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빈혈에 대한 보중익기탕 및 그 가미방의 효과: 체계적 문헌고찰과 메타분석

Effects of Bojungikgi-tang and its modifications for Anemia: A Systematic Review and Meta-Analysis of Randomized Controlled Trials

  • 김미경 (상지대학교 한의과대학 내과학교실) ;
  • 한창호 (동국대학교 한의과대학 내과학교실)
  • Mikyung Kim (Department of Internal Medicine, College of Korean Medicine, Sangji University) ;
  • Chang-ho Han (Department of Internal Medicine, College of Korean Medicine, Dongguk University)
  • 투고 : 2023.03.26
  • 심사 : 2023.05.10
  • 발행 : 2023.06.01

초록

Objectives: This study aimed to evaluate the efficacy and safety of Bojungikgi-tang (BJIG) and its modifications for patients with anemia. Methods: The subject of analysis of this study was a parallel design randomized controlled trial in which BJIG or its modifications was administered orally to patients who met the World Health Organization's anemia criteria and the efficacy and safety were prospectively measured. Electronic databases were searched to retrieve eligible literature published from 1 January 2000 to 12 February 2023. A meta-analysis was conducted, and the risk of bias (RoB) and level of evidence of the included studies was assessed using the Cochrane RoB 2 tool and GRADE method, respectively. Results: Five studies were included in the meta-analysis. When BJIG or its modifications was administered to anemia patients receiving conventional treatment, additional benefits compared to the non-administered group were found in terms of an increase in red blood cell count (mean difference (MD) 0.46 × 1012/L, 95% confidence interval (CI) 0.17 to 0.74), hemoglobin concentration (MD 9.28 g/L, 95% CI 6.06 to 12.51), hematocrit (MD 2.57%, 95% CI 1.76 to 3.38), total effective rate (odds ratio 5.29, 95% CI 2.05 to 13.68), and traditional Chinese medicine symptom scores (standardized MD -1.51, 95% CI -2.79 to -0.24). Conclusions: This study demonstrated the clinical potential of BJIG and its modifications to provide additional benefits to patients with anemia receiving conventional treatment.

키워드

참고문헌

  1. World Health Organization. Haemoglobin Concentrations for the Diagnosis of Anaemia and Assessment of Severity. Geneva: World Health Organization. 2011 [cited 2023 Mar 26]. Available at: ULR: https://apps.who.int/iris/handle/10665/85839
  2. Gardner, W., & Kassebaum, N. (2020). Global, Regional, and National Prevalence of Anemia and Its Causes in 204 Countries and Territories, 1990-2019. Current Developments in Nutrition, 4(Supple 2), 830. http://doi.org/10.1093/cdn/nzaa053_035
  3. Korea Disease Control and Prevention Agency. Health Outcomes: Prevalence of Anemia 2020. In: Chronic Disease Health Statistics. 2020 [cited 2023 Mar 26]. Available at: URL: https://chs.kdca.go.kr/cdhs/biz/pblcVis/details.do?ctgrSn=37
  4. Nah, E., Cho, S., Kim, S., Chu, J., Kwon, E., & Cho, H. (2020). Distribution of Hemoglobin Levels and Prevalence of Anemia according to Sex, Age Group, and Region in 13 Korean Cities. International Journal of Laboratory Hematology. 42(2),223-229. https://doi.org/10.1111/ijlh.13160
  5. Chueh, H.W., Jung, H.L., Shim, Y.J., Choi, H.S., Han, J.Y., & on the behalf of the Red Blood Cell Disorder Working Party of The Korean Society of Hematology. High anemia prevalence in Korean older adults, an advent healthcare problem: 2007-2016 KNHANES. BMC Geriatrics, 20(1):509. https://doi.org/10.1186/s12877-020-01918-9
  6. Faculty of Internal Medicine of Liver System of Korean Medicine. (2016). Textbook of Internal Medicine of Liver System in Korean Medicine. Seoul: Book Publisher Nadoh. 153-155, 166-170, 172-179, 526, 530-531, 548-550, 561, 566.
  7. East-West Medical Convergence Research Society. (1997) East-West Clinical Medicine. Seoul: Younglim Publishing Company. 113-116, 316-318.
  8. Kim, J., Jeong, C., Jang, W., & Baik, Y. (2015). A Study on the Function of Pi(脾) in Huangdineijing. The Journal of Korean Medical Classics, 28:141-158. https://doi.org/10.14369/skmc.2015.28.3.141
  9. Compliation Committee for Common Textbooks of Prescription of Herbal Medicine. (2020) Prescription of Herbal Medicine. Particulars Vol. 1. Paju: Gunja Publishing House. 556-557.
  10. So, J. (2022). Traslation of the theory of internal and external injury (內外傷辨惑論) by Dongyuan Li (李東垣). Paju: Fish forest. 68.
  11. Park, J., & Kim, K. (2017). A Survey on Uncovered Services in National Health Insurance of Traditional Korean Medicine Institution. Journal of Society of Preventive Korean Medicine, 21(3), 43-50. https://doi.org/10.25153/spkom.2017.21.3.005
  12. Kim, D., Shin, J., Park, B., Won, J., O, K., & Moon, G. (2008). Change of RBC Indices with Serum Iron, TIBC Level in Iron Deficiency Anemia Patients Who Treated Oriental Medicine. Journal of Physiology & Pathology in Korean Medicine, 22(6), 1579-1584.
  13. Chen, W., Huang, H., Su, Y., Chou, S., Ho, W., & Kao, M., et al. (2018). The Characteristics and Prescription Patterns of Chinese Herbal Medicine in Clinical Practice for the Treatment of Anemia. Taiwanese Journal of Obstetrics and Gynecology, 57(4):570-577. https://doi.org/10.1016/j.tjog.2018.06.030
  14. Kim, J., Park, S., Sin, C., Kwon, O., Lee, J., Seo, C., & et al. (2009). Clinical Study of Bojungikki-tang on Cerebrovascular Accident Patients with Normocytic Normochromic Anemia. The Journal of East-West Medicine, 34(1), 33-43.
  15. Choi, S., Lee, J., Nam, W., Jin, M., Jeong, H., Ju, W., & et al. (2012). A Case Reports of Cerebral Infarction with Normocytic Normochromic Anemia Treated with Bojungikki-tang and Bojungikki-tang-gamibang. The Journal of Internal Korean Medicine, Oct, 192-200.
  16. Son, C. (2009). Chronic Iron Deficiency Anemia Treated with Bojungicki-tang: A Case Report. The Journal of Internal Korean Medicine, 30(1), 228-232.
  17. Kim, D., Wu, H., Ha, S., Cho, G., Rhee, S., & Han, C. (2003). A Clinical Process Report on the Patient of Aplastic Anemia Treated with Bojoongyikgiboyol-tang. The Journal of Internal Korean Medicine, Nov, 238-245.
  18. He, M., Kong, S., & Shen, W. (2013). Objervation on Curative Effect of Modified Buzhong Yiqi Decoction Combined with Erythropoietin in Treating Renal Anemia (加减补中益气汤联合促红细胞生成素治疗肾性贫血疗效观察). Chinese Journal of Integrated Traditional and Western Nephrology (中国中西医结合肾病杂志), 14(03), 260-261.
  19. Li, W., Guo, Y., & Zou, Y. (2005). Observation of Curative Effect of Supplementing Qi and Removing Blood Satsis on 60 Cases of Hemorrhagic Anemia Induced by Trauma (益气祛瘀法治疗创伤致失血性贫血60例疗效观察). New Journal of Traditional Chinese Medicine (新中医), 37(08), 24-25.
  20. Xu, L. (2021). Clinical Study of Jiawei Buzhong Yiqi Decoction on Occult Blood Loss after Artificial Femoral Head Replacement. Yunnan University of Traditional Chinese Medicine. [Master's thesis].
  21. Chen, L., Feng, Q., Lin, F., Yue, H., & Tang, Y. (2021). Clinical Observation on Buzhong Yuqu Decoction Combined with Goverbor Vessel Moxibustion for the Treatment of Hemorrhoids with Mild to Moderate Anemia (补中益气汤联合督灸治疗轻中度贫血痔的临床疗效观察). Journal of Guangzhou University of Traditional Chinese Medicine (广州中医药大学学报), 38(08), 1596-1601. https://doi.org/10.13359/j.cnki.gzxbtcm.2021.08.011
  22. Zhou, Z., Wu, L., & Chen, Y. (2019). Efficacy and Safety of Buzhong Yiqi Granule Combined with Polysaccharide Iron Complex in the Treatment of Iron Deficiency Anemia during Pregnancy (补中益气颗粒联合多糖铁复合物治疗妊娠期缺铁性贫血疗效和安全性分析). Journal of International Reproductive Health/Family Planning (国际生殖健康/计划生育杂志), 38(02), 116-119.
  23. Garcia-Casal, M.N., Pasricha, S.R., Sharma, A.J., & Pena-Rosas, J.P. (2019). Use and Interpretation of Hemoglobin Concentrations for Assessing aAnemia Status in Individuals and Populations: Results from a WHO Technical Meeting. Annals of the New York Academy of Sciences, 1450(1), 5-14. https://doi.org/10.1111/nyas.14090
  24. Chen, L.J., Yu, Y., & Xiong, W.S. (2019). A Meta-analysis of Randomized Controlled Trials of Guipi Decoction in Assisting Treatment of Iron Deficiency Anemia (归脾汤辅助治疗缺铁性贫血随机对照实验的 Meta 分析). Journal of Zhejiang University of TCM (浙江中医药大学学报), 43(12), 1368-1376. https://doi.org/10.16466/j.issn1005-5509.2019.12.01
  25. Ministry of Food and Drug Safety. (2011). Guidelines for Non-Clinical and Clinical Evaluation of Biosimilars of Erythropoietin. Osong: MFDS. 10.
  26. Goh, B., Ong, L., Sivanandam, S., Lim, T., & Morad Z. (2007). Randomized Trial on the Therapeutic Equivalence between Eprex and GerEPO in Patients on Haemodialysis. Nephrology, 12(5), 431-436. https://doi.org/10.1111/j.1440-1797.2007.00831.x
  27. Locatelli, F., Villa, G., Messa, P., Filippini, A., Cannella, G., & De Ferrari, G., et al. (2008). Efficacy and Safety of Once-Weekly Intravenous Epoetin Alfa in Maintaining Hemoglobin Levels in Hemodialysis Patients. Journal of Nephrology, 21(3), 412-420.
  28. An, S., Jeong, Y., Kim, J., Shin, H., & Kwon, Y. (2021). Safety of Bojungikgi-tang Soft Extract after Single Oral Administration in Healthy Male Volunteers, Single Center Study. Journal of Korean Medicine Rehabilitation, 31(4), 157-166. https://doi.org/10.18325/jkmr. 2021.31.4.157
  29. Lee, J., Hwang, Y., Kwak, D., Kim, T., & Ma, J. (2011). Single Oral Dose Toxicity Test of Bojungikgi-tang (Buzhongyiqi-tang) and Fermented Bojungikgi-tang (Buzhongyiqi-tang) Extracts in Mice. Korean Journal of Oriental Internal Medicine, 32(4), 599-609.
  30. Han, Y., Shin, H., & Lee, S. (2010). Toxicological Effect of Bojungiggitang and Gwibitang(Herbal prescription) in the Pregnant Rat and Fetuses - Focusing on Reproductive and developmental Toxicity. Korean Journal of Oriental Preventive Medical Society, 14(2), 91-104.
  31. Park, H., Kim, S., Byun, M., & Jo, S. (2005). Effect of a Herb Mixture (HIM-I) on the Protection of the Hematopoietic-Immune System and Self-Renewal Tissue against Radiation Damage. Journal of the Korean Society of Food Science and Nutrition, 34(5), 605-612. https://doi.org/10.3746/jkfn.2005.34.5.605
  32. Ikeda, S., Kaneko, M., Kumazawa, Y., & Nishimura, C. (1990). Protective Activities of a Chinese Medicine, Hochu-ekki-to, to Impairment of Hematopoietic Organs and to Microbial Infection. Yakugaku Zasshi: Journal of the Pharmaceutical Society of Japan, 110(9), 682-687.
  33. Lee, N., & Choe, S. (1996). Effects of Bojungikgi-tang and Sayuk-tang on proliferation of splocytes of N:GP(S) mouse after irradation. Journal of Korean Oriental Oncology, 2(1), 91-100.
  34. Kang, H. (2015). Statistical Considerations in Meta-Analysis. Hanyang Medical Reviews, 35(1), 23-32. http://doi.org/10.7599/hmr.2015.35.1.23