Integrative Korean Medicine Treatment for Obesity and Overweight in Children and Adolescents: A Multicenter Retrospective Chart Review Study

Figures & data

Table 1 Characteristics of the Patients

Variables	Total	n	Boys	n	Girls	n	p value
Sex
Boys	111 (53.11)	209
Girls	98 (46.89)
Menarche (girls)
Yes	50 (51.02)	98
No	25 (25.51)
Not recorded	23 (23.47)
Family history
Hypertension	18 (8.61)	209
Diabetes mellitus	10 (4.78)
Obesity	6 (2.87)
Dyslipidemia	2 (0.96)
Precocious puberty	1 (0.48)
BMI category
Obese	183 (87.56)	209	103 (92.79)	111	80 (81.63)	98	0.026
Overweight	26 (12.44)		8 (7.21)		18 (18.37)
Age (years)	11.45 ± 3.98	209	10.74 ± 3.53	111	12.26 ± 4.3	98	0.006
Height (cm)	147.39 ± 17.24	209	146.71 ± 17.99	111	148.16 ± 16.4	98	0.545
Weight (kg)	59.89 ± 21.82	209	59.79 ± 22.48	111	60 ± 21.17	98	0.945
BMI (kg/m^2)	26.54 ± 4.47	209	26.69 ± 3.89	111	26.36 ± 5.07	98	0.594
Birth weight (kg)	3.27 ± 0.48	127	3.32 ± 0.49	79	3.2 ± 0.46	48	0.166
MPH (cm)	169.29 ± 7.09	135	173.98 ± 3.7	83	161.8 ± 4.15	52	<0.001

Notes: The values are presented as mean ± standard deviation and frequency (column proportion) for continuous and categorical variables, respectively. The p values for continuous and categorical variables were calculated from the independent two-sample t-test and chi-squared test, respectively.

Abbreviations: BMI, body mass index; MPH, mid-parental height.

Figure 1 A flowchart of inclusion of patients.

Abbreviations: BMI, body mass index; IKM, integrative Korean medicine treatment.

Table 2 Contents of Integrative Korean Medicine Treatment

Contents	n (%)
HM	114 (54.55)
HM + AT	40 (19.14)
HM + Moxa + AT + Chuna	19 (9.09)
HM + Moxa + AT	12 (5.74)
HM + Moxa	6 (2.87)
HM + Chuna	2 (0.96)
HM + AT + Chuna	2 (0.96)
HM + Moxa + AT + Pharmacopuncture	2 (0.96)
HM + Moxa + AT + Pharmacopuncture + Chuna	2 (0.96)
HM + Moxa + Cupping therapy + AT	2 (0.96)
HM + Moxa + Cupping therapy + AT + Pharmacopuncture	2 (0.96)
Moxa + AT	2 (0.96)
AT	2 (0.96)
HM + Moxa + Cupping therapy + AT + Chuna	1 (0.48)
HM + AT + Pharmacopuncture + Chuna	1 (0.48)
Total	209 (100)

Note: The values are presented as frequency (column proportion).

Abbreviations: AT, acupuncture therapy; HM, herbal medicine; Moxa, moxibustion.

Table 3 Change in Obesity-Related Outcome Measures

Variables	n	Baseline Measurement	Last Measurement	Effect Size	p value
BMI percentile	187	97.93 ± 3.13	96.4 ± 6.04	0.36	<0.001
BMI z-score	187	2.62 ± 0.97	2.36 ± 0.94	0.63	<0.001
Weight percentile	209	95.91 ± 6.19	94.27 ± 8.12	0.36	<0.001
Weight z-score	209	2.31 ± 0.95	2.11 ± 0.95	0.51	<0.001
Body fat mass	74	25.96 ± 10.77	24.11 ± 9.98	0.44	<0.001
Body fat percentage	74	38.9 ± 5.92	36.91 ± 5.87	0.51	<0.001
Height percentile	187	69.29 ± 26.77	70.24 ± 26.6	0.17	0.021
Height z-score	187	0.74 ± 1.03	0.79 ± 1.05	0.23	0.002

Notes: The values are presented as mean ± standard deviation. The p values were calculated from paired sample t-tests.

Figure 2 Changes of BMI percentile and z-score.

Abbreviation: BMI, body mass index.

Table 4 Adverse Events

Variables	Frequency (%)
Diarrhea	20 (41.67)
Nausea	8 (16.67)
Dizziness	4 (8.33)
Vomiting	3 (6.25)
Headache	2 (4.17)
Pruritus	1 (2.08)
Dry mouth	1 (2.08)
Difficulty falling asleep	1 (2.08)
Blurred vision	1 (2.08)
Increased stool frequency	1 (2.08)
Hair loss	1 (2.08)
Abdominal pain	1 (2.08)
Hand tremor	1 (2.08)
Cold sweat	1 (2.08)
Palpitation	1 (2.08)
Light sleep	1 (2.08)
Total	48 (100)

Note: The values are presented as frequency (column proportion).

Table 5 Characteristics of Patients According to the Treatment Response

Variables	Responder	n	Non-Responder	n	p value
Sex
Boys	7 (29.17)	24	92 (56.44)	163	0.023^†
Girls	17 (70.83)		71 (43.56)
BMI category
Obese	14 (58.33)	24	150 (92.02)	163	<0.001^†
Overweight	10 (41.67)		13 (7.98)
Herbal medicine
Including Ephedrae Herba	23 (95.83)	24	123 (77.36)	159	0.052*
Not including Ephedrae Herba	1 (4.17)		36 (22.64)
Age (years)	13.02 ± 2.97	24	10.8 ± 3.79	163	0.002
BMI percentile	94 ± 3.79	24	98.51 ± 2.57	163	<0.001
BMI z-score	1.64 ± 0.36	24	2.77 ± 0.95	163	<0.001
Weight percentile	90.47 ± 6.56	24	96.78 ± 5.58	163	<0.001
Weight z-score	1.44 ± 0.48	24	2.41 ± 0.91	163	<0.001
Height percentile	59.28 ± 25.55	24	70.76 ± 26.7	163	0.031
Height z-score	0.31 ± 0.83	24	0.8 ± 1.05	163	0.033
Birth weight (kg)	3.26 ± 0.47	11	3.27 ± 0.48	111	0.954
Administration period of herbal decoction (day)	101.58 ± 128.79	24	71.9 ± 80.76	156	0.113
The period between the first and last visits (day)	159.54 ± 157.05	24	187.85 ± 330.2	163	0.718
Number of visits	5.58 ± 5.63	24	6.15 ± 8.45	163	0.753

Notes: The values are presented as mean ± standard deviation and frequency (column proportion) for continuous and categorical variables, respectively. The p value^† and p value* for categorical variables were calculated from the chi-squared test and Fisher’s exact test respectively. The p values for continuous variables were calculated from Wilcoxon rank-sum tests.

Abbreviation: BMI, body mass index.