• 제목/요약/키워드: controlled trials

검색결과 1,394건 처리시간 0.025초

비만환자의 펜터민 복용에 따른 체중과 심박수 변화에 대한 메타분석 (Meta-analysis of Change in Weight and Heart Rate for Phentermine in Obesity)

  • 우연주;정효미
    • Journal of health informatics and statistics
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    • 제43권4호
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    • pp.290-299
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    • 2018
  • 목적: 식욕억제제인 펜터민의 투여에 따른 체중과 심박수 변화를 출판된 문헌을 토대로 메타분석을 시행하여 평가하고자 한다. 방법: 펜터민 투여군과 위약군의 체중과 심박수 변화를 측정한 무작위배정비교임상시험을 대상으로 PubMed, EMBASE, Cochrane library와 5개의 국내 전자데이터베이스 등 모두 8개의 전자데이터베이스로부터 검색전략에 따라 문헌들이 수집되었다. 메타분석에 따른 통합효과크기의 추정은 Mantel-Haenszel법에 의한 고정효과모델이 사용되었으며, 연구 간의 이질성이 존재하는 경우 변량효과모델이 사용되었다. 결과: 메타분석은 12개의 연구, 677명의 대상자에 대해 시행되었다. 펜터민의 투여에 따른 체중변화의 통합효과크기 추정치(SMD)는 -1.37 (95% 신뢰구간: -1.55, -1.19)로 통계적으로 유의하였으며, 출판연도, 국가, 펜터민의 용량, 추적관찰기간에 따른 하위그룹 분석에서 하위그룹 간 이질성은 나타나지 않았다. 펜터민의 투여에 따른 심박수 변화의 통합효과크기 추정치는 0.64 (95% 신뢰구간: 0.35, 0.92)로 통계적으로 유의하였다. 결론: 펜터민의 투여는 위약에 비해 유의하게 체중을 감소시키나, 심박수를 증가시킨다.

뇌졸중 환자의 상지기능 향상을 위한 경두개 직류 자극과 강제 유도 운동 치료의 결합 중재 효과에 대한 체계적 고찰 (Impact of Transcranial Direct Current Stimulation Combined With Constraint-Induced Movement Therapy on Upper Limb Function in Chronic Stroke: A Systematic Review)

  • 김선호
    • 재활치료과학
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    • 제8권4호
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    • pp.7-18
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    • 2019
  • 목적 : 경두개 직류 자극과 강제 유도 운동 치료의 결합된 중재를 적용한 뇌졸중 환자의 회복과 관련된 연구 동향을 알아보고, 중재 계획 시, 도움이 될 수 있는 정보 및 근거를 제시하는 데 목적이 있다. 연구방법 : 전자 데이터베이스 PubMed, NDSL 등을 이용하여 2009년 1월부터 2018년 12월까지 10년간 온라인 데이터에 등록된 논문을 검색하였다. 주요 검색어로 'Transcranial direct current stimulation' or 'tDCS', 'Constraint-induced movement therapy' or 'CIMT', 'Upper extremity function', 'Upper limb', 'Stroke'을 혼용하여 사용하여 본 연구의 선정기준과 배제기준에 부합하는 6편의 논문을 최종 선정하여 분석하였다. 결과 : 경두개 직류 자극의 적용 전류의 세기, 적용시간 등과 강제 유도 운동 치료의 프로토콜은 다양한 방법으로 이루어져 있었지만, 경두개 직류 자극 직 후 CIMT를 시행하는 중재 절차는 동일하게 시행되었다. 중재 효과를 알아보기 위해 상지기능, 일상생활동작, 대뇌피질 활성도 평가 등이 사용되었다. 경두개직류 자극과 강제 유도 운동 치료의 결합된 중재는 뇌졸중 환자의 상지기능과 일상생활동작 개선에 효과적인 것으로 나타났으며, 대뇌피질의 활성화에도 유의미한 효과가 있는 것으로 나타났다. 결론 : 본 연구를 통해 경두개 직류 자극과 강제 유도 운동 치료의 결합된 중재 적용에 필요한 정보 제공 및 근거를 마련하였다. 추후 연구를 통해, 경두개 직류 자극의 자극시간과 전류의 세기, 전극의 부착 위치 등에 대한 일반화가 필요할 것이며 가장 적절한 강제 유도 운동 치료 프로토콜을 사용하여 큰 모집단을 대상으로 장기간 추적 관찰을 포함한 무작위 대조군 실험연구가 필요하다.

뇌졸중 후 요실금에 대한 침치료 임상진료지침 (Clinical Practice Guideline for acupuncture in Post-stroke urinary incontinence)

  • 이지원;신병철;이명수;임성민;유정희;조충식;문상관;육태한;주종천;이의주
    • 사상체질의학회지
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    • 제29권4호
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    • pp.317-325
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    • 2017
  • Objectives This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the stroke patients with Post-stroke Urinary Incontinence(PSUI). Methods Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on PSUI, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions 8 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUI. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as BL23, CV3, SP6, CV4, CV6, ST28, BL28, BL32, GV20, BL22, GV4 or ST36, for 15-30 minutes. 1-150 Hz frequency is suggested if electro-acupuncture treatments is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. There was a moderate evidence to support safety of acupuncture treatment for PSUI. We recommend acu-points of constitutional acupuncture for Sasangin on the healthy side.

갱년기 여성의 안면홍조 증상에 대한 국내 한의학 연구 동향 분석 (A Review on Domestic Study Trends on Hot Flush in Menopausal Women with Traditional Korean Medicine)

  • 홍누리;장영숙;양수현;최윤영;오다윤;이수진;남궁진;김진환
    • 대한한방부인과학회지
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    • 제33권1호
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    • pp.86-103
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    • 2020
  • Objectives: The purpose of this study is to analyse the domestic trends of Traditional Korean Medicine on Hot flush in menopausal women. Methods: We searched six databases and selected relevant papers according to the criteria. Results: 12 papers included case report, literature review, randomized controlled clinical trials (RCTs), Non-RCTs, and retrospective chart analysis study design. 1. The daily diary, Kupperman's Index, Menopause Rating Scale, Menopause-specific Quality of Life Questionnaire, Digital Infrared Thermographic Imaging were used as a measure of the symptoms of hot flush. 2. There were significant correlations between Thermographic images, Pulse energy, Lifestyle Habits, Low frequency power/High frequency power (LF/HF) ratio and certain items of Menopausal Symptoms Measurement. 3. The case report using Er-Xian decoction and Hwangryunhaedoktang-Gamibang showed significant effect. 4. Domestic RCT studies using herbal or acupuncture treatments showed a significant value of 3.4 on average in the quality assessment conducted in the study. However, the number of domestic studies included was five, which is not enough compared to foreign countries. Conclusions: This study examined domestic research trends on hot flushes of menopausal women and found that various evaluation tools and diagnostic methods were applied. It is necessary to conduct various RCT studies in Korea, where the number of studies is insufficient compared to overseas.

Efficacy of medications in adult patients with trigeminal neuralgia compared to placebo intervention: a systematic review with meta-analyses

  • Peterson-Houle, Georgia M.;AbdelFattah, Magda R.;Padilla, Mariela;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제21권5호
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    • pp.379-396
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    • 2021
  • Background: Trigeminal neuralgia (TN) is characterized by brief, unilateral, sharp, stabbing, and shooting pain of the fifth cranial nerve. The objective of this systematic review with meta-analysis was to determine the effect of medications compared to placebo in adult patients with TN. Methods: Review authors identified randomized placebo-controlled trials (RCTs) from PubMed, Web of Science, Cochrane, and EMBASE up to February 2021. We assessed the inclusion and exclusion criteria as well as the risk of bias of the studies based on the Cochrane Handbook. A total of 324 unduplicated references were scanned independently and reduced to eight relevant RCTs, with 89 patients included. Medications investigated included oral carbamazepine, subcutaneous sumatriptan, lidocaine (intranasal, 8% spray on the oral mucosa or intravenous), buprenorphine (ganglionic local opioid analgesia), and oral Nav1.7, a selective sodium channel blocker. Results: Meta-analyses showed that overall patients receiving lidocaine reported a significantly lower post-treatment intensity of pain -3.8 points on a 0-10 scale (95% Cl = -4.653 to -2.873; P < 0.001). Patients who received lidocaine were 8.62 times more likely to have pain improvement than patients on placebo (P < 0.001). In one RCT, patients receiving oral carbamazepine showed a significant improvement in pain intensity of -32% compared to the placebo (P < 0.001). In one trial, patients receiving 3 mg subcutaneous sumatriptan had a significantly lower intensity of pain on average -6.1 points on a scale of 0-10 compared to placebo (P < 0.001) and a significant improvement in pain intensity of -75% compared to the improvement in the placebo group (P < 0.001). Patients who received subcutaneous sumatriptan were 10 times more likely to have pain improvement than those who received placebo (P = 0.001) in one study. Due to the unclear/high risk of bias and small sample size, the quality of the evidence for lidocaine in the treatment of TN was low. Conclusion: Further studies are needed for carbamazepine, sumatriptan, buprenorphine, and oral Nav1.7 sodium channel blockers, as only one study reported outcomes.

동결견의 한약 치료에 대한 체계적 문헌고찰 및 메타분석 (A Systematic Review and Meta-Analysis of Herbal Medicine for Frozen Shoulder)

  • 오태영;김연희;오은미;홍수민;하현주;이은정;오민석
    • 한방재활의학과학회지
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    • 제29권3호
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    • pp.15-33
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    • 2019
  • Objectives The objective of this study is to provide the evidence of the effectivness of herbal medicine for frozen shoulder. Methods 2 Korean medical on-line databases (Oriental Medicine Advanced Searching Integrated System, Korean Traditional Knowledge), and 3 foreign databases (Pubmed, Cochrane library, China National Knowledge Infrastructure) were searched to find articles concerning herbal medicine for frozen shoulder. We selected randomized controlled trials (RCTs). Several repeated articles and those not relevant to the topic were excluded, as well as review articles and commentaries. The methodological quality of RCTs were evaluated using the Cochrane risk of bias tool and meta-analyes were perfomed. Results Total 474 studies were founded and 22 RCTs were selected for systematic review. Efficiency rate was used as the primary evaluation method. Almost studies reported that herbal medicine has significant effect on pain reduction, increasing shoulder function on frozen shoulder. 3 studies comparing herbal medicine and chuna with chuna and 3 studies comparing herbal medicine with ibuprofen were included in the meta-analysis. At herbal medicine and chuna with chuna meta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.18, 95% confidence interval: 1.09-1.27, p<0.0001). At herbal medicine with ibuprofen medta-analysis, it showed positive results of herbal medicine for efficiency rate (risk ratio: 1.15, 95% confidence interval: 1.05-1.27, p=0.003). Conclusions The studies showed that herbal medicine can significantly effective on frozen shoulder. However, the risk of bias in RCTs were evaluated as uncertain. In the future, further well-designed RCTs are needed to prove the effectiveness of herbal medicine for frozen shoulder and reduce the risk of bias.

외전신경마비의 한의학 치료에 대한 체계적 문헌 고찰 (Systematic Review of Korean Medicine for the Treatment of Sixth Cranial Nerve Palsy)

  • 원서영;김민지;차지윤;정은선;조현경;유호룡;설인찬;김윤식
    • 대한한방내과학회지
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    • 제40권3호
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    • pp.409-424
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    • 2019
  • Objectives: This research aimed to confirm the efficacy of oriental medicine in sixth cranial nerve palsy and to evaluate the quality of the studies. Methods: Using the medical subject heading (MeSH) keywords "abducens nerve palsy", "abducens nerve paralysis", "sixth nerve palsy", "herbal medicine", "Chinese medicine", "oriental medicine" and "acupuncture", we collected the research papers through an electronic database search in Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leaders (NDSL), PubMed, Cochran Library, and China National Knowledge Infrastructure (CNKI). Results: A total of 136 papers were searched from the databases. Among these, 15 case reports and 8 randomized controlled trials (RCTs) met our criteria. 17 articles were found on the use of acupuncture as the main intervention, 11 on the use of herbal medicine as the main intervention, and 9 on the use of electroacupuncture as the main intervention. The frequently used acupoints were LI4, EX-HN5, GB1, BL2, TE23, LR3, BL1, ST2, GB20, and ST36. All 23 studies confirmed the efficacy of Korean medicine. According to the assessment using the risk of bias, the overall quality of the RCTs was low. Conclusions: Twenty-three papers suggested that Korean medicine treatment for abducens nerve palsy was effective in many cases. Analyzing the potential bias was difficult.

Functional Magnetic Resonance Imaging in the Diagnosis of Locally Recurrent Prostate Cancer: Are All Pulse Sequences Helpful?

  • Liao, Xiao-Li;Wei, Jun-Bao;Li, Yong-Qiang;Zhong, Jian-Hong;Liao, Cheng-Cheng;Wei, Chang-Yuan
    • Korean Journal of Radiology
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    • 제19권6호
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    • pp.1110-1118
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    • 2018
  • Objective: To perform a meta-analysis to quantitatively assess functional magnetic resonance imaging (MRI) in the diagnosis of locally recurrent prostate cancer. Materials and Methods: A comprehensive search of the PubMed, Embase, Cochrane Central Register of Controlled Trials, and Cochrane Database of Systematic Reviews was conducted from January 1, 1995 to December 31, 2016. Diagnostic accuracy was quantitatively pooled for all studies by using hierarchical logistic regression modeling, including bivariate modeling and hierarchical summary receiver operating characteristic (HSROC) curves (AUCs). The Z test was used to determine whether adding functional MRI to T2-weighted imaging (T2WI) results in significantly increased diagnostic sensitivity and specificity. Results: Meta-analysis of 13 studies involving 826 patients who underwent radical prostatectomy showed a pooled sensitivity and specificity of 91%, and the AUC was 0.96. Meta-analysis of 7 studies involving 329 patients who underwent radiotherapy showed a pooled sensitivity of 80% and specificity of 81%, and the AUC was 0.88. Meta-analysis of 11 studies reporting 1669 sextant biopsies from patients who underwent radiotherapy showed a pooled sensitivity of 54% and specificity of 91%, and the AUC was 0.85. Sensitivity after radiotherapy was significantly higher when diffusion-weighted MRI data were combined with T2WI than when only T2WI results were used. This was true when meta-analysis was performed on a per-patient basis (p = 0.027) or per sextant biopsy (p = 0.046). A similar result was found when $^1H$-magnetic resonance spectroscopy ($^1H$-MRS) data were combined with T2WI and sextant biopsy was the unit of analysis (p = 0.036). Conclusion: Functional MRI data may not strengthen the ability of T2WI to detect locally recurrent prostate cancer in patients who have undergone radical prostatectomy. By contrast, diffusion-weight MRI and $^1H$-MRS data may improve the sensitivity of T2WI for patients who have undergone radiotherapy.

키네시오 테이프 적용이 제자리멀리뛰기 시 건강한 남녀의 각 다리근육 근 활성도에 미치는 영향 (Effects on Muscle Activities after the Kinesio Tape Application in Each Lower Extremity of Normal People during Stand-broad Jumping)

  • 위준형;이상하;이진화;이호성;윤현석;양승수;양정원;김상덕;김상현;심나영;장희진;조건희;유현경;이규리
    • 대한물리치료과학회지
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    • 제26권1호
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    • pp.61-68
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    • 2019
  • Purpose: This study was to examine the differences in muscle activities for some muscles of the legs used in a broad jump after applying tape to healthy people. The purpose of this study was to improve the exercising ability of patients and athletes during the rehabilitation training. Design: Randomized Controlled Trial. Methods: The experimental group was attached with the Kinesio tape on Rectus femoris, Biceps femoris and Gastrocnemius. Before doing broad jumping, they had stretching with the following order. And we measured broad jumps five times. We gave the rest period between trials. After every trial was measured, they were performed to cool-down exercise with the same way of warm-up exercise. And the control group did the same exercises as the experimental group except for attaching the Kinesio tape on muscles. Results: The results of Rectus femoris, Biceps femoris and Gastrocnemius activities according to tape application of femoris muscle were significantly increased (p<.05) compared to untreated group. Conclusion: Therefore, Kinesio tape has an effect on the improvement of the broad jump recorded by affecting the increase in muscle activities.

Ginsenoside Rg1 supplementation clears senescence-associated β-galactosidase in exercising human skeletal muscle

  • Wu, Jinfu;Saovieng, Suchada;Cheng, I-Shiung;Liu, Tiemin;Hong, Shangyu;Lin, Chang-Yu;Su, I-Chen;Huang, Chih-Yang;Kuo, Chia-Hua
    • Journal of Ginseng Research
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    • 제43권4호
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    • pp.580-588
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    • 2019
  • Background: Ginsenoside Rg1 has been shown to clear senescence-associated beta-galactosidase (SA-${\beta}$-gal) in cultured cells. It remains unknown whether Rg1 can influence SA-${\beta}$-gal in exercising human skeletal muscle. Methods: To examine SA-${\beta}$-gal change, 12 young men (age $21{\pm}0.2years$) were enrolled in a randomized double-blind placebo controlled crossover study, under two occasions: placebo (PLA) and Rg1 (5 mg) supplementations 1 h prior to a high-intensity cycling (70% $VO_{2max}$). Muscle samples were collected by multiple biopsies before and after cycling exercise (0 h and 3 h). To avoid potential effect of muscle biopsy on performance assessment, cycling time to exhaustion test (80% $VO_{2max}$) was conducted on another 12 participants (age $23{\pm}0.5years$) with the same experimental design. Results: No changes of SA-${\beta}$-gal were observed after cycling in the PLA trial. On the contrary, nine of the 12 participants showed complete elimination of SA-${\beta}$-gal in exercised muscle after cycling in the Rg1 trial (p < 0.05). Increases in apoptotic DNA fragmentation (PLA: +87% vs. Rg1: +133%, p < 0.05) and $CD68^+$ (PLA:+78% vs. Rg1:+121%, p = 0.17) occurred immediately after cycling in both trials. During the 3-h recovery, reverses in apoptotic nuclei content (PLA:+5% vs. Rg1 -32%, p < 0.01) and increases in inducible nitrate oxide synthase and interleukin 6 mRNA levels of exercised muscle were observed only in the Rg1 trial (p < 0.01). Conclusion: Rg1 supplementation effectively eliminates senescent cells in exercising human skeletal muscle and improves high-intensity endurance performance.