• 제목/요약/키워드: Randomized controlled trials

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A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Chuna Manual Therapy for Cervicogenic Headache

  • Lee, Dong-Wha;Kim, Ju-Young;Hong, Min-Ho;Koo, Byung-Soo;Kim, Geun-Woo
    • 동의신경정신과학회지
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    • 제30권2호
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    • pp.89-105
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    • 2019
  • Objectives: We conducted this study to evaluate the efficacy of Chuna Manual Therapy (CMT) for treatment of cervicogenic headache (CeH) through systematic review and Meta-analysis of randomized controlled trials (RCTs) as a preceding research to further research the effective of Chuna Manual Therapy for patients who suffered from CeH. Methods: We conducted a systematic review and meta-analysis by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the studies from MEDLINE, Elsevier-EMBASE, The Cochrane Library, CAJD, KISS, KMBase, Korean Traditional Knowledge Portal, NDSL, and OASIS. The studies selected only in randomized controlled trials. We selected the chosen studies by the selection and the exclusion criteria, and evaluated the quality of the selected studies using the Jadad score and the Cochran ROB tool. We used the Visual Analogue Scale score (VAS) and Clinical total Effective Rate (CER) for the results and analyzed the results of the included studies using RevMan 5.3 software provided by the Cochran library. Results: We included 20 RCTs, including 1,673 subjects, in the systematic review and meta-analysis. After the intervention, the CMT group showed better results than the pharmacotherapy group, the physiotherapy group, and the combined treatment group. The CMT group showed a good effect on the CER and the VAS but showed a significant heterogeneity compared to the pharmacotherapy group. Conclusions: The CMT as monotherapy might have benefits on Cervicogenic Headache patient. Further well-designed studies need to be conducted.

Preventive Effects of Fluoride Gel Application on Dental Caries in the Permanent Tooth: A Systematic Review of Randomized Controlled Trials

  • Do, Kyung-Yi;Lee, Eun-Sun
    • 치위생과학회지
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    • 제19권1호
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    • pp.9-22
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    • 2019
  • Background: The purpose of this systematic review was to investigate the effects of topical fluoride gel application on dental caries prevention in the permanent teeth of children and adolescents. Methods: We searched the EMBASE, PubMed, and Cochrane Library databases for randomized controlled trials (RCTs) assessing the effects of self-applied or professionally applied topical fluoride gels in patients <18 years of age; the search was completed on April 1, 2018. All included trials involved an experimental group (fluoride gel application) and a control group (placebo or no treatment). The outcome measures were the D(M)FS and D(M)FT indices, which were compared between the two groups. Review Manager software was used for quantitative synthesis of the final selected articles, and a forest plot was generated via a meta-analysis conducted using a random effects model. Results: The results showed that the D(M)FS and D(M)FT indices were lower in the fluoride application group than in the control group, thus indicating that fluoride gel application was effective in dental caries prevention. We also performed a subgroup analysis to determine whether the effects of fluoride application differed if patients received oral prophylaxis (self or professional) before fluoride gel application. Therefore, the two groups showed slightly larger differences when studies without oral prophylaxis before fluoride gel application were considered; however, the difference was not statistically significant. Conclusion: These findings should be utilized to raise awareness about the caries-prevention effects of topical fluoride application among patients and guardians. Further RCTs should evaluate the effects of fluoride application with or without preceding oral prophylaxis, and appropriate fluoride application guidelines should be developed to maximize the effects of fluoride application in clinical practice.

퇴행성 슬관절염의 화침 치료에 대한 체계적 문헌 고찰 및 메타분석: 최근 5년간의 호침 치료 비교 연구를 중심으로 (A Systematic Review and Meta-Analysis of Fire Needling Treatment for Knee Osteoarthritis: Focused on Comparative Studies with Manual Acupuncture Treatment during Recent Five Years)

  • 고홍제;유재희;신정철
    • Korean Journal of Acupuncture
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    • 제36권2호
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    • pp.104-114
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    • 2019
  • Objectives : The purpose of this study is to review the effectiveness of fire needling treatment for knee osteoarthritis in comparison with manual acupuncture treatment. Methods : Through four foreign online databases (PubMed, Cochrane library, EMBASE, and CNKI) and five domestic online databases (NDSL, RISS, KISS, OASIS, and KTKP), we searched for clinical studies that performed fire needling treatment for knee osteoarthritis until May 10, 2019. Only randomized controlled trials were selected and we assessed the risk of bias according to the Cochrane RoB criteria. This review examined the selected studies into first author, publication year, sample size, outcome measurements, results, acupoints, treatment time & period and so on. Results : A total of 7 RCTs were selected in this review and all were conducted in China. Treatment period of more than 4 weeks and treatment visits of 10 to 20 times were the most common. EX-LE4 and ST35 (=EX-LE5) acupoints were most frequently selected in treatment. Among the evaluation indexes, a total efficacy rate was used the most. Most of fire needling groups showed more significant results compared with the manual acupuncture groups statistically. Conclusions : All studies showed that fire needling treatments for knee osteoarthritis were more effective than manual acupuncture treatments statistically. Therefore, the results of this study could be utilized as a preliminary data for another clinical research on fire needling treatment for knee osteoarthritis. However, further well-designed randomized controlled trials will be needed to develop sufficient evidence about the effectiveness and safety of fire needling treatment for knee osteoarthritis in the future.

무릎 골관절염의 도침 치료에 대한 연구 동향 : 체계적 문헌 고찰 (Research Trends on the Acupotomy Treatment for Knee Osteoarthritis : A Systematic Review)

  • 홍수민;윤광식
    • 동의생리병리학회지
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    • 제34권6호
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    • pp.285-298
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    • 2020
  • This study aimed to review clinical studies about Acupotomy used for Knee Osteoarthritis. We searched the following 12 online databases (KISS, NDSL, RISS, OASIS, Earticle, Kmbase, MEDLINE/Pubmed, Cochrane library, Ebscohost, Ovid, CNKI, Wanfang), to find randomized controlled trials that used Acupotomy for knee osteoarthritis. The methodological quality of randomized controlled trials were assessed by using the Cochrane risk of bias tool and meta-analyses were performed. 16 randomized controlled trials were included. Total number of patients was 1169. The average duration of treatment was 3.14 weeks and most of the patients were treated once a week. The major treatment sites were ligaments, muscles, and tender nodules and the most used evaluation tool was the efficiency. We selected 4 studies and meta-analyzed them. All of the studies performed Acupotomy+sodium hyaluronate injection as a treatment group, and sodium hyaluronate injection as a control group. Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of efficiency rate compared to sodium hyaluronate injection. Also Meta-analysis showed positive results for Acupotomy+sodium hyaluronate injection in terms of WOMAC (pain, stiffness, function) compared to sodium hyaluronate injection. In this study, we reviewed studies about Acupotomy used for knee osteoarthritis. The studies showed that Acupotomy can significantly effective on knee osteoarthritis. But according to Cochrane Risk of Bias (RoB) evaluation method, most of the study's risk of bias was unclear. Threrefore, more high-quality studies will be needed.

경혈경락 이론에 근거한 체외충격파 치료가 유착성 관절낭염에 미치는 영향: 무작위 대조 임상연구에 대한 체계적 문헌고찰과 메타분석 (Extracorporeal Shock Wave Therapy with Meridian and Acupoint Theory for Adhesive Capsulitis: A Systematic Review and Meta-analysis of Randomized Controlled Trials)

  • 한동훈;박인화;허인
    • 한방재활의학과학회지
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    • 제32권2호
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    • pp.55-63
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    • 2022
  • Objectives This review was conducted to evaluate effectiveness and safety of extracorporeal shock wave therapy (ESWT) with meridian and acupoint theory for adhesive capsulitis. Methods By December 2021, 11 electronic databases were reviewed with the key words 'extracorporeal shock wave' and '(acupuncture OR acupoint OR meridian)'. This key words was set up to increase the sensitivity of the search. After the search, adhesive capsulitis study was selected based on the title and abstract and then included after full-texts were read. Results Five randomized controlled trials were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using ESWT with meridian and acupoint theory for adhesive capsulitis compared with the control group on efficancy rate and range of shoulder flexion. Conclusions Some studies showed ESWT with meridian and acupoint theory were statistically effective to adhesive capsulitis. But the evidence is limited due to the defective design of the included randomized controlled trials (RCTs). So use of ESWT with meridian and acupoint theory for adhesive capsulitis has limited evidence. More well-designed RCTs are required to provide clearer evidence for this claim.

뇌졸중 환자의 상지 기능에 기능적 전기 자극이 미치는 영향: 무작위대조군연구에 기초한 체계적 고찰 (Effect of Electrical Stimulation on Upper Extremity Function in Stroke Patients: A Systematic Review Based on Randomized Controlled Trials)

  • 황수진;서연주
    • PNF and Movement
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    • 제20권2호
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    • pp.147-156
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    • 2022
  • Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

만성 골반 염증성 질환의 계지복령환 및 계지복령환 가감방 투여에 대한 중의학 연구 동향 : 무작위 대조군 임상 연구를 중심으로 (Review of Randomized Controlled Trials Research of Gyejibongnyeong-hwan and Gyejibongnyeong-hwan gagam for Chronic Pelvic Inflammatory Disease)

  • 정연수;윤영진;이희윤;박장경
    • 대한한방부인과학회지
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    • 제36권3호
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    • pp.78-94
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    • 2023
  • Objectives: The purpose of this study is to review the trends of clinical trials of traditional herbal medicine Gyejibongnyeong-hwan for chronic pelvic inflammatory disease in CNKI. Methods: We searched relevant studies using Chinese National Knowledge Infrastructure (CNKI). Data retrieval was carried out by December 20th, 2021. We analyzed characteristics of study subjects, treatment period, composition of prescription, outcome and adverse event of selected studies and the risk of bias was assessed by using Cochrane's risk of bias tool. Results: Among the total 988 studies, 10 studies met the inclusion criteria. All of the studies were randomized controlled studies and written in Chinese. In all studies, Gyejibongnyeong-hwan was effective in improving chronic pelvic inflammatory disease. Conclusions: This study suggests that Gyejibongnyeong-hwan can be effective in treating chronic pelvic inflammatory disease compared to antibiotics treatment. Further large and well-established randomized placebo controlled trials will be needed.

요추 척추관 협착증에 대한 전침 치료의 효과: 체계적 문헌고찰 및 메타분석 (Electroacupuncture for Lumbar Spinal Stenosis: A Systematic Review and Meta-Analysis)

  • 나복연;손우석;김영준;우창훈
    • 한방재활의학과학회지
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    • 제33권3호
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    • pp.67-78
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    • 2023
  • Objectives To evaluate the evidence supporting the efficacy and safety of electroacupuncture for lumbar spinal stenosis. Methods We searched eight electronic databases (PubMed, EMBASE, Cochrane Library, Chinese Academic Journals, Research Information Sharing Service, ScienceOn, KMBASE, DBpia) and related two journals up to March 2023. We included randomized controlled trials of testing electroacupuncture for lumbar spinal stenosis patients. The methodological quality of relevant randomized controlled trials assessed by the Cochrane risk of bias tool. Results Among 90 articles that were searched, seven randomized controlled trials involving 474 participants were finally selected in this systematic review. Electroacupuncture was more effective on lumbar spinal stenosis compared with other treatments including analgesics, acupuncture, bed rest and exercise therapy, but showed ambiguous effect compared with physical therapy. Most of the side effects and adverse reactions were reported as minor and temporary. Conclusions Electroacupuncture for lumbar spinal stenosis was more effective than analgesics, acupuncture, bed rest and exercise therapy. In terms of safety, it was limited because there are many papers that do not mention side effects and adverse reactions related to electroacupuncture. Additional studies are needed to determine the effect of electroacupuncture on lumbar spinal stenosis.

요실금의 매선 치료에 대한 무작위 대조군 연구의 문헌고찰 (A Review of Randomized Controlled Trials of Catgut Embedding Therapy for Urinary Incontinence)

  • 이현주;이희윤;박장경;윤영진
    • 대한한방부인과학회지
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    • 제37권2호
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    • pp.58-74
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    • 2024
  • Objectives: This study aims to evaluate the efficacy of urinary incontinence treatment using catgut embedding therapy. Methods: Using electronic databases including Pubmed, EMBASE, and CAJ, we looked for randomized controlled trials that treated urinary incontinence with catgut embedding that were published between January 2000 and December 2023. The chosen clinical studies' interventions and outcomes were examined. Results: Ultimately, eight randomized controlled trials met the inclusion and exclusion criteria. Treatment group was treated with catgut embedding alone in 3 studies, and with Biofeedback Electrical Stimulation Therapy (Biofeedback EST), Kegel exercises, Herbal Medicine and Acupuncture Injection in 5 studies. Control group was treated with Biofeedback EST, Kegel exercises, Herbal Medicine, Vitamin B, Electroacupuncture (EA), Denitine Tolterodine Tartrat with Bladder Drill, Tension-free Vaginal Tape Obturator (TVT-O) and Acupoint Injection Therapy. Outcome measures are total efficacy rate, Urine pad test, Urinary frequency, Maximum bladder capacity, VRP, POP-Q, etc. 關元 (CV4) was the most frequently used acupoint in catgut embedding therapy. In all of 8 studies, treatment group was more effective for urinary incontinence than the control group. Conclusions: According to this study, catgut embedding may be useful in enhancing the therapeutic outcome for urine incontinence, either by itself or in conjunction with standard medical treatment.

치료적 운동을 포함한 도인운동의 어깨 통증에 대한 적용 가능성 탐색: 체계적 문헌고찰 및 메타 분석 (Applicability of Daoyin Exercise with Therapeutic Exercise for Shoulder Pain: A Systematic Review and Meta-analysis)

  • 박현선;박상현;이지호;박서현;금동호
    • 한방재활의학과학회지
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    • 제33권4호
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    • pp.79-93
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    • 2023
  • Objectives The purpose of this study is to investigate therapeutic exercise and to provide the evidence of daoyin exercise for shoulder pain. Methods Electronic databases including PubMed, EMBASE, China National Knowledge Infrastructure, Science ON, Oriental Medicine Advanced Searching Integrated System were searched up to October 2022. We selected randomized controlled trials. The quality of studies was assessed by Cochrane risk of bias tool. Meta-analysis were perfomed by Review Manager software. Results Eighteen randomized controlled trials were collected in accordance with the selection and exclusion criteria. Among the 18 trials, 7 trials used strengthening exercise, 4 trials used stablilization exercise, 5 trials used both types of intervention, and 2 trials used daoyin exercise. The study characteristics, results and method of intervention were analyzed. Meta-analysis showed that therapeutic exercise appeared to more effective than no treatment group for shoulder pain (standardized mean difference=-1.18, 95% confidence interval=-1.44 to 0.91, Z=8.82, p<0.00001; chi2=2.71, p=0.61; I2=0%). Conclusions All of 18 selected studies reported the effectiveness of therapeutic exercise for shoulder pain. Combining strengthening and stablilization exercise is considered the most efficient way for shoulder pain. Based on this study, well-designed studies should be performed to be evidence of the use of daoyin exercise for shoulder pain.