사상의학적 중풍 후유증 치료에 대한 체계적 문헌 고찰
A Systematic Review on the Treatment of Post-Stroke Patients Based on Sasang Constitutional Medicine
2
조회
0
다운로드
0
인용
0
참고문헌
키워드
초록
Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane’s risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution- specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients’ motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.
Abstract
Objectives The purpose of this study was to review and evaluate the clinical evidence of the efficacy and safety of treatment based on Sasang constitutional medicine (SCM) for post-stroke patients by systematic review and meta-analysis. Methods Randomized controlled trials (RCTs), published in 10 electronic databases up to December 2020, were searched. For the included studies, Cochrane’s risk of bias assessment was performed to analyze the methodological quality. The strength of evidence was evaluated using the grading of recommendations assessment, development, and evaluation system based on the results of analyses. All review processes were performed by two independent researchers. Results Five RCTs were finally included. All included RCTs were conducted for one month on post-stroke patients in 60-80s, four studies on Tae-Eum patients and one study on So-Yang patients. Four types of constitution-specific herbal medicine (Chungpyesagan-tang, Cheongsimsanyak-tang, Yeoldahanso-tang, and Yangkyuksanhwa-tang) and constitution- specific acupuncture therapy were identified as interventions. More than half of the included studies were evaluated as low quality due to the high-risk of bias in selection, performance, and detection. The combination of constitution-specific herbal medicine, acupuncture, and conventional treatment was more effective in improving the patients’ motor impairment, dysphagia, aphasia, and depression than conventional treatment alone. No serious adverse events by SCM treatment were reported. Conclusions SCM treatment may improve the sequelae of post-stroke patients safely in combination with conventional treatment. Since the quality of clinical evidence included in this study was low, higher quality clinical evidence obtained in well-designed clinical studies will be needed.
참고문헌 (36)
- 김중길, "한의 중풍변증 표준안-Ⅰ에 대한 보고", 동의생리병리학회지, 20(1), pp.229~234 (2006), 한의병리학회
- Jun Yup Kim, "Executive Summary of Stroke Statistics in Korea 2018: A Report from the Epidemiology Research Council of the Korean Stroke Society", 대한뇌졸중영문학회지, 21(1), pp.42~59 (2019), 대한뇌졸중학회[DOI]
- Annual Report 2016, "World Stroke Organization", ~ (2016)
- "Medical statistics information on stroke" (2022)[URL]
- Guideline center for Korean Medicine, "Korean medicine clinical practice guideline of stroke", National Institute for Korean Medicine Development, ~ (2021)
- 송일병, "四象醫學的 中風管理의 臨床的 硏究", 사상체질의학회지, 8(2), pp.117~130 (1996), 사상체질의학회
- Lee KS, "Clinical research of wind stroke", The Journal of Oriental Chronic Diseases, 2(1), pp.160~175 (1996)
- 최재영, "사상의학적(四象醫學的) 중풍치험(中風治驗) 157례(例)에 대(對)한 임상적(臨床的) 연구(硏究)", 사상체질의학회지, 10(2), pp.431~453 (1998), 사상체질의학회
- 함통일, "중풍입원환자의 체질별 素證과 중풍 발생 후 病證에 관한 임상적 연구", 사상체질의학회지, 16(3), pp.34~45 (2004), 사상체질의학회
- 황민우, "腦卒中 患者의 四象體質別 特性에 關한 硏究", 사상체질의학회지, 17(1), pp.103~119 (2005), 사상체질의학회
- 전수형, "뇌졸중 환자의 체질별 혈액학적 특성 -1개 한방병원의 입원환자를 중심으로-", 사상체질의학회지, 25(1), pp.14~22 (2013), 사상체질의학회[DOI]
- 이성진, "QSCCⅡ를 이용한中風환자의 四象體質 분류에 대한 고찰", 사상체질의학회지, 27(3), pp.318~325 (2015), 사상체질의학회[DOI]
- Gladstone DJ, "The fuglmeyer assessment of motor recovery after stroke : a critical review of its measurement properties", Neurorehabil Neural Repair, 16(3), pp.232~240 (2002)[DOI]
- Aben I, "Validity of the beck depression inventory, hospital anxiety and depression scale, SCL-90, and hamilton depression rating scale as screening instruments for depression in stroke patients", Psychosomatics, 43(5), pp.386~393 (2002)[DOI]
- Perry L, "Screening swallowing function of patients with acute stroke. Part one: Identification, implementation and initial evaluation of a screening tool for use by nurses", J Clin Nurs, 10(4), pp.463~473 (2001)[DOI]
- Higgins JPT, "The Cochrane Collaboration’s tool for assessing risk of bias in randomised trials", BMJ, 343, pp.d5928~ (2011)[DOI]
- Borenstein M, "A basic introduction to fixed-effect and random-effects models for meta-analysis", Res Synth Methods, 1(2), pp.97~111 (2010)[DOI]
- Balshem H, "GRADE guidelines : 3. Rating the quality of evidence", J Clin Epidemiol, 64(4), pp.401~406 (2011)[DOI]
- 韩国栋, "朝医方清肺泻肝汤治疗太阴缺血性中风的临床疗效观察", 求医问药, 9(11), pp.75~76 (2011)
- 李玉军, "朝医方清肺泻肝汤治疗太阴人缺血性中风的临床疗效观察", 世界最新医学信息文摘, 19(65), pp.245~246 (2019)
- 李世明, "朝医补肾泻脾法治疗少阳人中风后吞咽障碍的临床研究", 临床医药文献电子杂志, 7(41), pp.10+70~ (2020)[DOI]
- 朴东振, "朝医热多寒少汤结合舍岩针法治疗太阴人中风后郁病-痰郁证的临床研究", 临床医药文献电子杂志, 6(62), pp.12~13 (2019)[DOI]
- 朱哲, "朝医规范化治疗太阴人中风后失语的临床研究", 中国民族医药杂志, 22(5), pp.3~5 (2016)[DOI]
- Boehme AK, "Stroke risk factors, genetics, and prevention", Circ Res, 120(3), pp.472~495 (2017)[DOI]
- 이태규, "一個 綜合病院 健康檢診者의 四象體質에 따른 慢性疾患의 有病率에 關한 硏究", 사상체질의학회지, 17(2), pp.32~45 (2005), 사상체질의학회
- 김민종, "四象體質에 따른 고혈압 유병률 및 위험인자", 사상체질의학회지, 21(1), pp.150~164 (2009), 사상체질의학회
- Jang E, "Sasang constitution may act as a risk factor for prehypertension", BMC Complement Altern Med, 15, pp.231~ (2015)[DOI]
- Lee TG, "Sasang constitution as a risk factor for diabetes mellitus : a cross-sectional study", Evid Based Complement Altern Med, 6(Suppl 1), pp.99~103 (2009)[DOI]
- Choi K, "Sasang constitutional types can act as a risk factor for insulin resistance", Diabetes Res Clin Pract, 91, pp.e57~e60 (2011)[DOI]
- Cho NH, "Predicting type 2 diabetes using Sasang constitutional medicine", J Diabetes Investig, 5(5), pp.525~532 (2014)[DOI]
- 문보경, "Apo E3 Genotype 고지혈증 환자에서 사상체질에 따른 의학영양치료가 혈중 지질 농도에 미치는 영향", 사상체질의학회지, 15(1), pp.60~71 (2003), 사상체질의학회
- Chung SK, "Genetic loci associated with changes in lipid levels leading to constitution-based discrepancy in Koreans", BMC Complement Altern Med, 14, pp.230~ (2014)[DOI]
- Cha S, "Genetic effects of FTO and MC4R polymorphisms on body mass in constitutional types", Evid Based Complement Alternat Med, 2011, pp.106390~ (2011)[DOI]
- Jang E, "Could the Sasang constitution itself be a risk factor of abdominal obesity?", BMC Complement Altern Med, 13, pp.72~ (2013)[DOI]
- Ko HY, "A relationship between stroke and Sasang constitution in Korean", Advances in Traditional Medicine, 5(4), pp.336~346 (2005)[DOI]
- Song IB, "Studies on the efficacy of combined preparation of crude drugs(ⅩⅩⅦ)", Kor J Pharmacogn, 17(2), pp.113~122 (1986)