본문 바로가기
KERD
논문KCI 등재

뇌졸중의 약침 치료에 대한 메타분석의 통합적 고찰

Pharmacopuncture for Stroke: An Overview of Meta-Analyses

한창호|김미경
대한한방내과학회 (The Society Of Korean Oriental Internal Medicine)|2019.12|대한한방내과학회지 (The Journal of Korean Oriental Internal Medicine)|제40권 제6호|pp. 1081-1100|DOI https://doi.org/10.22246/jikm.2019.40.6.1081

2

조회

0

다운로드

2

인용

0

참고문헌

키워드

strokepharmacopuncturecerebrovascular attackherbal drug injectionoverview of systematic reviews
주제분류한의학

초록

Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

Abstract

Objectives: This study is an overview of the meta-analysis and systematic review of randomized controlled trials investigating the clinical effectiveness and safety of pharmacopuncture for patients with stroke. Methods: Core electronic databases were searched from their inception to 21 May 2019. A measurement tool to assess systematic reviews (AMSTAR 2) was applied to screen high-quality studies. The results of these studies were summarized, and additional meta-analysis was conducted. The Grading of Recommendations Assessment, Development, and Evaluation (GRADE) was used to evaluate the certainty of evidence. Results: Sixteen studies met eligibility criteria. Four were excluded owing to insufficiency of AMSTAR 2 or low data reliability. The finally selected 12 studies were about pharmacopuncture using either a single herb extract, such as Dengzhan xixin, Sanch, Ginkgo biloba, or Acanthopanax, or a mixture of herbs, such as Compound danshen, Shenxiong, Xingnaojing, or Mailuoning. Most of the patients were from China, with acute ischemic stroke. All the studies using a pharmacopuncture versus a non-pharmacopuncture design reported the significant superiority of pharmacopuncture on every outcome measure. On the other hand, in a few studies, pharmacopuncture was inferior to active control in improving neurological deficit. Few studies reported adverse events. Conclusions: It is difficult to apply the results of this study directly to Korea, because the level of evidence is generally low and the clinical settings and social acceptance of pharmacopuncture therapy differ in Korea and China. Further studies are warranted to confirm the domestic applicability of evidence generated in China and to create evidence that supports the domestic situation.

참고문헌 (44)

  1. Keun-Sik Hong, "Stroke Statistics in Korea: Part I. Epidemiology and Risk Factors: A Report from the Korean Stroke Society and Clinical Research Center for Stroke", 대한뇌졸중영문학회지, 15(1), pp.2~20 (2013), 대한뇌졸중학회[DOI]
  2. Thiele I, "Time trends in stroke incidence and in prevalence of risk factors in Southern Germany 1989 to 2008", 09, 2018, pp.8(1), 11981~
  3. Katan M, "Global Burden of Stroke", Semin Neurol, 38(2), pp.208~211 (2018)
  4. Liao CC, "An investigation of the use of traditional Chinese medicine in stroke patients in Taiwan", Evid-Based Complementary and Altern Med, 2012, pp.387164~ (2012)
  5. Wang J, "Content analysis of systematic reviews on effectiveness of traditional Chinese medicine", J Tradit Chin Med, 33(2), pp.156~163 (2013)
  6. Lee YS, "A retrospective cohort study on the outcomes of ischemic stroke patients with adjuvant Korean Medicine treatment", Sci Rep, 8(1), pp.1656~ (2018)
  7. Lai CY, "Chinese herbal medicine reduced the risk of stroke in patients with Parkinson's disease : A population-based retrospective cohort study from Taiwan", PLoS One, 13(9), pp.e0203473~ (2018)
  8. Ton G, "Chinese Herbal Medicine and Acupuncture Reduced the Risk of Stroke After Bell's Palsy : A Population-Based Retrospective Cohort Study", J Altern Complement Med, 25(9), pp.946~956 (2019)
  9. Chen HZ, "Interpretation of “Guidelines for Diagnosis and Treatment of Acute Ischemic Cerebrovascular Diseases for Chinese and Western Medicine“", Clinical Journal of Traditional Chinese Medicine, 25(11), pp.949~954 (2013)
  10. Dept. of CVD &neurorehabilitation, Neurological disorders branch, Chinese Medical Association, "Chinese guideline of stroke rehabilitation:simplified version", Chin J Neurol, 45(3), pp.201~206 (2012)
  11. Park SU, "Integrative treatment modalities for stroke victims in Korea. Complement", Ther in Clin Pract, 20(1), pp.37~41 (2014)
  12. Zhou L, "Evaluating the implementation of evidence-based TCM Clinical Practice Guidelines for Cerebral Infarction", Eur J Integr Med, 6(2), pp.147~155 (2014)
  13. 우정아, "우울증 치료의 중의학 최신 임상연구 동향 -무작위 대조군 임상연구와 체계적 문헌 고찰을 중심으로-", 동의생리병리학회지, 29(6), pp.458~466 (2015), 한의병리학회[DOI]
  14. 김미경, "한의 중풍 진료 현황 파악 및 활성화 방안 모색을 위한 전자우편 설문조사", 대한한의학회지, 38(3), pp.143~159 (2017), 대한한의학회[DOI]
  15. Zhang X, "Traditional Chinese Patent Medicine for Acute Ischemic Stroke:An Overview of Systematic Reviews Based on the GRADE Approach", Medicine, 95(12), pp.e2986~ (2016)
  16. Liu S, "Comparative efficacy of Chinese herbal injections for treating acute cerebral infarction : a network meta-analysis of randomized controlled trials", BMC complem Altern M, 18(1), pp.120~ (2018)
  17. Li HQ, "Promoting blood circulation for removing blood stasis therapy for acute intracerebral hemorrhage : A systematic review and meta-analysis", Acta Pharmacol Sin, 36(6), pp.659~ (2015)
  18. Han SY, "Therapeutic effect of Chinese herbal medicines for post stroke recovery : A traditional and network meta-analysis", Medicine, 96(49), pp.e8830~ (2017)
  19. Shea BJ, "AMSTAR 2 : a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both", BMJ, 358, pp.4008~ (2017)
  20. Schunemann H, "GRADE Handbook : handbook for grading the quality of evidence and the strength of recommendations using the GRADE approach 2013", BMJ Open, pp.10~ (2008)
  21. Zhang X, "GRADE in systematic reviews of acupuncture for stroke rehabilitation : recommendations based on high-quality evidence", Sci Rep, 5, pp.16582~ (2015)
  22. Wu B, "Dan Shen agents for acute ischaemic stroke", The Cochrane Database Syst Rev, 18(2), pp.CD004295~ (2007)
  23. Sze FK, "Does Danshen improve disability after acute ischaemic stroke?", Acta Neurol Scand, 111(2), pp.118~125 (2005)
  24. Liu XT, "Effectiveness and safety of ShenXiong glucose injection for acute ischemic stroke : a systematic review and GRADE approach", BMC Complem Altern M, 16, pp.68~ (2016)
  25. Li JG, "Chinese herbal medicine Dengzhan Xixin injection for acute ischemic stroke : A systematic review and meta-analysis of randomised controlled trials", Complement Ther Med, 34, pp.74~85 (2017)
  26. Wang J, "Dengzhanxixin injection for cerebral infarction:A systematic review and meta-analysis of randomized controlled trials", Medicine, 96(32), pp.e7674~ (2017)
  27. Cao W, "Dengzhanhua preparations for acute cerebral infarction", Cochrane Database Syst Rev, 4, pp.CD005568~ (2008)
  28. Chen X, "Sanchi for acute ischaemic stroke", Cochrane Database Syst Rev, 4, pp.CD006305~ (2008)
  29. Xu YM, "Role of Xingnaojing combined with naloxone in treating intracerebral haemorrhage : A systematic review and meta-analysis of randomized controlled trials", Medicine, 97(43), pp.e12967~ (2018)
  30. Wu L, "Meta-Analysis of the Effects of Xingnaojing Injection on Consciousness Disturbance", Medicine, 95(7), pp.e2875~ (2016)
  31. Yang W, "Mailuoning for acute ischaemic stroke", Cochrane Database Syst Rev, 1, pp.CD007028~ (2015)
  32. Zeng X, "Ginkgo biloba for acute ischaemic stroke", The Cochrane Database Syst Rev, 4, pp.CD003691~ (2005)
  33. Li W, "Acanthopanax for acute ischaemic stroke", Cochrane Database Syst Rev, 3, pp.CD007032~ (2009)
  34. Yei YC, "Effectiveness of Ouhyul Pharmacopuncture on Central Post Stroke Pain", Master's, pp.2016
  35. 배한호, "중성어혈약침 병행치료가 뇌졸중으로 유발된 견비통 환자의 기능 및 삶에 미치는 영향(무작위 대조군연구-이중맹검)", Journal of Pharmacopuncture, 7(1), pp.77~86 (2004), 대한약침학회[DOI]
  36. Seo YR, "The effect of ouhyul herbal acupuncture point injections on shoulder pain after stroke", Evid Based Complement Alternat Med, 2013, pp.504686~ (2013)
  37. 허성웅, "生薑藥鍼이 中風後遺症으로 因한 肩臂痛에 미치는 효과", Journal of Acupuncture Research, 23(5), pp.145~154 (2006), 대한침구의학회
  38. Cho SW, "The Effectiveness o f Zingiberis Rhizom a Herbal Acupuncture Therapy and Bee Venom Herbal Acupuncture Therapy on the Poststroke Hemiplegic Shoulder Pain", JKMR, 15(4), pp.77~87 (2005)
  39. 노주환, "중풍 환자의 하지 경직에 대한 자하거 약침의 효과 연구", Journal of Pharmacopuncture, 12(4), pp.97~110 (2009), 대한약침학회
  40. Lim SM, "Effectiveness of bee venom acupuncture in alleviating post-stroke shoulder pain : A systematic review and meta-analysis", J Integr Med, 13(4), pp.241~247 (2015)
  41. Zhang L, "Pharmacovigilance practice and risk control of Traditional Chinese Medicine drugs in China : Current status and future perspective", J Ethnopharmacol, 140(3), pp.519~525 (2012)
  42. Li H, "Safety profile of traditional Chinese herbal injection : An analysis of a spontaneous reporting system in China", Pharmacoepidem DR S, 28(7), pp.1002~1013 (2019)
  43. Rutherford BR, "Less is more in antidepressant clinical trials : a meta-analysis of the effect of visit frequency on treatment response and dropout", J Clin Psychiatry, 74(7), pp.703~715 (2013)
  44. "A survey of Korean medicine use and herbal drug consumption 2017. Secondary National development institute of Korean medicine. A survey of Korean medicine use and herbal drug consumption 2017" (2018)[URL]

관련 논문AI추천

뇌졸중 후 우울증의 약침치료에 대한 중의학 임상논문 연구동향강현진, 김상범, 김종민, 박세진, 송금주, 오지연, 이여경대한한방신경정신과학회 · 동의신경정신과학회지2021 · 제32권 제3호뇌졸중 후 재활치료에 있어 침술의 효과에 대한 우리나라 연구들의 근거 수준 평가강영호, 윤석준, 이무송, 이상일, 이희영, 조민우대한임상건강증진학회 · Korean Journal of Health Promotion2004 · 제4권 제1호뇌졸중 후 우울증에 대한 침과 한약의 결합 치료 효과: 체계적 문헌 고찰 및 메타분석 연구김상호, 임수연, 정대규, 사공종원대한한방신경정신과학회 · 동의신경정신과학회지2020 · 제31권 제3호혈관성 치매의 약침 치료에 대한 중의학 임상연구 동향구병수, 김근우, 김만기, 홍민호대한한방신경정신과학회 · 동의신경정신과학회지2020 · 제31권 제4호뇌졸중 환자의 실어증에 대한 전침 치료 : 체계적 문헌 고찰양지수, 유재환, 이수정, 하정빈대한한방내과학회 · 대한한방내과학회지2021 · 제42권 제3호뇌졸중 후 연하장애에서 경혈 투자침법(透刺鍼法)을 포함한 침치료의 효과와 안전성 : 체계적 문헌고찰 및 메타분석김미경, 한창호대한한방내과학회 · 대한한방내과학회지2025 · 제46권 제4호

이 간행물의 다른 논문 (29건)

甘遂,瓜蔕의 임상활용에 관한 후향적 차트리뷰이병철, 노지원, 정수민, 김동현, 안세영, 안영민, 유정화pp. 1015-1025스타틴으로 조절되지 않는 이상지질혈증 환자에게 대시호탕 복용이 미치는 영향이병철, 유정화, 김동현, 정수민, 노지원, 안세영, 안영민pp. 1026-1034청심연자탕 복용이 한방병원 입원환자의 간 기능에 미치는 영향이인, 서희정, 한윤희pp. 1035-1042계지가부자탕이 근골격계 질환을 주소로 내원한 환자들의 간 기능에 미치는 영향심상송, 신선호, 신용진, 이준영, 채한나pp. 1043-1050흉통에 대한 평진수점산의 효과 : 후향적 연구신희연, 최정우, 고창남, 김하리, 이상화, 박정미, 양승보, 조승연, 박성욱pp. 1051-1062
원문 보기