KJ , Yang GY , Jang SG , Kim YH , Hong KE , Lee H et al, 19 ( 1 ) :262-9 ., , 2002

58. The clinical observation of 5 cases of tinnitus with physical conditions and myology, Kim HJ , Park SY , Kim JH , Choi JH, 14 ( 2 ) :146-53 ., , 2001

59. Case report : A case of Liver Seunggyeok Sa-am acupuncture on coldness of both feet ., Jang E , Kim H , Yoon G , Lee S., 8 ( 1 ) :61-9 ., , 2011

60. Case of persistent hiccup that ensued on aspiration pneumonia after pontine infarction, Lee SH , Jeong JJ , Kim SY , Song CH , Sun SH , Baek TH, 22 ( 6 ) :1621-5, , 2008

61. Clinical report of an aspect Soyangyangmyunghabbyung patient with acute pyelonephritis, Moon MH , Cho YK , Gug YJ , Park JY , Choi CH , Hur JC , et al, 19 ( 6 ) :1706-9, , 2005

62. Recent study trends of the Liver-tonification and Liver-sedation of Saam acupuncture ., Yoon MJ , Kim SY , Park JY, 35 ( 1 ) :1-17. http : //doi.org/10.14406/acu.2018.004 ., , 2018

63. Two cases report of herpes zoster patients improved by Korean medicine treatment alone, Bae JR , Kim SJ , Jang SC , Pi CM , Roh JH, 16 ( 1 ) :116-36 ., , 2016

64. A case Report on laryngopharyngeal reflux combined with depressive and anxiety disorder, Ahn S , Moon H , Lee S , Shin S , Choo W , Choi Y, 38 ( 5 ) :650-7. http : //doi.org/10.22246/jikm.2017.38.5.650 ., , 2017

65. A case report of a patient who was suspected osteitis pubis treated with Korean medicine, Lee H , Na G , Kim E , Kim C , Yang T , Jeong S , et al, 24 ( 4 ) :377-83. http : //doi.org/10.14374/HFS.2016.24.4.377 ., , 2016

66. A case report of delayed vascular chorea patient treated with Sukjihwangbogan-tang-gagam, Ok H , Park Y , Lim B , Kwon D , Choi M , Nam S., 37 ( 5 ) :741-9. http : //doi.org/10.22246/jikm.2016.37.5.741 ., , 2016

67. CRPS type-1 patient treated with acupuncture and Bee-venom acupuncture : A case report ., Ko J , Kim J , Lee J , Nam S , Choi D., 26 ( 3 ) :165-70 ., , 2009

68. New interpretation on 'MyeonGu ' of Baekho-tang text of Shanghanlun through case reports, Hong JE , Park MC , Kang SJ , Yang GJ , Jo EH, 34 ( 1 ) :45-52. http : //doi.org/10.15188/kjopp.2020.02.34.1.45 ., , 2020

69. The effect of Sa-am acupuncture Simjeongkyeok treatment for major symptom of Hwa-byung ., Jeong IC , Lee SR , Park YC , Hong KE , Lee YK , Kang WC , et al, 19 ( 1 ) :1-18 ., , 2008

70. A case report of thoracic outlet syndrome improved by integrated Korean medical treatment, Lee DG , Lee OJ , Lee JH , Lee SH , Lee JH , Cheong MS , et al ., 31 ( 2 ) :173-82. http : //doi.org/10.13045/acupunct.2014035 ., , 2014

71. Effects of Sa-am acupuncture treatment on a ALS ( amyotrophic lateral sclerosis ) patient, Lee S , Kim S , Jeong H , Park M , Lee J , Park O , et al, 29 ( 5 ) :187-95 ., , 2012

72. One case report of inflammatory acne treated with the Ko-Bang and the Sa-am acupuncture ., Kim HY , Sung EJ , Yun CS , Yun C , An MS , Kim HY , et al, 21 ( 3 ) :226-34 ., , 2008

73. A clinical report of 6 patients with oromandibular tremor diagnosed as Deficiency syndrome, Jin MK , Choi YH , Kim BK, 26 ( 3 ) :267-82. http : //doi.org/10.7231/jon.2015.26.3.267 ., , 2015

74. A clinical study on abducens nerve palsy patient improved with traditional Korean medicine, Jo EH , Noh HM , Park SG , Lee YJ , Park MC, 29 ( 2 ) :123-9. http : //doi.org/10.6114/jkood.2016.29.2.123 ., , 2016

75. A case report of progressive pigmented purpuric dermatosis improved with Jibaekjihwang-tang, Kim HJ , Kim TY , Lee CW , Kim CH ., 26 ( 2 ) :109-16. http : //doi.org/10.6114/jkood.2013.26.2.109 ., , 2013

76. A case of chronic allergic contact dermatitis treated with Oryeong-san-based Korean medicine, Song MS , Yoon HJ , Ko WS, 33 ( 2 ) :186-96. http : //doi.org/10.6114/jkood.2020.33.2.186 ., , 2020

77. A pilot study of Sa-am acupuncture treatment used by Sham acupuncture for the simple obesity, Kim S , Jang E , Na W , Lee S , Lee J , Moon H , et al, 24 ( 5 ) :67-88 ., , 2007

78. Cancer pain relieved by acupuncture on a patient with colorectal cancer : Single case report, Song JY , Jerng UM , Jeong JS , Park JW , Yoon SW., 14 ( 1 ) :37-44 ., , 2009

79. A clinical case study of low back pain caused by the herniated lumbar disc in Soeumin patient, Kim HH , Kim EY , Kim KS , Lim EC , Jung KS , Yoon HS, 16 ( 3 ) :108-13, , 2004

80. International statistical classification of diseases and related health problems ( 11th ed. ), World Health Organization, http : //icd.who.int/, , 2019

81. A case report for an eating disorders with Banhabaeckchulchunma-tang and acupuncture treatment, Jung DH , Shin WS , Park WH , Cha YY , Choi WJ, 15 ( 1 ) :45-50. http : //doi.org/10.15429/jkomor.2015.15.1.45 ., , 2015

82. Literature review and network analysis on the pain disease approach of Saam acupuncture method, Park J-Y , Lee S-H , Kim S-Y , Park H-J, 34 ( 2 ) :88-99. http : //doi.org/10.14406/acu.2017.011 ., , 2017

83. The clinical observation on 47 cases of patients with blepharospasm treated by Wisunghanggyeok, Park JH , Hong SU, 22 ( 2 ) :153-62 ., , 2009

84. The effect of Sa-am acupuncture treatment for major symptom of Hwa-byung : A preliminary study, Jung IC , Lee SR , Park YC , Hong KE , Koo YS , Jo JH , et al, 18 ( 1 ) :79-94 ., , 2007

85. A case study of a Taeyangin patient with vertebrobasilar insufficient after mistreat as Taeeumin, Kang SH , Jeon SH , Na YJ , Kim JW, 28 ( 4 ) :338-49. http : //doi.org/10.7730/JSCM.2016.28.4.338 ., , 2016

86. Three cases of verruca vulgaris treated mainly with Gwakhyangjeonggisangamibang and moxibustion ., Moon YK , Jeong WY , Shin JH , Kim YB , Nam HJ , Kim KS, 28 ( 2 ) :93-101 ., , 2015

87. A case report on right elbow pain caused by lateral epicondylitis treated with Sa-Am acupuncture ., Lee H , Jo J , Ahn J , Choi J , Yoon K , Kang J ., 12 ( 1 ) :35-48 ., , 2014

88. A clinical case study on the burst fracture patient improved by Saam acupuncture and herbal medicine, Ji M , Lim S , Kim J , Lee H , Lee Y, 11 ( 1 ) :19-24, , 2014

89. A clinical study of acute low back pain treated by Chuna & general oriental therapy during pregnancy, Lee EH, 29 ( 3 ) :110-20. http : //doi.org/10.15204/jkobgy.2016.29.3.110 ., , 2016

90. A pilot clinical study on the traditional Korean medicine treatment of amyotrophic lateral sclerosis, Kim S , Na W , Lim N , Lee D , Jang E , Song B, 12 ( 1 ) :53-65 ., , 2009

91. Effect of Sa-am acupuncture method for chronic tension-type headache : A randomized controlled trial, Hong K , Park Y , Jo J , Jo H , Jeong I , Kang W , et al, 24 ( 1 ) :13-28 ., , 2007

92. Case of monocular partial oculomotor nerve palsy in a patient with midbrain and thalamus hemorrhage ., Rhee JH , Kim YE , Kim IW , Lee KS , Lee SG, 24 ( 2 ) :333-7 ., , 2010

93. A case study of a Taeeumin patient with olivopontocerebellar atrophy improved with Jowisengcheong-tang, Lee MS , Bae NY, 25 ( 3 ) :243-53. http : //doi.org/10.7730/JSCM.2013.25.3.243 ., , 2013

94. A case report of the geriatric stress urinary incontinence patient improved by Korean medical treatment, Park SH , Chae MS , Jang JB , Lee JM , Lee CH , Lee KS , et al ., 27 ( 4 ) :133-40. http : //doi.org/10.15204/jkobgy.2014.27.4.133 ., , 2014

95. A case report of the Sa-am acupuncture and other treatment for the tic disorder patient with tachycardia, Yang DH , Oh KM , Kim BK, 18 ( 3 ) :225-36 ., , 2007

96. Two case reports of facial flushing of women in their twenties treated by Sasang constitutional medicine, Yoon SH , Jeon SH , Lee IS, 30 ( 2 ) :153-62. http : //doi.org/10.15204/jkobgy.2017.30.2.153 ., , 2017

97. 1 Case of Shoulder Pain Treated with Oriental Treatment Including Pharmacopuncture in Rotator Cuff Surgery, Jeong JY , Kim JH , Song CH , Jang KJ , Kim CH , Youn HM, 29 ( 6 ) :119-25, , 2012

98. A clinical report on episodic vertigo with Meniere 's disease treated by Saam acupuncture Sojangjungkyuk ., Oh KC ., 16 ( 1 ) :35-44 ., , 2012

99. Combination therapy with Gwakhyangjeonggisangamibang and Sojangjeonggyeok for the treatment of verruca plana, Yun JM , Shin SH , Yoon HJ , Ko WS, 23 ( 1 ) :169-81 ., , 2010

100. Oriental medical treatment and sleep restriction therapy of the Simdamhugub type of chronic insomnia patients, Kim HJ , Chu CN , Kim JW , Shin HK , Cha HJ , Lee JW , et al, 18 ( 3 ) :277-87, , 2007

101. Effect of Sa-Am acupuncture Bladder Reinforcing method to Ryodoraku on the patients with chronic low back pain, Oh M , Song H., 29 ( 2 ) :37-42 ., , 2012

102. The effect of traditional Korean medical treatment on low back pain during pregnancy : A report on three cases, Lee SY , Ryu SH , Kim HG , Ryoo DW , Kim SJ , Jeong SM , et al, 33 ( 3 ) :197- 205. http : //doi.org/10.13045/acupunct.2016047 ., , 2016

103. A case study of a Taeeumin patient with advanced Parkinson 's disease diagnosed as Dry-heat symptomatic pattern, Lee MS , Park YG , Bae NY, 25 ( 4 ) :442-53. http : //doi.org/10.7730/JSCM.2013.25.4.442 ., , 2013

104. The efficacy of Korean medical treatment for recalcitrant hand and foot warts with an experience of cryotherapy, Shin SH , Yun JM , Heo JE , Ko WS , Yoon HJ, 28 ( 2 ) :33-44. http : //doi.org/10.6114/jkood.2015.28.2.033 ., , 2015

105. A clinical report on 1 case of the jaundice caused by the hepatic resection to eliminate intra hepatic duct stone, Choi Y , Choi S , Sim M , Sim Y, 26 ( 3 ) :634-40 ., , 2005

106. Comparative clinical study between the acupuncture treatment and the Chuna treatment on temporomandibular disorder, Kim TS , Kim CY , Lee KH , Um TW , Jung YH , Kho YT, 1 ( 1 ) :55-64, , 2006

107. A case report of tinnitus occurred in the sudden sensory neural hearing loss treated with Korean medical treatments, Park M , Lee C , Kim J , Hwang-bo M , Lee H., 22 ( 2 ) :133-41. http : //doi.org/10.14374/HFS.2014.22.2.133 ., , 2014

108. The effects of Sa-am acupuncture Simpojeongkyeok treatment on the blood pressure , pulse rate , and body temperature, Choi WJ , Cho YY , Sun SH, 18 ( 2 ) :33-41 ., , 2015

109. A case report of otitis media in three children treated with the Sa-Am acupuncture Bi-Jung-Geouk and Bojoong-Ikgi-Tang, Hong SW , Lee YS, 23 ( 1 ) :125-35 ., , 2006

110. A case report of insomnia and fatigue in alcoholic hepatitis patients treated with Korean medicine and western medicine, Nam H , Han S , Jeong I , Sun S , Kim M , Han I , et al, 41 ( 2 ) :186-93, , 2020

111. A case report of 2 patients taking antidepressants who were treated by Korean medical treatments and M & L psychotherapy, Hwang S , Park A , Song G , Lim G , Mo M , Park S., 28 ( 2 ) :73-81. http : //doi.org/10.7231/jon.2017.28.2.073 ., , 2017

112. A clinical study on the case of fascioscapulohumeral ( FSH ) muscular dystrophy treated with traditional Korean medicine, Lee J , An C , Kwon G., 18 ( 3 ) :227-38, , 2001

113. Clinical study on 1 case of Hemichorea-Hemiballism patients with diabetes mellitus treated by Saamchimbeop Ganjeonggyeok, Park S , Kang J , Kim D , Kim J , Yin C , Woo H , et al, 20 ( 4 ) :230-6 ., , 2003

114. A case report of a patient with obsessive-compulsive disorder ( OCD ) treated by Koran medical treatments and psychotherapy, Kim D , Hwang SH , Park A , Kim T , Park S., 27 ( 2 ) :67-76. http : //doi.org/10.7231/jon.2016.27.2.067 ., , 2016

115. A clinical study on acute cholecystitis improved with Five Phases acupuncture therapy and Pyengwi-powder modified formula ., Lee H , Song H., 4 ( 1 ) :81-5, , 2007

116. A clinical case study on the long term respiration management of amyotrophic lateral sclerosis patient with respiratory failure, Lee JC , Jeong HH , Cha EH , Park MY , Kim TH , Song BK , et al ., 31 ( 3 ) :67-73. http : //doi.org/10.13045/acupunct.2014044 ., , 2014

117. A clinical study on 3 cases of complications after total thyroidectomy and neck dissection in the papillary thyroid carcinoma ., Park EY , Gwen HG , Kong BC , Kim DC ., 26 ( 3 ) :103-13 ., , 2013

118. A case report of patients with calcific tendinitis located at supraspinatus treated by oriental therapy including sweet bee venom, Lee Y , Kim C , Lee K., 29 ( 2 ) :89-97 ., , 2012

119. Case reports : Effect of M & L psychotherapy and Korean medical treatment on psychiatric & physical symptoms of North Korean Defectors, Lee H , Kang D , Lim M , Kim D , Sue J, 27 ( 3 ) :185-96. http : //doi.org/10.7231/jon.2016.27.3.185 ., , 2016

120. A case report of left shoulder pain from calcific tendinitis located at supraspinatus treated with Sa- Am acupuncture Sojangjeounggyeok, Lee J , Lee S , Yoon K , Kim E , Choi D , Kim J ., 10 ( 1 ) :35-45 ., , 2013

121. Comparison study on 30 cases of HIVD Patients with restricted on SLRT by Sa-Am acupuncture Banggwangjeonggyeok and general acupuncture ., Yoon K , Lee H , Kang J , Choi J, 27 ( 5 ) :79-87 ., , 2010

122. Report of two cases of shoulder pain diagnosed through MRI as partial tear of supraspinatus tendon treated by oriental medical treatment, Jeong DU , Song SC , Yeo KC , Kim KY , Lee HJ , Moon SI ., 30 ( 1 ) :163-72 ., , 2009

123. The clinical observation on 2 cases of patients with postherpetic neuralgia treated by Sa-am acupuncture and Arctii Fructus water extract, Nam S , Lee H., 13 ( 2 ) :259-65 ., , 2004

124. The effects of Sa-am acupuncture treatment on respiratory physiology parameters in amyotrophic lateral sclerosis patients : A pilot study ., Lee S , Kim S., 2013:506317. http : //doi.org/10.1155/2013/506317 ., , 2013

125. A case report of both lower limb dysesthesia after myelotomy treated with traditional Korean medicine treatment focusing on Saam acupuncture, Park JH , Kim S , Kwon M , Cho D , Lee S , Kim J , et al ., 12 ( 1 ) :1-9 ., , 2015

126. Effect of Sa-am acupuncture treatment on the dysmenorrhea ( Pilot study , single blind , randomized , Sham acupuncture , controlled clinical trial ), Lee I , Yoon H , Jung K , Kim S , Min Y , Kim C , et al, 24 ( 3 ) :63-79 ., , 2007

127. Study of the effects of Sa-am acupuncture on upper limb spasticity in patients with chronic post-stroke hemiparesis using real-time sonoelastography, Baek K , Kwon D , Park G., 35 ( 1 ) :1-11 ., , 2014

128. A clinical study on the case of diffuse idiopathic skeletal hyperostosis ( DISH ) treated with traditional Korean medicine , especially Korean Bee-venom therapy, Moon I , Choi S , Lim H , Seo W., 19 ( 4 ) :225-33, , 2002

129. The effects of Sa-am acupuncture Simpojeongkyeok treatment on Hwa-byung : Randomized , patientassessor blind , placebo-controlled acupuncture , pilot clinical trial, Choi WJ , Lee SG , Son IB , Sun SH, 22 ( 2 ) :1-13. http : //doi.org/10.7231/JON.2011.22.2.001 ., , 2011

130. A case report of a stroke patient with Korean medicine diagnosed with a catheterassociated urinary tract infection caused by multidrug-resistant pseudomonas aeruginosa, Jang C , Kim H , Hwang G , Yu K , Lee S , Kim J , et al ., 37 ( 6 ) :1042-50. http : //doi.org/10.22246/jikm.2016.37.6.1042 ., , 2016

131. Clinical observation of improvement made by prescription of Liver Supplementation on a case of essential tremor patient who was operated DBS ( Deep Brain Stimulation ), Yang D , Lee K , Shin H , Jo S , Lim C , Lim J , et al, 27 ( 6 ) :123-31, , 2010

132. Comparison of the improvement of back pain and sciatica between common acupuncture treatment group and common acupuncture with Shin Jong Gyuk of Ohaeng acupuncture treatment group, Kim JH , Park EJ , Park CH , Cho MR , Ryu CR , Chae WS, 19 ( 1 ) :84- 91, , 2002

133. A clinical case study of patient that not improved thrombocytopenia after intravenous immunoglobulin treatment at idiopathic thrombocytopenic purpura as a complication of deep vein thrombosis, Lee KA , Jung JY , Lee ES , Seo DG , Sin SY , Jang SH , et al, 30 ( 4 ) :203-10. http : //doi.org/10.13045/acupunct.2013038, , 2013