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Background: This study aimed to assess the toxicity of capsaicin (CP) pharmacopunture in an animal model.Methods: The toxicity of a single-muscular dose of CP (45.45 mg/mL) was evaluated in 6-week-old male and female Sprague-Dawley rats. A total of 20 rats were assigned to 2 groups which were sex and weight matched. All rats acclimatized for 1 week before receiving 1.0 mL of CP (45.45 mg/mL) or normal saline solution(control) intramuscularly. The general condition and mortality of the animals were observed. The rats were sacrificed 2 weeks after CP was administered and histopathology was performed.Results: No abnormal symptoms or deaths were observed, and there was no difference in body weights between the CP and control groups throughout the study. No significant differences in histopathology were observed between the groups.Conclusion: No toxicological changes related to the administration of CP were observed. This study indicated that the safe dose of CP in Sprague-Dawley rats was 1.0 mL of CP (45.45 mg/mL) or less. Further studies are needed to confirm the safety of CP in the human body.

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Background: Musculoskeletal disorders are the main reason for people to seek counseling and use of complementary and alternative medicine. Although pharmacopuncture is used to treat various diseases in traditional medicine, it is most often applied to treat musculoskeletal conditions. Here, we will review systematically the clinical evidence for the effectiveness and safety of pharmacopuncture for musculoskeletal diseases. Methods: A total of 13 databases will be searched for studies uploaded from January 2014 to December 2018 that investigated the treatment of musculoskeletal diseases. These databases are MEDLINE, EMBASE, AMED, Cochrane Library, CINAHL, 4 Korean databases, 2 Chinese database, and 2 Japanese databases. The methodological quality of randomized controlled trials will be analyzed using the Cochrane Collaboration tool to assess risk of bias, and the confidence in the cumulative evidence will be assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) instrument. Ethics and dissemination: This systematic review will be published in a peer-reviewed journal and disseminated electronically and in print. To inform and guide healthcare practices, the review will be updated. Registration number: CRD42019148795.

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