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      An introduction to Chuna manual medicine in Korea: History, insurance coverage, education, and clinical research in Korean literature

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          Abstract

          The objectives of this study were to summarize the curriculum, history, and clinical researches of Chuna in Korea and to ultimately introduce Chuna to Western medicine. Information about the history and insurance coverage of Chuna was collected from Chuna-related institutions and papers. Data on Chuna education in all 12 Korean medicine (KM) colleges in Korea were reconstructed based on previously published papers. All available randomized controlled trials (RCTs) of Chuna in clinical research were searched using seven Korean databases and six KM journals. As a result, during the modern Chuna era, one of the three periods of Chuna, which also include the traditional Chuna era and the suppressed Chuna era, Chuna developed considerably because of a solid Korean academic system, partial insurance coverage, and the establishment of a Chuna association in Korea. All of the KM colleges offered courses on Chuna-related subjects (CRSs); however, the total number of hours dedicated to lectures on CRSs was insufficient to master Chuna completely. Overall, 17 RCTs were reviewed. Of the 14 RCTs of Chuna in musculoskeletal diseases, six reported Chuna was more effective than a control condition, and another six RCTs proposed Chuna had the same effect as a control condition. One of these 14 RCTs made the comparison impossible because of unreported statistical difference; the last RCT reported Chuna was less effective than a control condition. In addition, three RCTs of Chuna in neurological diseases reported Chuna was superior to a control condition. In conclusion, Chuna was not included in the regular curriculum in KM colleges until the modern Chuna era; Chuna became more popular as the result of it being covered by Korean insurance carriers and after the establishment of a Chuna association. Meanwhile, the currently available evidence is insufficient to characterize the effectiveness of Chuna in musculoskeletal and neurological diseases.

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          TCM: Made in China.

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            Do certain countries produce only positive results? A systematic review of controlled trials.

            To determine whether clinical trials originating in certain countries always have positive results. Abstracts of trials from Medline (January 1966-June 1995). Two separate studies were conducted. The first included trials in which the clinical outcome of a group of subjects receiving acupuncture was compared to that of a group receiving placebo, no treatment, or a nonacupuncture intervention. In the second study, randomized or controlled trials of interventions other than acupuncture that were published in China, Japan, Russia/USSR, or Taiwan were compared to those published in England. Blinded reviewers determined inclusion and outcome and separately classified each trial by country of origin. In the study of acupuncture trials, 252 of 1085 abstracts met the inclusion criteria. Research conducted in certain countries was uniformly favorable to acupuncture; all trials originating in China, Japan, Hong Kong, and Taiwan were positive, as were 10 out of 11 of those published in Russia/USSR. In studies that examined interventions other than acupuncture, 405 of 1100 abstracts met the inclusion criteria. Of trials published in England, 75% gave the test treatment as superior to control. The results for China, Japan, Russia/USSR, and Taiwan were 99%, 89%, 97%, and 95%, respectively. No trial published in China or Russia/USSR found a test treatment to be ineffective. Some countries publish unusually high proportions of positive results. Publication bias is a possible explanation. Researchers undertaking systematic reviews should consider carefully how to manage data from these countries.
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              Integrative package for low back pain with leg pain in Korea: a prospective cohort study.

              Back pain significantly affects both patients and society through personal suffering, supporting burden, work loss, and incurred expenses. With no unequivocal support for surgery versus conservative treatment, an integrative approach has become popular in Korea. To investigate the outcomes of an integrative package for low back pain with leg pain. A prospective cohort study involving patients with low back and leg pain and confirmed disc herniation was carried out at an outpatient clinic in Korea. The treatment package comprised of herbal medicines, acupuncture, bee venom acupuncture, and a Korean version of spinal manipulation (Chuna). Study participants were evaluated at baseline and every 4 weeks for 24 weeks. Low back and leg pain intensity levels were measured on a visual analog scale (0-10), back function was evaluated with the Oswestry Disability Index (0-100), and the overall quality of life was assessed using the SF-36 Health Survey (0-100 in 8 different subcategories). Out of 150 patients, 128 completed the 24 weeks of therapy. Patients reported improvements in all outcome measures. At the completion of the study, low back pain scores improved by a mean of 3.3 (95% CI=2.8 to 3.8), and leg pain scores improved by a mean of 6.3 (95% CI=5.9 to 6.6). Significant improvements in ODI and SF-36 scores were observed at 4 weeks and sustained throughout. This integrative package was effective in the treatment of LBP with leg pain and warrants further rigorous investigations. Copyright (c) 2010 Elsevier Ltd. All rights reserved.
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                Author and article information

                Contributors
                Journal
                Integr Med Res
                Integr Med Res
                Integrative Medicine Research
                Elsevier
                2213-4220
                2213-4239
                30 August 2013
                June 2014
                30 August 2013
                : 3
                : 2
                : 49-59
                Affiliations
                [a ]College of Oriental Medicine, Wonkwang University, Iksan, Korea
                [b ]Bundang Jaseng Hospital of Oriental Medicine, Seongnam, Korea
                [c ]College of Oriental Medicine, Woo-suk University, Wanju, Korea
                [d ]School of Korean Medicine, Pusan National University, Yangsan, Korea
                [e ]Korean Medicine Health Technology Research Group, Korea Institute of Oriental Medicine, Daejeon, Korea
                Author notes
                [* ] Corresponding author. Department of Rehabilitation Medicine, School of Korean Medicine, Pusan National University, 49 Busandaehak-ro, Mulgeum-eup, Yangsan 626-870, South Korea drshinbc@ 123456gmail.com
                [☆]

                T.-Y. Park and T.-W. Moon contributed equally to this work.

                Article
                S2213-4220(13)00065-6
                10.1016/j.imr.2013.08.001
                5481700
                28664078
                554b5edc-08a3-4bb1-9b13-f661b32fc422
                © 2013 Korea Institute of Oriental Medicine. Published by Elsevier.

                This is an open access article under the CC BY-NC-ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).

                History
                : 12 June 2013
                : 21 August 2013
                Categories
                Review Article

                chuna manual medicine,clinical research,education,history,insurance coverage,korea

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