• 제목/요약/키워드: Randomized Clinical Trials

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

  • 김찬영;양지혜;채인철;최인우;유주영;정은선;김윤식;설인찬;유호룡
    • 대한한의학회지
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    • 제41권3호
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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
    • 대한한의학회지
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    • 제36권4호
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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.

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

  • 오범진;노형근
    • 대한임상독성학회지
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    • 제11권1호
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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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    • 제4권4호
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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.

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

  • 강하라;이연선;김혜련;김은정;김경호;김갑성;정찬영;이준규
    • Korean Journal of Acupuncture
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    • 제35권2호
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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.

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

  • 최유진;정누리;송광찬;김기태;고흥;신선미
    • 대한한방내과학회지
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    • 제39권6호
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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.

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

  • 이지연;김정환;이인선
    • 대한한방부인과학회지
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    • 제32권1호
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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.

Comparison of pregnancy outcomes using a time-lapse monitoring system for embryo incubation versus a conventional incubator in in vitro fertilization: An age-stratification analysis

  • Chera-aree, Pattraporn;Thanaboonyawat, Isarin;Thokha, Benjawan;Laokirkkiat, Pitak
    • Clinical and Experimental Reproductive Medicine
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    • 제48권2호
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    • pp.174-183
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    • 2021
  • Objective: The aim of this study was to compare the pregnancy outcomes of in vitro fertilization with embryo transfer between embryos cultured in a time-lapse monitoring system (TLS) and those cultured in a conventional incubator (CI). Methods: The medical records of 250 fertilized embryos from 141 patients undergoing infertility treatment with assisted reproductive technology at a tertiary hospital from June 2018 to May 2020 were reviewed. The study population was divided into TLS and CI groups at a 1 to 1 ratio (125 embryos per group). The primary outcome was the live birth rate. Results: The TLS group had a significantly higher clinical pregnancy rate (46.4% vs. 27.2%, p=0.002), implantation rate (27.1% vs. 12.0%, p=0.004), and live birth rate (32.0% vs. 18.4%, p=0.013) than the CI group. Furthermore, subgroup analyses of the clinical pregnancy rate and live birth rate in the different age groups favored the TLS group. However, this difference only reached statistical significance in the live birth rate in women aged over 40 years and the clinical pregnancy rate in women aged 35-40 years (p=0.048 and p=0.031, respectively). The miscarriage rate, cleavage rate, and blastocyst rate were comparable. Conclusion: TLS application improved the live birth rate, implantation rate, and clinical pregnancy rate, particularly in the advanced age group in this study, while the other reproductive outcomes were comparable. Large randomized controlled trials are needed to further explore the ramifications of these findings, especially in different age groups.

Suggestions for Potentially Useful Herbal Medicines for Treating Insomnia in COVID-19 Era: A Mini-Review

  • Suh, Hyo-Weon;Kwon, Chan-Young;Kim, Jong Woo
    • 동의신경정신과학회지
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    • 제32권2호
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    • pp.95-109
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    • 2021
  • Objectives: The coronavirus disease 2019 (COVID-19) has become a global pandemic. Mental sequelae occurring in patients with COVID-19 and the general population are important concerns. In Korea, herbal medicine is used nationwide to respond to this pandemic. It can be prescribed by COVID-19 telemedicine center of Korean medicine (KM). Among some herbal medicines, Gamiguibi-tang is the only herbal medicine prescribed for individuals with mental health, especially for those with insomnia. In this mini-review, the objective of this study was to summarize the evidence of some promising herbal medicines available for treating primary insomnia based on existing clinical and preclinical studies. Methods: A research team was formed for KM clinical practice guidelines for insomnia (version 1.0). Team members were provided with a list of references of relevant herbal medicines for insomnia. To gather evidence from clinical studies with appropriate sample sizes, among the list of references, randomized controlled trials for primary insomnia that included 50 subjects or more per arm and used herbal medicine were included in the final analysis. Moreover, pre-clinical studies examining the mechanism of action of each herbal medicine and studies on herb-drug interactions, were searched and summarized. Results: Four herbal medicines (Ondam-tang, Sanjoin-tang, Guibi-tang, and Hyeolbuchugeo-tang) were reviewed based on existing clinical and preclinical studies. Based on findings of existing studies, some suggestions of herbal medicines for insomnia in the COVID-19 era in Korea were suggested. Conclusions: Data of this study could be used to prepare a future revision of the manual of COVID-19 telemedicine center of KM.

사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰 (A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine)

  • 오현주;이정윤;이혜리;이준희
    • 사상체질의학회지
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    • 제34권2호
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.