• Title/Summary/Keyword: Randomized Clinical Trials

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A Delphi Study of Korean Medicine for Anorexia in Children for Clinical Practice Guidelines (소아 식욕부진의 한의표준임상진료지침 개발을 위한 델파이 연구)

  • Bang Miran;Lee Sun Haeng;Chang Gyu Tae
    • The Journal of Pediatrics of Korean Medicine
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    • v.38 no.2
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    • pp.21-31
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    • 2024
  • Objectives This study aimed to develop consensus-based recommendations for establishing standard clinical practice guidelines for pediatric anorexia through the utilization of a Delphi study. Methods We analyzed existing randomized controlled trials for pediatric anorexia treatment using the Delphi method-a structured process for achieving consensus among a panel of experts. A questionnaire was distributed among a select panel of nine specialists in the field. Results The initial Delphi round led to consensus on 30 distinct recommendations; however, consensus was not reached for 19 other recommendations, prompting a second Delphi round. In the subsequent round, adjustments were made based on feedback from the initial round, and deliberations were held on recommendations that previously lacked consensus. Following these adjustments, consensus was achieved on all recommendations. Additionally, a third Delphi iteration was conducted to address three specific queries that required amendment due to a reevaluation of the evidence levels of certain recommendations. In total, three Delphi rounds were carried out to produce informed recommendations related to the diagnosis, treatment, and general management of anorexia. Conclusions This investigation successfully generated evidence-based recommendations for the diagnosis and treatment of pediatric anorexia. The recommendations encompassed various practices, including herbal medicine, acupuncture, moxibustion, cupping, and Chuna manual therapy, which can be integrated into clinical settings.

Male Breast Carcinoma: Epidemiology, Risk Factors and Current Therapeutic Approaches

  • Zygogianni, Anna G.;Kyrgias, George;Gennatas, Costantinos;Ilknur, Aytas;Armonis, Vassilios;Tolia, Maria;Papaloukas, Christos;Pistevou, Gompaki;Kouvaris, John;Kouloulias, Vassilios
    • Asian Pacific Journal of Cancer Prevention
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    • v.13 no.1
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    • pp.15-19
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    • 2012
  • Male breast cancer is a very rare disease with an incidence of about 0.5-1% comparing with the one of female breast cancer but relatively little is known about its cause. Treatment strategies for breast cancer in males are derived from studies performed among females. The probable reasons behind the frequent, late diagnoses presented at stages III or IV might be the lack of awareness. The rarity of the disease precludes large prospective randomized clinical trials. This study reviews male breast cancer and its risk factors, recommendations for diagnosis and the management of patients with male breast cancer.

A Review Study on Periodic Therapy of Dysmenorrhea in Traditional Chinese Medicine (월경통의 한약 주기 요법 치료에 대한 중의학의 임상연구 동향)

  • Bae, Ju-Eun;Park, Kyung-Dug;Yoon, Young-Jin
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.1
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    • pp.16-28
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    • 2017
  • Objectives: This study was performed to review the research trends in the periodic therapy of dysmenorrhea in traditional Chinese medicine (TCM). Methods: We searched articles in Chinese Academic journal (CAJ). Search key words were 'dysmenorrhea' and 'periodic therapy or cyclic treatment'. Results: We selected 6 studies except unrelated studies. According to study design, study was classified into 1 single group before after study and 5 randomized controlled trials. According to dysmenorrheal type, study was classified into 4 studies on primary dysmenorrhea and 2 studies on secondary dysmenorrhea. In the selected studies, there were four studies in which the menstrual cycle was divided into 2 periods, one study divided into 3 periods, and one study divided into 4 periods. The most used herb was "Angelicae Gigantis Radix", "Cinnamomi Cortex Spissus". All studies showed effective results on dysmenorrhea. Conclusions: In TCM, Research on periodic therapy of dysmenorrhea was being conducted more actively than Korean medicine. The periodic therapy seems to be effective on dysmenorrhea from this research. It would be necessary to fulfill further clinical study with periodic therapy on dysmenorrhea in Korean medicine to establish standard evidence of them.

Review of the Application of Acupuncture for the HIV-associated Distal Sensory Neuropathy (HIV/AIDS 연관 말초신경병증에의 침 치료 활용가능성에 대한 고찰)

  • Kim, Tae-Hoon;Shin, Seon-Ho;Na, Juno;Jeong, Min-Jeong;Jang, In-Soo
    • The Journal of Internal Korean Medicine
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    • v.35 no.3
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    • pp.343-353
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    • 2014
  • Objectives: To discuss the application of the acupuncture therapy for the HIV-associated distal sensory neuropathy. Methods: We searched papers using KTKP, Oasis, CNKI, PubMed, Science Direct, CINAHL, J-STAGE, and CiNii with the keywords "HIV", "Peripheral neuropathy" and "acupuncture". The search range included randomized controlled trials (RCTs) and clinical case series. Reviews and animal experiments were not included. Not matched with inclusion criteria were excluded. Results: A total 675 studies were found. 670 were excluded by scanning titles and abstracts and finally 5 articles were selected. One of the five articles noted that acupuncture was not effective in HIV-SN, but two articles reanalyzing the former, pointed out the statistical errors and noted acupuncture significantly reduced pain, attrition and mortality. Other RCT and the other case series concluded acupuncture had a beneficial effect in HIV-SN. Conclusions: Acupuncture seems to be effective to improve HIV-SN symptoms, however further large-scale RCTs are warranted.

Adjuvant Therapy Efficacy of Herbal Medicine Zeo Lyung Tang (Zhu Ling Decoction) for Primary Glomerulonephritis: Systematic Review and Meta-Analysis (일차성 사구체신염에 대한 저령탕 병용요법의 효능 : 체계적 문헌고찰 및 메타 분석)

  • Kim, Bomin;Jo, Hee-Geun
    • The Journal of Internal Korean Medicine
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    • v.41 no.4
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    • pp.644-657
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    • 2020
  • Objectives: The aim of this study was to systematically evaluate the clinical therapeutic effects and safety of the Zeo lyung tang (ZLT) on primary glomerulonephritis (PGN). Methods: The MEDLINE, EMBASE, PubMed, CENTRAL, CNKI, RISS, NDSL, KISS, and OASIS databases were searched for randomized controlled trials (RCTs) testing the effects of ZLT on PGN. The Cochrane collaboration bias risk assessment scale was used to evaluate the methodological quality of the included studies. RevMan 5.3 software was used for data analysis. Results: Ten RCTs involving 781 patients were included in the review. Compared with conventional Western medicine (WM) therapy alone, a combination treatment of ZLT and WM improved the total effective rate (RR=1.24; 95%CI [1.16, 1.33]; p<0.00001), reduce the blood urea nitrogen (BUN; MD=-1.05; 95%CI [-1.32, -0.78]; p<0.00001) and the 24-hour urinary protein (MD=-0.38; 95%CI [-0.46, -0.29]; p<0.00001). Conclusions: The combination of ZLT with WM has therapeutic effects on PGN, and it has advantages over WM treatment alone in reducing BUN and 24-hour urinary protein. However, due to the low quality of the included studies and the small sample sizes, additional research is needed in this area.

Total Disc Replacement in Lumbar Degenerative Disc Diseases

  • Park, Chun Kun
    • Journal of Korean Neurosurgical Society
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    • v.58 no.5
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    • pp.401-411
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    • 2015
  • More than 10 years have passed since lumbar total disc replacement (LTDR) was introduced for the first time to the world market for the surgical management of lumbar degenerative disc disease (DDD). It seems like the right time to sum up the relevant results in order to understand where LTDR stands on now, and is heading forward to. The pathogenesis of DDD has been currently settled, but diagnosis and managements are still controversial. Fusion is recognized as golden standard of surgical managements but has various kinds of shortcomings. Lately, LTDR has been expected to replace fusion surgery. A great deal of LTDR reports has come out. Among them, more than 5-year follow-up prospective randomized controlled studies including USA IDE trials were expected to elucidate whether for LTDR to have therapeutic benefit compared to fusion. The results of these studies revealed that LTDR was not inferior to fusion. Most of clinical studies dealing with LTDR revealed that there was no strong evidence for preventive effect of LTDR against symptomatic degenerative changes of adjacent segment disease. LTDR does not have shortcomings associated with fusion. However, it has a potentiality of the new complications to occur, which surgeons have never experienced in fusion surgeries. Consequently, longer follow-up should be necessary as yet to confirm the maintenance of improved surgical outcome and to observe any very late complications. LTDR still may get a chance to establish itself as a substitute of fusion both nominally and virtually if it eases the concerns listed above.

The Effect of Traditional Oriental Herbal Medicine for Anorexia in Cancer Patients: A Systematic Review (한약 치료가 암 환자의 식욕부진에 미치는 영향: 체계적 문헌고찰)

  • Lee, Joon-Ho;Bae, Kyeore;Yoo, Hwa-Seung
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.8-20
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    • 2017
  • Objectives: Traditional oriental herbal medicine is used in cancer care to alleviate symptoms. Anorexia is a symptom which is frequently observed in patients with cancer and impairs their quality of life. The objective of this systematic review is to summarize current available evidence to evaluate the effect of traditional oriental herbal medicine on anorexia in cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of any types of herbal medicine on anorexia in cancer patients within 4 electronic databases and manual search up to December 2015. The Cochrane risk of bias tool (ROB) was used to assess the quality of RCTs. Results: In total, 11 RCTs met the inclusion criteria. All of the studies reported the rate or severity of anorexia improved after treatment in herbal-conventional medicine combined group compared to conventional medicine group. 7 of 11 studies showed between-group statistical differences. The methodological quality of RCTs was insufficient with unclear and high ROB. Conclusions: Traditional oriental herbal medicine may have a potential to improve anorexia in patients with cancer. To confirm the clinical recommendation, further researches with rigorous study design are required to support the effects of herbal medicine.

Research Trends of Herbal Medicine Treatment for Uterine Leiomyoma - Research using CNKI (자궁근종의 한약치료에 대한 최신 임상 연구 동향 - CNKI 검색을 중심으로)

  • Choi, Yu-Jin;Gim, Bo-Ri;Cho, Seong-Hee;Yang, Seung-Jeong
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.2
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    • pp.13-28
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    • 2020
  • Objectives: This study was conducted to find out research trends for uterine leiomyoma and to recognize the efficacy and safety of herbal medicine treatment for uterine leiomyoma and to help in the clinical research of herbal medicine treatment for uterine leiomyoma in the future. Methods: Based on eight domestic and foreign databases, We analyzed the Randomized Controlled Trials using herbal medicine for uterine leiomyoma. Data retrieval was carried out on September 10, 2019 and the latest five-year papers were included. The treatment group was treated with herbal medicine and the control group was treated with western medicine. Results: 473 studies were searched in domestic and foreign databases, and 12 studies were finally selected. Although the indicators varied, all studies used total efficiency rate as indicators. In all 12 studies, the treatment group treated with herbal medicine was more effective than the control group treated with Western medicine.

Chuna Manual Therapy Combined Acupuncture for Trigeminal Neuralgia: A Systematic Review (삼차신경통에 대한 추나와 침 복합치료의 효과: 체계적 문헌고찰)

  • Kim, Chan-Young;Heo, In;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.26 no.4
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    • pp.37-44
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    • 2016
  • Objectives To determine the effectiveness of Chuna manual therapy combined acupuncture for trigeminal neuralgia. Methods We searched 6 electronic databases (Pubmed, CAJ, Oasis, RISS, DBPIA, KoreanTK) and 2 journals up to August 2016. We included randomized controlled trials (RCTs) using Chuna manual therapy combined acupuncture for trigeminal neuralgia. The methodological quality of each RCT was assessed by the Cochrane risk of bias tool. Results 3 RCT studies were eligible in our review. The meta-analysis of 3 studies showed favorable results for the use of Chuna manual therapy combined acupuncture. High risk of bias were observed in all studies. Conclusions Although there are favorable results with meta-analysis, our systematic review are highly dependent on the single source of Chinese electrical database, CAJ. Now limited evidence is available to support Chuna manual therapy combined acupuncture for trigeminal neuralgia and further well-designed RCTs should be encouraged.

A Systemic Review of Korean Medical Treatment Combined with Continuous Passive Motion Therapy on the Knee Joint Postoperative Rehabilitation (슬관절 수술 후 재활에 대한 Continuous Passive Motion 치료와 한의 병행치료의 체계적 문헌 고찰)

  • Ha, Hyun Ju;Oh, Min-Seok
    • Journal of Korean Medicine Rehabilitation
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    • v.27 no.3
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    • pp.33-45
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    • 2017
  • Objectives The objective of this study is to report the evidence that continuous passive motion (CPM) therapy combined with Korean Medicine is effective for knee injuries. Methods We searched 2 Korean medical electronic databases, and 2 Chinese electronic databases to find randomized controlled clinical trials (RCTs) that treat knee injuries with Korean Medicine combined with CPM therapy. We selected studies by screening. We extracted data from selected RCTs, and analyzed RCTs by using Cochrane's Risk of bias criteria. Results 386 studies are searched, and 7 RCTs are selected. According to the study, several kinds of Korean Medicine such as hydrotherapy, decoction, acupuncture, moxibustion, and manual therapy are used with CPM therapy for the knee joint postoperative rehabilitation. We found the encouraging evidence that Korean Medicine and CPM combined therapy is more effective than single CPM therapy by alleviating pain, increasing range of motion, and improving knee function, etc. However, the risk of bias in most RCTs was judged to be uncertain. Conclusions Combination of Korean Medicine and CPM therapy can compensate the defect of single CPM therapy, and promotes the recovery of knee joint function.