• 제목/요약/키워드: Randomized clinical trials

검색결과 984건 처리시간 0.024초

뇌졸중 후 요실금에 대한 침치료 임상진료지침 (Clinical Practice Guideline for acupuncture in Post-stroke urinary incontinence)

  • 이지원;신병철;이명수;임성민;유정희;조충식;문상관;육태한;주종천;이의주
    • 사상체질의학회지
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    • 제29권4호
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    • pp.317-325
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    • 2017
  • Objectives This study is aimed to develop a Clinical Practice Guideline (CPG) on acupuncture treatment for the stroke patients with Post-stroke Urinary Incontinence(PSUI). 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 PSUI, 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 8 RCT were included to build the CPG. There was a strong evidence to support the effectiveness of acupuncture treatment for PSUI. The moderate evidence was presented that over 3 times a week of the acupuncture should be performed over 4 weeks on the acupoints, such as BL23, CV3, SP6, CV4, CV6, ST28, BL28, BL32, GV20, BL22, GV4 or ST36, for 15-30 minutes. 1-150 Hz frequency is suggested if electro-acupuncture treatments is performed with. It was also suggested that the procedure should begin at the acute stage just after the vital signs of the patients are stabilized. There was a moderate evidence to support safety of acupuncture treatment for PSUI. We recommend acu-points of constitutional acupuncture for Sasangin on the healthy side.

심적환$^{(R)}$이 흉통 흉민에 대하여 미치는 영향에 대한 다기관 무작위배정 이중맹검 임상연구 (Effect of Cardiotonic Pills$^{(R)}$ on Chest Pain and Discomfort: A Multi-center Double-blind Randomized Controlled Trial.)

  • 장인수;고창남;이인;박정미;김세현;김상우
    • 대한한의학회지
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    • 제26권2호
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    • pp.95-104
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    • 2005
  • Objectives: This was a double blinded, randomized, placebo-controlled clinical study for evaluation of safety and effective dose finding of Cardiotonic Pills$^{(R)}$ in patients with chest pain and discomfort. Cardiotonic Pills$^{(R)}$ are composed of Salviae Miltiorrhizae Radix (丹蔘), Notoginseng Radix (三七根) and Borneolum (龍腦). Major effects of Salviae Miltiorrhizae Radix and Notoginseng Radix are vasodilatation, sedation and analgesic action. Borneolum has an antibacterial effect, and can stimulate the central nervous system. All of these substances are oriental herbs that have been used for a long time in east Asia. Cardiotonic Pills fi received Investigational New Drug (IND) approval from the Food and Drug Administration (FDA) in the USA and 40 million people in the world take this pill. We performed a phase IV clinical study to confirm its efficacy and safety in patients who have probable cardiogenic or psychogenic chest pain or chest stifling. Methods: This study was planned for a multi-center clinical trial including four university hospitals of oriental medicine in Korea. This was the first time to evaluate the 'planning treatment according to diagnosis (辨證施治)' of chest pain or chest discomfort according to oriental medical guidelines. The patients who were included in this trial were adult volunteers from 20 to 70 years old who had chest pain or chest discomfort more than twice during a recent month, and we received written consent to participate in this study from all of them. After administration of Cardiotonic Pills$^{(R)}$ for 8 weeks, number of occurrences, duration, appearance and degree of chest pain or chest discomfort was observed and degree of symptoms (severity of illness, global improvement) were measured using a patient's global assessment composite scale. Results: In the patient's global assessment scale, the severity of illness of the Cardiotonic Pills$^{(R)}$ group (n=25) was 14/25=0.56 but of the placebo group (n=25) was 7/25=0.28 (p-value=0.0449). This result indicates Cardiotonic Pills$^{(R)}$have a positive effect on the symptoms of chest pain and discomfort. However, the global improvement of the Cardiotonic Pills$^{(R)}$group was 23/25=0.92, and of the placebo group was 22/25=0.88 (p-value=0.6374). The total symptom score of the Cardiotonic Pills$^{(R)}$ group was $1.68\pm20.06$, and of the placebo group was $16.76\pm72.l4$(p-value=0.2285). The number of symptom events of the Cardiotonic Pills$^{(R)}$ group was $72\pm29.78$, and of the placebo group (n=25) was $10.80\pm38.42$ (p­value=0.3660). We could not find any effects on the other factors examined besides the severity of illness, beyond the difference of standard deviations. Conclusions: Cardiotonic Pills$^{(R)}$ significantly reduced chest pain and chest discomfort in patients. Therefore, we expect that Cardiotonic Pills$^{(R)}$ will be helpful for patients with chest pain and chest discomfort not only caused by heart disease but also by other diseases.

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고충실도 시뮬레이션 기반 교육이 간호학생의 임상수행능력과 간호수행 자신감에 미치는 효과: 체계적 문헌 고찰 (The Effects of High Fidelity Simulation-Based Education on Clinical Competence and Confidence in Nursing Students: A Systematic Review)

  • 이정미;소향숙;김윤경;김정이;안민정
    • 한국콘텐츠학회논문지
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    • 제14권10호
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    • pp.850-861
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    • 2014
  • 본 연구는 국내 고충실도 시뮬레이터를 이용한 시뮬레이션 기반 교육 관련 선행연구들을 체계적으로 고찰하여 간호학생의 임상수행능력과 간호수행 자신감에 대한 효과를 분석하고, 이를 이용해 근거중심의 가이드라인 제공 및 향후 연구방향을 제시하고자 시도되었다. 데이터베이스인 한국교육학술정보원(RISS), 한국학술정보(KISS)와 Google Scholar에서 2005년부터 2014년까지의 문헌을 대상으로 키워드 '간호와 시뮬레이션' 또는 '간호와 시뮬레이터'로 검색하였다. 총 183편의 연구 중 16편의 논문이 최종 선정되었고, Quality Assessment Tool for Quantitative Studies를 이용해 문헌의 질을 확인하였다. 연구결과, 시뮬레이션 기반 교육은 간호학생의 임상수행능력과 자신감 증진에 긍정적인 효과가 있었고, 간호학생들의 직접 간호수행이 힘든 중환자와 분만간호 분야에서 임상실습 교육의 효과적인 교수-학습전략이 될 수 있음을 확인하였다. 시뮬레이션 기반 교육의 효과를 극대화하기 위해 교육자와 시설 등의 적절한 지원이 필요하다. 향후 결과의 일반화를 높이기 위해 충분한 표본수를 고려한 무작위대조연구, 교육효과 평가를 위한 표준화된 도구 개발 및 시뮬레이션이후 제공되는 디브리핑의 효과를 분석하는 연구를 고려해 볼 것을 제언한다.

노인성 난청의 한약 치료에 대한 체계적 문헌고찰: 신허(腎虛)을 중점으로 (Systematic Review on Presbycusis Treated by Herbal Medicine Focusing on Kidney Deficiency)

  • 임희영;진한솔;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제34권4호
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    • pp.49-70
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    • 2021
  • Objectives : This study was conducted to approve the effectiveness and safety of herbal medicine on presbycusis with kidney deficiency. Methods : We searched randomized controlled trials(RCTs) on presbycusis patients diagnosed with kidney deficiency through 10 electronic databases from the start to Sep 7, 2021. Study collection and data extraction, and evaluation of risk of bias were conducted by two independent collaborator. 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 : 1. The treatment group which used herbal medicine(HM) alone was more effective than the control group which used only western medicine(WM) on effective rate of hearing loss. 2. In 3 studies comparing the HM-WM combination treatment group with the control groups using the same WM treatment, the effective rate was statistically significantly higher in the HM-WM combination treatment group. 3. Of the 5 studies that reported adverse reactions, one study reported mild nausea and dizziness, but the difference between the HM treatment group and the WM control group was not statistically significant, and no side effects occurred in other 3 studies. 4. In studies comparing HM and WM, the HM treatment group improved hearing loss, whole blood viscosity, serum TNF-𝛼, IL-1𝛽, IL-6, and oxidative stress indicators better than the WM control group, and there was no significant difference. 5. In studies comparing the HM-WM treatment group with the WM control group, the severity of tinnitus, quality of life, and feelings of anxiety and depression were better in the treatment group than the control group. Conclusions : This study shows that the herbal medicine can improve symptoms of presbycusis with kidney deficiency.

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

  • 임희영;김지희;고우신;윤화정
    • 한방안이비인후피부과학회지
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    • 제35권3호
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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.

임신 중 벨 마비 한방치료에 대한 국내외 증례 연구 고찰 (A Review of Clinical Research Trends on Korean Medicine Treatment for Bell's Palsy during Pregnancy)

  • 김효정;안영태;현지수;최소연;김백준;이윤재
    • 대한한방부인과학회지
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    • 제37권3호
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    • pp.1-19
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    • 2024
  • Objectives: The purpose of this study is to analysis the clinical study trends on Korean Medicine treatment for Bell's palsy during pregnancy. Methods: Key words such as 'facial palsy', 'Bell's palsy, 'Korean medicine', 'herbal medicine', 'acupuncture', 'pregnancy' were searched through the 'RISS', 'OASIS', 'KISS', 'PubMed' and 'CNKI' databases. Results: Ten clinical studies with 107 patients were selected, and 1 randomized controlled trial and 9 case reports were included as the target studies. In the 9 case reports, the gestational age at the onset of facial palsy was most common in the third trimester (29-42 weeks) in 38 cases (56.7%). The most commonly used Korean medicine interventions were acupuncture, with the most frequently used acupoints being ST4, ST2, ST6, BL2, TE23, LI20, GB1, GB14, SI18, and CV24. The herbal medicine treatment most commonly utilized was Geumgwedanggwi-san (金匱當歸散), which is related to the principles of clearing heat, nourishing blood, and stabilizing the fetus (淸熱養血安胎). Among the 65 participants evaluated using the House-Brackmann facial nerve grading system, 81.5% showed complete recovery to grade 1, while 6% remained at grade 4 with no effect, indicating the efficacy of Korean medicine treatment for facial palsy during pregnancy. All the selected studies reported no abnormalities in the mothers or fetal growth, and all participants who had the reported delivery had full-term childbirth. Conclusions: The effect on Korean Medicine treatment for Bell's palsy during pregnancy had mostly positive results. However, further large, well-designed clinical trials are needed to establish the foundation of Korean Medicine treatment for Bell's palsy during pregnancy.

침구와 약침에 대한 중개연구 현황 (Current situation of Translational research on Acupuncture, Moxibustion and Pharmacopuncture)

  • 신대철;송호섭
    • Journal of Acupuncture Research
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    • 제33권2호
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    • pp.109-116
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    • 2016
  • Objectives : Our primary objective lies in understanding the current landscape of translational research on acupuncture, moxibustion and pharmacopuncture. Methods : We searched our own selection of keywords of acupuncture, moxibustion and pharmacopuncture and translational research from three overseas databases (Pubmed, Scopus, Medicine) and four domestic databases (DBpia, KISS, Riss4u, Korea Med). Results : We have chosen 41 articles in total-40 articles on acupunture, 6 article on moxibustion(5 articles were duplicated in use in each category). Origin-wise, 48.8 %/24.8 %/17.0 % of our articles pool came from USA/China/Korea, respectively. UK, Austria, Thailand and Italy contributed the rest of our article pool. For those articles written in USA and China, review articles were the most common type. For the US articles, all 10 review articles were non-systematic reviews, while, for China's contribution, one out of 4 review articles were systematic review. Type-wise, our research pool's breakdown is as follows ; 17 review articles, 11 experimental research, 2 randomized controlled trials(RCT), 1 clinical trial, 4 conference reports, 1 letter, 1 study protocol and 4 uncategorized. Topic-wise, brain-neurology was most frequently referred with 8 articles, followed by parkinson's disease (3 articles) and epilepsy (2 articles). Conclusion : 1. In terms of research submission articles, Korea appears to be lacking translational research on acupuncture, moxibustion and pharmacopuncture, compared to USA and China, in our view. 2. Unlike the cases of USA and China, most of Korean translational research is limited to doing a T1 level of translational research. In order to bring bench-to-bedside to light. we believe, there should be more studies, and thereby a certain level of activation, to the T2 level of translational research in Korea. 3. Further, in our view there should be more efforts to improve article quality at the T1 level of translational research, which eventually becomes the fundamentals of the next level of research (i.e. T2 research), as well as to increase the number of research submissions, going forward.

안면 비대칭에 대한 한의학적 치료의 효과: 증례보고 (The Effect of Korean Medicine Treatments on Facial Asymmetry: A Case Report)

  • 권찬영;이훈희;임용석
    • Korean Journal of Acupuncture
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    • 제34권3호
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    • pp.179-184
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    • 2017
  • 목적 : 안면 비대칭에 대한 한의학적 치료의 적용가능성에도 불구하고, 아직까지 관련 연구는 보고되지 않고 있다. 이 증례보고에서 저자들은 하악골 측방변위로 인한 안면 비대칭에 대하여 한의학적 치료의 효과와 안전성을 보고하였다. 방법 : 3명의 안면 비대칭 환자가 동작침법, 기능적 뇌척주요법의 음양균형장치, 연부조직이완술로 구성된 한의학적 치료를 12회 받았다. 치료 전후에 환자의 사진이 촬영되었다. 치료 전후의 4개의 주요 기준선의 변화가 평가되었다. 결과: 모든 환자들은 사진상의 호전을 보였다. 하지만 통계적으로 유의한 차이는 없었다. 결론 : 이 증례보고는 안면 비대칭에 대해 한의학적 치료의 효과를 보고하는 첫 번째 보고이다. 추후 이러한 결과를 확인하기 위한 더 잘 설계된, 무작위화, 플라세보 대조 연구가 필요하다.

구취 환자의 한방 치료 효과에 대한 전.후 비교 연구: OralChroma$^{TM}$를 이용하여 (A Before and After Study about the Effects of Korean Medical Treatment on Halitosis Patients: Using OralChroma$^{TM}$)

  • 최제인;김진성;장승원;손지영;백승환;한성준;이엄지;류봉하
    • 대한한방내과학회지
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    • 제35권4호
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    • pp.532-545
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    • 2014
  • Objectives: The purpose of this study was to evaluate the clinical effect of Korean medical treatments such as herbal medicine, acupuncture, and electroacupuncture by using the portable gas chromatograph OralChroma$^{TM}$ (Abimedical, Japan) in halitosis patients. Methods: We surveyed 30 halitosis patients who had visited the Oral Diseases Clinic in the Korean Medical Hospital of Kyunghee University from October, 2013 to November, 2014. Before starting Korean medical treatment, the subjects were evaluated on sociodemographic characteristics, severity of discomfort using visual analogue scale (VAS), unstimulated salivary flow rate (USFR), and halitosis associated life-quality test (HALT) score. To evaluate the therapeutic effect, we measured the volatile sulfur compounds (VSCs) in breath by using OralChroma$^{TM}$ before and after 3 weeks treatment. Results: The concentration of total VSCs measured by OralChroma$^{TM}$ significantly decreased (p=0.001). Furthermore, the level of hydrogen sulfide and methyl mercaptan also significantly decreased (p<0.05). However, although the level of dimethyl sulfide decreased as well, there was no significance(p>0.05). Conclusions: Korean medical treatment was effective in treating halitosis by decreasing VSCs. Further study, with well-designed randomized controlled trials with larger number of cases will be needed in the future.

Trend of Pharmacopuncture Therapy for Treating Cervical Disease in Korea

  • Kim, Seok-Hee;Jung, Da-Jung;Choi, Yoo-Min;Kim, Jong-Uk;Yook, Tae-Han
    • 대한약침학회지
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    • 제17권4호
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    • pp.7-14
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    • 2014
  • Objectives: The purpose of this study is to analyze trends in domestic studies on pharmacopuncture therapy for treating cervical disease. Methods: This study was carried out on original copies and abstracts of theses listed in databases or published until July 2014. The search was made on the Oriental medicine Advanced Searching Integrated System (OASIS) the National Digital Science Library (NDSL), and the Korean traditional knowledge portal. Search words were 'pain on cervical spine', 'cervical pain', 'ruptured cervical disk', 'cervical disc disorder', 'stiffness of the neck', 'cervical disk', 'whiplash injury', 'cervicalgia', 'posterior cervical pain', 'neck disability', 'Herniated Nucleus Pulposus (HNP)', and 'Herniated Intervertebral Disc (HIVD)'. Results: Twenty-five clinical theses related to pharmacopuncture were selected and were analyzed by year according to the type of pharmacopuncture used, the academic journal in which the publication appeared, and the effect of pharmacopuncture therapy. Conclusion: The significant conclusions are as follows: (1) Pharmacopunctures used for cervical pain were Bee venom pharmacopuncture, Carthami-flos pharmacopuncture, Scolopendra pharmacopuncture, Ouhyul pharmacopuncturen, Hwangryun pharmacopuncture, Corpus pharmacopuncture, Soyeom pharmacopuncture, Hwangryunhaedoktang pharmacopuncture, Shinbaro phamacopuncture. (2) Randomized controlled trials showed that pharmacopuncture therapy combined with other methods was more effective. (3) In the past, studies oriented toward Bee venom pharmacopuncture were actively pursued, but the number of studies on various other types of pharmacopuncture gradually began to increase. (4) For treating a patient with cervical pain, the type of pharmacopuncture to be used should be selected based on the cause of the disease and the patient's condition.