• 제목/요약/키워드: Randomized controlled trials

검색결과 1,167건 처리시간 0.03초

불면증에 대한 한방 족욕요법의 무작위 대조군 임상연구 현황 : CNKI를 중심으로 (Randomized Controlled Clinical Trials of Warm Herbal Foot Bath Therapy for Insomnia: A Literature Review Based on the CNKI)

  • 권찬영;이보람;이경은
    • 대한한방내과학회지
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    • 제44권4호
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    • pp.726-740
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    • 2023
  • 목적: 이 연구의 목적은 불면증에 대한 한방 족욕요법의 연구 동향을 검토하는 것이다. 방법: 관련 연구의 수집을 위해 CNKI에서 검색을 수행하여, 2023년 8월 29일까지 발표된 연구를 검토하였다. 불면증 환자를 대상으로 한방 족욕요법과 수면제를 비교한 무작위 대조군 임상시험 만을 분석에 포함하였다. 포함된 연구들의 방법론적 질은 Cochrane risk-of-bias assessment tool을 사용하여 평가하였다. 메타분석의 결과는 위험비(risk ratios, RRs)와 평균차(mean differences, MDs) 및 그 95% 신뢰구간(confidence intervals, CIs)으로 제시되었다. 결과: 총 11편의 무작위 대조군 임상시험이 포함되었다. 분석 결과, 한방 족욕요법은 벤조디아제핀계 약물과 비교하여 유의하게 더 높은 총유효율(RR, 1.25; 95% CI, 1.15 to 1.36; I2=25%)과 개선된 피츠버그 수면의 질 지수(Pittsburgh Sleep Quality Index, PSQI) 총 점수(MD, -3.10; 95% CI, -4.24 to -1.95; I2=73%)를 보였다. 또한, 벤조디아제핀계 약물에 한방 족욕요법을 병용한 경우, 벤조디아제핀계 약물을 단독으로 사용한 것과 비교하여 유의하게 더 높은 총유효율(RR, 1.15; 95% CI, 1.04 to 1.27; I2=0%)과 개선된 PSQI 총 점수(MD, -2.23; 95% CI, -4.09 to -0.38; I2=80%)을 보였다. 네트워크 분석을 통해 한방 족욕요법에 포함된 약재를 분석하고 시각화한 결과, 4개의 클러스터가 발견되었으며, 핵심 약재는 야교등과 산조인이었다. 포함된 연구들의 방법론적 질은 전반적으로 낮았다. 결론: 이 연구는 불면증 개선에 있어서 단독요법 또는 병행치료로서의 한방 족욕요법이 효과적이라는 제한된 수준의 근거를 보여준다. 이 연구의 발견은 향후 한국에서 시행할 한방 족욕요법 연구의 기초자료로 활용될 수 있을 것이다.

본태성 고혈압에 대한 기국지황환(杞菊地黄丸)의 효과에 관한 체계적 고찰 및 메타 분석 (Qu-Ji-Du-Huang-Wan for Essential Hypertension : Systemic Review and Meta-analysis)

  • 한인식;신지혜;조윤영;박해모;양창섭;정민정;장인수;선승호
    • 동의생리병리학회지
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    • 제31권2호
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    • pp.118-125
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    • 2017
  • The purpose of this study is to investigate the blood pressure reducing effect of Qi-Ju-Di-Huang-Wan (QJDHW) in adults with essential hypertension by using methods of systemic review and meta-analysis. Major search engines, such as PubMed, EMBASE, Cochrane library, Web of Science, CNKI, CiNii, J-STAGE, KISS, NDSL, RISS, OASIS, DBpia and so on, were used. The search period we used is from the start date of the search engine to October 30, 2016 and no language limits were placed. Randomized controlled trials using QJDHW in adults with essential hypertension were searched and extracted by two independent researchers. Meta-analysis was performed on outcome variables of the total effective rate (TER), systolic blood pressure (SBP) and diastolic blood pressure (DBP). Risk of bias (RoB) of Cochrane was used to assess methodological quality. Thirteen studies were finally selected. We observed that the combined treatment of QJDHW and antihypertensive drug had 3.6 times the odds ratio of TER for blood pressure lowering than a single use of an antihypertensive drug. Additionally, mean differences of SBP and DBP were -8.88 mmHg (95% Confidential Interval (CI) -12.77 mmHg, -5.00 mmHg, P<0.00001), -7.09 mmHg (95% CI -9.93, -4.25, P <0.00001), respectively. Single use of QJDHW did not reduce blood pressure more than an antihypertensive drug. All items of RoB were unclear and the methodological quality was low. Our analysis suggests that the combination of QJDHW and antihypertensive drugs may be more effective in reducing blood pressure than a single antihypertensive drug. But due to low methodological quality, careful interpretation will be needed and systematic long-term clinical trials will be required.

전립선 비대증에 대한 뜸치료의 효과 : 체계적 문헌고찰과 메타분석 (Moxibustion for Benign Prostatic Hyperplasia: A Systematic Review and Meta-analysis)

  • 배고은;이승환;홍진우;이인;김소연;최준용;한창우;윤영주;박성하;권정남
    • 대한한방내과학회지
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    • 제39권3호
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    • pp.372-388
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    • 2018
  • Objective: This study evaluates the effectiveness and safety of moxibustion for benign prostatic hyperplasia (BPH). Methods: Using the keywords "benign prostatic hyperplasia", "benign prostatic hypertrophy", "benign prostatic enlargement", "prostatic hyperplasia", and "moxibustion", we searched papers in numerous databases, including National Discovery for Science Leaders (NDSL), Korean Traditional Knowledge Portal (KTKP), Oriental Medicine Advanced Searching Integrated System (OASIS), Research Information Sharing Service (RISS), PubMed, Embase, and CENTRAL. The search range included randomized controlled trials (RCTs). Papers not matched with inclusion criteria were excluded. The methodological quality of each RCT was assessed using the Cochrane risk-of-bias tool. Where appropriate, meta-analyses were performed. Results: Initially, 77 studies were found. Of these, 11 duplicate studies were removed and 27 were excluded following title and abstract screening. After the remaining 39 papers were scanned, 13 RCTs were selected and analyzed. Among these 13 RCTs, five compared moxibustion therapy and oral medication, seven compared moxibustion plus acupuncture therapy and oral medication, and one compared moxibustion plus acupuncture therapy and sham-moxibustion. The meta-analysis showed positive results for the use of moxibustion therapy in terms of International Prostate Symptom Score (IPSS), Quality Of Life (QOL), Maximum Flow Rate (Qmax), Prostate Volume (PV), and the efficacy rate. The meta-analysis showed positive results for the use of moxibustion plus acupuncture therapy in terms of IPSS, QOL, and the efficacy rate. Conclusions: This meta-analysis of clinical trials suggests that moxibustion is effective intreating BPH patients. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.

어깨통증의 한의학적 치료에 대한 국내 임상 연구 고찰 (A Review of Clinical Research on Korean Medicine for Shoulder Pain Conducted in Korea)

  • 김찬영;양지혜;채인철;최인우;유주영;정은선;김윤식;설인찬;유호룡
    • 대한한의학회지
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    • 제41권3호
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    • pp.221-246
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    • 2020
  • Objectives: Shoulder pain is the third most common musculoskeletal complaint that necessitates physician consultation and significantly diminishes patients' quality of life. In this review, we analyzed clinical studies that investigated the use of Korean Medicine for the treatment of shoulder pain. Methods: We searched the online Korean databases, such as KMBase, DBpia, NDSL, RISS, KISS, and OASIS for clinical studies that report the use of Korean Medicine for shoulder pain. We analyzed the included studies with regard to study design, interventions, evaluations, and results. Results: We analyzed data from the following 29 studies: 14 clinical trials (which included 9 randomized controlled trials) and 15 observational studies (which included 11 case reports). In this review, we observed that post-stroke shoulder pain was the most common cause of shoulder pain, which was reported in 13 out of 29 studies (44.8%), although in actual clinical practice, patients are more likely to present with primary shoulder pain. Most included studies (72.4%) reported manual acupuncture as the most common intervention for shoulder pain. More than 50% of the studies used range of motion (58.6%) and the numeric rating scale (51.7%) to evaluate shoulder function and pain, respectively. Although the result was not statistically significant in all included studies, most studies concluded that Korean Medicine could be considered an effective treatment option in patients with shoulder pain. Conclusions: Based on analysis of studies included in this review, Korean Medicine can be considered useful clinical treatment for shoulder pain.

Acupuncture and Moxibustion for Cancer-related Fatigue: a Systematic Review and Meta-analysis

  • He, Xi-Ran;Wang, Quan;Li, Ping-Ping
    • Asian Pacific Journal of Cancer Prevention
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    • 제14권5호
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    • pp.3067-3074
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    • 2013
  • Background: Faced with highly prevalent and recalcitrant cancer-related fatigue (CRF), together with the absence of any official guidelines on management, numerous groups have been striving to seek and test alternative therapies including acupuncture and moxibustion. However, different patients have various feedbacks, and the many clinical trials have given rise to varied conclusions. In terms of the therapeutic effect of acupuncture and moxibustion, there exist vast inconsistencies. Objective: The aim of the study was to evaluate the auxiliary effectiveness of acupuncture and moxibustion in the treatment of CRF, and to provide more reliable evidence to guide clinical practice. Methods: Randomized controlled trials (RCTs) published before December 2012 were all aggregated, focusing on evaluation of acupuncture or moxibustion for CRF. The quality of the included studies was assessed basing on Cochrane handbook 5.1.0, and the available data were analyzed with RevMan software (version 5.2.0). Descriptive techniques were performed when no available data could be used. Results: A total of 7 studies involving 804 participants were eligible. With real acupuncture versus sham acupuncture, subjects receiving true acupuncture benefited more in the reduction of fatigue. With real acupuncture versus acupressure or sham acupressure, fatigue level appeared 36% improved in the acupuncture group, but 19% in the acupressure group and only 0.6% with sham acupressure. When real acupuncture plus enhanced routine care was compared with enhanced routine care, the combination group improved mean scores for general fatigue, together with physical and mental fatigue. With real acupuncture versus sham acupuncture or wait list controls, the real acupuncture group displayed significant advantages over the wait list controls at 2 weeks for fatigue improvement and better well-being effects at 6 weeks. When moxibustion plus routine care was compared with routine care alone, the meta-analyses demonstrated the combination had a relatively significant benefit in improving severe fatigue and QLQ-C30. Conclusion: Up to the search date, there exist few high quality RCTs to evaluate the effect of acupuncture and moxibustion, especially moxibustion in English. Yet acupuncture and moxibustion still appeared to be efficacious auxiliary therapeutic methods for CRF, in spite of several inherent defects of the included studies. Much more high-quality studies are urgently needed.

생강 건조 분말의 임신 및 멀미에 의한 오심, 구토 개선 기능성에 대한 체계적 고찰 (Systematic review of the effect of dried ginger powder on improvement of nausea and vomiting associated with early pregnancy or motion sickness)

  • 곽진숙;백주은;정세원;김주희;김지연;권오란
    • Journal of Nutrition and Health
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    • 제47권1호
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    • pp.45-50
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    • 2014
  • 생강 건조 분말의 임신 또는 멀미로 인해 발생하는 오심, 구토 개선 기능성을 평가하기 위하여 체계적 고찰을 실시하였다. 2013년 3월 기준으로 DB 검색을 통해 870건의 자료를 수집하여, 선정/제외 기준에 따라 선별한 결과 총 12건의 연구가 평가되었다. 12건 (2,694명) 중 11건 (2,630명)의 연구에서 통계적으로 유의한 개선 효과 나타났으며 (p < 0.05), 효과를 보이는 일일 섭취량은 0.25~2.5 g이었다. 특히 임신부 대상 연구 9건에서는 모두 유의한 개선 효과를 보였고, 멀미에 대한 효과를 관찰한 3건의 연구 중 1,741명을 대상으로 한 대규모 연구 1건을 포함한 2건에서 구토를 유의하게 개선시키는 것으로 보고되었다. 해당 연구에서 모두 생강섭취로 인한 이상 반응은 없는 것으로 확인되었다.

Root coverage using a coronally advanced flap with or without acellular dermal matrix: a meta-analysis

  • Guan, Wei;Liao, Haiqing;Guo, Li;Wang, Changning;Cao, Zhengguo
    • Journal of Periodontal and Implant Science
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    • 제46권1호
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    • pp.22-34
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    • 2016
  • Purpose: Gingival recession is a major esthetic concern and may lead to root sensitivity during periodontal treatment. Coronally advanced flaps (CAFs) with and without acellular dermal matrix (ADM) are widely used in root coverage procedures. The aim of this study was to analyze the efficacy of CAF in combination with ADM in the treatment of gingival recession. Methods: PubMed, The Cochrane Library, and Embase were used to identify relevant articles. The articles were screened, data were extracted, and the quality of the studies was assessed by three reviewers with expertise in clinical practice, trials, statistics, and biomedical editing. The clinical endpoints of interest included changes in recession, probing depth (PD), clinical attachment level (CAL), and keratinized tissue (KT). Results: Ten randomized controlled trials were identified, including six studies that compared CAFs with ADM and CAFs using connective tissue grafting (CTG) and four studies that compared CAFs with or without ADM. No statistically significant differences were found between the use of ADM and CTG, whereas statistically significant differences were found between groups in which ADM and CAF were combined and groups that underwent CAF alone with regard to recession coverage, CAL, and KT. The combination of CAF with an ADM allograft achieved more favorable recession coverage and recovery of CAL and KT than CAF alone. Conclusions: The results from the ADM and CTG groups suggest that both procedures may be equally effective in clinical practice. Given the limitations of this study, further investigation is needed to clarify the effectiveness of ADM and CAF in clinical practice.

견봉하-삼각근하 점액낭염의 한의치료에 대한 국내외 연구동향 분석 (Analysis of Research Trends on the Korean Medicine Treatments of Subacromial-Subdeltoid Bursitis)

  • 박현석;장동진;이종현;유성재;선민지;김준수;김용준;노정희;김시형;윤정민
    • 한방재활의학과학회지
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    • 제34권2호
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    • pp.85-100
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    • 2024
  • Objectives This study aims to analyze clinical studies on subacromial-subdeltoid (SA-SD) bursitis and propose future directions for clinical research on SA-SD bursitis. Methods We searched eight databases to investigate research trends in Korean medicine treatments for SA-SD bursitis up to November 2023. A total of thirty-one studies were included in this analysis. Results Among the included studies, there were six case reports from Korea, fifteen case reports, and ten randomized controlled trials from abroad. Various interventions were uesd, including acupuncture, pharmacopuncture, manual therapy, electro-acupuncture, cupping, physiotherapy, acupotomy, warm-acupuncture, herbal medicine, and moxibustion. The evaluation tools used in these studies included the total effective rate, visual analogue scale, range of motion, and numeral rating scale. Conclusions This study provides an overview of the research trends in Korean medicine treatments for SA-SD bursitis. However, given the low quality and small sample sizes of the studies, the evidence supporting effect of Korean medicine treatments for SA-SD bursitis was insufficient. Further clinical trials and systematic reviews are required.

New techniques for wound management: A systematic review of their role in the management of chronic wounds

  • Bekara, Farid;Vitse, Julian;Fluieraru, Sergiu;Masson, Raphael;De Runz, Antoine;Georgescu, Vera;Bressy, Guillaume;Labbe, Jean Louis;Chaput, Benoit;Herlin, Christian
    • Archives of Plastic Surgery
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    • 제45권2호
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    • pp.102-110
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    • 2018
  • Debridement is a crucial component of wound management. Recent technologies such as hydrosurgery (Versajet), ultrasound therapy (the MIST therapy device), or plasma-mediated bipolar radio-frequency ablation therapy (Coblation) seem to represent interesting alternatives for wound debridement. The purpose of this systematic review was to describe, evaluate, and compare these three recently developed methods for the management of chronic wounds. In January 2016, an electronic database search was conducted of MEDLINE, PubMed Central, and Embase for articles concerning these three innovative methods for the management of chronic wounds. A total of 389 references were identified by our search strategy, and 15 articles were included. We extracted data regarding the number and age of patients, indications, operating time, number of procedures, costs, wound healing time, decrease in exudation, perioperative blood loss, bacterial load, and the occurrence of complications. The 15 articles included studies that involved 563 patients who underwent hydrosurgery (7 studies), ultrasound therapy (6 studies), or Coblation (2 studies). Six randomized controlled trials were included that compared the use of a scalpel or curette to hydrosurgery (2 studies) or ultrasound therapy (6 studies). Hydrosurgery, in addition to being a very precise and selective tool, allows significantly faster debridement. Ultrasound therapy provides a significant reduction of exudation, and improves the wound healing time. No comparative study dedicated to Coblation was identified. Despite the obvious clinical interest of the topic, our review of the current literature revealed a lack of prospective randomized studies comparing these devices with each other or with standard techniques, particularly for Coblation and hydrosurgery.

Antispastic Effect of Electroacupuncture on Upper Extremity in Stroke Patients by T-reflex Study : A Single-Blind, Randomized Controlled, Preliminary Study

  • Cho, Min Kyoung;Lee, In;Kwon, Jung Nam;Shin, Byung Cheul;Ko, Sung Hwa;Ko, Hyun Yoon;Shin, Yong Il;Hong, Jin Woo
    • 대한한의학회지
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    • 제36권4호
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    • pp.8-18
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    • 2015
  • Objectives: There have been several studies evaluated effect of electroacupuncture (EA) on spasticity but most studies could not assess spasticity quantitatively because they used clinical rating scales for assessment spasticity. The objective of this study is to evaluate effect of EA on poststroke spasticity quantitatively using tendon reflex (T-reflex). Methods: 29 stroke patients with upper extremity spasticity were randomized to EA group and control group. The EA group received combined EA and rehabilitation therapy 5 times a week for 3 weeks. Acupuncture treatment was given at Jian Yu (LI 15), Qu Chi (LI 11), Shao Hai (HT 3), Wai Guan (TE 5), He Gu (LI 4), Lie Que (LU 7), Hou Xi (SI 3) of the affected side, 30 minutes of electrical stimulation with a frequency of 40/13 Hz was applied at Qu Chi (LI 11), He Gu (LI 4). The control group received only rehabilitation therapy. The efficacy of treatment was assessed using T-reflex latency and amplitude, modified Ashworth scale (MAS) of biceps brachii, brachioradialis and triceps brachii. Fugl-Meyer motor function assessment (FMA) and functional independence measure (FIM) were also measured to assess motor function and functional independence. All outcomes were measured before treatment, immediately after 3 weeks of treatment and 1 week after 3 weeks of treatment. Results: No statistically significant differences were found in outcomes including T-reflex between the study groups except for FIM values immediately after 3 weeks of treatment (p=0.037). Conclusions: These results suggest that 3 weeks of EA does not reduce poststroke upper extremity spasticity electrophysiologically and clinically. However, small sample sizes and contradictory tendency between results from T-reflex and those from MAS require cautious judgement on interpretation of the results. A larger, well-designed clinical trials for quantitative evaluation of effect of EA on poststroke spasticity will be needed.