• 제목/요약/키워드: Randomized Clinical Trials

검색결과 940건 처리시간 0.026초

The effects of diagnostic hysteroscopy on the reproductive outcomes of infertile women without intrauterine pathologies: a systematic review and meta-analysis

  • Yang, Soo Yeon;Chon, Seung-Joo;Lee, Seon Heui
    • 여성건강간호학회지
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    • 제26권4호
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    • pp.300-317
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    • 2020
  • Purpose: Hysteroscopy can be used both to diagnose and to treat intrauterine pathologies. It is well known that hysteroscopy helps to improve reproductive outcomes by treating intrauterine pathologies. However, it is uncertain whether hysteroscopy is helpful in the absence of intrauterine pathologies. This study aimed to confirm whether hysteroscopy improves the reproductive outcomes of infertile women without intrauterine pathologies. Methods: We conducted a systematic review of 11 studies retrieved from Ovid-MEDLINE, Ovid-Embase, and the Cochrane Library. Two independent investigators extracted the data and used risk-of-bias tools (RoB 2.0 and ROBINS-I) to assess their quality. Results: Diagnostic hysteroscopy prior to in vitro fertilization (IVF)/intracytoplasmic sperm injection (ICSI) was associated with a higher clinical pregnancy rate (CPR) and live birth rate (LBR) than non-hysteroscopy in patients with recurrent implantation failure (RIF) (odds ratio, 1.79 and 1.46; 95% confidence interval, 1.40-2.30 and 1.08-1.97 for CPR and LBR, respectively) while hysteroscopy prior to first IVF was ineffective. The overall meta-analysis of LBR showed statistically significant findings for RIF, but a subgroup analysis showed effects only in prospective cohorts (odds ratio, 1.40 and 1.47; 95% confidence interval, 0.62-3.16 and 1.04-2.07 for randomized controlled trials and prospective cohorts, respectively). Therefore, the LBR should be interpreted carefully and further research is needed. Conclusion: Although further research is warranted, hysteroscopy may be considered as a diagnostic and treatment option for infertile women who have experienced RIF regardless of intrauterine pathologies. This finding enables nurses to educate and support infertile women with RIF prior to IVF/ICSI.

기공 운동 치료가 고혈압에 미치는 영향: 체계적 문헌 고찰 (Qigong Exercise Therapy for Hypertension: A Systematic Review)

  • 안재규;이상현;김현태;박선영;허인;정민정;황의형;장인수
    • 척추신경추나의학회지
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    • 제15권2호
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    • pp.9-18
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    • 2020
  • Objectives This study verified the clinical effectiveness of Qigong exercise therapy for individuals with hypertension. Methods Ten electronic databases were used for information retrieval. Only randomized controlled trials (RCTs) using Qigong exercise therapy as a treatment for hypertension were included in this study. Cochrane risk of bias tool was used to assess the methodological quality of each RCT. Results After a thorough review, six RCTs were deemed eligible. These studies were divided into two groups: Qigong vs. no intervention and Qigong plus anti-hypertensive drug vs. anti-hypertensive drug alone. Among the six RCTs, four studies were Qigong vs. no intervention, and two studies were Qigong plus anti-hypertensive drug vs. anti-hypertensive drug alone. The meta-analysis demonstrated that adding Qigong exercise to anti-hypertensive drug treatment lowers diastolic blood pressure more than the anti-hypertensive drug alone. Conclusions Although Qigong exercise is not widely used in the Korean medical field, the results of this study demonstrated the necessity of exercise while controlling hypertension. However, the number of included studies was small, with their high risk of bias. In conclusion, although it is difficult to determine whether Qigong exercise lowers blood pressure in hypertensive patients, exercise including Qigong must be parallel with the intake of anti-hypertensive drugs.

Effect of Manual Acupuncture for Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review

  • Huh, Jeong Ho;Jeong, Hye In;Kim, Kyeong Han
    • 대한약침학회지
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    • 제24권4호
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    • pp.153-164
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    • 2021
  • Objectives: Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. Methods: We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. Results: We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in posttreatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 (Daereung) was used to treat CTS in all of the included studies. Conclusion: MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.

Efficacy of cannabis-based medications compared to placebo for the treatment of chronic neuropathic pain: a systematic review with meta-analysis

  • Sainsbury, Bradley;Bloxham, Jared;Pour, Masoumeh Hassan;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권6호
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    • pp.479-506
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    • 2021
  • Background: Chronic neuropathic pain (NP) presents therapeutic challenges. Interest in the use of cannabis-based medications has outpaced the knowledge of its efficacy and safety in treating NP. The objective of this review was to evaluate the effectiveness of cannabis-based medications in individuals with chronic NP. Methods: Randomized placebo-controlled trials using tetrahydrocannabinol (THC), cannabidiol (CBD), cannabidivarin (CBDV), or synthetic cannabinoids for NP treatment were included. The MEDLINE, Cochrane Library, EMBASE, and Web of Science databases were examined. The primary outcome was the NP intensity. The risk of bias analysis was based on the Cochrane handbook. Results: The search of databases up to 2/1/2021 yielded 379 records with 17 RCTs included (861 patients with NP). Meta-analysis showed that there was a significant reduction in pain intensity for THC/CBD by -6.624 units (P < .001), THC by -8.681 units (P < .001), and dronabinol by -6.0 units (P = .008) compared to placebo on a 0-100 scale. CBD, CBDV, and CT-3 showed no significant differences. Patients taking THC/CBD were 1.756 times more likely to achieve a 30% reduction in pain (P = .008) and 1.422 times more likely to achieve a 50% reduction (P = .37) than placebo. Patients receiving THC had a 21% higher improvement in pain intensity (P = .005) and were 1.855 times more likely to achieve a 30% reduction in pain than placebo (P < .001). Conclusion: Although THC and THC/CBD interventions provided a significant improvement in pain intensity and were more likely to provide a 30% reduction in pain, the evidence was of moderate-to-low quality. Further research is needed for CBD, dronabinol, CT-3, and CBDV.

남, 북한의 화침 연구문헌에 대한 비교연구 (A Comparative Study of the Literature on Fire Acupuncture (Hwachim) between South and North Korea)

  • 임수란;김시혜;김유라;김연섭;김송이
    • Korean Journal of Acupuncture
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    • 제38권4호
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    • pp.209-221
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    • 2021
  • Objectives : The aim of this study was to compare and analyze studies related to fire acupuncture (FA) published in South and North Korea. Methods : FA studies published in South Korea were searched through domestic and overseas databases (KISS, RISS, OASIS, and EMBASE). For North Korean studies, databases from the Information Center on North Korea and Korea Institute of Science and Technology Information were used. Among the searched literatures, clinical studies using FA as a treatment intervention were selected (i.e., randomized controlled trials, and case reports). Finally, information such as the disease for which FA was used, the characteristics of FA, and details of treatment methods for FA were extracted from the screened literatures and the results of South and North Korean studies were compared and analyzed. Results : This review included 28 South Korean studies and 9 North Korean studies. All studies in South Korea, except for the three articles that used traditional FA treatment, applied "warm needling"-like acupuncture (WA) in the form of heating the handle of the needle after inserting the needle into the skin, and most studies were conducted on diseases of the musculoskeletal system. Whereas in the North Korean studies, FA was applied to various diseases such as trigeminal neuralgia, skin diseases, and gastrointestinal diseases, and standardized FA tools were used. Conclusions : Studies on traditional FA treatment have rarely been reported in South Korea. The amount of information described in the FA studies in North Korea was limited. In this review, the characteristics of FA treatment tools in South and North Korean studies were mainly analyzed. In the future, FA studies from more diverse perspectives are needed.

한약이 류마티스 관절염 환자의 골다공증에 미치는 영향: 체계적 문헌 고찰 및 메타분석을 위한 프로토콜 (Effects of Herbal Medicines on Osteoporosis in Rheumatoid Arthritis: Study Protocol for a Systematic Review and Meta-Analysis)

  • 권도영;구지향;이은정
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.77-84
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    • 2022
  • Objectives This study is designed to identify the effectiveness of herbal medicine for osteoporosis in rheumatoid arthritis. Methods We will investigate 10 databases, 4 Korean databases (KoreaMed, KMBASE, Koreanstudies Information Service System [KISS], ScienceOn) and 6 of abroad (PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure [CNKI], WanFang, Citation Information by NII [CiNii]) without publication date, language limitation for clinical study of herbal medicine for osteoporosis in rheumatoid arthritis. Type, dose, duration, frequency of herb medicine will be analyzed. Results Randomized controlled trials about herbal medicine or herb extract for osteoporosis in rheumatoid arthritis should be included in the study. Cochrane's risk of bias tools will be used to assess quality of the study. Mean differences or standardized mean differences of 95% confidence intervals will calculated and data synthesis will be conducted using Review Manager (RevMan, ver.5.3; The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark). Conclusions It is expected to provide basic data for the active use of herb medicine by systematically synthesizing and analyzing the actual situation, effectiveness, and safety of herb medicine for osteoporosis in rheumatoid arthritis.

부위마취로 제왕절개 수술을 받은 산모의 조기 경구섭취가 장 기능, 위장관 합병증 및 수술 후 회복에 미치는 효과: 체계적 문헌고찰 및 메타분석 (Effects of Early Oral Feeding versus Delayed Oral Feeding on Bowel Function, Gastrointestinal Complications and Surgical Recovery after Cesarean Section under Regional Anesthesia: Systematic Review and Meta-Analysis)

  • 김효진;전영경;윤소영;이금문
    • 대한간호학회지
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    • 제51권6호
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    • pp.732-745
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    • 2021
  • Purpose: This study aimed to assess combined effects of early oral feeding after Cesarean section (C/S) under regional anesthesia on bowel function, gastrointestinal complications and surgical recovery. Methods: A systematic literature search was conducted using KISS, RISS, PubMed, CINAHL, EMBASE, CENTRAL and Google Scholar to identify randomized clinical trials comparing early oral feeding (EOF) with delayed oral feeding (DOF) after C/S. Outcome variables were bowel function and gastrointestinal complications and surgical recovery. Effect size was calculated using weighted mean differences (WMDs) and relative risks (RRs), with 95% confidence intervals (CIs). Results: Seven studies involving 1,911 patients from 568 studies, 7 studies were included in meta-analysis. EOF was significantly associated with shorter time to recover bowel movement compared with DOF (WMD, - 2.50; CI, - 3.50~- 1.50). EOF was not associated with nausea (RR, 1.15; CI, 0.87~1.53) and vomiting (RR, 0.96; CI, 0.65~1.42), but lower incidence of abdominal distension (RR, 0.70; CI, 0.50~0.98). EOF was significantly associated with shorter time to discontinuation of intravenous fluids (WMD, - 8.88; 95% CI, - 16.65~- 1.11) and removal of urinary catheter (WMD, - 15.23; CI, - 25.62~- 4.85). Conclusion: This meta-analysis provides evidence that EOF after C/S under regional anesthesia not only accelerates return of bowel function and surgical recovery but also reduces gastrointestinal complications. These results suggest that EOF should be offered to women who have undergone C/S to improve the recovery experience and reduce overall medical costs.

요추 척추관 협착증의 비수술적 치료에 대한 최근 국내·외 연구 동향 (Recent Domestic and International Trends on Non-Surgical Treatment of Lumbar Spinal Stenosis)

  • 김미현;박은상;황현호;이여경;송금주;권미리;강준혁
    • 한방재활의학과학회지
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    • 제31권3호
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    • pp.1-17
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    • 2021
  • Objectives The present study examined the recent domestic and international trends of non-surgical treatment of lumbar spinal stenosis (LSS). Methods The studies on non-surgical treatment of LSS were investigated via searching Korean web databases and PubMed. As a result, 39 studies were analyzed according to the authors, the types of study, the relationship to surgical treatment and the method of treatment. Results The first authors' occupations were identified as 17 doctors, 12 Korean medicine doctors, six physiotherapists, three chiropractic doctors and one doctor of science. The most common type of study in Korea was the case report and most of the studies were retrospective. Overseas, there were many prospective or experimental studies including randomized controlled trials (RCT). In Korea, non-surgical treatment was performed independently of surgical treatment in most cases. Among non-surgical treatments, the most researched treatment was traditional Korean medicine (TKM), followed by injection therapy, exercise therapy, and physical therapy. Conclusions Through this review, we can determine the effectiveness of TKM and its research direction. TKM should be studied experimentally including RCT and it should be conducted not only on acupuncture, but also on other treatment methods such as acupotomy, chuna, and herbal medicine. It is also necessary to conduct studies on TKM before and after surgery to compare the effects of surgery and TKM together, as well the effects on non-surgical treatments.

Integrated Rehabilitation for Children with Cerebral palsy: A Prospective Observational Study

  • Lee, Hye-Yoon;Yun, Young-Ju;Shin, Yong-Beom;Kim, Soo-Yeon;Han, Jun-hee;Yu, Sun-ae
    • 대한한의학회지
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    • 제42권4호
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    • pp.61-74
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    • 2021
  • Objectives: This study aimed to analyse: 1) the clinical effectiveness and safety of traditional Korean Medicine (TKM) and frequency of TKM therapies used and their relationship with conventional treatments. Methods: This prospective observational study enrolled children with cerebral palsy (CP) aged 6-78 months (n=126). The children who used herbal medication for >30 days or acupuncture treatment >12 sessions within 6 months were defined as the integrated rehabilitation (IR) group; the remaining participants were included in the conventional rehabilitation (CR) group. Results: Changes in the Gross Motor Function Measure-66 (GMFM-66) were greater in the IR group (6.4±6.1) than in the CR group (4.6±5.8). The reduction in the number of other health problems was greater in the IR group than in the CR group. The GMFM-66 improvement was greatest in gross motor function classification system level 1. There was no between-group difference in the frequency of rehabilitation therapy (10.9±6.6 and 12.0±9.9 in the IR and CR groups, respectively). Conclusion: TKM may offer additional benefits in terms of the GMFM-66 score and other health problems. However, there is a need for further randomized controlled trials involving a restricted CP type and a controlled treatment type and intensity to confirm these findings.

비스테로이드성 소염진통제를 복용하는 원발성 월경곤란증 환자에 대한 이침치료의 무작위대조군임상시험 (Effect of Auricular Acupuncture on Nonsteroidal Antiinflammatory Drug Dose in Primary Dysmenorrhea : A Randomized Controlled Trials)

  • 허다희;강소현;권한슬;안하영;백형찬;김형준
    • 대한한방부인과학회지
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    • 제35권4호
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    • pp.161-173
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    • 2022
  • Objectives: This study was conducted to evaluate the effectiveness of acupuncture in patients with primary menstrual difficulties taking NSAIDs. Methods: 30 women with primary menstrual difficulties with NSAIDs were assigned to treatment groups (n=15) and control groups (n=15). On their first visit, both groups were provided with a menstrual diary and were required to record the intensity of pain and the dosage of painkillers during each menstrual cycle. The treatment group received two acupuncture treatments per cycle during two cycles, and the control group did not receive acupuncture. Pain strength during menstruation was evaluated using Visual Analogue Scale (VAS), and the total number of painkillers taken during menstruation and the average number of painkillers taken during a single dose was measured. Results: The treatment group had significant pain relief compared to the pre-test group and significant differences from the control group. In addition, there was a significant difference between the treatment group and the control group in the frequency of taking painkillers during the menstrual period and the dose in the test group was significantly lower than before treatment. Conclusions: This clinical trial showed that this acupuncture can help alleviate primary menstruation and reduce the use of nonsteroidal anti-inflammatory drugs.