Dunsan Korean Medicine Hospital

Minwoo Bang, Suyong Shin, Jungsang Kim, Minwhee Kang, Donghun Lee, Junho Kim, Chunghee Kim, Jiyoung Son, Seonghyeon Jeon, Byungsoo Kang. JKOMOR 2025;25:69-78. https://doi.org/10.15429/jkomor.2025.25.2.69

Objectives: Vascular dementia (VaD) is the second most common form of dementia worldwide, yet no disease-modifying therapies are currently available.Hyperlipidemia is a major modifiable risk factor contributing to VaD pathogenesis.This study aimed to explore the therapeutic potential of traditional herbal medicines for hyperlipidemia-associated VaD using an integrative network pharmacology approach.Methods: Prescriptions were retrieved from the traditional Chinese medicine (TCM) Information Database and cross-referenced with the pharmacopoeia of China and Taiwan.Disease-prescription-herb networks were constructed using Cytoscape.Therapeutic targets for hyperlipidemia and VaD were identified from the Therapeutic Target Database and mapped to herbal candidates via the TCM Systems Pharmacology Database and Analysis Platform.Network integration was performed to identify overlapping herbs with multi-target potential.Results: Analysis revealed convergence between hyperlipidemia and dementia prescriptions, with Dengzhanshengmai-jiaonang identified as a shared formulation.Core herbs such as Salviae Miltiorrhizae Radix, Crataegi Fructus, and Puerariae Radix were highly connected across both conditions.Target-herb network analysis identified peroxisome proliferator -activated receptor alpha, apolipoprotein A, and insulin-like growth factor-binding protein 3 as key therapeutic nodes.A total of 23 herbs were predicted to act on all three targets simultaneously.Notably, Nelumbinis Folium, Carthami Flos, and Eucommiae Cortex demonstrated overlapping activity, while dementia-specific herbs including Schisandrae Fructus, Ginseng Radix, and Gastrodiae Rhizoma were highlighted for neuroprotective potential.Conclusions: This integrative network pharmacology study demonstrates that traditional herbal medicines possess multi-target activity relevant to both metabolic and neurovascular pathways.The findings provide a rational basis for developing optimized herbal combinations as novel therapeutic strategies for hyperlipidemia-induced VaD, bridging traditional knowledge with modern pharmacological insights.

Objectives: This proposal aims to establish a standardized ultrasound-guided cervical interlaminar epidural pharmacopuncture technique using 5% dextrose as an alternative to conventional fluoroscopy-guided methods.It addresses limitations such as radiation exposure, limited soft-tissue visualization, and false loss-of-resistance responses related to the retrodural space of Okada.Methods: With the patient positioned prone and the cervical spine slightly flexed, the target level is identified using high-resolution ultrasound based on the morphology of the transverse processes, starting at C7.A posterolateral transverse scan is performed to visualize the "triple bar sign," which represents the interspinous ligament, ligamentum flavum, and dura mater.A tangential in-plane needle trajectory is used to access the posterior epidural space.To prevent a sudden increase in epidural pressure, D5W is injected using a fractionated protocol: an initial 0.5 mL test dose is administered to confirm anterior dural displacement under real-time ultrasound visualization, followed by incremental injections of 0.5 mL until a total of 3-5 mL is delivered depending on the patient's response.Discussion: Direct visualization of neural, vascular, and dural structures improves needle placement accuracy compared to tactile Loss-of-Resistance (LOR) blind techniques and may reduce the risk of unintended retrodural or intravascular injections. Conclusion:The proposed ultrasound-guided method offers a radiation-free, tissuevisualized approach for cervical epidural pharmacopuncture and may serve as a practical and safe procedural framework in clinical settings.Further clinical research is necessary to evaluate treatment outcomes and long-term safety.

Panax ginseng hydrosol, a water-distilled coproduct of ginseng extraction, contains diverse volatile and semi-volatile terpenoids beyond the well-studied ginsenosides. We applied HS-SPME-GC-MS semiquantitative analysis-based network pharmacology approach to systematically characterize the multi-target and multi-pathway potential of 30 principal hydrosol constituents. In silico target prediction (BATMAN-TCM) identified 78 human protein targets, which were integrated with high-confidence protein-protein interactions. Ginsenol is the main volatile component in Panax ginseng hydrosol, followed by sandaracopimarinol, (+)-spathulenol, (-)-spathulenol, isospathulenol, (+)-cycloisolongifol-5-ol, and rosifoliol. Minor components include monoterpenes such as alpha-terpineol and menthol, alcohols, ketones, and hydrocarbons like (-)-globulol and ferruginol. For the top 5 diseases and indications, most strongly supported as target gene explanations based on main components and robust database-backed evidence, pain modulation, neurodegenerative diseases, breast cancer, androgen receptor-related disorders, and autoimmune-metabolic genetic disorders emerge as leading categories. These findings validate a multicomponent, multi-target mechanism underlying Panax ginseng hydrosol's traditional uses and highlight synergistic interactions that extend the pharmacological landscape beyond ginsenoside-centric models. Our study provides a molecular framework for future experimental validation and rational development of hydrosol-based therapeutics.

Objectives This study aimed to compare the effectiveness and safety of acupotomy with or without pharmacopuncture combined with epidural steroid injection for patients with cervical radiculopathy in a pragmatic clinical setting.Methods This three-arm, evaluator-blinded, randomized pilot trial will enroll 39 patients with cervical radiculopathy, allocating them in a 1:1:1 ratio.All participants will receive epidural steroid injections.Experimental group A will additionally receive acupotomy and pharmacopuncture, while experimental group B will receive only acupotomy.The primary outcome is the change in the Neck Disability Index (NDI) at week 4. Secondary outcomes include NDI changes at weeks 2 and 8, the Numeral Rating Scale (NRS) for cervical and upper extremity pain, the Northwick Park Neck Pain Questionnaire (NPQ), the European Quality of Life 5 Dimension (EQ-5D), and the incidence of adverse events.Results The mean changes in the primary and secondary outcomes will be calculated and compared among the three treatment groups.Safety outcomes, including the incidence of adverse events, will also be analyzed.Conclusions This pragmatic pilot randomized controlled trial will provide preliminary results on the comparative effectiveness and safety of adding acupotomy, with or without pharmacopuncture, to epidural steroid injections.The findings are expected to inform treatment selection and guide the design of a larger, multi-center, full-scale study..

Background/Objectives: Dioscoreae Rhizoma, commonly known as yam, has long been used in East Asia as a medicinal food for gastrointestinal (GI) health. This systematic review aimed to assess the GI-related benefits of Dioscoreae Rhizoma by synthesizing findings from both human clinical trials and in vivo experimental studies. Methods: A structured search of eight major databases—including PubMed, EMBASE, and Web of Science—was conducted through April 2025. This systematic review includes both human and in vivo animal studies that investigated the effects of Dioscoreae Rhizoma on gastrointestinal function. Studies such as in vitro experiments, non-original articles and studies involving multi-herbal formulations were excluded. Risk of bias was assessed with three different tools including the Cochrane Risk of Bias 2 (RoB 2) tool. Results: Twenty-seven studies met the inclusion criteria, comprising two human trials and twenty-five animal experiments. Clinical trials reported improvements in gut-microbiota balance, glycemic control, and postsurgical recovery, including enhanced wound healing and reduced infection rates. In animal models, yam-derived interventions attenuated inflammatory responses, enhanced antioxidant defenses, preserved mucosal-barrier integrity, and favorably modified gut-microbiota composition. Discussion and Conclusions: Accumulating evidence supports the GI-beneficial effects of Dioscoreae Rhizoma, mediated through diverse biological pathways, including immunomodulation, antioxidation, and microbiota regulation. This study has limitations on lack of high-quality human studies, small sample size and heterogeneity among studies regarding different plant parts used, extraction processes, and dosage. Further rigorously designed studies are warranted to clarify the mechanisms, standardize intervention protocols, and validate clinical efficacy.