• Title/Summary/Keyword: Clinical Trials

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Study on Clinical Research Methodologies for Acupuncture: Based on Review of Clinical Studies on Back Pain (침 임상연구방법론 연구: 요통 임상연구 사례를 중심으로)

  • Park, Yu Lee
    • Korean Journal of Acupuncture
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    • v.31 no.4
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    • pp.158-167
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    • 2014
  • Objectives : The results from randomized controlled trials on traditional medicine have been negative or ambiguous. The appropriateness of the research methodology started to be questioned. However, the research methodology appropriate for studying traditional medicine has not been well-established. This study aims to explore the appropriate research methodologies for clinical studies on acupuncture. Methods : Clinical researches evaluating the efficacy and effectiveness of acupuncture for back pain were systematically searched and evaluated focusing on research methodology. The acupuncture treatment protocol is evaluated by 9 items which is individual treatment based on diagnosis, combining proximal and distal acupoints, exact location of acupoint, De Qi, adequate stimulation, duration of acupuncture, treatment sessions, treatment interval, and establishing relationship between patients and doctors. Results : Systematic review of acupuncture researches on low back pain suggested that observational studies and pragmatic trials rather than explanatory studies could incorporate these elements. Qualitative studies also could help understanding complex characteristics of acupuncture treatment which could not be evaluated by quantitative studies. Conclusions : In designing clinical researches on acupuncture, various study designs, especially observational study and pragmatic study, should be considered according to research objectives and subjects. The efforts to incorporate the core characteristics of acupuncture practiced in everyday clinical setting are also essential.

Herbal Medicine for Pediatric Epilepsy: Clinical Research Trends in Traditional Chinese Medicine

  • Kim, Sang-Ho;Kim, Da-Woon
    • Journal of Oriental Neuropsychiatry
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    • v.33 no.2
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    • pp.181-214
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    • 2022
  • Pediatric epilepsy, a chronic, recurrent brain disorder, is the most common neurological disorder in children. Its prevalence is increasing. Early management is very important since 30~40% of cases persist into adulthood. To provide basic data for future clinical research on pediatric epilepsy using Korean medicine treatment and cooperation between Western medicine doctors and Korean medicine doctors, we reviewed recent clinical research in traditional Chinese medicine (TCM) using herbal medicine for pediatric epilepsy. A total of 23 articles (1 clinical practice guideline, 3 systematic reviews, 15 randomized controlled trials (RCTs), and 4 non-RCTs) were reviewed in this study. The authors summarized characteristics of included studies regarding study subjects, diagnostic tools, pattern identification tools, treatment period, evaluation tools, detail of herbal medicines, treatment effects, and adverse events. Combination therapy using both herbal medicine (HM) and anti-epileptic drugs (AEDs) was performed more frequently than herbal medicine alone. Liver-pacifying medicinal, water-draining medicine, and orifice-opening medicine were frequently used. The main single HMs were Cheonma, Boglyeong, Jogudeung, and Seogchangpo. Combined therapy using HM and AEDs had significant benefits in improving total effective rate. It also appeared to be safer than AEDs. However, since the quality of clinical trials was poor and only studies in the last 10 years were included, the clinical evidence was uncertain. Finally, the authors provided limitations of this study and several suggestions for future research based on our analysis results.

Review and Analysis of Sham Acupuncture in Acupuncture Clinical Trials (침 임상연구에 사용된 거짓침의 분석)

  • Jang, Jin-Young;Kim, So-Jung;Kim, Nam-Sik;Nam, Sang-Soo;Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.28 no.5
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    • pp.29-38
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    • 2011
  • Objectives : Recent well-designed randomized controlled trials(RCTs) and their meta-analysis have been published on the efficacy of acupuncture in different condition. In most of them, real acupuncture is compared with sham acupuncture including invasive and non-invasive sham methods. But it is not clear how active sham methods are. These results tend to lead the conclusion that acupuncture has no more effective than sham acupuncture. In order to investigate that sham acupuncture is appropriate as a control, we reviewed several acupuncture trials using different sham acupuncture as a control. Methods : We searched Cochrane researches of acupuncture, reviewed and analyzed 25 RCTs in 42 Cochrane reviews. And especially we compared the effect of acupuncture according to the type of sham acupuncture. Results : Invasive sham acupunctures are used in 12 RCTs and non-invasive types are used in the rest. The majority of studies(19 RCTs) fail to show effects beyond a sham acupuncture. Streitberger's sham needle is a validated sham acupuncture of non-invasive type that was used in 8 trials and also no significant group differences are shown except one trial. Conclusions : Acupuncture is a complex intervention. Clinical trials of acupuncture need to be reexamined and redesigned to remove several bias. Especially, sham acupuncture as a control might be investigated for physiological effects as well as validation test including patient-blinding and de qi sensation. Other research need to be investigated and developed for acupuncture trials.

Review of Randomized Controlled Trials on Pharmacopuneture Treatment for Musculoskeletal Diseases (무작위대조군연구(RCT)를 중심으로 한 근.골격계 질환의 약침 치료에 관한 고찰)

  • Jang, Min-Ki;Yoon, Eun-Hye;Jung, Chan-Yung;Kim, Eun-Jung;Lee, Seung-Deok;Hwang, Min-Seop;Kim, Kap-Sung
    • Journal of Acupuncture Research
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    • v.26 no.3
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    • pp.149-163
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    • 2009
  • Objectives : The purpose of this study is to review RCTs on pharmacopuncture treatment for musculoskeletal diseases and to establish standards of pharmacopuncture treatment model. Methods : We searched articles up to date of March 2009 via computerized databases of Pubmed, The Journal of Korean Acupuncture & Moxibustion, Journal of Korean institute of Herbal Acupuncture, Journal of Oriental Rehabilitation and Journal of Korean Oriental Medicine. Only Randomized Controlled Trials (RCT) concerning the effects of pharmacopuncture on musculoskeletal diseases. The pharmacopuncture treatment methods were assessed based on STRICTA and items considering the feature of pharmacopuncture. And the methodological quality of the trials was assessed by FEAS and modified Jadad score. Results : Eighteen trials of pharmacopuncture on musculoskeletal diseases were analyzed. Except for 4 trials comparing the effect of SBV and BV, positive outcome was reported in ten trials. Among eighteen trials; most of the trials were about Bee Venom acupuncture, and most of the trials used about five acupuncture points, mainly local acupuncture points. But, the amount of injection to each point and total injection were various. And most of trials were lack in the information about method of stimulation. The adjusted FEAS score ranged from 0 to 12, and modified Jadad scoreranged from 1 to 5. Conclusions: To standardize pharmacopuncture treatment, we need more well-designed, high quality clinical trials. And methodological assessment tools designed for pharmacopuncture treatment are also needed.

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The Review on the Prostate Disease-related Studies with Acupuncture Therapy in PubMed (PubMed 검색(檢索)을 이용한 전립선(前立腺) 질환(疾患)의 침치료(鍼治療)관련 연구(硏究)에 대한 고찰(考察))

  • Song, Ho-Sueb
    • Journal of Pharmacopuncture
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    • v.7 no.2
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    • pp.65-73
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    • 2004
  • Objective : This study was to review on the prostate disease-related studies with Acupuncture therapy in renowned medical internet site of PubMed, and to make master plan of the study, especially, on Bee Venom Acupuncture(BVA) of Prostate disease and then to devise the idealistic therapeutic ways of it. Method : We made the internet search with the key words of bee venom(bee venom therapy, apitoxin, apitherapy, bee sting, bee sting therapy), acupuncture, prostate, prostatitis, prostrate cancer in Pubmed, from June 1st to July 1st,2004. Results : 1.25 papers were found in 19 publised jounals. of which two named'Urology'and Prostate' had three papars, two called 'JUrology' and 'Cancer Immunol Immunother' had two papers, and the others had a paper respectively. 2. In the classification by papers' types, Review papers were 8 and Original were 17 where there were 5 clinical trials, 11 experimental studies and 1 epidemiologic paper. Of 5 clinical trials, 2 belonged to Randomized Control Study, and of 11 experimental studies, 4 belonged to in vitro and 7 belonged to in vivo with in viro studies, and 1 epidemeologic belonged to meta-analysis. 3. In the classification by prostate diseases, 4 were about prostatitis, 3 were about prostate related symptoms, 16 were about prostate cancer, and two were about the others. 4. In the classification by applied treatment methods, 5 were related with Acupuncture, 10 were related with BVA(Bee Venom, Bee), and 10 were related with the others. Of 5 related with Acupuncture, 3 used general acupuncture, 1 used electrical acupuncture, and 1 used general acupuncture and electrical acupuncture at the same time. 5. In 2 RCTs of Clinical trials, Control group was set up to the group using different compatible treatment method or using meridians not related with treating prostate disease. Single or double blind methods couldn't be found. 6. In the clinical trials, IPSS, NIH, CPSI or subjective global assessment were used as the Index of Evaluation. 7. The Leg Greater Yang Bladder Meridian(B), The Leg Lesser Um Kidney Meridian(K) and Conception Vessel Meridian(CV) were used as major meridians, and B10(Taejo, Dazhu), B23(Shinsu, Shenshu), B28(Panggwangsu, Pangguangshu), B35(Hoeyang, Huiyang), B39(Wiyang, Weiyang), B40(Wijung, Weizhong), B54(chilbyon, Zhibian), K1(Yongchon, Yongquan), K10(Umgok, Yingu), CV3(Chungguk, Zhongji), CV4(Kwanwon, Guanyuan),S6(Hyopko, Jiache) were used as acupoints. Electrical acupuncture(EA) was considered to be more important and CV3(Chungguk, Zhongji), CV4(Kwanwon, Guanyuan) were mainly selected as EA applied acupoints. 8. It is mostly said that Acupuncture appeared to be a safe, effective, and durable treatment alternative in improving symptoms of patients with prostate diseases, refractory to conventional medicine. A larger controlled study was required to confirm these encouraging initial results. Conclusion : Papers about BVA of Prostate cancer or Prostatitis were not found, and low permeability of Prostate is concerned, BVA with the anti-inflammatory and anti-cancer effect can be adopted as a new alternatives of Prostate disease treatment, so it is thought that Study of how to make access to prostate, animal experiment including in vivo and in vitro and more clinical trials with using acupoints on related meridian should be followed.

Recent Topics of Clinical Trials in Obesity and Metabolic Study (비만과 대사증후군에 관한 임상시험의 최근 경향)

  • Lee, Ju-Ah;Kong, Kyung-Hwan;Ko, Ho-Yeon;Bae, Kwang-Ho;Park, Sun-Young;Park, Kyung-Moo;Song, Yun-Kyung;Park, Jung-Hyeon;Kim, Ho-Jun;Park, Sun-Jun;Park, Jeong-Su;Ko, Seong-Gyu
    • Journal of Korean Medicine for Obesity Research
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    • v.9 no.1
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    • pp.15-22
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    • 2009
  • Objectives The aim of this study is to review and analyze the status on the recent clinical trials of 'obesity' and 'metabolic syndrome'. Methods We search 'www.clinicaltrail.gov' for research trend of Obesity and metabolic syndrome. Search terms used were 'obesity' and 'metabolic syndrome'. In order to see detail review, searching was performed from 01, 01, 2007 to 05, 31, 2009 with intervention, phase III or phase IV, And we classified all the searched studies into design, intervention, purpose, end point, diseases and condition Results We could search total 232 trials. Of them, we found 32 trials with intervention, phase III or phase IV from 01, 01, 2007 to 05, 31, 2009 Also we could see various design of clinical trials. Conclusion To improve obesity and metabolic study in Traditional Korean Medicine, it is need to activate clinical trial, meta analysis, develope of clinical practice guidelines, co-works with conventional medicine and etc.

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Independent Data Monitoring Committees: Review of Current Guidelines (국내 및 해외의 임상시험 데이터모니터링위원회 지침의 현황)

  • Lee, Bo Ram;Lee, Kyung Eun
    • Korean Journal of Clinical Pharmacy
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    • v.26 no.2
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    • pp.181-186
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    • 2016
  • Background: There has been on increasing emphasis on the importance of monitoring the safety of participants in a clinical trial to protect patients and maintain the integrity of the trial. The independent data monitoring committee (IDMC) has become common component of randomized clinical trials in recent years. Methods: It is important to consider the implications of different approaches that are being used in various countries. IDMC guidelines in Korea, US, and Europe were reviewed and compared to provide the objective, composition and operation of IDMC in detail. Results: IDMC is a group of experts in related subject are as who perform interim data monitoring to make a recommendation to the sponsor or organizer regarding appropriateness of trial continuation and the need for modifications of the trial. Independence of IDMC is preferred in order to minimize influence of factors unrelated to scientific, medical and ethical considerations that should underlie decision-making. Conclusion: IDMC has become an increasingly important component of clinical trials in recent years. Practical operating procedures need to be developed considering the future regulatory status of data monitoring committees.

Nanotechnology in reproductive medicine: Opportunities for clinical translation

  • Shandilya, Ruchita;Pathak, Neelam;Lohiya, Nirmal Kumar;Sharma, Radhey Shyam;Mishra, Pradyumna Kumar
    • Clinical and Experimental Reproductive Medicine
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    • v.47 no.4
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    • pp.245-262
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    • 2020
  • In recent years, nanotechnology has revolutionized global healthcare and has been predicted to exert a remarkable effect on clinical medicine. In this context, the clinical use of nanomaterials for cancer diagnosis, fertility preservation, and the management of infertility and other pathologies linked to pubertal development, menopause, sexually transmitted infections, and HIV (human immunodeficiency virus) has substantial promise to fill the existing lacunae in reproductive healthcare. Of late, a number of clinical trials involving the use of nanoparticles for the early detection of reproductive tract infections and cancers, targeted drug delivery, and cellular therapeutics have been conducted. However, most of these trials of nanoengineering are still at a nascent stage, and better synergy between pharmaceutics, chemistry, and cutting-edge molecular sciences is needed for effective translation of these interventions from bench to bedside. To bridge the gap between translational outcome and product development, strategic partnerships with the insight and ability to anticipate challenges, as well as an indepth understanding of the molecular pathways involved, are highly essential. Such amalgamations would overcome the regulatory gauntlet and technical hurdles, thereby facilitating the effective clinical translation of these nano-based tools and technologies. The present review comprehensively focuses on emerging applications of nanotechnology, which holds enormous promise for improved therapeutics and early diagnosis of various human reproductive tract diseases and conditions.