title: Effects of Shinbaro pharmacopuncture in sciatic pain patients with lumbar disc herniation: study protocol for a randomized controlled trial.
abstract: BACKGROUND
  Lumbar disc herniation is a major cause of sciatica and low back pain and imposes a heavy burden on both individual and society. While use of pharmacopuncture, a combined form of acupuncture and herbal medicine, for lumbar disc herniation is widespread in Korea and China, there is a paucity of research.
  
  
  METHODS
  This study is the protocol for a three-armed, randomized, patient, physician, and assessor-blinded controlled pilot study. Sixty patients with severe non-acute sciatic pain diagnosed with lumbar disc herniation (NRS ≥ 5, onset between 4 weeks and 6 months) will be recruited and randomized 20 each to the Shinbaro pharmacopuncture (pharmacopuncture with acupuncture), acupuncture, and usual care groups, respectively. The 2 acupuncture groups will receive 2 sessions/week of acupuncture alone or with pharmacopuncture for 4 weeks (total 8 sessions), and the usual care group will receive conventional medication 2-3 times/day and physical therapy 2 sessions/week over 4 weeks (total 8 sessions). The initial acupuncture physician will administer acupuncture at 5 acupoints (GB30, BL40, BL25, BL23, GB34) in the 2 acupuncture groups, and mark an additional acupoint. A second acupuncture physician will administer pharmacopuncture to the marked acupoint in the pharmacopuncture group, and acupuncture in the acupuncture group during acupuncture needle retention. The second physician will administer acupuncture and pharmacopuncture in a similar manner in terms of advice and manual stimulation to maintain patient-blinding, treat the patient out of view of the initial physician, remove the additional acupuncture needle immediately, and cover the area with adhesive bandage to maintain physician-blinding. The primary endpoint will be at 5 weeks post-randomization, and the primary outcome will be Visual Analog Scale (VAS) of sciatic pain. Secondary outcomes will be VAS of low back pain, Numeric Rating Scale (NRS) of low back pain and sciatic pain, ODI, SF-36, EQ-5D, and PGIC. Post-treatment evaluations will take place 5, 7, 9, and 12 weeks after randomization.
  
  
  CONCLUSIONS
  This trial will evaluate the comparative clinical effectiveness of pharmacopuncture for severe non-acute sciatic pain patients diagnosed with lumbar disc herniation with usual care of conventional medicine and that of Korean medicine (acupuncture), monitor its safety, and serve as basis for a large-scale, multicenter trial.
  
  
  BACKGROUND
  ClinicalTrials.gov NCT02384928 , registered 27 February 2015.
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. jasengjsr@gmail.com.
authors.forename: Jinho
authors.initials: J
authors.lastname: Lee
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. Jasengmaster@gmail.com.
authors.forename: Joon-Shik
authors.initials: JS
authors.lastname: Shin
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. goodsmile8119@gmail.com.
authors.forename: Yoon Jae
authors.initials: YJ
authors.lastname: Lee
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. krmkmr@naver.com.
authors.forename: Me-Riong
authors.initials: MR
authors.lastname: Kim
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. ahnyj322@gmail.com.
authors.forename: Yong-Jun
authors.initials: YJ
authors.lastname: Ahn
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. kbpark@jaseng.co.kr.
authors.forename: Ki Byung
authors.initials: KB
authors.lastname: Park
authors.affiliation: Spine Center, Cedars-Sinai Medical Center, 444 S. San Vicente Blvd, Suites 800/901, Los Angeles, CA, USA. MKropfMD@gmail.com.|LA Spine, Inc., 444 S. San Vicente Blvd, Suite 901, Los Angeles, CA, USA. MKropfMD@gmail.com.
authors.forename: Michael A
authors.initials: MA
authors.lastname: Kropf
authors.affiliation: Busan National University, Yangsan campus, 49 Busandaehak-ro, Mulgeum-eup, Yangsan-si, Gyeongsangnam-do, Republic of Korea. drshinbc@pusan.ac.kr.
authors.forename: Byung-Cheul
authors.initials: BC
authors.lastname: Shin
authors.affiliation: Division of Medical Research, Korea Institute of Oriental Medicine, 1672 Yuseongdae-ro, Yuseong-gu, Daejeon, Republic of Korea. drmslee@gmail.com.
authors.forename: Myeong Soo
authors.initials: MS
authors.lastname: Lee
authors.affiliation: Jaseng Spine and Joint Research Institute, Jaseng Medical Foundation, 858 Eonju-ro, Gangnam-gu, Seoul, 135-896, Republic of Korea. hanihata@gmail.com.
authors.forename: In-Hyuk
authors.initials: IH
authors.lastname: Ha
mesh_terms: D015670:Acupuncture Therapy / Q000009:adverse effects / Q000379:methods*; D000328:Adult; D000700:Analgesics / Q000008:administration & dosage* / Q000009:adverse effects; D002985:Clinical Protocols; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D007267:Injections; D007403:Intervertebral Disc / Q000503:physiopathology*; D007405:Intervertebral Disc Displacement / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D008159:Lumbar Vertebrae / Q000503:physiopathology*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement; D010936:Plant Extracts / Q000008:administration & dosage* / Q000009:adverse effects; D056910:Republic of Korea; D012107:Research Design; D012585:Sciatica / Q000175:diagnosis / Q000503:physiopathology / Q000628:therapy*; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D000700:Analgesics; D010936:Plant Extracts; C571726:shinbaro