• Title/Summary/Keyword: RCTs Review

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Reduction of headache intensity and frequency with maxillary stabilization splint therapy in patients with temporomandibular disorders-headache comorbidity: a systematic review and meta-analysis

  • Manrriquez, Salvador L.;Robles, Kenny;Pareek, Kam;Besharati, Alireza;Enciso, Reyes
    • Journal of Dental Anesthesia and Pain Medicine
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    • v.21 no.3
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    • pp.183-205
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    • 2021
  • This systematic review and meta-analysis aimed to analyze the effectiveness of maxillary stabilization splint (SS) therapy to reduce headache (HA) intensity and HA frequency in patients with temporomandibular disorders (TMD)-HA comorbidity. Randomized controlled trials (RCTs) using full-arch coverage, hard resin, and maxillary SS therapy were included. Electronic databases, including Cochrane Library, MEDLINE through PubMed, Web of Science, and EMBASE, were searched. The risk of bias was analyzed based on Cochrane's handbook. The search yielded 247 references up to January 28, 2020. Nine RCTs were included at a high risk of bias. The comparison groups included other splints, counseling, jaw exercises, medications, neurologic treatment, and occlusal equilibration. Four studies reported a statistically significant reduction in HA intensity, and five studies reported significant improvement in HA frequency from baseline at 2-12 months in patients with TMD-HA comorbidity treated with a full-arch hard maxillary SS. HA frequency in tension-type HA (TTH) comorbid with TMD diagnoses of myofascial pain (MFP) or capsulitis/synovitis improved significantly with SS than that with full-arch maxillary non-occluding splint (NOS) in two studies. Comparison groups receiving hard partial-arch maxillary splint nociceptive trigeminal inhibition (NTI) showed statistically significant improvements in HA intensity in patients with mixed TMD phenotypes of MFP and disc displacement comorbid with "general HA." Comparison groups receiving partial-arch maxillary resilient/soft splint (Relax) showed significant improvements in both HA intensity and frequency in patients with HA concomitant with MFP. The meta-analysis showed no statistically significant difference in the improvement of pain intensity at 2-3 months with comparison of the splints (partial-arch soft [Relax], hard [NTI], and full-arch NOS) or splint use compliance at 6-12 months with comparison of the splints (partial-arch Relax and full-arch NOS) versus the SS groups in patients with various TMD-HA comorbidities. In conclusion, although SS therapy showed a statistically significant decrease in HA intensity and HA frequency when reported, the evidence quality was low due to the high bias risk and small sample size. Therefore, further studies are required.

Effect of Herbal Medicines on Preventing Restenosis After Percutaneous Coronary Intervention: A Systematic Review and Meta-analysis of Randomized Controlled Trials (경피적 관상동맥중재술 후 재협착 예방에 대한 한약의 효과 : 무작위배정 대조군 임상연구에 대한 체계적 문헌고찰 및 메타분석)

  • Nayeon Hur;Subin Ahn;Hongjun Kim;Insoo Jang
    • The Journal of Internal Korean Medicine
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    • v.44 no.3
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    • pp.387-401
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    • 2023
  • Objective: This study was conducted to investigate the preventive effect of herbal medicines on restenosis after percutaneous coronary intervention (PCI) by reviewing randomized controlled trials (RCTs). Methods: RCTs were searched for herbal medicine treatment after PCI using eight online databases (PubMed, CNKI, Wanfang, J-STAGE, OASIS, ScienceON, KTKP, and KISS). Studies that confirmed restenosis through coronary angiography at follow-up were selected according to the inclusion and exclusion criteria. The primary outcome was the restenosis rate, and the secondary outcome was the angina recurrence rate. Data were extracted from the final selected studies according to the research methodology and then analyzed with Review Manager 5.4.1. Study quality was assessed using Cochrane's risk-of-bias (RoB) tool. Results: Of the 252 papers obtained through the primary search, nine studies that met the selection criteria were finally selected. In these nine studies, herbal medicine combined with western medicine was used for the experimental group, and western medicine treatment was used alone for the control group. The meta-analysis result revealed that the restenosis rate and angina recurrence rate were significantly lower in the experimental group than in the control group (RR=0.34, 95% CI: 0.22-0.53, p<0.00001, I2=0% and RR=0.47, 95% CI: 0.29-0.78, p=0.004, I2=0%, respectively). Furthermore, the quality of studies assessed by Cochrane's RoB was low. Conclusions: This study showed that the combined treatment of herbal medicine and western medicine was effective in preventing restenosis and angina after PCI. As the number of papers included in this study was small, a large number of high-quality clinical studies should be considered in the future.

Influence of the root canal filling technique on the success rate of primary endodontic treatments: a systematic review

  • Daniel Feijolo Marconi ;Giovana Siocheta da Silva ;Theodoro Weissheimer;Isadora Ames Silva ;Gabriel Barcelos So;Leonardo Thomasi Jahnke ;Jovito Adiel Skupien ; Marcus Vinicius Reis So ; Ricardo Abreu da Rosa
    • Restorative Dentistry and Endodontics
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    • v.47 no.4
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    • pp.40.1-40.18
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    • 2022
  • Objectives: This study aimed to investigate the influence of different obturation techniques compared to cold lateral compaction on the success rate of primary non-surgical endodontic treatments. Materials and Methods: Systematic searches were performed for studies published up to May 17th, 2022 in MEDLINE/PubMed, Cochrane Library, Web of Science, Scopus, EMBASE, and Grey Literature Reports. Randomized clinical trials and nonrandomized (nonrandomized clinical trials, prospective or retrospective) studies that evaluated the success rate of primary non-surgical endodontic treatments obturated with the cold lateral compaction (control) and other obturation techniques were included. The revised Cochrane risk of bias tools for randomized trials (RoB 2) and nonrandomized studies of interventions (ROBINS-I) were used to evaluate the risk of bias. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) tool was used to evaluate the certainty of evidence. Results: Eleven studies (4 randomized clinical trials (RCTs), 4 prospective, and 3 retrospectives) were included. Two RCTs were classified as having some concerns risk of bias and 2 as a low risk of bias. Two nonrandomized studies were classified as having a critical risk of bias and 5 as having a moderate risk of bias. The GRADE analysis demonstrated a very low to moderate certainty of evidence. Conclusions: This systematic review generally evidenced no differences in the success rate of primary non-surgical endodontic treatments when the cold lateral compaction technique and other obturation techniques are performed. Further well-designed studies are still necessary.

Traditional Asian Medicine Treatment for Childhood Cancer - Review of Controlled Clinical Studies (소아암의 한의약치료 임상 동향 - 대조군 임상연구를 중심으로)

  • Kim, Younhwan;Kim, Hanseul;Oh, Jeongmyeong;Lee, Hyeyoon;Min, Yuri;Yun, Youngju
    • Journal of Society of Preventive Korean Medicine
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    • v.24 no.2
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    • pp.17-30
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    • 2020
  • Objectives : To find treatment techniques and design clinical studies, this study reviewed controlled clinical studies on traditional Asian medicine treatment for childhood cancer. Methods : Literature searches were performed on four databases, such as NDSL, OASIS, PubMed, and CNKI. Studies were categorized and analyzed according to the treatment goal and we also assessed the quality of the randomized controlled trials (RCT) using Van Tulder Scale. Results : Twenty-seven studies met our inclusion criteria: 21 RCTs, 4 controlled trials, 2 Cohort studies, however only 6 among the 21 RCTs got the scores of high quality. Various interventions were used, such as herbal medicine, acupuncture, acupressure, and chuna. 7 studies were focused on cure of leukemia or solid cancer. 11 studies were performed to alleviate chemotherapy induced nausea and vomiting. 9 studies were focused on other complications of chemotherapy. Conclusions : Most of the studies reported significant effectiveness of traditional medicine treatment compared to controlled group. However we could not made a definite conclusion because of the low quality and heterogeneity of the studies included. More studies should be performed to introduce traditional Asian medicine to childhood cancer treatment.

A Systemic Review of Clinical Trials Using Medication for Acute Bronchitis: A Pre-study on the Development of Traditional Korean Medicine Clinical Practice Guideline (급성기관지염의 약물중재 임상시험에 대한 체계적 문헌 고찰: 임상시험 가이드라인 개발을 위한 예비연구)

  • Lyu, YeeRan;Park, So jung;Lee, Eun Jung;Jeon, Ju Hyun;Jung, In Chul;Park, Yang Chun
    • The Journal of Korean Medicine
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    • v.38 no.1
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    • pp.93-111
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    • 2017
  • Objectives: The aim of this study is to make evidence-based data for developing a traditional Korean medicine clinical practice guideline for acute bronchitis. Methods: We searched 3 international databases(PubMed, EMBASE, CENTRAL) and 7 domestic databases (KoreaMed, Kmbase, NDSL, KISS, KISTI, OASIS, KoreaTK) to identify randomized controlled trials (RCTs) of acute bronchitis using medicine in recent 10 years. The chosen trials were analyzed by their study design, age range, intervention group, control group, primary and second outcome measure, inclusion and exclusion of participants and adverse events. Results: 15 RCTs are finally included in this study and most of their medications are herbal medicine. For diagnosis and outcome measure of acute bronchitis, Bronchitis Severity Score(BSS) was mostly used. Other measurements eligible are coughing fits, quality of life scale, sputum viscosity, change of individual symptoms and patient's satisfaction. Test duration was for average 7days and safety assessment was held by recording adverse events. Except for anti-inflammatory and antibiotic trials, all medications are found to be effective and well-tolerated. General risk of bias of chosen trials is evaluated low. Conclusions: A well designed clinical trials for traditional Korean medicine of acute bronchitis is needed and this study is expected to make it available.

A Review of the Treatment to Prevent Neonatal Jaundice - Based on Traditional Chinese Medicine (신생아 황달의 예방적 치료에 대한 연구동향)

  • Jeong, Minjeong;Kang, Kiwan
    • The Journal of Pediatrics of Korean Medicine
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    • v.30 no.4
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    • pp.99-110
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    • 2016
  • Introduction Jaundice is one of the most common conditions found in neonatal period. Phototherapy is one of the main treatments for neonatal jaundice. However, several adverse effects of the phototherapy have been reported, including DNA damage recently. Therefore, a variety of treatments have been conducted to shorten the duration of phototherapy. Meanwhile, it has been hardly tried to prevent neonatal jaundice, but diverse approaches have been tried in traditional Chinese medicine (TCM) for many years. Therefore, this study aims to analyze the studies for the treatments to prevent neonatal jaundice based on TCM. Materials and Methods Various literatures have been searched via CNKI, and PubMed using the terms "neonatal jaundice" (新生儿黄疸, 胎黃, 胎疸) in category of 'Traditional Chinese Medicine', 'Traditional Chinese Medicinal Herbs' and 'Combination of Traditional Chinese Medicine With Western Medicine'. The search range included randomized controlled trials (RCTs), controlled clinical trials (CCTs), case reports, reviews and animal experiments published from 2013 to 2015. Results A total of 104 studies were found. 93 articles were excluded by reviewing the titles and abstracts. Out of the remaining 11 studies, 9 articles were RCTs, 2 articles were CCTs. The treatment used in neonatal babies in the studies were, using herbal remedies (meditation 5, bath 3 and retention enema 1) and the acupressure. All treatments were initiated within the first 24-48 hours after their birth. Then, there was a study that the subjects taken the herbal medicine were women during pregnancy. The outcome assessments used were the serum total bilirubin (TB), transcutaneous bilirubin measurement (TCB), the incidence of the hyperbilirubinemia, the duration time of the jaundice. Especially, TB, TCB and the incidence of the hyperbilirubinemia have decreased significantly more than that of the control group in the most of the results. No severe adverse events were reported in all articles reviewed. Conclusions Conventional treatment such as, herbal medicine in TCM, seems to be the effective way to prevent neonatal jaundice or hyperbilirubinemia. Therefore, the conventional treatment may be favorable choice for preventive treatment for neonatal jaundice.

Analysis of Recent Clinical Studies to Establish Korean Herbal Medicine Clinical Trial Guidelines for the Common Cold (감기 임상시험 가이드라인 제정을 위한 최신 임상시험 연구 분석)

  • Kim, Kwan-il;Lee, Ho-jung;Lee, Beom-joon;Jung, Hee-jae;Jung, Sung-ki;Lee, Jun-hee
    • The Journal of Internal Korean Medicine
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    • v.37 no.1
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    • pp.109-134
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    • 2016
  • Objectives: The aim of this study was to help develop a guideline for the common cold. We searched recent clinical studies of the common cold in Western medicine and reviewed their objectives, inclusion and exclusion criteria, primary outcome, secondary outcome, and assessment tools to establish evidenced-based guideline.Methods: We searched electronic databases (Cochrane Library, MEDLINE, EMBASE) to identify eligible randomized controlled trials (RCTs) about the common cold for the last 10 years. We included 29 RCTs and showed their research summary via their objectives, participants, interventions, control, treatment duration, and results. We also analyzed the definition of the common cold presented in the article, inclusion and exclusion criteria, primary and secondary outcomes, and assessment tools.Results: We reported the aforementioned areas in detail. At first, the definition of the common cold was confused across the articles. Second, herbal medication clinical trials for the common cold have been extensively studied recently. Third, the eligibility criteria frequently included the Jackson Symptom score. Fourth, validated assessment tools (i.e., the Wisconsin Upper Respiratory Symptom Survey-21) have only been used in a few recent studies.Conclusions: Our research will be helpful to establish Korean herbal medicine clinical trial guidelines for the common cold.

Review of the Large-Scale Clinical Researches on Acupuncture in Germany: ASH, ART, ARC, and GERAC (2000년부터 독일에서 수행된 대규모 침 임상연구들에 대한 고찰: ASH, ART, ARC, GERAC)

  • Yoon, Juyeon;Han, Kuk-In;Jeong, Jinsu;Lee, Seungho;Jang, Insoo
    • Korean Journal of Acupuncture
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    • v.30 no.1
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    • pp.21-26
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    • 2013
  • Objectives : The purpose is to introduce the recent large-scale clinical researches for safety, efficacy and effectiveness of acupuncture in Germany. Results : In 2000, the German Federal Committee of Physicians and Health insurer proposed that large research initiatives on acupuncture, Acupuncture Model Projects(Modellvorhaben Akupunktur), could be conducted by health insurance companies for several pain that acupuncture is syndromes to justify the insurance-based reimbursement. Accordingly, 4 clinical researches were carried out; the Acupuncture Safety and Health economics studies(ASH), the Acupuncture Randomised Trial(ART), the Acupuncture in Routine Care studies(ARC), and the German Acupuncture trial(GERAC). Meanwhile, ASH is a prospective observational study for safety and costs. ART and GERAC are composed of RCTs for efficacy. ARC includes 6 pragmatic RCTs with additional non-randomized cohort study for effectiveness. We investigated the papers related to them and discussed about the outcomes. The researches showed that acupuncture is effective in practice for several chronic conditions such as migraine, tension-type headache, chronic low back pain, osteoarthritis of knee, dysmenorrhea, and allergic rhinitis. Based in part on them, the German health authorities decided that acupuncture would be included into routine reimbursement by social health insurance funds for chronic low back pain and chronic osteoarthritis of the knee in 2006. Conclusions : The German clinical researches may suggest the clues for establishing the evidence of acupuncture treatment.

A Literature Review on the Recent Tendency of the Treatment about Atypical Hyperplasia of Breast on the Chinese Herbal Medicine (비정형유방증식에 대한 최근 중의 약물치료 동향에 대한 문헌연구)

  • Kim, Jun-Hee;Lee, In-Seon
    • The Journal of Korean Obstetrics and Gynecology
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    • v.33 no.1
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    • pp.36-58
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    • 2020
  • Objectives: We conducted a literature study on the treatment trends in China to find out the possibility of Oriental medicine treatment of atypical hyperplasia of breast (AHB). Methods: RCTs (randomized controlled trial) on AHB were collected from CNKI (China National Knowledge Infrastructure). The search words were "乳腺增生", "乳腺囊性增生", "乳癖", "中医", "中药" and "中西医结合". The search period was limited from July 2006 to May 2017. Finally, we selected 107 RCTs which were clinical studies to find out the effectiveness of Chinese herbal medicine in comparison with Western medicine. After reviewing, we investigated Chinese herbal medication guide, Chinese treatment method and prescriptions. And the correlation between the treatments and the medicinal herbs was investigated to be useful in the clinical practice. Results: 1. The administration of herbal medicine was 58.9 percent in 63 cases, followed by menstrual cycles, and 41.1 percent in 44 cases, regardless of menstrual cycles. 2. In the basic frequency analysis between the treatment and the medicinal herb, the frequency of dissipate binds (散結) was the highest. Next, there was a high frequency of therapies such as activating blood-activating (活血), relieve pain (止痛), soothe the liver (疏肝), regulate qi (理氣), resolve phlegm (化痰), soften hardness (軟堅), resolve depression (解鬱), move qi (行氣) of frequency was high. In herbal medicine, bupleuri radix (柴胡), cyperi rhizoma (香附子), angelicae gigantis radix (當歸), fritillaria thunbergii bulb (貝母), paeoniae radix alba (白芍藥), prunellae spica (夏枯草), corydalis rhizoma (玄胡索) showed high frequency. 3. We finded out the correlation between the frequent treatment methods and the medicinal herbs using Text Mining. Conclusions: These findings are thought to help implement Korean traditional medicine treatments for AHB.

Rview of Recent Clinical Research for Herbal Medicine Treatment on Vitiligo in Children - Focused on Chinese Randomized Controlled Trials - (소아 백반증의 한약 치료에 대한 최신 임상 연구 동향 - 중국 무작위 대조군 연구를 중심으로 -)

  • Jang, Jin Woo;Choi, Il Shin;Park, Beom Chan;Kim, Ki Bong;Cheon, Jin Hong
    • The Journal of Pediatrics of Korean Medicine
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    • v.35 no.4
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    • pp.141-155
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    • 2021
  • Objective The purpose of this study is to gather information from clinical studies conducted in China and analyze the effects of herbal medicine treatment for childhood vitiligo. Methods The randomized controlled trials (RCTs) with herbal medicine treatment for childhood vitiligo from the Chinese Academic Journal (CAJ) from China National Knowledge Infrastructure (CNKI) were searched. Then, each study was analyzed by demographics, disease durations, interventions, treatment periods, outcomes, adverse events, and compositions of the herbal medicine used. Result A total of 6 RCTs were included. All the trials except for one used a combination of Chinese herbal medicine with Western medicine as their treatment groups. The total efficacy rate was used to measure the effectiveness, and the treatment groups reported a significantly higher total efficacy rate compared to the control groups in all studies. In one study, a control group treated with compound glycyrrhizin capsule and topical compound kaliziran tincture combination treatment was compared with a treatment group which used the same treatment that the control group received in addition to oral herbal medicine. This study also showed higher total effectiveness in the treatment group than the control group. Conclusions In pediatric vitiligo, a combination of herbal medicine treatment rather than Western medical treatment alone can improve symptoms. In addition, it was suggested that the therapeutic effect can be enhanced when oral herbal medicine is used in combination with other herbal medicine treatments.