• 제목/요약/키워드: Randomized controlled trials

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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.

Effect of Marham-i-Raal on Episiotomy Wound Healing: A Single-Arm pre-and post-treatment study

  • Sultana, Arshiya;Joonus, Aynul Fazmiya Mohamed;Rahman, Khaleequr
    • 셀메드
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    • 제11권4호
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    • pp.17.1-17.4
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    • 2021
  • Episiotomy is the commonest obstetrics intervention in the world to reduce severe perineal injuries. Its prevalence is 43% to 100% in primiparous women in Asia. Further, worldwide approximately 10-95% of pregnant women undergo episiotomy incision during birth. Delay in wound healing probably increases the risk of wound infection, changes the muscular structure, and ultimately causes muscle tone loss. So, wound care is of specific significance to postnatal maternal outcomes. Hence, this case study aimed to evaluate the effect of Marham-i-Raal in episiotomy wound healing and pain relief. The study was conducted in eleven postpartum primi or multipara pregnant women aged between group 19 and 35 years with term gestational age, singleton pregnancy in a cephalic presentation who had a normal vaginal delivery with mediolateral episiotomy, without a perineal tear, and perineal hematoma. Externally, application of Marham-i-Raal 2g on episiotomy incisional wound, twice a day for 10 days was advised. Wound healing of episiotomy and pain intensity was assessed with REEDA ["redness, oedema, ecchymosis, discharge and approximation of the edges"] scoring and VAS scoring for pain intensity respectively. At one hour (baseline), the REEDA mean score of eleven patients was 3.90±1.04 whereas on day 7-10 it was 0.18±0.40 with statistically significant difference (p<0.001). The VAS mean score at one hour was 6.90±1.22 whereas on day 7-10 it was 0.72±0.78 with a statistically significant difference (p<0.001). Marham-i-Raal would be effective in episiotomy wound healing and reducing pain intensity. Further, randomized double-blind controlled trials in large sample size are recommended.

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.

구강건조증에 대한 경피적전기신경자극(Transcutaneous electrical nerve stimulation)의 최근 임상연구 동향 고찰 - Pubmed와 국내 논문을 중심으로 (A Review of Recent Clinical Studies of Transcutaneous Electrical Nerve Stimulation (TENS) on Xerostomia - PubMed and Domestic Studies)

  • 이은경;전혜진;김민정;박재우;고석재
    • 대한한방내과학회지
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    • 제43권3호
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    • pp.375-386
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    • 2022
  • Objectives: The purpose of this study was to summarize current clinical study trends and results regarding transcutaneous electrical nerve stimulation (TENS) treatment for xerostomia. Methods: Studies published from 2017 to 2022 were searched on domestic databases and PubMed. The included studies were analyzed according to the year, language, study design, diagnosis xerostomia method, and TENS treatment method. Results: Nine studies were included. There were three randomized controlled trials (RCTs), three case series, one case report, one case-control study, and one cross-sectional study. Conventional TENS was used in seven studies, and acupuncture-like TENS (ALTENS) was used in one study. The most common TENS attachment site was externally on the skin overlying the parotid gland region, and the setting of TENS was 50 Hz-250 μs the most. In all nine studies, TENS was effective for xerostomia as assessed by salivary flow rate or quality of life questionnaire. Additionally, no persistent adverse events were reported after TENS treatment. Conclusions: TENS treatment for xerostomia can be considered effective and safe, so it can be used in clinical practice.

사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰 (A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine)

  • 오현주;이정윤;이혜리;이준희
    • 사상체질의학회지
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    • 제34권2호
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    • pp.48-64
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    • 2022
  • Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane's risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution-specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients' motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.

과민성 대장증후군 환자를 대상으로 수행된 한약 및 침구치료의 객관적 효과와 기전 연구에 대한 문헌고찰 (Review on the Objective Effect and Mechanism Studies of Herbal Medicine, Acupuncture and Moxibustion Treatment for Irritable Bowel Syndrome Patients)

  • 노현덕;김민정;조임학;김소연
    • 동의생리병리학회지
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    • 제35권5호
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    • pp.199-209
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    • 2021
  • The purpose of this study was to explore objective indicators(outcomes) which are used to evaluate clinical efficacy and figure out the mechanisms of herbal medicine, acupuncture and moxibustion treatment for Irritable bowel syndrome(IBS). We searched randomized controlled trials(RCTs) that mediated with herbal medicine, acupuncture and moxibustion treatment for IBS and used objective indicators for outcome from November 1, 2020 to December 31, 2020. The RCTs that were published in Korean, English and Chinese were included in this study. The selected literatures were analyzed about methods of result measurement and assessed by Cochrane's risk of bias(RoB). Total 18 RCTs were included in this study. There were lots of objective indicators for result measurement; the concentration of hormones in blood and neurotransmitters, the sensitivity of rectum, the functional assessment of central nerve and autonomic nerve system, the change of intestinal flora, the concentration of serum cytokines. Various objective indicators can be used to evaluate the clinical efficacy of with herbal medicine, acupuncture and moxibustion treatment for IBS, but due to the limitations of the quality of the included studies, systematic review and meta-analysis will be needed.

슬개대퇴통증증후군의 침 치료에 대한 체계적 문헌고찰의 프로토콜 (Acupuncture Treatment for Patellofemoral Pain Syndrome: A Protocol for a Systematic Review)

  • 지민준;서경준;김호걸;구지향;하현주;오민석
    • 한방재활의학과학회지
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    • 제32권3호
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    • pp.29-35
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    • 2022
  • Objectives The purpose of this systematic review is to analyse randomized controlled trials about acupuncture for patellofemoral pain syndrome (PFPS) and evaluate it's pain improvement effect. Methods Studies will be searched from ten databases (Medline/PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure [CNKI], WanFang Data, Citation Information by NII [CiNII], ScienceON, Koreanstudies Information Service System [KISS], KMBASE, and KoreaMed). Participants will be patients diagnosed with PFPS, regardless of cause, gender, age or race, and interventions will be acupuncture, electroacupuncture, dry needling, fire needle, and acupotomy. Other treatments than interventions will be the control group and the main outcome will be reviewed by visual analogue scale (VAS). Results Data will be extracted and assessed according to the Preferred Reporting Items for Systematic Review and Meta-Analysis flow chart and Cochrane risk of bias tools. Meta-analysis will be conducted using random effect model within 95% confidence interval. Conclusions We expect this systematic review to provide useful data about the pain improvements of patellofemoral pain using acupuncture and expect to stimulate and systematize acupuncture treatment on PFPS in the future.

가상현실을 이용한 모아간호 실습교육이 간호 대학생의 실습역량에 미치는 영향: 체계적 문헌고찰 (The effects of maternal-child nursing clinical practicum using virtual reality on nursing students' competencies: a systematic review)

  • 황성우;김현경
    • 여성건강간호학회지
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    • 제28권3호
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    • pp.174-186
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    • 2022
  • Purpose: This study aimed to investigate the effects of virtual reality used in maternal-child nursing clinical practicums on nursing students' competencies through a systematic review. Methods: The inclusion criteria were peer-reviewed papers in English or Korean presenting analytic studies of maternal-child nursing practicums using virtual reality. An electronic literature search of the Cochrane Library, CINAHL, EMBASE, ERIC, PubMed, and Research Information Sharing System databases was performed using combinations of the keywords "nursing student," "virtual reality," "augmented reality," "mixed reality," and "virtual simulation" from February 4 to 15, 2022. Quality appraisal was performed using the RoB 2 and ROBINS-I tools for randomized controlled trials (RCTs) and non-RCTs, respectively. Results: Of the seven articles identified, the RCT study (n=1) was deemed to have a high risk of bias, with some items indeterminable due to a lack of reported details. Most of the non-RCT studies (n=6) had a moderate or serious risk of bias related to selection and measurement issues. Clinical education using virtual reality had positive effects on knowledge, skills, satisfaction, self-efficacy, and needs improvement; however, it did not affect critical thinking or self-directed learning. Conclusion: This study demonstrated that using virtual reality for maternal-child nursing clinical practicums had educational effects on a variety of students' competencies. Considering the challenges of providing direct care in clinical practicums, virtual reality can be a viable tool that supplements maternal-child nursing experience. Greater rigor and fuller reporting of study details are required for future research.

두드러기의 한약 치료에 대한 최근 국내외 임상 연구 동향 (Research Trend of Herbal Medicine Treatments for Urticaria)

  • 남혜진;박재은;김현진;안재영;신나영;전명규;이영진;채고은;고아라;조혜정;김현우
    • 한방안이비인후피부과학회지
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    • 제35권2호
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    • pp.49-60
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    • 2022
  • Objectives : The purpose of this review is to overview the research trend of herbal medicine for urticaria. Methods : We searched for studies of urticaria treated with herbal medicine published from 2010 until March 2022, through 5 web databases. After searching studies, we analyzed selected studies. Results : As a result, 7 studies have been found and analyzed. Three studies were randomized controlled trials, and four studies were before & after clinical research. All of research which selected have reported that herbal medicine treatment was effective for urticaria. Conclusion : According to the results, herbal medicine treatments can be effective treatment for urticaria. Further clinical studies are expected using evaluation methods to analyze the results and to establish high level of evidence.