• 제목/요약/키워드: Randomized Clinical Trials

검색결과 951건 처리시간 0.033초

뇌졸중 후 우울증에 대한 침과 한약의 결합 치료 효과: 체계적 문헌 고찰 및 메타분석 연구 (Clinical Effect of Acupuncture Combined with Herbal Medicine in Treatment of PSD: A Systematic Review and Meta-Analysis)

  • 사공종원;임수연;김상호;정대규
    • 동의신경정신과학회지
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    • 제31권3호
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    • pp.169-186
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    • 2020
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of acupuncture combined herbal medicine for post-stroke depression. Methods: Studies were identified by searching Pubmed, EMBASE, Cochrane Library, NDSL, RISS, KMbase, KISS, and CNKI. Randomized controlled trials that verified effects of the acupuncture combined with the herbal medicine for PSD were included in this study. Literature searches of English, Chinese, and Korean databases were performed. Two authors independently extracted the data and assembled the study quality. Results: Of 698 RCTs screened, 17 RCTs were selected. Most of the studies had unclear risk of bias. Among the 17 RCTs, 10 were meta-analyzed. As for the outcome measurement, the effective rate and the HAMD were most commonly used. The meta-analysis of the studies revealed that the PSD cure effective rate in the acupuncture combined with herbal medicine group was higher than that in the Western medicine group (RR: 1.23, 95% CI: 1.14 to 1.33, p<0.00001, I2=0%). Also, the HAMD in the acupuncture combined with herbal medicine group was significantly different compared to the Western medicine group (MD -5.54, 95% CI -9.80 to -1.29, p=0.01, I2=99%). The quality of the selected RCTs was low. Conclusions: Acupuncture combined with herbal medicine is effective for treating post-stroke depression. However, It is worth noting that the included studies were of relatively poor quality. The sample sizes were also small. Based on the findings of this study, further investigations into the diagnosis and treatment of PSD are warranted.

구강자극요법이 미숙아의 경구수유 이행에 미치는 효과에 대한 체계적 문헌고찰과 메타분석 (A Systematic Review and Meta-Analysis on the Effects of Oral Stimulation Interventions on the Transition from Tube to Oral Feeding in Premature Infants)

  • 김승남;김연아;전미혜;김다슬;김효인
    • 임상간호연구
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    • 제23권2호
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    • pp.151-160
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    • 2017
  • Purpose: The purpose of this study was to evaluate the effects of oral stimulation interventions on the transition from tube to oral feeding in preterm infants through systematic review. Methods: The randomized clinical trials published between 1980 and 2015 were searched using domestic and international databases, and five randomized studies were selected for this study. The quality of study was assessed by assessment tool from the SIGN and meta-analysis was performed using the Cochrane Review Manager software Version 5.3 (RevMan). Results: Oral stimulation intervention in preterm infants decreased the transition time from tube to oral feeding (Post Menstrual Age, Day of life). Especially, a significant medium effect size was found in the number of days needed on the transition (ES=-4.95, p=.02). The oral stimulation intervention also had a significant large effect on the length of stay at hospital (ES=-8.33, p<.001). Conclusion: Based on the findings, oral stimulation interventions could be useful to facilitate the transition from tube to oral feeding in preterm infants in terms of reducing the length of stay at hospital and the number of days needed on transition.

Type of tooth movement during en masse retraction of the maxillary anterior teeth using labial versus lingual biocreative therapy in adults: A randomized clinical trial

  • Sadek, Mais M.;Sabet, Noha E.;Hassan, Islam T.
    • 대한치과교정학회지
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    • 제49권6호
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    • pp.381-392
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    • 2019
  • Objective: The objective of this two-arm parallel trial was to compare the type of tooth movement during en masse retraction of the maxillary anterior teeth using labial versus lingual biocreative therapy. Methods: Twenty-eight subjects were randomized in a 1 : 1 ratio to either the labial or lingual group. En masse anterior retraction was performed using labial biocreative therapy in group A and lingual biocreative therapy in group B. Cone beam computed tomography scans were taken before and after retraction and the primary outcome was the type of tooth movement during anterior retraction. Data were analyzed using paired t-tests for comparisons within each group and independent-sample t-test for comparison of the mean treatment changes between the two groups. Results: Significant differences were found between the two groups in relation to the type of tooth movement (labiolingual inclination of the central incisor; mean difference, $5.85{\pm}1.85^{\circ}$). The canine showed significant distal tipping in the lingual group (mean difference, $6.98{\pm}1.25^{\circ}$). The canine was significantly more intruded in the lingual group (mean difference, $1.67{\pm}0.49mm$). Good anchorage control and significant soft tissue changes occurred in both groups. No serious adverse effects were detected. Conclusions: With a 10-mm retraction hook, the labial biocreative technique with the reverse curve overlay provided anterior retraction with good torque control, while in the lingual group, anterior retraction occurred with controlled tipping movement with significant distal tipping and intrusion of the canine (trial registration: The trial was registered at ClinicalTrials.gov [NCT03239275]).

Effectiveness of the novel impression tray "cleftray" for infants with cleft lip and palate: a randomized controlled clinical trial

  • Kalaskar, Ritesh;Bhaje, Priyanka;Balasubramanian, Shruti;Kalaskar, Ashita
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • 제47권2호
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    • pp.82-90
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    • 2021
  • Objectives: Cleft lip and palate (CLP) is one of the most common congenital deformities with worldwide prevalence. It causes a range of issues for infants that mainly involve difficulty in feeding due to abnormal oronasal communication. For this purpose, feeding plates are provided to infants to act as an artificial palate to aid in feeding. The most crucial procedure in fabrication of a feeding plate is creation of the impression using the traditional finger technique or impression trays. This preliminary research aims to compare the effectiveness of novel impression trays with that of the traditional finger technique for recording impressions of infants with CLP. Materials and Methods: This randomized controlled trial was conducted among 30 infants who were divided into two groups based on the method of obtaining impressions: Group I, finger technique; Group II, specialized acrylic tray (cleftray). Results: Use of cleftray required less impression time, a reduced amount of material, no incidence of cyanosis/choking in infants, and lower anxiety among doctors compared to the traditional method. Additionally, there was no distortion of cleft impressions, recorded maxillary tuberosity, or other fine details. Therefore, the novel impression tray (cleftray) exhibited superior outcomes in all the parameters compared to the finger technique. Conclusion: Within the limitations of this study, we conclude that impression trays are superior to the traditional finger, spoon, or ice cream stick methods of creating impressions of CLP. However, it is necessary to conduct more clinical trials on a larger population based on other parameters to compare the effectiveness of the two techniques to draw definitive conclusions.

C형간염에 대한 한약의 치료효과 : 체계적 문헌고찰과 메타분석 (Effect of Herbal Medicine on Hepatitis C: a Systematic Review and Meta-analysis)

  • 강은진;김경림;김경민
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.312-330
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    • 2019
  • Objectives: The present study aimed to provide clinical evidence on the effect of herbal medicine on the treatment of hepatitis C using a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: This study included RCTs that verified the effects of herbal medicine for the treatment of hepatitis C. A literature search of English, Chinese, and Korean databases was performed, and the selected literature was assessed to investigate the risk of bias. Results: The analysis included 14 RCTs. The total effective rate was the most commonly used outcome measure. The meta-analysis revealed that the total effective rate and total bilirubin difference were higher and that the recurrent rate was lower in the herbal medicine group than in the western medicine group (RR: 1.20, 95% CI: 1.06-1.35, p=0.003, I2=52; MD: 0.52, 95% CI: -0.62 to 1.66, p=0.37, I2=0; RR: 0.35, 95% CI: 0.11-1.09, p=0.07, I2=0). The included RCTs had relatively poor quality and a small sample size. Conclusion: Treatment with herbal medicine was found to be partially effective in treating hepatitis C. The included RCTs had relatively poor quality and a small sample size. This study can serve as a foundation for further clinical studies on the development of treatment methods for hepatitis C based on herbal medicine.

The Effect of Locally Administered Fibrinolytic Drugs Following Aneurysmal Subarachnoid Hemorrhage : A Meta-Analysis with Eight Randomized Controlled Studies

  • Jang, Kyoung Min;Choi, Hyun Ho;Nam, Taek Kyun;Park, Yong Sook;Kwon, Jeong Taik;Byun, Jun Soo;Hwang, Doyeon
    • Journal of Korean Neurosurgical Society
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    • 제64권2호
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    • pp.207-216
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    • 2021
  • Objective : Rapid dissolution of blood clots reduces vasospasm and hydrocephalus after subarachnoid hemorrhage (SAH), and locally administered fibrinolytic drugs (LAFDs) could facilitate the dissolution. However, the efficacy of LAFDs remains controversial. The aim of this meta-analysis was to determine the efficacy of LAFDs for vasospasm and hydrocephalus and in clinical outcomes. Methods : From PubMed, EMBASE, and Cochrane database, data were extracted by two authors. Meta-analysis was performed using a random effect model. Inclusion criteria were patients who had LAFDs with urokinase-type or recombinant tissue-plasminogen activator after SAH in comparison with medically untreated patients with fibrinolytic drugs. We only included randomized controlled trials (RCTs) in this analysis. The outcomes of interest were vasospasm, hydrocephalus, mortality, and 90-day unfavorable functional outcome. Results : Data from eight RCTs with 550 patients were included. Pooled-analysis revealed that the LAFDs were significantly associated with lower rates of vasospasm (LAFDs group vs. control group, 26.5% vs. 39.2%; odds ratio [OR], 0.48; 95% confidence interval [CI], 0.32-0.73); hydrocephalus (LAFDs group vs. control group, 26.0% vs. 31.6%; OR, 0.54; 95% CI, 0.32-0.91); and mortality (LAFDs group vs. control group, 10.5% vs. 15.7%; OR, 0.58; 95% CI, 0.34-0.99). The proportion of 90-day unfavorable outcomes was lower in the LAFDs group (LAFDs group vs. control group, 32.7% vs. 43.5%; OR, 0.55; 95% CI, 0.37-0.80). Conclusion : This meta-analysis with eight RCTs indicated that LAFDs were significantly associated with lower rates of vasospasm and hydrocephalus after SAH. Thus, LAFDs could consequently reduce mortality and improve clinical outcome after SAH.

Clinical Research Using Salviae Miltiorrhizae Radix-Pharmacopuncture for Lumbar Herniated Intervertebral Disc: Analysis of Trends

  • Kim, Seon Woo;Park, Cheol Woo;Jo, Myeong Jae;Kim, Min Wook;Yu, Jae Hee;Hee, Jeon Seok;Jang, Seung Won;Kang, Do Young;Jeong, Hyun Jin
    • Journal of Acupuncture Research
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    • 제38권1호
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    • pp.1-7
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    • 2021
  • This review of national and international randomized controlled trials of Salviae miltiorrhizae radix pharmacopuncture for lumbar herniated intervertebral discs was performed to assess its clinical efficacy. There were 5 online databases (PubMed, EMBASE, CNKI, NDSL, OASIS, and RISS) searched on June 1st, 2020. Studies were selected according to the inclusion and exclusion criteria and were reviewed by risk of bias assessment. This review included 14 Chinese studies. The sample sizes ranged from 50 to 100. The numbers of treatments ranged from 20 to 30, with most patients receiving 20 treatments. The longest treatment periods were 10-15 and 15-20 days, of which each accounted for 29% of the studies. The most frequently used evaluation indices were the Japanese Orthopedic Association and the Visual Analog Scale scoring method. The most frequently used acupoints were EX18 and BL25, which accounted for 31% of the total number of acupoints. In 50% of the studies, the pharmacopuncture injection volume was 2 mL. Acupuncture treatment was the most common control group. Eleven studies reported that the intervention group had significantly improved symptoms. However, most of the included studies were of low quality.

중의학 데이터베이스 (CAJ)를 이용한 급성백혈병의 한약치료에 대한 임상 연구 동향 (Review of Clinical Studies for Herbal Medicine Treatment on Acute Leukemia - Focusing on Studies from the China Academic Journal (CAJ) -)

  • 김정은;장진우;박범찬;김기봉;천진홍
    • 대한한방소아과학회지
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    • 제35권1호
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    • pp.48-62
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    • 2021
  • Objectives The purpose of this study is to obtain knowledge from clinical studies conducted in China to examine the effectiveness of herb medicine in childhood acute leukemia. Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on childhood acute leukemia from the 'CAJ', Chinese Academic Journal from China National Knowledge Infrastructure (CNKI). And then, demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Result 10 RCT studies were selected and analyzed. The control group were given western medicine therapy, the treatment group was given herbal medicine on the basis of the control group. The most commonly used herbal medicine were 淸熱解毒藥, 補氣藥, 補陰藥, 活血祛瘀藥 in 'boosting vital force and driving out evil spirit (扶正祛邪)' way to 'relieve heat (熱毒)' and 'assist the vital force (正氣)'. In the treatment group, complete remission was significantly higher than control group and the decrease in TCM syndrome scores also showed significant effects. Adverse events were significantly lower in the treatment group. Conclusions Herbal medicine treatment on childhood acute leukemia can be suggested as a new treatment for children who have less response to the conventional therapy, and can supplement the limitations of the western medicine by increasing complete remission and reducing adverse events.

한의 종양학 연구 분야에서의 Propensity Score Matching Method 적용에 대한 문헌 고찰 (A Literature Review on the Application of the Propensity Score Matching Method in the Field of Asian Oncology)

  • 김동현;김종희;유화승;박소정
    • 대한암한의학회지
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    • 제27권1호
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    • pp.25-36
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    • 2022
  • The Randomized Control Trial (RCT) is the most well-established and widely used statistical methodology in clinical research; however, applying thorough RCT to cancer patients presents challenges such as ethical concerns, high costs, short clinical periods, and limitations in collecting various side effects. To address this issue, the propensity score matching method, which takes advantage of the benefits of observational research while compensating for the drawbacks of randomized control trials, is used in a variety of fields. In recent years, 28 studies on the effectiveness of Korean medicine on tumors have been conducted abroad using the Propensity Score Matching Method, but none have been conducted in Korea. The majority of studies have focused on liver cancer, colon cancer, lung cancer, and stomach cancer, with endpoints such as survival time, incidence rate, quality of life, and treatment outcomes revealing statistical differences in how Korean medicine intervention affects treatment outcomes. As a result, well-established studies using the propensity matching score methodology should be useful in evaluating the impact of Korean medicine in oncology treatments.

Acupuncture and Electroacupuncture Treatment for Temporomandibular Joint Disorder Focused on Recent Randomized-Controlled Studies: A Systematic Review and Meta-Analysis

  • Jin-Sol Yoon;Joonyong Noh;Seonju Ahn;Yun-Gwon Seon;Hong-Wook Choi;Sun-Joong Kim;Jae-Uk Sul;Jae-Hong Kim
    • Journal of Acupuncture Research
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    • 제40권3호
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    • pp.214-237
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    • 2023
  • This study aimed to evaluate the clinical efficacy and safety of acupuncture and electroacupuncture for temporomandibular joint disorder (TMD). We searched 11 databases to find randomized-controlled trials (RCTs) published between January 2018 and January 2023 that used acupuncture and electroacupuncture to treat patients with TMD. We performed a meta-analysis of 18 RCTs involving 1,109 patients. Nine studies reported that the treatment and control groups showed improvement in the evaluation index post-treatment. The results of the meta-analysis showed that the treatment groups receiving acupuncture combined with manual therapy had significantly improved visual analog scale score and dysfunction index than the control groups receiving manual therapy. Moreover, the treatment groups receiving acupuncture combined with Western medicine had statistically improved maximum mouth opening than the control groups using Western medicine. In conclusion, acupuncture and electroacupuncture have clinical effects on TMD patients. Given that 11 studies were obtained from the Chinese database, a regional bias would be considered. Furthermore, the included studies had high a risk of bias in terms of randomization, concealment, and blinding. Further studies are required to correct these limitations.