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Background: Recently, Korean Medicine treatment with pharmacopuncture therapy (PPT) has been increasingly used in clinical practice to improve symptoms in patients with lumbar spinal stenosis (LSS). The aim of this study is to evaluate the effectiveness and safety of PPT in addition to conventional Korean Medicine treatment (CKMT) for the treatment of patients with LSS, compared with CKMT alone. Methods: This study is designed as a pragmatic, randomized, two-armed, parallel, stratified (by sex), controlled pilot trial. Forty patients diagnosed with LSS will be randomly allocated to the PPT + CKMT group or the CKMT group. Patients in the two groups will receive treatment two times weekly for 5 weeks. The primary outcome will be the mean change in the 100-mm visual analog scale score from the baseline to the end of treatment (week 5). The secondary outcomes will include the clinically important difference, Zurich Claudication Questionnaire score, self-reported walking capacity, Modified-Modified Schober test, EuroQol 5-dimension 5-level questionnaire, and Patients' Global Impression of Change. Adverse events will be assessed at each visit. Discussion: The results of this study will provide meaningful data to evaluate the add-on effect and safety of PPT in the medical care of patients with LSS.

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The rate constants of solvolysis of 1,4-benzodioxan-6-sulfonyl chloride (C 8 H 7 ClO 4 Cl, 1) were determined by a conductivity technique. These rate constants of 1 in 28 different solvents correlated well with the extended Grunwald-Winstein equation. The l (1.00) and m (0.59) values support an S N 2 reaction pathway having a similar transition state structure to that of the benzenesulfonyl chloride (2, l = 1.10, m = 0.61) reaction. This interpretation is further supported by the activation parameters, i.e., relatively small positive ΔH 6 ¼ (8.9 to 15.5 kcal/ mol) and large negative ΔS 6 ¼ (−27.3 to −49.2 cal/mol/K) values, and the solvent kinetic isotope effect (1.62). The Kivinen's n values (n = 0.03 in methanol, 0.04 in ethanol) obtained in binary solvents were consistent with the proposed bimolecular reaction mechanism.

Gold thread therapy (GTT) continuously stimulates acupoints and is used to treat chronic conditions/diseases such as chronic lumbar pain. During the procedure gold thread is embedded into the skin and although gold thread is medically pure, GTT is an irreversible treatment where there is limited evidence on its safety. Here, we report a case of a 79-year-old woman being treated for low back pain who developed side effects following moving cupping therapy at a site of GTT (performed in the 1970s). Adverse reactions causing radiating pain persisted more than at least 9 days following moving cupping therapy. The symptoms of pain were evaluated using the numerical rating scale, and changes in tenderness and the state of bruising was recorded. Low back pain improved but the radiating low leg pain did not improve. This case highlights the need for caution when performing moving cupping therapy where GTT has been previously performed.