Korean medicine clinical practice guideline for lumbar herniated intervertebral disc in adults: An evidence based approach

Introduction: Lumbar herniated intervertebral disc (HIVD) is a common chronic disease, and in Korea many patients use Korean medicine (KM) for treatment. However, KM clinical practice guideline (CPG) for HIVD remain poor. Therefore, this aim is to describe the KM approach for managing HIVD in Korea from an evidence-based medicine (EBM) perspective. Methods: A systematic review was undertaken of literature focusing on key areas of KM practice aimed at managing HIVD. The evidence obtained was based on the study design and the risk of bias. Recommendations were formulated, taking the quality, quantity, and level of the evidence into consideration, as well as the likely clinical impact and the applicability of the evidence to KM practice in Korea. Preliminary CPGs were then recommended for the application of KM for the management of HIVD. After several rounds of expert consensus meetings, the final guideline was endorsed by relevant professional committees. Results: The final recommendation was made based on a draft of the recommendations of the working group during the consensus process. A total of 15 recommendation statements were made regarding KM treatments for HIVD, which included acupuncture (n = 3), pharmacopuncture (n = 3), herbal medicine (n = 3), chuna (n = 2), moxibustion (n = 2), and cupping therapy (n = 2). Conclusions: Following on from the above development, we sought to carry out a high-quality follow-up KM clinical study with the objective of improving HIVD patients understanding of medical treatments for the condition. Also, future research in this area will formally examine the success of the guideline's implementation. (C) 2017 Elsevier GmbH. All rights reserved.