• 제목/요약/키워드: Randomized Clinical Trials

검색결과 950건 처리시간 0.022초

뇌졸중의 약침 치료에 대한 메타분석의 통합적 고찰 (Pharmacopuncture for Stroke: An Overview of Meta-Analyses)

  • 김미경;한창호
    • 대한한방내과학회지
    • /
    • 제40권6호
    • /
    • pp.1081-1100
    • /
    • 2019
  • Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

Clinical Study on Safety of Cantharidin Sodium and Shenmai Injection Combined with Chemotherapy in Treating Patients with Breast Cancer Postoperatively

  • Wang, Lin;Huang, Xin-En;Cao, Jie
    • Asian Pacific Journal of Cancer Prevention
    • /
    • 제15권14호
    • /
    • pp.5597-5600
    • /
    • 2014
  • Objectives: To assess side effects on Cantharidin sodium and Shenmai injection combined with chemotherapy in treating patients with breast cancer postoperatively. Method: Patients with breast cancer receiving postoperative chemotherapy were retrospectively collected, and divided into four groups: group A with cantharidin sodium injection combined with chemotherapy; group B with Shenmai injection combined with chemotherapy; group C with both cantharidin sodium and Shenmai injection combined with chemotherapy; while group D (control group) received chemotherapy alone. All patients were administered docetaxel at a dose of $75mg/m^2$ on day 1, epirubicin hydrochloride at a dose of $60mg/m^2$ on day 1, and cyclophosphamide at a dose of $500mg/m^2$ on day 1 for 3 cycles (repeated at 21 day intervals). After ${\geq}$ three courses of treatment, quality of life and side effects were evaluated. Results: There were a total of 78 patients in this study, and the incidence of leukopenia and gastrointestinal reactions in groups A and B were lower than those in the control group and lowest in group C (p<0.05). Conclusions: Thus cantharidin sodium and Shenmai injection combined with chemotherapy reduce side effects and deserve to be further investigated in randomized clinical control trials.

소아의 난치성 신증후군의 한약 치료에 대한 최신 임상연구 동향 (Review of Clinical Research for Herbal Medicine Treatment on Refractory Nephrotic Syndrome in Children)

  • 장은하;민상연;김장현
    • 대한한방소아과학회지
    • /
    • 제34권3호
    • /
    • pp.1-17
    • /
    • 2020
  • Objectives The purpose of this study is to analyze clinical studies on effectiveness of herbal medicine in refractory nephrotic syndrome (RNS). Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on RNS from the Pubmed, CNKI, OASIS, NDSL, J-stage, and CiNii. The demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Results 11 RCT studies were selected and analyzed. The children in the control group were given western medicine therapy, and the treatment group was given herbal medicine along with the same western medicine of the control group. The most commonly used herbal medicines were the prescriptions to treat 'Kidney Deficiency with Blood Stasis (腎虛兼瘀血)' which composed of 'Promoting blood circulation (化瘀)', 'Diuresis-inducing (利水)', or 'Heating Yang (溫陽)' medicine based on 'Replenishing Kidney or Spleen (補腎, 補脾)' medicine. In the treatment group, proteinuria and serum lipid was significantly decreased, serum albumin was significantly increased, and total effective rate was significantly higher than the control group. Hypercoagulation and relapse rate was also significantly reduced. Adverse events were significantly lower in the treatment group. Conclusions Herbal medicine treatment on pediatric RNS can be suggested as a new treatment for children who have less response to the conventional therapy. It can also supplement the limitations of the western medicine by reducing adverse events from the steroids and immuno-suppressive agents, and lower the relapse rate as well.

Treatment of refractory IgA vasculitis with dapsone: a systematic review

  • Lee, Keum Hwa;Hong, Sung Hwi;Jun, Jinhae;Jo, Youngheun;Jo, Woogyeong;Choi, Dayeon;Joo, Jeongho;Jung, Guhyun;Ahn, Sunghee;Kronbichler, Andreas;Eisenhut, Michael;Shin, Jae Il
    • Clinical and Experimental Pediatrics
    • /
    • 제63권5호
    • /
    • pp.158-163
    • /
    • 2020
  • IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.

치매환자의 두침(頭鍼)치료에 대한 최신 임상연구 동향 -CAJ (China Academic Journals: 중국기간전문수거고(中国期刊全文数据库))의 2001~2011년 검색을 통하여- (The Current State of Clinical Studies on Scalp Acupuncture - Treatment for Dementia-by Search for China Literature published from 2001 to 2011 in CAJ(China Academic Journals) -)

  • 이고은;박장호;양현덕;허은정;전원경;류영수;강형원
    • 동의신경정신과학회지
    • /
    • 제23권2호
    • /
    • pp.13-32
    • /
    • 2012
  • Objectives : The purpose of this study was to obtain some knowledge concerning the scalp acupuncture treatment on patients with dementia for the future practice and research from clinical studies in China. Methods : The literatures were searched using the data base-China Academic Journals(CAJ) (2001-2011). Results : We found out 1 case study, and 17 randomized controlled trials(RCT) which met the inclusion criteria in most studies. There were 3 types of scalp acupuncture-applying method, cho-si scalp acupuncture(焦氏頭鍼法), combination of using ordinary acupoints(正經鍼) and extraordinary acupoints(經外寄穴), standard method of scalp acupuncture(標準頭鍼法). The often used acupoints are Yundongqu(運動區), Ganjuequ(感覺區), Yuntingqu(暈聽區), Zuyunganqu(足運感區), Sishencong (HN23), Baihui(GV20), Shenting(GV24), Fengchi(GB20), Dingnieqianxiexian(MS6), and Dingniehouxiexian(MS7). Conclusions : There were significant improvements on the scalp acupuncture-treated groups, compared to the control groups(western medication group or other acupuncture treatment group). Results of this study could be used for future studies concerning the scalp acupuncture for dementia.

기립빈맥증후군 환자의 임상적 및 자율신경 특성 (Clinical and autonomic characteristics in patients with postural tachycardia syndrome)

  • 김덕주;강사윤;김중구
    • Journal of Medicine and Life Science
    • /
    • 제16권3호
    • /
    • pp.96-100
    • /
    • 2019
  • Postural tachycardia syndrome (POTS) is common, although not so well-known variant of cardiovascular autonomic disorder characterized by an excessive heart rate increase on standing. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology. This study aimed to evaluate the clinical and autonomic features in patients with POTS. We reviewed the medical records of patients with POTS. Medical records include onset age, sex, presenting symptoms, body mass index (BMI) and prognosis. All patients had an autonomic function and laboratory tests. Ninety-nine patients met the inclusion criteria for POTS (51.5% male; mean±SD age, 20.0±9.7 years; mean±SD, BMI 21.9±3.9). Common presenting symptoms were a brief loss of consciousness, dizziness, blurred vision and headache. Autonomic function tests showed abnormal quantitative sudomotor axon reflex testing in 20 patients of 99 POTS patients. The abnormal post-ganglionic sympathetic sudomotor function is generally considered to reflect a neuropathic form of POTS. In treatments, 83 patients were treated by non-pharmacological management including lifestyle changes and 16 patients required the initiation of pharmacological therapies. Most patients with POTS showed a relatively favorable prognosis. POTS is a chronic disease with a substantial subset of patients recovering within a few years after the initial presentation. Future efforts should focus on better understanding of POTS pathophysiology and designing randomized controlled trials for the selection of more effective therapy.

추나요법을 포함한 수기치료의 효과 및 안전성에 관한 문헌고찰 (Review on Efficacy and Safety of Manipulation Therapy including Chuna Manipulation)

  • 김기병;박태용;이정한;공재철;이수경;신병철;권영달;송용선
    • 한방재활의학과학회지
    • /
    • 제18권4호
    • /
    • pp.103-120
    • /
    • 2008
  • Objectives : This study aims to educate clinical doctors of the valuable practice of Manipulative Therapy(MT) as an opportunity for evidence-based medicine. Consequently it also serves to review the effectiveness and safety of MT. Methods : The literature studies of overseas were done by Cochrane Library and Medline website; those of domestic researches were completed by utilizing the sources which are gained from KERIS, KISS, DBpia, Kisti, and domestic institutes related with MT. Results : Eight papers related to the effectiveness of MT were published in South Korea, which concluded with the positive effects of MT. None of them are, however, well-designed randomized controlled trials(RCT). On the other hand, fifteen cases of nine articles indicate the adverse reaction of MT, and numbers of the researches in overseas revealed the side effects of MT in order of cervical, lumbar, and thoracic vertebrae. A vascular adverse reaction such as vertebral and carotid artery dissection was a highly reported cervical adverse reaction; in the thoracic and lumbar regions, neurological adverse reaction in terms of disc hemiation was frequently discovered. Conclusions : Henceforth, highly qualitative studies are required developing the effective outcomes and preventing any possible complications of MT. Therefore, systemic curriculums in institutions and sufficient clinical training in the filed are strongly recommended.

특발성 척추측만증의 한의학적 치료에 대한 국내 연구 동향: 국내 학술지를 중심으로 (A Review of the Domestic Trends of Korean Traditional Medicine for Idiopathic Scoliosis)

  • 이상운;추희영;김호;이상건;최재용;이유진;최강의
    • 한방재활의학과학회지
    • /
    • 제30권4호
    • /
    • pp.55-64
    • /
    • 2020
  • Objectives This study aimed to analyze the trends of Korean traditional medicine treatment for idiopathic scoliosis. Methods We searched clinical studies used Korean traditional medicine for idiopathic scoliosis in 4 Korean online databases 'Koreanstudies Information Service System', 'Earticle', 'Oriental Medicine Advanced Searching Integrated System', 'Research Information Sharing Service'. We selected 18 studies and analyzed their characteristics according to author, publication year, number/sex/age of patient, treatment period, intervention, outcome measure and result. Results Eighteen case report studies were selected by criteria and randomized controlled trials were not found. The most frequently used therapy was Chuna therapy. Cobb's angle was most commonly used outcome measure. Conclusions In this study, we reviewed studies used Korean traditional medicine treatments for idiopathic scoliosis. However, evidence is limited because all selected studies were case reports. This study suggests that further clinical studies are needed to provide higher evidence about Korean traditional medicine treatment for idiopathic scoliosis.

Influence of implant mucosal thickness on early bone loss: a systematic review with meta-analysis

  • Di Gianfilippo, Riccardo;Valente, Nicola Alberto;Toti, Paolo;Wang, Hom-Lay;Barone, Antonio
    • Journal of Periodontal and Implant Science
    • /
    • 제50권4호
    • /
    • pp.209-225
    • /
    • 2020
  • Purpose: Marginal bone loss (MBL) is an important clinical issue in implant therapy. One feature that has been cited as a contributing factor to this bone loss is peri-implant mucosal thickness. Therefore, in this report, we conducted a systematic review of the literature comparing bone remodeling around implants placed in areas with thick (≥2-mm) vs. thin (<2-mm) mucosa. Methods: A PICO question was defined. Manual and electronic searches were performed of the MEDLINE/PubMed and Cochrane Oral Health Group databases. The inclusion criteria were prospective studies that documented soft tissue thickness with direct intraoperative measurements and that included at least 1 year of follow-up. When possible, a meta-analysis was performed for both the overall and subgroup analyses. Results: Thirteen papers fulfilled the inclusion criteria. A meta-analysis of 7 randomized clinical trials was conducted. Significantly less bone loss was found around implants with thick mucosa than around those with thin mucosa (difference, -0.53 mm; P<0.0001). Subgroups were analyzed regarding the apico-coronal positioning, the use of platform-matched vs. platform-switched (PS) connections, and the use of cement-retained vs. screw-retained prostheses. In these analyses, thick mucosa was found to be associated with significantly less MBL than thin mucosa (P<0.0001). Among non-matching (PS) connections and screw-retained prostheses, bone levels were not affected by mucosal thickness. Conclusions: Soft tissue thickness was found to be correlated with MBL except in cases of PS connections used on implants with thin tissues and screw-retained prostheses. Mucosal thickness did not affect implant survival or the occurrence of biological or aesthetic complications.

근거중심 소아치과학의 개념과 응용 (EVIDENCE-BASED PEDIATRIC DENTISTRY : CONCEPTS AND APPLICATIONS)

  • 이광희
    • 대한소아치과학회지
    • /
    • 제33권2호
    • /
    • pp.269-280
    • /
    • 2006
  • 연구 목적은 근거중심 소아치과학의 개념을 정립하고 그 응용 방법을 모색하는 것이었다. 근거중심 소아치과학의 정의는 '어린이와 청소년의 치과 진료에서 최고의 과학적 연구근거를 소아치과의사의 임상 기술, 그리고 어린이 환자 및 그 보육자의 가치와 통합하는 것'으로 가정하였다. 근거중심 소아치과학의 실행 방법을 조사하였고, 근거중심 소아치과학의 최신 결론을 선별하여 주제별로 정리하였으며, 근거중심 소아치과학 연구의 기본이 되는 체계적 고찰과 임상진료지침의 연구 방법을 분석하고, 개별 연구 방법으로서 무작위 대조 시험 등을 조사하였다. 근거중심 소아치과학이 발전하기 위한 기본 방향으로서, 근거중심 소아치과학의 필요성에 대한 인식 제고와 공감대 형성, 근거중심 소아치과학의 방법에 대한 교육, 소아치과학 문헌의 전산화, 체계적 고찰과 임상진료지침의 지속적 연구 개발 및 보급, 우리나라 소아치과학 근거의 생성, 소아치과 진료환경의 사회적 요인 개선 등이 제안되었다.

  • PDF