• Title/Summary/Keyword: RCTs Review

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Effects of Laughter Therapy on Depression and Sleep Wake Disorders of the Elderly in Residential Facilities : A Systematic Review and Meta-analysis (웃음요법이 시설거주 노인의 우울과 수면 장애에 미치는 효과 : 체계적 고찰 및 메타분석)

  • Kim, Eun-Jung;Yang, Jin-Hyang
    • Journal of Korea Entertainment Industry Association
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    • v.15 no.8
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    • pp.291-303
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    • 2021
  • The purpose of this study is to identify the effects of laughter therapy on depression and sleep wake disorders among the elderly in residential facilities using a systemic review and meta-analysis. Twelve databases were searched. Two researchers independently performed the selection of the studies, data coding and assessment. The risk of bias was assessed using risk of bias (RoB) and risk of bias assessment tool for non-randomized studies (RoBANs). To estimate the effect size, meta-analysis of the studies was performed using R version 4.04. Out of the 1,122 retrieved articles, one randomized controlled trial (RCT) and eleven non-randomized controlled trials (non-RCTs) were selected for analysis. The overall effect size of eleven studies on depression was determined to be -1.04 (95% Cl: -1.53~-0.54, p<.001). There were statistically significant in the effect of below ten sessions and the effect of below 400 minutes'and 400 to 1000 minutes'interventions on depression. The overall effect size of five studies on sleep wake disorders was 0.83 (95% Cl: -0.26~1.93, p=.136), which was not statistically significant. There was statistically significant in the effect of below 300 minutes'interventions on sleep wake disorders. Laughter therapy was an effective non-pharmacological intervention to reduce depression among the elderly in residential facilities. The findings also suggest that guidelines for laughter therapy need to be developed considering the number of sessions and a duration of intervention to reduce depression and sleep wake disorders of the elderly in residential facilities.

A Systematic Review of effect on Heat-sensitive Moxibustion for Benign Prostatic Hyperplasia (전립선비대증에 대한 열민구(熱敏灸)의 효과에 관한 체계적 문헌 고찰)

  • Kim, MinSeok;Ju, HongMin;Kim, MinHwa;Park, SunYoung;Yun, YoungJu;Park, SeongHa
    • The Journal of Korean Medicine
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    • v.42 no.3
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    • pp.153-164
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    • 2021
  • Objectives: The aim of this study is to investigate the effect of Heat-sensitive Moxibustion on Benign Prostatic Hyperplasia Methods: We searched articles from Academic Journals(CAJ) online databases, Oriental Medicine Advanced Searching Integrated System (OASIS), Searching key words were '前列腺增生', '熱敏灸' and '열민구', '전립선비대'. The search range included randomized controlled trials (RCTs). Among the articles published to 2020, 10 articles were found. After review the title, abstract and original, 3 articles were selected finally to rule out treatment combined with completely different treatments. Result: The Heat-sensitive moxibustion at acupoints in the treatment of Benign prostatic hyperplasia were significantly superior to control group after treatment in the symptoms of patients, IPSS, QOL, PVR and Qmax(P<0.05). The Heat-sensitive moxibustion can significantly reduce the incidence of temporary urinary incontinence after Transurethral resection of the prostate(TURP) and improve life quality and satisfaction of patients(P<0.05). The individualized desensitization saturated time and amount of Heat-sensitive moxibustion is superior effective to general amount and time of traditional moxibustion in the total effective rate, IPSS, Ru and Qmax(P<0.01) for Benign prostatic hyperplasia. Conclusion: Heat sensitive moxibustion directly transfer heat to the source of a disease. So it can be considered as a good treatment for Benign prostate hypertrophy. It was also shown a better effect on BPH compared to traditional moxibustion, According to the thermo principles of tumor, if the tumor cell's death temperature of 43℃ is reached, that can cause tumor degeneration. Therefore I think Heat sensitive moxibustion can be applied to various tumor disease. The results of this study could be applied to clinical treatment of BPH. However, additional large-scale clinical researches should be conducted.

A Narrative Review of the Korean Medicine Treatments for Achilles Tendinopathy (아킬레스 건병증의 한의학적 치료에 대한 국내외 연구 동향 분석)

  • Yoon, Kyung-Young;Hwang, Dong-Wook;Bae, In-Su;Youn, Jun-Heum;Lee, Yu-Jin;Jang, Won-Suk;Yoo, Sang-Joon;Lee, Do-Hoon;Kang, Dong-Hyeob;Son, Ja-Yean;Yang, Seok-Gyu;Cho, Hyun-Woo
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.4
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    • pp.33-45
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    • 2022
  • Objectives The purpose of this review was to investigate clinical treatment trends of Achilles tendinopathy. Methods Clinical studies about Korean medicine treatments on Achilles tendinopathy were searched in 5 databases. The included studies were classified according to the authors, published years, study designs, purposes of study, methods, interventions outcome measures and adverse event. Results In 23 studies, total number of patients were 1,135. The included studies consist of 14 randomized controlled trials (RCT), 5 non-RCT, 2 retrospective study and 2 case reports. Patients were conducted with 9 kinds of treatment, which is acupuncture, electro-acupuncture, pharmacopuncture, acupotomy, moxibustion, cupping, Chuna, herbal medicine, physiotherapy. Most studies used visual analogue scale as primary outcome. Conclusions Based on the results of the collected studies, the use of Korean medicine treatment on Achilles tendinopathy seem to be effective. Despite the large number of RCTs, the level of research cannot be guaranteed, so it is considered that more rigorous researches are needed in future studies.

Comparison of the Effectiveness of Herbal Medicine Eye Drops on Conjunctivitis : A Systematic Literature Review and Meta-Analysis (결막염에 대한 한방 점안액의 효과 비교 : 체계적 문헌 고찰과 메타 분석)

  • Lim, Hui-Yeong;Kim, Jee-Hee;Ko, Woo-Shin;Yoon, Hwa-Jung
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.3
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    • pp.48-65
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    • 2022
  • Objectives : This study was conducted to find out the effectiveness and safety of herbal medicine eye drops on conjunctivitis. Methods : We searched randomized controlled trials on conjunctivitis through 10 DBs from the start to April 27, 2022. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent researchers. The evaluation of the risk of bias in included RCTs was carried out by using Cochrane risk-of-bias tool. And the data synthesis was conducted by using Review Manager(RevMan, ver.5.4). Results : Total of 106 studies are researched and 7 studies of them are finally included. 1. The herbal medicine eye drops are more effective on than the western medicine eye drops, but the heterogeneity was very high. So we conducted sensitivity analysis and compared to the herbal medicine eye drops and the western medicine eye drops, the total effective rate was higher in the herbal medicine eye drops and the heterogeneity was somewhat reduced. 2. In the subgroup analysis, Fufang Xiongdan eye drops and Houttuynia cordata Thunb eye drops are more effective than the western medicine. It may represent substantial heterogeneity. 3. In the subgroup analysis, the herbal medicine eye drops are more effective than antibiotic and antiviral eye drops on acute bacterial conjunctivitis, but showed high heterogeneity. On the other hand, the herbal medicine eye drops are more effective than antibiotic and antiviral eyed drops on acute viral conjuctivitis and showed low heterogeneity. 4. In the subgroup analysis, we compared the effectiveness of herbal and western medicine eye drops according to total effectiveness rate evaluation methods. When comparing the studies calculating the total effective rate by the sum of 'Cured', 'Significantly Impaired', and 'Improved', the effective rate of the herbal medicine eye drops was higher than that of the western medicine eye drops, and the heterogeneity was very low. 5. In most studies, side effects of herbal medicine eye drops were absent or mild. Conclusions : This study shows that herbal medicine eye drops may be more effective than western medicine eye drops and have safety. But further researches are needed to resolve the heterogeneity of this study.

The Effect of Oriental Medicine Treatments for Supraspinatus Tendinopathy: Systematic Review and Meta-Analysis (극상근 건병증의 한의학적 치료에 대한 연구 동향: 체계적 문헌 고찰과 메타 분석)

  • Dong-Hyeob Kang;Do-Hoon Lee;Sang-Joon Yoo;Seok-Gyu Yang;Ja-Yean Son;Seol Jung;Hea-Ju Kim;Minjin Kwon;Oh-Bin Kwon;Seon-Woo Jang;Hyun-Woo Cho
    • Journal of Korean Medicine Rehabilitation
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    • v.33 no.4
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    • pp.45-59
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    • 2023
  • Objectives The aim of this study was to analyze the trends of researches on oriental medicine treatments for supraspinatus tendinopathy. Methods We used five databases for searching researches; Korean studies Information Service System, Oriental Medicine Advanced Searching Integrated System, Research Information Sharing Service, PubMed, and China National Knowledge Infrastructure. Only randomized controlled trials suitable for the subject were selected. The methodological quality of included randomized controlled trials (RCTs) was assessed by the Cochrane risk of bias tool. Results Twenty randomized controlled trials were analyzed. There were 9 types of treatment interventions; acupuncture, acupotomy, pharmacopuncture, electroacupuncture, fire needling, warming needle, catgut-embedding therapy, herbal medicine, cupping. The most frequently used treatment intervention was acupuncture and acupotomy. There were 9 outcome measurements including visual analog scale (VAS), Constant-Murley Score (CMS), and range of motion. The most used measurement was VAS. As a result of meta-analysis, acupuncture was more effective than control group in VAS. Additionally, acupotomy was clinically significant compared to control groups in VAS and CMS. Conclusions In this review, we analyzed researches on effectiveness of oriental medicine for supraspinatus tendinopathy. A provisional conclusion can be produced that acupuncture and acupotomy showed beneficial effect to supraspinatus tendinopathy. Although there were some RCT studies, many of them had a high risk of bias, so it is hard to conclude that our study can include overall clinical status. Further well-designed trials are needed.

Clinical Practice Guideline on Acupuncture for Post-stroke Spasticity (뇌졸중후 경직에 대한 침치료 임상진료지침)

  • Kim, Je-Shin;Shin, Seung-Won;Lee, Eui-Ju;Shin, Byung-Cheul;Lee, Myeong-Soo;Lim, Sung-Min;Nam, Dong-Woo;Moon, Sang-Kwan
    • The Journal of Korean Medicine
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    • v.36 no.1
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    • pp.1-8
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    • 2015
  • Objectives: This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the patients with post-stroke spasticity. Methods: Experts committee, consisting of stroke or methodology specialists, searched Medline, EMBASE, Cochrane Library, China National Knowledge Infrastructure, and 19 Korean medicine journals. The search terms were selected to screen the randomized controlled trials (RCTs) or systematic reviews for the effectiveness of acupuncture on post-stroke spasticity, compared with placebo or conventional group. Levels of evidence and grades of recommendations were appraised based on Recommendations for Development of Clinical Practice Guideline in Korean Medicine. Results & Conclusions: One systematic review and 7 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of electroacupuncture treatment for post-stroke spasticity. However, it did not show any sufficient evidence to treat the patients with post-stroke spasticity with the sole acupuncture. The moderate evidence was presented that over 3 times of the electroacupuncture treatments with 1-100 Hz frequency should be performed every week on the acupoints, such as LI11, LI10, TE5, LI4, ST36, GB34, ST40, or LR3, for 20-30 minutes. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. Finally, there was a moderate evidence to support safety of acupuncture treatment for post-stroke spasticity.

Analysis of the Numeric Rating Scale (NRS) Used in Clinical Studies Based on Randomized Controlled Studies (임상연구에서 사용되고 있는 NRS에 대한 분석 : 무작위대조군연구를 중심으로)

  • Lee, Chan;Cho, Im-hak;Heo, Gi-yoon;Kang, Hee-kyung;Kim, Min-hwa;Han, Chang-woo;Kim, So-yeon;Choi, Jun-yong;Park, Seong-ha;Yun, Young-ju;Hong, Jin-woo;Kwon, Jung-nam;Lee, In
    • The Journal of Internal Korean Medicine
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    • v.42 no.4
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    • pp.510-531
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    • 2021
  • Objectives: The purpose of this study was to review the status of numeric rating scale (NRS) usage and suggest the potential for use in multicenter retrospective studies of various diseases. Methods: Articles published from 2011 to 2021 that used the keywords "NRS", "Multi-center", and "RCT" were identified in foreign databases, including EMBASE, PubMed, CENTRAL. The articles were analyzed according to their use of "NRS" by symptoms and by disease group using the major classifications of the Korean Standard Classification of Diseases (KCD-7). Results: Classification by symptom in a total of 288 articles illustrates that the NRS was not only commonly used in pain evaluation but also for non-pain symptoms. In usage with non-pain symptoms, chief complaint of patients was the most common at 79%, and other factors included treatment satisfaction, evaluation of daily life, and sleep quality. In disease classification according to the KCD-7, the NRS was commonly used in connection with musculoskeletal and connective tissue diseases but was also utilized in various other disease groups. Conclusions: This study confirms usage of the NRS in multi-center RCTs, as the NRS was widely used in all types of diseases and symptoms. Considering the result and the advantages of the NRS, it is recommended for use as a daily evaluation tool for the collection of common data in multicenter retrospective studies.

East Asian Herbal Medicine (EAHM) Alone for the Treatment of Women with Diminished Ovarian Reserve (DOR): A Systematic Review and Meta-analysis (난소예비력 저하 여성에 대한 한약 단독 치료의 임신 관련 지표 개선 효과에 관한 체계적 문헌 고찰 및 메타분석)

  • Lee, Ju Hyun;Choi, Su-Ji;Noh, Eun-Ji;Min, Sang-Yeon;Kim, Dong-Il
    • The Journal of Korean Medicine
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    • v.43 no.1
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    • pp.136-153
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    • 2022
  • Objectives: The aim of this study was to find out whether east asian herbal medicine (EAHM) treatment alone is effective in improving pregnancy-related indicators compared to conventional medicine in women with Diminished Ovarian Reserve (DOR). Methods: We searched eligible studies from PubMed, Cochrane Library, EMBASE, Chinese National Knowledge Infrastructure Database, CiNii, Korean Medical Database, Korean Studies Information Service System, Oriental Medicine Advanced Searching Integrated System, ScienceOn. GRADE pro was used to evaluate the current evidence of the study. Result: A total of 5 studies, 325 women with DOR were included. EAHM showed a significant effect on improvement of pregnancy rate (n=270, RR 2.13 [95% CI 1.44 to 3.15], Z=3.78, p=0.0002, I2=0%) and Anti-Mullerian Hormone (AMH) level (n=211, SMD 0.82 [95% CI 0.40 to 1.25], Z=3.80, p=0.0001) compared to conventional medicine. In ovulation rate (n=156, RR 0.86 [95% CI 0.70 to 1.06], Z=1.43, p=0.15, I2=0%), Antral Follicle Count (n=245, SMD 0.27 [95% CI -0.25 to 0.79], Z=1.01, p=0.31), and follicle stimulating hormone (n=245, SMD 0.29 [95% CI -0.13 to 0.70], Z=1.36, p=0.17) level, EAHM showed similar effects to conventional medicine. In this study, the most frequently used herbal medicines were Cuscutae Semen, Dipsaci Radix, and Angelicae Gigantis Radix. Conclusion: This meta-analysis showed that EAHM could improve pregnancy rates and AMH levels in women with DOR. However, more well-designed RCTs will have to be performed further in the future.

A Review of Herbal Medicine Treatments on Aftereffects of Thyroidectomy (갑상선 절제술 후 후유증의 한약 치료에 대한 최신 임상 연구 동향)

  • Soo-duk Kim;Min-jo Seo;Su-na Park;Hye-ri Jo;So-hyeon Ryu;Geon-sik Kong;Yo-sup Choi
    • The Journal of Internal Korean Medicine
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    • v.45 no.4
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    • pp.615-634
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    • 2024
  • Objectives: This study summarizes the current trends and results in clinical studies on herbal medicine treatments after thyroidectomy. Methods: Studies published between 2019 and 2024 were searched for on the China National Knowledge Infrastructure (CNKI), PubMed, and Research Information Sharing Service (RISS). The studies were analyzed according to year, study design, characteristics of the patients, and traditional Chinese medicine (TCM) intervention. A meta-analysis was conducted and classified according to the outcome measurements, such as the total effective rate (TER), thyroid stimulating hormone (TSH), free T4 (FT4), self-rating depression scale (SDS), CD3+, CD4+, and CD8+. CD8+. Results: A total of 18 randomized controlled trials (RCTs) and 5 non-randomized controlled trials were reviewed. The most common herbal prescriptions were decoctions made from Yangyin Sanjie (Yangeumsangyeol-tang), Yiqi Sanjie (Ikgisangyeol-tang), Yiqi Yangyin Sanjie (Ikgiyangeumsangyeol-tang), Yiqi Yangyin (Ikgiyangeum-tang), and Huiyan Zhuyu (Hoeyeomchugeo-tang). The most frequently used herbs were Prunellae Spica, Scrophulariae Radix, and Astragali Radix. The meta-analysis found that the group using both herbal and Western medicine was benefited more than the group using Western medicine alone (RR: 1.28, 95% CI: 1.20-1.37, P<0.00001). The experimental group had higher TSH, CD3+, and CD4+ levels, while FT4, SDS, and CD8++ were lower. However, due to high study heterogeneity, the results were not statistically significant. Conclusion: Complications after thyroidectomy include hypothyroidism, hypoparathyroidism, and psychological aftereffects. Herbal and conventional treatments showed potential in improving hormone levels, immune function, and depression, but statistical significance was limited due to study variability. These results should be interpreted cautiously given the risk of bias in the trials.

Literature review and future tasks necessary to establish of Korean Dietary Reference Intake for choline (콜린의 한국인 영양소 섭취기준 제정 검토를 위한 문헌 고찰 및 향후 과제)

  • Shim, Eugene;Park, Jae-Hee;Lee, Yunjung;Park, Eunju
    • Journal of Nutrition and Health
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    • v.55 no.2
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    • pp.211-226
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    • 2022
  • Choline, an essential nutrient for humans, is required for the structural integrity of the cell membranes, methyl-group metabolism, synthesis of the neurotransmitter acetylcholine, synthesis of the membrane phospholipid components of the cell membranes, and the transport of lipids and cholesterol. Choline can be synthesized in the body, but it is insufficient to meet the daily requirements and hence it must be obtained through the diet. In the United States/Canada, Australia/New Zealand, Europe, China, and Taiwan, the adequate intake (AI) and tolerable upper intake level (UL) of choline have been established, while the establishment of the 2020 Dietary Reference Intakes for Koreans (KDRI) for choline was postponed due to the lack of a choline database for Korean foods and studies on the choline intake of Koreans. However, as part of the preparation work for the 2020 DRI revision and finalization, choline intake and the possibility of disease occurrence were verified through analysis of published data. The groundwork for the subsequent establishment of a choline DRI was laid through a literature search, evaluation, and review of the literature reported from 1949 up to 2019. This can be regarded as the culmination of this project. According to the results of randomized controlled trials (RCTs), cohort studies, case-control studies, and cross-sectional observational studies in humans, approximately 400-500 mg/day of choline intake was effective in preventing liver function damage (fatty liver), neural tube damage, cardiovascular disease, breast cancer, and cognitive function improvement. The same amount of choline intake, however, also correlated with the risk of prostate and colorectal cancer. At present, there is limited information available on choline intake and health outcomes, particularly for the Korean population. More human studies, including clinical trials on the requirements and the physiological benefits associated with dietary intake, are needed to establish the KDRI for choline.