KJC Korea
Journal Central

Objectives This study was designed to evaluate the bone regeneration effects of Sintongchukea-tang (SC) on rib fractured rats. Methods Rats were randomly divided into 5 groups (normal, control, positive control, SC low [SC-L] and SC high [SC-H]). All groups were subject to fractured rib except normal group. Normal group received no treatment at all. Control group was orally fed with phosphate buffered saline, and positive control group was medicated with tramadol (20 mg/kg). SC group was orally medicated with SC (50 mg/kg, 100 mg/kg) once a day for 14 days. The fracture healing process was observed by x-ray, micro CT and fracture tissue slide was observed by immunohistochemical staining. We analysed levels of transforming growth factor-β1, Ki67, alkaline phosphatase (ALP), runt-related transcription factor 2 (Runx2), receptor activator of nuclear factor kappa-β, tartrate resistant acid phosphatase (TRAP) and analysed levels of Osteocalcin in plasma. We measured levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), ALP, blood urea nitrogen (BUN) and creatinine in plasma, for hepatotoxicity and nephrotoxicity of SC. Results Though X-ray and micro-computed tomography, more callus formation was observed and bone union was progressing. Through Hematoxylin and Eosin, callus formation was increased compared to the control group. Runx2 level at SC-H was significantly increased and TRAP level at SC-L was significantly decreased compared with the control group. AST, ALT, ALP, BUN and creatinine were not statistically different from the control group. Conclusions As described above, SC promoted fracture healing by stimulating the bone regeneration factor. And SC shows no hepatotoxicity and nephrotoxicity. In conclusion, it seems that SC helps to promote fracture regeneration and it can be used clinically to patients with fracture. (J Korean Med Rehabil 2020;30(3):1-21)

Objectives The purpose of this study is to evaluate the healing effect of Hyeolbuchugeo- tang (HC) in rats with rib fracture. Methods Rats were randomly divided into 5 groups (naive, control, positive control, HC-L and HC-H). All groups except naive group were subjected to bone fracture of rib. Naive group received no treatment at all. Control group was fed with phosphate buffered saline. Positive control group was orally medicated with tramadol. Experimental group was orally medicated with HC extract (50 mg/kg for low concentration [HC-L], 100 mg/kg for high concentration [HC-H]). X-ray and micro-computed tomography (micro-CT) were conducted to assess the effect of HC. We analysed the level of 2) transforming growth factor-β1 (TGF-β1), Ki67, alkaline phosphatase (ALP), receptor activator of nuclear factor kappa-β, runt-related transcription factor 2 (Runx2) and tartrate resistant acid phosphatase (TRAP) on 7 and 14 days after fracture. ALP, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine was measured for safety assessment. Results X-ray and micro-CT, showed HC enhance bone repair process. Callus formation was increased in experimental group at 7 days after fracture, but decreased at 14 days after fracture. 7 days after fracture, the level of TGF-β1 in experimental group was decreased. The level of Ki67, Runx2 in HC-H, TRAP in HC-L was increased. 14 days after fracture, the level of Ki67 in HC-L and HC-H was decreased. The level of ALP, Runx2, BUN in HC-L, TRAP in HC-L and HC-H was increased. Conclusions Taken together the results, HC promoted healing of bone fracture. In conclusion, HC has a potential to promote healing of bone fracture. (J Korean Med Rehabil 2020;30(3):23-44)

Objectives This study was designed to investigate the effects of ChondroT on thrombus in FeCl3-induced rats. Methods We exposed FeCl3 to rat’s carotid artery to induce thrombus. Specimens were divided in 5 groups; Intact, Control, ASA10 (aspirin 10 mg/kg), CT100 (ChondroT 100 mg/kg), and CT200 (ChondroT 200 mg/kg), each n=6. We investigated thromboxane, platelet activating factor (PAF), histological change, lipid metabolism, transaminase, leukocyte, erythrocyte and thrombocyte level. Results In ASA10, CT200 groups, there was significants decrease in both thromboxane level and total cholesterol level, compared to control group and there were significant histological changes of blood vessel, compared to control group. In CT200 group, there was significant decrease in PAF level, compared to control group (p<0.05). In ASA10, CT200 groups, triglycerides level tended to decrease, compared to control group. Conclusions Based on these results, it could be suggested that ChondroT was effective on thrombus in FeCl3-induced rats, and further study is needed to conduct a rigorous clinical research. (J Korean Med Rehabil 2020;30(3):45-56)

Objectives The aim of this study was to investigate the inhibitory effect of ChondroT in indomethacin-induced gastric mucosal injury rat model. Methods Sprague-Dawley rats were randomly assigned to intact, control Joins, Celebrex, ChondroT50 and ChondroT200. Indomethacin (25 mg/kg) was used to induce damage to the gastric mucosal injury. ChondroT was administered by orally to inhibit the indomethacin-induced gastric mucosal injury. At the end of the experiment, pH level in stomach, stomach contents volume, tumor necrosis factor-α (TNF-α) level, interleukin-1β (IL-1β) level, prostaglandin E2 (PGE2) level, myeloperoxidase (MPO) activity, erythrocytes, and thrombocytes were measured. Ophthalmologic and histopathological examination was also analyzed. Results pH level in stomach and Stomach contents volume had no difference between Control, PC-Joins, PC-Cele, ChondroT50 and ChondroT200 group. TNF-α level was decreased in PC-Joins, PC-Cele, ChondroT50 and ChondroT200 group and there were no significant difference. IL-1β level was decreased in PC-Joins group and ChondroT200 group compared to control group. PGE2 level had no significant difference between Control, PC-Joins, PC-Cele, ChondroT50 and ChondroT200 group. MPO level and complete blood count level were decreased in PC-Joins, PC-Cele, ChondroT50 and ChondroT200. Symptom score of ophthalmologic examination was decreased in ChondroT50 and ChondroT200 group compared to control group. Conclusion Based on these results, It could be suggested that ChondroT was effective in reducing damage to the gastric mucosal injury. And further study is needed to conduct a rigorous clinical research. (J Korean Med Rehabil 2020;30(3):57-69)

Objectives Even though the various alternative herbal medicine has applied for osteoarthritis (OA) treatment, its scientific proof remains uncertain. The aim of the present study evaluates the effects of Chulbu-tang on inflammatory responses in a monosodium iodoacetate (MIA)-induced osteoarthritis rat model. Methods OA rat model was established by MIA injection in intra-joint of rats. 7 days after, OA rats except OA control rats were administrated Chulbu-tang (100 or 200 mg/kg) or Indomathacin (5 mg/kg) once a day for 14 days. The weight-bearing ability of hind paws were measured when group isolation 0, 7, and 14 days. Western blotting was performed to examine the knockdown/overexpressing efficiency of Chulbu-tang. In addition, cartilage destruction was measured histologically. Results Chulbu-tang treatment significantly reduced the protein expressions of inflammatory mediators such as inducible nitric oxide synthase and cyclooxygenase 2, and inhibited inflammatory cytokines including tumor necrosis factor alpha, interleukin (IL)-1β, and IL-6 through nuclear factor-kappa B (NF-κB) inactivation. Moreover, anti-oxidant enzymes such as superoxide dismutase and glutathione peroxidase-1/2 through nuclear factor-erythroid 2-related factor 2 (Nrf2) pathway significantly increased. Our findings indicate that Chulbu-tang has the potential therapeutic effect on OA through inhibiting the inflammatory responses via inactivating NF-κB signaling pathway. In addition, upregulation of Nrf2 led to anti-oxidant effects. Conclusions Taken together, Chulbu-tang is believed to have antioxidant, anti-inflammatory effects, and cartilage protection for arthritis-causing rats. (J Korean Med Rehabil 2020;30(3):71-87)

Objectives The purpose of this study is to assess the effectiveness of Chuna manual therapy for shoulder pain in hemiplegic patients after stroke. Methods For a systematic review and meta-analysis, we set a key question in accordance with participants, intervention, comparison, outcome, study design (PICO-SD). we searched for clinical studies that conducted chuna manual therapy for shoulder pain in hemiplegic patients after stroke 7 databases until September 2019. Only randomized controlled trials were chosen. Results Total 14 randomized controlled trials were chosen for systematic review and meta-analysis. 9 studies used efficacy rate as evaluation tool, and 8 used visual analogue scale. Pressure method (壓力型) was used in 11 studies, followed by osteopathy method (整骨型) and wave motion method (波動型) in 9 studies. Chuna manual therapy showed statistically significant pain reduction effect. Through meta analysis, Chuna manual therapy showed significant pain reducing effect except the study with Chuna manual therapy and electroacupuncture compared to electroacupuncture only. Conclusion As a result, Chuna manual therapy showed statistically significant effect in pain reduction. However, almost studies were evaluated in a state of having probable high risk of bias. This suggests that it requires attention to make an interpretation in this study. Furthermore, more clinical research need to be accomplished in the future. (J Korean Med Rehabil 2020;30(3):89-101)

Objectives This study was designed to review the effect of herbal medicine on animal model with rheumatoid arthritis. Methods We reviewed studies published both in Korea and overseas, all published after 2008. We investigated 8 databases, 6 Korean databases and 2 of abroad. Searching was conducted through flowchart and 24 studies met our guideline. Datas were extrated and organized as animal model characteristics, experimental period, study design, herbal medicine used as intervention and rheumatoid arthritis indicator. Results 336 articles were primarily selected. After screening, 24 articles were left in the end. All 24 studies showed that the herbal medicine used in the animal experiment was effective on treating rheumatoid arthris, proven by macroscopic, histological, hematological and osteological indicators. Conclusions The result showed that herbal medicine is effective in treating rheumatoid arthritis through various pathways. However, study design and intervention were all different from each other and we could not specify the certain compound, material or substance of efficacy. Further study should be conducted to figure out the effectiveness of herbal medicine on rheumatoid arthritis. (J Korean Med Rehabil 2020;30(3):103-116)

Objectives The purpose of this study was to compare the effect of herb medication based on ‘Go-bang’ treatment, ‘Huse-bang’ treatment for patients with acute neck pain caused by traffic accidents. Methods We studied 40 patients with acute neck pain after traffic accidents who had admitted to Department of Korean Medicine Rehabilitation, College of Korean Medicine, Daejeon University from November 25, 2018 to November 25, 2019. 20 patients had received Herb Medication Based on ‘Go-bang’ and 20 patients had received herb medication based on ‘Huse-bang’ three times a day. The study was conducted as a retrospective observation study which analyze the patient’s medical records. We used visual analogue scale (VAS) to evaluate pain reduction and neck disability index (NDI) to evaluate function improvement twice (hospitalization day and 5 days later). Statistical analysis was performed using the IBM SPSS statistics 25 program. Result The VAS scores, NDI scores decreased statistically significantly after treatment in all patients. Both ‘Go-bang’ and ‘Huse-bang’groups showed a statistically significant VAS reduction and improvement of NDI on the fifth day of hospitalization. In the ‘Huse-bang’ group, there was a statistically significant improvement of NDI than in the ‘Go-bang’ group. Conclusion We found that both types of herbal-medication were significantly effective on acute neck pain and neck disability after traffic accident. Further study is needed about the comparison of effectiveness between Go-bang’ and ‘Huse-bang’groups. (J Korean Med Rehabil 2020;30(3):117-127)

Objectives The purpose of this study was to compare the effect of supine JS cervical therapy and muscle release/strengthening technique in patients with acute neck pain caused by traffic accidents. Methods We studied 42 patients with acute neck pain caused by traffic accidents from July 1, 2019 to November 30, 2019. The study was conducted as a retrospective study which analyzes the patient’s medical records. 21 patients (group A) had received supine JS cervical therapy and 21 patients (group B) had received muscle release/strengthening technique. We used the neck disability index (NDI) and visual analog scale (VAS) to evaluate improvements in symptoms and pain, and used the five point Likert scale to evaluate patient’s satisfaction with chuna manual therapy. In each group, we compared the NDI and VAS of hospitalization day to those of 5 days later. Then we compared the NDI, VAS variation and five point Likert scale between the groups. Statistical analysis was conducted using the IBM SPSS for windows 25.0. Result Both group A and group B showed a statistically significant decrease in the NDI and VAS on the 5th day of hospitalization. In group A, there was a statistically significant decrease in the NDI compared to group B. The VAS and Five Point Likert Scale decrease was greater in group A than in group B, but the difference was not statistically significant. Conclusion We found that using supine JS cervical therapy may be more effective than muscle release/strengthening technique in acute stage after traffic accidents. (J Korean Med Rehabil 2020;30(3):129-139)

Objectives The purpose of this study is to find the effect of Korean medicine treatments on pain reduction and range of motion recovery in patients with proximal tibia fractures. Methods We studied 15 patients who had been diagnosed as proximal tibia fracture. This study was conducted as retrospective observational study which analyzed patient's medical records with IBM SPSS statistics 25 program. We used numeric rating scale to evaluate pain reduction and range of motion to observe the patient's recovery. Results The average of numeric rating scale reduced statistically significantly from 5.26±1.38 to 2.73±1.17 (p<0.001). The average of knee flexion range of motion increased statistically significantly from 81.11±34.34 to 117.66±19.01 (p<0.01). Conclusions We found that Korean medicine treatments have a positive effect on pain reduction and knee rom improvement in patients with proximal tibia fractures. (J Korean Med Rehabil 2020;30(3):141-149)

Objectives This study aimed to evaluate the effectiveness of postoperative Korean rehabilitation treatment for patients with musculoskeletal disorders. Methods The medical records of patients undergoing Korean medical rehabilitation after a musculoskeletal surgery, from January 1, 2016, to December 31, 2019, were analyzed retrospectively. The effect of treatment was evaluated by using a numeric rating scale (NRS) and questionnaire for each surgical site. When the same patient was re-admitted after discharge, it was treated as the same case if it was within 7 days from the discharge date; otherwise, it was treated separately. If the period of hospitalization was within 7 days or the chief complaint was not related to musculoskeletal surgeries, the case was excluded. Results In total, 480 cases were included in this study. Acupuncture (99.8%), moxibustion (95.6%), cupping (97.5%), Chuna manual therapy (81.5%), Korean medical physiotherapy (61.0%), Daoyin exercise therapy (26.3%), and herbal medicine (87.7%) were used as the Korean medical rehabilitation treatments. A significant improvement was noted when comparing the NRS and questionnaire results for each surgical site at the time of admission and discharge. Conclusions Korean medical rehabilitation can be effectively used for patients who have undergone musculoskeletal surgeries, to relieve pain and enable returning to daily activities. However, further research with a high level of evidence is necessary to support this finding. (J Korean Med Rehabil 2020;30(3):151-162)

This study reports on the effectiveness of Korean traditional medicine treatment on a patient with right hip pain caused by obturator nerve entrapment due to ganglion cyst. The patient had been misdiagnosed for a stenosis at the other hospital, but he got a different diagnosis this time with the examination. The patient was treated with Korean traditonal medicine, which includes pharmacopuncture, acupuncture, manual treatment (Chuna), and herbal medicine. Numerical rating scale (NRS), Oswestry Disability Index (ODI) and Euroqol five dimension (EQ-5D) index were used as a objective tool for evaluating the patient's symptoms. After treatment, NRS and ODI were decreased, while EQ-5D index was increased. This study suggests that a combined Korean traditional medicine may be effective in reducing symptoms related to obturator nerve entrapment. (J Korean Med Rehabil 2020;30(3):163-169)