• Title/Summary/Keyword: Randomized Clinical Trials

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Acupuncture for glaucoma: A systematic review and meta-analysis of randomized controlled trials (녹내장의 침치료 효과에 대한 체계적 문헌고찰 및 메타분석)

  • Yi, Gil-Hee;Jung, Chan-Yung;Chang, Seok-Joo;Hong, Seung-Ug
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.33 no.3
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    • pp.45-68
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    • 2020
  • Objectives : This study aims to evaluate the effectiveness and safety of manual and electroacupuncture on glaucoma. Method : We searched 11 electronic databases using index words to identify randomized clinical trials. Meta-analysis of weighted mean difference (WMD) or standardized mean difference (SMD) were used to evaluate the outcomes. Cochrane bias risk assessment tool was used to assess the risk of bias in each clinical study. The collected data was analyzed using RevMan software (ver. 5.3). Results : At the initial stage of data retrieval, 549 papers were searched. After reviewing 37 full texts, a total of 10 RCT studies (426patients, 715 eyes) were selected and 8 RCT studies (357 people, 617 eyes) were involved in meta-analysis. Meta-analysis of 8 RCTs showed that acupuncture alone was more effective in reducing intraocular pressure(IOP) than conventional treatment (WMD = -5.73, 95% CI: [-12.30, 0.83], P = 0.09, I2 = 97%) The combination of acupuncture or electroacupuncture with conventional treatment was also effective in lowering IOP (WMD = -1.84, 95% CI: [-2.31, -1.37], P <0.00001, I2 = 45%). It was estimated that the combination of acupuncture with conventional treatment was also effective for improving visual field (VF) (WMD = -2.17, 95% CI: [-4.32, -0.02], P = 0.05, I2 = 89%) but improvement in visual acuity (VA) was not significant (MD = 0.06, 95% CI: [-0.03, 0.15], P = 0.23, I2 = 0%). Subgroup analyzes were performed only for the studies that used open glaucoma as the study's disease and combination of acupuncture or electroacupuncture with conventional therapy would have an effect on lowering intraocular pressure (WMD = -1.68)., 95% CI: [-2.46, -0.90], P <0.0001, I2 = 29%). Conclusion : This study suggests that acupuncture treatment for glaucoma may be effective in reducing intraocular pressure and helpful in improving visual field defects. However, due to the small sample size, high risk of bias and high heterogeneity in the methodology, it is expected that further studies will be needed to verify the results. Further studies in large-scale samples based on a minimized biased methodology would be necessary.

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 Acupuncture in the Treatment of Post-Disaster Musculoskeletal Pain: A Systematic Review (재난 후 근골격계 통증에 침치료의 유효성: 체계적 문헌고찰)

  • Ka-Hyun Kim;Sung-Won Choi;Hae-Won Hong;Ju-Young Yoon;Yong-Jun Kim;Jung-Hyun Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.3
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    • pp.135-148
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    • 2023
  • Objectives To investigate the effectiveness of acupuncture in the treatment of post-disaster musculoskeletal pain by reviewing relevant clinical studies. Methods A systematic search was conducted across 10 electronic databases to identify relevant clinical studies on acupuncture treatment for post-disaster musculoskeletal pain until May 2023. The methodological quality was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias Assessment tool for non-randomized studies tools. Results Six articles were analyzed, including two randomized controlled trials (RCTs), two before-after studies, one qualitative research, and one case series. Overall, acupuncture therapy showed some improvement in pain scale among musculoskeletal pain survivors. However, no significant improvement was observed in the Short-Form McGill Pain Questionnaire (SF-MPQ-2). Subgroup analysis of participants who completed at least four acupuncture sessions revealed a significant effect on the SFMPQ-2. Additionally, a significant improvement in 36-Item Short Form Survey (SF36P) was observed after 6 months of treatment, but the 2-month treatment period did not show statistically significant effects on SF-36P improvement. The evaluation of the methodological quality of the RCTs identified some concerns of bias. Conclusions The results suggest that acupuncture is effective in alleviating post-disaster musculoskeletal pain. However, considering the limited number of selected studies and the inclusion of subjective evaluation measures, caution should be exercised in interpreting the results. Further large-scale follow-up studies are needed to determine the optimal frequency and duration of acupuncture treatment. Well-designed controlled trials should be conducted to provide more robust evidence regarding the effectiveness of acupuncture for post-disaster musculoskeletal pain.

A Review of Clinical Research on Korean Medicine for Shoulder Pain Conducted in Korea (어깨통증의 한의학적 치료에 대한 국내 임상 연구 고찰)

  • Kim, Chan-young;Yang, Ji-hye;Chae, In-cheol;Choi, In-woo;Ryu, Ju-young;Jung, Eun-sun;Kim, Yoon-sik;Seol, In-chan;Yoo, Ho-ryong
    • The Journal of Korean Medicine
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    • v.41 no.3
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    • pp.221-246
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    • 2020
  • Objectives: Shoulder pain is the third most common musculoskeletal complaint that necessitates physician consultation and significantly diminishes patients' quality of life. In this review, we analyzed clinical studies that investigated the use of Korean Medicine for the treatment of shoulder pain. Methods: We searched the online Korean databases, such as KMBase, DBpia, NDSL, RISS, KISS, and OASIS for clinical studies that report the use of Korean Medicine for shoulder pain. We analyzed the included studies with regard to study design, interventions, evaluations, and results. Results: We analyzed data from the following 29 studies: 14 clinical trials (which included 9 randomized controlled trials) and 15 observational studies (which included 11 case reports). In this review, we observed that post-stroke shoulder pain was the most common cause of shoulder pain, which was reported in 13 out of 29 studies (44.8%), although in actual clinical practice, patients are more likely to present with primary shoulder pain. Most included studies (72.4%) reported manual acupuncture as the most common intervention for shoulder pain. More than 50% of the studies used range of motion (58.6%) and the numeric rating scale (51.7%) to evaluate shoulder function and pain, respectively. Although the result was not statistically significant in all included studies, most studies concluded that Korean Medicine could be considered an effective treatment option in patients with shoulder pain. Conclusions: Based on analysis of studies included in this review, Korean Medicine can be considered useful clinical treatment for shoulder pain.

A Trend Analysis of Case Reports and Case Series on Hwa-byung in Korea

  • Sung, Soo-Hyun;Park, Jong-Hyun;Lee, Young-Joon;Park, Soo-Jin;Park, Eun-Jung;Han, Chang-Hyun
    • The Journal of Korean Medicine
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    • v.36 no.4
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    • pp.129-144
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    • 2015
  • Objectives: This study aimed to provide a basis for treatment of Hwa-byung, a mental disorder frequently found among Koreans, by analysing published case reports and case series. Methods: In June 2015, a literature search for case reports and case series describing interventions for Hwa-byung was conducted in 7 databases for research publications in Korea, using Korean and English terms. Results: Thirty-two papers, reporting 439 cases of Hwa-byung, met the inclusion criteria. Since the first case report on Hwa-byung in 1996, case reports were continuously published until 2012. A total of 22 interventions were described, of which herbal medicine (71.9%), acupuncture (65.6%), and moxibustion (34.4%) were the most frequently described interventions. Twenty-five papers reported patterns, for which liver qi depression (28%) was most frequently used. A total of 48 outcome measures were used in 32 papers, of which Beck Depression Index (46.9%) and Symptom change (43.8%) were used in at least 10 papers. Conclusions: Since only 32 case reports/case series have been published on Hwa-byung in Korea, a strong basis for recommending standardized treatments is lacking. Therefore, a sufficient number of clinical studies, in particular randomized clinical trials (RCTs), are warranted to provide a clinical basis for treatment of Hwa-byung.

Proper Understanding and Application of Gastric Lavage (위세척의 올바른 이해와 적용)

  • Oh, Bum Jin;Roh, Hyung-Keun
    • Journal of The Korean Society of Clinical Toxicology
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    • v.11 no.1
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    • pp.1-8
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    • 2013
  • Gastric lavage is one of gastrointestinal decontamination methods which have been controversial in the clinical toxicology field for a long time. Expert groups of American and European clinical toxicologists have published the position papers regarding gastric lavage three times since 1997. They recommended that gastric lavage should not be used as a routine procedure in the management of acute intoxication, because they thought that there is no certain evidence of improving clinical outcome by its use. However, the studies they reviewed were not well-controlled randomized trials, which cannot be conducted in the clinical toxicology field due to variability of patients and ethical problems. Therefore, the results from these studies should be interpreted with caution. They also insisted that gastric lavage can be undertaken within 60 minutes of ingestion. The limitation of one hour after ingestion is too arbitrary and may cause a lot of misunderstanding. Formation of pharmacobezoar or gastric hypomotility after ingestion may significantly delay the gastric emptying time so that gastric lavage can be useful even after several hours or more in case of highly toxic substances or severe intoxication. Furthermore, as there are a number of serious intoxication by toxic pesticides with large amount in suicidal attempts in Korea, it seems that gastric lavage may be used more frequently in Korea than in Western countries. When deciding whether or not to use gastric lavage, all the indications, contraindications, and possible adverse effects should be taken into account on the basis of risk-benefit analysis. If the procedure is decided to be done, it should only be performed by well-trained experts.

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Number of implants for mandibular implant overdentures: a systematic review

  • Lee, Jeong-Yol;Kim, Ha-Young;Shin, Sang-Wan;Bryant, S. Ross
    • The Journal of Advanced Prosthodontics
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    • v.4 no.4
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    • pp.204-209
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    • 2012
  • PURPOSE. The aim of this systematic review is to address treatment outcomes of Mandibular implant overdentures relative to implant survival rate, maintenance and complications, and patient satisfaction. MATERIALS AND METHODS. A systematic literature search was conducted by a PubMed search strategy and hand-searching of relevant journals from included studies. Randomized Clinical Trials (RCT) and comparative clinical trial studies on mandibular implant overdentures until August, 2010 were selected. Eleven studies from 1098 studies were finally selected and data were analyzed relative to number of implants. RESULTS. Six studies presented the data of the implant survival rate which ranged from 95% to 100% for 2 and 4 implant group and from 81.8% to 96.1% for 1 and 2 implant group. One study, which statistically compared implant survival rate showed no significant differences relative to the number of implants. The most common type of prosthetic maintenance and complications were replacement or reattaching of loose clips for 2 and 4 implant group, and denture repair due to the fracture around an implant for 1 and 2 implant groups. Most studies showed no significant differences in the rate of prosthetic maintenance and complication, and patient satisfaction regardless the number of implants. CONCLUSION. The implant survival rate of mandibular overdentures is high regardless of the number of implants. Denture maintenance is likely not inflenced substantially by the number of implants and patient satisfaction is typically high again regardless os the number of implants.

Current Research Trend on the Acupuncture and Moxibustion Treatment for Pancreatitis (국내외 췌장염 관련 침구치료 연구 현황)

  • Kang, Ha Ra;Lee, Yeon Sun;Kim, Hye Ryeon;Kim, Eun Jung;Kim, Kyung Ho;Kim, Kap Sung;Jung, Chan Yung;Lee, Jun Kyu
    • Korean Journal of Acupuncture
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    • v.35 no.2
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    • pp.56-69
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    • 2018
  • Objectives : The aim of this study is to review the current research trend on the acupuncture and moxibustion treatment for pancreatitis. Methods : Through nine search engines, articles were collected, which had involved the use of acupuncture and moxibustion treatment for pancreatitis. Data were extracted from the selected articles regarding the year, country, type of pancreatitis, study design, evaluation variable, intervention, point for acupuncture and moxibustion, and effectiveness of treatment. Results : Total 56 articles were reviewed. The number of studies increased gradually every ten years. Fifty-one studies(91%) were conducted in China. Most of clinical studies and animal experimentations reported on acute pancreatitis. Thirty-nine studies were randomized controlled trials(RCTs), but most of them were assessed as uncertain in the risk of bias evaluation. The degree of overall improvement(79%) was used mainly as evaluation variable of clinical studies. In animal experimentations, the examination of pancreatitis tissue(77%) and blood test(77%) were used the most. Most of studies were conducted with the acupuncture, one with moxibustion. Among them, electroacupuncture was the most common intervention of treatment group. ST36 was the most frequently used acupuncture point in the included studies. Effective rate increased and serum amylase, clinical symptoms, recovery time of gastrointestinal function decreased statistically significantly in the treatment group of clinical studies. Conclusions : The result of this study could be used for the future practice and research about the acupuncture and moxibustion treatment for pancreatitis.

Recent Research Trends in Korean Medicine Treatment of Hyperthyroidism: A Review of Literature Focusing on Domestic Articles from 2000 to 2018 (갑상선 기능 항진증의 한의학적 치료에 대한 최신 연구 동향 : 2000년부터 2018년까지 국내 학술논문을 중심으로 한 문헌고찰)

  • Choi, Yu-jin;Jung, Nu-ri;Song, Kwang-chan;Kim, Gi-tae;Ko, Heung;Shin, Seon-mi
    • The Journal of Internal Korean Medicine
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    • v.39 no.6
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    • pp.1116-1135
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    • 2018
  • Objective: This study was performed to research Korean medical treatment methods for hyperthyroidism by summarizing domestic clinical studies. Methods: The study was based on 14 papers published in Korea since 2000, on Korean medicine treatments for hyperthyroidism. Papers were searched on four domestic electronic databases. Results: 1. This paper analyzed 14 studies on the subject of clinical research on hyperthyroidism in Korea. 12 of them reported cases while two of them reported on clinical research. 2. The average age of the subjects was 39 years, 71.3% of women, 20-60 years of age accounted for 92%, and the average duration of disease was 22 months. 3. Of the 115 subjects, 102 had experienced Western medical treatment. So most of them chose Western medical treatment as the first treatment method, of which 24 experienced side effects. 4. Eumhuhwadong (陰虛火動) and Gieumyanghu (氣陰兩虛) appeared 3 times respectively. 5. The Korean herbal medicine, Ahnjeonbaekho-tang was the most frequent herbal medicine used to treat hyperthyroidism, with the next most frequent being Yanggyuksanhwa-tang. 6. The study, which was performed using herbal medicine alone, showed a marked improvement in clinical symptoms and thyroid function test, compared with administration of antithyroid drugs and herbal medicines. Conclusions: Large-scale studies and randomized controlled trials will be needed to evaluate the validity of Korean medical treatment for hyperthyroidism.

A Literature Review on Syndrome Differentiation of Dysmenorrhea (월경통의 변증별 증상특징에 대한 문헌 연구)

  • Lee, Ji-Yeon;Kim, Jeong-Hwan;Lee, In-Seon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.1
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    • pp.48-72
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    • 2019
  • Objectives: This study was conducted to comprehend the syndrome differentiations of dysmenorrhea and find out their clinical symptoms, tongue images and pulse patterns by analyzing previous studies. Methods: The following researches were collected by searching the medical journals published from November, 2007 to October, 2017, from KISS, OASIS, CNKI. : researches on the syndrome differentiation of dysmenorrhea, researches on the criteria of diagnosis of syndrome differentiation of dysmenorrhea, randomized controlled trials (RCT) used syndrome differentiation for treating dysmenorrhea. Results: By investigating the frequency of syndrome differentiations used in RCT studies, the frequent ones were chosen. They were qi stagnation and blood stasis (氣滯血瘀), qi-blood deficiency (氣血虛弱), congealing cold with blood stasis (寒凝血瘀), liver-kidney depletion (肝腎虧損), blood stasis with dampness-heat (濕熱瘀阻). Conclusion: 4 syndrome differentiations were frequently used in RCT studies. And the frequency of clinical symptoms on each syndrome differentiations from each RCT study was analyzed and compared. Clinical symptoms chosen as chief symptoms in more than one reference, appeared in more than half of the references, most frequent tongue images and pulse conditions were organized. The most frequent clinical symptoms included the period and pattern of pain, the accompanying symptoms of whole-body and the pattern of menstrual bleeding.