• 대한암한의학회지
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• 제22권2호
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• pp.1-11
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• 2017

Objectives: Postoperative pain is one of postoperative complications in patients with solid tumor. This systematic review and meta-analysis were aimed to evaluate the efficacy of acupuncture for postoperative pain in solid tumor. Methods: We searched for randomized controlled trials (RCTs) using acupuncture for postoperative pain in adult patients with solid tumor up to September 2016. Acupuncture was defined as manual acupuncture, electroacupuncture and pharmacopuncture. The following databases were searched: PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KoreaMed, Kmbase, KISS, NDSL, KISTI. The results of the studies were meta-analyzed and the risk of bias was assessed. Results: Five studies were included in this review. When acupuncture was compared with usual care, Prince-Henry pain scale score was significantly lower in acupuncture group (MD=-0.44, 95% CI: -0.62 to -0.26, P<0.001, $I^2=87%$) and 10 points pain score (including Numeric Rating Scale and Visual Analog Scale) was lower in acupuncture group but not significantly (MD=-1.00, 95% CI: -2.00 to -0.00, p=0.05). When acupuncture was compared with sham acupuncture, 10 points pain score was significantly lower in acupuncture group (MD=-0.39, 95% CI: -0.65 to -0.14, p=0.002, $I^2=0%$). Any serious adverse events were not reported. Conclusion: This review shows that acupuncture may be considered for postoperative pain in patients with solid tumor without serious adverse events. However, only a few studies were included in this study, further investigation is needed in this area.

• 임상간호연구
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• 제23권1호
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• pp.83-90
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• 2017

Purpose: This study was to develop evidence-based clinical practice guideline in order to prevent contrastinduced nephropathy (CIN) for patients undergoing percutaneous coronary intervention (PCI). Methods: The guideline was developed based on the "Scottish Intercollegiate Guidelines Network (SIGN)". The first draft of guideline was developed through 5 stages and evaluated by 10 experts.(1) Clinical questions were ensured in PICO format.(2) Two researchers conducted a systematic search through electronic database, identifying 170 studies. We selected 27 full text articles including 16 randomized clinical trials, 7 systematic reviews, and 4 guidelines. Quality of each studies were evaluated by the Cochran's Risk of Bias, AMSTAR, K-AGREEII. Among the studies, 11 studies were excluded.(3) The strength of recommendations were classified and quality of recommendations were ranked.(4) Guideline draft was finalized.(5) Content-validation was conducted by an expert group. All contents were ranked above 0.8 in CVI. Results: Evidence-based clinical practice guideline to prevent CIN was dveloped.(1) The guideline for preventing CIN recommends using 0.9% saline.(2) Standardized rate of fluid therapy is 1 to 1.5ml/kg/hr.(3) Execute hydration for 6~12hrs before PCI and after PCI. Conclusion: This study suggests evidence-based clinical practice guideline for preventing CIN which can be more efficiently used in clinical practice.

• 한방비만학회지
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• 제20권1호
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• pp.52-68
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• 2020

Objectives: The purpose of this study is to investigate the weight loss effects of auricular acupuncture in obese patients. Methods: Six databases (Research Information Sharing Service [RISS], Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], PubMed, The Cochrane Library, China National Knowledge Infrastructure [CNKI]) were searched up to May 20, 2020. Eight eligible randomized controlled trials were included the present study. The quality of included studies was assessed by the Cochrane risk of bias tool and a meta-analysis was performed by Review Manager software. A meta-analysis was conducted using a random-effects model and a subgroup analysis was performed to detect the sources of heterogeneity, identify the selection of acupuncture methods and explore its contributions to the weight loss effects. Results: Among 8 trials, 5 trials used auricular acupuncture and 2 trials used auricular acupressure, 1 trial used both types of intervention. Most commonly selected acupoints were Shenmen (TF4) and stomach (CO4). Treatment duration was six to twelve weeks, and total treatment session was six to twelve. Compared to the control groups, auricular acupuncture significantly decreased body weight, body mass index (BMI), high density lipoprotein-cholesterol (HDL) and ghrelin. For the selection of acupuncture methods, both methods performed similarly in most outcome except waist circumference (WC), body fat percentage (BFP), and triglycerides (TG). Conclusions: We found that auricular acupuncture can be effective for weight loss and controlling appetite. However, the findings should be interpreted with caution due to heterogeneity. So further vigorous and well-designed studies should be conducted to strengthen the evidence of the use of auricular acupuncture for obesity.

• 한국산학기술학회논문지
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• 제18권4호
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• pp.366-379
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• 2017

본 연구는 운동중재가 심장질환자의 혈관내피전구세포에 미치는 효과에 대한 선행연구들을 체계적으로 고찰하고, 그 효과에 대한 메타분석을 위해 실시되었다. 국내외 데이터베이스인 Cochrane Library, PubMed, EMBASE, ScienceDirect, CINAHL, Scopus, KoreaMed, KISS, RISS, KMBASE 온라인 검색을 실시하였고, 검색어는 심질환, 관상동맥질환, 심부전, 심혈관질환, 운동, 신체활동, 재활, 혈관내피전구세포를 조합하여 사용하였다. 그 결과, 539편의 논문이 검색되었고, 논문 선정기준에 부합하는 9편의 논문을 최종 분석에 이용하였다. Comprehensive Meta-Analysis version 2.0을 활용하여 효과크기, 출판편중을 분석하였다. 운동군의 혈관내피성장인자(VEGF), 혈관내피세포의 수(CD34+KDR+), 혈관내피세포의 기능(FMD)은 대조군에 비해 각각 2.008 (95% CI 0.204-3.812), 1.399 (95% CI 0.310-2.489), 1.881 (95% CI 0.848-2.914) 효과크기가 나타났다. 따라서 운동 중재가 혈관내피성장인자와 혈과내피전구세포의 수를 증가시키고, 혈관내피세포의 기능을 향상시키는데 효과가 있음을 알 수 있다. 국내 심혈관질환자의 유병률과 사망률이 증가하고 있음을 고려할 때, 심혈관질환자를 대상으로 한 운동중재의 효과를 분석한 본 연구결과는 심혈관질환자의 운동중재를 계획하는데 있어 실질적인 가이드라인을 제시할 수 있을 것이다.

• 한국노년학
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• 제36권3호
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• pp.727-749
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• 2016

본 연구는 국내 외 지역사회에 거주하는 노인의 근감소증과 인지기능에 관한 연구 동향을 파악하기 위해 수행된 체계적 문헌 고찰이다. 본 연구의 선정 논문은 국내 외 문헌 중 지역사회에 거주하는 노인을 대상으로 근감소증의 유병률 또는 근감소증과 인지기능의 상관관계를 조사하였거나, 근감소증 완화 목적으로 시행된 중재 연구로, 총 43편의 논문이 포함되었다. 국내 외 근감소증의 유병률은 총 25편의 논문에서 2.5-42.4%의 다양한 범위로 보고되었으며, 인지기능과의 관계를 분석한 6편의 논문 중 4편에서 근감소증과 인지기능 저하가 유의한 양의 상관관계로 보고되었다. 근감소증 개선을 위한 중재 연구 12편에서 근육량, 근력 또는 신체 기능 향상에 대한 중재 효과를 확인하였으나, 근감소증 결과지표로 인지기능 평가를 시행한 논문은 없었다. 지역사회거주 노인을 대상으로 근감소증을 예방 및 개선하고 효과를 평가하기 위해서는 표준화된 진단을 적용한 지역사회 내 근감소증 감시체계와 신체기능 뿐만 아니라 인지기능 평가를 포함하는 포괄적이고 지속적인 근감소증 관리체계가 필요하다. 또한 지역사회 기반 근감소증 예방을 위한 근거를 생산하기 위해 지속적인 중재연구의 개발 및 적용이 요구된다.

• 동의신경정신과학회지
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• 제29권4호
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• pp.267-280
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• 2018

Objectives: The objective of this study was to provide clinical evidence to support the use of a herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet (TWBXP)) for insomnia. Methods: Randomized controlled trials that verified effects of Herbal Medicine (Cheonwangbosim-Dan, Tianwangbuxin-Pellet) treating primary insomnia were carried out. A literature search of English, Chinese, Korean databases was also performed. The selected literature were assessed by Risk of Bias (RoB). Results: The total number of selected trials was 13 RCTs. Among the 13 RCTs, 10 were meta-analyzed. The Chinese Classification of Mental Disorders-3 (CCMD-3) was frequently used as the diagnostic criteria for interventions during the analysis of the use of herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet) for management of primary insomnia. As for outcome measurement, the effective rate was used. From the Meta-analysis of the studies, it was established that the insomnia cure effective rate in the TWBXP group was higher than that in the Western Medicine (WM) group (RR: 1.15, 95% CI: 1.07 to 1.24, p<0.0001, $I^2=33%$). Also, the effective rate in the TWBXP+ACU group was significantly different compared to the WM group (RR: 1.32, 95% CI: 1.13 to 1.54, p=0.0004, $I^2=0%$). The quality of the selected RCTs was low. Conclusions: Herbal medicine (Cheonwangbosim-Dan/Tianwangbuxin-Pellet) is effective for treating primary insomnia. It is worth noting that this studies were of relatively poor quality. The sample sizes were also small. Therefore, further investigations into the diagnosis and treatment of insomnia are warranted.

• 재활치료과학
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• 제8권2호
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• pp.7-30
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• 2019

목적 : 본 연구는 지역사회 노인에게 적용한 라이프스타일 중재의 형태와 효과를 알아보고자 하며, PRISMA 가이드라인를 통해 체계적 고찰을 시행하였다. 연구방법 : 2008년 1월부터 2017년 12월까지 국 내외 학술지에 개제된 논문을 국가과학기술정보센터(National Digital Science Library), RISS, PubMed, CINAHL을 통하여 검색하였다. 선정기준에 따라 최종적으로 20편의 연구를 분석하였으며, PEDro scale(Physiotherapy Evidence Database scale)을 사용하여 문헌의 질 평가를 하였다. 문헌에서 사용된 중재는 참가자들의 질환적 특성에 따라 분류하였다. 결과 : 라이프스타일 중재의 주요 구성요소는 중등도 이상의 운동과 같은 신체활동 증진과 건강한 식습관 형성을 위한 교육 및 훈련으로 확인되었다. 최종 분석된 20편 중 17편의 연구에서는 운동프로그램과 교육 또는 식단관리와 운동과 같이 두 가지 이상의 구성요소를 갖는 형태로 중재가 적용되었다. 노인의 건강 및 삶의 질을 평가하기 위해 다면적인 평가가 이뤄졌으며 그 중 생화학적 요인(biochemical factor)과 건강 및 웰빙(Health and well-being)을 평가하는 도구가 가장 많았다. 연구 분석 결과 지역사회 노인을 대상으로 한 라이프스타일 중재의 효과는 연구별로 상이하게 나타났으나, 14편의 연구에서 중재 직후 실험군과 대조군 간에 건강 및 삶의 질의 유의한 차이가 나타났다. 결론 : 본 연구는 노인의 질환적 특성에 따른 라이프스타일 중재기법을 선택하는데 도움을 줄 수 있을 것으로 사료된다. 향후 국내 지역사회 상황에 부합되는 중재의 개발 및 효과에 관한 연구를 통해, 작업치료적 라이프스타일 중재의 실행가능성에 관한 연구들이 체계적으로 이루어져야 할 것이다.

• 한국산학기술학회논문지
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• 제22권1호
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• pp.520-530
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• 2021

목표: 본 연구는 음악요법이 치매 노인의 인지기능, 초조행동, 불안, 우울에 미치는 영향을 규명하는 것을 목적으로 한다. 방법: 2010년부터 2019년까지 PubMed, EMBASE, Cochrane Library, CINAHL, Web of Science, Google scholar, PsycINFO에서 종합적인 문헌검색을 하였고 메타분석에서는 RevMan 5.4 프로그램을 사용하여 표준화된 평균 차이(Hedge's g)와 95% 신뢰 구간은 요약 측정으로 산출하고 랜덤 효과 모델과 역분산 방법을 적용하였다. 총 13개의 연구가 포함되었으며, 모두 오류 위험 평가를 위한 코크란 평가도구를 근거로 질 평가를 하였다. 결과: 효과 크기(Hedge's g)는 1차 결과 변수인 인지기능 0.31[95% CI:-0.02, 0.65], 초조행동 -0.03[95% CI: -0.17, 0.11], 2차 결과 변수인 불안 -0.61[95% CI: -1.17, -0.05], 우울 -0.44[95% CI: -0.88, 0.00]이었다. 음악중재 유형별 하위그룹 분석 결과 복합음악요법이 치매 환자의 인지기능(g=0.45[95% CI: 0.03, 0.87])에 유의한 증가 효과가 있는 것으로 나타났다. 결론: 음악요법은 불안과 우울을 감소시키는 데 유의한 효과를 보였으며, 복합음악치료는 치매 환자의 인지기능 개선 효과를 보였다.

• 동의신경정신과학회지
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• 제34권3호
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• pp.259-274
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• 2023

Objectives: The purpose of this study was to provide clinical evidence to support the use of auricular blood-letting therapy (ABT) for headaches. Methods: Studies were identified by a comprehensive search of five databases. Randomized controlled trials (RCTs) that investigated the effects of the ABT for headaches were included. Two authors independently extracted the data and assessed the methodological quality of the included studies using Cochrane's risk-of-bias tool. If two or more studies reported the same outcome, a meta-analysis was performed. Meta-analysis results for dichotomous variables are expressed as risk ratios (RRs) and 95% confidence intervals (CIs). Results: A total of eight RCTs were included in this review. The total effective rate (TER) was the most commonly used outcome measurement. Among the eight RCTs, five were included in the metaanalysis. The TER was not statistically significantly different in the ABT group compared to the medication group (two studies, n=55, RR=1.24, 95% CI: 0.78 to 1.96, p=0.36, I² =86%). However, the TER of the combined ABT and medication group was significantly different compared to the medication alone group (four studies, n=159, RR=1.23, 95% CI: 1.12 to 1.35, p<0.0001, I² = 0%). Pain and mental health-related outcomes in the combined ABT and medication group were significantly different from the control groups. The methodological quality of the included RCTs was generally low. Conclusions: ABT combined with medication may be effective for treating headaches. However, the number of studies included was small, so the results were insufficient, and statistically significant effects were not confirmed for a single implementation of ABT. Thus, well-designed further studies based on the findings of this study are recommended.

• 대한한방내과학회지
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• 제44권3호
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• pp.387-401
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• 2023

Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I²=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I²=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.