2 2. Methods 2.1. Participants. The Kyung Hee University Oriental Medicine Hospital Institutional Review Board approved the present study (KOMC IRB 2009-14), which was conducted as a comparative, observational, and pragmatic study. Over a 31-month period spanning from March 2009 to September 2011, 77 Korean Asian patients in total (mean ± SD age 53.7 ± 14.4 years) with a clinical diagnosis of post-stroke aphasia of diﬀerent severities (mild to severe) were enrolled in the study. Participants who were treated with language therapy after 6 months from the onset of stroke were also excluded from the study. 2.2. Study Design (Figure 1). After admission to Kyung Hee Medical Center (Department of Cardiovascular and Neu- rologic Diseases of the Oriental Medicine Hospital, and Department of Neurology, Neurosurgery, and Rehabilitation of the Western Medicine Hospital), the participants received language therapy until they were discharged. The frequency and intensity of language therapy were adjusted individually according to the severity and the type of the participants’ aphasia. Participants completed the K-WAB (Korean version of the Western Aphasia Battery) AQ test (Table 7) at 2 time-points: an initial (“baseline”) test was administered at the time of recruitment of the participants, and a second test was administered after the last language therapy session (discharge time). Discharge time was decided according to the Korean health policy which limit the admission duration of one hospital to 6–8 weeks. The AQ test was performed by four language therapists. All participants were evaluated by language therapist in charge twice. These language therapists did not know that they were participating in the present study. Calculation of the AQ test scores included the total AQ score and the AQ subsection score. The type of stroke was determined by the results of the initial AQ test. Medical records of each participant’s age, medical history, and associ- ated symptoms were recorded. The patients were diagnosed with stroke when neurological deﬁcits were accompanied by abnormal ﬁndings in computed tomography (CT) or magnetic resonance imaging (MRI) of the brain. The participants were assigned to one of the two treat- ment groups. The Combined Oriental Medicine Therapy (COT) group admitted to the Oriental Medicine Hospital of Kyung Hee Medical Center and received conventional therapy that included taking antiplatelet agent, control risk factor (e.g. hypertension, diabetes mellitus, dyslipi- demia and cardiac disease), rehabilitation exercise, working exercise for stroke, language therapy for aphasia, and an oriental medicine regimen that included herbal medicine, acupuncture, and moxibustion. oriental medicine therapy administered to patients in the COT group was adjusted individually according to the severity and type of aphasia, general condition, and associated symptoms. Details of the Oriental medicine therapies (herbal medicine type and contents, using frequency, acupuncture, method, and moxi- bustion method) were recorded in Table 1. Herbal medicine adjusted in each patient was selected by patient’s condition, characters, and oriental diagnosis (pattern recognition). Evidence-Based Complementary and Alternative Medicine Patient COT group (language therapy + conventional therapy + oriental medicine therapy) OLT group (language therapy + conventional therapy) 47 patients 30 patients Baseline: language therapy starting point, 1st AQ Followup: language therapy ending point, 2nd AQ Compare COT group with OLT group Figure 1: Study protocol. Acupuncture and moxibustion were conducted equally in all COT group patients. The Only Language Therapy (OLT) group was admitted to the Western Medicine Hospital of Kyung Hee Medical Center and received conventional therapy for stroke and language therapy for aphasia. In Kyung Hee Medical Center, there are two hospitals, Western Medicine Hospital which treat patients with conventional therapy and Oriental Medicine Hospital which treat patients with conventional therapy and oriental medicine therapy. Each patient who is admited Kyung Hee Medical Center can choose one of the two hospitals according to their preference. Therefore, inclusion in each group was not randomized, but based on the participants’ choice. 2.3. Measurements. The AQ test was used to estimate the eﬀectiveness of the oriental medicine combination therapy for aphasia. The primary outcome of this study was mea- sured as the delta value of the total AQ score (diﬀerence between the initial total AQ score and the ﬁnal total AQ score, “ﬁnal total AQ score—initial total AQ score”). The secondary outcome was the delta value of each subsection score of the AQ test, such as spontaneous speech, comprehension, repetition, and naming. The third outcome was the change of aphasia severity distribution. Patients were classiﬁed into two severity groups according to the AQ scores as follows: non-severe aphasia: AQ 36.3 ∼ 92.2, severe aphasia: AQ 0– 36.2. We compared the scores of AQ test and the distribution of severity (severe, and non-severe) of the COT group with the OLT group. 2.4. Statistical Analysis. All data and results were analyzed using SPSS 12.0 for Windows. Fisher’s exact test was used to compare categorical variables, including gender, hand- edness, type of stroke, type of aphasia, risk factors, fre- quency of related symptoms, and distribution of aphasia severity between the two groups. The Mann-Whitney U test was used to compare continuous variables such as age, education, treatment periods from onset, duration of treat- ment, and diﬀerences in AQ scores between the 2 groups.