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1. Introduction
Acupuncture has only been used for 60 years in Korean medicine. However, since the treatment was commercialized, many studies have confirmed its efficacy. Although herbal acupuncture developed from acupuncture, its mechanism of action differs somewhat. Herbal acupuncture smooths the flow of blood, which is referred to as “energy” in oriental medicine. Furthermore, the medicine contains concentrated herbal ingredients that work simultaneously, thus surpassing the efficacy of acupuncture itself.
Until recently, there was no proper English word for herbal acupuncture. However, the term “pharmacopuncture” was registered in the 2017 medical academic information classification system (MeSH), which is used by the US National Library of Medicine (NLM) to link academic information in the healthcare field. Additionally, the term “pharmacopuncture” has been added to the new index of PubMed, which is the world’s largest medical journal database.
Pharmacopuncture has strong anti-inflammatory and pain-relieving effects because it directly treats the acupuncture point. In one survey of patients who had visited oriental medicine hospitals, 48% of responders preferred pharmacopuncture to other oriental medicine treatments, because it caused a rapid decrease in pain [1, 2]. Moreover, the safety investigation suggested that acupuncture/pharmacopuncture led to a lower range, frequency, and severity of significant adverse events [3].
The venom of the European honey bee (Apis mellifera) comprises a mixture of proteins, peptides, and other small molecules. In bee venom pharmacopuncture (BVP), which has pain-relieving and anti-inflammatory effects, the venom is injected at appropriate doses onto acupuncture points that are selected through syndrome differentiation [4]. BVP has significant therapeutic effects on degenerative knee and rheumatoid arthritis [5–9]. The main active component of bee venom pharmacopuncture (BVP) is melittin: a peptide with antimicrobial, antitumor, and anti-inflammatory effects. In oriental medicine, honey bee venom products containing about 50% melittin are widely used for BVP. However, these products also contain the proteins phospholipase A2 (PLA2) and apamin, which are major allergens as they are capable of inducing the IgE response in susceptible individuals, according to the International Union of Immunological Societies (IUIS) [10–12]. Thus, to protect patients against side effects of BVP, both of...