Objective. Abdominal examination (AE) is one of the essential diagnostic methods in traditional Korean medicine that has been widely used for deciding treatment, cause, and prognosis of the disease. AE majorly depends on the experience of practitioners; therefore, standardization and quantification of AE are desperately needed. However, few studies have tried to objectify AE and established its standard. We assessed the reliability and validity of newly developed diagnostic device for AE called modified algometer (MA). Methods. Thirty-six subjects with functional dyspepsia were allocated into one of 2 groups according to gold standard of AE: epigastric discomfort without tenderness ( = 23) group or epigastric discomfort with tenderness ( = 13) group. Pressure pain threshold was evaluated at participants' epigastric region with algometer and MA. We assessed reliability and validity (sensitivity and specificity) and calculated optimal cutoff value. Results. MA showed high intertrial reliability (ICC 0.849; 0.703-0.923; < 0.000) and validity (sensitivity: 76.92%; specificity: 60.87%), and cutoff value was 330.0 mmHg. Algometer and MA showed moderate correlation ( = 0.583, ≤ 0.000). Conclusion. MA can be reliable and valid diagnostic device for AE and has the possibility of practical use for quantification and standardization of AE.

Objective. To explore the existing scientific information regarding safe needling depth of acupuncture points and the needling depth of clinical efficacy. Methods. We searched the PubMed, EMBASE, Cochrane, Allied and Complementary Medicine (AMED), The National Center for Complementary and Alternative Medicine (NCCAM), and China National Knowledge Infrastructure (CNKI) databases to identify relevant monographs and related references from 1991 to 2013. Chinese journals and theses/dissertations were hand searched. Results. 47 studies were recruited and divided into 6 groups by measuring tools, that is, MRI, in vivo evaluation, CT, ultrasound, dissected specimen of cadavers, and another group with clinical efficacy. Each research was analyzed for study design, definition of safe depth, and factors that would affect the measured depths. Depths of clinical efficacy were discussed from the perspective of de-qi and other clinical observations. Conclusions. Great inconsistency in depth of each point measured from different subject groups and tools exists. The definition of safe depth should be established through standardization. There is also lack of researches to compare the clinical efficacy. A well-designed clinical trial selecting proper measuring tools to decide the actual and advisable needling depth for each point, to avoid adverse effects or complications and promote optimal clinical efficacy, is a top priority.

No abstract

Objective: This study investigated the perception, diagnosis, and treatment of irritable bowel syndrome (IBS) in the general population, in patients, and in Korean medicine doctors (KMDs) in order to provide basic information for the development of Korean medicine clinical practice guidelines for IBS.Methods: A questionnaire was developed in two versions, one for the general population/patients and one for KMDs. The questions were about the general perception, diagnosis, and treatment of IBS. Both online and offline surveys were conducted using these questionnaires.Results: In total, 213 general population/patients and 435 KMDs responded to the survey. The results of the analysis were as follows. Most of the KMDs diagnosed IBS based on clinical aspects. Acupuncture was the most common treatment, followed by prescription herbal medicine, moxibustion, and manufactured herbal medicine. 34.3% of KMDs used clinical practice guidelines for IBS patient treatment. 57.8% of patients were diagnosed with IBS by doctors at primary medical institutions, and 53.1% were diagnosed with colonoscopy. More than half of the IBS patients who have been treated with Korean medicine said they experienced improvement of symptoms and prevention of recurrence, but more than 70% of the respondents said future safety and effectiveness studies of Korean medicine were needed.Conclusions: In spite of the positive perception of IBS treatment with Korean medicine, actual utilization was relatively low. The development and promotion of, as well as education about, appropriate and reasonable Korean medicine practice guidelines for IBS is necessary.

This study aimed to compare the effects of Zusanli and nonacupoint electroacupuncture stimulation on ultrasonographic gastric emptying and vital signs in eight healthy participants. Gastric emptying and its rate of change were analyzed to search for correlation with physical characteristics such as body mass index (BMI), sternocostal angle, and abdominal wall thickness. Methods: Eight healthy participants with no gastrointestinal disorders were enrolled in this study. Each participant went through three abdominal sonographies for gastric emptying assessment. At the second and third visits, participants received Zusanli and nonacupoint electroacupuncture stimulation in a random order. During the study period, we examined the BMI, sternocostal angle, and abdominal wall thickness of all participants. Vital signs (blood pressure, heart rate, and temperature) were also examined before and after the electroacupuncture stimulation. Results: Electroacupuncture stimulation at Zusanli significantly improved gastric emptying when compared to nonacupoint stimulation. Gastric emptying showed a positive correlation with BMI, sternocostal angle, and abdominal wall thickness, but this correlation was statistically insignificant. The improvement rate of gastric emptying by Zusanli electroacupuncture stimulation showed a positive correlation with BMI and sternocostal angle and a negative correlation with abdominal wall thickness. However, such results were also statistically insignificant. Among vital signs, only heart rate showed a significant decrease according to Zusanli electroacupuncture stimulation. Conclusions: A significant effect of Zusanli electroacupuncture was confirmed through ultrasonographic gastric emptying in healthy participants.