• Title/Summary/Keyword: RCTs Review

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A Study on Homogeneity Analysis of the Guipi Decoction for Treatment of Insomnia Disorder -Focusing on Randomized Controlled Clinical Trials in CNKI (불면장애에 사용된 귀비탕의 동질성 연구 -CNKI에서 검색한 무작위배정 임상연구를 중심으로-)

  • Kim, Dong-Hee;Sakong, Jong-Won;Kang, Chang-Wan;Lee, Sang-Hyup;Ha, Ji-Won;Kim, Bo-Kyung
    • Journal of Oriental Neuropsychiatry
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    • v.29 no.3
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    • pp.145-163
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    • 2018
  • Objectives: The study was designed to provide clinical evidence of homogeneity in analysis of the herbal medicine, Guipi decoction in treating insomnia, using a t-test of randomized controlled trials (RCTs). Methods: This study included RCTs that verified homogeneity of Guipi decoction in treating insomnia. Literature studies of CNKI (Chinese National Knowledge Infrastructure Database) were performed. The basic components group was made to the Guipi decoction of the Yixuerumen?s text. The excluded group was created with the number of herbs excluded from the basic components group. T-test performed that the effective rate in the basic components group and excluded groups. Results: The basic components of Guipi decoction contain Atractylodis Rhizoma Alba, Poria Sclerotium (Poria Sclerotium Cum Pini Radix), Polygalae Radix, Astragali Radix, Zizyphi Semen, Angelicae Gigantis Radix, Aucklandiae Radix, Glycyrrhiza uralensis Fischer, Ginseng Radix (Codonopsis Pilosulae Radix), Longanae Arillus. Herbs excluded from the basic components group were Longanae Arillus, Ginseng Radix (Codonopsis Pilosulae Radix), Glycyrrhiza uralensis Fischer and herbs added to the basic components group were Polygonum multiflorum Thunberg, Schisandrae Fructus, Salviae Militiorrhizae Radix, Paeoniae Radix Alba (in order from the most used to the least). T-test revealed the effective rate in the basic components group was not statistically significant compared to the excluded groups (p=0.161/p=0.162/p=0.103). Conclusions: Effectiveness in treatment of basic components of Guipi decoction and excluded groups were revealed to be homogeneous in treating insomnia. As the number of herbs in the basic components group decreased, mean value in effectiveness of treatment also decreased consequentially. However, there were no statistical significances.

Effectiveness and Safety of Pemetrexed Versus Docetaxel as a Treatment for Advanced Non-small Cell Lung Cancer: a Systematic Review and Meta-analysis

  • Di, Bao-Shan;Wei, Kong-Ping;Tian, Jin-Hui;Xiao, Xiao-Juan;Li, Yan;Zhang, Xu-Hui;Yu, Qin;Yang, Ke-Hu;Ge, Long;Huang, Wen-Hui;Zhang, Fang-Wa
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.8
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    • pp.3419-3424
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    • 2014
  • Background: Our aim was to conduct a meta-analysis to compare the efficacy and safety of pemetrexed and docetaxel for non-small cell lung cancer (NSCLC). Materials and Methods: We systematically searched the Cochrane Library, PubMed, Embase, China Biology Medicine Database for randomized controlled trials (RCTs) comparing the efficacy and toxicities of pemetrexed versus docetaxel as a treatment for advanced NSCLC. We limited the languages to English and Chinese. Two reviewers independently screened articles to identify eligible trials according to the inclusion and exclusion criteria and assessed the methodological quality of included trials, and then extracted data. The meta-analysis was performed using STATA12.0. Results: Six RCTs involving 1,414 patients were identified. We found that there was no statistically significant differences in overall response rate, survival time, progression-free survival, disease control rate, and 1-2yr survival rate (p>0.050) but it is worthy of mention that patients in the pemetrexed arms had significantly higher 3-yr survival rate (P=0.002). With regard to the grade 3 or 4 hematological toxicity, compared with docetaxel, pemetrexed led to lower rate of grade 3-4 febrile neutropenia, neutropenia, and leukocyts toxicity (p<0.001). There was no significant difference in anemia between the two arms (p=0.08). In addition, pemetrexed led to higher rate of grade 3-4 thrombocytopenia toxicity (p=0.03). As for the non-hematological toxicities, compared with docetaxel, pemetrexed group had lower rate of grade 3-4 diarrhea and alopecia. Conclusions: Pemetrexed was almost as effective as docetaxel in patients with advanced NSCLC. At the same time, pemetrexed might increase the 3-yr survival rate. As for safety, pemetrexed led to lower rate of grade 3-4 febrile neutropenia, neutropenia, leukocytes, diarrhea and alopecia toxicity. However, it was associated with a higher rate of grade 3-4 thrombocytopenia.

Efficacy and Safety of Neurokinin-1 Receptor Antagonists for Prevention of Chemotherapy-Induced Nausea and Vomiting: Systematic Review and Meta-analysis of Randomized Controlled Trials

  • Yuan, Dong-Mei;Li, Qian;Zhang, Qin;Xiao, Xin-Wu;Yao, Yan-Wen;Zhang, Yan;Lv, Yan-Ling;Liu, Hong-Bin;Lv, Tang-Feng;Song, Yong
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.4
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    • pp.1661-1675
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    • 2016
  • Objectives: Can addition of neurokinin-1 receptor antagonists (NK1-RAs) be considered as an ideal strategy for the prevention of chemotherapy-induced nausea and vomiting (CINV)? Researchers differ on this question. Materials and Methods: Electronic databases were searched for randomized control trials (RCTs) that evaluated the effectiveness and safety of NK1-RAs in preventing CINV. The primary end point was complete response (CR) in the acute, delayed, and overall phases after chemotherapy. Subgroup analyses evaluated the types of NK1-RAs, routines of administration, types of malignancies, regimens used in combination with NK1-RAs, and age of patients included in the studies. The incidences of different types of adverse events were also extracted to estimate the safety of NK1-RAs. Results: A total of 38 RCTs involving 13,923 patients were identified. The CR rate of patients receiving NK-RAs was significantly higher than patients in the control groups during overall phase (70.8% vs 56.0%, P<0.001), acute phase (85.1% vs 79.6%, P<0.001), and delayed phase (71.4% vs 58.2%, P<0.001). There were three studies including patients of children or adolescents, the CR rate was also significantly higher in the treatment group (overall phase: OR=2.807, P<0.001; acute phase: OR=2.863, P =0.012; delayed phase: OR=2.417, P<0.001). For all the other outcomes, patients in the NK1-RAs groups showed improvements compared to the control groups (incidence of nausea: 45.2% vs 45.9%, P<0.001; occurrence of vomiting: 22.6% vs 38.9%, P<0.001; usage of rescue drugs: 23.5% vs 34.1%, P<0.001). The pooled side effects from NK1-RAs did not significantly differ from previous reports and the toxicity rates in patients less than eighteen years old also did not diff between the two groups (P=0.497). However, we found that constipation and insomnia were more common in the patients of control groups, whereas diarrhea and hiccups were more frequently detected in patients receiving NK1-RAs. Conclusions: NK1-RAs improved the CR rate of CINV. They are effective for both adults and children. The use of NK1-RAs might be associated with the appearance of diarrhea and hiccups, while decreasing the possibility of constipation and insomnia.

Systematic Review of Korean Medicine for the Treatment of Sixth Cranial Nerve Palsy (외전신경마비의 한의학 치료에 대한 체계적 문헌 고찰)

  • Won, Seo-young;Kim, Min-ji;Cha, Ji-yun;Jung, Eun-sun;Cho, Hyun-kyoung;Yoo, Ho-ryong;Seol, In-chan;Kim, Yoon-sik
    • The Journal of Internal Korean Medicine
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    • v.40 no.3
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    • pp.409-424
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    • 2019
  • Objectives: This research aimed to confirm the efficacy of oriental medicine in sixth cranial nerve palsy and to evaluate the quality of the studies. Methods: Using the medical subject heading (MeSH) keywords "abducens nerve palsy", "abducens nerve paralysis", "sixth nerve palsy", "herbal medicine", "Chinese medicine", "oriental medicine" and "acupuncture", we collected the research papers through an electronic database search in Oriental Medicine Advanced Searching Integrated System (OASIS), National Discovery for Science Leaders (NDSL), PubMed, Cochran Library, and China National Knowledge Infrastructure (CNKI). Results: A total of 136 papers were searched from the databases. Among these, 15 case reports and 8 randomized controlled trials (RCTs) met our criteria. 17 articles were found on the use of acupuncture as the main intervention, 11 on the use of herbal medicine as the main intervention, and 9 on the use of electroacupuncture as the main intervention. The frequently used acupoints were LI4, EX-HN5, GB1, BL2, TE23, LR3, BL1, ST2, GB20, and ST36. All 23 studies confirmed the efficacy of Korean medicine. According to the assessment using the risk of bias, the overall quality of the RCTs was low. Conclusions: Twenty-three papers suggested that Korean medicine treatment for abducens nerve palsy was effective in many cases. Analyzing the potential bias was difficult.

A Study on the Effect of Virtual Reality Intervention on Cognitive Function in Individuals With Stroke Through Meta-analysis (메타분석을 통한 뇌졸중 환자의 인지기능에 대한 가상현실 중재 효과 연구)

  • Kwon, Jae Sung
    • Therapeutic Science for Rehabilitation
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    • v.10 no.3
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    • pp.7-22
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    • 2021
  • Objective : The purpose of this study was to verify the effect of virtual reality interventions (VRIs) on cognitive function in individuals with stroke through a systematic literature review and meta-analysis. Methods : We reviewed randomized controlled trials (RCTs) the last 10 years using academic databases. PubMed, MEDLINE, and CINAHL were used for international studies, and DBpia, KISS, Kyoboscholar, and e-article were used for Korean studies. For the quantitative meta-analysis, subgroups of outcomes were classified into general cognitive function (G-CF), attention and memory (A&M), and executive function (EF). Results : Nine RCTs were analyzed. The total number of participants was 271 (140 in the experimental group). The effect size (Cohen's d) was estimated using a random effects model. The effect sizes of the outcome subgroups of were as follows: small to medium for G-CF (d=0.422; 95% CI: 0.101~0.742; p=0.010), small for A&M (d=0.249; 95% CI: -0.107~0.605; p=0.170), and medium for EF (d=0.666; 95% CI: 0.136~1.195; p=0.014). Conclusion : Considering the various stimuli provided by the virtual environment and the results from available research, virtual reality should be applied to interventions for integrated cognitive functions. In addition, it would be appropriate to be used as an additional intervention to traditional cognitive rehabilitation for stroke.

Effect of Acupuncture on Patients with Hypertension : A Review of Clinical Studies in the Republic of Korea (고혈압의 침치료에 대한 문헌고찰 : 국내 임상 연구를 중심으로)

  • Sang Yeon, Jung;Ye-Chae, Hwang;Seung-Yeon, Cho;Han-Gyul, Lee;Seungwon, Kwon;WooSang, Jung;Sang-Kwan, Moon;Jung-Mi, Park;Chang-Nam, Ko;Seong-Uk, Park
    • The Journal of the Society of Stroke on Korean Medicine
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    • v.23 no.1
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    • pp.25-40
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    • 2022
  • ■Objectives This study aimed to collect and analyze clinical studies on the significance of acupuncture in the treatment of hypertension among Korean patients. ■Methods Among Korean patients with a blood pressure (BP) of 120 mmHg or higher and a diastolic BP of 80 mmHg or higher, those, treated with acupuncture only, were included. A literature search was conducted through 'Embase', 'Medline', 'Science and Technology Information Integration Service (NDSL)', 'Traditional Korean Knowledge Portal (OASIS)', 'PubMed', and 'Scopus'. The search keywords were (hypertension OR 'blood pressure') AND acupuncture. The papers, published before the day of the search (02. January 2022), were included in this study. ■Results Among the 12 selected papers, seven involved randomized controlled trial (RCT), four before-and-after studies, and one case series. The number of RCTs has increased yearly. The treatment methods used in the studies included needle acupuncture in eight studies, auricular acupuncture in two, pharmacopuncture in one, and si-acupuncture in one. The average numbers of patients enrolled in RCTs, before-and-after studies, and case series were 21.1, 30, and 23 respectively. Six studies were conducted on prehypertensive patients, two on stage 1 hypertension patients, and four on stage 2 hypertension patients. The involved acupoints have been reported to be ST36 in eight papers, LI11 in four papers, and PC6 in three papers. The treatment period lasted for < 1 week in eight studies and 8 weeks in four studies. Acupuncture successfully lowered blood pressure in nine out of 12 studies ■Conclusions Acupuncture is a viable alternative treatment option for prehypertensive patients, who are not taking medications. Additionally, it is also useful in further lowering the BP of patients with stage 1 and stage 2 hypertension in the short term. Large-scale and long-term studies on acupuncture for hypertension should be conducted.

Effects of Exercise-Based Intervention Before and After Lung Cancer Surgery: A systematic review in pubmed database (허파암 수술 전과 후에 적용한 운동의 효과: PubMed 내 연구에 대한 체계적 문헌고찰)

  • Boram Oh;Heesu Kim;Sookyoung Park
    • Journal of The Korean Society of Integrative Medicine
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    • v.11 no.2
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    • pp.23-35
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    • 2023
  • Purpose : Lung cancer induces a decrease in physical activity and a deterioration of respiratory ability. Exercise is an effective treatment to reduce side effects of anti-cancer treatments, also influence the survival and successful rehabilitation in lung cancer patients. However, there is insufficient evidence to show which period is the most effective to apply exercise for lung cancer patients. Therefore, this study was conducted to evaluate the efficacy of exercise-based interventions before and after surgery. Methods : Clinical trials (CTs) and randomized controlled trials (RCTs) reported in PubMed database were investigated. The trials investigated in this study were published for 10 years before August 20, 2022. The risk of bias was judged according to the Cochrane guideline. The materials included in this meta-analysis were 6-minute walk test (6MWT), pulmonary function, and quality of life (QOL). Results : 1 CT and 9 RCTs were selected in current study. In the meta-analysis, exercise increased 6MWT in preoperation (mean difference [MD] 29.49; 95 % confidence interval [CI] .99 to 57.99; p=.04; I2=0 %), 3 months postoperation (MD 54.97; 95 % CI 31.85 to 78.09; p<.001; I2=45 %) and 6 months postoperation (MD 85.59; 95 % CI 45.06 to 126.12; p<.001; I2=47 %). Exercise, also enhanced the lung function such as FEV1/FVC (%) in postoperation (MD 7.64; 95 % CI 6.26 to 9.02; p<.001; I2=19 %). Additionally, exercise improved QOL, such as preoperative EORTC-QLQ-C30-LC13 in mental function (MD 3.21; 95 % CI .64 to 5.79; p=.01; I2=0 %) and postoperative SF-36 in mental component summary (MD 9.24; 95 % CI 4.94 to 13.54; p<.001; I2=0%). Conclusion : These results indicate that exercise-based intervention can elevate the ability to exercise and the mental componentof QOL within 3 months.

Effectiveness of Acupuncture in the Treatment of Post-Disaster Musculoskeletal Pain: A Systematic Review (재난 후 근골격계 통증에 침치료의 유효성: 체계적 문헌고찰)

  • Ka-Hyun Kim;Sung-Won Choi;Hae-Won Hong;Ju-Young Yoon;Yong-Jun Kim;Jung-Hyun Kim
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.3
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    • pp.135-148
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    • 2023
  • Objectives To investigate the effectiveness of acupuncture in the treatment of post-disaster musculoskeletal pain by reviewing relevant clinical studies. Methods A systematic search was conducted across 10 electronic databases to identify relevant clinical studies on acupuncture treatment for post-disaster musculoskeletal pain until May 2023. The methodological quality was evaluated using the Cochrane Risk of Bias 2 and Risk of Bias Assessment tool for non-randomized studies tools. Results Six articles were analyzed, including two randomized controlled trials (RCTs), two before-after studies, one qualitative research, and one case series. Overall, acupuncture therapy showed some improvement in pain scale among musculoskeletal pain survivors. However, no significant improvement was observed in the Short-Form McGill Pain Questionnaire (SF-MPQ-2). Subgroup analysis of participants who completed at least four acupuncture sessions revealed a significant effect on the SFMPQ-2. Additionally, a significant improvement in 36-Item Short Form Survey (SF36P) was observed after 6 months of treatment, but the 2-month treatment period did not show statistically significant effects on SF-36P improvement. The evaluation of the methodological quality of the RCTs identified some concerns of bias. Conclusions The results suggest that acupuncture is effective in alleviating post-disaster musculoskeletal pain. However, considering the limited number of selected studies and the inclusion of subjective evaluation measures, caution should be exercised in interpreting the results. Further large-scale follow-up studies are needed to determine the optimal frequency and duration of acupuncture treatment. Well-designed controlled trials should be conducted to provide more robust evidence regarding the effectiveness of acupuncture for post-disaster musculoskeletal pain.

A Systematic Review of Randomized Controlled Trials on Acupuncture Treatment for Neck Pain (경항통에 침치료를 시행한 무작위대조군연구(RCT)들에 대한 계통적 연구)

  • Kim, Hyun-Wook;Kim, Sung-Soo;Kang, Jung-Ah;Nam, Dong-Woo;Kim, Eun-Jung;Hong, Kwon-Eui;Kim, Sung-Chul;Lee, Jae-Dong;Kim, Kap-Sung;Lee, Geon-Mok
    • Journal of Acupuncture Research
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    • v.26 no.2
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    • pp.103-123
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    • 2009
  • Objectives : The aim of this study is to review RCTs of acupuncture treatment for neck pain and to establish standards of acupuncture treatment for neck pain. Methods : We searched articles in Pubmed using ICD 10. Study quality was assessed using the FEAS and Jadad score. Results and Conclusions : Three review studies and nineteen clinical trials were searched and reviewed. Among the nineteen clinical trials reviewed, positive outcome was reported in thirteen studies. Most frequently used meridians were GB, BL, SI, GV and LI, The most frequently used acupuncture points were $GB_{20}$, $GB_{21}$, $LI_4$, $BL_{10}$, $GV_{14}$ and $SI_3$. More than two needles were inserted in the studies and needle retention time was more than 10 minutes. The most frequently used needle length was 40mm, and diameter was 0.25mm and 0.30mm. The mean number of treatment sessions were more than 10 times. Frequency of treatment was more than once a week, And treatment duration was more! than 5 weeks. The total FEAS scores ranged from 3 to 15.5, and the mean value was 9.39. Jadad score ranged from 2 to 5, and the mean value was 3.42. The number of studies scoring over three points on the Jadad scale was sixteen.

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Criteria for diet pattern and meal management to improve cognitive function: A systematic review (체계적 문헌 고찰을 통한 인지기능 개선에 도움을 주는 식사 관리에 대한 연구)

  • Park, Young-Sook;Lee, Hyun-Jung;Choi, Kui-Jeong;Xu, Lin;Nam, Ye-Rim;Kim, Yoon-Ha;Kim, Min-Ji;Shin, Weon-Sun
    • Korean Journal of Food Science and Technology
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    • v.52 no.5
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    • pp.450-458
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    • 2020
  • The purpose of this study was to conduct a systematic review of the current published research related to improvement in cognitive function. A systematic search was performed in three bibliographic databases (PubMed, Cochrane Library, and EMBASE) using "dementia", "memory", "food", "diet", and "nutrition" as keywords. Meal management intervention, including Dietary Approaches to Stop Hypertension (DASH) diet, Mediterranean (Med) diet, Diet Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diet, and other studies, was also included in the analysis. Through extensive screening, 21 articles, out of 2101 papers retrieved, were used for the final systematic review. The methodological quality of the randomized controlled clinical trials (RCTs) was assessed using the Cochrane Risk of Bias tool. These articles recommended vegetables, fruits, whole grains, olive oil, fish, berries, nuts, and beans. In conclusion, this study suggests the potential use of meal management to improve cognitive function.