• Title/Summary/Keyword: RCTs Review

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Yukgunja-tang for Irritable Bowel Syndrome: A Protocol for a Systematic Review and Meta-Analysis

  • Kangwook Lee;Seok-Jae Ko;Minjeong Kim;Chaehyun Park;Min-Seok Cho;Jae-Woo Park
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.285-293
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    • 2023
  • Background: Irritable bowel syndrome (IBS) is a digestive disorder characterized by abdominal discomfort or pain accompanied by a change in stool condition. Owing to its complicated mechanisms, a standard treatment for IBS has not yet been established. Yukgunja-tang (YGT) is a Korean herbal medicine known in Asia to be effective in the treatment of gastrointestinal symptoms. In this study, we will conduct a systematic review of randomized controlled trials (RCTs) to assess the efficacy and safety of YGT in IBS treatment. Methods and analysis: English databases, such as Embase, Medline (via PubMed), Allied and Complementary Medicine Database, and Cochrane Central Register of Controlled Trials, will be searched for articles published up to April 2023. Additional databases, such as five Korean, one Chinese, and one Japanese database, will be included. RCTs and quasi-RCTs will also be included in the assessment of the efficacy of YGT. The overall efficacy rate will be the primary outcome, and data such as IBS quality-of-life measurements, global symptom scores, and adverse events will be the secondary outcomes. Review Manager Version 5.3 will be used for evaluation, and the risk of bias (RoB) will be evaluated using Cochrane Collaboration's RoB tool. The Grading of Recommendations Assessment, Development, and Evaluation approach will be used to score the quality of evidence. Conclusion: This study will demonstrate the efficacy and safety of YGT for treating patients with IBS.

Herbal Medicine for Sarcopenia: A Systematic Review of Randomized Controlled Trials (근감소증에 대한 한약 치료 : 체계적 문헌 고찰)

  • Se-eun Chun;Soo-hyung Lee;Yong-jeen Shin;Sun-ho Shin
    • The Journal of Internal Korean Medicine
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    • v.44 no.6
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    • pp.1118-1138
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    • 2023
  • Objectives: Sarcopenia is an age-associated skeletal muscle disorder that can profoundly impact the health of elderly people. However, the efficacy of herbal medicine in sarcopenia is uncertain. This review aims to investigate evidence of the effect of herbal medicine on sarcopenia. Methods: We systematically searched 12 electronic databases for relevant randomized controlled trials (RCTs). Only trials that met the inclusion criteria were selected, and the characteristics of the included studies were extracted and synthesized in a narrative manner. The quality of the included studies was assessed using Cochrane's Risk of Bias (RoB) 2.0 tool. Results: 7 RCTs involving 672 participants with sarcopenia met the inclusion criteria. The intervention combining herbal medicine and conventional treatment (i.e., exercise, nutritional support) had a significant therapeutic effect compared with the conventional treatment, showing improvement in muscle strength (i.e., grip strength), muscle mass (i.e., appendicular skeletal muscle mass index), and physical function (i.e., gait speed, short physical performance battery, and timed up and go test). However, the methodological quality of the included RCTs was relatively low due to their high RoB, making it difficult to evaluate the efficacy of herbal medicine in sarcopenia. In terms of safety, several adverse events were reported. Conclusion: This review suggests that herbal medicine has a positive effect on muscle strength, muscle mass, and physical performance in elderly patients with sarcopenia, but there is a clear need for further research in this area.

Recent Trends in the Treatment of Voice Disorders: Evidence-based Practice and Translational Biology Research (음성 장애 치료 연구의 최근 동향: 증거에 기초한 임상 치료 및 전이 생물학적 연구)

  • Choi, Seong-Hee
    • Phonetics and Speech Sciences
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    • v.2 no.1
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    • pp.99-112
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    • 2010
  • This study attempted to review the recent, high-quality evidence-based practical research related to the treatment effectiveness of voice disorders which focus on randomized controlled trials (RCTs) and translational research of vocal fold tissue engineering for vocal fold regeneration. Methodology including PICO (P; Populations or Patients, I; Interventions, C; Comparison group (control, placebo, gold standard), O; Outcomes or measures made) information for RCTs and animal models (species), regenerative therapy method, and outcomes of translational research for clinical application was summarized and discussed for future voice disorder research.

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Fascia Chuna Therapy for Piriformis Syndrome: A Review of Clinical Study (이상근증후군의 근막 추나 요법에 대한 문헌 고찰 연구 보고)

  • Park, In-hwa
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.16 no.2
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    • pp.39-45
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    • 2021
  • Objectives The purpose of this study was to assess the effect of fascia chuna therapy in the treatment of piriformis syndrome. Methods A literature search was conducted using 8 databases to identify all randomized controlled clinical trials (RCTs) that investigated fascia chuna therapy as a treatment for piriformis syndrome. The selected studies are analyzed the risk of bias through Cochrane risk of bias tool. Results Among 37 articles that were searched, 3 RCTs met our inclusion criteria and were included in this analysis. These studies demonstrated positive results of Fascia Chuna Therapy with respect to the reduction of pain scale and functional scale compared with other treatment methods. Conclusions Based on results, fascia chuna therapy could be effective in piriformis syndrome. However there are limitations that the number of selected studies was small and risk of bias was unclear. More well-designed RCTs are required to provide clearer evidence.

Reporting of Adverse Events in Randomized Controlled Trials of Bee Venom Acupuncture: A Systematic Review (봉침을 이용한 무작위배정 비교임상시험연구에서의 유해사례 보고에 대한 체계적 문헌고찰)

  • Yi, Woon-Sup;Kim, Sung-Soo
    • Journal of Korean Medicine Rehabilitation
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    • v.24 no.4
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    • pp.97-109
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    • 2014
  • Objectives Bee venom acupuncture (BVA) is emerging as a potential therapeutic option for several conditions. However, evidence regarding accurate estimates of its adverse events are not available. Therefore, by combining occurrence rates of adverse events in relevant randomized controlled trials (RCTs), we have aimed to give an overall estimated rate of each adverse event following BVA intervention. Methods A systematic search for adverse events of BVA in Pubmed, Cochrane Central Register of Controlled Trials, Embase, NDSL, KoreaMed, KISS, RISS, KISTI, and KMbase was performed. For the quality assessment of the trials, we applied the CONSORT harms reporting recommendations. The overall occurrence rate of each adverse event was assessed as the primary outcome. The overall drop-out rate due to adverse events was assessed as the secondary outcome. Results Ten RCTs reported adverse events following BVA. Two RCTs were eligible of further synthesis. Adverse events of pruritus, localized edema, and erythema occurred significantly more frequently in the BVA group compared to the control group. Data of drop-outs were available in seven RCTs. However, no comparisons showed a significant difference. Conclusions Currently evidence of adverse events is far from sufficient for assessing a reliable, precise occurrence rate. Still, limited evidence shows a tendency that adverse events occur more frequently after the appliance of BVA compared to the control. Thus, we await well designed future studies of BVA with more proper and strict harms reporting methods.

Clinical Effect of Acupuncture Combined with Herbal Medicine in Treatment of PSD: A Systematic Review and Meta-Analysis (뇌졸중 후 우울증에 대한 침과 한약의 결합 치료 효과: 체계적 문헌 고찰 및 메타분석 연구)

  • Sakong, Jong-Won;Lim, Su-Yeon;Kim, Sang-Ho;Chung, Dae-kyoo
    • Journal of Oriental Neuropsychiatry
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    • v.31 no.3
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    • pp.169-186
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    • 2020
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of acupuncture combined herbal medicine for post-stroke depression. Methods: Studies were identified by searching Pubmed, EMBASE, Cochrane Library, NDSL, RISS, KMbase, KISS, and CNKI. Randomized controlled trials that verified effects of the acupuncture combined with the herbal medicine for PSD were included in this study. Literature searches of English, Chinese, and Korean databases were performed. Two authors independently extracted the data and assembled the study quality. Results: Of 698 RCTs screened, 17 RCTs were selected. Most of the studies had unclear risk of bias. Among the 17 RCTs, 10 were meta-analyzed. As for the outcome measurement, the effective rate and the HAMD were most commonly used. The meta-analysis of the studies revealed that the PSD cure effective rate in the acupuncture combined with herbal medicine group was higher than that in the Western medicine group (RR: 1.23, 95% CI: 1.14 to 1.33, p<0.00001, I2=0%). Also, the HAMD in the acupuncture combined with herbal medicine group was significantly different compared to the Western medicine group (MD -5.54, 95% CI -9.80 to -1.29, p=0.01, I2=99%). The quality of the selected RCTs was low. Conclusions: Acupuncture combined with herbal medicine is effective for treating post-stroke depression. However, It is worth noting that the included studies were of relatively poor quality. The sample sizes were also small. Based on the findings of this study, further investigations into the diagnosis and treatment of PSD are warranted.

Electroacupuncture for Treatment of Polycystic Ovarian Syndrome: Systematic Review of Randomized Controlled Trials (다낭성 난소증후군의 전침 치료 연구에 관한 체계적 문헌 고찰)

  • Yoon, Jun-Geol;Park, Nam-Chun;Ji, Hae-Ri;Park, Kyoung-Sun;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.31 no.4
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    • pp.39-53
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    • 2018
  • Objectives: The purpose of this review was to overview and evaluate the efficacy of electroacupunture for women with polycystic ovarian syndrome (PCOS) Methods: Relevant randomized controlled studies (RCTs) were identified by database searches in PubMED, EMBASE, OASIS, and Google scholar, up to May 2018. Data were extracted regarding hyperandrogenism, obesity and hyperinsulinemia indices. The risk of bias was assessed. Results: Five RCTs were included for analysis. In one RCT, electroacupuncture group had significantly lower free testosterone and testosterone, compared to no treatment group. However, The other RCTs showed no significant difference between two groups. For LH/FSH, Ferriman Gallway score, anti-mullerian hormone, body mass index, weight and waist, and insulin, electroacupuncture group showed no significant difference, compared to physical exercise, no treatment, and sham acupuncture group. Conclusions: Only a limited number of RCTs have been reported. At present, there is insufficient evidence to support the use of electroacupuncture for treatment of PCOS.

A Review on Randomized Controlled Clinical Study on Acupuncture Treatment of Breast Cancer Patients (유방암 환자 대상 침치료 무작위비교임상연구 고찰)

  • Lee, Yoon-Jae;Lee, Sung-Yeop;Jung, You-Hwa;Lee, Seung-Yeol;Jang, Jun-Bock;Hwang, Deok-Sang
    • The Journal of Korean Obstetrics and Gynecology
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    • v.29 no.1
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    • pp.78-91
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    • 2016
  • Objectives: Breast cancer patients in Korea need to care about symptoms with complementary medicine including acupuncture. We reviewed the randomized controlled studies using acupuncture in breast cancer patients to establish a basic knowledge of clinical practice guidelines. Methods: We searched the following databases through July 2015: the Cochrane Central Register of Controlled Trials, Ovid-Medline, Ovid-EMBASE, the Allied and Complementary Medicine Databases and OASIS. The articles of RCTs using acupuncture in breast cancer for all symptoms were selected and analyzed. The acupoints, treatment period, inclusion criteria of participants, follow-up period and effectiveness were extracted. Results: Three hundred fifty five records after duplicate were screened, and 14 RCTs were selected. RCTs of Hot flush, pain, fatigue were reviewed. The adverse symptoms using medical treatment in breast cancer patients were targets of acupuncture in RCTs. The acupuncture treatment was decreased the hot flush, pain and fatigue. However, the effect was not confirmed due to various study design. Conclusions: The analysis of the research would be conjugated to establish a basic knowledge of clinical practice guidelines. Well designed studies in Korea are needed to confirm the efficacy and safety of acupuncture in patients with breast cancer.

The Effect of Moxibustion Treatment for Cardiac Arrhythmia : A Systematic Review (부정맥의 뜸 치료 효과에 대한 체계적 문헌고찰)

  • Lee, Bora;Hwang, Juyeong;Kwon, Jungnam
    • The Journal of Korean Medicine
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    • v.40 no.3
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    • pp.99-111
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    • 2019
  • Objectives: The purpose of this study was to assess the effects of moxibustion treatment for Cardiac arrhythmia through a systematic review. Methods: Electronic database including Cochrane library, Pubmed, China National Knowledge Infrastructure, Embase, DBpia, and Korean studies Information Service System were searched by combining the keywords such as "arrhythmias", "cardiac arrhythmias", "心律失常", "moxibustion" and "艾灸". Through the searching, 5 randomized controlled trials(RCTs) were included except animal testing and cellular experiment etc. The quality of each RCTs was assessed using the Cochrane risk of bias tool. Results: We included 5RCTs involving 468 participants. Two RCTs compared moxibustion versus conventional treatment, another RCT compared moxibustion plus acupuncture versus conventional treatment, another RCT compared moxibustion plus herbal medicine verus conventional treatment, the other RCT compared moxibustion plus herbal medicine and ointment versus conventional treatment. These studies were evaluated by the efficacy rate of treatments. Studies measured outcomes in efficacy, heart rate, electrocardiogram and symptoms. Each of 5 trials statistically showed a significant differences in efficacy rate. One study reported about side effects and another study reported about complications. The overall risk of bias was unclear in 5 studies. Conclusions: The evidence suggests that moxibustion treatment may help to reduce cardiac arrhythmia, however, it is limited, low-certainty and we cannot rule out benefits or risks with this treatment. High-quality studies that report adverse effects are needed.

Effects of Acupuncture after Rotator Cuff Surgery: A Systematic Review (회전근개 수술 후 침 치료의 효과: 체계적 문헌고찰)

  • Lee, Sang-Jin;Ko, You-Me;Park, Jung-Sik;Park, Tae-Yong;Lee, Jung-Han;Cho, Jae-Heung;Hwang, Eui-Hyoung;Kim, Kyoung-Ja;Choi, Mi-Young;Song, Yun-Kyung
    • Journal of Korean Medicine Rehabilitation
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    • v.31 no.4
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    • pp.25-34
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    • 2021
  • Objectives This study was conducted to evaluate the therapeutic effect of acupuncture after rotator cuff surgery. Methods Key words such as rotator cuff surgery and acupuncture were searched in 10 databases (Ovid-Medline, Ovid-EMBASE, Ovid-AMED, Cochrane Library, China National Knowledge Infrastructure [CNKI], National Digital Science Library [NDSL], Koreanstudies Information Service System [KISS], Oriental medicine Advanced Searching Integrated System [OASIS], KoreaMed, KMBASE), and only suitable randomized controlled trials (RCTs) were selected. Results 6 RCTs were finally selected, and acupuncture showed positive results for pain relief and functional recovery after rotator cuff surgery. However, the analyzed 6 RCTs showed a high overall risk of bias. Conclusions In the future, RCTs with a higher level of evidence on the effect of acupuncture after rotator cuff surgery need to be continuously conducted.