• 한방안이비인후피부과학회지
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• 제33권4호
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• pp.74-99
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• 2020

Objectives : The purpose of this study is to assess the effectiveness and safety of Socheongryong-tang(SCRT) for allergic rhinitis(AR). Methods : We searched randomized controlled trials(RCTs) that used SCRT for AR in 8 databases(PubMed, Cochrane Library, CNKI, CiNii Articles, OASIS, NDSL, KISS, KMbase) from their inception until August 2019. The primary outcome was effective rate and scores evaluating the improvement of AR symptoms. The secondary outcome was quality of life scale, adverse events, recurrence rate, and laboratory indicators. Two researchers assessed the risk of bias in the included trials through the Cochrane Risk of Bias tool independently. The study synthesized outcomes using RevMan 5.3. Results : Eighteen RCTs involving 1686 participants were included in this review. The risk of bias was unclear for the majority of the included studies. Meta-analysis of 12 RCTs showed that there was no statistically significant difference between the SCRT group and usual care group in the effective rate(RR 1.18, 95% CI(0.98, 1.41), p=0.09, I²=46%). Meta-analysis of 5 RCTs showed that the combination treatment group of SCRT and usual care was significantly higher than the usual care group in the effective rate(RR 1.24, 95% CI(1.12, 1.38), p<0.0001, I²=0%). The SCRT group was more effective in improving nasal symptoms and quality of life than the placebo group according to one RCT. Mild adverse events such as dry mouth were identified in 5 RCTs, but no serious adverse events were reported. Conclusion : This review showed that in terms of the effective rate for AR, there was no statistically significant difference between SCRT and usual care and the combination treatment of SCRT and usual care was more effective than usual care. There were no serious adverse events. However, it is difficult to make a definite conclusion because of few included studies and heterogeneity between studies, and the quality of included studies was mostly insufficient. Further well-designed randomized controlled trials are needed.

• 치위생과학회지
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• 제17권2호
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• pp.160-167
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• 2017

본 연구는 치주질환과 신장질환의 연관성을 알아보기 위한 체계적 고찰이다. Embase, PubMed, The Cochrane Library 데이터베이스에서 2016년 4월 17일 검색을 완료하였다. 문헌의 선택은 코호트 연구 설계를 기준으로 하였으며, 환자군은 치주질환 또는 중증의 치주질환이 있는 대상자로 하였다. 최종 결과는 만성신장질환의 발생이나 신장기능의 저하로 eGFR을 제시한 연구로 하였다. 최종 선정된 문헌의 양적합성을 위하여 Review Manager (RevMan) 통계 분석 소프트웨어를 이용하였다. 고정효과모형 멘텔-헨젤 방법(M-H)을 이용하여 메타분석을 시행하여 치주질환과 만성신장질환의 연관성을 추정하였다. 검색 전략을 이용하여 총 3,018개의 문헌이 검색되었고, 그 중 4개의 문헌이 최종 분석에 포함되어 메타 분석한 결과 치주질환이 만성신장질환 발생위험과 유의한 연관성이 있음이 나타났다(OR, 1.65; 95% CI, 1.44~1.90; p<0.001). 만성신장질환 발생 및 신장기능저하를 예방하기 위해서는 개인의 삶의 질 저하와 의료비용부담을 줄이기 위해 기존에 알려진 전통적 위험인자 외에 만성신장질환에 영향을 미치는 치주질환의 예방 및 관리의 필요성이 크다.

• 한방안이비인후피부과학회지
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• 제33권3호
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• pp.45-68
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• 2020

Objectives : This study aims to evaluate the effectiveness and safety of manual and electroacupuncture on glaucoma. Method : We searched 11 electronic databases using index words to identify randomized clinical trials. Meta-analysis of weighted mean difference (WMD) or standardized mean difference (SMD) were used to evaluate the outcomes. Cochrane bias risk assessment tool was used to assess the risk of bias in each clinical study. The collected data was analyzed using RevMan software (ver. 5.3). Results : At the initial stage of data retrieval, 549 papers were searched. After reviewing 37 full texts, a total of 10 RCT studies (426patients, 715 eyes) were selected and 8 RCT studies (357 people, 617 eyes) were involved in meta-analysis. Meta-analysis of 8 RCTs showed that acupuncture alone was more effective in reducing intraocular pressure(IOP) than conventional treatment (WMD = -5.73, 95% CI: [-12.30, 0.83], P = 0.09, I² = 97%) The combination of acupuncture or electroacupuncture with conventional treatment was also effective in lowering IOP (WMD = -1.84, 95% CI: [-2.31, -1.37], P <0.00001, I² = 45%). It was estimated that the combination of acupuncture with conventional treatment was also effective for improving visual field (VF) (WMD = -2.17, 95% CI: [-4.32, -0.02], P = 0.05, I² = 89%) but improvement in visual acuity (VA) was not significant (MD = 0.06, 95% CI: [-0.03, 0.15], P = 0.23, I² = 0%). Subgroup analyzes were performed only for the studies that used open glaucoma as the study's disease and combination of acupuncture or electroacupuncture with conventional therapy would have an effect on lowering intraocular pressure (WMD = -1.68)., 95% CI: [-2.46, -0.90], P <0.0001, I² = 29%). Conclusion : This study suggests that acupuncture treatment for glaucoma may be effective in reducing intraocular pressure and helpful in improving visual field defects. However, due to the small sample size, high risk of bias and high heterogeneity in the methodology, it is expected that further studies will be needed to verify the results. Further studies in large-scale samples based on a minimized biased methodology would be necessary.

• 한방안이비인후피부과학회지
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• 제34권4호
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• pp.49-70
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• 2021

Objectives : This study was conducted to approve the effectiveness and safety of herbal medicine on presbycusis with kidney deficiency. Methods : We searched randomized controlled trials(RCTs) on presbycusis patients diagnosed with kidney deficiency through 10 electronic databases from the start to Sep 7, 2021. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent collaborator. The evaluation of the risk of bias in included RCTs was carried out by using Cochrane risk-of-bias tool. And the data synthesis was conducted by using Review Manager(RevMan, ver.5.4). Results : 1. The treatment group which used herbal medicine(HM) alone was more effective than the control group which used only western medicine(WM) on effective rate of hearing loss. 2. In 3 studies comparing the HM-WM combination treatment group with the control groups using the same WM treatment, the effective rate was statistically significantly higher in the HM-WM combination treatment group. 3. Of the 5 studies that reported adverse reactions, one study reported mild nausea and dizziness, but the difference between the HM treatment group and the WM control group was not statistically significant, and no side effects occurred in other 3 studies. 4. In studies comparing HM and WM, the HM treatment group improved hearing loss, whole blood viscosity, serum TNF-𝛼, IL-1𝛽, IL-6, and oxidative stress indicators better than the WM control group, and there was no significant difference. 5. In studies comparing the HM-WM treatment group with the WM control group, the severity of tinnitus, quality of life, and feelings of anxiety and depression were better in the treatment group than the control group. Conclusions : This study shows that the herbal medicine can improve symptoms of presbycusis with kidney deficiency.

• Journal of Korean Neurosurgical Society
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• 제64권2호
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• pp.297-308
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• 2021

Objective : Shunt infection is a common complication while treating hydrocephalus. The antibiotic-impregnated shunt catheter (AISC) was designed to reduce shunt infection rate. A meta-analysis was conducted to study the effectiveness of AISCs in reduction of shunt infection in terms of age, follow-up time and high-risk patient population. Methods : This study reviewed literature from three databases including PubMed, EMBASE, and Cochrane Library (from 2000 to March 2019). Clinical studies from controlled trials for shunt operation were included in this analysis. A subgroup analysis was performed based on the patient's age, follow-up time and high-risk population. The fixed effect in RevMan 5.3 software (Cochrane Collaboration) was used for this meta-analysis. Results : This study included 19 controlled clinical trials including 10105 operations. The analysis demonstrated that AISC could reduce the infection rate in shunt surgery compared to standard shunt catheter (non-AISC) from 8.13% to 4.09% (odds ratio [OR], 0.48; 95% confidence interval [CI], 0.40-0.58; p=0.01; I2=46%). Subgroup analysis of different age groups showed that AISC had significant antimicrobial effects in all three groups (adult, infant, and adolescent). Follow-up time analysis showed that AISC was effective in preventing early shunt infections (within 6 months after implant). AISC is more effective in high-risk population (OR, 0.24;95% CI, 0.14-0.40; p=0.60; I2=0%) than in general patient population. Conclusion : The results of meta-analysis indicated that AISC is an effective method for reducing shunt infection. We recommend that AISC should be considered for use in infants and high-risk groups. For adult patients, the choice for AISC could be determined based on the treatment cost.

• 한방안이비인후피부과학회지
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• 제35권3호
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• pp.48-65
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• 2022

Objectives : This study was conducted to find out the effectiveness and safety of herbal medicine eye drops on conjunctivitis. Methods : We searched randomized controlled trials on conjunctivitis through 10 DBs from the start to April 27, 2022. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent researchers. The evaluation of the risk of bias in included RCTs was carried out by using Cochrane risk-of-bias tool. And the data synthesis was conducted by using Review Manager(RevMan, ver.5.4). Results : Total of 106 studies are researched and 7 studies of them are finally included. 1. The herbal medicine eye drops are more effective on than the western medicine eye drops, but the heterogeneity was very high. So we conducted sensitivity analysis and compared to the herbal medicine eye drops and the western medicine eye drops, the total effective rate was higher in the herbal medicine eye drops and the heterogeneity was somewhat reduced. 2. In the subgroup analysis, Fufang Xiongdan eye drops and Houttuynia cordata Thunb eye drops are more effective than the western medicine. It may represent substantial heterogeneity. 3. In the subgroup analysis, the herbal medicine eye drops are more effective than antibiotic and antiviral eye drops on acute bacterial conjunctivitis, but showed high heterogeneity. On the other hand, the herbal medicine eye drops are more effective than antibiotic and antiviral eyed drops on acute viral conjuctivitis and showed low heterogeneity. 4. In the subgroup analysis, we compared the effectiveness of herbal and western medicine eye drops according to total effectiveness rate evaluation methods. When comparing the studies calculating the total effective rate by the sum of 'Cured', 'Significantly Impaired', and 'Improved', the effective rate of the herbal medicine eye drops was higher than that of the western medicine eye drops, and the heterogeneity was very low. 5. In most studies, side effects of herbal medicine eye drops were absent or mild. Conclusions : This study shows that herbal medicine eye drops may be more effective than western medicine eye drops and have safety. But further researches are needed to resolve the heterogeneity of this study.

• 대한한방내과학회지
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• 제43권6호
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• pp.1045-1062
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• 2022

Objectives: The aim of this study was to analyze the latest clinical studies on Korean medicine treatment of idiopathic thrombocytopenic purpura (ITP) in the Chinese National Knowledge Infrastructure (CNKI) database. Methods: We searched the last 6 years of clinical studies discussing Oriental medicine-based treatments for ITP in the CNKI database. A meta-analysis of 13 RCTs was performed by synthesizing the outcomes, including the measured platelet count and total effective rate. The quality of the studies was assessed using Cochrane's risk of bias (RoB) tool. RevMan 5.4.1 software was used for data analysis. Results: Of the 15 selected studies, 1 was a non-randomized controlled trial (nRCT), 2 were case series, and 12 were randomized controlled trials (RCTs). Treatments in all studies included oral herbal medicine. The most frequently used herbal decoction was the Liangxue Jiedu prescription (凉血解毒方), and the most commonly used herb was Agrimonia pilosa (仙鶴草), Astragali Radix (黃芪), Fossilia Glycyrrhizae Radix et Rhizoma (甘草), and Rehmannia glutinosa Liboschitz ex Steudel (地黃). The meta-analysis showed significantly better improvement in platelet counts and total effective rate for ITP in the treatment group than in the control group. Conclusion: Treatment with herbal medicine was effective in treating ITP. However, the significance of this conclusion is somewhat limited due to the low quality of the available studies. Multifaceted and scientifically designed clinical studies are required to develop treatments for ITP based on Korean medicine. The results of this study could be used as basic data for further ITP studies.

• 동의신경정신과학회지
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• 제34권2호
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• pp.95-113
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• 2023

Objectives: To review studies evaluating effects of acupuncture on pain and depressive symptoms in fibromyalgia. Methods: Quantitative evidences (RCTs) were systematically reviewed. Literature were searched for a combination of fibromyalgia and depression (The Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE, medline (via PubMed), Kmbase, KISS, ScienceON, OASIS, CiNii, CNKI). Quantitative research findings were critically appraised by Cochrane risk of bias (RoB) tool and pooled. Meta-analysis was then conducted using Review Manager (RevMan) 5.4. Results: Eighteen studies were selected. American College of Rheumatology (ACR) classification criteria for Fibromyalgia Syndrome was most frequently used as diagnostic criteria for fibromyalgia. As for outcome measurement, Hamilton Rating Scale for Depression (HAMD), Visual Analog Scale (VAS), and Total Effective Rate (TER) were used most commonly. Meta-analysis of ten studies revealed that both Depression and VAS scores of the Acupuncture+Western Medicine group were significantly lower than those of Western Medicine group (Depression: SMD, -0.94, 95% CI, -1.17 to -0.70; VAS: MD, -1.51, 95% CI, -1.83 to -1.19). Also, TERs of both Acupuncture group and Acupuncture+Western Acupuncture+Western Medicine group were significantly higher than those of the Western Medicine group (OR: 2.38, 95% CI: 1.29 to 4.41; and OR: 7.40, 95% CI: 3.41 to 16.07). There was no significant difference in Depression or VAS score between the Acupuncture Group and the Western Medicine Group. Conclusions: Acupuncture might be an effective option for pain and depressive symptoms of fibromyalgia when it is combined with Western Medicine treatment. For more accurate results, more types of Korean medicine treatment should be conducted.

• 한방안이비인후피부과학회지
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• 제36권4호
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• pp.122-144
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• 2023

Objectives : The purpose of this study is to evaluate the effects of herbal medicine treatment in patients with cold urticaria. Methods : We searched randomized controlled trials(RCTs) reporting the effects of herbal medicine for cold urticaria through domestic and international databases from their inception to September 2023. The results were summarized in tables. We assessed the risk of bias in included RCTs through Cochrane risk of bias tool and the data synthesis was conducted through RevMan version 5.4. Results : A total of 12 RCTs were included in this review and all trials compared herbal medicine alone treatment(treatment group) with western medicine alone treatment(control group). The total effective rate(TER) of treatment group was statistically higher than that of control group(RR: 1.49, 95% CI: 1.38 to 1.62, p<0.00001, I²=65%). On the other hand, when comparing except for 1 trial with different evaluation period, the TER of treatment group was statistically higher than that of control group and heterogeneity was very low(RR: 1.36, 95% CI: 1.26 to 1.47, p<0.00001, I²=0%). And when comparing 8 trials using the total symptom score(TSS) change index as an indicator of TER, the TER of treatment group was statistically higher than that of control group and heterogeneity was very low(RR: 1.38, 95% CI: 1.26 to 1.51, p<0.00001, I²=0%). The treatment group showed more statistically significant decrease compared to the control group in TSS(MD: -2.51, 95% CI: -2.63 to -2.40, p<0.00001, I²=99%). The relapse rate of treatment group was statistically lower than that of control group(RR: 0.19, 95% CI: 0.10 to 0.40, p<0.00001, I²=0%). Mild adverse events such as sleepiness, dizziness were reported in control group and gastric discomfort was reported in treatment group. In the risk of bias assessment, many cases were evaluated as 'Unclear risk'. Conclusions : This review found that herbal medicine alone treatment could more effective and safe than western medicine alone treatment for cold urticaria. But further well-designed researches are needed because of heterogeneity between trials and the quality of the included trials.

• 한방안이비인후피부과학회지
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• 제34권3호
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• pp.27-54
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• 2021

Objectives : This review was conducted to validate the effectiveness and safety of herbal medicine combined with conventional therapy for rosacea. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on rosacea were searched through eight electronic databases from 2016 to March 17, 2020. This study collection and data extraction were performed by two independent reviews. The Cochrane risk-of-bias tool was used for the evaluation of the risk of bias in all included RCTs. Mean differences(MD) and Risk ratio(RR) of 95% Confidence intervals(Cls) were calculated and data synthesis was conducted using Review Manager(RevMan, ver.5.4) Results : Eighteen RCTs were included and all trials compared the combined therapy of herbal medicine with conventional western therapy to conventional therapy alone. The effective rate of the combination of herbal medicine with western medicine(RR 1.20, 95% CI : 1.13-1.28, p<0.00001, I²=0%), the effective rate of the combination of herbal medicine with laser-based therapy(RR 1.12, 95% CI : 1.04-1.21, p=0.004, I²=18%) and the effective rate of the combination treatment group using herbal medicine, western medicine and external drugs were all statistically higher that of the control group(RR 1.19, 95% CI : 1.11-1.28, p<0.00001, I²=0%). The score of non transient erythema(MD -0.36, 95% CI : -1.01 0.29, p=0.27, I²=93%), flushing(MD -0.69, 95% CI : -0.97, 0.41, p<0.00001, I²=32%), papules or pustules(MD 0.10, 95% CI : -0.15, 0.35 p=0.44, I²=0%) were also seen in the herbal medicine and western medicine combination group. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the safety and effectiveness of the combined therapy of herbal medicine with conventional western therapy for rosacea.