• 대한한방내과학회지
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• 제45권1호
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• pp.31-54
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• 2024

Objectives: This study assessed the effectiveness of Hwanggigyejiomul-tang for postoperative breast cancer-related lymphedema (BCRL) by a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "breast cancer", "lymphedema", "edema", "Huangqi Guizhi Wuwu decoction", "Huangqi Guizhi Wuwu tang", and "Hwanggigyejiomul tang" in 10 databases (PubMed, Cochrane, ScienceDirect, CNKI, CiNii, RISS, KISS, ScienceON, OASIS, DBpia) on February 11, 2024. There were no limits on the publication period and language, and the quality of the studies was evaluated using Cochrane's risk of bias tool. A meta-analysis was performed based on the outcome measurements, such as total effective rate (TER), increase in shoulder joint mobility (flexion, extension, abduction, adduction), Fugl-Meyer assessment (FMA), and visual analog scale (VAS) using Review Manager Web. Results: Eleven RCTs were selected. The treatment group (Hwanggigyejiomul-tang-gagambang or hapbang with control group intervention) showed a more statistically significant effect compared with the control group (physical therapy or western medicine) in TER (upper limb circumference change), TER (upper limb edema grade change), increase in flexion angle, increase in extension angle, increase in adduction angle, FMA, and VAS. Conclusions: Hwanggigyejiomul-tang is effective in treating postoperative BCRL. However, because of the low quality of the included studies, more clinical studies are required to increase the possibility of clinical use.

• Physical Therapy Rehabilitation Science
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• 제9권4호
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• pp.309-317
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• 2020

Objective: One of the treatment strategies for controlling chronic pain and preventing disability is patient education. Pain neuroscience education (PNE) has been proven to be effective in explaining the biological and physiological processes associated with pain experiences to patients. The purpose of this review is to investigate the effectiveness of PNE for kinesiophobia such as avoidance response in patients with chronic pain. Design: A systematic review and meta-analysis. Methods: MEDLINE, EMBASE, CINAHL, PEDro, and the Cochrane Central Register of controlled trials databases were searched through November 2020 and included a randomized controlled trials evaluating kinesiophobia in musculoskeletal patients with chronic pain. In 8 randomized controlled trial studies, 'Cochrane's risk of bias (RoB) tool was used for qualitative analysis, and results of post-intervention were analyzed through RevMan 5.4 for quantitative analysis. Results: For this review, 8 randomized controlled trials of 369 patients with chronic pain were selected for PNE. A systematic review and meta-analysis also included 8 randomized controlled trials. The effect on kinesiophobia was more effective than the control group (-0.86; 95% confidence interval [CI], -1.22 to -0.51; heterogeneity [χ²=21.18, df=7, I²=67%]; overall effect [Z=4.80]). In addition, the effect on pain was more effective than the control group (-0.53; 95% CI, -1.05 to -0.01; heterogeneity [χ²=47.42, df=7, I²=85%]; overall effect [Z=2.01]). Conclusions: The results of this review suggest that PNE and combined PNE have a positive effect on the improvement of pain and kinesiophobia in patients with chronic pain.

• 대한한방내과학회지
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• 제44권6호
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• pp.1197-1211
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• 2023

Objectives: This study presents evidence by analyzing the research trends in acupuncture treatment for cluster headache in the last 10 years. Methods: Randomized controlled trials (RCTs) about acupuncture for cluster headache were searched from the China National Knowledge Infrastructure, PubMed, Cochrane Library, Oriental Medicine Advanced Searching Integrated System, ScienceON, Korean Studies Information Service System, and Research Information Sharing Service. The search terms were the combinations of "cluster headache", "acupuncture", and "needle therapy", and the articles were restricted to those published between 2013 and 2023. Only RCTs were selected. The risk of bias (RoB) was assessed according to the revised Cochrane RoB2 criteria. Results: Six RCTs were selected and analyzed in this review. All selected studies were conducted in China. All RCTs comprised 628 participants. Manual acupuncture was used in all studies. Acupuncture targeting the sphenopalatine ganglion was performed in two papers published after 2020. ST8, Ex-HIN3, and GB14 were the most frequently used acupoints in acupuncture treatment. The most commonly used indicators for evaluation were headache attack frequency, clinical efficacy, and the visual analog scale. In each study, adding acupuncture treatment to conventional therapy had significant effects in relieving the symptoms of cluster headaches. Conclusion: The results suggest that acupuncture is an effective treatment for cluster headache. To ensure objective evidence for the effectiveness of acupuncture treatment in cluster headache, it is important to continue large-scale case reports and RCTs.

• Asian Pacific Journal of Cancer Prevention
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• 제15권15호
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• pp.6131-6136
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• 2014

Objective: Epidemiology studies have reported conflicting results between glutathione S-transferase Mu-1 (GSTM1), glutathione S-transferase theta-1 (GSTT1) and glutathione S-transferase pi-1 (GSTP1) and ovarian cancer (OC) susceptibility. In this study, an updated meta-analysis was applied to determine whether the deletion of GSTM1, GSTT1 and GSTP1 has an influence on OC susceptibility. Methods: A published literature search was performed through PubMed, Embase, Cochrane Library, and Science Citation Index Expanded database for articles published in English. Pooled odds ratios (ORs) and 95% confidence intervals (95%CIs) were calculated using random or fixed effects models. Heterogeneity between studies was assessed using the Cochrane Q test and $I^2$ statistics. Sub-group analysis was conducted to explore the sources of heterogeneity. Sensitivity analysis was employed to evaluate the respective influence of each study on the overall estimate. Results: In total, 10 published studies were included in the final analysis. The combined analysis revealed that there was no significant association between GSTM1 null genotype and OC risk (OR=1.01, 95%CI: 0.91-1.12). Additionally, there was no significant association between GSTT1 genetic polymorphisms and OC risk (OR=0.98, 95% CI: 0.85-1.13). Similalry, no significant associations were found concerning the GSTP1 rs1695 locus and OC risk. Meanwhile, subgroup analysis did not show a significant increase in eligible studies with low heterogeneity. However, sensitivity analysis, publication bias and cumulative analysis demonstrated the reliability and stability of the current meta-analysis. Conclusions: These findings suggest that GSTs genetic polymorphisms may not contribute to OC susceptibility. Large epidemiological studies with the combination of GSTM1 null, GSTT1 null and GSTP1 Ile105Val polymorphisms and more specific histological subtypes of OC are needed to prove our findings.

• 한방재활의학과학회지
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• 제31권1호
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• pp.149-163
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• 2021

Objectives This study is to review the effectiveness of exercise after lung cancer surgery. Methods Relevant randomized controlled trials (RCTs) were searched in PubMed database. The systematic review was conducted through flow diagram. The risk of biases were assessed through the Cochrane guideline. Characteristics and outcomes were extracted from each study. Meta-analyses of forced expiratory volume in one second (FEV1), 6-minute walk test (6MWT), quality of life (QoL), pulmonary complications were conducted. Results 14 RCTs were selected. In meta-analysis, exercise improved FEV1 (mean difference [MD] 0.14; 95% confidence interval [CI] 0.04 to 0.25; p=0.009; I2=55%) and mean change of FEV1 (MD 0.11; 95% CI 0.02 to 0.20; p=0.02; I2=0%). Exercise increased the distance of 6MWT, but there was considerable heterogeneity (MD 45; 95% CI 21.16 to 68.83; p=0.0002, I2=89%). There was no differences in QoL scores by 2 questionnaires (European Organisation for Research and Treatment of Cancer quality of life questionnaire, short form-36). Exercise reduced the duration of hospital stay (MD -3.32; 95% CI -5.27 to -1.36; I2=0%; 2 studies) but not duration of chest tube intubation (MD -1.37; 95% CI -2.81 to 0.06; I2=0%) and incidence of pulmonary complications (pooled risk ratio 0.54; 95% CI 0.23 to 1.30; I2=0%). Conclusions Exercise might reduce the duration of hospital stay after lung surgery. There was not enough evidence to prove improvement of lung function, aerobic capacity, muscle strength, QoL, and decline of pulmonary complications. Low-quality risk of bias, different units or estimation of outcome, different exercise type and duration, heterogeneity among studies make the evidence of effectiveness weak. Future researches are required to redeem these defects.

• Restorative Dentistry and Endodontics
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• 제45권3호
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• pp.26.1-26.18
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• 2020

Objectives: This study aimed to systematically review the pain and flare-up effects of calcium hydroxide (CH) as intracanal medication (ICM) in non-vital mature teeth. Materials and Methods: Electronic-databases searching for published and grey literature and manual searching were conducted. Only randomized clinical trials (RCTs) were included comparing CH to other ICMs in non-vital mature teeth. The risk of bias was assessed using the RoB 2.0 Cochrane tool. The main outcomes were pain and flare-up. Qualitative and quantitative analysis, wherever applicable, was performed. The certainty of evidence (CoE) was assessed using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Results: Sixteen articles were included in 6 comparisons at different time points for different outcomes. CH reduced pain risk than no ICM within the 1-14-days interval (p < 0.05) and than triple-antibiotic paste within the first day (p < 0.05) and was similar to corticosteroid/antibiotics combination (p > 0.05). Chlorhexidine (CHX) or CH/CHX, however, reduced pain levels than CH alone (p < 0.05). CH showed higher flare-up risk than CHX (p < 0.05). CoE, however, ranged from very low to moderate. Conclusion: Most comparisons for different outcomes are based on very few studies, mostly low-powered, with an overall low CoE. Thus, the available evidence is considered insufficient to either support or refute CH effectiveness or to recommend one ICM over another. Therefore, further well-designed, larger RCTs are required.

• The Journal of Korean Physical Therapy
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• 제32권1호
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• pp.21-28
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• 2020

Purpose: This study identified the effects of physical therapists on the quality of life when applying exercise-based movement techniques to breast cancer survivors. Methods: To conduct meta-analysis, 186 RCT studies were searched in five databases (RISS, Pubmed, CINAHL, Medline, and Cochrane Library), without limitation, for the year of publication, and papers published in April 2018 were selected. Four studies met the inclusion criteria and were selected for meta-analysis based on the risk of bias. The basic demographic data, athletic characteristics, and outcome data were extracted from all included clinical trials. The data were analyzed using the RevMan 5.2 program. Results: As a result of meta-analysis, exercise-based movement techniques applied by the control group (Pilates, yoga, tai chi, and qigong) or physical therapists showed no significant difference in the impact on the quality of life of breast cancer survivors. Conclusion: In this study, exercise-based movement techniques mediated by control groups or physical therapists showed no significant difference in the quality of life of breast cancer survivors, but the types and duration of exercise in each study varied, and the number of subjects was small. Considering randomized studies, more randomized studies will be needed to draw conclusions.

• Journal of Acupuncture Research
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• 제36권4호
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• pp.211-219
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• 2019

This review analyzed randomized controlled trials and case reports to identify the effectiveness, and level of evidence showing that acupuncture treatment aids the recovery of patients with tennis elbow. A literature search was performed between $1^{st}$ to $10^{th}$ September, 2019 which used PubMed, the Cochrane library, the Korean databases Oriental Medicine Advanced Searching Integrated System, Korean Studies Information Service System to retrieve Korean and international studies. Amongst the 243 articles retrieved there were 9 randomized controlled trials and 18 case reports. The level of evidence for the recovery of patients with tennis elbow, for efficacy and safety of acupuncture was low. It was observed that the studies had a high risk of bias, missing acupuncture details, multiple combinations of treatments rather than a single treatment, insufficient indicators of assessment, and lacked robustness. Compliance with international standards such as using consolidated standards of reporting trials, will improve the quality of evidence.

• 대한한방내과학회지
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• 제44권6호
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• pp.1176-1185
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• 2023

Introduction: Non-erosive reflux disease (NERD) is the most common subtype of gastroesophageal reflux disease (GERD). This study aims to synthesize evidence on the efficacy and safety of various herbal medicines for the treatment of NERD. Methods and analysis: Ten electronic databases will be examined: MEDLINE (via PubMed), Cochrane Central Register of Controlled Trials, Embase, Allied and Complementary Medicine Database, China National Knowledge Infrastructure Database, Citation Information by Nii, Korean Medical Database, Korean Studies Information Service System, National Digital Science Library, and Oriental Medicine Advanced Searching Integrated System. All randomized controlled trials published from inception to May 2023 that meet the eligibility criteria will be selected. Two independent researchers will extract data, such as publication year, study design, intervention details, outcome measures, main results, and adverse events. The risk of bias and quality of evidence will be assessed, and subgroup analyses will be performed according to the type of control intervention and herbal medicine. The analysis process will be conducted using Review Manager 5.4 software. Discussion: This review will present a summary and rationale for herbal medicine's effectiveness in treating NERD. The findings of this review can help those who want to apply herbal medicine to the treatment of NERD.

• 대한한방부인과학회지
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• 제30권3호
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• pp.79-91
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• 2017

Objectives: The purpose of this systematic review is to overview and evaluate the effect on postpartum hypogalactia after acupuncture treatment. Methods: Relevant randomized controlled trials (RCTs) were identified by database searches in Embase, Pubmed, CENTRAL, CNKI, KISS. Searching keywords were "Hypogalactia" or "Hypolactaion" and "Acupuncture". After searching qualified articles, we independently assessed the risk of bias according to the Cochrane Rob criteria. Results: Among the 81 articles five RCTs were finally selected. Four of the selected were statistically significant. One of them was not statistically significant because it was comparative study of chinese medicine and acupuncture treatment. The quality of the evidence for specific comparisons ranged from low to high. Conclusions: Our systematic review found encouraging. Acupuncture treatment would be effective way to increase insufficient milk supply on postpartum hypogalactia.