• 제목/요약/키워드: Randomized controlled trials

검색결과 1,181건 처리시간 0.03초

Comparison of Ligasure Versus Conventional Surgery for Curative Gastric Cancer Resection: a Meta-Analysis

  • Hu, Tian-Peng;He, Xiang-Hui;Meng, Zhao-Wei;Jia, Qiang;Tan, Jian;Li, Xue
    • Asian Pacific Journal of Cancer Prevention
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    • 제17권4호
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    • pp.2049-2053
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    • 2016
  • Background: The LigaSure vessel sealing system has been proposed to save operation time and reduce intraoperative blood loss for various surgeries. However, its usage for gastric cancer is still controversial. The aim of the present meta-analysis was to compare the effectiveness of LigaSure with conventional surgery in gastrectomy. Materials and Methods: Sources were retrieved from the Cochrane Library, MEDLINE, EMBASE, SCOPUS and Google Scholar until February, 2015. All randomized controlled trials comparing LigaSure with conventional surgery in curative gastric cancer resection were selected. After data extraction, statistics were performed by Review Manager 5.1 software. Results: Three eligible randomized controlled trials were evaluated, with a total of 335 patients. The quality of the included trials was good, yet some methodological and clinical heterogeneity existed. There were no significant differences between the LigaSure and conventional groups in operative time (weighted mean difference [WMD], -22.95 minutes; 95% confidence interval [CI], [-59.75, 13.85]; P = 0.22), blood loss (WMD, -45.8 ml; 95% CI, [-134.5, 42.90]; P = 0.31), nor the incidence of surgical complications (odds ratio, 1.18; 95% CI, [0.68, 2.05]; P = 0.54). But there was a longer duration of hospital stay in LigaSure group (WMD, 1.41 days; 95% CI, [0.14, 2.68]; P = 0.03). Conclusions: All available randomized evidence has been summarized. LigaSure does not confer significant advantage over conventional surgery for curative gastric cancer resection. The usefulness of the device may be limited in gastrectomy. But, more trials are needed for further assessment of the LigaSure system for gastric cancer.

국내 교통사고 후유증의 침치료에 대한 체계적 문헌고찰 (Acupuncture for Rehabilitation in Patients with Traffic Accident in South Korea: a Systematic Review)

  • 김건형;남동우;강중원;이재동;최도영
    • Journal of Acupuncture Research
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    • 제27권1호
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    • pp.21-29
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    • 2010
  • Objectives : This study aims to evaluate current clinical evidence of acupuncture treatment for rehabilitation in patients with traffic accident in South Korea. Methods : Seven Korean databases were searched for prospective clinical trials for acupuncture on rehabilitation in patients with traffic accident from their inception to June, 2009. Only studies conducted in Korean language were searched. Risk of bias in included randomized controlled trials were assessed by Cochrane Handbook procedure. Results : Fifteen clinical trials were included among 31 studies searched. Eight were observational studies, five were non-randomizedcontrolled trials, and two were randomized controlled trials. In all of included studies, acupuncture were conducted with other concomitant treatment. Included studies dealt with such conditions as neck pain, low back pain tinnitus after traffic accident, post-traumatic stress, oculomotor nerve palsy, diplopia and insomnia. All of included studies reported favorable effects of acupuncture group compared to baseline or control group. All of included studies lacked the occurrence of adverse events. High risk of bias were observed in two randomized controlled trials. Conclusions : There is no evidence that acupuncture is effective for rehabilitation of traffic accident. All of included studies lacked appropriate methodological qualities and internal validity. Future welldesigned clinical trials that evaluate the effects and safety of acupuncture treatment for rehabilitation in patients with traffic accident is needed.

대체의학 임상실험 현황에 대한 문헌고찰 (A Literature Review of Clinical Trials on Alternative Medicine)

  • 조현;유진영;박수희
    • 한국산학기술학회논문지
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    • 제11권11호
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    • pp.4395-4403
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    • 2010
  • 본 연구는 2000년 1월부터 2010년 3월까지 Pubmed에 게재된 논문 중, alternative medicine 으로 검색하여 근거중심 대체의학에 대한 연구 현황을 알아보고자 문헌고찰을 하였다. 682편의 연구 중 대체의학에 관한 임상연구는 19개였으며 연구전체 대상자는 2,573명이었다. 논문분석 결과 RCT(Randomized Controlled Trial) 실험 설계연구가 44%였으며 CCT(Controlled Clinical Trials)가 16%, OD(efficacy studies with either a controlled or an Other than controlled Design) 40%였다. 가장 많은 임상실험이 시행된 중재 방법은 Acupuncture과 Massage 였다. 대상 질병군 분포는 근골격계 및 결합조직의 질환과 관련된 '통증 완화'에 대한 임상연구가 20%, 다음으로 특정 감염성 및 기생충성 질환, 신생물이 각각 15% 순이었다. 근거중심 대체의학 현황을 파악하고자 문헌 고찰한 결과 대체의학을 통한 중재가 질병치료에 효과가 있는지에 대한 과학적 근거를 제시한 임상연구가 부족하다. 대체의학의 품질, 안정성, 유효성 확보를 위해 대체의학에 대한 질 높은 연구필요하며 근거중심 대체의학의 활성화가 필요할 것으로 생각된다.

봉침을 이용한 무작위배정 비교임상시험연구에서의 유해사례 보고에 대한 체계적 문헌고찰 (Reporting of Adverse Events in Randomized Controlled Trials of Bee Venom Acupuncture: A Systematic Review)

  • 이운섭;김성수
    • 한방재활의학과학회지
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    • 제24권4호
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    • pp.97-109
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    • 2014
  • Objectives Bee venom acupuncture (BVA) is emerging as a potential therapeutic option for several conditions. However, evidence regarding accurate estimates of its adverse events are not available. Therefore, by combining occurrence rates of adverse events in relevant randomized controlled trials (RCTs), we have aimed to give an overall estimated rate of each adverse event following BVA intervention. Methods A systematic search for adverse events of BVA in Pubmed, Cochrane Central Register of Controlled Trials, Embase, NDSL, KoreaMed, KISS, RISS, KISTI, and KMbase was performed. For the quality assessment of the trials, we applied the CONSORT harms reporting recommendations. The overall occurrence rate of each adverse event was assessed as the primary outcome. The overall drop-out rate due to adverse events was assessed as the secondary outcome. Results Ten RCTs reported adverse events following BVA. Two RCTs were eligible of further synthesis. Adverse events of pruritus, localized edema, and erythema occurred significantly more frequently in the BVA group compared to the control group. Data of drop-outs were available in seven RCTs. However, no comparisons showed a significant difference. Conclusions Currently evidence of adverse events is far from sufficient for assessing a reliable, precise occurrence rate. Still, limited evidence shows a tendency that adverse events occur more frequently after the appliance of BVA compared to the control. Thus, we await well designed future studies of BVA with more proper and strict harms reporting methods.

Efficacy and Safety of Gabapentin in the Treatment of Chronic Cough: A Systematic Review

  • Shi, Guanglin;Shen, Qin;Zhang, Caixin;Ma, Jun;Mohammed, Anaz;Zhao, Huan
    • Tuberculosis and Respiratory Diseases
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    • 제81권3호
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    • pp.167-174
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    • 2018
  • Despite recent clinical guidelines, the optimal therapeutic strategy for the management of refractory chronic cough is still a challenge. The present systematic review was designed to assess the evidence for efficacy and safety of gabapentin in the treatment of chronic cough. A systematic search of PubMed, Embase, Cochrane Library databases, and publications cited in bibliographies was performed. Articles were searched by two reviewers with a priori criteria for study selection. Seven relevant articles were identified, including two randomized controlled trials, one prospective case-series designed with consecutive patients, one retrospective case series of consecutive patients, one retrospective case series with unknown consecutive status, and two case reports comprising six and two patients, respectively. Improvements were detected in cough-specific quality of life (Leicester Cough Questionnaire score) and cough severity (visual analogue scale score) following gabapentin treatment in randomized controlled trials. The results of prospective case-series showed that the rate of overall improvement of cough and sensory neuropathy with gabapentin was 68%. Gabapentin treatment of patients with chronic cough showed superior efficacy and a good safety record compared with placebo or standard medications. Additional randomized and controlled trials are needed.

선천성 근성 사경 환아에서 수기신장과 자세와 발달을 이용한 치료의 효과에 대한 무작위 연구 (The Effect of Manual Stretching and Positioning and Developmental Treatment in Congenital Muscular Torticollis: randomized Controlled Trials)

  • 이인희
    • 한국전문물리치료학회지
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    • 제16권1호
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    • pp.34-41
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    • 2009
  • The purpose of this study is to compare the outcomes of manual stretching treatment with those of motor development and positioning physical therapy (MDPPT) for congenital muscular torticollis (CMT). This study was designed to be randomized controlled trials and to evaluate the outcomes of 43 consecutive patients with CMT who were first seen when they were average 26 days old. Before treatments, the patients were unintentionallv classified into two clinical groups along with the treatment methods. Among the 43 patients, 22 were classified to the manual stretching group and 21 to the MDPPT group. By means of independent t-test on the result. the duration of treatment according to methods was not significantly different in two groups (p>.05). The duration of treatment in accordance with head tilt level was not significantly different in two groups (p>.05). There was change of mass diameter, between at the beginning day of treatment and after treatment in manual stretching group with a strong positive linear correlation (p=.000, r=.734), but slightly positive linear correlation in MDPPT group. The result of this study indicates that two therapeutic methods make little difference in effectiveness.

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기능성 자궁출혈에 대한 한약치료 : 체계적 문헌 고찰 (Traditional Herbal Medicine for Dysfunctional Uterine Bleeding versus Western Medicine: A Systematic Review of Randomized Controlled Trials)

  • 박어진;조희근;최지현
    • 대한한방부인과학회지
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    • 제31권4호
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    • pp.110-127
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    • 2018
  • Objectives: To evaluate the effectiveness and safety of traditional herbal medicine (THM) in the treatment of dysfunctional uterine bleeding (DUB) versus conventional western medicine. Methods: Randomized Controlled Trials (RCTs) comparing THM vs. conventional western medicine for DUB, were obtained from PubMed, Cochrane Library, Embase, CNKI, RISS, NDSL, KISS and OASIS. The risk of bias was assessed by using Cochrane's risk of bias tool. Results: 16 RCTs with 1,659 patients were identified and reviewed. 10 RCTs reported THM was statistically effective than control group in effective rate. Also recurrent rate was estimated in 6 RCTs and was lower than control group. 7 studies observed adverse events (AEs) and severe AEs were not reported. Conclusions: Despite several limitations, this review suggested that THM was safe and effective in the treatment of DUB. THM may also decrease the recurrence rate. However, this could not be proven conclusively. To ensure evidence-based clinical practice, more sternly designed trials are warranted.

위축성 질염에 대한 한약 투약의 효과 : 체계적 문헌 고찰 (Application of Traditional East Asian Herbal Medicine for Atrophic Vaginitis: A Systematic Review of Randomized Controlled Trials)

  • 박어진;조희근
    • 대한한방부인과학회지
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    • 제32권3호
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    • pp.227-244
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    • 2019
  • Objectives: To evaluate the effectiveness and safety of application of Traditional East Asian Herbal Medicine (TEAM) in the treatment of Atrophic Vaginitis (AV). Methods: Randomized Controlled Trials (RCTs) were obtained from PubMed, Cochrane Library, Embase, CNKI, RISS, NDSL, and KISS. The risk of bias was assessed by using Cochrane's risk of bias tool, and RevMan 5.3 software was used. Results: 26 RCTs with 3,162 patients were identified and reviewed. Among them, 21 RCTs observe the effect of integrated traditional Chinese and Western medicine. 23 RCTs reported treatment groups was statistically effective than control groups in the study. Also, the recurrence rate was estimated in 10 RCTs and was lower than control groups. 12 studies observed adverse events (AEs) and severe AEs were not reported. Conclusions: This review suggested that TEAM was safe and effective in the treatment of AV. TEAM may also decrease the recurrence rate. However, this could not be proven conclusively. To ensure evidence-based clinical practice, well-designed trials with larger sample sizes are needed.

임신오조의 한약 치료 효과에 대한 무작위 대조군 임상 연구 고찰 (A Review of Randomized Controlled Trials on the Treatment Effects of Herbal Medicine for Hyperemesis Gravidarum)

  • 이지원;안수연;김동철
    • 대한한방부인과학회지
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    • 제34권4호
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    • pp.62-77
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    • 2021
  • Objectives: This study aimed to anaylze randomized controlled trials on the effectiveness of herbal medicine for hyperemesis gravidarum. Methods: We searched the randomized controlled trials that intervented oral herbal medicine treatment on hyperemesis gravidarum retrieved using seven domestic and foreign databases. Literature search was conducted on April 19, 2021. Results: 185 studies were searched, and 7 were finally selected based on inclusion and exclusion criteria. All subjects were treated with western symptomatic treatment and in treatment group, additional oral herbal medicine was administered. Although the evaluation index was different for each study, all the indexes in the treatment group were significantly improved compared to the control group. Conclusions: Herbal medicine treatment for hyperemesis gravidarum showed significant effectiveness compared to western symptomatic treatment. In the future, additional studies are needed to evaluate the safety of herbal medicine treatment.

투렛장애 (Tourette syndrome)의 침 치료에 대한 중의학 임상 연구 고찰 (A Review of Clinical Researches for Acupuncture Treatment on Tourette Syndrome)

  • 김보람;최일신;김기봉;천진홍
    • 대한한방소아과학회지
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    • 제36권2호
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    • pp.13-25
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    • 2022
  • Objective This study aimed to analyze randomized controlled trials of the effect of acupuncture on Tourette syndrome and to evaluate the efficacy of the treatment. Methods Based on the China National Knowledge Infrastructure (CNKI) and Pubmed search with the key search terms of 'Tourette syndrome, acupuncture', dated from 2000 to 2021, ten randomized controlled trials were identified and analyzed for this study. Results 1. The most commonly used acupoints were Taechung (LR3), Sinmun (HT7), Hapgok (LI4), Pungji (GB20) and Backhoe (GV20). 2. The most commonly used meridians were Bladder Meridian, Stomach Meridian and Gallbladder Meridian. 3. Acupuncture treatment was found to be significantly more or equally effective than western medicine such as haloperidol and tiapride. Conclusions Based on the results of the randomized controlled trials analyzed in this study, acupuncture was found to be effective in the treatment of Tourette syndrome. However, more clinical studies are needed to prove the effectiveness of acupuncture in Tourette syndrome.