• Title/Summary/Keyword: Placebo-controlled study

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Intravaginal Administration of Oriental Medicine on Vaginal Atrophy in Menopause : A Systemic Review (폐경기 질 위축에 대한 한약제제 질 내 투여의 효과 : 체계적 문헌 고찰)

  • Lee, Soo-Hyung;Jung, Hyun-Tae;Kim, Song-Baek
    • The Journal of Korean Obstetrics and Gynecology
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    • v.34 no.2
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    • pp.62-81
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    • 2021
  • Objectives: The purpose of this study is to review clinical studies and evaluate effectiveness of intravaginal administration of oriental medicine on vaginal atrophy in menopausal women. Methods: 'postmenopause', 'menopause', 'vaginal atrophy', 'atrophic vaginitis', 'vaginal cream', 'vaginal gel', 'pessary', 'suppository' were searched on 3 online databases (Pubmed, Cochrane Library, OASIS). The risk of bias was assessed by using Cochrane risk of bias (RoB) 2.0 tool. Results: 9 randominized controlled trials (RCTs) were selected among 489 articles. The types of intervention were intravaginal administration of oriental medicine. 6 studies showed that treatment group was better than placebo control group or both treatment group and western medicine control group improved similarly. 2 studies were not significant effective in some results and 1 study was not statistically significant. Conclusions: Intravaginal administration of oriental medicine can be an effective option in treating menopausal women with vaginal atrophy. but considering the small number and low quality of studies, further well-designed studies are needed to confirm the effectiveness of this treatment.

Effects of Ethyl Chloride Spray before Arteriovenous Fistula Puncture on Pain, Depression, and Noncompliance of Hemodialysis (혈액투석 환자의 동정맥루 천자 시 에틸클로라이드 스프레이 적용이 통증, 우울 및 치료 지시 불이행에 미치는 효과)

  • Shin, Chang-Min;Lee, Minju
    • Journal of muscle and joint health
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    • v.30 no.1
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    • pp.25-35
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    • 2023
  • Purpose: This study was conducted to examine the effects of ethyl chloride spray during arteriovenous fistula puncture on pain, depression, and noncompliance in hemodialysis patients. Methods: This study used a randomized controlled trial design on adults with chronic renal failure who received hemodialysis treatment through arteriovenous fistula. Ethyl chloride spray was applied to 20 subjects in the experimental group during arteriovenous fistula puncture, and a placebo spray was applied to 20 subjects in the control group; the intervention was conducted 12 times for 4 weeks. A total of 33 participants were used in the final analysis. The outcomes were measured using the face pain rating scale, Center for Epidemiological Studies Depression Scale (CES-D), and modified United States Renal Data System tools. Results: As a result of the pre-homogeneity test between the two groups, it was confirmed that the sexes were not homogeneous. Therefore, sex was treated as a covariate and analyzed. Puncture pain was significantly reduced in the experimental group (p<.001). However there was no significant difference between the groups in depression and noncompliance. Conclusion: Ethyl chloride spray was convenient and effective pain management intervention for both hemodialysis patients and medical staff.

A Systematic Review on the Efficacy of Fire Needling for the Treatment of Acne (여드름의 화침치료 효과에 대한 체계적 문헌 고찰)

  • Kim, Eui Byeol;Kang, Ki Wan;Kim, Min Ji;Kang, Ja Yeon;Jeong, Min Jeong;Jang, In Soo
    • Journal of Acupuncture Research
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    • v.33 no.2
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    • pp.151-164
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    • 2016
  • Objectives : The purpose of this study is to review clinical studies about the efficacy of fire needling for the treatment of acne vulgaris. Methods and Results : In this review, Oasis, NDSL, CNKI, PubMed, Cochrane, J STAGE and CINII were used as the main databases for searching for medical journals, using the keywords "acne and fire needling"," acne and fire needle"," acne and fire acupuncture", and" acne and red hot needle". The initial search range included only randomized controlled trials (RCTs), and papers not matching inclusion criteria were excluded. Initially a total of 108 studies were found, with ten being excluded during title and abstract screening. After scanning 98 papers, a total of 31 RCTs were selected and analyzed. In the 31 RCTs, patients with acne were randomized into groups for treatment and control. Specifically, the treatment group received fire needling, while the control group were concurrently given other treatments. The results of the completed studies have shown that the treatment group receiving fire needling demonstrated significant improvement compared to the control group. Conclusion : During our study, it was verified that the efficacy of fire needling for the treatment of acne vulgaris was both significant and meaningful. Therefore, fire needling can be a safe and effective alternative treatment for acne. However, to confirm this result, further investigation in a traditional clinic is required, accompanied by high quality studies including randomized, placebo-controlled double-blind trials.

A Review of Acupuncture for the Treatment of Raynaud's Disease (레이노병의 침치료에 대한 연구동향)

  • Jeon, Sang-woo;Kim, Ho;Jeong, Min-jeong;Jang, In-soo
    • The Journal of Internal Korean Medicine
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    • v.38 no.4
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    • pp.433-442
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    • 2017
  • Objectives: The purpose of this study was to assess the effectiveness of acupuncture for the treatment of Raynaud's disease. Methods: This review was conducted using nine electronic databases (CINAHL, CiNii, CNKI, EMBASE, J-STAGE, NDSL, OASIS, PubMed, and WANFANG) and the keywords "Raynaud's disease", "Raynaud disease", "acupuncture", and "needling". Only randomized controlled trials (RCTs) using acupuncture for Raynaud's disease were included, and the methodological quality of the trials was assessed using the Cochrane risk-of-bias tool. Results: After screening, six RCTs were selected among 67, and the total effective rate and peripheral blood flow were used as evaluation methods. In five studies, the total effective rate was significantly higher in the intervention group than in the control group. In three studies, peripheral blood flow was higher in the intervention group than in the control group, with two studies being statistically significant and the remaining study not being statistically significant. Conclusions: Acupuncture could be a suitable treatment without adverse effects for Raynaud's disease because it improves peripheral blood flow. However, further studies, including randomized, placebo-controlled, double-blind methods, and clear evaluation criteria are needed.

Effects of Aromatherapy on Sleep Quality: A Systematic Review and Meta-Analysis (아로마테라피가 수면에 미치는 효과: 체계적 문헌고찰 및 메타분석)

  • Kim, Mi-Eun;Jun, Ji Hee;Hur, Muyng-Haeng
    • Journal of Korean Academy of Nursing
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    • v.49 no.6
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    • pp.655-676
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    • 2019
  • Purpose: The purpose of this study was to investigate the effects of aromatherapy on sleep quality. Methods: This is a systematic review of randomized controlled trial studies (PROSPERO registration number CRD42017064519). In this study, the PICO were adults and the elderly, aromatherapy intervention, a comparative intervention with the control and placebo oil groups, and sleep. The selected articles were in English, Korean, and Chinese. Results: The results of the meta-analysis showed that the effect sizes of the experimental group were 1.03 (n=763, SMD=1.03, 95% CI 0.66 to 1.39) (Z=5.47, p<.001). In the aromatherapy intervention group, the effect size of sleep was statistically significant (QB=9.39, df=2, p=.009), with a difference of 0.77 for inhalation, 1.12 for oral intake and 2.05 for massage. A post-analysis showed that the effect of massage on sleep was significantly greater than the inhalation method. The regression coefficient of the intervention period, B=0.01 (Z=1.43, p=.154), also showed that the longer the intervention period, the larger the effect size; however, it was not statistically significant. Conclusion: A total of 23 literature analyses showed that aromatherapy is effective in improving quality of sleep, and the massage method is more effective in improving quality of sleep than the inhalation method. A meta-ANOVA showed that the aromatherapy intervention affected the high heterogeneity of the effect size. Thus, future research with stricter control in methods and experimental procedures is necessary.

Efficacy of Herbal Medicines for the Treatment of Psoriasis : Systematic Review and Meta-analysis (건선의 한약치료 효과에 대한 체계적 문헌 고찰과 메타 분석)

  • Ryu, Deok-Hyun;Ryu, Deok-Seon;Roh, Seok-Sun
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.30 no.3
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    • pp.1-19
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    • 2017
  • Objectives : This study aimed to validate the effect of herbal medicine intervention to relieve the symptoms of psoriasis using systematic review and meta-analysis and provide the newest reason of effectiveness of Korean medicine to psoriasis. Methods : Data were collected through electronic database including Pubmed, Cochrane CENTRAL, NDSL OASIS, Koreantk. Two experts assessed risk of bias of randomized controlled trials by Cochrane group's Risk of Bias tool after searching, reviewing and selecting papers. Data were analyzed using Review Manager(RevMan) 5.3 and Comprehensive Meta Analysis 2.0. Results : Total number of selected trials was 16 randomized controlled trials. This study evaluated the risk of bias and effectiveness of herbal medicine to psoriasis. There were high frequency uncertain in selection bias, performance bias and detection bias. In this meta-analysis, Korean medicine treatment was more effective than western medicine (ES:0.507, 95%CI:0.147-0.867) and placebo (ES:0.955, 95%CI:0.598-1.312). Conclusions : Herbal medicine intervention can be an effective for treatment in psoriasis. But enhancing levels of evidence, we must try to accumulate clinical researches of herbal medicine to psoriasis in Korea.

Variability in Drug Interaction According to Genetic Polymorphisms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • Environmental Mutagens and Carcinogens
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    • v.24 no.1
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    • pp.15-18
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    • 2004
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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Variability in Drug Interaction According to Genetic Polymorph isms in Drug Metabolizing Enzymes

  • Jang, In-Jin;Yu, Kyung-Sang;Cho, Joo-Youn;Chung, Jae-Yong;Kim, Jung-Ryul;Lim, Hyeong-Seok;Shin, Sang-Goo
    • Environmental Mutagens and Carcinogens
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    • v.23 no.4
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    • pp.131-134
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    • 2003
  • There are significant differences in the extent of drug interactions between subjects. The influence of the genetic make up of drug metabolizing enzyme activities (CYP3A5, CYP2C19 and UDP-glucuronosyl transferase) on the pharmacokinetic drug interaction potential were studied in vivo. Nineteen healthy volunteers were grouped with regard to the $CYP3A5^{*}3$ allele, into homozygous wild-type (CYP3A5^{*}1/1^{*}1$, n=6), heterozygous $(CYP3A5^{*}1/^{*}3$, n=6), and homozygous variant-type $(CYP3A5^{*}3/^{*}3$, n=7) subject groups. The pharmacokinetic profile of intravenous midazolam was characterized before and after itraconazole administration (200 mg once daily for 4 days), and also following rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. For omeprazole and moclobemide pharmacokinetic interaction study 16 healthy volunteers were recruited. The volunteer group comprised 8 extensive metabolizers and 8 poor metabolizers of CYP2C19, which was confirmed by genotyping. Subjects were randomly allocated into two sequence groups, and a single-blind, placebo-controlled, two-period crossover study was performed. In study I, a placebo was orally administered for 7 days. On the eighth morning, 300 mg of moclobemide and 40 mg of placebo were coadministered with 200 mL of water, and a pharmacokinetic study was performed. During study n, 40 mg of omeprazole was given each morning instead of placebo, and pharmacokinetic studies were performed on the first and eighth day with 300 mg of moclobemide coadministration. In the UGT study pharmacokinetics and dynamics of 2 mg intravenous lorazepam were evaluated before and after rifampin pretreatment (600 mg once daily for 10 days), with a washout period of 2 weeks in between. The subjective and objective pharmacodynamic tests were done before and 1, 2, 4, 6, 8, and 12 hrs after lorazepam administration. The pharmacokinetic profiles of midazolam and of its hydroxy metabolites did not show differences between the genotype groups under basal and induced metabolic conditions. However, during the inhibited metabolic state, the $CYP3A5^{*}3/^{*}3$ group showed a greater decrease in systemic clearance than the $CYP3A5^{*}1/^{*}1$ group $(8.5\pm3.8$ L/h/70 kg vs. $13.5\pm2.7$ L/h/70 kg, P=0.027). The 1'-hydroxymidazolam to midazolam AUC ratio was also significantly lower in the $CYP3A5^{*}3/^{*}3$,/TEX> group $(0.58\pm0.35,$ vs. $1.09\pm0.37$ for the homozygous wild-type group, P=0.026). The inhibition of moclo-bemide metabolism was significant in extensive metabolizers even after a single dose of omeprazole. After daily administration of omeprazole for 1 week, the pharmacokinetic parameters of moclobemide and its metabolites in extensive metabolizers changed to values similar to those in poor metabolizers. In poor meta-bolizers, no remarkable changes in the pharmacokinetic parameters were observed. The area under the time-effect curves of visual analog scale(VAS), choice reaction time, and continuous line tracking test results of lorazepam was reduced by 20%, 7%, 23% respectively in induced state, and in spite of large interindividual variablity, significant statistical difference was shown in VAS(repeated measures ANOVA, p=0.0027).

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Clinical Reports of Patients with Singi-hwan Teatment of Male Climateric Syndrome with AMS Questionnaire (AMS 설문지 검사를 이용한 성기능 장애 환자의 신기환(腎氣丸) 투여 10례에 대한 임상보고)

  • Shin, Seon Mi;Ko, Heung;Kim, Gi Tea;Kim, Ho Hyun;Park, Sun Young
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.28 no.5
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    • pp.558-564
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    • 2014
  • The purpose of this study was to investigate the clinical results of the 10 male climateric syndrome cases while treated with Singi-hwan. All patients were treated with Singi-hwan two times a days for 5 weeks. We checked testosterone, PSA in blood, HRV and AMS questionnaire score. The questionnaire score was improved after taking Singi-hwan. Stress resistance and autonomic nervous system activity is increased, but there was no statistical significance except for ApEn. Taking Singi-hwan did not affect the serum concentration of testosterone, PSA and blood biochemical tests. The next placebo-controlled studies about late onset hypogonadism treated with Singi-hwan are needed.

Review of Clinical Acupuncture Research Protocols on Cancer in the USA (미국의 암 관련 침 임상 연구 프로토콜 분석)

  • Dobs, Adrian S;Lee, Sang-Hoon
    • The Journal of Korean Medicine
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    • v.28 no.3 s.71
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    • pp.116-125
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    • 2007
  • Objective : To overview the protocols of clinical acupuncture research on cancer in the USA. Methods : Using 'acupuncture' and 'cancer' as keyword search terms in Clinical Trials. gov, 28 clinical studies were found. Three studies by non-American institutions were excluded and 25 studies were analyzed. Analytic parameters were cancer condition, primary outcome, research institution, study design, and acupuncture intervention. Results : Breast cancer was the most frequent single condition in the searched protocols. Pain and quality of life were the primary outcomes in many studies. Memorial Sloan-Kettering Cancer Centerin New York has performed the largest number of acupuncture cancer studies. The majority of studies were randomized controlled trials with active controls or placebo/sham controls. Total enrollment varied between the range of 10 and 700 subjects and ages of these subjects were at least above 18 years old (except one protocol). Most protocols had strict exclusion criteria for acupuncture needling such as bleeding disorders, infection, heart disorder, and central nervous system disorder. Conclusions : Clinical acupuncture studies for cancer patients have focused on pain, quality of life, and side effects induced by anti-cancer therapies. Re-evaluation and cautions for strict exclusion criteria in foreign countries are required to perform multi-national acupuncture trials.

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