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Introduction: Herbal medicines (HM) and growth hormones (GH) are widely used to treat short stature (SS) in children. This systematic review aimed to evaluate the effectiveness and safety of combination therapy with HM and GH (CHG) compared to those of GH monotherapy (GHM) in children with SS., Methods: We searched 17 electronic databases from inception to 1 April 2021. Only randomized controlled trials (RCTs) were included. Two authors independently performed the selection and quality assessment of the included studies using Cochrane Handbook criteria. Relative risk (RR) was used to measure dichotomous outcomes with a 95% confidence interval (CI). Mean difference (MD) or standard MD (SMD) was used to measure continuous outcomes with a 95% CI., Results: Seven RCTs involving 455 participants with SS were included. Standard deviations in height (MD = 0.31, 95% CI: 0.24-0.38, p < 0.00001), and insulin-like growth factor binding protein-3 (MD = 1.39, 95% CI: 0.93-1.85, p < 0.00001) were significantly higher in the CHG group than in the GHM group. Growth velocity (MD = 1.82, 95% CI: 1.34-2.31, p < 0.00001) and insulin-like growth factor-1 (MD = 61.85, 95% CI: 55.80-67.90, p < 0.00001) were significantly higher in the CHG group. Adverse events were significantly lower in the CHG group (risk ratio: 0.10, 95% CI: 0.02-0.54, p = 0.007). However, the level of evidence was low., Conclusions: CHG demonstrated significantly better efficacy than GHM for treating SS, with a low incidence of adverse events. However, since the level of evidence is low, methodologically standardized RCTs are required to verify these results., Competing Interests: The authors declare that they have no conflicts of interest., (Copyright © 2022 Soo Bo Shim et al.)

Blood stasis syndrome (BSS) is an important pathological condition in traditional East Asian medicine and is associated with ischemic heart disease, cerebral vascular accident, diabetes mellitus, chronic renal failure, severe traumatic injury, and dysmenorrhea. However, previous studies have been unable to reveal the clinical and biological characteristics or biological markers of BSS. We hypothesized that the heterogeneity among the manifestations of BSS or non-BSS could interfere with an analysis to describe the characteristics of BSS. In this study, male participants based on the severity of BSS-associated symptoms and signs were clustered and classified into four subgroups: BSS subgroups (1), (2), (3), and (4). Non-BSS core subgroup was redefined using manifestation cluster analysis. Biological characteristics of subgroups BSS(1) and BSS(2) belong to the range of the non-BSS core subgroup (1), whereas that of subgroups BSS(3) and BSS(4) are characterized by different biological parameters such as systemic inflammatory conditions and elevated D-dimer level. Our results suggested that patients in subgroups of BSS(3) and BSS(4) are more likely to be exposed in an inflammatory state than other BSS subgroups. We found the heterogeneity among the manifestations which could mask the characteristics of BSS and identified the clinical and biological profiles of the four BSS subgroups through comparisons of the redefined non-BSS and BSS subgroups. This finding could provide accurate diagnostic criteria and new approaches for BSS treatments in different subgroups.

Objective: In the traditional oriental medicine, it is sometimes difficult to diagnose Blood Stasis Syndrome (BSS) in patients, because the diagnosis of BSS is based on the subjective signs and symptoms of patients. This study is aimed at developing the prediction tool of BSS using cut-off value for BSS score. The identification of a cut-off value for BSS score to diagnose BSS would be helpful., Methods: A total of 887 patients admitted to six traditional Korean medical hospitals in 2013 and three hospitals in 2014. All patients have an identical pattern as a result of diagnostic decision of two experts. The cut-off value for BSS score for BSS diagnosis was determined by the receiver-operating characteristic curve., Results: The area under the curve of this curve was 0.897. The optimal cut-off point for detection of BSS was 49.0. The sensitivity and specificity of this cut-off value were 80.8% and 83.2% in modelling data (2013 dataset) and 84.6% and 83.1% in validation data (2014 dataset), respectively., Conclusion: Our study suggests that a BSS score cut-off value of 49.0 can be used to detect BSS in the traditional Korean medical hospitals. This cut-off value for diagnosis of BSS will make up the lack of objectivity.

Background: This study aimed to investigate medical records using traditional Korean medicine (TKM) in Sewol Ferry disaster in 2014 and further explore the possible role of traditional medicine in disaster situation., Methods: After Sewol Ferry accident, 3 on-site tents for TKM assistance by the Association of Korean Medicine (AKOM) in Jindo area were installed. The AKOM mobilized volunteer TKM doctors and assistants and dispatched each on-site tent in three shifts within 24 hours. Anyone could use on-site tent without restriction and TKM treatments including herb medicine were administered individually., Results: The total of 1,860 patients were treated during the periods except for medical assistance on the barge. Most patients were diagnosed in musculoskeletal diseases (66.4%) and respiratory diseases (7.4%) and circulatory diseases (8.4%) followed. The most frequently used herbal medicines were Shuanghe decoction (80 days), Su He Xiang Wan (288 pills), and Wuji powder (73 days)., Conclusions: TKM in medical assistance can be helpful to rescue worker or group life people in open shelter when national disasters occur. Therefore, it is important to construct a rapid respond system using TKM resources based on experience.

Aim. To investigate whether dyspepsia symptoms differ depending on the presence or absence of cold hypersensitivity in the hands and feet (CHHF). Methods. In all, 6044 patients were recruited and provided with a questionnaire about CHHF and dyspepsia. Based on their responses, subjects were divided into a CHHF group (persons who noted cold sensations; n = 1209) and a non-CHHF group (persons who noted warm or intermediate sensations; n = 1744). The groups were compared in terms of their usual digestion status, using chi-square tests and logistic regression analyses to calculate the propensity score and odds ratios (ORs). We analyzed the participants' responses to questions on dyspepsia symptoms. Results. After matching, chi-square tests indicated that the CHHF group had higher frequencies of the following symptoms: bad digestion, poor appetite, discomfort in the upper abdomen, motion sickness, epigastric burning, postprandial fullness, nausea, and bloating. Additionally, CHHF was associated with an increased OR for dyspepsia (bad digestion, vomiting, motion sickness, epigastric burning, postprandial fullness, nausea, epigastric pain, and bloating) compared with the non-CHHF group. Conclusion. This study confirmed that CHHF patients have elevated frequencies of most dyspepsia symptoms.

Objective. The aim of this study was to identify the patient demographics, health issues, and type of acupuncture treatments who visited a traditional Korean medical hospital for acupuncture treatment. Methods. We retrospectively analysed the data using the electronic medical records (EMRs) of patients treated with at least one treatment of acupuncture from 1 January 2010 to December 2012 in the Chung-Ju Korean hospital at Semyung University. Results. The total number of identified patients was 1189 inpatients and 10138 outpatients. The 50-59 age group received acupuncture treatment in the hospital the most, followed by the 40-49 age group. Among the patients undergoing acupuncture treatment because of a diagnosis of pain, 82.74% were outpatients and 72.85% were inpatients. Additionally, all patients with a spine condition received acupuncture treatment. The most common musculoskeletal conditions of patients at the traditional Korean medicine (TKM) hospital were associated with spine conditions, such as low back pain and neck pain. Various treatments have been performed at the hospital in conjunction with acupuncture. The study results show a high prevalence of acupuncture treatment for diagnosed diseases. Conclusion. Our study suggests the need to investigate additional TKM hospitals to analyse characteristics of patients who received specific treatments. Analysis of the characteristics of patients treated with Korean acupuncture at the TKM hospital in this study will help future researchers who want to implement strong clinical evidence. However, we cannot completely discount all symptoms because of the retrospective nature of this study, and only one hospital was used, which limits the generalisation of our findings.

The aim of this study is to extract indicators that are associated with the heat/nonheat and excess/deficiency patterns in stroke pattern identification through the large-scale analysis of clinical data. Two experts, who had more than three years of clinical experience with stroke, independently performed the pattern identification. We analyzed indicators of clinical data with two doctors' concurrent diagnoses on the patient's pattern identification. To verify heat/nonheat and excess/deficiency patterns, which are the basic elements of pattern identification, we grouped 960 patients diagnosed as the fire-heat pattern, the Yin deficiency pattern, and the Qi deficiency pattern in to two groups, the heat/nonheat group and the excess/deficiency group. We then extracted significant indicators using univariate and multivariate analysis. As a result of the comparison of 65 indicators, we were able to extract 10 indicators for the heat pattern, 6 for the nonheat pattern, 9 for the excess pattern, and 10 for the deficiency pattern. Extracted indicators in this study can be used for pattern identification in the context of stroke. These are positive indicators from large-scale clinical studies and are greatly expected to be crucial discriminant indicators in individual pattern identification henceforth.

Blood stasis is one of the important pathological concepts in Korean medicine. We analyzed the Korean studies concerning blood stasis. We searched for articles in eight electronic databases from their inception to September, 2014. We included reviews, clinical studies, and preclinical studies that had studied blood stasis and excluded articles in which blood stasis was not mentioned or in which the original authors had not explained blood stasis. Of 211 total included studies, 19 were reviews, 52 were clinical studies, and 140 were preclinical articles. "Stagnant blood within the body" was the most frequently mentioned phrase of the traditional concept of blood stasis. Traumatic injury was the most frequently studied disease/condition in the clinical studies. In the preclinical studies, coagulopathy was studied most frequently, followed by hyperviscosity, hyperlipidemia, inflammation, neoplasm, ischemic brain injury, and atherosclerosis. Hyeolbuchukeo-tang and Angelicae Gigantis Radix were the most frequent formula and single herb, respectively, used in the blood stasis researches. The results showed that blood stasis was mainly recognized as disorder of circulation and many studies showed the effectiveness of activating blood circulating herbs for diseases and pathologies such as traumatic injury or coagulopathy. Further studies are needed in the pathologic mechanisms and various diseases of blood stasis.

Objective. The aim of this study is to evaluate the consistency of pattern identification (PI), a set of diagnostic indicators used by traditional Korean medicine (TKM) clinicians. Methods. A total of 168 stroke patients who were admitted into oriental medical university hospitals from June 2012 through January 2013 were included in the study. Using the PI indicators, each patient was independently diagnosed by two experts from the same department. Interobserver consistency was assessed by simple percentage agreement as well as by kappa and AC1 statistics. Results. Interobserver agreement on the PI indicators (for all patients) was generally high: pulse diagnosis signs (AC1 = 0.66-0.89); inspection signs (AC1 = 0.66-0.95); listening/smelling signs (AC1 = 0.67-0.88); and inquiry signs (AC1 = 0.62-0.94). Conclusion. In four examinations, there was moderate agreement between the clinicians on the PI indicators. To improve clinician consistency (e.g., in the diagnostic criteria used), it is necessary to analyze the reasons for inconsistency and to improve clinician training.

In traditional Korean medicine (TKM), pattern identification (PI) diagnosis is important for treating diseases. The aim of this study was to comprehensively investigate the relationship between the PI type and tongue diagnosis or pulse diagnosis variables. The study included 1,879 stroke patients who were admitted to 12 oriental medical university hospitals from June 2006 through March 2009. The status of the pulse and tongue was examined in each patient. Additionally, to investigate relatively important indicators related to specialist PI, the quantification theory type II analysis was performed regarding the PI type. In the first axis quantification of the external criteria, the Qi-deficiency and the Yin-deficiency patterns were located in the negative direction, while the dampness-phlegm (DP) and fire-heat patterns were located in the positive direction. The explanatory variable with the greatest impact on the assessment was a fine pulse. In the second axis quantification, the external criteria were divided into either the DP or non-DP patterns. The slippery pulse exhibited the greatest effect on the division. This study attempted to build a model using a statistical method to objectively quantify PI and various indicators that constitute the unique diagnosis system of TKM. These results should assist the development of future diagnostic standards in stroke PI.

Observation of the tongue, also known as tongue diagnosis, is an important procedure in diagnosis by inspection in Traditional Korean medicine (TKM). We investigated the reliability of TKM tongue diagnosis in stroke patients by evaluating interobserver reliability regarding tongue indicators as part of the project named the Fundamental Study for the Standardization and Objectification of Pattern Identification in TKM for Stroke (SOPI-Stroke). A total of 658 patients with stroke admitted to 9 oriental medical university hospitals participated. Each patient was independently seen by two experts from the same department for an examination of the status of the tongue. Interobserver agreement about subjects regarding pattern identification with the same opinion between the raters (n = 451) was generally high, ranging from "moderate" to "excellent". Interobserver agreement was nearly perfect for certain signs of special tongue appearance (mirror, spotted, and bluish purple), poor for one of the tongue colors (pale) and moderate for others. Clinicians displayed measurable agreement regarding tongue indicators via both observation and pattern identification consistency. However, interobserver reliability regarding tongue color and fur quality was relatively low. Therefore, it is necessary to improve objectivity and reproducibility of tongue diagnosis through the development of detail-oriented criteria and enhanced training of clinicians.