• Title/Summary/Keyword: Randomized Clinical Trials

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Systematic Review of Selection of Acupoints in Domestic Clinical Studies Related to Nuchal Pain (국내 경항통 연구에서의 경혈 선정에 관한 계통적 연구)

  • Lee, Hyung Eun;Lee, Eun Jung;Oh, Min Seok
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.27 no.6
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    • pp.698-704
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    • 2013
  • The purpose of this study is to figure out which acupoints are selected to treat nuchal pain and attempt to analyze the meaning of those acupoints in current clinical trials. We searched ten electronic databases and manually checked related Korean journals and references. We included randomized controlled trials(RCT), clinical controlled trials(CCT), case reports/series, and literature reviews using acupojnts to treat nuchal pain. We investigated the frequency of selected acupoints. We included 31 articles in this study. The most frequently adopted acupoints were GB20(77.41%), followed by GB21(61.29%). In distribution according to meridian system, BL was the most(25.60%), followed by Extra points of Dong-Shi(12.19%). Selected acupoints for treat nuchal pain were considered to be affected by flow of meridian system. It is necessary for more studies to provide clinical guideline of acupoint selection.

The Trends in Foreign Clinical Trials for Pediatric Asthma in Complementary and Alternative Medicine (소아 천식 치료의 국외 보완대체의학 임상 연구 동향)

  • Bang, Mi Ran;Kim, Jang Hyun;Min, Sang Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.29 no.3
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    • pp.1-11
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    • 2015
  • Objectives : The purpose of this study is to analyze the trends in foreign clinical trials for pediatric asthma in complementary and alternative medicine (CAM). Methods : We reviewed 31 randomized controlled trials (RCT) for pediatric asthma treatment in CAM published from 2005 to 2015 in PubMed and analyzed their treatments, compounds of herbal medicines, acupoints, methods of assessment, and treatment results. Results : The treatments used in the studies were herbal medicines, acupuncture, acupoint application, breathing training, supplement, normocaloric diet, yoga, massage therapy, and art therapy. The frequently used herbs were Asari Herba Cum Radix (細辛). Ephedrae Herba (麻黃), Astragali Radix. The most common acupoints were Feishu (肺兪, BL13). The methods of assessment in pediatric asthma were symptom scale, questionnaire of Quality of Life, lung function test, laboratory studies, and medication usage. In 28 out of 31 studies, treatment group gets better than non-treated group. Conclusions : This study shows that CAM is effective in treating pediatric asthma. More clinical studies using objective outcome measures are needed to prove its efficacy clearly.

Contemporary treatment with radiosurgery for spine metastasis and spinal cord compression in 2015

  • Ryu, Samuel;Yoon, Hannah;Stessin, Alexander;Gutman, Fred;Rosiello, Arthur;Davis, Raphael
    • Radiation Oncology Journal
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    • v.33 no.1
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    • pp.1-11
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    • 2015
  • With the progress of image-guided localization, body immobilization system, and computerized delivery of intensity-modulated radiation delivery, it became possible to perform spine radiosurgery. The next question is how to translate the high technology treatment to the clinical application. Clinical trials have been performed to demonstrate the feasibility of spine radiosurgery and efficacy of the treatment in the setting of spine metastasis, leading to the randomized trials by a cooperative group. Radiosurgery has also demonstrated its efficacy to decompress the spinal cord compression in selected group of patients. The experience indicates that spine radiosurgery has a potential to change the clinical practice in the management of spine metastasis and spinal cord compression.

Chuna Manual Therapy for Primary Insomnia; A Review of Clinical Study (일차성 불면증의 추나 치료에 대한 문헌 연구 보고)

  • Hwang, Man-Suk
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.3
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    • pp.79-84
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    • 2016
  • Objectives To evaluate the evidence supporting the effectiveness of Chuna manual therapy for primary insomnia. Methods The researcher conducted search across the 3 electronic databases (Pubmed, CAJ and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy as a treatment for primary insomnia. Results Four RCTs met inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy in terms of the PSQI when compared to medication treatments alone. Positive results were also obtained, in terms of the PSQI, when comparing Chuna manual therapy combined with acupuncture therapy to acupuncture therapy alone, but was not statistically significant. Conclusions The review found encouraging but limited evidence of Chuna manual therapy for primary insomnia. We recommend clinical trials which compare the effectiveness of Chuna manual therapy with usual care to obtain stronger evidence without the demerits of trial design.

Endovascular Stroke Therapy Focused on Stent Retriever Thrombectomy and Direct Clot Aspiration : Historical Review and Modern Application

  • Kang, Dong-Hun;Park, Jaechan
    • Journal of Korean Neurosurgical Society
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    • v.60 no.3
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    • pp.335-347
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    • 2017
  • Intravenous recombinant tissue plasminogen activator had been the only approved treatment for acute ischemic stroke since its approval in 1995. However, the restrictive time window, numerous contraindications, and its low recanalization rate were all limitations of this modality. Under those circumstances, endovascular stroke therapy went through a great evolution during the past two decades of intravenous thrombolysis. The results of the 2013 randomized trials for endovascular stroke therapy were neutral, although they were limited by insufficient imaging screening at enrollment, early-generation devices with less efficacy, and treatment delays. Huge progress was made in 2015, as there were five randomized clinical trials which all demonstrated the safety and efficacy of endovascular stroke treatment. Despite differences in detail patient enrollment criteria, all 5 trials employed key factors for good functional recovery; (1) screening with non-invasive imaging to identify the proximal occlusion and exclude a large infarct core, (2) using highly effective modern thrombectomy devices mainly with stent retriever, and (3) establishment of a fast workflow to achieve effective reperfusion. The results of those trials indicate that modern thrombectomy devices can allow for faster and more effective reperfusion, which can lead to improved clinical outcomes compared to intravenous thrombolysis alone. These advances in mechanical thrombectomy are promising in the global fight against ischemic stroke-related disability and mortality. Two current mainstreams among such mechanical thrombectomy techniques, "stent retriever thrombectomy" and "direct clot aspiration", are the topic of this review. Stent retriever thrombectomy using Solitaire and Trevo retriever will be firstly discussed. And, the commonalities and the differences between two major clot aspiration thrombectomy techniques; a direct aspiration first pass technique (ADAPT) and forced arterial suction thrombectomy (FAST), will be additionally explained. Finally, details regarding the combination of direct clot aspiration and stent retriever thrombectomy, the switching strategy and the Solumbra technique, will be described.

Review on Clinical Trials of Chemotherapy Induced Toxicity with Acupuncture in PubMed Database (PubMed 검색을 통한 항암화학요법 부작용 관련 침 임상시험 현황 고찰)

  • Kim, Jong Yoon;Kim, Jin Youp;Kim, Nam Sik;Kim, So Jung;Oyungerel, Munkhgerel;Kim, Yong Suk;Choi, Do Young;Nam, Sang Soo
    • Journal of Acupuncture Research
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    • v.30 no.2
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    • pp.43-53
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    • 2013
  • Objectives : The purpose of this study is to review of Clinical trials related to the treatment of chemotherapy induced-toxicity by acupuncture therapy. Methods : We searched PubMed by using word of "chemotherapy induced, acupuncture" (Limits : Full text available, 10 years, Clinical trials, Humans, English). We analyzed 15 research paper and examined published journals, years, countries, topic, study design, their results, interventions, participants and instruments of assessment. Results : Eleven journals with fifteen papers were searched. These papers were published in USA, Germany, etc. On the topic of these clinical trials, seven of them were about nausea(vomiting), two about peripheral neuropathy, two about hot flash, two about arthralgia and one about neutropenia, one about fatigue. Six of these studies were single blinded, randomized controlled trial. Twelve studies reported significant effect. The median for number of final participants was 35.5 persons. Assessment for outcomes were versatile questionnaire, nerve conduction studies, WBC, ANC, G-CSF examination, etc. Conclusions : Their median for impact factor was 3.650 and average modified Jadad score of six RCTs was 4.33. In order to provide appropriate evidence regarding the effectiveness of acupuncture in treatment for chemotherapy-induced toxicity, more rigorous and well-designed studies are necessary.

Chuna Manual Therapy for Nocturnal Crying; A Systematic Review (소아 야제에 대한 추나요법 효과; 체계적 문헌고찰)

  • Hwang, Man-Suk;Shin, Byung-Cheul;Heo, Kwang-Ho;Heo, In;Kim, Byung-Jun;Kim, Ki-Bong;Cheon, Jin-Hong;Park, Jae-Hong;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.25 no.3
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    • pp.51-57
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    • 2015
  • Objectives To evaluate the evidence supporting the effectiveness of Chuna manual therapy for nocturnal crying. Methods We conducted search across the 3 electronic databases (Pubmed, CAJ and Oasis) to find all of randomized controlled clinical trials(RCTs) that used Chuna manual therapy as a treatment for nocturnal crying. The methodological quality of each RCTs was assessed using the Cochrane Risk of Bias tool and nRCTs was assessed using the Cochrane Risk of Bias Assessment tool for Non-randomized Study tool. Results Two RCTs and three nRCTs met our inclusion criteria. The meta-analysis showed positive results for the use of Chuna manual therapy in terms of the efficacy rate when compared to medication treatments alone. Positive results were also obtained, in terms of the efficacy rate, when comparing Chuna manual therapy combined with acupoint application therapy to Chuna manual therapy alone, but was not statistically significant. Conclusions Our systematic review found encouraging but limited evidence of Chuna manual therapy for nocturnal crying. We recommend clinical trials which compare the effectiveness of Chuna manual therapy with usual care to obtain stronger evidence without the demerits of trial design.

Analysis of Recent Clinical Studies to Establish Korean Herbal Medicine Clinical Trial Guidelines for the Common Cold (감기 임상시험 가이드라인 제정을 위한 최신 임상시험 연구 분석)

  • Kim, Kwan-il;Lee, Ho-jung;Lee, Beom-joon;Jung, Hee-jae;Jung, Sung-ki;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.109-134
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    • 2016
  • Objectives: The aim of this study was to help develop a guideline for the common cold. We searched recent clinical studies of the common cold in Western medicine and reviewed their objectives, inclusion and exclusion criteria, primary outcome, secondary outcome, and assessment tools to establish evidenced-based guideline.Methods: We searched electronic databases (Cochrane Library, MEDLINE, EMBASE) to identify eligible randomized controlled trials (RCTs) about the common cold for the last 10 years. We included 29 RCTs and showed their research summary via their objectives, participants, interventions, control, treatment duration, and results. We also analyzed the definition of the common cold presented in the article, inclusion and exclusion criteria, primary and secondary outcomes, and assessment tools.Results: We reported the aforementioned areas in detail. At first, the definition of the common cold was confused across the articles. Second, herbal medication clinical trials for the common cold have been extensively studied recently. Third, the eligibility criteria frequently included the Jackson Symptom score. Fourth, validated assessment tools (i.e., the Wisconsin Upper Respiratory Symptom Survey-21) have only been used in a few recent studies.Conclusions: Our research will be helpful to establish Korean herbal medicine clinical trial guidelines for the common cold.

Citalopram and Escitalopram for Management of Hot Flashes: A Review of Recent Clinical Trials in Humans (Citalopram과 Escitalopram의 안면홍조 증상개선효과에 대한 최근 연구 고찰)

  • Lee, Yu-Jeung
    • Korean Journal of Clinical Pharmacy
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    • v.21 no.4
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    • pp.376-382
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    • 2011
  • The results from eight clinical studies demonstrate that citalopram and escitalopram could be an effective option in the treatment of hot flashes with tolerable adverse effects. However, there are limitations in the above studies. The inclusion criteria of 2 studies reviewed in this paper was breast cancer patients, so it's hard to apply the results to the general population in clinical practice. Also 4 studies had less than 50 subjects included, and the duration of study was 8 weeks or less in 7 studies reviewed in this paper. Moreover, only 4 studies were randomized, placebo-controlled trials (3 for citalopram and 1 for escitalopram). Therefore, further randomized, double-blind, placebo-controlled studies with the general population should be needed to use citalopram and escitalopram for the treatment of hot flashes in clinical practice.

Laparoscopic Versus Open Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Zhang, Feng-Wa;Zhou, Zhao-Yu;Wang, Hai-Lin;Zhang, Jv-Xia;Di, Bao-Shan;Huang, Wen-Hui;Yang, Ke-Hu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.22
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    • pp.9985-9996
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    • 2014
  • Background and Aim: Laparoscopic and open rectum surgery for rectal cancer remains controversial. This systematic review compared the short-term and long-term efficiency and complications associated with laparoscopic and open resection for rectal cancer. Materials and Methods: We searched PubMed, Embase, Cochrane Library, ISI Web of Knowledge and the China Biology Medicine Database to identify potential randomized controlled trials from their inception to March 31, 2014 without language restriction. Additional articles were identified from searching bibliographies of retrieved articles. Two reviewers independently assessed the full-text articles according to the pre-specified inclusion and exclusion criteria as well as the methodological quality of included trials. The meta-analysis was performed using RevMan 5.2. Results: A total of 16 randomized controlled trials involving 3,045 participants (laparoscopic group, 1,804 cases; open group, 1,241 cases) were reviewed. Laparoscopic surgery was associated with significantly lower intraoperative blood loss, earlier return of bowel movement and reduced length of hospital stay as compared to open surgery, although with increased operative time. It also showed an obvious advantage for minimizing late complications of adhesion-related bowel obstruction. Importantly, there were no significant differences in other postoperative complications, oncological clearance, 3-year and 5-year or 10 year recurrence and survival rates between two procedures. Conclusions: On the basis of this meta-analysis we conclude that laparoscopic surgery has advantages of earlier postoperative recovery, less blood loss and lower rates of adhesion-related bowel obstruction. In addition, oncological outcome is comparable after laparoscopic and open resection for rectal cancer.