• 한국임상약학회지
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• 제32권3호
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• pp.251-259
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• 2022

Background: Intravenous fluid therapy is one of the most common interventions in critically ill patients. Normal saline is frequently used, but there have been some concerns about hyperchloremia. Due to closer to plasma composition, crystalloids have been used as alternatives to normal saline. However, the optimal choice of resuscitative fluids remains controversial. Methods: MEDLINE, EMBASE, and CENTRAL were comprehensively searched until July 2021 to compare balanced crystalloids with normal saline in critically ill patients with the risk factors for multiple organ dysfunction syndromes (MODS).The primary endpoint was composite mortality. Secondary outcomes were acute kidney injury (AKI)/acute renal failure (ARF), and new receipt of renal replacement therapy (RRT). Results: A total of 1,240 studies were searched, and finally, 8 randomized controlled trials and 5 cohort studies were included. In the meta-analysis of composite mortality of 30,710 patients, balanced crystalloids compared to normal saline were significantly associated with reduced mortality (OR 0.80, 95% CI 0.68-0.95). In AKI/ARF, balanced crystalloids had a lower risk than normal saline (OR 0.91, 95% CI 0.84-0.99). There was no difference between balanced crystalloids and normal saline in risk of new receipt of RRT (OR 0.91, 95% CI 0.80-1.04). Conclusion: In fluid resuscitation for patients at high risk of MODS, the use of balanced crystalloids showed a significantly lower incidence of mortality compared to normal saline.

• 대한한방소아과학회지
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• 제37권1호
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• pp.1-14
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• 2023

Objectives This study aimed to evaluate the effect of Samryungbaekchul-san on childhood anorexia. Methods We searched 11 English, Korean, Chinese, and Japanese databases for studies published up to May 30, 2022. Randomized controlled trials (RCTs) assessing the effect of Samryungbaekchul-san on childhood anorexia were included. In the meta-analysis, relative risk (RR) and 95% confidence intervals (CI) were indicated as dichotomous variables, and mean difference (MD) or standardized mean difference (SMD) and 95% CIs were indicated as continuous variables. Results We included 12 RCTs with 1345 participants. The Samryungbaekchul-san treatment group had a significantly higher total effective rate (TER) than that of the western medicine control group (RR 1.42, 95% CI 1.23-1.64, I² = 0%). The combined Samryungbaekchul-san and western medicine treatment group had significantly higher TER (RR 1.31, 95% CI 1.23 to 1.40, I² = 0%) and levels of neuropeptide Y (SMD 0.93, 95% CI 0.47-1.39, I² = 70%) and ghrelin (SMD 1.45, 95% CI 1.14-1.76, I² = 0%) than those of the western medicine alone group. Additionally, leptin levels were significantly lower in the combined treatment group (SMD -1.19, 95% CI -1.88 to -0.51, I² = 86%) compared with the western medicine alone group, although statistical heterogeneity was substantial. Conclusions Samryungbaekchul-san may be effective for childhood anorexia. However, owing to limitations such as high clinical heterogeneity between the studies, unclear risks of biases, and insufficient reports of adverse events and follow-ups, well-designed RCTs with a low risk of bias are needed in the future.

• 대한약침학회지
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• 제26권3호
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• pp.227-237
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• 2023

Objectives: Pharmacopuncture is considered a unique new type of acupuncture in Korean medicine (KM). This study was performed to investigate the research trends regarding pharmacopuncture through a bibliometric analysis using VOSviewer. Methods: The Web of Science Core Collection was searched for this study. The search terms were pharmacopuncture and pharmaco-puncture. The search was conducted on May 23, 2023, and 185 studies retrieved up to this date were included. Software VOSviewer version 1.6.19 was used to perform the bibliometric analysis. After data clearing, keyword co-occurrence and cooperation pattern analyses were performed. Results: The number of studies on pharmacopuncture have gradually increased since the mid-2000s, with the most published in 2020 (46 studies). The quality of the studies has also steadily increased, and recently, several randomized controlled trials of pharmacopuncture have been conducted. Moreover, this treatment has been investigated in the context of KM clinical practice guideline development in Korea. The scope of pharmacopuncture studies to date seems to be limited to musculoskeletal pain and bee venom pharmacopuncture. The researchers from Jaseng Medical Foundation have been the core researchers in the field of pharmacopuncture in Korea. They collaborated with researchers from universities or government-funded research institutes. However, small-scale research teams from KM clinics and university researchers were also identified as independent clusters. Conclusion: Pharmacopuncture research has grown both quantitatively and qualitatively, but the scope needs to be further expanded. There is also a gap between the use of pharmacopuncture by KM doctors in clinical settings and pharmacopuncture research. Based on these findings, some suggestions for future studies in this field are discussed. Furthermore, these findings may be used as data to expand and globalize pharmacopuncture research in the future.

• 대한통합의학회지
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• 제11권2호
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• pp.77-86
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• 2023

Purpose : This study systematically assessed 9 emotion-function programs for schizophrenic individuals that have been implemented over the past 10 years in Korea and abroad, with the objective of providing clinical grounds and data for further programs. Methods : This study identified 2,558 studies from among those registered in the RISS, KISS, EMbase, PubMed and Scopus databases from 2013 to September 2023, using 'schizophrenia' AND 'emotion' AND ('program' OR 'therapy') as keywords. Of the 2,558 studies retrieved from electronic databases, 602 duplicate papers were excluded. After this process, 1,915 papers that did not meet the study's inclusion and exclusion criteria were excluded based on their titles and abstracts. Following a review of the texts of the remaining 41 papers, nine papers were finally selected, excluding 32 papers according to the selection and exclusion criteria. Results : Programs for the emotional function of patients with schizophrenia have continued to be researched. The results of an evaluation on the quality of the selected literature confirmed that a majority of the reviewed items were "uncertain", confirming that there was a risk of bias. The interventions for emotions included art, cognitive-behavioral, and physical programs, of which art programs were frequently applied. Most of the interventions were implemented in hospitals. The dependent variables for evaluating emotions included emotional expression, depression, anxiety, and positive emotions, and among them, emotional expression was used most frequently. Accordingly, the Berkeley expressivity questionnaire was commonly used as an evaluation tool. Conclusion : This study is significant for intending to analyze domestic and overseas programs for the emotions of patients with schizophrenia, thereby proposing the direction for planning and applying interventions in clinical settings. In follow-up studies, it will be necessary to develop a protocol that confirms interventions according to the settings and patient characteristics of programs and expands the scope of literature reviews.

• 대한한방부인과학회지
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• 제22권4호
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• pp.65-82
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• 2009

Purpose: The purpose of this study is to examine acupuncture intervention suggested in the papers of assisted reproductive technology(ART, hereafter) in medicine journals and to establish the further direction. Methods: The papers published between 1996 and 2009 in Pubmed were reviewed. Results: 1. A variety of randomized controlled trials and case series were found in Pubmed concerning influence of acupuncture in ART. It was investigated into improvement of pregnancy rate, analgesic effect during oocyte retrieval, change of serum hormone, and reduction of anxiety. 2. It was on clinical pregnancy rate that main focus of the investigation was placed and the improvement of pregnancy rate differed from studies. 3. For the analgesic effect during oocyte retrieval, the electro acupuncture was mainly used and the studies reported the reduced pain rate, tiredness, and nausea. 4. Acupuncture was reported as significant in improving the state of anxiety during ART. Conclusion: It would be necessary to further study the period of acupuncture intervention, the selection of acupoint through well-designed study, and establish standard of evidence of them.

• 동의신경정신과학회지
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• 제33권1호
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• pp.79-111
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• 2022

Major depressive disorder (MDD) causes a persistent feeling of sadness and loss of interest. It can lead to emotional and physical problems. Treatments such as antidepressant and cognitive behavioral therapy for MDD have many limitations. Traditional East Asian Herbal Medicine (TEAM) is a representative modality of Complementary and Integrative Medicine (CIM) which can be used for MDD. However, no study has systematically reviewed the efficacy or safety of TEAM for MDD so far. Therefore, we performed a systematic review and meta-analysis to evaluate effectiveness and safety of TEAM as a monotherapy for MDD. We only included TEAM that could be used in context of clinical setting in Korean Medicine. Outcomes were the Hamilton Depression Rating Scale (HAMD) and total effective rate (TER). After comprehensive electronic search of 11 databases, we included 28 randomized controlled trials (RCTs) that compared HM as monotherapy with antidepressant for MDD. Meta-analysis showed that TEAM had significant benefits in reducing HAMD (MD=-0.40, 95% CI: -0.67 to -0.13, p=0.003, I²=85%) and improving TER (RR=1.06, 95% CI: 1.02 to 1.10, p=0.003, I²=0%). It also appeared to be safer than antidepressant in terms of adverse effects. Methods used for RCTs were poor and the quality of evidence was graded 'low' or 'moderate'. These findings indicate that the use of HM as a monotherapy might have potential benefits in MDD treatment as an alternative to antidepressant. However, considering the methodological quality of included RCTs, the clinical evidence is uncertain. Further well-designed RCTs are required to confirm these findings.

• 한국임상약학회지
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• 제33권2호
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• pp.128-134
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• 2023

Background: This systematic review and meta-analysis aimed to evaluate the efficacy and cardiovascular safety of romosozumab compared with placebo. Methods: Randomized controlled trials (RCTs) were searched from Medline, EMBASE, Cochrane Central, and Web of Science until July 2022. Primary outcomes included the change in bone mineral density (BMD) from baseline at month 6. The secondary outcomes were the change of bone turnover markers (N-terminal propeptide of type 1 procollagen (P1NP); C-terminal telopeptide of type 1 collagen (CTX)) from baseline at month 3, and the incidence of cardiovascular adverse events for the total follow-up period. Results: A total of 7 RCTs on 8,370patients were included. Romosozumab showed better effects in improving BMD in both lumbar spine and femoral neck at month 6 (standardized mean difference, SMD 2.20 [95% CI: 1.89-2.52], SMD 0.63 [95% CI: 0.41-0.86]). In contrast to placebo, romosozumab significantly increased PINP levels and reduced CTX levels at month 3 (SMD 0.93 [95% CI: 0.65-1.22], SMD -1.03 [95% CI: -1.23~ -0.82]. However, there was no significant difference in the composite incidence of cardiovascular adverse events and major adverse cardiovascular events (OR 1.16 [95% CI: 0.82-1.65], OR 1.08 [95% CI: 0.75-1.56]). Conclusion: This analysis showed that romosozumab significantly improved BMD compared to placebo and was beneficial for change in bone turnover markers. There is no significant difference in the incidence of cardiovascular adverse events compared to placebo.

• 대한한방내과학회지
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• 제44권4호
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• pp.675-702
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• 2023

Objective: This study assessed the effectiveness of using Yijung-tang to treat chronic gastritis through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as "gastritis", "Lizhong", "Yijung", and "Chronic gastritis" on July 31, 2023. A meta-analysis was conducted according to outcome measurements, such as total effective rate (TER), Traditional chinese medicine symptom score (TSS), gastric hormones, and symptom relief time, using the Review Manager website. Results: A total of 11 RCT studies were selected. The treatment group (Yijung-tang-gagam or Yijung-tang-gagam+Western medicine) showed significant improvement effects in terms of TER, TSS, serum gastrointestinal hormones (motilin (MTL), gastrin (GAS), and somatostatin (SS)), and symptom relief time compared to the control group (Western medicine). TER-RR : 1.20, 95% CI : 1.11 to 1.30, P≤0.00001, RR : 1.21, 95% CI : 1.14 to 1.28, P≤0.00001; MTL-MD : 35.99, 95% CI : 30.79 to 41.20, P≤0.00001); GAS-MD : 103.33, 95% CI : 97.62 to 109.04, P≤0.00001); SS : MD : -37.19, 95% CI : -41.75 to -32.64, P≤0.00001; symptom relief time (nausea)-MD : -1.96, 95% CI : -2.47 to -1.45, P≤0.00001; symptom relief time (colic)-MD : -1.75, 95% CI : -2.31 to -1.18, P≤0.00001. Conclusion: This study suggests that Yijung-tang is effective against chronic gastritis. However, the number of studies was insufficient, and the diagnosis and evaluation criteria were not standardized. Furthermore, because of the low quality of the included studies, more clinical studies need to be conducted to increase the possibility of clinical use.

• 대한한방내과학회지
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• 제45권1호
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• pp.31-54
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• 2024

Objectives: This study assessed the effectiveness of Hwanggigyejiomul-tang for postoperative breast cancer-related lymphedema (BCRL) by a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: A search was conducted using keywords such as "breast cancer", "lymphedema", "edema", "Huangqi Guizhi Wuwu decoction", "Huangqi Guizhi Wuwu tang", and "Hwanggigyejiomul tang" in 10 databases (PubMed, Cochrane, ScienceDirect, CNKI, CiNii, RISS, KISS, ScienceON, OASIS, DBpia) on February 11, 2024. There were no limits on the publication period and language, and the quality of the studies was evaluated using Cochrane's risk of bias tool. A meta-analysis was performed based on the outcome measurements, such as total effective rate (TER), increase in shoulder joint mobility (flexion, extension, abduction, adduction), Fugl-Meyer assessment (FMA), and visual analog scale (VAS) using Review Manager Web. Results: Eleven RCTs were selected. The treatment group (Hwanggigyejiomul-tang-gagambang or hapbang with control group intervention) showed a more statistically significant effect compared with the control group (physical therapy or western medicine) in TER (upper limb circumference change), TER (upper limb edema grade change), increase in flexion angle, increase in extension angle, increase in adduction angle, FMA, and VAS. Conclusions: Hwanggigyejiomul-tang is effective in treating postoperative BCRL. However, because of the low quality of the included studies, more clinical studies are required to increase the possibility of clinical use.

• Hip & pelvis
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• 제35권2호
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• pp.73-87
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• 2023

The aim of this review is to conduct an analysis of existing literature on outcomes of application of various methods of joint decompression in management of septic arthritis of the hip in children. A search of literature in PubMed, Embase, and Google Scholar was conducted for identification of studies reporting on the outcomes of intervention for septic arthritis of the hip in children. Of the 17 articles selected, four were comparative studies; two of these were randomized controlled trials while the rest were single arm studies. Statistical difference was observed between the proportion of excellent clinical and radiological outcomes in arthrotomy (90%, 95% confidence interval [CI] 81-98%; 89%, 95% CI 80-98%), arthroscopy (95%, 95% CI 91-100%; 95%, 95% CI 90-99%), and arthrocentesis (98%, 95% CI 97-100%; 99%, 95% CI 97-100%), respectively. The highest overall rate of additional unplanned procedures was observed in the arthrocentesis group (24/207, 11.6%). Patients who underwent arthrocentesis had a statistically greater chance of excellent clinical and radiological outcomes, although the highest level of need for additional unplanned surgical intervention was observed in the arthrocentesis group, followed by the arthroscopy group and the arthrotomy group. Future conduct of a prospective multi-centric study focusing on the developed and developing world, along with acquisition of data. such as delay of treatment and severity of disease will enable assessment of the efficacy of one technique over the other by surgeons worldwide.