• Journal of muscle and joint health
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• v.26 no.2
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• pp.141-154
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• 2019

Purpose: This study aimed to analyze the effects of exercise on pulmonary function in patients with ankylosing spondylitis (AS). Methods: Randomized controlled trials (RCTs) were identified by searching MEDLINE, EMBASE, CENTRAL, and CINAHL (through Jan 2019). Three reviewers independently retrieved articles, extracted data, and assessed methodological quality using the Cochrane's Risk of Bias for randomized studies. Results: Fourteen studies met the inclusion criteria with a total of 729 participants. CE (SMD 0.58, 95% CI 0.41~0.75, p<.001) and $VO_2peak$ (SMD 0.56, 95% CI 0.24~0.88, p=.001) had a significant effect on the most exercise interventions. As a secondary variable, BASFI (SMD -0.53, 95% CI -0.70~-0.37, p<.001), BASMI (SMD -0.75, 95% CI -0.92~-0.58, p<.001) showed an effect size of more than medium. However, PFT and QoL did not produce a significant results. Conclusion: Pulmonary involvement is common in patients with AS and might have disturbed functionality and exercise modality. Exercise can be an effective intervention to improve pulmonary function in patients with AS. More attention is needed to improve the chest and spinal mobility to maintain the appropriate pulmonary function. It is also necessary to consider how to construct a patient-tailored exercise program to increase performance, accuracy and safety of exercise.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.13
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• pp.5343-5348
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• 2014

Background: A meta-analysis was performed to examine the benefit/risk ratio for the addition of anti- HER MoAbs to chemotherapy in patients with advanced gastric and gastroesophageal cancer from six randomized phase II/III trials. Materials and Methods: We searched relative trials from Pubmed, EMBASE, Cochrane library databases, China National Knowledge Infrastructure databases, Google Scholar and the NIH ClinicalTrials. Primary outcomes were overall response rate (ORR), progression-free survival (PFS), overall survival (OS). Secondary outcomes were toxicities. All analyses were performed using STATA 12.0. Results: This meta-analysis included six randomized controlled trials (RCTs) with 2, 297 patients and we demonstrated that the anti-HER MoAbs arm did have a positive effect on ORR in the anti-HER MoAbs arm (OR 1.28, 95% CI 1.00-1.64, p=0.01). There was an increasing benefit regarding OS (HR 0.74, 95% CI 0.60-0.88, p<0.05) and PFS (HR 0.72, 95% CI 0.60-0.84, p<0.05) in the anti-HER2 subgroup, but a reduction of OS (HR 1.11, 95% CI 0.87-1.36, p<0.05) and PFS (HR 1.13, 95% CI 0.98 -1.28, P<0.05) in anti-EGFR subgroup. Some grade 3-4 toxicity had a significantly higher incidence in the anti-HER MoAbs arm. There was no significant publication bias for all endpoints. Conclusions: The addition of trstuzumab MoAb to chemotherapy for gastric and gastroesophageal cancer significantly improved outcome of OS and PFS endpoints, while other MoAbs led to no improvement in results. Some adverse events were increased in anti-HER MoAbs arm compared with the control.

• The Journal of Internal Korean Medicine
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• v.41 no.3
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• pp.306-325
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• 2020

Objectives: The aim of this study is to investigate the effect of a Dachaihu decoction for hyperlipidemic acute pancreatitis (HLAP) by systematic review and meta-analysis of Chinese clinical studies. Methods: China National Knowledge Infrastructure (CNKI) was utilized as the major search engine. The date of the literature search was March 7, 2020. Randomized controlled trials (RCTs) about using a Dachaihu decoction for HLAP were included in this study. Meta-analysis was performed by synthesizing outcome data, including total effective rate, abdomen pain relief time, first bowel movement time, blood amylase recovery time, and triglyceride (TG) levels (mmol/L). The selected literature was assessed using Cochrane's risk of bias (RoB). Results: Twelve of 44 RCTs met the inclusion criteria. Most studies were evaluated with RoB as having unclear risk. The total effective rate of herbal medicine treatment based on the Dachaihu decoction was significantly higher than that of symptomatic supportive treatment in 10 articles (risk ratio=1.15, 95% CI: 1.08 to 1.21, p<0.00001, I²=0%). Herbal medicine treatment based on a Dachaihu decoction was significantly more effective than symptomatic supportive treatment in terms of reducing abdomen pain relief time (in all articles; mean difference=-1.70, 95% CI: -1.91 to -1.41, p<0.00001, I²=45%), first bowel movement time (in 7 articles; mean difference=-1.46, 95% CI: -1.86 to -1.05, p<0.00001, I²=73%), blood amylase recovery time (in 8 articles; mean difference=-1.48, 95% CI: -2.04 to -0.92, p<0.00001, I²=90%), and TG levels (in 8 articles; mean difference=-1.59, 95% CI: -2.28to -0.91, p<0.00001, I²=90%). Only one article reported side effects of treatment among the intervention group and control group, citing pancreatic ulcer and pancreatic pseudocyst formation. Conclusions: This study suggests that herbal medicine treatment based on a Dachaihu decoction could yield higher efficacy for HLAP than symptomatic supportive treatment alone. However, the results might be somewhat biased because of the poor quality and small sample size of the included RCTs. Well-qualified clinical studies are needed to prove the effectiveness of Dachaihu decoction therapy for HLAP.

• Journal of Nutrition and Health
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• v.47 no.4
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• pp.236-246
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• 2014

Purpose: Walnut is known to have unique favorable fatty acids, phytochemicals, and other nutrient profiles. As a result, there has been growing interest in evaluation of its health benefit related to cardiovascular disease (CVD). Although inverse associations of nut consumption and risk factors of cardiovascular disease have been reported in many epidemiological studies and qualitative reviews, few meta-analysis studies have been reported. This meta-analysis was conducted in order to evaluate the effect of a walnut-enhanced diet on CVD risk factors. Methods: We searched Pubmed, Cochrane, Science Direct, and KISS (Korean studies Information Service System) through July 2014. A random-effects meta-analysis was conducted on 17 trials reporting total cholesterol (TC), 14 trials reporting LDL cholesterol (LDL-C), 15 trials reporting HDL cholesterol (HDL-C), 17 trials reporting triglyceride (TG), and four trials reporting flow-mediated dilation (FMD). Results: In meta-analysis, intake of a walnut-enhanced diet resulted in significantly lowered TC, LDL-C, and TG by -0.124 mmol/l (95% CI, -0.209, -0.039; p = 0.004), -0.085 mmol/lL (95% CI, -0.167, -0.004; p = l0.039), and -0.080 mmol/l (95% CI, -0.155, -0.004; p = 0.039), respectively. The overall pooled estimate of the effect on FMD was +1.313% (95% CI, 0.744, 1.882, p = 0.000). HDL-C was not affected by walnut intake. No statistical heterogeneity was observed for any analysis. Results of funnel plots and Egger's regression suggested a low likelihood of publication bias in all biomarkers (p > 0.05). Conclusion: Findings of this meta-analysis provide consistent evidence that walnut-enhanced diet intake reduces the CVD risk factors.

• Journal of Pharmacopuncture
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• v.27 no.1
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• pp.14-20
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• 2024

Objectives: Frozen shoulder (FS) is one of the most challenging shoulder disorders for patients and clinicians. Its symptoms mainly include any combination of stiffness, nocturnal pain, and limitation of active and passive glenohumeral joint movement. Conventional treatment options for FS are physical therapy, nonsteroidal anti-inflammatory drugs, injection therapy, and arthroscopic capsular release, but adverse and limited effects continue to present problems. As a result, pharmacoacupuncture (PA) is getting attention as an alternative therapy for patients with FS. PA is a new form of acupuncture treatment in traditional Korean medicine (TKM) that is mainly used for musculoskeletal diseases. It has similarity and specificity compared to corticosteroid injection and hydrodilatation, making it a potential alternative injection therapy for FS. However, no systematic reviews investigating the utilization of PA for FS have been published. Therefore, this review aims to standardize the clinical use of PA for FS and validate its therapeutic effect. Methods: The protocol was registered in Prospero (CRD42023445708) on 18 July 2023. Until Aug. 31, 2023, seven electronic databases will be searched for randomized controlled trials of PA for FS. Authors will be contacted, and manual searches will also be performed. Two reviewers will independently screen and collect data from retrieved articles according to predefined criteria. The primary outcome will be pain intensity, and secondary outcomes will be effective rate, Constant-Murley Score, Shoulder Pain and Disability Index, range of motion, quality of life, and adverse events. Bias and quality of the included trials will be assessed using the Cochrane handbook's risk-of-bias tool for randomized trials. Meta analyses will be conducted using Review Manager V.5.3 software. GRADE will be used to evaluate the level of evidence for each outcome. Results: This systematic review and meta-analysis will be conducted following PRISMA statement. The results will be published in a peer-reviewed journal. Conclusion: This review will provide scientific evidence to support health insurance policy as well as the standardization of PA in clinical practice.

• Journal of Nutrition and Health
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• v.54 no.5
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• pp.459-473
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• 2021

Purpose: Although numerous systematic reviews or meta-analysis have reported the hypotensive effects of garlic, the application of these results in the area of functional food is limited. This is because the trials used various garlic preparations and patients with differing hypertensive intensities. To validate the use of garlic powder as a blood pressure lowering functional food, we performed the current meta-analysis, focusing on the study of prehypertensive subjects. Methods: Literature search was carried out using various database up to July 2020, including PubMed, Cochrane, ScienceDirect and Korean studies Information Service System, and each study was screened by pre-stated inclusion/exclusion criteria. We identified nine trials that met the eligibility, of which two studies with moderate or high risk of bias were excluded. Results: Meta-analysis of the seven studies revealed that an intake of garlic powder significantly lowered the systolic blood pressure (SBP) and diastolic blood pressure (DBP) by -6.0 mmHg (95% confidence interval [CI], -11.2, -0.8; p = 0.025) and -2.7 mmHg (95% CI, -5.3, -0.1; p = 0.046), respectively. Shapes of the funnel plot for both SBP and DBP seemed symmetrical, and the Egger's regression revealed no publication bias. Moreover, duration of the intervention period was inversely associated with the pooled effects of garlic powder on SBP (p = 0.019) and DBP (p = 0.019), and this result was supported by the subgroup-analysis. The daily dose of garlic powder, baseline value of each biomarker, and subject number, did not moderate the effects on SBP and DBP. Conclusion: Results of the present meta-analysis indicate that garlic powder supplements are superior to placebo for improving the BP in prehypertensive individuals.

• Journal of Oriental Neuropsychiatry
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• v.34 no.3
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• pp.259-274
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• 2023

Objectives: The purpose of this study was to provide clinical evidence to support the use of auricular blood-letting therapy (ABT) for headaches. Methods: Studies were identified by a comprehensive search of five databases. Randomized controlled trials (RCTs) that investigated the effects of the ABT for headaches were included. Two authors independently extracted the data and assessed the methodological quality of the included studies using Cochrane's risk-of-bias tool. If two or more studies reported the same outcome, a meta-analysis was performed. Meta-analysis results for dichotomous variables are expressed as risk ratios (RRs) and 95% confidence intervals (CIs). Results: A total of eight RCTs were included in this review. The total effective rate (TER) was the most commonly used outcome measurement. Among the eight RCTs, five were included in the metaanalysis. The TER was not statistically significantly different in the ABT group compared to the medication group (two studies, n=55, RR=1.24, 95% CI: 0.78 to 1.96, p=0.36, I² =86%). However, the TER of the combined ABT and medication group was significantly different compared to the medication alone group (four studies, n=159, RR=1.23, 95% CI: 1.12 to 1.35, p<0.0001, I² = 0%). Pain and mental health-related outcomes in the combined ABT and medication group were significantly different from the control groups. The methodological quality of the included RCTs was generally low. Conclusions: ABT combined with medication may be effective for treating headaches. However, the number of studies included was small, so the results were insufficient, and statistically significant effects were not confirmed for a single implementation of ABT. Thus, well-designed further studies based on the findings of this study are recommended.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.18 no.6
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• pp.438-448
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• 2017

This study was a systematic review and meta-analysis that evaluated the results of research on the pain reduction effects of lidocaine gel for urethral catheterization in adults. A literature search was conducted using seven electronic databases, gray literature and other resources based on the guidelines of Preferred Reporting Items for Systematic review and Meta-Analysis (PRISMA). A Risk of Bias (RoB) tool was applied to assess the quality of selected studies. Data were analyzed using the RevMan 5.3.-program. Sixteen randomized controlled trials involving 1904 adults were included. RoB was not observed in the funnel plot. Overall, lidocaine gel was effective for pain reduction during urethral catheterization (Standard Mean Difference[SMD] -0.96;95% CI: -1.43, -0.49). To explore the cause of heterogeneity (I2=95%, p<.001), subgroup analysis was conducted according to three catheter types (urinary catheter, flexible cystoscopy, and rigid cystoscopy) and the SMDs were -0.88 (95% CI:-1.51, -0.26), -0.31 (95% CI:-0.63, 0.01), and -1.93 (95% CI:-2.88, -0.97), respectively. A significant pain reduction effect was observed regardless of gender in urinary catheterization. However, in rigid cystoscopy, a significant pain reduction effect was observed only in male subjects. Pain reduction effects were observed when 10~11ml lidocaine gel was used during rigid cystoscopy and when lubrication was used during urinary catheterization, irrespective of application time. These findings suggest that lidocaine gel is a useful anesthetic lubricant for urinary catheterization and rigid cystoscopy in male adults.

• The Journal of Internal Korean Medicine
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• v.43 no.6
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• pp.1045-1062
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• 2022

Objectives: The aim of this study was to analyze the latest clinical studies on Korean medicine treatment of idiopathic thrombocytopenic purpura (ITP) in the Chinese National Knowledge Infrastructure (CNKI) database. Methods: We searched the last 6 years of clinical studies discussing Oriental medicine-based treatments for ITP in the CNKI database. A meta-analysis of 13 RCTs was performed by synthesizing the outcomes, including the measured platelet count and total effective rate. The quality of the studies was assessed using Cochrane's risk of bias (RoB) tool. RevMan 5.4.1 software was used for data analysis. Results: Of the 15 selected studies, 1 was a non-randomized controlled trial (nRCT), 2 were case series, and 12 were randomized controlled trials (RCTs). Treatments in all studies included oral herbal medicine. The most frequently used herbal decoction was the Liangxue Jiedu prescription (凉血解毒方), and the most commonly used herb was Agrimonia pilosa (仙鶴草), Astragali Radix (黃芪), Fossilia Glycyrrhizae Radix et Rhizoma (甘草), and Rehmannia glutinosa Liboschitz ex Steudel (地黃). The meta-analysis showed significantly better improvement in platelet counts and total effective rate for ITP in the treatment group than in the control group. Conclusion: Treatment with herbal medicine was effective in treating ITP. However, the significance of this conclusion is somewhat limited due to the low quality of the available studies. Multifaceted and scientifically designed clinical studies are required to develop treatments for ITP based on Korean medicine. The results of this study could be used as basic data for further ITP studies.

• The Journal of Internal Korean Medicine
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• v.39 no.3
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• pp.372-388
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• 2018

Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.