• 제목/요약/키워드: Randomized Clinical Trials

검색결과 940건 처리시간 0.021초

반월상 연골 손상에 대한 수기치료의 효과: 체계적 고찰 및 메타분석 (Efficacy of Manual Therapy for Knee Meniscus Injuries: A Systematic Review and Meta-Analysis)

  • 강석범;박한별;손우석;김영준;우창훈
    • 척추신경추나의학회지
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    • 제17권2호
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    • pp.17-25
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    • 2022
  • Objectives This study aimed to evaluate the efficacy of manual therapy for knee meniscus injuries. Methods We searched seven electronic databases (MEDLINE, Cochrane Library, CAJ, Wanfang, RISS, ScienceON, and OASIS) to collect randomized controlled trials (RCTs) using the keywords "manual therapy OR chuna OR tuina" and "meniscus injury." Results Eleven RCTs were selected based on the inclusion criteria, and all studies were conducted in China. Five studies were meta-analyzed. The systematic review revealed a positive effect of manual therapy for knee meniscus injury. Low risk of selection, attrition, and reporting bias were demonstrated in all studies. Ten studies had a high risk of performance bias. Conclusions The systematic review reported favorable results using manual therapy for knee meniscus injury. However, this study has several limitations because of the high risk of bias. Further clinical studies and reviews with higher levels of evidence are warranted.

폐경기 기억력에 대한 한약의 효과 : 체계적 문헌고찰 (The Efficacy of Oriental Medicine on Memory in Menopause: A Systemic Review)

  • 이수형;권하린;조인정;천세은;김송백
    • 대한한방부인과학회지
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    • 제36권2호
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    • pp.20-35
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    • 2023
  • Objectives: The purpose of this study is to review clinical studies and investigate the efficacy and safety of oriental medicine on memory in menopausal women. Methods: 'menopause', 'memory', 'oriental medicine' were searched on 4 online databases (Cochrane Library, Pubmed, CNKI, OASIS). Randomized controlled trials (RCTs) that evaluated menopausal memory with oriental medicine treatment were included. The methodological quality of each RCT was assessed by using Cochrane risk of bias tool. Results: 8 RCTs were selected among 1067 articles. The overall risk of bias was evaluated as uncertain. 5 studies showed that oriental medicine alone was significant effective, but 1 long-term study with the same oriental medicine did not sustain the effect, and 2 studied were not statistically significant. Conclusions: Oriental medicine can be an effective option for improving memory in menopausal women. but considering the small number and quality of studies, inconsistent and insufficient evidence, further well-designed studies are needed to confirm the efficacy and safety of this treatment.

불면장애에 대한 부항요법의 체계적 문헌고찰 (A Systematic Review of Cupping Therapy for Insomnia Disorder)

  • 이정한;최미라;임정화;김보경
    • 동의신경정신과학회지
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    • 제34권3호
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    • pp.181-212
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    • 2023
  • Objectives: To examine the efficacy and safety of cupping therapy for insomnia disorder and provide clinical evidence that could contribute to further research. Methods: We searched randomized controlled trials (RCTs) that verified effects of cupping therapy for insomnia disorder from 11 domestic and foreign databases. Included studies were evaluated using Risk of Bias (RoB). Results: Nineteen RCTs were selected. Wet cupping was more frequently used than dry cupping. Moving cupping was mostly used among dry cupping methods. Dry cupping was mainly performed in Bladder Meridian on the back. Wet cupping was mainly performed on BL18, LR14, and BL15. The most common treatment period was 4 weeks. The average number of treatments per week was about 2.4 times for all types of cupping, about 3.2 times for dry cupping and about 1.9 times for wet cupping. All selected studies showed a significant sleep improvement compared to the control group. As a result of the meta-analysis, in terms of effective rate, SAS score, and SDS score, the wet cupping in combination with acupuncture was significantly more effective than acupuncture alone, although the quality of selected RCTs was low. Conclusions: Cupping therapy is effective for insomnia disorder. Based on results of this study, it is reasonable to use wet cupping two times per week on BL18, LR14, and BL15 or use moving cupping three times per week in Bladder Meridian on the back for 4 weeks to treat insomnia disorder.

어깨관절 질환에 대한 관절가동술 유형의 연구 동향 : 주제범위 문헌고찰 (Research Trend of Joint Mobilization Type on Shoulder : A scoping review)

  • 이정우;이남기
    • 대한통합의학회지
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    • 제11권3호
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    • pp.171-183
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    • 2023
  • Purpose : This study sought to investigate research trends regarding joint mobilization type among patients with shoulder joint diseases. Methods : A scoping review was conducted according to the five steps outlined by Arskey and O'Malley and PRISMA-ScR. We searched six domestic databases (ScienceOn, DBpia, Riss, Kmbase, Kiss, KCI) and three international databases (CINAHL, Pubmed, Cochrane central) between 2013 and June 2023. The keyword terms used were 'joint mobilization', 'Kaltenborn', 'Maitland', 'Mulligan', and 'shoulder joint'. Results : There were a total of 44 studies that investigated the topic, and these were divided into quantitative analysis and topic analysis. In terms of publication year, the number of studies within the last five years has increased more than compared to the previous five years, with most of them being randomized clinical trials. In shoulder joint diseases, it was found that the majority of joint movement studies focused on adhesive joint cystitis and shoulder collision syndrome. The Mulligan concept was the most commonly studied type of joint motion. The dependent variables used included pain, joint function (disability), and muscle function. The visual analog scale was the most commonly used for the pain variable, followed by the numeric rating scale. For joint function and disability variables, range of motion was the most commonly used, followed by shoulder pain and disability index, and disabilities of the arm, shoulder, and hand. For muscle function, variables such as muscle tone, strength, and activity were used. Conclusion : We believe that findings of this scoping review can serve as valuable mapping data for joint mobilization research on shoulder joint diseases. Further studies including systematic reviews and meta-analyses based on these results are recommended.

Effectiveness of acupuncture-type interventions to prevent nausea and vomiting during and after cesarean delivery under spinal anesthesia : A systematic review

  • Kim, Eun-Sook;Cho, Jung-Hoon;Jang, Jun-Bock;Lee, Jin-Moo;Lee, Chang-Hoo;Lee, Kyung-Sub
    • 대한한방부인과학회지
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    • 제22권2호
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    • pp.209-221
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    • 2009
  • 목 적: 이 논문은 제왕절개 분만을 위한 척수마취로 인해 수술 중 또는 그 후에 발생할 수 있는 오심 및 구토에 대한 침관련 치료의 항구토 효과를 규명하기 위한 계통적 리뷰 논문이다. 방 법: 제왕절개 분만을 위한 척수마취로 인해 발생할 수 있는 오심 및 구토를 예방하기 위한 침관련 치료에 대한 randomized clinical trials(RCT's)를 검색하기 위해 2008년 3월까지 수록된 6개의 데이터베이스(MEDLINE, EMBASE, The Cochrane Library, CINAHL, AMED and PsycINFO)를 검색하였다. 논문의 선정 기준은 원저이며, 플라시보 대조군을 설정한 무작위 임상시험이고, 오심 또는 구토에 대한 결과가 실려 있는 것으로 하였다. 결 과: 총 5개의 논문을 선정하였으며 각 논문들의 연구방법은 일반적으로 좋은 편이었다. 5개의 논문들을 종합한 결과는 수술중 오심 발생률(OR=0.468, 95%CI:0.250 -0.876, P=0.018), 수술 후 오심 발생률(OR=0.616, 95%CI:0.042-0.942, P=0.026), 수술 후 구토 발생률(OR=0.640, 95%CI:0.432-0.948, P=0.026)이 침관련 치료군이 대조군에 비해서 통계적으로 의미있게 적었다. 결 론: 본 문헌 고찰을 통해 제왕절개 수술을 위해 시행한 척수 마취로 인해 수술중 또는 수술후 발생한 오심 및 구토에 대해 침관련 치료가 예방효과가 있음을 밝힐 수 있었다.

경구탕액요법(經口湯液療法)을 제외한 난소낭종의 다양한 치료법에 대한 조사 연구 - 중의학 논문을 중심으로 - (Investigation of Various Remedies of Ovarian Cyst except Oral Decoction of Medical Ingredients in Chinese Medicine Journals)

  • 배경미;조혜숙;이승환;이인선
    • 대한한방부인과학회지
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    • 제22권3호
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    • pp.152-168
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    • 2009
  • Purpose: The purpose of this study is to examine remedies suggested in the papers of ovarian cyst in Chinese Medicine Journals and to establish the further direction. Methods: The papers published between 1994 and 2009 in China Academic Journal were reviewed. Results: 1. It was on Bo-Ryu Enema that main focus of investigation was placed. A variety of randomized controlled trials and case series were found. As a result, a lot of proper manual arts and prescriptions were provided out of them. 2. Acupuncture is reported as significant in reducing the size of ovarian cyst and improving clinical symptoms, which covers electrical acupuncture, enlongated needle and moxibustion, burning acupuncture. 3. External application was verified as an effective therapy for the case of a combined treatment with oral medicine. 4. Modern medical equipments such as ultra short wave medical cure, TDP could improve the efficiency of traditional remedies like Bo-Ryu Enema, external application. Conclusion: It would be necessary to practically come up with a diversity of remedies besides oral decoction of medical ingredients, and establish standard of evidence of them.

Sodium Citrate가 효과적으로 비전도성 후각장애에 치료효과를 보일 수 있을지에 대한 문헌 고찰 (Can Sodium Citrate Effectively Improve Olfactory Function in Non-Conductive Olfactory Dysfunction?)

  • 김수빈;강하람;진호준;황세환
    • Korean Journal of Otorhinolaryngology-Head and Neck Surgery
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    • 제62권2호
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    • pp.75-81
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    • 2019
  • The objective of this study was to perform a systematic review of the literature for application of intranasal sodium citrate in the patients with olfactory dysfunction to help determine the sodium citrate treatments for this condition. Two authors independently searched the data base (Medline, Scopus, and the Cochrane database) for relevant studies from inception to January 2018. Included studies were randomized controlled studies published in English comparing topical sodium citrate application (treatment group) with saline (control group) in patients who had olfactory dysfunction. Outcomes of interest included the change of olfactory identification and threshold during 2 hours post-treatment. Three studies were enrolled in the meta-analysis. Compared with control group, treatment group did not increase posttreatment score of olfactory identification [standardized mean difference (SMD)=-0.03; 95% confidence interval (CI)=-0.29-0.24; I2=0%] and olfactory threshold (SMD=0.18; 95% CI=-0.09-0.45; I2=0%) significantly. In the degree of pre-post improvement of two outcomes, although treatment group statistically showed the significant improvement in olfactory threshold (SMD=0.30; 95% CI=0.05-0.55; I2=17%), the clinical significance of this outcome was meaningless. Similarly, there was no significant difference in olfactory identification between two groups (SMD=0.17; 95% CI=-0.11-0.45; I2=22%). Unlike the recent favorable results, our summated results presented the uselessness for the local application of sodium citrate in improving patient's olfactory function. However, we also had some limitation such as small sample size and inconsistent application methods. Therefore, larger trials and standardized methodology are needed to reach more stronger and exact results.

Prognosis of Unrepaired Ascending Aorta after the Surgical Replacement of Bicuspid Aortic Valves

  • Hong Ju Shin;Wan Kee Kim;Dong Kyu Kim;Ho Jin Kim;Joon Bum Kim
    • Journal of Chest Surgery
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    • 제56권4호
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    • pp.255-261
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    • 2023
  • Background: The surgical threshold for bicuspid aortic valve (BAV)-related aortopathy is a matter of debate due to its uncertain etiology and prognosis. This study investigated the prognosis of unrepaired BAV aortopathy in patients undergoing surgical aortic valve replacement (SAVR). Methods: We retrospectively analyzed data from 720 patients (age, 60.8±11.5 years; 246 women) who underwent SAVR for BAV disease without aortic repair between 2005 and 2020 at Asan Medical Center. The clinical endpoints were defined as occurrences of sudden death, aortic dissection or rupture, and elective aortic repair. To estimate postoperative changes in the dimensions of the unrepaired aorta, the individual annual aortic expansion rate was calculated. Multiple linear regression models were used to evaluate the risk of aortic expansion. Results: The mean ascending aortic diameter was 39.5±4.6 mm, and 299 patients (41.5%) had a baseline ascending aorta diameter >40 mm. During 70.0±68.3 months of follow-up, the mean annual aortic expansion rate was 0.39±1.96 mm/yr, no aortic dissection or rupture was observed, and sudden deaths were reported in 12 patients (0.34% per person-year). Linear regression analysis revealed no significant correlation between the baseline ascending aortic diameter and postoperative aortic expansion (R2=0.004, β=-0.84, p=0.082). Conclusion: In selected patients undergoing SAVR for a BAV (<55 mm), the risk of adverse aortic events was very low. As this observation contradicts current practice guidelines advocating for proactive aortic replacement in dilated ascending aortas measuring >45 mm, the study results need further validation by studies involving larger populations or randomized controlled trials.

국내 뇌졸중 환자를 위한 디지털 치료의 효과: 메타분석 (The Effects of Digital Therapy for Stroke Patients in Korea: Meta-analysis)

  • 정재훈
    • 대한통합의학회지
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    • 제11권4호
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    • pp.1-15
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    • 2023
  • Purpose : This study investigates the effectiveness of digital therapy for stroke patients in Korea. Methods : A comprehensive database search was performed using KCI, Science on, e-article, RISS, KISS and Korea OpenMed databases for randomized controlled trials (RCTs) that studied the effects of digital therapy on patients who had a stroke. This study includes RCTs published from January 2000 to July 15, 2022, which fulfilled the inclusion and exclusion criteria. A total 697 studies were screened and 30 studies were included in the final analysis. Methodological quality was assessed with the Cochrane's RoB (risk of bias) tool. Meta-analysis was performed using CMA 4.0 software. Results : A total of 56 effect sizes were calculated from the 30 selected studies. As a result of the analysis, the overall effect size of digital therapy was .59 (95 % CI=.43-.74). When classified according to type of intervention, VR (virtual reality) (g=.58, 95 % CI=.40-.75), and CACR (computer assisted cognitive rehabilitation) (g=.62, 95 % CI=.30-.95) were statistically significant. VR showed medium to large effect sizes in cognitive function (g=.78, 95 % CI=.20-1.37), psychosocial function (g=.63, 95 % CI=.20-1.07), and physical function (g=.61, 95 % CI=.38-.83). In the CACR, there was a large effect size in cognitive function (g=.84, 95 % CI=.52-1.15), but there was no significant difference in psychosocial function. Also, there was no significant difference between the two interventions in activities of daily living and no significant difference in the effect size of both interventions according to the intervention session. Furthermore, medium to large effect sizes were found for subacute and chronic stroke patients according to the duration of disease. Conclusion : This study presents evidence that digital therapy has a positive effect on various functions of stroke patients in Korea. The researchers expect to actively accept the new paradigm of digital therapy and continue to apply digital therapy in clinical practice.

항정신병약물 복용 환자의 대사증후군에 대한 한약치료의 체계적 문헌고찰 (A Systematic Review of Traditional Herbal Medicine Treatments for Metabolic Syndrome in Patients Receiving Antipsychotic Drugs)

  • 임선우;박오른;박소현;최성열;김보경;임정화
    • 동의신경정신과학회지
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    • 제35권1호
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    • pp.69-99
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    • 2024
  • Objectives: This study aimed to systematically review the effectiveness and safety of traditional herbal medicine treatments for metabolic syndrome (MS) in patients receiving antipsychotic drugs (APs). Methods: We searched 11 domestic and foreign databases for randomized controlled trials (RCTs) using traditional herbal medicines for MS in patients receiving APs. Results: Twenty RCTs conducted in China were included in the analysis. The most common disease among the participants was schizophrenia. Most studies used the 2004 Chinese Diabetes Society (CDS) standards as the diagnostic criteria for MS. The most used prescription was Yukultang (Liuyu-tang). The most used herbal material was Pinelliae Rhizoma, followed by Poria, Citri Reticulatae Pericarpium, and Glycyrrhizae Radix et Rhizoma. Traditional herbal medicines were mostly reported to improve the symptoms of MS. Conclusions: Traditional herbal medicines may be effective in improving the symptoms of MS in patients receiving APs. However, the quality of the included studies was low, and the studies were heterogeneous. Methodologically rigorous clinical studies on traditional herbal medicine treatments for MS in patients receiving APs are needed.