• 제목/요약/키워드: randomized controlled trials (RCTs)

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뇌졸중 후 우울증에 대한 침과 한약의 결합 치료 효과: 체계적 문헌 고찰 및 메타분석 연구 (Clinical Effect of Acupuncture Combined with Herbal Medicine in Treatment of PSD: A Systematic Review and Meta-Analysis)

  • 사공종원;임수연;김상호;정대규
    • 동의신경정신과학회지
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    • 제31권3호
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    • pp.169-186
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    • 2020
  • Objectives: The purpose of this study was to provide clinical evidence to support the use of acupuncture combined herbal medicine for post-stroke depression. Methods: Studies were identified by searching Pubmed, EMBASE, Cochrane Library, NDSL, RISS, KMbase, KISS, and CNKI. Randomized controlled trials that verified effects of the acupuncture combined with the herbal medicine for PSD were included in this study. Literature searches of English, Chinese, and Korean databases were performed. Two authors independently extracted the data and assembled the study quality. Results: Of 698 RCTs screened, 17 RCTs were selected. Most of the studies had unclear risk of bias. Among the 17 RCTs, 10 were meta-analyzed. As for the outcome measurement, the effective rate and the HAMD were most commonly used. The meta-analysis of the studies revealed that the PSD cure effective rate in the acupuncture combined with herbal medicine group was higher than that in the Western medicine group (RR: 1.23, 95% CI: 1.14 to 1.33, p<0.00001, I2=0%). Also, the HAMD in the acupuncture combined with herbal medicine group was significantly different compared to the Western medicine group (MD -5.54, 95% CI -9.80 to -1.29, p=0.01, I2=99%). The quality of the selected RCTs was low. Conclusions: Acupuncture combined with herbal medicine is effective for treating post-stroke depression. However, It is worth noting that the included studies were of relatively poor quality. The sample sizes were also small. Based on the findings of this study, further investigations into the diagnosis and treatment of PSD are warranted.

성인 변비에 대한 추나요법의 효과 : 체계적 문헌 고찰 (Chuna Manual Therapy for Adult Constipation : A Systematic Review)

  • 김병준;황의형;허인;임경태;조주찬;신병철
    • 척추신경추나의학회지
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    • 제11권2호
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    • pp.23-33
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    • 2016
  • Objectives : This study aimed to determine the evidence of effectiveness and safety of Chuna manual therapy for adult constipation patients. Methods : We searched 10 electronic databases(Ovid-MEDLINE, Pubmed, EMBASE, Cochrane Library, CAJ, Oasis, KISS, NDSL, KMBASE, KISTI) and related 2 journals up to October 2016. We included randomized controlled trials(RCTs) of testing Chuna manual therapy for adults constipation patients. The methodological quality of RCTs related assessed by the Cochrane risk of bias tool. Results : Nine RCTs were eligible in our inclusion criteria. The meta-analysis of 6 studies showed positive results for the use of Chuna manual therapy for constipation. Conclusions : There is favorable evidence of Chuna manual therapy for treating adult constipation with meta-analysis. However, our systematic review has limited evidence to support Chuna manual therapy for constipation because of low quality of original articles and further well-designed RCTs should be encouraged.

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소아 알레르기 비염에 대한 추나요법의 효과 : 체계적 문헌 고찰과 메타분석 (Chuna Manual Therapy for Pediatric Allergic Rhinitis : A Systematic Review and meta-analysis)

  • 박선영;박인화;이상현;황만석;황의형;신병철
    • 척추신경추나의학회지
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    • 제14권1호
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    • pp.25-37
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    • 2019
  • Objectives : This review determines the evidence of effectiveness and safety of Chuna manual therapy (CMT) for pediatric allergic rhinitis. Methods : We searched 12 electronic databases (Pubmed, EMBASE, Cochrane Library, Web of Science, CAJ, J-STAGE, RISS, DBpia, NDSL, KISTI, KISS, and KMBASE) and two related journals up to the end of April, 2019. We only included randomized controlled trials (RCTs) investigating CMT for the treatment of pediatric allergic rhinitis. The methodological quality of the included RCTs was evaluated using the Cochrane risk of bias tool 1.0. Results : Twelve RCTs were eligible in our inclusion criteria. A meta-analysis of five studies demonstrated positive results for the using CMT for the treatment of pediatric allergic rhinitis. When used in conjunction with traditional Chinese medicine, CMT treatment significantly improved total efficacy rate compared with traditional Chinese medicine alone (P<0.02, n=5). Conclusions : Based on a published meta-analysis, there is reliable evidence for the use of CMT in treating pediatric allergic rhinitis. However, it should be noted that the studies included in this systematic review were heterogeneous and were of low quality, warranting further investigation using well-designed RCTs.

손목 터널 증후군에 대한 추나요법의 효과: 체계적 문헌 고찰 (Chuna Manual Therapy for Carpal Tunnel Syndrome: A Systematic Review)

  • 박선영;이상현;허인;황의형
    • 척추신경추나의학회지
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    • 제16권2호
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    • pp.9-19
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    • 2021
  • Objectives This systematic review aimed to provide evidence for the effectiveness and safety of Chuna manual therapy (CMT) for carpal tunnel syndrome (CTS). Methods We searched 12 electronic databases (PubMed, Ovid-MEDLINE, EMBASE, The Cochrane Library, CNKI, CiNii, ScienceON, KMbase, KISS, OASIS, KMTANK, and RISS) up to the end of October 2021. We only included randomized controlled trials (RCTs) investigating CMT for the treatment of CTS. The methodological quality of the included RCTs was evaluated using the Cochrane Risk of Bias Tool 1.0. Results Six RCTs were eligible for inclusion in our study. A meta-analysis of four studies demonstrated positive results for the use of CMT when used in conjunction with Korean medicine treatment compared to those for Western conservative treatment for CTS. Conjunction treatment significantly improved the total efficacy rate compared to conservative treatment alone (P=0.0007, n=4). Conclusions There is reliable evidence for the use of CMT in treating CTS based on a published meta-analysis. To measure only the effect of Chuna, an experimental group should be designed with Chuna alone to evaluate its effectiveness. However, it should be noted that the studies included in this systematic review were heterogeneous and of low quality, thus warranting further investigation using well-designed RCTs.

좌골신경통에 대한 전침 치료: 체계적 문헌고찰 및 메타분석 (The Effect of Electro Acupuncture for Sciatica: A Systematic Review and Meta-analysis)

  • 김예은;안정훈;차윤엽;한인식;허인;박인화
    • 한방재활의학과학회지
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    • 제32권2호
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    • pp.105-121
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    • 2022
  • Objectives This study was conducted to evaluate the effect of electro-acupuncture for sciatica. Methods We searched 13 online databases (Kmbase, Research Information Sharing Service [RISS], National Digital Science Library [NDSL], Oriental Medicine Advanced Searching Integrated System [OASIS], Koreanstudies, Koreantk, DBpia, PubMed, Cochrane, EMBASE, Medline, China National Knowledge Infrastructure [CNKI], J-stage) to find randomized-controlled clinical trials (RCTs) that used electro-acupuncture for sciatica. Efficacy rate and visual analogue scale (VAS) were mainly analyzed as a main evaluation criteria. Results Among 583 articles that were searched, 24 RCTs were finally selected and 18 RCTs were statistically analyzed. Electro-acupuncture was more effective than acupuncture in terms of efficacy rate (p<0.00001) and VAS (p<0.00001). Also, Electro-acupuncture was more effective than western medication in terms of efficacy rate (p=0.0005). However, the effectiveness of electro-acupuncture was not identified compared to physical therapy (p=0.42). Electro-acupuncture significantly improved efficacy rate when combined with physical therapy than physical therapy alone (p<0.0001). In addition, electro-acupuncture plus Chuna manual therapy compared to Chuna manual therapy alone showed positive results for efficacy rate (p=0.05) and VAS (p<0.0001). Conclusions Based on results, the effectiveness of electro-acupuncture for sciatica was identified. However, this study has limitations because the RCTs included in this study were small in number and published in a particular region. Although this study could be a groundwork for well designed research for sciatica.

비만 치료 한약 무작위 대조 임상시험에서의 음식 섭취량과 운동량 실태분석 (Analysis of Food Intake and Physical Activity in Randomized Controlled Trials on Herbal Medicine for Treatment of Human Obesity)

  • 김두희;신우석;박원형;차윤엽;송윤경;안민윤;고성규
    • 한방비만학회지
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    • 제13권2호
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    • pp.58-65
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    • 2013
  • Objectives: The objective of this study was to analyse the methods being used to control food intake and physical activity in RCTs of human obesity. Methods: A total of 21 randomized controlled trials (RCTs) were investigated. Nine of which were domestic studies from "http://oasis.kiom.re.kr" and the other of which were foreign studies from systematic reviews of RCTs on herbal medicine for treatment of human obesity. Results: According to domestic studies, "low calorie diet" were recommended in five cases of the domestic studies, "maintain current dietary habit" were recommended in two and no information on diet was two. Considering the seven cases where the information on diet was available, patients' food intake were checked at every visit in six cases. Only two cases among the six had been dropped owing to the violation of dietary habit by patients. Exercises were prohibited in two cases, "maintain current level of phisical activity" were recommended in three cases and, from the rest, no information was available. The level of physical activity were not strictly controlled by any means hence no drop out. According to foreign studies, "low calorie diet" were recommended in two cases, "very low calorie diet (less than 700 kcal/day)" in one case, "maintain current dietary habit" in two cases, "do not eat fat" in two cases and no information was available in the rest five cases. Exercises which concerns spending about 300 kcal/day was recommended in one case, "moderate exercise" were recommended in three cases, "maintain current level of physical activity" were recommended in three cases and no information available in the rest five cases. Conclusions: In order to improve the accuracy of RCT, for the dietary side, researchers should record patient food intake at every visit by means of 24-hour dietary recall methods. This can be supplemented by multiple choice survey that are designed to help patients to diagnose themselves more accurately leading to less bias. For the exercise side, it is highly recommended to confine the exercises to walking only so as to quantify the amount of physical activity more easily by using pedometer.

Overview of RCT for Non-Alcoholic Fatty Liver Disease and Non-Alcoholic Steatohepatitis

  • Son, Chang-Gue
    • 대한한의학회지
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    • 제32권3호
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    • pp.44-49
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    • 2011
  • Objective: This study aimed to get information on the current status of therapies to date for non-alcoholic fatty liver disease (NAFLD), including non-alcoholic steatohepatitis (NASH). Methods: All randomized clinical controlled trial (RCT)-derived papers for NAFLD or NASH were reviewed via PubMed Database. Results: 39 RCTs met the review criteria, of which 15 and 24 papers were for NAFLD and NASH, respectively. 83% of the papers were released since 2006, and 30 studies were conducted for western medicines, antioxidants and lifestyle intervention whereas nine trials were done using herbal medicine or acupuncture which showed positive outcome. Conclusions: NAFLD and NASH are new epidemic disorders which can be a target of traditional Oriental medicine. This study will be helpful for the Oriental medicine-based strategies or therapeutic development for them.

Efficacy and Safety of Sorafenib for Advanced Non-Small Cell Lung Cancer: a Meta-analysis of Randomized Controlled Trials

  • Wang, Wei-Lan;Tang, Zhi-Hui;Xie, Ting-Ting;Xiao, Bing-Kun;Zhang, Xin-Yu;Guo, Dai-Hong;Wang, Dong-Xiao;Pei, Fei;Si, Hai-Yan;Zhu, Man
    • Asian Pacific Journal of Cancer Prevention
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    • 제15권14호
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    • pp.5691-5696
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    • 2014
  • Background: Many clinical trials have been conducted to evaluate sorafenib for the treatment of advanced NSCLC, but the results for efficacy have been inconsistent. The aim of this study was to evaluate the efficacy and safety of sorafenib in patients with advanced NSCLC in more detail by meta-analysis. Methods: This meta-analysis of randomized controlled trials (RCTs) was performed after searching PubMed, EMBASE, ASCO Abstracts, ESMO Abstracts, and the proceedings of major conferences for relevant clinical trials. Two reviewers independently assessed the quality of the trials. Outcomes analysis were disease control rate (DCR), progression- free survival (PFS), overall survival (OS) with 95% confidence intervals (CI) and major toxicity. Subgroup analysis was conducted according to sorafenib monotherapy, in combination with chemotherapy or EGFR-TKI to investigate the preferred therapy strategy. Results: Results reported from 6 RCTs involving 2, 748 patients were included in the analysis. Compared to sorafenib-free group, SBT was not associated with higher DCR (RR 1.31 (0.96- 1.79), p=0.09), PFS (HR 0.82 (0.66-1.02), p=0.07) and OS (HR 1.01 (0.92-1.12), p=0.77). In terms of subgroup results, sorafenib monotherapy was associated with significant superior DCR and longer PFS, but failed to show advantage with regard to OS. Grade 3 or greater sorafenib-related adverse events included fatigue, hypertension, diarrhea, oral mucositis, rash and HFSR. Conclusions: SBT was revealed to yield no improvement in DCR, PFS and OS. However, sorafenib as monotherapy showed some activity in NSCLC. Further evaluation may be considered in subsets of patients who may benefit from this treatment. Sorafenib combined inhibition therapy should be limited unless the choice of platinum-doublet regimen, administration sequence or identification of predictive biomarkers are considered to receive better anti-tumor activity and prevention of resistance mechanisms.

슬관절 수술 후 재활에 대한 Continuous Passive Motion 치료와 한의 병행치료의 체계적 문헌 고찰 (A Systemic Review of Korean Medical Treatment Combined with Continuous Passive Motion Therapy on the Knee Joint Postoperative Rehabilitation)

  • 하현주;오민석
    • 한방재활의학과학회지
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    • 제27권3호
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    • pp.33-45
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    • 2017
  • Objectives The objective of this study is to report the evidence that continuous passive motion (CPM) therapy combined with Korean Medicine is effective for knee injuries. Methods We searched 2 Korean medical electronic databases, and 2 Chinese electronic databases to find randomized controlled clinical trials (RCTs) that treat knee injuries with Korean Medicine combined with CPM therapy. We selected studies by screening. We extracted data from selected RCTs, and analyzed RCTs by using Cochrane's Risk of bias criteria. Results 386 studies are searched, and 7 RCTs are selected. According to the study, several kinds of Korean Medicine such as hydrotherapy, decoction, acupuncture, moxibustion, and manual therapy are used with CPM therapy for the knee joint postoperative rehabilitation. We found the encouraging evidence that Korean Medicine and CPM combined therapy is more effective than single CPM therapy by alleviating pain, increasing range of motion, and improving knee function, etc. However, the risk of bias in most RCTs was judged to be uncertain. Conclusions Combination of Korean Medicine and CPM therapy can compensate the defect of single CPM therapy, and promotes the recovery of knee joint function.

요가 요법이 월경통 증상 완화에 미치는 효과 고찰 (An Effect of Yoga Therapy on Relieving Dysmenorrhea ; RCTs(Randomized controlled trials) Review)

  • 박기언;황의형;설재욱;신미숙
    • 대한예방한의학회지
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    • 제15권2호
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    • pp.39-49
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    • 2011
  • Objectives : This study is to explain the effects of Yoga therapy for relieving dysmenorrhea on the aspect of Oriental Medicine and to identify the therapeutic Yoga asanas applicable to clinic medicine. Methods : We searched papers using Pubmed, CNKI and 7 Korean medical databases. We used "Yoga" and "Dysmenorrhea" as keyword. Limitations were as follows ; the last 20 years of publications and search range only including RCTs. Papers without inclusion criteria were excluded. We classified all the searched RCTs studies into Yoga exercise prescriptions. Results : A total of 47 studies were found. And 38 were excluded during extract screening. Finally 3 RCTs were selected and analyzed out of 9 papers. Blood sampling and survey questionnaires were used in the outcome measure. They reported that Yoga exercise could be used for dysmenorrhea patients, which has a curative effect. Conclusions : Yoga therapy can be explained as Meridian muscle theory in the concept of Oriental Medicine. Also, it may be a favorable choice for dysmenorrhea patients. Further studies to describe the effects of Yoga therapy will be needed more.