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Review of Pragmatic Clinical Trials on Acupuncture

  • Lee, Sang-Hoon;Seo, Byung-Kwan;Seo, Jung-Chul;Lee, Seung-Deok;Choi, Sun-Mi;Kim, Yong-Suk
    • Journal of Acupuncture Research
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    • v.22 no.2
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    • pp.163-170
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    • 2005
  • Background : Over the last thirty years, majority of researches on clinical effectiveness of acupuncture have been explanatory (or experimental) randomized controlled trial. The benefits of acupuncture in clinical trials are still controversial and most studies concluded that further control studies were required. Standardized combinations of acupuncture points for all the experimental subjects in various past studies have been criticized because such treatments do not reflect current routine clinical treatment. Objective : This paper aims to review pragmatic clinical trials on the effect of acupuncture treatment and to develop the ideal clinical research methodology of acupuncture study. Method : Clinical studies of acupuncture relevant with pragmatic or individualized trials were searched mainly in Pubmed and Science direct databases. All articles were fully reviewed by researchers, and data were evaluated by usage of a standardized form. Results & Suggestion : Pragmatic acupuncture researches were tried for various symptoms (eg. low back pain, hypertension, depression during pregnancy, sleep quality in HIV disease, chronic poststroke leg spasticity, headache, etc). Individualized acupuncture treatments based on oriental disease pattern diagnosis reflexes practical treatments which is more effective than unified and fixed acupuncture treatments without any theoretical basis of oriental medical philosophy. Conclusion : To overcome the controversies and limitations of past explanatory acupuncture trials, more individualized and tailored acupuncture trials with the theoretical basis of oriental medical diagnosis is highly recommended. Also clear definition and categorization of pattern identification should be established for further active clinical researches and applications of acupuncture.

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The Experiences of Alternative Therapy with the Menopausal Symptom in middle-aged Women (중년여성의 갱년기 증상완화를 위한 대체요법 경험)

  • Lee, Hea-Sook
    • The Journal of Korean Academic Society of Nursing Education
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    • v.10 no.1
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    • pp.149-160
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    • 2004
  • The primary purpose of this study was to describe psychological aspects of menopausal women who have experiences on alternative therapies, such as pomegranate tree fluid, life pack, evening primerose, zacro syrup, zacro pill, multi-vitamin, oriental medicine instead of estrogen. In order to have insights on the participants behaviors, this qualitative research was conducted. The participants in this study were six women who have been taking at least one of the alternative therapies to relieve the menopausal symptom. Data had been collected from November 2002 to May 2003. The interview questions were about motivations to seek the alternative therapy, menopausal symptoms, feelings or positive effects after the treatment. The interviews were recorded and transcribed into written documents. The method described by Giorgi was utilized for data analysis. The study results were as follows : 1. The participants sought the alternative therapy based on their own information or by friends' recommendations. The motivations of taking the therapy were to live younger and healthier by reliving menopausal symptoms including somatic symptoms, such as irregular menstruation, flushing sense, cold sweating, insomnia, dull headache, vagina dryness, cystitis after sexual intercourse, joint pain, nervousness, depression, skin dryness, and suppression of activity. 2. The participants expressed that they became more active and felt better with disappearing menopausal symptoms after about 2 to 3 weeks treatment. 3. The participants did not want to accept the fact that they had menopause, which caused avoidance of having medical diagnosis and medical treatment. They also did not want to let their spouses know about their symptoms. 4. The major reason of taking the alternative therapy was to avoid the side effects of estrogen therapy in spite of high costs of the alternative way. 5. The participants suggested that menopausal women needed to be educated about physical and psychological symptoms of menopause. They also needed to be informed about how to manage it. In conclusion, accurate information about foods and drugs utilized for the alternative therapy was needed. Medically proved methods to recognize positive effects and side effects were also necessary. These goals could be achieved by continuous medical observations and further research.

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Comparative Study on Diseases and Symptoms between Shanghan-lun and Juyan Wooden Slips (거연한간(居延漢簡)과 상한론(傷寒論)의 병증(病症) 비교 연구)

  • Ha, Ki-Tae;Jeong, Han-Sol;Shin, Sang-Woo
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.25 no.1
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    • pp.19-28
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    • 2011
  • More than 30,000 Wooden Slips were excavated in the Juyan region in 1930s and 1970s. These slips recorded military actions of Juyan Frontier Fortress during Han dynasty, which is about BC 100 ~ AD 30. On the slips, there are many disease names and symptoms mentioned. We focused on a certain disease name, namely, Shnaghan(傷寒; injured by cold), which is the main subject of Shangha-lun(傷寒論). Looking closely into these Juan Wooden Slips, we found many articles recording Shanghan, including related diseases and symptoms, such as Shanghan(傷汗; injured by sweat), headache, fever and chills, immobilization of limbs, unacceptance of foods. And there are another Shanghan-related symptoms, such as inflation of upper-abdomen(心腹支滿), pain of upper abdomen(心腹痛), strain of both armpits(兩胠葥急), inflation of chest(胸脇支滿), tightness and fear in the chest(煩滿). Although they have no direct relationship with Shanghan, there are many symptoms, including the external wounds of waist, finger, thigh, back, breast and head, abscess of leg and elbow, sore throat, itching, leucorrhea, powerlessness of hands and legs(手足癃), visceral injury(傷臟), tinnitus, cold, warm and heat. Because the Wooden Slips are very short, with some characters even missing, we can not confirm the detail of the disease and symptoms. In addition, we will report about the herbal medicines and other treatments, which are recorded on the slips, by further research.

Factors Affecting to the Fatigue and Subjective Symptoms of Labor Women (근로여성의 피로자각증상 및 요인별 피로도)

  • Her, Young-Gu;Kim, Keun-Jo
    • Journal of Korean Physical Therapy Science
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    • v.1 no.2
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    • pp.223-234
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    • 1994
  • To investigate the affecting factors to the fatigue and subjective symptoms of adult women, the author analyzed the data from 300 women from 3 groups, manufacture workes, clerical workers and service workers, from august 31, 1993 to the September 30, 1993. Followings are the results there from. 1. For the physical symptoms of fatigue, more than 50 % of respondens comiained were "eye strain" with 73.7 %, "malaise" with 67.0 % "went lay down side" with 60.7 %, "yawing" with 60.3 % and "feel sleep" eith 50.3 % in that order. There was no statistically significant difference between labor woker group, but the fatiger rate was highest among office group. For the mental symptoms. There was no symptom over 50 % of responders complained. For the neurotic symptoms, more than 50 % of respondents complained were "backache" with 53.7 %, "headache" with 49.7 % "shoulder pain" with 54.0 % and "unconfortable" with 43.3 %, in that order, "backache" was higest in manufacture group, but the other symptoms were highest among office group. 2. For the most fatigue weekday, most women answered monday with 56.0 % thursday with 16.3 % and friday with 12.0 % in that order, but saturday was 2.0 %, and sunday was 2.05 labor worker group answered monday was the most fatigue day. 3. 37.7 % of respondents answered afternoon was the most fatigue hours, but 22.0 % was answered evening difference among groups. 4. Nothing to do with the general characteristics, such as age, residence, sleep hours, personality, health status, and exercise, and working conditons such as means to attend office, time to attend office, job satisfaction, work hours, and work years, the mean scores of subjective symptoms of fatigue was highest among office group.

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Assessment of Nutritional Status and Factors Related to Smoking in Adolescent Males -II. Psychosocial Factors Influencing Smoking among Male High School Students- (남자 고등학생 흡연자의 영양상태 판정 및 흡연관련 요인분석 -II. 흡연과 관련된 사회심리적 요인에 대한 연구-)

  • 김경원;김소림;김정희
    • Korean Journal of Community Nutrition
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    • v.3 no.3
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    • pp.358-367
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    • 1998
  • The study purpose was to investigate psychosocial factors related to smoking among adolescent boys. The Theory of Planned Behavior provide the basis for the study. Twenty-five attitudinal beliefs, 9 normative beliefs and 20control beliefs were identified through questionnaire development. The data were analyzed using t-test and χ2-test. Thirty-three percent of 300 students were smokers. Most of the beliefs examined were significantly different between smokers(n=92) and nonsmokers(n=92). With respect to attitudinal beliefs, smokers responded less negatively on the items of bad health effects of smoking such as sore throat, headache, chest pain, risk of cancer and bad blood circulation(p<0.001), and decreased physical strength(p<0.05). Smokers believed less negatively on the items that smoking leads to bothering others, bad breath, yellow teeth and making them spend money(p<0.001). In contrast, smokers felt more positively on smoking as a means of stress management, relaxing, helping digestion(P<0.001). Smokers felt less pressure for not smoking from significant others. Especially mother, siblings, friends, girl friends, seniors of school were important sources of influence regarding subject's smoking. Smokers felt less confident in controlling the urge to smoke in several situations including; when they were with friends or asked to smoke by friends; after the meal, or drinking; when they were bored or stressed, upset, and when they felt unstable(p<0.001). Smokers also scored lower on specific skills to quit or control the urge to smoke as well as overall perceived control, compared to nonsmokers(p<0.001). These results suggest that interventions for adolescents incorporate diverse strategies to increase the perceived control over smoking in specific situations as well as overall perceived control, to help them realize and modify attitudinal beliefs, and to elicit support from significant others for not smoking. (Korean J Community Nutrition 3(3) : 358∼367,1998)

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Case Report of Autonomic Dysreflexia in a Pressure Sore Patient (욕창 환자에서 자율신경성 반사부전증의 경험례)

  • Nam, Seung Min;Park, Eun Soo;Park, Sun A;Kim, Young Bae
    • Archives of Plastic Surgery
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    • v.34 no.4
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    • pp.531-534
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    • 2007
  • Purpose: Plastic surgeons are responsible for the management of spinal cord injury patients with upper and lower extremity reconstruction, pressure sore, and wounds. Derailment of autonomic nervous systems caused by injury to the spinal cord may result in fatal autonomic dysreflexia. Autonomic dysreflexia is a syndrome of massive imbalance of reflex sympathetic discharge occurring in patients with spinal cord lesion above the splanchnic outflow(T6). It is characterized by a sudden onset and severe increase in blood pressure and is potentially life threatening. The other classic symptoms are headache, chest pain, sweating, and bradycardia. In order to lower the blood pressure, it is important to remove the noxious stimulus for autonomic dysreflexia. If such symptoms last for more than 15 minutes despite conservative interventions, antihypertension drugs are recommended. Methods: In this case study, we report an autonomic dysreflexia case that developed in a 45 year-old tetraplegia patient with sacral pressure sore. When he got bladder irrigation, his blood pressure went up very high and his mentality became stuporous. He was sent to ICU for his blood pressure and mental care. ICU care made his vital sign stabilized and his mentality alert. Results: After the patient underwent proper treatment like inotropic agent, he was transferred to the general ward and his pressure sore on sacral area was coveraged with gluteus maximus myocutaneous advancement flap. Conclusion: If treatment is not effective, the patients have to undergo sudden, severe hypertension, which can cause stroke or death. To provide safe and effective care, plastic surgeons should be able to recognize and treat autonomic dysreflexia.

The Complaints Rates of Minor Discomforts and Its Influencing Factors. (임신중 경증불편감 호소율과 영향 요인에 관한 연구)

  • Lee, Mi-La;Cho, Cheong-Ho;Kim, Eun-Kyung;Song, Mi-Seung
    • 모자간호학회지
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    • v.1
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    • pp.16-22
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    • 1991
  • Various minor discomforts are reported to be complained by the pregnant women. but what were and how much were they complained has not been revealed until recently. So, These lack of knowledge have given nurses difficulties in planning of care to promote the health during the pregnancy. Objectives of this study were to identify the rate of complaints in each minor discomforts and to explore the influencing factor on reduction of complaints of minor discomforts. The subjects were 120 mothers, who delivered their babies in hospital, from September to December 1990 and the reason why the postpartum mothers were selected as the subjects were minor discomforts could develope during the entire period of pregnancy. Data were gathered by the questionnares and analized statistically using SAS and SPSS program. Results were as follows. 1. More than one third of the subjects complained frequent urination, fatigue, increase of the vaginal discharge, morning sickness, the increased urination at night, pain in leg, backache, edema in leg, constipation, dyspnea, varicose vein, flatulence, headache. 2. Minor discomforts complained to be severe in more than one third of the subjects were frequent urination and increased urination at night. 3. The influencing factor to reduce the complaints of minor discomfort was revealed to be the perceived family support (r=0.030431, t=0.0007). We suggest that nurses should emphasize the importance of the family support to the pregnant women and their family, and to explore the relationships among the locus of control, the perceived family support and the complaints of minor discomforts.

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Analysis on Heart Rate Variability (HRV) Characteristics of Patients with Insomnia during Perimenopause and Postmenopause: A Retrospective Chart Review (불면증이 동반된 여성 갱년기 환자의 심박변이도 특성 분석 : 후향적 차트리뷰)

  • Ahn, Soo-Yeon;Park, Eun-Ji;Lee, Ji-Yeon;Yoo, Jeong-Eun
    • The Journal of Korean Obstetrics and Gynecology
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    • v.30 no.3
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    • pp.54-64
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    • 2017
  • Objectives: The purpose of this study is to demonstrate Heart Rate Variability characteristics of menopausal patients with insomnia. Methods: From March 1, 2014 to June 20, 2017, Heart Rate Variability was measured in 102 menopausal patients who visited Cheonan Korean Medicine Hospital of Daejeon University. We compared accompanying symptoms and Heart Rate Variability values depending on sleep quality in menopausal women. Results: The accompanying symptoms of menopausal patients were as follows: hot flushes (45.1%), tiredness (25.49%), chest discomfort and palpitations (23.53%), headache (17.65%), arthralgia and muscular pain (17.65%), cold sensitivity of hands and feet (15.69%), urinary frequency (14.71%) and anxiety (10.78%). The frequency of chest discomfort and palpitation was significantly higher in the menopausal insomnia group than in normal sleep group. Comparing Heart Rate Variability between two groups, Standard deviation of the NN interval (SDNN), Total Power (TP), and Low Frequency (LF) values were significantly lower in insomnia group. Conclusions: Chest discomfort and palpitations were more frequent in insomnia patients in menopausal women than normal sleep group, and Standard deviation of the NN interval (SDNN), Total Power (TP), Low Frequency (LF) were significantly lower in HRV values.

Prophylactic Therapy Response in Children with Abdominal Migraine: A Single Centre Experience in Oman

  • Al Lawati, Tawfiq Taki;Saadah, Omar I.;al Riyami, Ruwaina;al Yarubi, Zuwaina
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.25 no.2
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    • pp.121-128
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    • 2022
  • Purpose: Abdominal migraine (AM) is a very common functional gastrointestinal disorder in children. This study reports the clinical features and response of AM to prophylactic treatment in children. Methods: This retrospective study was conducted between January 2010 and December 2019 at the Royal Hospital in the Sultanate of Oman. This study included children aged ≤ 13 years with a diagnosis of AM based on the Rome IV criteria for functional diagnoses. Clinical, demographic, and treatment data were collected. Results: Seventy-four children were identified, of which 43 were eligible for inclusion in this study. The median age at the onset of symptoms was 7 years (range, 2-12 years). The most frequent symptoms were headache (81.4%), nausea (79.1%), and vomiting (72.1%). Of the total cohort, 46.5%, 23.3%, and 6.9% received riboflavin, pizotifen, and propranolol monotherapy, respectively. Combination therapy was also used; 16.3% of children received pizotifen and propranolol, 4.7% received riboflavin and pizotifen, and 2.3% received riboflavin and propranolol. Patients treated with propranolol monotherapy showed 100% clinical improvement and those treated with riboflavin or pizotifen monotherapy showed 90% clinical improvement. Response to combination therapy with pizotifen and propranolol was 71.4%, and with riboflavin and pizotifen was 100%. In addition, treatment response was significantly associated with the presence of vomiting (p=0.039). Conclusion: We found a favorable response to various modalities and combination treatments with riboflavin, pizotifen, and propranolol in children with AM. In addition, the presence of vomiting may predict treatment response.

Short-term safety profile of COVID-19 vaccination in children and adolescents with underlying medical conditions: a prospective cohort study

  • Naye Choi;Seung-Ah Choe;Yo Han Ahn;Young June Choe;Ju-Young Shin;Nam-Kyong Choi;Seong Heon Kim;Hee Gyung Kang
    • Childhood Kidney Diseases
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    • v.27 no.1
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    • pp.34-39
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    • 2023
  • Purpose: This article was to collect data on the safety of coronavirus disease 2019 (COVID-19) vaccines in children with underlying medical conditions. Methods: We constructed a prospective cohort of children and adolescents aged 5 to 19 years who had received at least one dose of COVID-19 vaccine. Patients diagnosed with and treated for chronic kidney disease, autoimmune disease, or other chronic conditions at the Seoul National University Children's Hospital were recruited from June to December 2022. A mobile survey questionnaire was sent to their guardians. The presence of adverse events on the day (day 0), 3 weeks (day 21), and 6 months (day 180) after the 1st dose of COVID-19 vaccine was recorded by the guardians. Results: A total of 73 children participated. The median age was 14 years, and 64.4% of the patients were male. On the day of immunization, 65.8% of the patients reported at least one adverse event. Pain at the injection site, fatigue, headache, arthralgia, and myalgia were the most common symptoms. The prevalence of adverse events decreased over time (65.8% on day 0, 27.4% between days 0 and 21, and 24.6% between days 21 and 180). Severe acute respiratory syndrome coronavirus 2 infection after the 1st dose occurred in 17 patients (23.3%) and one of the patients (5.88%) was hospitalized due to infection. Conclusions: Adverse events after COVID-19 vaccination were generally mild in children and adolescents with underlying medical conditions. Our findings provide evidence for the safety of COVID-19 vaccination in the vulnerable pediatric population.