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This review examined recently published (July 2014 to June 2017), randomized controlled trials (RCTs) which investigated the safety and effectiveness of combined Korean medicine/complementary alternative medicine (CAM) and Western medicine, to indicate the direction for integrative medical practice. The Korean Medicine Convergence Research Information Center evidence-based medicine database (KMCRIC EBM DB) was used to retrieve relevant RCTs indexed in the last 3 years. Study design, country, sample size, disease/condition with the Korean Standard Classification of Diseases code, interventions, direction of outcomes, and adverse events were extracted and summarized. A total of 93 RCTs were included in this review. Acupuncture/moxibustion was the most commonly used intervention (n = 47; 51%), and 19% (n = 18) of the studies treated musculoskeletal disorders, followed by circulatory disorders (n = 16; 17%), and mental and behavioral disorders (n = 9; 10%). Integrative treatment was reported as more effective than monotherapy in approximately 83% of these studies. Adverse events were poorly reported in most studies. This review suggests that integrative treatments are feasible, effective, and safe for various diseases/conditions, based on the evidence from recently published RCTs. Future studies on integrative healthcare are warranted.

Dural ectasia is defined as ballooning or expansion of the dural sac surrounding the spinal cord. This report describes a rare case of low back pain and sciatica, suspected as being dural ectasia. The patient was hospitalized for 45 days, and underwent integrative Korean medical treatment, including pharmacopuncture, acupuncture, herbal medicine, Chuna therapy, cupping therapy, and physiotherapy. The effect of the treatment was evaluated using the numerical rating scale, Oswestry disability index, European quality of life 5 dimensions, and subjective symptoms. After inpatient treatment, the pain the patient experienced was significantly reduced and the evaluation indices improved. This case report suggested that integrative Korean medical treatment could be an effective therapeutic choice for low back pain and sciatica, with dural ectasia. Further clinical studies are needed to support this observation.

Background This study was designed to evaluate the clinical effectiveness of traditional Korean medicine treatment for lumbar spinal stenosis as assessed by radiological criteria. Methods This was an observational study of 122 patients who were diagnosed with lumbar spinal stenosis and admitted to Jaseng Hospital between January 2016 and June 2017. They were analyzed according to sex, age, cause of disease, disease stage, length of admission, type of stenosis, morphological grade, and dural sac cross-sectional area. All patients were treated with traditional Korean medicine. Patients were assessed with the Numeric Rating Scale (NRS), Oswestry Disability Index (ODI) and EQ-5D before and after treatment. Results Regarding the distribution of the factors analyzed, these were of note: more females than males (1:3.52); and highest proportions were age more than 70 years (37.70%), cause of lumbar spinal stenosis unknown (67.21%), and subacute stage (42.62%). Comparing before and after treatment, the NRS score for low back and pelvic pain decreased from 6.14 ± 1.71 to 4.28 ± 1.91 (p < 0.001), and the NRS score for radiating pain and numbness decreased from 6.27 ± 1.61 to 2.02 ± 1.54 (p < 0.001). ODI decreased from 46.86 ± 19.40 to 33.63 ± 18.66 (p < 0.001), and gait-related ODI decreased from 3.34 ± 1.23 to 2.80 ± 1.11 (p < 0.001). There were no statistically significant differences in improvement of the NRS, ODI, gait-related ODI, and EQ-5D for morphological grade and dural sac cross-sectional area. Conclusions Traditional Korean medicine is effective treatment for patients with lumbar spinal stenosis. Even in patients with severe radiological findings, it is possible to reduce pain and improve quality of life.

본 논문에서는 시진핑 시대의 중국 대외정책에 대한 전망을 통해, 차기 지도부의 집권기간에 대한 국제체제의 구조적 변화 발생 가능성을 타진해 보고 있다. 시진핑 시대의 국가전략은 국가발전전략에 따른 시대적 요구와 이에 대한 부응, 그리고 전임 정부와의 차별화된 정체성의 확보와 이에 따른 정권의 안정 및 공고화의 측면에 근거해 볼 때, 안정적인 경제성장을 유지하는 가운데 임기기간의 일정시점에 강대국을 지향하는 비전과 정책성 방향성을 표방하고 이를 추진할 가능성이 높다. 이와 같은 차기 지도부의 전략적 추진은 강대국의 지위를 추구하는 과정에서 미국과의 직접적인 패권경쟁은 회피하면서도 일극하의 다자체제나 다극체제의 강화와 같은 부분적인 세계질서의 변화를 통해 국제사회의 규칙제정과 의제설정에 주도적으로 참여하면서 중국의 영향력을 확대할 것임을 의미하는 것이다. 따라서 중국 차기 지도부의 집권과 정책변화로 인해 중미 양자 관계에서 직접적 충돌이나 대결적 국면이 전개될 가능성은 높지 않지만, 다자적 메커니즘이 작동하는 영역에서 양국 간 경쟁은 대단히 치열해질 것이다.