• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.35 no.4
• /
• pp.139-162
• /
• 2022

Objectives : The review was conducted to validate the effectiveness of herbal medicines on acne. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on acne were searched through seven electronic databases from the time of application of the material to October 2021. Cochrane Collaboration's Risk of Bias was used to assess the risk of bias. Analysis was performed using Review Manager 5.4 and R 4.1.0 Meta, Metafor program. Results : 34 RCTs was selected and meta-analysis was performed with 30 studies. The inflammatory lesion count of the herbal medicine(MD=0.29, 95% CI:-0.59-0.01, p<0.01, I²=80%) and the non inflammatory lesion count of herbal medicine(MD=-0.30, 95% CI:-0.70-0.10, p<0.01, I²=78%) were seen. The score of IGA(RR=1.43, 95% CI:0.90-2.27, p<0.91, I²=0%), VISIA(MD=0.36, 95% CI:0.21-0.51, p=0.07, I²=40%), effective rate(RR=1.23, 95% CI:1.05-1.44, p<0.01, I²=98%), DLQI(MD : 0.59, 95% CI:0.14-1.04, p=0.07, I²=63%) and recurrence rate(RR=0.36, 95% CI:0.23-0.58, p=0.73, I²=0%) were seen. The effective rate of herbal medicine were statistically higher that of the control group(WM)(RR=1.19, 95% CI:1.04-1.37, p<0.01, I²=97%). As a result of dividing the treatment groups into OHM, EHM, and OEHM, the EHM group(RR=1.17, 95% CI:0.79-1.72, p<0.01, I²=99%) showed the most statistically significant effect. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the effectiveness of herbal medicine for acne.

• The Journal of Internal Korean Medicine
• /
• v.44 no.3
• /
• pp.485-505
• /
• 2023

Objective: The purpose of this study is to assess the effectiveness and safety of using Taeksa-tang for dyslipidemia through a systematic review and meta-analysis of randomized controlled trials (RCTs). Methods: The search was conducted using keywords such as "dyslipidemia", "hyperlipidemia", "taeksa tang", "zexie tang", and "takusha to" in 12 databases (Pubmed, Cochrane, Embase, ScienceDirect, CNKI, Wanfang, CiNii, RISS, KISS, ScienceON, OASIS, and DBpia) on April 13, 2023. There were no limits on the publication period and language. Cochrane's risk of bias (RoB) was used to evaluate the quality of the studies. A meta-analysis was conducted according to the outcome measurements such as total effective rate (TER), total cholesterol (TC), triglyceride (TG), HDL-cholesterol (HDL-C), LDL-cholesterol (LDL-C), and adverse effects, using the Review Manager web. Results: A total of 9 RCTs were selected. In evaluating the RoB, 2 studies mentioning the random sequence generation, 1 study conducting double blindness, and 8 studies without missing values were evaluated as low risk, while 1 study without mentioning the random sequence generation was evaluated as high risk. All other parts were evaluated as unclear risk. The treatment group (Taeksa-tang or Taeksa-tang-gagam) showed more statistically significant effects compared to the control group (Western medicine or Chinese patent medicine) in TER (RR : 1.24, 95% CI 1.15 to 1.34, P<0.00001), TC (MD : -1.12, 95% CI -1.68 to -0.56, P<0.0001), TG (MD : -1.08, 95% CI -1.65 to -0.51, P=0.0002), HDL-C (MD : 0.63, 95% CI 0.34 to 0.93, P<0.0001), LDL-C (MD : -0.81, 95% CI -1.10 to -0.53, P<0.00001). In addition, the treatment group showed lower adverse effects compared to the control group (RR : 0.30, 95% CI 0.12 to 0.74, P=0.008). Conclusion: This study suggests that Taeksa-tang is effective and safe to use for treating dyslipidemia. However, due to the low quality of the included studies, more clinical studies need to be conducted in the future to increase the possibility of clinical use.

• Journal of Korean Medicine Rehabilitation
• /
• v.33 no.4
• /
• pp.15-29
• /
• 2023

Objectives The purpose of this study is to systematically review the effects of Neuromuscular Electrical Stimulation treatment on muscle wasting in cancer patients. Methods Randomized controlled trials (RCTs) were searched from seven online databases (PubMed, Cochrane Library, EMBASE, China National Knowledge Infrastructure, Oriental Medicine Advanced Searching Integrated System, Korean studies Information Service System, Research Information Sharing Service. The selected RCTs were evaluated for methodological quality through the Cochrane RoB. Results A total of 126 articles were identified, and 4 randomized controlled trials were selected for systematic review. In one study, it was found that there were statistically significant improvements in the Health-Related Quality of Life (FACTH&N total score, p<0.001). Additionally, significant effects were observed in measurements that represented the size of the quadriceps muscle (cross-sectional area of Vastus lateralis and Rectus femoris, p=0.004), maximum muscle strength, the twitch response of resistance muscles, and voluntary activation (p<0.001). However, no significant differences were observed between the intervention and control groups in terms of quadriceps muscle strength in two other studies (p>0.05). Lastly, while one study showed no significant differences in muscle fiber characteristics between the two groups, it did report significant improvements in measurements related to mitochondria within muscle tissue and muscle strength in the intervention group (p<0.05). Conclusions Neuromuscular electrical stimulation can be a method used to improve muscle strength in muscle wasting of cancer patients, but it is difficult to see its effects as significant compared to other treatments.

• International Journal of Advanced Culture Technology
• /
• v.10 no.4
• /
• pp.110-116
• /
• 2022

The purpose of this study was to examine the effectiveness of gamification in nursing practice for undergraduate students, as well as to explore the use of gamification in nursing education. This study is a systematic review of RCTs evaluating the effectiveness of gamification in nursing practice for undergraduate students. A total of 7 articles were identified in a search of PubMed, Cochrane Library, and Embase, and the additional databases were CINAHL (in English) and RISS (in Korean) between September 28, 2022 to October 5, 2022. Themes related to the environment and personal behaviors between 2002 and 2021 were extracted. The intervention themes were blood transfusion, postoperative pediatric nursing, postoperative hemorrhage and brain trauma nursing, basic and advanced life support, disaster nursing, and neonatal resuscitation. The primary outcomes were knowledge in five studies, satisfaction in one study, and competency in one study. The secondary outcomes were satisfaction in three studies, confidence in two studies, performance in two studies, skills in two studies, and self-efficacy, motivation, professional attitude, cognition, gameful experience, and affective response in one study each. Therefore, gamification interventions can be utilized in nursing practice education instead of traditional teaching methods such as lectures and face-to-face clinical practice.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
• /
• v.34 no.3
• /
• pp.27-54
• /
• 2021

Objectives : This review was conducted to validate the effectiveness and safety of herbal medicine combined with conventional therapy for rosacea. Methods : Randomized controlled trials(RCTs) reporting the effects of herbal medicine treatment on rosacea were searched through eight electronic databases from 2016 to March 17, 2020. This study collection and data extraction were performed by two independent reviews. The Cochrane risk-of-bias tool was used for the evaluation of the risk of bias in all included RCTs. Mean differences(MD) and Risk ratio(RR) of 95% Confidence intervals(Cls) were calculated and data synthesis was conducted using Review Manager(RevMan, ver.5.4) Results : Eighteen RCTs were included and all trials compared the combined therapy of herbal medicine with conventional western therapy to conventional therapy alone. The effective rate of the combination of herbal medicine with western medicine(RR 1.20, 95% CI : 1.13-1.28, p<0.00001, I²=0%), the effective rate of the combination of herbal medicine with laser-based therapy(RR 1.12, 95% CI : 1.04-1.21, p=0.004, I²=18%) and the effective rate of the combination treatment group using herbal medicine, western medicine and external drugs were all statistically higher that of the control group(RR 1.19, 95% CI : 1.11-1.28, p<0.00001, I²=0%). The score of non transient erythema(MD -0.36, 95% CI : -1.01 0.29, p=0.27, I²=93%), flushing(MD -0.69, 95% CI : -0.97, 0.41, p<0.00001, I²=32%), papules or pustules(MD 0.10, 95% CI : -0.15, 0.35 p=0.44, I²=0%) were also seen in the herbal medicine and western medicine combination group. The overall risk of bias of the included studies was some concerns. No serious adverse effects were observed. Conclusions : This review found the safety and effectiveness of the combined therapy of herbal medicine with conventional western therapy for rosacea.

• Journal of Korean Medicine for Obesity Research
• /
• v.23 no.2
• /
• pp.112-124
• /
• 2023

Objectives: Obesity is a chronic metabolic disease that negatively affects quality of life and health. It is associated with various disease and its prevalence is on the rise. Although various treatments for obesity are used, they have several adverse effects. Pharmacoacupuncture is a widely used method for treating various diseases and has the advantage of having fewer adverse effects. This systematic review and meta-analysis evaluate the efficacy of pharmacoacupuncture in treating obesity. Methods: Eight electronic databases were searched from their inception to August 2023. Only randomized controlled trials were included in this review. Intervention groups included pharmacoacupuncture. Control groups had no limitation. The primary outcome was body mass index (BMI), and the secondary outcomes were body weight (BW), waist circumference (WC), and adverse effects. Continuous outcome data were presented as mean differences (MD) with 95% confidence intervals (CI). Results: Four randomized controlled trials (RCTs) involving 139 participants were included in this systematic review and meta-analysis. Results revealed that BMI ((MD)=-0.98, 95% CI -1.84 to -0.11, Z=2.22, P=0.03, I²=0%), WC (MD=-4.29, 95% CI -7.51 to -1.08, Z=2.62, P=0.009, I²=38%) were significantly improved in the intervention groups compared to control groups. Adverse effects were reported in two studies. Conclusions: This systematic review and meta-analysis suggests that pharmacoacupuncture is an effective and safe therapy for simple obesity. Further detailed studies should be conducted on effects of pharmacoacupuncture for obesity to increase reliability.

• The Journal of Internal Korean Medicine
• /
• v.39 no.1
• /
• pp.22-43
• /
• 2018

Objective: The purpose of this study is to investigate the effect of Cheonmagudeung-eum (CGE) for essential hypertension by systematic review and meta-analysis. Methods: The period of literature search was until October 30, 2016, and 14 electronic databases were utilized as search engines. The evaluation for the risk of bias (RoB) was conducted by using the Cochrane Risk of Bias Tool. The meta-analysis was performed by synthesizing outcome data, including total effective rate (TER), systolic blood pressure (SBP), diastolic blood pressure (DBP), and the incidence of adverse events. Result: There were a total of 64 RCTs using CGE on adult essential hypertension. In the RoB evaluation, most of the items were unclear, and the qualities of studies were rated low. The concurrent treatment of CGE and antihypertensive drug (AHD) showed a significant hypotensive effect since the risk ratio (RR) of TER was 1.17 times (95% CI 1.14, 1.20, p<0.01) higher than that of AHD alone. In addition, the mean difference (MD) appeared low as 8.73 mm/Hg in SBP (95% CI -11.36, -6.09, p<0.01) and 5.81 mm/Hg in DBP (95% CI -7.50, -4.12, p<0.01). Conclusion: Through this study, it was identified that the combined treatment of CGE and AHD on hypertension would be more effective than that of AHD treatment alone. However, due to the low quality of the selected original articles, the significance of this conclusion is somewhat limited, and we hope that this would be complemented through more rigorous RCTs in the future.

• Asian Pacific Journal of Cancer Prevention
• /
• v.15 no.3
• /
• pp.1313-1320
• /
• 2014

Introduction: Although most prostate cancers initially respond to castration with luteinizing hormonereleasing analogues or bilateral orchiectomy, progression eventually occurs. Based on the exciting results of several randomized controlled trials (RCTs), it seems that patients with metastatic castration-resistant prostate cancer (mCRPC) might benefit more from treatment withabiraterone. Therefore we conducted a systematic review to evaluate the efficacy and toxicity of abiraterone in the treatment of mCRPC. Methods: Literature was searched from Embase, PubMed, Web of Science, and Cochrane Library up to July, 2013. Quality of the study was evaluated according to the Cochrane's risk of bias of randomized controlled trial (RCT) tool, then the Grading of Recommendations Assessment, Development and Evaluation (GRADE) System was used to rate the level of evidence. Stata 12.0 was used for statistical analysis. Summary data from RCTs comparing abiraterone plus prednisone versus placebo plus prednisone for mCRPC were meta-analyzed. Pooled hazard ratios (HRs) for overall survival (OS), radiographic progression-free survival (RPFS) and time to PSA progression (TTPP); Pooled risk ratios (RR) for PSA response rate, objective response rate and adverse event were calculated. Results: Ten trials were included in the systematic review; Data of 2,283 patients (1,343 abiraterone; 940 placebo) from two phase 3 trials: COU-AA-301 and COU-AA-302 were meta-analyzed. Compared with placebo, abiraterone significantly prolonged OS (HR, 0.74; 95% confidence interval [CI], 0.66 to 0.84), RPFS (HR, 0.59; 95% CI, 0.48 to 0.74) and time to PSA progression (HR, 0.55; 95% CI, 0.43 to 0.70); it also significantly increased PSA response rate (RR, 3.63; 95% CI, 1.72 to 7.65) and objective response rate (RR, 3.05; 95% CI, 1.51 to 6.15). This meta-analysis suggested that the adverse events caused by abiraterone are acceptable and can be controlled. Conclutios: Abiraterone significantly prolonged OS, RPFS and time to progression patients with mCRPC, regardless of prior chemotherapy or whether chemotherapy-na$\ddot{i}$ve, and no unexpected toxicity was evident. Abiraterone can serve as a new standard therapy for mCRPC.

• Asian Pacific Journal of Cancer Prevention
• /
• v.14 no.5
• /
• pp.3337-3343
• /
• 2013

This systematic review was conducted to assess the efficacy and safety of bisphosphonates for prevention and treatment of osteopenia or osteoporosis in men with non-metastatic prostate cancer receiving androgendeprivation therapy. We searched for randomised controlled trials (RCTs) of bisphosphonates compared with placebo from Pubmed, Embase, the Cochrane Library, and ISI - Science Citation Index. Meta-analyses of prespecified outcomes (bone mineral density, fractures, and adverse events) were performed using Review Manager. Ten RCTs with a total patient population of 1,017 were identified. There was generally more improvement in bone mineral density of the lumbar spine for patients who received bisphosphonate treatment than placebo or other medical treatment at 12 months (WMD 6.02,95%CI 5.39 to 6.65). Similar effects were also observed for total hip, trochanter or femoral neck bone mineral density. However, there was no significant reduction in fractures. Fever and gastrointestinal symptoms were the most common adverse events (10.4% vs. 1.2%; 0.10% vs. 0.03%). Currently, our meta-analysis suggested that oral and intravenous bisphosphonates caused a rapid increase in spine and hip or femoral BMD in non-metastatic prostate cancer patients receiving androgen-deprivation therapy. Fever and gastrointestinal symptoms were common with the use of bisphosphonates. These short-term trials (maximum of 12 months) did not show fracture reduction. In future, more efficient performance of higher quality, more rigorous, large sample, long-term randomised controlled trials (>12 months) are needed where outcomes are detailed.

• Journal of Korean Medicine Rehabilitation
• /
• v.29 no.3
• /
• pp.35-49
• /
• 2019

Objectives The purpose of this research is to evaluate the effectiveness of moxibustion theraphy for frozen shoulder through systematic review and meta-analysis. Methods The effect of moxibustion for frozen shoulder was constructed as a key question to search randomized controlled trials (RCTs) in 16 databases without type of publication restriction. Results A total of 790 studies were searched and 22 RCTs were finally selected through primary and secondary selection/exclusion process. In most of the evaluation indexes used in each study, moxibustion treatment for shoulder pain was statistically significant compared with other treatments. A meta-analysis of effective rate in 10 studies comparing moxibustion with acupuncture and acupuncture showed a statistically significant effect of moxibustion treatment. And there was a significant effect on the improvement of the shoulder mobility, but the effect size of shoulder pain was no significant effect for shoulder pain reduction. In addition in the result of meta-analysis of 4 studies' effective rate comparing moxibustion with electronic acupuncture, the effect of moxibustion was significantly higher than that of electronic acupuncture in frozen shoulder. Conclusions Moxibustion therapy was effective in symptoms in patients with frozen shoulder. However because of the high risk of bias in the quality of the included studies, the applicability of this study seems to be limited. It is thought that future randomized controlled trials will need to be designed and performed by reviewing ways to minimize bias.