• 제목/요약/키워드: Randomized controlled trials

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유방암 환자의 림프부종에 대한 한의학적 치료 : 체계적 문헌 고찰 (The Effect of Traditional Medicine for Lymphedema in Breast Cancer Patients: A Systematic Review)

  • 박찬란;이가영;손창규;조정효;이남헌
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.343-355
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    • 2019
  • Objectives: Traditional oriental medicine is used in treating breast cancer-related lymphedema to alleviate symptoms. Upper limb lymphedema is a symptom that is frequently observed in patients with breast cancer, and it impairs their quality of life. This systematic review aimed to summarize the current available evidence to evaluate the effect of traditional oriental medicine on upper limb lymphedema in breast cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of herbal medicine, acupuncture, and moxibustion on upper limb lymphedema in breast cancer patients within four electronic databases. The Cochrane risk of bias (ROB) tool was used to assess the quality of the RCTs. Results: In total, 23 RCTs met the inclusion criteria. Among them, 22 studies reported that the rate of severity of lymphedema improved after treatment in the traditional treatment group using herbal medicine, acupuncture, or moxibustion better than in the conventional medicine group. The methodological quality of the RCTs was insufficient with an unclear and high ROB. Conclusions: Traditional oriental medicine may have a potential to improve lymphedema in patients with breast cancer. To confirm the clinical recommendation, further research with a rigorous study design is required to support the effects of traditional oriental medicine.

급성췌장염의 전침치료에 대한 체계적 문헌 고찰 (Systematic Review on Electroacupuncture for Acute Pancreatitis)

  • 황현호;주성민;장인수;정민정
    • 대한한방내과학회지
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    • 제40권4호
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    • pp.649-662
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    • 2019
  • Objective: The purpose of this study was to investigate the effect of electroacupuncture on acute pancreatitis (AP). Method: The search engines that were used included PubMed, CNKI, OASIS, NDSL, the Korean Traditional Knowledge Portal, and J-STAGE. The search period was from the creation of the search engine to May 6, 2019; there were no language limitations. Extractions and selections from the literation were made by two authors. The study included randomized controlled trials with electroacupuncture for patients with acute pancreatitis. Cochrane's risk of bias (RoB) was used as the methodological quality assessment scale. Results: Nine studies were finally selected. It was observed that using electroacupuncture with general Western medicine treatment for AP was more effective than using only general Western medicine treatment. Although most of the studies showed a high risk of bias, there were significant differences among the indicators. Conclusion: The electroacupuncture treatment with Western medicine may be more effective in reducing symptoms of AP than Western medicine alone. However, due to the limitations of the research design, it was not enough to obtain reliable information. As a result, high quality research will be additionally required.

월경통의 한의학적 치료에 대한 국내 임상 연구 경향 : 체계적 문헌 고찰 (Review of Domestic Clinical Research about Dysmenorrhea: A Systematic Review of Clinical Studies in Korean Medical Journals)

  • 고지윤;권기현;신현수;이주현;조승완
    • 대한한방내과학회지
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    • 제40권4호
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    • pp.612-628
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    • 2019
  • Objective: The aim of this review was to investigate clinical studies on Korean medical treatments for dysmenorrhea. Method: Using the keywords "dysmenorrhea," "Korean medical treatment," "acupuncture," and "herbal medicine," searches were conducted using domestic databases, including the National Discovery for Science Leaders (NDSL), the Research Information Sharing Service(RISS), and the Oriental Medicine Advanced Searching Integrated System (OASIS). The keywords were combined in various ways, instead of being searched individually. Papers that did not cover clinical studies or were not matched with the subject, absent of the abstract and text, were excluded. Results: Using the above searching method, 20 studies were found. Of these, 15 were in the form of case reports and five were in the form of randomized controlled trials. Acupuncture, herb medicine, pharmacopuncture, moxibustion, and cupping were used as treatments for dysmenorrhea. All of these studies reported that the Korean medical treatment was effective. Conclusion: According to the results, Korean medical treatments can provide an effective treatment for dysmenorrhea. However, more clinical studies on dysmenorrhea should be conducted for further clinical applications.

Effectiveness of worksite-based dietary interventions on employees' obesity: a systematic review and meta-analysis

  • Park, Seong-Hi;Kim, So-Young
    • Nutrition Research and Practice
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    • 제13권5호
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    • pp.399-409
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    • 2019
  • BACKGROUND/OBJECTIVES: This study was designed to provide scientific evidence on the effectiveness of worksite-based dietary intervention to reduce obesity among overweight/obese employees. MATERIALS/METHODS: Electronic search was performed using Ovid Medline, Embase, Cochrane Library, and CINAHL databases. The keywords used were "obesity," "nutrition therapy," and "worksite." The internal validity of the randomized controlled trials (RCTs) was assessed using the Cochrane's Risk of Bias. Meta-analysis of selected studies was performed using Review Manager 5.3. RESULTS: A total of seven RCTs with 2,854 participants were identified. The effectiveness of dietary interventions was analyzed in terms of changes in weight, body mass index (BMI), total cholesterol, and blood pressure. The results showed that weight decreased with weighted mean difference (WMD) of -4.37 (95% confidence interval (CI): -6.54 to -2.20), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). BMI also decreased with WMD of -1.26 (95% CI: -1.98 to -0.55), but the effectiveness was statistically significant only in short-term programs < 6 months (P = 0.001). Total cholesterol decreased with WMD of -5.57 (95% CI: -9.07 to -2.07) mg/dL, demonstrating significant effectiveness (P = 0.002). Both systolic (WMD: -4.90 mmHg) and diastolic (WMD: -2.88 mmHg) blood pressure decreased, demonstrating effectiveness, but with no statistical significance. CONCLUSIONS: The worksite-based dietary interventions for overweight/obese employees showed modest short-term effects. These interventions can be considered successful because weight loss was below approximately 5-10 kg of the initial body weight, which is the threshold for the management of obesity recommended by the Scottish Intercollegiate Guideline Network (SIGN).

소아 1형 당뇨의 한약과 양약 병용 치료에 대한 체계적 문헌 고찰 및 메타분석 (Efficacy of Combination Treatment of Herbal Medicine and Western Medicine for the Treatment of Type 1 Diabetes in children : Systemic Review and Meta-analysis)

  • 김미연;강정인;정민정
    • 대한한방소아과학회지
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    • 제33권3호
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    • pp.15-29
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    • 2019
  • Objectives The purpose of this study is to investigate the clinical studies on the effect of herbal medicine in type 1 diabetes in children and to seek better approach of herbal medicine to treat type 1 diabetes in children. Methods This study researched randomized controlled trials through various databases in the world about herbal medicine treatments in type 1 diabetes in children. Results 10 out of 337 studies were selected and analyzed. All studies were conducted in China. All studies were using herbal medicines, as an adjunctive treatment to the main regimen. As a result, the integrated Chinese medicine and western medicine lowered FPG by -1.56 mmol/L and 2hPG by -1.94 mmol/L on average, respectively. The HbA1c also decreased by -1.11% in the treatment group compared to the control group. Total efficacy of the treatment was 1.21 times more effective in the treatment group than in the control group. Conclusions Based on the results of the studies, it seems that the herbal medicine for the treatment of type 1 diabetes in children will be effective as a combination with conventional medicines. Further research is needed to prove the findings of this observatoional studies.

CNKI 검색을 통한 중국에서의 성장통의 한의학적 치료에 대한 임상연구 동향 (Review of Clinical Studies of Traditional Chinese Medicine Treatment for Growing Pains in China using CNKI Database)

  • 도태윤;박슬기;이선행;이진용
    • 대한한방소아과학회지
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    • 제33권2호
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    • pp.32-47
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    • 2019
  • Objectives The purpose of this study is to investigate clinical studies on the effectiveness of Traditional Chinese Medicine treatment on growing pains in China, and to seek better methods to treat and study for growing pains in South Korea. Methods The clinical studies from the China Academic Journal (CAJ) in China National Knowledge Infrastructure (CNKI) that were published up to January 2019 were reviewed. The key word used were '生長痛', '發育期痛', '治療', '中?治療', '中藥'. Then, the literature were analyzed in regards to the treatment methods and results. Results Among the 35 searched studies, 1 randomized controlled trials, 16 case series, and 3 case reports were selected and analyzed. In most of the studies, the effectiveness of Traditional Chinese Medicine treatment on growing pains was significantly positive. The most commonly used herbs for oral administration were Glycyrrhizae Radix et Rhizoma (甘草), Achyranthis Bidentatae Radix (牛膝), Paeoniae Radix Alba (白芍藥), Dioscoreae Rhizoma (山藥), Angelicae Gigantis Radix (當歸), Astragali Radix (黃?), Atractylodis Rhizoma Alba (白朮), Poria Sclerotium (茯?) Rehmanniae Radix Preparata (熟地黃), Lycopodii Herba (伸筋草). Other treatment methods such as, external application of herb medicine, massage, acupuncture were also used to treat growing pains. Conclusion Based on the results of the clinical studies from China, the use of chinese medicine for treatment of growing pains has been shown to be effective. Additional clinical studies are needed to confirm these findings.

Fall prevention strategies in community-dwelling older adults aged 65 or over with type 2 diabetes mellitus: a systematic review and meta-analysis

  • Hwang, Sujin;Woo, Youngkeun
    • Physical Therapy Rehabilitation Science
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    • 제7권4호
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    • pp.197-203
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    • 2018
  • Objective: Independent walking is the most essential prerequisite to maintain quality of life in older persons. The purpose of this review was to investigate the effect of fall prevention strategies on fall risk for type 2 diabetes mellitus (T2DM) within community-dwelling older adults aged 65 and over. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to October 31st, 2018 and randomized controlled trials (RCTs) evaluating fall prevention strategies for fall risk in persons who were 65 years of age or above with T2DM were included. The review extracted the following information from each study selected: first author's surname, published year, country, study population, type of intervention, intensity of intervention, comparison, measurement variables, additional therapy, summary of results, and mean and standard deviation from selected studies. Results: This review selected fourteen RCTs with 460 older adults with diabetes mellitus. Of the 14 studies, the types of intervention used to improve the risk of falls were strengthening (5), aerobic exercises (2), multimodal exercises (4), one virtual reality exercise (1), whole body vibration with balance exercise (1), and Tai Chi exercise (1). Seven RCTs were eligible for the meta-analysis. Therapeutic interventions were more effective than the control group for the Timed Up-and-Go test (-1.11; 95% CI, -1.82 to -0.41) and the 6-minute Walk Test (-1.89; 95% CI, -8.33 to 4.54). Conclusions: The results of the review suggest that interventions to prevent fall risk in older adults with T2DM should focus on strengthening, balance, aerobic, and multimodal exercises.

Long-term assessment of periodontal disease progression after surgical or non-surgical treatment: a systematic review

  • Sanz-Martin, Ignacio;Cha, Jae-Kook;Yoon, Sung-Wook;Sanz-Sanchez, Ignacio;Jung, Ui-Won
    • Journal of Periodontal and Implant Science
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    • 제49권2호
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    • pp.60-75
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    • 2019
  • The primary aim of this systematic review was to assess the evidence on periodontal disease progression after treatment in patients receiving supportive periodontal therapy (SPT) and to identify predictors of clinical attachment level (CAL) loss. A protocol was developed to answer the following focused question: In adult patients treated for periodontitis, what is the disease progression in terms of CAL loss after surgical or non-surgical treatment? Randomized controlled clinical trials, prospective cohort studies, and longitudinal observational human studies with a minimum of 5 years of follow-up after surgical or non-surgical treatment that reported CAL and probing depth changes were selected. Seventeen publications reporting data from 14 investigations were included. Data from 964 patients with a follow-up range of 5-15 years was evaluated. When the CAL at the latest follow-up was compared to the CAL after active periodontal therapy, 10 of the included studies reported an overall mean CAL loss of ${\leq}0.5mm$, 3 studies reported a mean CAL loss of 0.5-1 mm, and 4 studies reported a mean CAL loss of >1 mm. Based on 7 publications, the percentage of sites showing a CAL loss of ${\geq}2mm$ varied from 3% to 20%, and a high percentage of sites with CAL loss was associated with poor oral hygiene, smoking, and poor compliance with SPT. The outcomes after periodontal therapy remained stable over time. Disease progression occurred in a reduced number of sites and patients, mostly associated with poor oral hygiene, poor compliance with SPT, and smoking.

Motor imagery on upper extremity function for persons with stroke: a systematic review and meta-analysis

  • Lee, Dongsu;Hwang, Sujin
    • Physical Therapy Rehabilitation Science
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    • 제8권1호
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    • pp.52-59
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    • 2019
  • Objective: The purpose of this review was to investigate whether motor imagery training has an effect on the recovery of upper extremity function in individuals with hemiparetic stroke or not. Design: A systematic review and meta-analysis. Methods: PubMed and three other databases were searched up to December 18th, 2018 and randomized controlled trials (RCTs) evaluating motor imagery training on upper extremity function in persons with a diagnosis of hemiparetic stroke were included. This review selected the following information from each study: surname of the first author, published year, nation, population, intervention, therapeutic intensity of intervention, therapeutic comparison, outcome measures, additional therapy, summary of results, and descriptive statistics of outcome measures. Results: This review selected seventeen RCTs with 487 stroke survivors and the following intervention methods: six motor imagery training with additional therapeutic technology, two motor imagery training with additional modified constraint-induced therapy, four mirror therapy, and five motor imagery training. Ten RCTs were eligible for meta-analysis after systematic review. The motor imagery group were more effective than the control group based on the Fugl-Meyer assessment (3.43; 95% confidence interval [CI], 1.65 to 5.22; heterogeneity [$chi^2=8.03$, df=8, $I^2=0%$], test of overall effect Z=3.76; test for subgroup differences [$chi^2=2.56$, df=2, $I^2=21.8%$]) and the Action Research Arm Test (1.32; 95% CI, -8.12 to 10.76; heterogeneity [$Tau^2=70.74$, $chi^2=15.22$, df=3, $I^2=80%$], test of overall effect Z=3.76). Conclusions: The results of this review suggests that motor imagery shows positive effectiveness on improving upper extremity function in persons with hemiparetic stroke.

Systematic Review of Acupuncture Treatment for Mild Cognitive Impairment

  • Kim, Min Wook;Yoo, Jae Hee;Go, Hong Je;Kim, Seon Woo;Jang, Seung Won;Jeong, Hyun Jin;Kim, Jae Hong
    • Journal of Acupuncture Research
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    • 제36권2호
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    • pp.72-79
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    • 2019
  • Background: The aim of this study was to review clinical efficacy of acupuncture treatment of mild cognitive impairment. Methods: Randomized controlled trials that performed acupuncture treatment for mild cognitive impairment were retrieved from 6 online databases (PubMed, Cochrane Library, EMBASE, CNKI, NDSL, OASIS) on September $30^{th}$, 2018. Studies were selected according to inclusion and exclusion criteria, and were reviewed by Risk of Bias assessment. Results: In total, 21 studies were included in this review. All studies were Chinese (19 studies published in Chinese and 2 in English). The sample size, 50 to 100, and the number of treatment times, 20 to 30, were the largest range in all studies. The most treatments performed was 30. The longest treatment period was 56 days, which accounted for 33% of the studies. The most frequently used evaluation index was the Mini Mental State Examination followed by the Montreal Cognitive Assessment, each used 17 times and 15 times, respectively. The most frequently used acupoints were GV20, EX-HN1, GB20, and GV24, which accounted for 47% of total number of acupoints used. In 48% of the studies, needle retention time was 30 minutes. Western medicine treatment was the most common control group. Most studies reported that the intervention group was statistically significantly different to the control group. Conclusion: These results suggest that acupuncture for mild cognitive impairment was effective. However, it is difficult to confirm this conclusion because the quality of most of these studies were of low quality.