• Title/Summary/Keyword: randomized controlled clinical trials

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Review of Clinical Research on Herbal Medicine Treatment of Migraine (편두통 환자의 한약치료 임상연구에 대한 고찰)

  • Lee, Su-yeong;Yun, Jong-min;Moon, Byung-soon
    • The Journal of Internal Korean Medicine
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    • v.39 no.4
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    • pp.550-569
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    • 2018
  • Objectives: The purpose of this study was to investigate the effects of herbal medicine treatment for patients with migraine and to suggest research methods for herbal medicine treatment on migraine. Methods: In this study, a search was conducted through several academic sites using a combination of terms '편두통', 'Migraine', '한약', '한약치료', 'Herbal medicine', 'Herbal medicines', 'Herb', 'Traditional Chinese Medicine', and 'TCM'. Randomized controlled trials using herbal medicine treatments for adult patients with migraine were selected. Results: Ultimately, 46 papers were selected and analyzed. A statistically significant improvement was noted in the treatment group in terms of clinical migraine symptoms and other migraine evaluation tools before and after the herbal medicine treatment. Herbal medicines were administered in decoction, pill, and granule formulations. Many kinds of medicinal herbs, such as 解表藥類, 補益藥類, 淸熱藥類, 活血祛瘀藥類, and 平肝藥類, have been used for migraine. Among them, 川芎, belonging to 活血祛瘀藥類, is mentioned 36 times and is the most frequently used medicine. Herbal medicine was used safely for migraine treatment, without major adverse reactions, and the recurrence rate was significantly lower in the treatment group than in the control group. Conclusions: In conclusion, the herbal medicine treatment for patients with migraine showed a statistically significant improvement in 46 papers. Future studies should utilize standardized and objective evaluation tools, along with appropriate experimental design. The relevant articles should be increased to a significant level to verify the effect of herbal medicine treatments on migraine.

High Intensity Laser for Laser Acupuncture Application (침구치료에 사용되는 고출력 레이저에 대한 고찰)

  • Yang, Chang-Sop;Sun, Seung-Ho;Jang, In-Soo
    • Korean Journal of Acupuncture
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    • v.28 no.3
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    • pp.1-12
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    • 2011
  • Objectives : The purpose of this study is to review laser acupuncture studies to find possibility for applying high intensity laser to acupuncture and moxibustion treatment. Methods : Searching papers was performed using search engines of five electronic databases, including Pubmed, Thomson ISI, EMBASE, Sciencedirect, and EBSCO, from inception to May 2011 without language limitation. Inclusion criteria were clinical studies with human, randomized controlled trials (RCTs), case-control studies, and case reports. Selecting papers was performed with titles and abstracts in first step, scrutinize full text in second step, and then the extrated data was analyzed by two authors independently. The methodological quality for RCTs was evaluated using Jadad's scale. Results : Total 8 papers, (3 RCTs, 5 controlld studies, and 1 case reports), were finally selected. The study dealt with surgical laser, argon and $CO_2$ laser was one for each, with GaAs laser was two, and with new semiconductor laser, GaN, were four. The output range was from 110 mW to 15 W. The study diseases were alcohol addiction, knee osteoarthritis, bronchopneumonia and asthma for children, and circulation. All studies reported positive effect. The methodological quality in all RCTs was low because of below 3 points and all studies had few subject numbers. Conclusions : We suggest that high intensity laser can be applied to acupuncture and moxibustion. Further rigorous and well-designed study will be needed for various disease. The oriental medical society needs to take active measures to study and clinical application of acupuncture and moxibustion treatment with high intensity laser.

Systemic review: The study on Rhinitis with acupuncture in PubMed and Chinese medical journals (비염(鼻炎)의 침구치료(鍼灸治療)에 대한 최근(最近) 연구(硏究) 동향(動向) -Pubmed와 중의학(中醫學) 학술지(學術紙)를 중심으로-)

  • Kim, Jeung-shin;Kim, Yong-suk;Nam, Sang-soo
    • Journal of Acupuncture Research
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    • v.21 no.1
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    • pp.70-85
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    • 2004
  • Objective: To research the trends of study related to rhinitis and acupuncture in PubMed, and to establish the hereafter direction of treating rhinitis with acupuncture Methods: We searched PubMed and chinese medical journals related to rhinitis and acupuncture. Results: 1. The pattern of the study was as follows: Review article(3), Randomized controlled trials(2), Clinical trial(11), Case report(12). 2. The effect of acupuncture on rhinitis is reported as follows: Acupucture treatment improves the scale of symptoms, nasal airways resistance and velocity of the mucociliary transport, decreasing absolute numbers of blood eosinophils, serum IgE and percentage of nasal eosinophils. Immunologically acupuncture treatment could reduce plasma IL-10 level, control IL-2, and balance between cell-specific pro-inflammatory and anti-inflammatory cytokines, TNF-${\alpha}$ and IL-10. After acupuncture treatment, there is statistically significant changes in IgA, IgE, E-rosette formative rate. 3. Many of these article have affirmative view for therapeutic effect of rhinitis with acupuncture. Statistical test was done only in 6 papers. There showed statically significant results in 4 articles, and in 2 article there showed some clinical improvement but no statically significant changes. 4. In Western countries, alternative treatments are frequent among adults with rhinitis or other allergic disease, and affirmative tendency for acupuncture treatment is increased.

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Infratemporal fossa approach: the modified zygomatico-transmandibular approach

  • Kim, Soung Min;Paek, Sun Ha;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.41
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    • pp.3.1-3.9
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    • 2019
  • Background: The infratemporal fossa (ITF) is an anatomical lateral skull base space composed by the zygoma, temporal, and the greater wing of the sphenoid bone. Due to its difficult approach, surgical intervention at the ITF has remained a heavy burden to surgeons. The aim of this article is to review basic skull base approaches and ITF structures and to avoid severe complications based on the accurate surgical knowledge. Methods: A search of the recent literature using MEDLINE (PubMed), Embase, Cochrane Library, and other online tools was executed using the following keyword combinations: infratemporal fossa, subtemporal fossa, transzygomatic approach, orbitozygomatic approach, transmaxillary approach, facial translocation approach, midface degloving, zygomatico-transmandibular approach, and lateral skull base. Aside from our Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) trial, there have been very few randomized controlled trials. The search data for this review are summarized based on the authors' diverse clinical experiences. Results: We divided our results based on representative skull base approaches and the anatomy of the ITF. Basic approaches to the ITF include endoscopic endonasal, transzygomatic, orbitozygomatic, zygomatico-transmandibular, transmaxillary, facial translocation, and the midfacial degloving approach. The borders and inner structures of the ITF (with basic lateral skull base dissection schemes) are summarized, and the modified zygomatico-transmandibular approach (ZTMA) is described in detail. Conclusions: An anatomical basic knowledge would be required for the appropriate management of the ITF pathology for diverse specialized doctors, including maxillofacial, plastic, and vascular surgeons. The ITF approach, in conjunction with the application of microsurgical techniques and improved perioperative care, has permitted significant advances and successful curative outcomes for patients having malignancy in ITF.

Pharmacopuncture for Stroke: An Overview of Meta-Analyses (뇌졸중의 약침 치료에 대한 메타분석의 통합적 고찰)

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Internal Korean Medicine
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    • v.40 no.6
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    • pp.1081-1100
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    • 2019
  • Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

Review of Clinical Research for Herbal Medicine Treatment on Refractory Nephrotic Syndrome in Children (소아의 난치성 신증후군의 한약 치료에 대한 최신 임상연구 동향)

  • Jang, Eun Ha;Min, Sang Yeon;Kim, Jang Hyun
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.3
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    • pp.1-17
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    • 2020
  • Objectives The purpose of this study is to analyze clinical studies on effectiveness of herbal medicine in refractory nephrotic syndrome (RNS). Methods We searched the randomized controlled trials (RCTs) with herbal medicine treatment on RNS from the Pubmed, CNKI, OASIS, NDSL, J-stage, and CiNii. The demographic data, duration of illness, intervention, treatment period, outcome, adverse events, and composition of herbal medicine were analyzed for this study. Results 11 RCT studies were selected and analyzed. The children in the control group were given western medicine therapy, and the treatment group was given herbal medicine along with the same western medicine of the control group. The most commonly used herbal medicines were the prescriptions to treat 'Kidney Deficiency with Blood Stasis (腎虛兼瘀血)' which composed of 'Promoting blood circulation (化瘀)', 'Diuresis-inducing (利水)', or 'Heating Yang (溫陽)' medicine based on 'Replenishing Kidney or Spleen (補腎, 補脾)' medicine. In the treatment group, proteinuria and serum lipid was significantly decreased, serum albumin was significantly increased, and total effective rate was significantly higher than the control group. Hypercoagulation and relapse rate was also significantly reduced. Adverse events were significantly lower in the treatment group. Conclusions Herbal medicine treatment on pediatric RNS can be suggested as a new treatment for children who have less response to the conventional therapy. It can also supplement the limitations of the western medicine by reducing adverse events from the steroids and immuno-suppressive agents, and lower the relapse rate as well.

Treatment of refractory IgA vasculitis with dapsone: a systematic review

  • Lee, Keum Hwa;Hong, Sung Hwi;Jun, Jinhae;Jo, Youngheun;Jo, Woogyeong;Choi, Dayeon;Joo, Jeongho;Jung, Guhyun;Ahn, Sunghee;Kronbichler, Andreas;Eisenhut, Michael;Shin, Jae Il
    • Clinical and Experimental Pediatrics
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    • v.63 no.5
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    • pp.158-163
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    • 2020
  • IgA vasculitis, formerly known as Henoch-Schönlein purpura, is a systemic IgA-mediated vasculitis of the small vessels commonly seen in children. The natural history of IgA vasculitis is generally self-limiting; however, one-third of patients experience symptom recurrence and a refractory course. This systematic review examined the use of dapsone in refractory IgA vasculitis cases. A literature search of PubMed databases retrieved 13 articles published until June 14, 2018. The most common clinical feature was a palpable rash (100% of patients), followed by joint pain (69.2%). Treatment response within 1-2 days was observed in 6 of 26 patients (23.1%) versus within 3-7 days in 17 patients (65.4%). Relapse after treatment discontinuation was reported in 17 patients (65.4%) but not in 3 patients (11.5 %). Four of the 26 patients (15.4%) reported adverse effects of dapsone including arthralgia (7.7%), rash (7.7%), and dapsone hypersensitivity syndrome (3.8%). Our findings suggest that dapsone may affect refractory IgA vasculitis. Multicenter randomized placebo-controlled trials are necessary to determine the standard dosage of dapsone at initial or tapering of treatment in IgA vasculitis patients and evaluate whether dapsone has a significant benefit versus steroids or other medications.

The Current State of Clinical Studies on Scalp Acupuncture - Treatment for Dementia-by Search for China Literature published from 2001 to 2011 in CAJ(China Academic Journals) - (치매환자의 두침(頭鍼)치료에 대한 최신 임상연구 동향 -CAJ (China Academic Journals: 중국기간전문수거고(中国期刊全文数据库))의 2001~2011년 검색을 통하여-)

  • Lee, Go-Eun;Park, Jang-Ho;Yang, Hyun-Duk;Heo, Eun-Jung;Jeon, Won-Kyung;Lyu, Yeoung-Su;Kang, Hyung-Won
    • Journal of Oriental Neuropsychiatry
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    • v.23 no.2
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    • pp.13-32
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    • 2012
  • Objectives : The purpose of this study was to obtain some knowledge concerning the scalp acupuncture treatment on patients with dementia for the future practice and research from clinical studies in China. Methods : The literatures were searched using the data base-China Academic Journals(CAJ) (2001-2011). Results : We found out 1 case study, and 17 randomized controlled trials(RCT) which met the inclusion criteria in most studies. There were 3 types of scalp acupuncture-applying method, cho-si scalp acupuncture(焦氏頭鍼法), combination of using ordinary acupoints(正經鍼) and extraordinary acupoints(經外寄穴), standard method of scalp acupuncture(標準頭鍼法). The often used acupoints are Yundongqu(運動區), Ganjuequ(感覺區), Yuntingqu(暈聽區), Zuyunganqu(足運感區), Sishencong (HN23), Baihui(GV20), Shenting(GV24), Fengchi(GB20), Dingnieqianxiexian(MS6), and Dingniehouxiexian(MS7). Conclusions : There were significant improvements on the scalp acupuncture-treated groups, compared to the control groups(western medication group or other acupuncture treatment group). Results of this study could be used for future studies concerning the scalp acupuncture for dementia.

Clinical and autonomic characteristics in patients with postural tachycardia syndrome (기립빈맥증후군 환자의 임상적 및 자율신경 특성)

  • Kim, Duk Ju;Kang, Sa-Yoon;Kim, Joong Goo
    • Journal of Medicine and Life Science
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    • v.16 no.3
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    • pp.96-100
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    • 2019
  • Postural tachycardia syndrome (POTS) is common, although not so well-known variant of cardiovascular autonomic disorder characterized by an excessive heart rate increase on standing. POTS is probably underdiagnosed due to the heterogeneity in both presentation and etiology. This study aimed to evaluate the clinical and autonomic features in patients with POTS. We reviewed the medical records of patients with POTS. Medical records include onset age, sex, presenting symptoms, body mass index (BMI) and prognosis. All patients had an autonomic function and laboratory tests. Ninety-nine patients met the inclusion criteria for POTS (51.5% male; mean±SD age, 20.0±9.7 years; mean±SD, BMI 21.9±3.9). Common presenting symptoms were a brief loss of consciousness, dizziness, blurred vision and headache. Autonomic function tests showed abnormal quantitative sudomotor axon reflex testing in 20 patients of 99 POTS patients. The abnormal post-ganglionic sympathetic sudomotor function is generally considered to reflect a neuropathic form of POTS. In treatments, 83 patients were treated by non-pharmacological management including lifestyle changes and 16 patients required the initiation of pharmacological therapies. Most patients with POTS showed a relatively favorable prognosis. POTS is a chronic disease with a substantial subset of patients recovering within a few years after the initial presentation. Future efforts should focus on better understanding of POTS pathophysiology and designing randomized controlled trials for the selection of more effective therapy.

Review on Efficacy and Safety of Manipulation Therapy including Chuna Manipulation (추나요법을 포함한 수기치료의 효과 및 안전성에 관한 문헌고찰)

  • Kim, Ki-Byoung;Park, Tae-Yong;Lee, Jeong-Han;Kong, Jae-Cheol;Lee, Su-Kyung;Shin, Byung-Cheul;Kwon, Young-Dal;Song, Yung-Sun
    • Journal of Korean Medicine Rehabilitation
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    • v.18 no.4
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    • pp.103-120
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    • 2008
  • Objectives : This study aims to educate clinical doctors of the valuable practice of Manipulative Therapy(MT) as an opportunity for evidence-based medicine. Consequently it also serves to review the effectiveness and safety of MT. Methods : The literature studies of overseas were done by Cochrane Library and Medline website; those of domestic researches were completed by utilizing the sources which are gained from KERIS, KISS, DBpia, Kisti, and domestic institutes related with MT. Results : Eight papers related to the effectiveness of MT were published in South Korea, which concluded with the positive effects of MT. None of them are, however, well-designed randomized controlled trials(RCT). On the other hand, fifteen cases of nine articles indicate the adverse reaction of MT, and numbers of the researches in overseas revealed the side effects of MT in order of cervical, lumbar, and thoracic vertebrae. A vascular adverse reaction such as vertebral and carotid artery dissection was a highly reported cervical adverse reaction; in the thoracic and lumbar regions, neurological adverse reaction in terms of disc hemiation was frequently discovered. Conclusions : Henceforth, highly qualitative studies are required developing the effective outcomes and preventing any possible complications of MT. Therefore, systemic curriculums in institutions and sufficient clinical training in the filed are strongly recommended.