• Title/Summary/Keyword: RCTs Review

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Chuna Manual Therapy for Pediatric Functional Constipation : A Systematic Review (소아변비에 대한 추나요법의 효과 : 체계적 문헌 고찰)

  • Park, In-Hwa;Park, Sun-Young;Hwang, Eui-Hyoung
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.23-34
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    • 2018
  • Objectives : This review aims to evaluate the effects and the safety of Chuna manual therapy(CMT) for pediatric functional constipation. Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, RISS, KISS, NDSL, KMBASE, KISTI) and related 2 journals until October 2018. We included randomized controlled trials(RCTs) of testing CMT for pediatric functional constipation. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : 16 RCTs were eligible in our inclusion criteria. The meta-analysis of 11 studies showed positive for use CMT for pediatric functional constipation. CMT significantly improved total efficancy rate compared with medications (P < 0.00001). Conclusions : There is evidence of CMT for pediatric functional constipation with meta-analysis. However, our systematic review has limited evidence to support CMT for pediatric functional constipation. because the quality of relevant trials is relatively poor. Further well-designed RCTs should be encouraged. the quality of relevant trials is relatively poor.

Chuna Manual Therapy for Lumbar Spinal stenosis : A Systematic Review (요추 척추관협착증에 대한 추나요법의 효과 : 체계적 문헌 고찰)

  • Lim, Kyeong-Tae;Shin, Byung-Cheul;Heo, In;Hwang, Man-Suk
    • The Journal of Churna Manual Medicine for Spine and Nerves
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    • v.13 no.2
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    • pp.1-10
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    • 2018
  • Objectives : To evaluate the evidence supporting the effectiveness and safety of Chuna manual therapy(CMT) for lumbar spinal stenosis Methods : We searched 10 electronic databases(Pubmed, EMBASE, Cochrane Library, CAJ, RISS, KISS, KISTI, KMBASE, DBpia, NDSL) and related 2 journals up to October 2018. We included randomized controlled trials(RCTs) of testing CMT for lumbar spinal stenosis patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool 1.0. Results : Three RCTs were eligible in our inclusion criteria. The meta-analysis of 3 studies showed positive results for the using CMT for lumbar spinal stenosis. Conclusions : The review found favorable evidence of CMT for treating lumbar spinal stenosis with meta-analysis. However, our systematic review has limited evidence to support CMT for lumbar spinal stenosis because of low quality of original articles and further well-designed RCTs should be encouraged.

The Effect of Aerobic Exercise on Brain-Derived Neurotrophic Factor (BDNF) in Individuals with Mild Cognitive Impairment: a Systematic Review and Meta-Analysis of a Randomized Controlled Trials

  • Kim, Hyun-Joong;Lee, DongJin;Lee, YeonSeop
    • Physical Therapy Rehabilitation Science
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    • v.11 no.3
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    • pp.304-310
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    • 2022
  • Objective: Mild cognitive impairment (MCI) is a condition in which cognitive and executive functions are reduced, and older adults with MCI are ten times more likely to develop dementia than healthy older adults. Expression of brain-derived neurotrophic factor (BDNF) through aerobic exercise is associated with increased cognitive and executive functions. in this review, randomized controlled trials (RCTs) on the effects of aerobic exercise on BDNF in individuals with mild cognitive impairment are summarized and qualitatively and quantitatively analyzed to suggest the necessity of aerobic exercise. Design: a systematic review and meta-analysis. Methods: RCTs were searched for changes in BDNF through aerobic exercise using four international databases. Quality assessment and quantitative analysis were performed using RevMan 5.4. Quantitative analysis was quantified with a standardized mean difference (SMD) and presented as a random effect model. Results: Three RCTs evaluated BDNF in 123 patients with MCI. There was a significant improvement in the experimental group that performed aerobic exercise compared to the control group. The results analyzed using the random effects model were SMD = 0.48. Conclusions: In this review, we reported the effects and mechanisms of aerobic exercise in individuals with MCI. As a result of synthesizing RCTs that performed aerobic exercise, a significant increase in BDNF was confirmed.

The effectiveness and safety of cupping therapy for stroke survivors: A systematic review and meta-analysis of randomized controlled trials

  • Kim, Mikyung;Han, Chang-ho
    • The Journal of Korean Medicine
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    • v.42 no.4
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    • pp.75-101
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    • 2021
  • Objectives: ncluding stroke. The aim of this study was to systematically review the clinical evidence of CT for stroke. Methods: To identify randomized controlled trials (RCTs) reporting the effectiveness and/or safety of CT, seven databases including PubMed, EMBASE, and Cochrane Library were searched for articles published from January 2000 to February 2021 without language restrictions. Meta-analysis was performed using Review Manager 5.4 software and the results were presented as mean difference (MD) or standard mean difference (SMD) for continuous variables and odds ratio (OR) for diverse variables with 95% confidence intervals (CIs). Assessment of the methodological quality of the eligible trials was conducted using the Cochrane Collaboration tool for risk of bias in RCTs. Results: Twenty-two RCTs with 1653 participants were included in the final analysis. CT provided additional benefit in improving upper limb motor function (Fugl-Meyer assessment for upper limb motor function, MD 6.91, 95% CI 4.64 to 1.67, P<0.00001) and spasticity (response rate, OR 3.28, 95% CI 1.31 to 8.22, P=0.08) in stroke survivors receiving conventional medical treatment. These findings were supported with a moderate level of evidence. CT did not significantly increase the occurrence of adverse events. Conclusions: This study demonstrated the potential of CT to be beneficial in managing a variety of complications in stroke survivors. However, to compensate for the shortcomings of the existing evidence, rigorously designed large-scale RCTs are warranted in the future.

Therapeutic Effects of Acupuncture for Shoulder Impingement Syndrome: A Systematic Review and Meta-Analysis (어깨충돌증후군에 대한 침치료의 효과: 체계적 문헌고찰 및 메타분석)

  • Jeong Hoon Ahn;Gun Hee Bae;Byung-Jun Kim;In-Hwa Park;In Heo;Yun-Yeop Cha
    • Journal of Korean Medicine Rehabilitation
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    • v.34 no.1
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    • pp.83-95
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    • 2024
  • Objectives This review was conducted to evaluate the therapeutic effects of manual acupuncture (MA) for shoulder impingement syndrome (SIS). Methods We searched 12 electronic databases (DBpia, Korean studies Information Service System [KISS], Oriental Medicine Advanced Searching Integrated System [OASIS], Research Information Sharing Service [RISS], China National Knowledge Infrastructure [CNKI], CINAHL, Clinical Key, Cochrane Library, Embase, JAMA, PubMed, Web of Science) to find randomized-controlled clinical trials (RCTs) investigating therapeutic effects of MA for treating SIS. Shoulder Pain and Disability Index scores and numeric pain rating scale or visual analogue scale were analyzed as the main evaluation criteria. Results Among 181 studies, 169 were screened and only 12 RCTs were eligible in our review. Finally, 11 RCTs could be statistically analyzed. MA was more effective than sham treatment and physical therapy in terms of reducing pain (p=0.003, p=0.0007 each). Electroacupuncture (EA) showed more significant effect than physical therapy (PT) for improving shoulder pain (p<0.00001) and shoulder functionality (p<0.00001). Conclusions These results suggest that MA and EA could be superior option for treating SIS than sham treatment or PT. However this review has its limitations due to the small sample size and lack of well-designed RCTs that were included in the study. Further well-designed RCTs are necessary to provide high-level evidence.

Ginseng for Reducing the Blood Pressure in Patients with Hypertension: A Systematic Review and Meta-Analysis

  • Hur, Myung-Haeng;Lee, Myeong-Soo;Yang, Hye-Jeong;Kim, Chan;Bae, Ik-Lyul;Ernst, Edzard
    • Journal of Ginseng Research
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    • v.34 no.4
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    • pp.342-347
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    • 2010
  • Ginseng is one of the most-widely used herbal remedies. This systematic review evaluates the current evidence for its use in the reducing blood pressure (BP) in patients with hypertension. Systematic searches of 12 electronic databases were conducted without language restrictions. All randomized clinical trials (RCTs) of ginseng as a treatment for hypertension were candidates for inclusion. Methodological quality was assessed using the Cochrane risk of bias. Five RCTs met the inclusion criteria. The risk of bias was low in most of the trials. Four of the included RCTs compared the effectiveness of ginseng to placebo. The meta-analysis of these data failed to show a statistically significant acute effect on systolic BP (SBP) or diastolic BP (DBP). However, subgroup analyses showed beneficial effects of Korean red ginseng (KRG) on both SBP (n=54, mean difference [MD], -6.52; 95% confidence interval [CI], -9.99 to -3.04; p=0.0002) and DBP (n=54, MD, -5.21; 95% CI, -7.90 to -2.51; p=0.0001). Two RCTs tested the long-term effects of ginseng for BP for 24hours. One of these trials failed to show any benefits of KRG compared to no treatment, and the other failed to show superior effects of North American ginseng compared to placebo. Adverse events with ginseng were none in one trial or not assessed. Collectively, these RCTs provide limited evidence for the acute effectiveness of KRG in the treatment of high BP. The total number of RCTs included in the analysis and the total sample size were insufficient to draw definitive conclusions. More rigorous studies are warranted.

Effect of Manual Acupuncture for Mild-to-Moderate Carpal Tunnel Syndrome: A Systematic Review

  • Huh, Jeong Ho;Jeong, Hye In;Kim, Kyeong Han
    • Journal of Pharmacopuncture
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    • v.24 no.4
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    • pp.153-164
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    • 2021
  • Objectives: Despite the low cost and high accessibility of manual acupuncture (MA) treatments for the carpal tunnel syndrome (CTS), this intervention has not been uniformly evaluated in systematic reviews (SR), and no SR has evaluated MA monotherapy for CTS. This review was conducted to summarize the findings and undertake a quality assessment of randomized controlled trials (RCTs) of acupuncture treatment methods for mild-to-moderate CTS to identify clinical evidence for the use of MA in CTS. Methods: We searched five databases for articles on relevant RCTs that were published until June 2021 without imposing specific restrictions, such as age or sex, on CTS patients. RCTs that evaluated MA were included without any restriction on comparator interventions. Measurement tools for evaluating pain reduction and functional improvement or for evaluating efficacy using electrophysiological indicators were included as outcome measures. Results: We included seven RCTs, of which three studies reported both post-treatment improvement effects and statistical significance using p-values for all outcomes. Five studies reported statistically significant intergroup differences (p-values for all outcomes) in posttreatment improvement. None of the studies reported severe adverse effects of MA. In all of the RCTs, the reporting rates of the 2c, 2a, and 6a items of STRICTA 2010 were 14%, 29%, and 29%, respectively. PC7 (Daereung) was used to treat CTS in all of the included studies. Conclusion: MA can be used for CTS treatment without serious adverse effects. PC7 was the most commonly used acupoint. In order to ensure objective and reliable reporting, accurate standardization of acupuncture treatment methods acupoint terms should be undertaken in future RCTs.

Sanjoin-tang (Suanzaoren decoction) for Insomnia in Menopausal Syndromes: A Systematic Review and Meta-analysis (산조인탕치료가 여성갱년기 수면장애에 미치는 효과 : 체계적 문헌고찰 및 메타분석)

  • Jun, Ji Hee;Choi, Tae-Young;Lee, Myeong Soo;Song, Eunhye;Ang, Lin;Park, Sunju
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.1
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    • pp.1-14
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    • 2020
  • Objectives : The purpose of this systematic review was to investigate the efficacy and safety of Sanjoin-tang (Suanzaoren decoction, SZRD) for insomnia in menopausal syndromes. Method : We searched the following databases: PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure (CNKI), Chinese Science and Technique Journals Database (VIP), Wanfang, Research Information Service System (RISS), OASIS, Korean studies Information Service System (KISS), and National Digital Science Library (NDSL) databases. Randomized controlled trials (RCTs) or quasi-RCTs that used SZRD for women in menopause were included. The methodological quality of each RCT was assessed using the risk of bias tool. Results : In total, nine RCTs were finally included. The included RCTs had a high risk of bias across their domains. Three RCTs examined the effects of SZRD compared with western medicine (WM) in insomnia. Three RCTs showed favorable effects of SZRD with insomnia. Infrastructure also showed that SZRD resulted in better clinical WM (RR 1.19, 95% CI 1.07 to 1.32, P=0.001, I2=0%). Four RCTs showed favorable effects of Modified SZRD with insomnia. Infrastructure also showed that Modified SZRD resulted in better clinical WM (RR 1.13, 95% CI 1.04 to 1.23, P=0.004, I2=0%). Among the 4 RCTs, three RCTs showed an equivalent effect on the total Pittsburh Sleep Quality Index (PSQI). The meta-analysis also showed that Modified SZRD had a superior effect on the total of PSQI (total of PSQI : MD -2.55, 95% CI -3.72 to -1.37, P<0.0001, I2=85%). Only 2 trials reported adverse events and none reported severe adverse events. Conclusion : SZRD appears to be safe, but there is insufficient evidence to make a definitive conclusion because only a few studies reported adverse events. Due to the poor methodological quality of the included studies and the small number of trials included, the evidence cannot be reproduced and assessed. Well-designed RCTs with a larger sample size are needed in the future.

Effects of Acupuncture on Parasympathetic Nervous System: A Review of the Literature (침치료가 부교감신경계에 미치는 영향에 대한 문헌 고찰)

  • Lee, Dong-Hua;Lim, Jin-Woong;Nam, Sang-Su;Kim, Yong-Suk;Lee, Sang-Hoon
    • Journal of Acupuncture Research
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    • v.28 no.1
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    • pp.109-115
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    • 2011
  • Objectives : This review is to summarize and assess the effects of acupuncture on parasympathetic nervous system(PNS). Methods and Materials : We searched two electronic databases (CNKI, PubMed) for the articles published until Oct. 2010. The randomized clinical trials (RCTs) and uncontrolled clinical trials (UCTs) were considered to be reviewed. We selected four RCTs, seven UCTs and one article which conducted both RCT and UCT, and reviewed them. The quality of RCTs was also assessed with Cochrane criteria. Results : There were four RCTs which reported acupuncture enhanced PNS, and one RCT reported acupuncture reduced PNS. Four UCTs reported acupuncture enhanced PNS, three UCTs reported acupuncture reduced PNS and one UCT reported there was no remarkable change of PNS after acupuncture. Conclusions : Although the majority of reviewed articles showed acupuncture enhance PNS, it is hard to conclude clearly how acupuncture affects PNS due to insufficient quality of trials. Therefore, more trials with strict condition need to be conducted to obviously identify the effects of acupuncture on PNS.

The Effect of Traditional Oriental Herbal Medicine for Anorexia in Cancer Patients: A Systematic Review (한약 치료가 암 환자의 식욕부진에 미치는 영향: 체계적 문헌고찰)

  • Lee, Joon-Ho;Bae, Kyeore;Yoo, Hwa-Seung
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.8-20
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    • 2017
  • Objectives: Traditional oriental herbal medicine is used in cancer care to alleviate symptoms. Anorexia is a symptom which is frequently observed in patients with cancer and impairs their quality of life. The objective of this systematic review is to summarize current available evidence to evaluate the effect of traditional oriental herbal medicine on anorexia in cancer patients. Methods: The review evaluated randomized controlled trials (RCTs) measuring the effect of any types of herbal medicine on anorexia in cancer patients within 4 electronic databases and manual search up to December 2015. The Cochrane risk of bias tool (ROB) was used to assess the quality of RCTs. Results: In total, 11 RCTs met the inclusion criteria. All of the studies reported the rate or severity of anorexia improved after treatment in herbal-conventional medicine combined group compared to conventional medicine group. 7 of 11 studies showed between-group statistical differences. The methodological quality of RCTs was insufficient with unclear and high ROB. Conclusions: Traditional oriental herbal medicine may have a potential to improve anorexia in patients with cancer. To confirm the clinical recommendation, further researches with rigorous study design are required to support the effects of herbal medicine.