Vol.40 No.4, November 30, 2023 Article TypeCase ReportOriginal ArticleReview Article

Cover ImageTable of Contents

• Review Article 2023-11-30

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  A Bibliometric Analysis of Acupuncture Treatment of Osteoarthritis over the past 20 Years: 2003−2022

  Jisu Lee , Hyonjun Chun , Sungjun Joo , Yubin Kim , Seonghyeon Jeon , Hyewon Yeum

  Journal of Acupuncture Research 2023; 40(4): 293-307

  Abstract

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  Abstract : This study uses bibliometric methods to analyze publications regarding the use of acupuncture in osteoarthritis over the past 20 years and presents an overview of global research trends. Publications related to acupuncture in osteoarthritis from 2003 to 2022 were retrieved from the Web of Science Core Collection Database. An analysis of the extracted records was conducted according to their publication year, research area, journal title, country, organization, author, and keywords. The VOSviewer program was used to visualize the research trends on acupuncture in osteoarthritis. An analysis of 380 articles indicated a consistent increase in the use of acupuncture for osteoarthritis treatment over the past 20 years. Many articles have been published in research areas such as “integrative complementary medicine” and “general internal medicine.” The most prolific journal was Evidence- Based Complementary and Alternative Medicine. In terms of article publication, the most productive country and research organization were China and the Beijing University of Chinese Medicine, respectively. The most frequently occurring keywords were “acupuncture,” “knee osteoarthritis,” and “pain.” This study used a bibliometric analysis to provide an overview of global research trends on acupuncture in osteoarthritis. These findings may suggest the future direction of research on the treatment of acupuncture in osteoarthritis.

• Review Article 2023-11-30

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  Acupuncture Treatment for Restless Legs Syndrome: A Review of Randomized Controlled Trials

  Go Eun Chae , Hyun Woo Kim , Hye Jeong Jo , Ahra Koh , Young Jin Lee , Ji Eun Choi , Woo Young Kim

  Journal of Acupuncture Research 2023; 40(4): 308-318

  Abstract

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  Abstract : To determine the effectiveness of acupuncture in treating restless legs syndrome (RLS), we conducted a literature review of randomized controlled trials (RCTs) that utilized acupuncture as an intervention for patients diagnosed with RLS. Relevant clinical studies (n = 158) from seven databases (the Cochrane Library, PubMed, Embase, CNKI, KISS, RISS, and OASIS) were included based on the inclusion and exclusion criteria and analyzed. Moreover, 6 RCTs were selected for review. In all six studies, it was indicated people who underwent acupuncture treatment showed significant improvements in their overall health. An increase in the treatment efficacy rate, sleep quality, and quality of life indicators after the acupuncture treatment was confirmed. The severity of pain as assessed using the visual analog scale (VAS) scores and International RLS Study Group Rating Scale (IRLSRS) scores and the severity of RLS symptoms were significantly reduced. Any significant side effects were not reported. Acupuncture is suggested as an effective and safe treatment method for RLS. However, further large-scale RCT studies are needed to confirm our findings.

• Review Article 2023-11-30

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  Narrative Review of the Association between Cervical Region Treatment and Facial Paralysis

  Young-Jun Kim , Hye-Ri Jo , So-Rim Kim , Dong-Guk Shin , Da-Won Lee , Yeon-Sun Lee

  Journal of Acupuncture Research 2023; 40(4): 319-328

  Abstract

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  Abstract : Facial nerve palsy refers to sudden, unilateral lower motor neuron facial paralysis. This study aimed to determine the importance of neck treatment in the treatment of facial paralysis. A literature search was performed on six online databases and other sources until January 15, 2023. A total of 426 papers were retrieved. After excluding duplicated and inconsistent papers, papers not including cervical treatment, and experimental papers on animals, two papers were finally selected. The type of treatment method, therapeutic effects, assessment of the risk of bias in randomized controlled trials, and non-randomized controlled trials and side effects were evaluated. Chiropractic, manual therapy, facial meridian massage, and acupotomy were applied to the face and cervical spine region. The results showed that each treatment had a significant therapeutic effect through evaluation index measurement methods, such as the visual analog scale and Yanagihara’s unweighted regional grading system. This study demonstrated the importance of the cervical spine area in the treatment of facial paralysis. However, this study has many limitations. Thus, high-quality randomized controlled comparative studies on the treatment of the cervical spine area only or studies that include cervical spine area treatment as an interventional treatment while performing oriental or comprehensive treatment are needed.

• Review Article 2023-11-30

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  Research Trends on Immune Mechanisms of Acupuncture: A Literature Review

  Joonyong Noh , Jinkang Lim , Jeong Cheol Shin , Sung-Pil Bang , Geunwoong Noh , Jin-Sol Yoon , Yun-Gwon Seon , Siyoung Song , Jae-Hong Kim

  Journal of Acupuncture Research 2023; 40(4): 329-343

  Abstract

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  Abstract : Recently, acupuncture has demonstrated extraordinary clinical results in the treatment of several categories of health conditions worldwide. The mechanisms of action of acupuncture (including immune mechanisms) have been investigated by biomedical studies over the last few decades. The immune mechanisms of representative clinical conditions and their clinical effects were thoroughly assessed, with a comprehensive investigation into the mechanisms of action of acupuncture (including immune responses) in this study. Conditions such as stroke, migraine, depression, chronic fatigue syndrome, lower back pain, hypertension, irritable bowel syndrome, sepsis, and allergic diseases were meticulously examined. This in-depth analysis aims to ensure a foundational understanding of the immune mechanisms involved in acupuncture, thereby serving as an initial step toward integrating the impact of acupuncture on the immune system.

• Original Article 2023-11-30

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  The Evaluation of the Single-Dose Toxicity and Safety of 4-Carvomenthenol in ICR Mice

  Yigun Lim , Jihoon Kong , Jiwon Lee , Gabsik Yang , Taehan Yook

  Journal of Acupuncture Research 2023; 40(4): 344-350

  Abstract

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  Abstract : Background: 4-carvomenthenol[4-methyl-1-(1-methylethyl)-3-cyclohexen-1-ol] is a main component of Origanum vulgare L., Zanthoxylum piperitum (L.) DC., and other plants. It has been reported to exhibit anti-inflammatory, antibacterial, and anti-tumor effects. Furthermore, it is necessary to conduct a toxicity test on 4-carvomenthenol to ensure its safety.
  Methods: This study included 5-week-old Institute of Cancer Research mice that were categorized into 3 treatment groups (12, 25, and 50 mg/kg 4-carvomenthenol dose levels) and a control group (10% dimethyl sulfoxide, 40% polyethylene glycol 300, 5% Tween 80, and 45% normal saline injection of the final volume), with 5 male mice and 5 female mice per group. All groups were observed for clinical symptoms and body weight in a period of 14 days and were subjected to gross necropsy after euthanasia.
  Results: No deaths were recorded. No test substance-related clinical signs in the female mice of the 12 mg/kg dose group were observed. Abnormal gait was observed in 1 male from day 1 to day 3 in the 12 mg/kg dose group; 1−3 males from day 1 to day 7 and 1−5 females from day 1 to day 15 in the 25 mg/kg dose group; and 2−5 males and 2–5 females from day 1 to day 15 in the 50 mg/kg dose group. No test substance-related effect on the body weight and necropsy findings was observed.
  Conclusion: The results of this study suggested that the lethal dose of 4-carvomenthenol could be greater than 50 mg/kg. However, further research is needed, especially repeated-dose toxicity studies, to confirm the efficacy and safety of 4-carvomenthenol.

• Original Article 2023-11-30

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  Effects of Wet Cupping (Al-Hijamah) on Cholesterol in a Sudanese Population

  Amna Mohammed Alamin Abbshar , Hafsa Ahmed Elrheima Ahmed

  Journal of Acupuncture Research 2023; 40(4): 351-355

  Abstract

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  Abstract : Background: Wet cupping (WC) is an efficient and cost-effective technique for removing metabolic waste from the bloodstream via the skin. The study aimed to examine the effect of WC on cholesterol levels including total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and low-density lipoprotein cholesterol (LDL-C) in a Sudanese population.
  Methods: In this prospective cross-sectional study, 30 participants undergoing regular WC therapy were enrolled. Blood samples collected twice: pre-WC therapy (case group) and 10–14 days afterward (controls).
  Results: Of the participants, 56.67% were male and 43.33% were female, aged 24–69. Pre-WC TC and LDL-C levels were significantly higher than the post-WC control group (p = 0.001). Conversely, HDL-C levels decreased significantly in the pre-WC cases compared to controls (p = 0.001). No significant sex-based difference in mean cholesterol levels (p > 0.05).
  Conclusions: After WC, males and females experienced significant reductions in TC and LDL-C, and significant increase in HDL-C.

• Original Article 2023-11-30

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  A Study of the Antioxidant and Anti-Inflammatory Effects of Dusokohwaeum

  Yun-Gwon Seon , Jae Min Jeong , Jin-Sol Yoon , Joonyong Noh , Seung Kyu Im , Sung-Pil Bang , Jeong Cheol Shin , Jae-Hong Kim

  Journal of Acupuncture Research 2023; 40(4): 356-367

  Abstract

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  Abstract : Background: The aim of this study is to determine the antioxidant and anti-inflammatory effects of Dusokohwaeum (DOE).
  Methods: To measure the antioxidant and anti-inflammatory effects of DOE, the total flavonoid and polyphenol contents and radical scavenging activity were measured. Furthermore, reactive oxygen species (ROS), nitric oxide, and cytokine production were measured by treating lipopolysaccharide-induced RAW264.7 cells with DOE, and gene expression levels of inducible cyclooxygenase-2, nitric oxide synthase, and cytokines were evaluated.
  Results: Radical scavenging experiments revealed a significant concentration-dependent increase in scavenging capacity. The production of ROS, nitric oxide, and cytokines in the cells showed a significant concentration-dependent decrease when compared with the control group. The gene expression levels of inducible cyclooxygenase-2, nitric oxide synthase, and cytokines also showed a significant concentration-dependent decrease when compared with the control group.
  Conclusion: Interestingly, the antioxidant and anti-inflammatory effects of DOE were 23.42 ± 0.64 mg GAE/g and 20.83 ± 0.98 mg QE/g, respectively. The administration of DOE resulted in a concentration-dependent increase in scavenging ability in the 1,1-diphenyl-2-picrylhydrazyl (DPPH) and 2,2′-azinobis-(3-ethylbenzothiazoline- 6-sulfonic acid) (ABTS) radical scavenging ability experiments. The production of intracellular ROS and nitric oxide was significantly reduced in the presence of DOE. The production of inflammatory cytokines (prostaglandin E2, tumor necrosis factor-alpha [TNF-α], interleukin-1 beta [IL-1β], and IL-6) was significantly reduced in the presence of DOE. Finally, the expression levels of inducible nitric oxide synthase, cyclooxygenase-2, TNF-α, IL-1β, and IL-6 were significantly decreased in the presence of DOE.

• Original Article 2023-11-30

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  The Anti-Inflammatory Effects of Bee Venom in Monosodium Urate Crystal-Induced THP-1 Cells

  Sang-Yeup Chae , Dongmin Lee , Min-Jung Ko , Seungeun Lee , Jaeho Song , Jinkyung Park , Sinwoo Park , Yeon-Cheol Park , Foo Young Cho

  Journal of Acupuncture Research 2023; 40(4): 368-376

  Abstract

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  Abstract : Background: Although bee venom (BV) has clinical benefits in osteoarthritis and rheumatoid arthritis, it has not been tested as treatment for gouty arthritis. Moreover, in vitro, BV has been proven to exhibit anti-inflammatory and positive effects on osteoarthritis, but only limited evidence can confirm its beneficial effects on gout. Thus, this study aims to assess the anti-inflammatory effects of BV on monosodium urate (MSU)-induced THP-1 monocytes.
  Methods: THP-1 monocytes were differentiated into mature macrophages using phorbol 12-myristate 13-acetate (PMA) and pretreated for 6 hours with BV and a Caspase-1 inhibitor in a physiologically achievable range of concentrations (BV, 0.1–1 μg/mL; Caspase-1 inhibitor, 1–10 μM), followed by MSU crystal stimulation for 24 hours. The secretions of interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), IL-6, IL-8, cyclooxygenase-2 (COX-2), prostaglandin E2 (PGE2), and nitric oxide (NO) were increased in the MSU crystal-stimulated THP-1 cells.
  Results: Caspase-1 inhibitors suppressed the production of all mediators in a dose-dependent manner. BV worked on equal terms with Caspase-1 inhibitors and showed more satisfactory effects on TNF-α, PGE2, COX-2, and inducible nitric oxide synthase (iNOS). Moreover, the western blot analysis revealed that BV regulated the transcriptional levels of these mediators via the suppression of extracellular signal-regulated kinase (ERK) pathway activation.
  Conclusion: The results of the present study clearly suggest that BV inhibits MSU-induced inflammation in vitro, suggesting a possible role for BV in gout treatment.

• Case Report 2023-11-30

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  Acupuncture Analgesia in Total Thyroidectomy for Graves’ Disease: A Case Report

  Dong Phuong Tran

  Journal of Acupuncture Research 2023; 40(4): 377-381

  Abstract

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  Abstract : This study included a 42-year-old female farmer with a 2-year history of Graves’ disease who visited the hospital for a total thyroidectomy for her grade III goiter based on World Health Organization classification. Besides Hegu (LI4) and Neiguan (PC6), extensively used for acupuncture analgesia in thyroid surgery in previous studies, three additional acupuncture points for acupuncture analgesia in thyroidectomy were evaluated in this study: Shuitu (ST10), Quepen (ST12), and Yifeng (SJ17). In this case, we used an electroacupuncture stimulator to stimulate the acupuncture points and combined acupuncture analgesia with diazepam and atropine sulfate administration as adjunct medications to calm the patient. The operation was completed without any complications. The findings revealed that stimulating the five acupuncture points, i.e., Hegu (LI4), Neiguan (PC6), Shuitu (ST10), Quepen (ST12), and Yifeng (SJ17), for acupuncture analgesia combined with adjunct medications is safe for maintaining an adequate level of analgesia and hemodynamic stability during thyroidectomy.

• Case Report 2023-11-30

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  Efficacy of Integrated Korean Medicines in the Treatment of Partial Triangular Fibrocartilage Complex Tears: A Case Report

  Jae-Joon Ha , Myeong-Yeol Yang , Ji-Sun Kim , Hong-Wook Choi , Gyu-Bin Lee , Dong-Ju Yoon , Dong-Jin Kim , Do-Young Kim

  Journal of Acupuncture Research 2023; 40(4): 382-388

  Abstract

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  Abstract : The triangular fibrocartilage complex (TFCC) is crucial for stabilizing the ulnar side of the wrist but can be partially torn due to degenerative changes, falling, or sudden injuries. However, only a few studies have focused on the use of Korean medicine treatments for TFCC-related wrist pain. This case report presents the successful outcomes of integrated Korean medicine treatment in a patient with a partial TFCC tear. The diagnosis was confirmed via magnetic resonance imaging, which revealed the tear. Subsequently, the patient received integrated Korean medicine treatments. The assessment of the pain scale scores revealed a significant reduction in wrist pain and an improvement in daily life activities. Based on the findings of this study, integrated Korean medicine treatments have been proven to be an effective treatment option for patients with a partial TFCC tear. However, further research is needed to determine the potential benefits and mechanisms of these treatments in managing TFCC-related wrist pain.

• Case Report 2023-11-30

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  Integrated Korean Medicine Treatments for Infrapatellar Bursitis: A Case Report

  Myeong-Yeol Yang , Jae-Joon Ha , Ji-Sun Kim , Hong-Wook Choi , Gyu-Bin Lee , Dong-Ju Yoon , Dong-Jin Kim , Do-Young Kim

  Journal of Acupuncture Research 2023; 40(4): 389-394

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  Abstract : In infrapatellar bursitis, an acute or chronic inflammation of the infrapatellar bursa causes pain and swelling at the front of the knee. To date, only a few studies have reported cases of infrapatellar bursitis that are treated using Korean medicine. The aim of the present study is to report a case of a 27-year-old male with front knee pain caused by infrapatellar bursitis that was treated with integrated Korean medicine treatments (e.g., acupuncture, pharmacopuncture, herbal medicine). The patient- reported numeric rating scale confirmed that the patient’s pain was relieved, while the physical function tests also indicated a significant improvement. Based on the findings of this study, it can be suggested that integrated Korean medicine treatments could be an effective therapeutic option for patients diagnosed with infrapatellar bursitis.

• Case Report 2023-11-30

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  Korean Medicine Treatments in Threepatients with Bell’s Palsy after Coronavirus Disease 2019 Infection: A Retrospective Case Series

  Pil Je Park , Yeon Soo Kang , Hyun Jin Jang , So Jeong Kim , Min Ju Kim , Hyeon Kyu Choi , Jeong Kyo Jeong , Ju Hyun Jeon , Young Il Kim

  Journal of Acupuncture Research 2023; 40(4): 395-402

  Abstract

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  Abstract : Bell’s palsy is an acute facial paralysis caused by peripheral facial nerve dysfunction. The aim of this study is to assess the efficacy of Korean medicine in the treatment of three patients who were hospitalized and diagnosed with Bell’s palsy within 2 weeks of coronavirus disease 2019 (COVID-19) infection. The patients were administered with Korean medicine treatments, steroids, and antiviral drugs. Moreover, the Korean medicine treatments include acupuncture, pharmacopuncture, moxibustion, physical therapy, and herbal medicine. Symptom improvement was evaluated daily using the Yanagihara facial nerve grading system, a facial function evaluation tool. Furthermore, it was suggested that the patients affected by Bell’s palsy after COVID-19 infection may have a slower improvement in their treatment progress compared with those without COVID-19 infection in the acute stage.