• Title/Summary/Keyword: RCTs Review

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Systematic Review and Meta-Analysis of Efficacy and Safety of Fire Needling and Warm Needling on Acute Gout

  • Ji Hye Hwang;Aejin Song;Ho-Sueb Song
    • Journal of Pharmacopuncture
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    • v.25 no.4
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    • pp.301-316
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    • 2022
  • Objectives: This study aimed to evaluate the efficacy and safety of heat stimuli (e.g., fire needling, warm needling) in acupuncture for acute gout. Methods: Four international online databases (PubMed, Cochrane, Embase, and Chinese National Knowledge Infrastructure) were searched to identify randomized, controlled trials (RCTs) that used fire needling and warm needling for acute gout. The methodological quality of the RCTs was evaluated using the Cochrane risk-of-bias (RoB) tool. Thirteen RCTs (840 patients) were included and analyzed. Three evaluation tools (total effective rate, uric acid level, and pain score) were mainly used. Comparisons were made between Western medicine (WM) and i) fire needling or warm needling treatment alone, ii) fire needling and bloodletting combination treatment, iii) combination of fire needling, bloodletting, and herbal medicine, iv) warm needling (concurrently). Heat stimuli in acupuncture alone or in combination treatment were more effective in terms of the total efficacy rates, uric acid levels, and pain scores than WM alone. Results: In all the evaluation tools, the treatment effects in the fire needling alone or warm needling alone treatment group and the fire needling and bloodletting combination intervention group were significantly better than those in the WM control group. The warm needling and WM combination intervention groups also experienced significantly better treatment effects in terms of total efficacy rates and uric acid levels. Only the pain scores in the fire needling, bloodletting, and herbal medicine combination groups demonstrated significant improvement. Only four studies mentioned adverse reactions: one reported loss of appetite; three studies reported none. According to the Cochrane RoB tool, most studies showed either high or uncertain RoB. Conclusion: Heat stimuli during acupuncture could be effective for acute gout. However, as the included studies were regionally biased, more high-quality studies are needed to confirm the level of evidence.

A Systematic Review of Cupping Therapy for Insomnia Disorder (불면장애에 대한 부항요법의 체계적 문헌고찰)

  • Jeong-Han Lee;Mi-Ra Choi;Jung-Hwa Lim;Bo-Kyung Kim
    • Journal of Oriental Neuropsychiatry
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    • v.34 no.3
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    • pp.181-212
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    • 2023
  • Objectives: To examine the efficacy and safety of cupping therapy for insomnia disorder and provide clinical evidence that could contribute to further research. Methods: We searched randomized controlled trials (RCTs) that verified effects of cupping therapy for insomnia disorder from 11 domestic and foreign databases. Included studies were evaluated using Risk of Bias (RoB). Results: Nineteen RCTs were selected. Wet cupping was more frequently used than dry cupping. Moving cupping was mostly used among dry cupping methods. Dry cupping was mainly performed in Bladder Meridian on the back. Wet cupping was mainly performed on BL18, LR14, and BL15. The most common treatment period was 4 weeks. The average number of treatments per week was about 2.4 times for all types of cupping, about 3.2 times for dry cupping and about 1.9 times for wet cupping. All selected studies showed a significant sleep improvement compared to the control group. As a result of the meta-analysis, in terms of effective rate, SAS score, and SDS score, the wet cupping in combination with acupuncture was significantly more effective than acupuncture alone, although the quality of selected RCTs was low. Conclusions: Cupping therapy is effective for insomnia disorder. Based on results of this study, it is reasonable to use wet cupping two times per week on BL18, LR14, and BL15 or use moving cupping three times per week in Bladder Meridian on the back for 4 weeks to treat insomnia disorder.

A Systemic Review and Meta-Analysis of Herbal Medicine Treatment for Acute Pharyngitis : Based on Chinese Articles (급성인두염의 한약 치료에 대한 체계적 문헌 고찰 및 메타분석 : 중국 논문을 중심으로)

  • Young-Eun Lee;Ji-One Im;Ji-Young Choi;Seon-Young Jee;Min Hwangbo
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.37 no.3
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    • pp.1-16
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    • 2024
  • Objectives : The purpose of this study is to investigate the effectiveness and safety of herbal medicine treatment for acute pharyngitis. Methods : 2 databases(Wangfang Med Online, CNKI) were used to search Randomized Controlled Trials(RCTs) that used herbal medicine treatment for acute pharyngitis, which were published from January 2007 until April 2024. Results : 9 RCTs were selected in this study, and all studies compared herbal medicine alone treatment with western medicine alone treatment. The most frequently used medicine was Toxin-removing medicinal(淸熱解毒藥). Platycodonis Radix(桔梗) was the most frequently used herb. Meta-analysis of nine studies showed that the Total Effective Rate(TER) of treatment group was statistically higher than that of control group(RR:1.12, 95% CI:1.06 to 1.19, p<0.00001, I2=22%). Meta-analysis of 3 studies showed that the total symptom score of treatment group statistically improved than that of control group(MD: -1.00, 95% CI: -1.30 to -0.71, p<0.00001, I2=0%). Mild adverse events such as anorexia were identified in 4 RCTs, but no serious adverse events were reported. Conclusion : Using herbal medicine alone can be more effective and safe in improving acute pharyngitis than using western medicine. But further well-designed studies are needed because heterogeneity between studies existed and the quality of the reports needs to be improved.

Efficacy and safety of low-dose naltrexone for the management of fibromyalgia: a systematic review and meta-analysis of randomized controlled trials with trial sequential analysis

  • Akhil Deepak Vatvani;Pratik Patel;Timotius Ivan Hariyanto;Theo Audi Yanto
    • The Korean Journal of Pain
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    • v.37 no.4
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    • pp.367-378
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    • 2024
  • Background: Fibromyalgia is characterized by the presence of chronic widespread pain that may impair patient's quality of life. Currently, the use of naltrexone as a therapeutic agent for fibromyalgia is not supported by enough evidence, especially from randomized controlled trials (RCTs). This study aims to analyze the efficacy and safety of low-dose naltrexone (LDN) for the management of fibromyalgia. Methods: A comprehensive search was conducted on the Scopus, Medline, ClinicalTrials.gov, and Cochrane Library databases up until May 20th, 2024. This review incorporates RCTs that examine the comparison between LDN and placebo in fibromyalgia patients. We employed random-effect models to analyze the odds ratio and mean difference (MD) for presentation of the outcomes. Results: A total of 4 RCTs with 222 fibromyalgia patients were incorporated. The results of our meta-analysis showed a significant reduction in pain scores (MD: -0.86, 95% confidence interval [CI]: -1.20, -0.51, P < 0.001, I2 = 33%) and higher increment in pressure pain threshold (MD: 0.17, 95% CI: 0.08, 0.25, P < 0.001, I2 = 0%) among fibromyalgia patients who received LDN than those who only received a placebo. The fibromyalgia impact questionnaire revised and pain catastrophizing scale did not differ significantly between the two groups. LDN was also associated with higher incidence of vivid dreams and nausea, but showed no significant difference with the placebo in terms of serious adverse events, headache, diarrhea, and dizziness. Conclusions: This study suggests the efficacy of LDN in mitigating pain symptoms for fibromyalgia patients with a relatively good safety profile.

Effectiveness of Telemonitoring Intervention in Children and Adolescents with Asthma: A Systematic Review and Meta-Analysis (천식 아동 및 청소년에서 원격모니터링 중재의 효과: 체계적 문헌고찰 및 메타분석)

  • Jung, Youjin;Kim, Jimin;Park, Dong Ah
    • Journal of Korean Academy of Nursing
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    • v.48 no.4
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    • pp.389-406
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    • 2018
  • Purpose: This review aimed to evaluate the effectiveness of telemonitoring (TM) in the management of children and adolescents with asthma. Methods: We searched Ovid-MEDLINE, Ovid-EMBASE, CENTRAL (Cochrane Central Register of Controlled Trials), CINAHL (Cumulative Index to Nursing and Allied Health Literature), and 5 domestic databases to identify randomized controlled trials (RCTs) published through December 2017. Two reviewers independently selected relevant studies, assessed methodological quality and extracted data. We performed a meta-analysis of TM versus usual care and summarized the intervention characteristics of included studies. Results: Of the 3,095 articles identified, 8 RCTs (9 articles) were included in this review. The type of TM intervention of included studies was varying across studies (transmitted data, transmission frequency, data review, etc.). The pooled asthma control score was not significantly different between TM and usual care (standardized mean difference 0.04, 95% confidence interval (CI) -0.20~0.28). Another pooled analysis demonstrated no statistically significant difference in asthma exacerbation between TM and usual care (odds ratio 0.95, 95% CI 0.43~2.09). Overall, the pooled results from these studies revealed that TM did not lead to clinically significant improvements in health outcomes, but some studies in our analysis suggested that TM increased patient medication adherence and intervention adherence. Conclusion: The current evidence base does not demonstrate any differences between TM intervention and usual care, but TM intervention might be considered a promising strategy for the delivery of self-management support for children and adolescents with asthma. Further well-designed studies are needed to assess the effects on clinical outcomes.

A Systematic Review and Meta-Analysis of Randomized Controlled Trials on Chuna Manual Therapy for Cervicogenic Headache

  • Lee, Dong-Wha;Kim, Ju-Young;Hong, Min-Ho;Koo, Byung-Soo;Kim, Geun-Woo
    • Journal of Oriental Neuropsychiatry
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    • v.30 no.2
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    • pp.89-105
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    • 2019
  • Objectives: We conducted this study to evaluate the efficacy of Chuna Manual Therapy (CMT) for treatment of cervicogenic headache (CeH) through systematic review and Meta-analysis of randomized controlled trials (RCTs) as a preceding research to further research the effective of Chuna Manual Therapy for patients who suffered from CeH. Methods: We conducted a systematic review and meta-analysis by the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. We searched the studies from MEDLINE, Elsevier-EMBASE, The Cochrane Library, CAJD, KISS, KMBase, Korean Traditional Knowledge Portal, NDSL, and OASIS. The studies selected only in randomized controlled trials. We selected the chosen studies by the selection and the exclusion criteria, and evaluated the quality of the selected studies using the Jadad score and the Cochran ROB tool. We used the Visual Analogue Scale score (VAS) and Clinical total Effective Rate (CER) for the results and analyzed the results of the included studies using RevMan 5.3 software provided by the Cochran library. Results: We included 20 RCTs, including 1,673 subjects, in the systematic review and meta-analysis. After the intervention, the CMT group showed better results than the pharmacotherapy group, the physiotherapy group, and the combined treatment group. The CMT group showed a good effect on the CER and the VAS but showed a significant heterogeneity compared to the pharmacotherapy group. Conclusions: The CMT as monotherapy might have benefits on Cervicogenic Headache patient. Further well-designed studies need to be conducted.

Systematic Review on Clinical Equivalence of Generic and Brand-name Drugs in Statin Therapy (Statin 계열 약물의 제네릭 및 브랜드 제품 간 임상 치료결과 비교를 위한 체계적 문헌 고찰)

  • Shim, Haeri;Lee, Iyn-Hyang
    • Korean Journal of Clinical Pharmacy
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    • v.27 no.2
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    • pp.105-112
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    • 2017
  • Background: Generic medications are approved on the basis of bioequivalence with brand medications in healthy volunteers rather than the target population, there remains a substantial uncertainty regarding their clinical effectiveness and safety. The object of this paper is to compare the clinical equivalence of generic statin drugs in patients. Methods: Literature published before September 2016, which is indexed in PubMed, EMBASE, RISS, comparing generic to brand products in statins. Outcomes included blood lipid level, proportion of days covered (adherence), hospitalization and mortality. Results: 511 citations were screened, of which 11 studies met eligibility criteria (6 randomized clinical trials, 5 observational studies). Generic atorvastatin was clinical equivalent with brand drugs in blood lipid level (3 RCTs) and generic simvastatin was also clinical equivalent with brand drugs (2 RCTs). 2 of 3 studies reported no significant difference in proportion of days covered except 1 study which reported generic statin significantly enhance proportion of days covered (p<0.001). Hospitalization was no significant difference in all studies (p>0.05). 1 study reported that all cause of mortality was significantly low in generic drugs (p<0.0001). Conclusion: Published data on comparing clinical efficacy of generic and brand statins were insufficient in both quantity and quality. This systematic review suggests that additional studies on clinical equivalence and safety of generic medications in patients would be needed.

The Effect of Acupuncture combined with Conventional Rehabilitation Treatment for Cerebral palsy: A Systematic review of Randomized Controlled Trials(RCTs) (뇌성마비(Cerebral palsy) 소아의 재활치료와 재활과 침치료의 병행치료를 비교한 체계적 문헌 고찰)

  • Chang, Seok Joo;Seong, Eun Hak;Kim, Jang Hyun;Min, Sang Yeon
    • The Journal of Pediatrics of Korean Medicine
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    • v.34 no.3
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    • pp.81-96
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    • 2020
  • Objectives This study aims to evaluate the effect of acupuncture combined with rehabilitation treatment for cerebral palsy in children. Methods 7 electro-database (PubMed, CENTRAL, CNKI, DBpia, KISS, OASIS, KJTK) were searched for using the keywords "cerebral palsy AND acupuncture" which study is designed in randomized controlled trials (RCTs). Results 10 out of 303 studies were included in analysis after screened. Acupuncture combined with rehabilitation treatment had a significant effect on motor function. Only 1 study reported minor adverse effects. Conclusions All of the studies have shown acupuncture combined with conventional rehabilitation treatment was effective in cerebral palsy. Additional well-designed studies are needed to justify the effectiveness of acupuncture in cerebral palsy.

The effectiveness of corticotomy and piezocision on canine retraction: A systematic review

  • Viwattanatipa, Nita;Charnchairerk, Satadarun
    • The korean journal of orthodontics
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    • v.48 no.3
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    • pp.200-211
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    • 2018
  • The aim of this systematic review was to evaluate the effectiveness and complications of corticotomy and piezocision in canine retraction. Five electronic databases (PubMed, SCOPUS, Web of Science, Embase, and CENTRAL) were searched for articles published up to July 2017. The databases were searched for randomized control trials (RCTs), with a split-mouth design, using either corticotomy or piezocision. The primary outcome reported for canine retraction was either the amount of tooth movement, rate of tooth movement, or treatment time. The secondary outcome was complications. The selection process was based on the PRISMA guidelines. A risk of bias assessment was also performed. Our search retrieved 530 abstracts. However, only five RCTs were finally included. Corticotomy showed a more significant (i.e., 2 to 4 times faster) increase in the rate of tooth movement than did the conventional method. For piezocision, both accumulative tooth movement and rate of tooth movement were twice faster than those of the conventional method. Corticotomy (with a flap design avoiding marginal bone incision) or flapless piezocision procedures were not detrimental to periodontal health. Nevertheless, piezocision resulted in higher levels of patient satisfaction. The main limitation of this study was the limited number of primary research publications on both techniques. For canine retraction into the immediate premolar extraction site, the rate of canine movement after piezocision was almost comparable to that of corticotomy with only buccal flap elevation.

Review of Recent Researches on the Acupuncture Treatment for Interstitial Cystitis (간질성 방광염의 침 치료에 관한 임상 연구 고찰)

  • Ku, Su-Jeong;Hwang, Deok-Sang;Lee, Jin-Moo;Lee, Chang-Hoon;Jang, Jun-Bock
    • The Journal of Korean Obstetrics and Gynecology
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    • v.32 no.3
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    • pp.86-101
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    • 2019
  • Objectives: This review is aimed at assessing the efficacy and effectiveness of acupuncture treatment for interstitial cystitis patients through literature research and overview. Methods: Database searching was conducted to identify relevant randomized controlled trials (RCTs) and clinical studies on the acupuncture treatment for interstitial cystitis patients. Studies were searched from Journal of Korean Obstetrics and Gynecology, KISS, KMBASE, CNKI, Cochrane library, PubMed and EmBase up to April 2019. Results: Five studies including three RCTs and two clinical studies were finally selected. Three studies showed that acupuncture was effective for interstitial cystitis. One study showed ineffectiveness of acupuncture treatment. Conclusions: From three studies, acupuncture treatment for interstitial cystitis patients showed symptoms relief and improvement of QoL (Quality of Life). Further strictly designed studies are needed to confirm the efficacy and setup the acupuncture treatment protocol.