• 제목/요약/키워드: Randomized controlled trials

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슬개대퇴통증증후군의 침 치료 효과에 대한 체계적 문헌고찰 (A Systematic Review of Acupuncture Treatment Effect for Patellofemoral Pain Syndrome)

  • 지민준;권도영;양재은;구지향;오민석
    • 한방재활의학과학회지
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    • 제33권2호
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    • pp.19-32
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    • 2023
  • Objectives The purpose of this study is to systematically review the degree of pain and function improvement in acupuncture treatment for patellofemoral pain syndrome (PFPS). Methods Randomized controlled trials (RCTs) were searched from Medline/PubMed, Cochrane Library, Embase, WanFang Data, China National Knowledge Infrastructure (CNKI), Citation Information by NII (CiNII), Koreanstudies Information Service System (KISS), ScienceON, KoreaMed, and Korean Medical Database (KMbase). The methodological quality of selected RCTs' were evaluated according to Cochrane RoB2 tool. Results Total of 158 studies were identified and 7 RCTs were selected for systematic review. Frequently used evaluation method were visual analogue scale and Kujala scores. All studies showed significant effect on pain reduction and knee function between before and after treatment, but showed partial significance between the intervention and control group. Conclusions Research showed that acupuncture treatment is an effective treatment for improving the pain and function of PFPS, but it is difficult to conclude that it has a significant effect compared to other treatments. Selected studies included subjective evaluation indicators and the total of selected studies were small, so the interpretation of the results is limited. Also most of the included studies are evaluated to have some concerns of bias. Therefore, subsequent research should continously be done in more objective and systematic method.

Healthy lifestyle interventions for childhood and adolescent cancer survivors: a systematic review and meta-analysis

  • Kyung-Ah Kang;Suk Jung Han;Jiyoung Chun;Hyun-Yong Kim;Yerin Oh;Heejin Yoon
    • Child Health Nursing Research
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    • 제29권2호
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    • pp.111-127
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    • 2023
  • Purpose: This study investigated the effects of healthy lifestyle interventions (HLSIs) on health-related quality of life (HR-QoL) in childhood and adolescent cancer survivors (CACS). Methods: Major databases were searched for English-language original articles published between January 1, 2000 and May 2, 2021. Randomized controlled trials (RCTs) and non-RCTs were included. Quality was assessed using the revised Cochrane risk-of-bias tool, and a meta-analysis was conducted using RevMan 5.3 software. Results: Nineteen studies were included. Significant effects on HR-QoL were found for interventions using a multi-modal approach (exercise and education) (d=-0.46; 95% confidence interval [CI]=-0.84 to -0.07, p=.02), lasting not less than 6 months (d=-0.72; 95% CI=-1.15 to -0.29, p=.0010), and using a group approach (d=-0.46; 95% CI=-0.85 to -0.06, p=.02). Self-efficacy showed significant effects when HLSIs provided health education only (d=-0.55; 95% CI=-0.92 to -0.18; p=.003), lasted for less than 6 months (d=-0.40; 95% CI=-0.69 to -0.11, p=.006), and were conducted individually (d=-0.55; 95% CI=-0.92 to -0.18, p=.003). The physical outcomes (physical activity, fatigue, exercise capacity-VO2, exercise capacity-upper body, body mass index) revealed no statistical significance. Conclusion: Areas of HLSIs for CACS requiring further study were identified, and needs and directions of research for holistic health management were suggested.

Effectiveness of Acupuncture and Acupotomy for Trigger Finger: A Systematic Review and Meta-Analysis

  • Hae-Won Hong;Myung-In Jeong;Hyun-Il Jo;Sun-Ho Lee;Ka-Hyun Kim;Sung-Won Choi;Jae-Won Park;Ji-Su Ha
    • Journal of Acupuncture Research
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    • 제40권2호
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    • pp.111-128
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    • 2023
  • Trigger finger is a common cause of hand disability that results in finger catching, clicking, or locking. Conventional treatment options such as medication, injection, and surgery have limitations. Studies have indicated that acupuncture and acupotomy can be effective in treating trigger finger. However, no review regarding these treatment modalities has been published yet. This review included randomized controlled trials published until January 2023, investigating acupuncture-related interventions. The primary outcomes of interest included the effectiveness rate (ER) and pain intensity, measured using a visual analog scale (VAS) and Numerical Rating Scale (NRS), and secondary outcomes were the Quinnell grade (QG) and recurrence rate (RR). Adverse events (AEs) have also been reported wherever available. Overall, 19 studies were included, and results demonstrated that arcedge acupuncture improved the ER and QG and reduced NRS, and acupuncture was effective in reducing VAS. Compared with conventional surgery, acupotomy alone improved the ER and QG and lowered VAS and RR, with relatively fewer AEs. Acupotomy add-on treatment was more effective than conventional treatment; however, careful interpretation is needed for VAS. Acupotomy add-on treatment was more effective than acupotomy alone. However, the overall results must be interpreted with caution because of study quality, small sample size, and heterogeneity of the results.

The Effects of Acupuncture on Crohn's Disease: a systematic review and meta-analysis

  • Joon Hyun Bae;Seo Young Kang;Si Eun You;Hye In Jeong;Soobin Jang;Kyeong Han Kim
    • 대한약침학회지
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    • 제26권3호
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    • pp.211-226
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    • 2023
  • Objectives: Crohn's disease is a chronic gastrointestinal disease that belongs to inflammatory bowel disease. This systematic review aims to assess the level of evidence in randomized controlled trials (RCTs) on the effects of acupuncture for Crohn's disease. Methods: We searched 12 databases from the date of the establishment of each database up to May, 2023 for relevant RCTs. The risk of bias of each study was assessed independently by three reviewers. The level of evidence of meta-analysis was assessed using GRADE (Grading of Recommendations, Assessment, Development, and Evaluation). Results: A total of 12 studies were included. The effective rate (odds ratio [OR] 3.23, 95% confidence interval [CI] 1.43, 7.30) for mild to moderate Crohn's disease patients showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. CDAI change (mean difference [MD] -74.15, 95% CI -93.28, -55.01) for mild to moderate Crohn's disease showed a significant difference between the acupuncture with moxibustion group and the sham-acupuncture with sham-moxibustion group. Conclusion: Although acupuncture with moxibustion showed significant effects compared to sham-acupuncture with sham-moxibustion, the effect of acupuncture alone is inconclusive. Moreover, only the effect of acupuncture treatment on mild to moderate Crohn's disease patients was derived as a remarkable result. To confirm the effectiveness of acupuncture treatment for Crohn's disease, studies using only acupuncture for intervention or more RCTs targeting various Crohn's disease patients according to the CDAI are required.

Research Trends of Pharmacopuncture: a bibliometric analysis using VOSviewer (2007-2023)

  • Chan-Young Kwon
    • 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.

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.

아토피 피부염에서 한약 외용제와 양약 병용 치료의 효과: 체계적 문헌고찰 및 메타분석 (Efficacy of Combination Treatment of Herbal Medicine for External Use and Western Medicine for Atopic Dermatitis: A Systematic Review and Meta Analysis)

  • 이지은;박수진;전서연;김규석
    • 대한융합한의학회지
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    • 제5권1호
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    • pp.5-23
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    • 2023
  • Objectives: This study was conducted to evaluate the effect of combination treatment of herbal medicine for external use and western medicine for atopic dermatitis (AD). Methods: We searched randomized controlled trials (RCTs) which assess the effect of combination treatment of herbal and western medicine for AD through 8 electronic databases from the start to December 2022. The data synthesis was conducted by using Review Manager (RevMan, ver.5.4.1) and Cochrane risk-of-bias tool was used to evaluate the risk of bias. Results: 13 RCTs were included. The combination treatment group had significantly higher total efficacy rate(p<0.0001) and lower SCORAD score (p<0.00001) than the western medicine treatment group. The adverse event rate was also significantly lower in the combination treatment than the western medicine treatment group (p<0.0001). But there was no significant difference in recurrence rate (p=0.09). Conclusion: This study demonstrates that the combination treatment of herbal and western medicine could be safe and effective for AD. However, due to limits of included studies such as high heterogeneity between the literature and unclear risk of bias, further studies are warranted.

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건선 환자에서 아시트레틴 치료에 추가한 한방 약욕 효과 : 체계적 문헌 고찰과 메타 분석 (Add-on Effect of Herbal Bath Combined with Acitretin Treatment in Patients with Psoriasis : Systemic Review and Meta-analysis)

  • 전서연;박수진;이지은;김규석
    • 한방안이비인후피부과학회지
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    • 제36권3호
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    • pp.74-98
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    • 2023
  • Objectives : This study aims to evaluate the add-on effect of herbal bath combined with acitretin in patients with psoriasis. Methods : We searched randomized controlled trials(RCTs) reporting the effect of herbal bath and acitretin combined treatment for psoriasis in 10 electronic databases from their inception to January 2023. Study collection, data extraction, and risk of bias assessment were performed by two independent researchers. Data synthesis and risk of bias evaluation was conducted using Revman 5.4. Results : Ten RCTs with 1,008 subjects were included. Herbal bath and acitretin combined treatment group showed higher average total effective rate than acitretin alone group(RR 1.39; 95% CI: 1.15-1.68, P=0.0006, I2 =0%). Herbal bath and additional treatments such as phototherapy(NB-UVB) and oral herbal medicine, combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.81; 95% CI: 1.47-2.22, P<0.00001, I2 =43%). Herbal bath and phototherapy(NB-UVB) combined with acitretin group also showed higher average total effective rate than acitretin alone group(RR 1.51; 95% CI: 1.18-1.93, P=0.0009, I2 =0%). The overall risk of bias of the included studies was unclear or of high risks. Conclusions : This review showed that the add-on of herbal bath combined with acitretin treatment could be more effective than acitretin alone treatment in patients with psoriasis. However, because of few included studies, heterogeneity between studies, and insufficient quality of included studies, further well-designed RCTs are needed to confirm the add-on effect of herbal bath on psoriasis.

Influences of Aerobic and Resistance Exercise on Health-related Problems in Cancer Patients: A review of the literature

  • Ye-Na Jeon;Jeongwoo Jeon;Jihoen Hong;Jaeho Yu;Jinseop Kim;Seong-Gil Kim;Dongyeop Lee
    • 대한통합의학회지
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    • 제11권3호
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    • pp.79-89
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    • 2023
  • Purpose : Until recently, the number of cancer patients continues to increase, and these patients have many limitations in their activities of daily living. In the republic of Korea, cancer patients are showing an increasing trend every year. Cancer disease not only significantly reduces the quality of life in individuals, but also causes various side effects if not managed. The purpose of this study was to investigate the effects of aerobic exercise and resistance exercise on health-related problems in cancer patients. Methods : This study searched for studies that applied aerobic exercise and resistance exercise to cancer patients reported in search engines (google scala, dbpia, and pubmed) from 2017 to 2022. Six randomized controlled trials and two systematic reviews and meta-analyses were used for analysis in our study. "physical activity", "exercise", "aerobic exercise", "resistance exercise", and "cancer patient" were the main search terms. The data included aerobic exercise, resistance exercise, cancer patients' muscle strength, physical strength, quality of life, and physical activity. Results : According to the eight studies that met the criteria included in this review study, it was found that aerobic exercise and resistance exercise had an effect on the increase in physical fitness, muscular strength, quality of life, and range of motion in cancer survivors. Conclusion : It was confirmed that aerobic exercise and resistance exercise are safe and effective interventions that can be applied to cancer patients without side effects. A limitation of this study is that it did not examine cancer diseases in various population groups such as the elderly and children. Therefore, in future studies, studies that consider specific details such as age, gender, type of cancer, and physical differences are needed.

The association between dietary sodium intake and obesity in adults by sodium intake assessment methods: a review of systematic reviews and re-meta-analysis

  • Jounghee Lee;Cheongmin Sohn;Oh-Yoen Kim;Young-Min Lee;Mi Ock Yoon;Myoungsook Lee
    • Nutrition Research and Practice
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    • 제17권2호
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    • pp.175-191
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    • 2023
  • BACKGROUND/OBJECTIVES: The scientific evidence of a sodium-obesity association is limited by sodium intake assessments. Our specific aim is to synthesize the association between dietary sodium intake and obesity across the sodium intake assessments as evidenced by systematic reviews in adults. SUBJECTS/METHODS: A systematic search identified systematic reviews comparing the association of dietary sodium intakes with obesity-related outcomes such as body mass index (BMI), body weight, waist circumference, and risk of (abdominal) obesity. We searched PubMed on October 24, 2022. To assess the Risk of Bias in Systematic Reviews (ROBIS), we employed the ROBIS tool. RESULTS: This review included 3 systematic reviews, consisting of 39 unique observational studies (35 cross-sectional studies and 4 longitudinal studies) and 15 randomized controlled trials (RCTs). We found consistently positive associations between dietary sodium intake and obesity-related outcomes in cross-sectional studies. Studies that used 24-h urine collection indicated a greater BMI for those with higher sodium intake (mean difference = 2.27 kg/m2; 95% confidence interval [CI], 1.59-2.51; P < 0.001; I2 = 77%) compared to studies that used spot urine (mean difference = 1.34 kg/m2; 95% CI, 1.13-1.55; P < 0.001; I2 = 95%) and dietary methods (mean difference = 0.85 kg/m2; 95% CI, 0.1-1.51; P < 0.05; I2 = 95%). CONCLUSIONS: Quantitative synthesis of the systematic reviews has shown that cross-sectional associations between dietary sodium intake and obesity outcomes were substantially different across the sodium intake assessments. We need more high-quality prospective cohort studies and RCTs using 24-h urine collection to examine the causal effects of sodium intake on obesity.