• The Journal of Korean Obstetrics and Gynecology
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• v.34 no.3
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• pp.96-113
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• 2021

Objectives: The purpose of this study is to analyze the effectiveness of herbal medicine that are used for endometrial hyperplasia. Methods: We searched on three databases [PubMed, China national knowledge infrastructure (CNKI), and Oriental medicine advanced searching integrated system (OASIS)] with keywords for Endometrial hyperplasia(English, Korean, and Chinese) and evaluated the risk of bias. Meta-analysis was performed on the selected studies. Results: 15 RCTs were finally selected. According to the analysis, Most of the participants were endometrial hyperplasia without atypia. And the combined therapeutic effects of hormonal medicine and herbal medicine were statistically significant (RR 1.21 [95% CI 1.15, 1.28], P<0.00001), The endometrial thickness tended to be thinner when treated combined therapy. And they also showed improvement on levels of pictorial blood assessment chart (PBAC) and hemoglobin. Also, the therapeutic effects of herbal medicine can be identified as similar to Western medicine, and no superior effects have been confirmed (RR 1.05 [95% CI 0.87, 1.28], P=0.60). Conclusion: The combination Western and herbal medicine was more effective than Western medicine alone treated for endometrial hyperplasia without atypia. Moreover there were also significant improvements in endometrial thickness, PBAC and hemoglobin levels.

• The Journal of Internal Korean Medicine
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• v.42 no.6
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• pp.1184-1198
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• 2021

Objectives: The aim of this study was to investigate the latest clinical studies on Korean medicine treatment of post-concussion syndrome (PCS) in the Chinese National Knowledge Infrastructure Database (CNKI). Methods: We searched the last 10 years of clinical studies discussing Oriental medicine-based treatments for PCS in the CNKI database. The search focused on the authors, publication year, type of study, purpose of the study, method and duration of treatment, evaluation criteria, and results of each article. Results: Of the 22 selected studies, 1 was a non-randomized controlled trial (nRCT), 2 were case series, and 19 were randomized controlled trials (RCTs). Treatments included oral herbal medicine in 16 studies, oriental medicine through external use in 2 studies, acupuncture in 3 studies, and traditional Chinese medicine injection in 2 studies. The most frequently used herb was Cnidii Rhizoma (川芎). All 22 studies confirmed the efficacy of Oriental medicine treatments. Conclusion: More varied and scientifically designed clinical studies are required to develop treatments for PCS. The results of this study could be used as basic data for further PCS studies.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.36 no.2
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• pp.45-59
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• 2023

Objectives : The purpose of this study is to analyze the various methods of sound therapy(ST) applied to tinnitus patients and their effectiveness, and to suggest an effective method that can be applied in clinical settings. Methods : Studies published from January 2018 to March 2023 were searched on 5 databases(Pubmed, RISS, OASIS, KISS, KCI). All RCTs that applied sound therapy as a main treatment method were included. Results : 14 studies were included. In 13 studies, sound therapy was statistically significant in improving tinnitus. Basic sound therapy was used in 6 studies(42%), followed by tinnitus rehabilitation therapy(TRT)(n=5, 35%). White noise(n=11, 75%) and nature sound(n=4, 28%) were the most frequently used sound sources. In the case of intensity, mixing point were the most common with 6 studies(42%). The mobile application(n=4) was the most frequently used implement. The application time of sound therapy per day was more than 3 hours(n=7), and the total treatment period was more than 3 months(n=9). Conclusions : Our findings indicate that sound therapy could be considered as an intervention for tinnitus patients. For better use, we suggest a basic type of sound therapy or TRT using white noise or nature sound at the mixing point level provided as a mobile phone application. In addition, the treatment period is recommended to be more than 3 hours/day for 3 months.

• Journal of Oriental Neuropsychiatry
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• v.34 no.4
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• pp.403-420
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• 2023

Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

• The Journal of Internal Korean Medicine
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• v.45 no.4
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• pp.568-590
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• 2024

Objectives: This study aimed to evaluate the effect of herbal medicine on patients with non-dialysis chronic kidney disease (CKD). Methods: Articles published from 2011 to February 17, 2024 were searched via PubMed, EMBASE, Cochrane Library, CNKI, CiNii, KISS, RISS, and OASIS. The quality of included articles was evaluated using a risk-of-bias tool. Meta-analyses considered the effects of herbal medicines on the total effective rate, renal function estimates (GFR, SCr, BUN, 24h-Upro), and other indicators (e.g., uric acid, hemoglobin, and bone density-related indicators). Results: A total of 13 RCTs were included in this study. The treatment group showed a significantly higher total effective rate (RR: 1.47, 95% CI: 1.33-1.62, P<0.00001) and GFR (MD: 9.28, 95% CI: 6.52-12.04, P<0.00001), together with improvements in other renal function indicators, except for 24h-Upro (p=0.05). There were no significant differences in uric acid, hemoglobin, and bone density-related indicators. Adverse events were minimal in both groups. Conclusion: For non-dialysis CKD, this study supports the effectiveness of nine herbal medicines, either alone or in combination with Western medicines. However, even the meta-analyses provide insufficient evidence to conclusively guarantee the safety and efficacy of all types of herbal medicines in treating CKD. Therefore, additional well-designed studies are necessary to enhance the clinical application of herbal medicines in CKD.

• The Journal of Internal Korean Medicine
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• v.44 no.4
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• pp.726-740
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• 2023

Objectives: This review investigated the research on warm herbal foot bath therapy (WHFT) for insomnia. Methods: A search was conducted on the China National Knowledge Infrastructure (CNKI) database to collect relevant studies published up to August 29, 2023. Randomized controlled trials (RCTs) comparing WHFT and sleeping pills in patients with insomnia were included. The methodological quality of the included studies was assessed using the Cochrane risk-of-bias assessment tool. The results of the meta-analysis were presented as risk ratios (RRs) or mean differences (MDs) and their 95% confidence intervals (CIs). Results: A total of 11 RCTs were included. WHFT as monotherapy resulted in a significantly higher total effective rate (TER) (RR, 1.25; 95% CI, 1.15 to 1.36; I²=25%) and an improved Pittsburgh Sleep Quality Index (PSQI) global sore (MD, -3.10; 95% CI, -4.24 to -1.95; I²=73%) compared to benzodiazepines. Additionally, WHFT as a combined therapy with benzodiazepines resulted in a significantly higher TER (RR, 1.15; 95% CI, 1.04 to 1.27; I²=0%) and an improved PSQI global score (MD, -2.23; 95% CI, -4.09 to -0.38; I²=80%) compared to benzodiazepines alone. In network analysis visualizing the components of HWFT, four clusters were discovered, and Polygoni Multiflori Ramuls and Ziziphi Spinosae Semen were the key herbs used in WHFT. Overall, the methodological quality of the included studies was poor. Conclusions: There was limited evidence that WHFT as a monotherapy or combined therapy was effective in improving insomnia. The findings can be used as basic data for future WHFT research in South Korea.

• Asian Pacific Journal of Cancer Prevention
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• v.15 no.12
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• pp.4787-4793
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• 2014

Background: Many cancer patients experience poor pain control due to various factors, including misconceptions regarding the use of opioid analgesics. For management of cancer pain, interventions involving education of both patients and physicians have been attempted. Objectives: This review aimed to assess the current evidence of the benefits of education for the management of cancer pain. Methods: We searched the Medline, EMBASE, Cochrane library, and major Korean databases to identify relevant studies. We included most study designs, but excluded case series. The primary outcomes were pain intensity and quality of life (QoL). Two reviewers assessed the risk of bias using the Cochrane's tool for RCT and Risk of Bias Assessment tool for Non-randomized Studies (RoBANS) for non-randomized studies, independently. Results: After extensive searches, 3,324 publications were screened, and 32 studies were selected. The education interventions used in the included studies included a wide variety of education methods, but the most common method was a booklet produced for patients. Regardless of the education method used, the results of the meta-analysis were as follows. The SMDs of the most severe, average, and current pain in the RCTs were significant. The SMD of worst, average, and current pain were -0.34 (-0.55, -0.13), -0.40 (-0.64, -0.15), and -0.79 (-1.35, -0.23). In the non-randomized studies, the effects on average pain were significant, but those on worst and current pain were not. Conclusions: Education intervention reduced the pain of cancer patients. Therefore, patient education could be considered to be an effective method of cancer pain management. However, our data should be interpreted with caution, and studies using standardized protocols are needed to confirm these observations.

• Asian Pacific Journal of Cancer Prevention
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• v.16 no.14
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• pp.5681-5686
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• 2015

Background: Pancreatic cancer ranks fourth in deaths caused by cancers throughout the world. Gemcitabine chemotherapy is the primary method of treatment of advanced pancreatic cancer, and in asco2014, it is still firstline chemotherapy. Howeve,r gemcitabine+fluorouracil regimens are also licensed and widely used worldwide. Clinical trials are the best way to evaluate drug efficacy. In this study, we performed a systematic review and a meta-analysis of randomized controlled trials (RCTs) to assess whether gemcitabine+fluoropyrimidine combination therapy improves the prognosis of unresectable pancreatic cancer compared with gemcitabine treatment alone. Materials and Methods: A quantitative up-to-date meta-analysis was undertaken to investigate the efficacy of gemcitabine-based combination treatment compared with gemcitabine monotherapy for locally advanced or metastatic pancreatic cancer. Inclusion was limited to high-quality randomized clinical trials. Results: A total of 12 studies were included in the present analysis, with a total of 3,038 patients recruited. The studies were divided into three subgroups including 5-FU / CAP / S-1 combined with gemcitabine. For the primary endpoint of overall survival (OS), gemcitabine-based combination therapy demonstrated significantly better outcome (HR, 0.88; 95% CI, 0.81-0.95) than gemcitabine monotherapy. The analysis of progression free survival (PFS) also provided a significant result for the combined therapy in a total of 8 trials (2,130 patients) (HR, 0.74; 95% CI, 0.63-0.86). With subgroup analysis according to the method of dosing delivery, we found that in the injection group with 3 trials (889 patients), a negative result was found (HR, 0.93; 95% CI, 0.77-1.12); while a positive result was observed in the oral group with 9 trials (2,149 patients) (HR, 0.87; 95% CI, 0.80-0.95). Conclusions: Gemcitabine combination therapy provides a modest improvement of survival, but is associated with more toxicity compared with gemcitabine monotherapy.

• The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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• v.33 no.3
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• pp.45-68
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• 2020

Objectives : This study aims to evaluate the effectiveness and safety of manual and electroacupuncture on glaucoma. Method : We searched 11 electronic databases using index words to identify randomized clinical trials. Meta-analysis of weighted mean difference (WMD) or standardized mean difference (SMD) were used to evaluate the outcomes. Cochrane bias risk assessment tool was used to assess the risk of bias in each clinical study. The collected data was analyzed using RevMan software (ver. 5.3). Results : At the initial stage of data retrieval, 549 papers were searched. After reviewing 37 full texts, a total of 10 RCT studies (426patients, 715 eyes) were selected and 8 RCT studies (357 people, 617 eyes) were involved in meta-analysis. Meta-analysis of 8 RCTs showed that acupuncture alone was more effective in reducing intraocular pressure(IOP) than conventional treatment (WMD = -5.73, 95% CI: [-12.30, 0.83], P = 0.09, I² = 97%) The combination of acupuncture or electroacupuncture with conventional treatment was also effective in lowering IOP (WMD = -1.84, 95% CI: [-2.31, -1.37], P <0.00001, I² = 45%). It was estimated that the combination of acupuncture with conventional treatment was also effective for improving visual field (VF) (WMD = -2.17, 95% CI: [-4.32, -0.02], P = 0.05, I² = 89%) but improvement in visual acuity (VA) was not significant (MD = 0.06, 95% CI: [-0.03, 0.15], P = 0.23, I² = 0%). Subgroup analyzes were performed only for the studies that used open glaucoma as the study's disease and combination of acupuncture or electroacupuncture with conventional therapy would have an effect on lowering intraocular pressure (WMD = -1.68)., 95% CI: [-2.46, -0.90], P <0.0001, I² = 29%). Conclusion : This study suggests that acupuncture treatment for glaucoma may be effective in reducing intraocular pressure and helpful in improving visual field defects. However, due to the small sample size, high risk of bias and high heterogeneity in the methodology, it is expected that further studies will be needed to verify the results. Further studies in large-scale samples based on a minimized biased methodology would be necessary.

• The Journal of Internal Korean Medicine
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• v.43 no.4
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• pp.625-642
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• 2022

Objectives: Postoperative ileus (POI) is a common impairment of gastrointestinal motility and causes a delay in postoperative recovery, as well as an increased length of hospital stay, but no single strategy has a significant recuperative effect on POI. Studies of traditional Korean medicine (TKM) have reported improvements in bowel function after surgery. The aim of this systematic review was to assess the effectiveness of TKM on postoperative ileus in gastric cancer patients. Methods: We used six databases to search for studies published from January 1, 2007, until May 11, 2022. The included studies were those reporting gastric cancer patients who received TKM treatment after gastrectomy through indicators related to POI. Results: The search identified 27 RCTs that used herbal medicine (Daegeonjung-tang and Gami-leejoongtang), herbal medicine combined with acupuncture (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, acupuncture and moxibustion, electroacupuncture, warm needling, transcutaneous electroacupuncture (TEA), low-frequency electrical acupoint stimulation (LEAS), moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine as treatments for POI. The time to first flatus was shortened by herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). The time to the first defecation decreased significantly in response to the herbal medicine combined with warm needling (Sama-tang, Gumiseunggi-tang, Daeseunggi-tang, and Insam-tang), acupuncture, electroacupuncture, warm needling, TEA, moxibustion, auricular acupressure, and ST-36 acupoint injection with neostigmine (p<0.00001). No serious adverse events occurred. Conclusions: TKM could be a promising option for preventing and resolving POI in gastric cancer patients after gastrectomy.