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Complementary and Alternative Medicine Treatment for Burns and Sequela : A Scoping Review of Randomized Controlled Trials (화상 및 후유증의 보완 대체 의학 치료 : 무작위 대조 시험에 대한 주제범위 문헌고찰)

  • Byung-Soo Kang;Seok-Yeong Yoon;Min-Yeong Jung;Soo-Yeon Park;Jung-Hwa Choi;Jong-Han Kim
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.36 no.3
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    • pp.42-73
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    • 2023
  • Objectives : In order to investigate the current status of recent clinical evidence related to complementary and alternative medicine(CAM) treatment for burns and to inform research and treatment strategies for future, we publish a scoping review(ScR) of randomized controlled trials(RCTs). Methods : The research question of the ScR was "Are there any RCTs of CAM treatment for burn?". RCTs published from 2000 to 2022 were identified in 7 databases(PubMed, Cochrane, CNKI, OASIS, RISS, KCI, KMbase) in March 2023. Data were tabulated and analyzed descriptively with respect to the research questions. Results : 41 RCTs were included. 21(51.2%) were conducted in China, 13(31.7%) in Iran. The main treatment criteria were herbal medicine in 28 cases, acupuncture in 9 cases, chuna therapy in 4 cases, and psychotherapy in 3 cases. Among the herbal medicine, there were 19 topical medications, 5 injections(intravenous pharmacopuncture), 4 aerosol drugs(aromatherapy), and 1 oral drug. Among the acupuncture, there were 4 plum blossom needles(seven-star needles), 2 wrist-ankle acupunctures, 2 press needles, and 1 electroacupuncture. CAM treatments were effective in treating burns. It reduced pain and pruritus at the burn site, helped recovery and management of the donor site, reduced anxiety and pain during dressing change, improved hematological problems and vital signs, and finally lowered the mortality rate. CAM treatments also lowered health care costs. Conclusions : CAM treatments for burns is prospective, and that it deserves to make high-quality studies including additional large-scale RCTs.

Effectiveness of Acupotomy for Migraine: A Systematic Review (편두통의 침도 치료에 대한 체계적 문헌고찰)

  • Seok-Hee Jeon;Soo-Min Jeong;Jeong-Cheol Shin
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.62-78
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    • 2023
  • Objectives : This study aims to assess the impact of acupotomy on migraine through an examination of clinical studies conducted since 2015. Methods : We conducted a comprehensive search for randomized controlled trials (RCTs) and non-randomized controlled trials (nRCTs) related to acupotomy treatment for migraine, utilizing five Korean online databases (OASIS, Science ON, DBPIA, KISS, RISS), as well as four foreign online databases (CNKI, PubMed, EMBASE, Cochrane Library). We identified a total of 10 relevant studies for analysis. Participants characteristics, treatment points, combination treatments, treatment cycles or frequencies, evaluation indices, efficacy, and adverse events were analyzed. The risk of bias in the 10 RCTs was assessed using the Revised Cochrane risk-of-bias tool for randomized trials (RoB 2.0). Results : A total of 931 participants were included in 10 studies. In the intervention group, the average duration of migraine morbidity ranged from 15.5±4.5 months to 15.9±4.2 years. Six studies based their diagnoses on the International Classification of Headache Disorders (ICHD), while five studies relied on Chinese diagnostic criteria. All studies specified the treatment area as the region exhibiting tenderness or induration on the head and neck. Treatment cycles ranged from a minimum of 2 days to a maximum of 1 week, with the number of days per treatment course varied from 5 days to 4 weeks. The diameter of acupuncture needles used varied between 0.3 mm and 1 mm. Of the eight studies specifying needle length, the shortest was 20 mm, and the longest was 40 mm. A total of eight evaluation indices were employed, with total efficacy rate (TER) and visual analogue scale (VAS) being the most frequently used. Statistically, all intervention groups showed more significant results compared to the control groups. Adverse events were reported in only two studies within the intervention group. Overall, the risk of bias assessment for the selected RCTs ranged from 'some concerns' to 'high risk of bias.' Conclusions : This study showed that acupotomy treatments for migraine were effective.

Clinical Application of Focused Ultrasound in Korean Medicine (집속초음파 치료의 한의 임상 활용에 대한 고찰)

  • Yoomin Choi;Maeum Lee;Nayeon Hur;Eunhee Lee;Hyugyong Choi;Hyung-Sik Seo;Eui-Hyoung Hwang;Insoo Jang
    • Korean Journal of Acupuncture
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    • v.40 no.3
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    • pp.79-89
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    • 2023
  • Objectives : The purpose of this study is to investigate various application methods of focused ultrasound and apply them to clinical use in Korean medicine. Methods : Search was performed using the search engines of electronic databases, including PubMed, ScienceDirect, Cumulative Index to Nursing and Allied Health Literature (CINAHL), ScienceON, Oriental Medicine Advanced Searching Integrated System (OASIS), China National Knowledge Infrastructure (CNKI), Wanfang Data, Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii), from inception to July 2023 without language limitation. Inclusion criteria were clinical studies including randomized controlled trials (RCTs), and animal experimental studies related with focused ultrasound treatments for acupoints or meridian sinews. Results : Total 17 papers, 7 for RCT, 6 for in vivo animal studies, and other experimental studies, were finally selected. Indications used in studies were shoulder pain, back pain, chronic back pain, and degenerative knee arthritis. In experimental studies, studies on animal models of hypoxic ischemic brain damage and hyperlipidemia were also conducted. As for the acupoints, LR3, LI4, and ST36 were used in clinical studies and, in animal experimental studies, GV20, KI1, and ST36 were used. As for the dose, 4 studies below 3 W/cm2 and 3 studies in the range of 0.625 to 5 W/cm2 in clinical studies, and all studies did not exceed 5 W/cm2. In animal experimental studies, 0.5 W/cm2, 2 W/cm2, 7.5 WW/cm2, 15 W/cm2, 10~20 W/cm2 were used. In all three studies describing the penetration depth during irradiation, it was less than 1 cm. Conclusions : We suggest that focused ultrasound is an appropriate treatment tool for stimulating the acupoints to transfer heat energy. Future studies with rigorous and well-designed RCTs for various diseases will be required to ascertain the focused ultrasound stimulate acupoints or meridian sinews.

Effectiveness of Acupuncture for Pain and Depressive Symptoms in Fibromyalgia: Systematic Review and Meta-Analysis (섬유근통의 통증 및 우울증상에 대한 침치료의 효과성: 체계적 문헌고찰 및 메타분석)

  • Hyunwoo Lee;Chan Park;Tae Hoon Bang;Hyung Min Ji;Jong-Woo Kim;Sun-Yong Chung
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.2
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    • pp.95-113
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    • 2023
  • Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

The Effect of Taeksa-tang for Dyslipidemia: A Systematic Review and Meta-Analysis (이상지질혈증에 대한 택사탕(澤瀉湯)의 효과 : 체계적 문헌 고찰 및 메타 분석)

  • Yeong-seo Lee;Tae-young Huh;Kyoung-min Kim
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.485-505
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    • 2023
  • Objective: The purpose of this study is to assess the effectiveness and safety of using Taeksa-tang for dyslipidemia through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as "dyslipidemia", "hyperlipidemia", "taeksa tang", "zexie tang", and "takusha to" in 12 databases (Pubmed, Cochrane, Embase, ScienceDirect, CNKI, Wanfang, CiNii, RISS, KISS, ScienceON, OASIS, and DBpia) on April 13, 2023. There were no limits on the publication period and language. Cochrane's risk of bias (RoB) was used to evaluate the quality of the studies. A meta-analysis was conducted according to the outcome measurements such as total effective rate (TER), total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and adverse effects, using the Review Manager web. Results: A total of 9 RCTs were selected. In evaluating the RoB, 2 studies mentioning the random sequence generation, 1 study conducting double blindness, and 8 studies without missing values were evaluated as low risk, while 1 study without mentioning the random sequence generation was evaluated as high risk. All other parts were evaluated as unclear risk. The treatment group (Taeksa-tang or Taeksa-tang-gagam) showed more statistically significant effects compared to the control group (Western medicine or Chinese patent medicine) in TER (RR : 1.24, 95% CI 1.15 to 1.34, P<0.00001), TC (MD : -1.12, 95% CI -1.68 to -0.56, P<0.0001), TG (MD : -1.08, 95% CI -1.65 to -0.51, P=0.0002), HDL-C (MD : 0.63, 95% CI 0.34 to 0.93, P<0.0001), LDL-C (MD : -0.81, 95% CI -1.10 to -0.53, P<0.00001). In addition, the treatment group showed lower adverse effects compared to the control group (RR : 0.30, 95% CI 0.12 to 0.74, P=0.008). Conclusion: This study suggests that Taeksa-tang is effective and safe to use for treating dyslipidemia. However, due to the low quality of the included studies, more clinical studies need to be conducted in the future to increase the possibility of clinical use.

Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석)

  • Nayeon Hur;Subin Ahn;Hongjun Kim;Insoo Jang
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.387-401
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    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

Herbal Medicine for Premenstrual Syndrome: A Systematic Review and Meta-analysis (월경전증후군에 대한 한약 치료의 효과 : 체계적 문헌 고찰과 메타 분석)

  • Ji-In Seo;Yun-Jae Lee;Seo-Lim Ko;Nu-Ree Kim;Jeong-Hun Kim;Mi-Ju Son;Young-Eun Kim;An-Na Kim;Eun-Hee Lee
    • The Journal of Korean Obstetrics and Gynecology
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    • v.36 no.4
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    • pp.96-120
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    • 2023
  • Objectives: This study reports the findings that support the efficacy of herbal medicine (HM) for premenstrual syndrome (PMS). Methods: We conducted meta-analysis of findings from randomized controlled trials (RCTs) for PMS treated with HM. The articles were published before July 2022, located using 9 databases (Pubmed, EMBASE, Cochrane Library, CINAHL, CNKI, CiNii, SCIENCE ON, KoreaMed, OASIS). Results: We observed 2,034 studies, of which 23 RCTs met our inclusion criteria. The risk of bias in the included studies was relatively unclear or high. Meta-analysis of 3 RCTs showed that HM group had a significantly higher total effective rate than the western medicine group (RR 1.20 [95% CI 1.06, 1.36, p=0.004]). Meta-analysis of 1 RCT showed that HM group had a significantly lower symptom score (MD -3.04 [95% CI -5.36, -0.72, p=0.01]), while there was no significant difference in daily record of severity of problems scale (MD -20.52 [95% CI -49.33, 8.29, p=0.16]). Conclusions: HM significantly improved PMS symptoms than general treatment and no serious adverse events were reported. However, the evidence on the effectiveness and safety of HM for PMS was not enough to provide reliable results due to the small number and low quality of included studies. We believe that rigorous RCTs will lead to more reliable evidence of the intervention.

Utilizing the Application of High-Intensity Yttrium Aluminum Garnet (YAG) Lasers Focused on Acupoint Irradiation (경혈 조사를 중심으로 본 고출력 Yttrium Aluminum Garnet (YAG) 레이저의 활용)

  • Maeum Lee;Yoomin Choi;Subin Ahn;Gihyang Lee;Eunhee Lee;Myungjin Yim;Hyung-Sik Seo;Eui-hyoung Hwang;Insoo Jang
    • Korean Journal of Acupuncture
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    • v.40 no.4
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    • pp.141-148
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    • 2023
  • Objectives : The purpose of this study is to investigate on the application of the yttrium aluminum garnet (YAG) lasers for acupoints irradiation. Methods : We conducted a systematic search for peer-reviewed studies published from inception to November 2023, in the following electronic databases: PubMed, Scopus, and Web of Science in English, Science ON, Oriental Medicine Advanced Searching Integrated System (OASIS) and Research Information Sharing Service (RISS) in Korean, and China National Knowledge Infrastructure (CNKI) and Wanfang in Chinese, and Japan Science Technology Information Aggregator, Electronic (J-STAGE) and Citation Information by NII (CiNii) in Japanese. Inclusion criteria were original articles including clinical and experimental studies related with YAG lasers for acupoints including Ashi or meridian sinews. Results : Among the 8 selected studies, there were 7 studies on human subjects and 1 study on animals, 7 studies on Nd:YAG (1,064 nm) laser, and 1 study on Er:YAG (2,940 nm) laser. A total of 16 acupoints were used, 15 of which were in the face and 1 of which was located in the foot. In addition, there were two studies using Ashi. 4 studies looked at the effect of pain relief, 2 studies looked at safety, 1 study looked at changes in blood flow, and 1 study looked at the effect of skin care. There were no reported adverse events, and the YAG laser was confirmed to be safe and effective in pain relief, beautifying the skin, and increasing blood flow. Conclusions : We suggest that high intensity YAG lasers can be applied to laser acupuncture or laser moxibustion. YAG lasers are considered to be worth using for various clinical indications of Korean medicine because of photobiomodulation effects, analgesic action, and deep penetration depth. Further scientific research and clinical evidences should be warranted.

Efficacy and Safety of Combination Treatment of Traditional Korean Medicine after Gastric Cancer Surgery: A Systematic Review and Meta-analysis Protocol (위암 수술 후 항암치료를 병행한 한의치료의 유효성 및 안전성: 체계적 문헌고찰 및 메타분석 프로토콜)

  • Jong-hee Kim;Eunbin Kwag;So-jung Park;Donghyun Kim;Soodam Kim;Jihye Park;Hwa-seung Yoo
    • Herbal Formula Science
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    • v.31 no.4
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    • pp.361-371
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    • 2023
  • Objectives : Gastric cancer is a malignant tumor of the digestive tract that not only has a high mortality rate, but also affects quality of life. In Traditional Korean Medicine, acupuncture and herbal medicines can increase the survival rate for Gastric cancer and improve the quality of life. Traditional Korean Medicine treatment played an important role when used alone or in combination with chemotherapy. However, there is still insufficient evidence to support the efficacy and safety of Traditional Korean Medicine in patients undergoing chemotherapy after surgery. Therefore, the purpose of this study is to systematically evaluate the effect of oriental medicine treatment on patients as a complementary therapy for Gastric cancer. Methods : 2 researchers will search using EMBASE, Pubmed, CNKI, Cochrane Library, CiNii, KMBASE, KISS, OASIS, RISS, ScienceON. The search period of the database is from inception until June 2022. This study will include a randomized controlled trial of GC for acupuncture and herbal treatment. Primary outcomes include anti-cancer effects. Secondary outcomes evaluate survival rates and improvements in quality of life. The data uses Review Manager Software 5.4. Results : This study will provide a systematic evaluation by synthesizing the anti-cancer effect, survival rate and quality of life of Gastric cancer when Traditional Korean Medicine is combined with chemotherapy. Conclusion : The conclusion of this study will provide a basis for determining whether Traditional Korean Medicine treatment for Gastric cancer treatment is an effective and safe treatment method in clinical practice.

Orally Administered Korean Herbal Medicine Medications of Randomized Controlled Trials Published in the Journal of Korean Medicine and Related Journals: A Narrative Analysis using CONSORT-CHM 2017 (CONSORT-CHM 2017 지침에 근거한 대한한의학회지 및 회원학회지에 투고된 경구투여 한약 중재를 활용한 무작위 배정 비교 임상 연구(RCT)의 양적, 질적 평가 연구)

  • Se-hun Moon;Jung-ho Jo;Seung-kwan Choi;Yun-hee Han;Hyeon-jun Woo;Byeong-hyeon Jeon;Won-bae Ha;Jung-han Lee
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1212-1242
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    • 2023
  • Objectives: This study aims to explore the current usage status of orally administered Korean herbal medicine in randomized controlled trials (RCTs) published in the Journal of Korean Medicine and member journals using the CONSORT-Chinese Herbal Medicine Formulas 2017 (CONSORT-CHM 2017) checklist. Methods: We searched the OASIS, RISS, and KMBASE archives as well as the websites of the Journal of Korean Medicine and 45 member journals to identify RCTs that used herbal interventions. Two independent researchers searched and categorized the RCTs and performed a quantitative evaluation by journal, study design, and target disease, as well as qualitative evaluation of the literature using CONSORT-CHM 2017. Results: After the search, 66 articles were selected. The quantitative evaluation resulted in 13 articles (19.6%) that were published in the Journal of Korean Medicine and 12 articles (18.1%) in the Journal of Internal Korean Medicine. In terms of study design, 62 articles (93.9%) were parallel, 4 articles (6%) were crossover, and 2-arm parallel study designs were the most common in 45 articles (68.2%). In terms of the study participants, physiological characteristics and mechanisms in healthy individuals were the most common in 21 studies (31.8%) and obesity in 9 studies (13.6%). In terms of assessing completeness in the CONSORT-CHM 2017 items, 29 articles were rated high, 31 were rated moderate, and 6 were rated low. Items 4a, 6a, and 7a had low reporting rates (≤ 30%), while items 2a, 2b, and 12a were completely reported in all studies. Conclusion: Future RCTs using orally administered Korean herbal medicine need to be reported completely, and the CONSORT-CHM 2017 checklist can be a helpful tool for this purpose.