Cheonwangbosim-dan (CWBSD) is a traditional Korean herb formula that has been widely prescribed for insomnia patients with a heart-yin deficiency (HYD) pattern. Several studies have reported that heart function and insomnia are interrelated, and few have explored associations between insomnia, oral microbiota, and tongue diagnosis. This study aimed to evaluate the effects of CWBSD on primary insomnia, tongue diagnosis, and oral microbiota. At baseline, 56 patients with primary insomnia were assigned to two groups, a HYD group and a non-HYD (NHYD) group and they took CWBSD for 6 weeks. During the study, Pittsburgh Sleep Quality Indices (PSQIs) and Insomnia Severity Indices (ISIs) decreased significantly in both groups. However, the PSQI reduction observed in the HYD group was greater than in the NHYD group and sleep times increased only in the HYD group. As sleep quality improved, the amount of tongue coating increased at the posterior tongue, where heart function appears. At baseline, the HYD and NHYD group had a specific oral microbiota (Veillonella at genus level), but no significant change was observed after taking CWBSD. Additionally, subjects were divided into two oral microbiota types (“orotypes”). The genera Prevotella, Veillonella, or Neisseria were abundant in each orotype. The reduction in PSQI in orotype 1 during the 6-week treatment period was greater than in orotype 2. In conclusion, this study shows that CWBSD could be used to treat primary insomnia in patients with a HYD pattern as determined using tongue diagnosis and oral microbiota distributional patterns.

Background: Herbal medicine based on pattern identification (PI) is used widely in Traditional Chinese Medicine. Proper herbal medicine based on PI has been suggested for effective weight reduction and decreasing the adverse events. This systematic review examined the effectiveness and safety of herbal medicine, focusing on PI in treating obesity. Methods: Eight electric databases were used for searching randomized controlled trials (RCT) (to August 31, 2021). RCTs which prescribed herbal medicine to obese patients based on PI were included. Body weight (BW) and body mass index (BMI) were the primary outcomes. The risk of bias was assessed using Cochrane risk of bias tool, and the meta-analysis was conducted. Grading the evidence was conducted by using GRADEpro. Results: Sixteen RCTs (1052 patients) were included: 2 studies compared herbal medicine to placebo (128 patients); 2 studies compared them to western medication (161 patients); 12 studies compared them with usual care (763 patients). The meta-analysis showed that the herbal formulas reduced the BW and BMI without significant Adverse events compared to the control group (BW: mean difference = –4.10, 95% confidence interval: –5.14 to –3.06, I ² = 2% and BMI: mean difference = –1.53, 95% confidence interval: –1.88 to –1.19, I ² = 25%). Moderate-quality evidence on the primary outcomes was found. Conclusions: Herbal medicine – has good clinical efficacy and safety in treating obesity. This study has limitations that some literatures with high risk of bias in blinding or without using a standardized diagnosis of PI were included. However, the current evidence suggests the possibility of precision medicine using PI.

Scoliosis is a spinal disease in which the Cobb angle is >10°. Scoliosis treatment can be surgical or conservative, and clinical practice guidelines (CPGs) for conservative treatments have been updated since 2006. There have been several articles regarding the efficacy and safety of Korean medicine (KM) in treating scoliosis, but there are no CPGs. Our study investigated the current clinical practice using a survey for the future establishment of KM-CPGs. The survey mainly comprised clinical practice status, diagnosis, treatment, progress and prognosis, and perception of KM on scoliosis, with reference to existing surveys of other musculoskeletal disorders and scoliosis-related articles. A web-based survey was conducted from February 16, 2021 to February 28, 2021. We found that 60% of KM doctors (KMDs) respondents treated patients with scoliosis, and they valued radiographical measurements and scoliosis-related factors in the diagnosis. KMDs used multiple KM treatments, including acupuncture, Chuna, cupping, pharmacopuncture, and herbal medicine, and they emphasized the importance of KM more in nonstructural scoliosis than in structural scoliosis. Although the perception of the prognosis of scoliosis was in agreement with that suggested by previous guidelines, KMDs showed outstanding focus on reduction of symptoms of scoliosis and improvement of quality of life. Despite some limitations, including low participation and the need for consulting other medical practitioners, our study may be helpful for the development of KM-CPGs because it is the first to analyze the perceptions of KMDs on scoliosis and to collect preliminary data that are of significance for preparing clinical guidelines.

Ji-Ho Lee, Hyeon-Sun Park, Sang-Hyeon Park, Dong-Ho Keum, Seo-Hyun Park. J Pharmacopuncture 2024;27:14-20. https://doi.org/10.3831/KPI.2024.27.1.14

Recently, Bacteroides species, a dominant genus of commensal gut bacteria, have been increasingly recognised as potential next-generation postbiotics. The present study isolated nine Bacteroides POTENTIAL postbiotics from healthy human feces. Among them, Phocaeicola vulgatus (PV-1), Bacteroides thetaiotaomicron (BT-1), and Bacteroides uniformis (BU-1) were selected based on their capacity to inhibit lipogenesis and their potential synergy in vitro . Subsequently, the anti-obesity effect of the three Bacteroides postbiotics was comparatively investigated, both in combination (VTU) and individually, using a high-fat diet (HFD)-fed mouse model. VTU more notably reduced HFD-triggered excessive body mass, fat, and liver weights compared to the individual postbiotics. Additionally, VTU markedly attenuated serum triglyceride, total cholesterol, fasting blood glucose, and insulin levels compared to the HFD-alone treatment. Furthermore, VTU significantly downregulated the expression of lipogenesis-associated genes in the liver, including PPAR γ, C/EBP α, AP2 , CD36 , FAS , ACC1 , and LDLR , while upregulating beige-specific marker genes in the white adipose tissue, such as PRDM16 , UCP1 , and PPAR γ. Moreover, VTU significantly altered the serum metabolomic profile, significantly changing several metabolites like lysophosphatidylcholines (LPCs) and Boc-homoglutamic acid. These findings indicate that the combination of PV-1, BU-1, and BT-1 synergistically ameliorated obesity by regulating lipid and glucose metabolism. Hence, we propose that Bacteroides postbiotics, including their combinations, could be developed as novel therapeutic agents for alleviating obesity and its complications in the future.