• Title/Summary/Keyword: Evidence Based Medicine (EBM)

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Analysis of Studies on Guibi-tang(Guipitang) for Fundamental Establishment of Evidence Based Medicine(EBM) (EBM 기반구축을 위한 귀비탕(歸脾湯) 연구 문헌 분석)

  • Kim, Jung-Hoon;Lee, Jun-Kyoung;Ha, Hye-Kyoung;Seo, Chang-Seob;Lee, Mi-Young;Lee, Ho-Young;Jung, Da-Young;Lee, Nam-Hun;Lee, Jin-Ah;Huang, Dae-Sun;Shin, Hyun-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.20 no.3
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    • pp.205-216
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    • 2009
  • Objectives : To establish the fundaments for EBM of Traditional Korean Medicine, the papers on Guibi-tang(Guipitang) which were frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. Methods : The papers were classified by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Results : Of total 39 papers were registered in domestic journals. Since 1980, publishments of papers have continuously increased. The papers on biological studies were 34 volumes, clinical studies were 5 volumes. Biological studies mainly showed the effects of anti-stress, anti-oxidant, hemostasis, anti-osteoporosis, gastroprotection, reproductive ability, brain cell activity, radioprotection. And clinical studies showed improvements of fearful throbbing, memory and orientation, insomnia, vericose vein, schizophrenia. Conclusions : Guibi-tang(Guipitang) could be used to fortify the spleen, nourish the heart and then control the blood. However biological studies need to be conducted in accordance with clinical study and further clinical studies on randomized controlled trials should be proceeded.

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Analytic Study on Treatises of the Journal of Oriental Obstetrics & Gynecology (대한한방부인과학회지(大韓韓方婦人科學會誌) 수재(收載) 논문(論文) 분석(分析))

  • Yun, Young-Jin;Lee, Jin-Moo;Lee, Chang-Hoon;Cho, Jung-Hoon;Jang, Jun-Bockq;Lee, Khung-Sub
    • The Journal of Korean Obstetrics and Gynecology
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    • v.24 no.2
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    • pp.97-103
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    • 2011
  • Objectives: Recently, high attention has been drawn towards evidence based medicine(EBM). However, there is little follow study after Park's analysis research (2002) in the journal of oriental gynecology. Therefore, there is a need to conduct analyzed research on the topic, due to the increasing interest about EBM. Methods: To analyze the treatises of the journal of oriental gynecology, we examined 56 journals published from 1987 to 2010. we followed the way of Park, classifying treatises into bibliographic, experimental and clinical categories. Results: Analytic research, as a part of clinical treatises, increased rapidly from 2001. As a result, it took 53.3% of whole study in general after 2002 and it reached up to 70.0% in 2004. Most part of clinical treatises until 2002 was about case report of patients, but the amount of clinical trial started to increase since 2003. Case report and case series showed dramatic increase after 2001, and clinical trial started to increase after 2003. As a result, 43.8% of the analyzed research was due to clinical trial by 2009. Conclusions: On the base of this research, quality evaluation of clinical treatises using guality assessment tool is needed for EBM in the part of oriental obstetrics & gynecology.

Analysis of studies on Bangpungtongseong-san (Fangfengtongsheng-san) to establish the fundament for Evidence Based Medicine (EBM) (EBM 기반구축을 위한 방풍통성산 실험 연구 분석)

  • Kim, Jung-Hoon;Lee, Jun-Kyoung;Shin, Hyeun-Kyoo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.24 no.1
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    • pp.1-15
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    • 2011
  • Objective : To establish the fundament for EBM of Traditional Korean Medicine, the papers on Bangpungtongseong-san (Fangfengtongsheng-san) frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international papers. Methods : The papers were classified by the registration of domestic or international journals, the year of publishment, experimental fields and the kinds of studies on biological activities. Results : Among 324 volumes of papers on Bangpungtongseong-san (Fangfengtongsheng-san), 38 volumes were selected according to selective criteria. 18 volumes were published in domestic journals, 20 volumes were in Japanese journal. The papers on instrumental analyses reported the quantification of standard compounds of herbal medicines in Bangpungtongseong-san (Fangfengtongsheng-san) using HPLC method. The papers on biological activities of Bangpungtongseong-san (Fangfengtongsheng-san) showed inhibitory effect to obesity, arteriosclerosis, allergic response, inflammation, pain, hyperlipidemia, hypertension, atopy, diabete mallatus and improvement of gastrointestinal activity and cerebral blood circulation. Among biological activities, papers on anti-obesity effect were reported mostly. Conclusions : Further studies including anti-obesity activity need to be preceeded to establish the fundament for EBM of Bangpungtongseong-san (Fangfengtongsheng-san).

Pharmacological Treatments for Dysthymic Disorder and Atypical Depression (기분부전장애와 비전형우울증의 약물치료)

  • Lim, Se-Won;Oh, Kang-Seob
    • Korean Journal of Biological Psychiatry
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    • v.14 no.1
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    • pp.14-20
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    • 2007
  • Objectives : The diagnosis of depression is based on a highly variable set of symptoms. Therefore, depression should not be viewed as a single disease, but a heterogenous syndrome comprised of different pathophysiologies. There are several subtypes of depression which were already incorporated in DSM-IV. This article provides a systematic review of pharmacological treatments of two recognized subtypes of depression-dysthymic disorder and atypical depression. Methods : Systematic search of relevant literatures on dysthymic disorder and atypical depression was performed by proposed search strategy of the Clinical Research Center for Depression of Korean Health 21 R&D Project. All identified literatures were carefully reviewed and classified according to SIGN grading system and summarized in a narrative manner. Results : For the treatment of dysthymic disorder and atypical depression, selective serotonin reuptake inhibitors( SSRIs) and moclobemide have more evidence than the other antidepressants. SSRIs and moclobemide showed superior tolerability than tricyclic antidepressants. Conclusions : The authors proposed treatment recommendations for dysthymic disorder and atypical depression by the methods of evidence-based medicine(EBM). However, guideline developing methods of EBM also have several inevitable limitations. Therefore, in the absence of clear and significant differences in efficacy, the choice of medication must be individualized for a particular patient based on psychiatrist's own clinical decision.

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Analysis of Studies on Samul-tang for Fundamental Establishment of Evidence Based Medicine (EBM 기반구축을 위한 사물탕 연구 문헌 분석)

  • Kim, Jung-Hoon;Lee, Jun-Kyoung;Ha, Hye-Kyoung;Seo, Chang-Seob;Lee, Ho-Young;Jung, Da-Young;Lee, Nam-Hun;Lee, Jin-Ah;Huang, Dae-Sun;Shin, Hyun-Kyoo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.23 no.4
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    • pp.779-788
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    • 2009
  • To establish the fundament for EBM of Traditional Korean Medicine, the papers on Samul-tang which was frequently used in medical institutions of Traditional Korean Medicine were analyzed through researching domestic and international literatures. The papers were classified by the registration of domestic or international journals, by the year of publishment, by experimental methods, by laboratory animals used in biological experiment and by the kinds of studies on biological efficacy. Of total 67 papers on Samul-tang, 58 volumes were registered in domestic journals and 9 volumes were in international journals of which 8 volumes were in SCI journals. Since 1978, publishments of papers have continuously increased. The papers on instrumental analyses were 6, biological studies were 58 volumes, clinical studies were 3. Instrumental analyses were preceeded with standard compounds(gallic acid, albiflorin, paeoniflorin, benzoic acid, ferulic acid, 5-HMF). And biological studies showed improvement of cardiovascular function and circulation, antianemia, brain protection, immunoregulation, antistress, radioprotection, antifatigue, antiinflammation and antiallergy, antioxidative effect. Through clinical studies, antifatigue, improvement of insomnia and osteoporosis were reported. Samul-tang could be used to tonify and activate blood. And further study on clinical field need to be conducted in accordance with biological study.

Systematic Studies on Galgeun-tang(gegen-tang, kakkon-to) for Establishment of Evidence Based Medicine (표준한방처방의 EBM 구축을 위한 갈근탕(葛根湯) 문헌 분석 연구)

  • Lee, Jun-Kyoung;Kim, Jung-Hoon;Shin, Hyeun-Kyoo
    • Herbal Formula Science
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    • v.19 no.1
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    • pp.103-111
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    • 2011
  • Objectives : The purpose of this report was to provide the information of activity and safety of galgeun-tang by analyzing domestic/international papers and theses about galgeun-tang. Methods : Domestic/international papers and theses related to galgeun-tang were reviewed and analyzed. These papers were then classified by efficacy, or clinical trials. Results : The basic pharmacological experiment showed antipyretic, analgesic and anti-virus and anti-oxidant efficacy of galgeun-tang. In the case report of galgeun-tang, it showed therapeutic effect for patient with chronic rhinitis. But administration of galgeun-tang induced pruritic eruption in the two case report as a side effects of galgeun-tang. Conclutions : galgeun-tang showed tantipyretic, analgesic and anti-virus and anti-oxidant efficacy in the basic pharmacological experiment. Also, galgeun-tang showed therapeutic effect for patient with chronic rhinitis. But it was reported that galgeun-tang induced pruritic eruption in two case report, so physicians should be aware of the potential side effects.

Systematic Studies on Yijin-tang(Erchen-tang) for Establishment of Evidence Based Medicine (표준한방처방 EBM 구축을 위한 이진탕 문헌 연구 분석)

  • Lee, Jun-Kyoung;Seo, Chang-Seob;Jung, Da-Young;Kang, Ki-Sung;Shin, Hyeun-Kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.21 no.3
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    • pp.77-86
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    • 2010
  • Objectives : The purpose of this report was to provide the information activity and safety of Yijin-tang by analyzing domestic/international papers and theses about Yijin-tang. Methods : Domestic/international papers and theses related to Yijin-tang were reviewed and analyzed. These papers were then classified by year, experimental method and subject. Results : 1. Administration of Yijin-tang showed therapeutic effects on diseases of the circulatory system such as thrombosis and hyperlipisemia in in vivo experiments. 2. Administration of Yijin-tang reduced hemorrhagic erosion and ulcer by inhibition of gastric juice secretion and protection effect of gastric mucosa in in vivo experiments. 3. Both clinical and basic science researches, Administration of Yijin-tang showed improvement of digestive function by up-regulated of digestive enzyme and gut-regulated protein in plasma levels. Conclusions : Administration of Yijin-tang showed therapeutic effects on diseases of the circulatory system and protection effect of gastric mucosa in in vivo experiments. Furthermore, both clinical and basic science researches, administration of Yijin-tang showed improvement of digestive function.

A study of Korean medical knowledge system which Korean medical doctors want (한의사들이 원하는 한의학 지식체계에 대한 고찰)

  • Son, Mi-Ju;Kim, Wu-Young;Jerng, Ui-Min;Park, Hwang-Jin;Han, Chang-Hyun
    • Journal of Society of Preventive Korean Medicine
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    • v.16 no.3
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    • pp.89-105
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    • 2012
  • Objectives : This study was carried out to know the status of clinical utilization of Korean medical knowledge and the Korean medical knowledge system which Korean medical doctors want. Methods : Questionnaires were distributed to Korean medical doctors registered for the Association of Korean medicine via the email and 249 answered questionnaires were analyzed. Results : 50.6 % of Korean medical doctors utilized the textbooks for Korean medicine when they treated their patients. The reason why they did not utilize the textbooks for Korean medicine was mostly that 'it could not be applied directly into clinical application with only contents of textbook because clinical approach (diagnosis and treatment methods) was not clearly described in the textbook'. 48.6 % of Korean medical doctors utilized the EBM materials when they treated their patients. EBM materials that they referred included domestic articles, other EBM materials excluding papers and international academic papers based on PubMed in order. The reasons why they did not utilize the EBM materials were mostly that 'it was difficult to find the evidence' and 'EBM materials were not actually helpful for the clinical practice.' It was found that Korean medical doctors approached the disease in aspects of Korean and Western Medicine concurrently upon the diagnosis of patients and performed the diagnosis and treatment of Korean medicine on the diseases which seemed to be effective with Korean medicine. It was also found that they thought that they needed to know the Western medical knowledge as much as general doctors who have a doctor's license or family medicine specialists who comprehensively treat the general diseases know. Korean medical doctors wanted to have the systematic summary of modern research performance in fields of acupoint, acupuncture, herbal drugs and formula. They thought that constitutional medicine and Sa-am acupuncture therapy were representative characteristics in Korean medicine differentiated from Traditional Chinese medicine and Kampo medicine. Conclusions : Korean medical doctors wanted to establish the Korean medical knowledge system based on evidence focusing on clinical and practical contents. New Korean medical knowledge system should be established based on these requirements in the future.

Analysis of the current status of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance (건강보험 급여 한약제제 56종 처방의 계량적 문헌 근거 현황 분석)

  • Chul Kim;Hyeun-kyoo Shin
    • The Journal of Korean Medicine
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    • v.44 no.3
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    • pp.189-200
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    • 2023
  • Objectives: The purpose of this study is to analyze the current state of quantitative literature evidence for the prescription of 56 herbal medicines covered by health insurance that have been studied in Korea for the past 30 years, to evaluate the reliability of the evidence, and to find out the research direction of herbal medicine prescription in the future. Methods: 56 kinds of herbal medicine prescriptions were searched in domestic literature search databases OASIS, DBpia, and overseas PubMed, classified into chemistry, toxicity, cells, animals, clinical cases, and clinical trial studies, and built into an EBM pyramid structure. Results: When classified according to research contents, there were 61 cases (7.5%) of physicochemical analysis to identify constituent substances, 80 cases (9.8%) of toxicity evaluation, and 672 cases (82.7%) of efficacy evaluation. The efficacy evidence was classified according to the evidence-based medical pyramid structure: 196 cell trials (29.1%), 372 animal trials (55.4%), 89 case and case reporting series (13.3%), 7 comparative case studies (1.1%), and 8 randomized control clinical trials (1.2%). In the pyramid composition, the basis for the validity of 56 kinds of herbal medicines prescribed was 568 cases (84.5%) in cell and animal units, which could not be said to be highly reliable. There was no relationship between the ranking of quantitative literature evidence for herbal medicine prescriptions and the ranking of salary administration. Conclusions: In an era that continues to require scientific evidence for herbal medicine, traditional herbal medicine should secure the basis for safety validity even for the 10th most frequent prescription among 56 herbal medicine prescriptions for consumers. In particular, traditional herbal medicine should increase the quantitative and qualitative level of case reports on related herbal medicine prescriptions, focusing on each clinical society, and move toward comparative case studies and randomized clinical trial so that traditional herbal medicine is positioned as Evidence-based medicine.

Clinical research methodology for Traditional Korean Medicine treatment of lung cancer : Evidence-based approach (폐암(肺癌)의 한방치료 임상연구 방법론)

  • Kim, Kyung-Suk;Kim, Sme-Hyun;Eo, Wan-Kyu;Cheon, Seong-Ha;Eom, Seok-Ki;Jo, Hak-Jun
    • Journal of Korean Medical classics
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    • v.23 no.4
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    • pp.39-62
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    • 2010
  • Background : I investigated clinical research methodology of Traditional Korean Medicine(TKM) for treatment of lung cancer with Evidence Based Medicine(EBM) approach. Methods : I conducted the internet search of National Central Library, the National Assembly Library, Korea Education & Research Information Service, Korea Institute of Science and Technology Information for Korean theses and papers, and MEDLINE for the outside articles. Conclusion : In addition to outcomes of clinical trial, abundant clinician's experience and patients' preference are also considered. Pragmatic trials and quasi-experimental trials are better than clinical trials to plan clinical design of TKM for lung cancer and appropriate endpoints includes overall survival, disease-free survival, patient reporting outcome.