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Kwon CY, Lee B, Lee JY. Effectiveness and safety of East Asian herbal medicine for menopausal insomnia: a systematic review and meta-analysis. Front Pharmacol 2024; 15:1414700. [PMID: 39175534 PMCID: PMC11338872 DOI: 10.3389/fphar.2024.1414700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Accepted: 07/23/2024] [Indexed: 08/24/2024] Open
Abstract
Background: Menopausal insomnia significantly impacts the quality of life in women. East Asian herbal medicines (EAHMs) have been traditionally used in Asian countries, but their efficacy and safety require systematic evaluation. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of EAHM for treating menopausal insomnia. Methods: A comprehensive literature search was conducted across 10 electronic databases from inception until 19 July 2023. Randomized controlled trials (RCTs) investigating EAHM for menopausal insomnia were included. Two reviewers independently screened studies, extracted data, and assessed the risk of bias using the Cochrane risk of bias tool. The primary outcome was sleep quality, insomnia severity, and sleep architecture. Secondary outcomes included total effective rate (TER), menopausal symptoms, and adverse effects. Meta-analysis was conducted using a random-effects model, and the results were calculated as mean differences (MDs) or risk ratios (RRs) and their 95% confidence intervals (CIs). Also, the certainty of evidence was assessed using the GRADE approach. Results: A total of 70 RCTs involving 6,035 participants met the inclusion criteria. The most frequently used EAHMs were modified Suan Zao Ren Tang, and the most frequently used herbal component was Zizyphus jujuba Miller var. spinosa Hu ex H. F. Chou [Rhamnaceae; Zizyphi Semen]. Compared with sedative-hypnotics, EAHM significantly improved sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI) (MD -2.18, 95% CI -2.56 to -1.80), and reduced menopausal symptoms, as assessed by the Kupperman Index (MD -4.92, 95% CI -6.03 to -3.80). Similar results were seen when EAHM was added to sedative-hypnotics. When EAHM was additionally used in sedative-hypnotics, similar benefits were shown for PSQI (MD -2.46, 95% CI -3.09 to -1.82) and the Kupperman Index (MD -4.64, 95% CI -5.07 to -4.21). EAHM was generally safer than sedative-hypnotics, with significantly fewer adverse reactions (RR 0.15, 95% CI 0.07-0.34). However, the certainty of evidence was moderate to low. Conclusion: EAHMs, alone or with sedative-hypnotics, may be effective and safe for improving sleep quality and managing menopausal symptoms. Future studies should include diverse populations, rigorous methodologies, and explore mechanisms of action to confirm these findings. Systematic Review Registration: [https://www.crd.york.ac.uk/prospero/display_record.php?], identifier [CRD42023446708].
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Affiliation(s)
- Chan-Young Kwon
- Department of Oriental Neuropsychiatry, Dong-eui University College of Korean Medicine, Busan, Republic of Korea
| | - Boram Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ji-Yeon Lee
- Department of Obstetrics and Gynecology, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
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Kim PW, Kim S, Kim DI, Cha J, Lee HS, Ko MM, Jang S, Yang C, Lee MS. Development of the Korean Medicine Core Outcome Set for Primary Dysmenorrhea (COS-PD-KM) for Herbal Medicine Treatment of Primary Dysmenorrhea in Primary Clinics. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15321. [PMID: 36430040 PMCID: PMC9690837 DOI: 10.3390/ijerph192215321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Revised: 11/16/2022] [Accepted: 11/17/2022] [Indexed: 06/16/2023]
Abstract
The aim of this study was to develop a Korean medicine (KM) core outcome set (COS) for primary dysmenorrhea to evaluate the effectiveness of herbal medicine (HM) in treating primary dysmenorrhea in patients visiting KM primary clinics. Previously reported outcomes were identified through a literature review to define outcomes and effect modifiers (EMs) for the questionnaire. Experts were invited to conduct modified Delphi consensus exercises, and primary care clinicians were invited to conduct Delphi consensus exercises to evaluate suitability and feasibility. Finally, an additional round of a modified Delphi exercise was conducted with experts to obtain a final agreement on the COS. Seventeen outcomes and 15 EMs were included from a literature review, and one effect modifier was suggested by the experts (Phase 1). In Phase 2, after the modified Delphi consensus exercises by experts, 10 outcomes and 11 EMs were included in the COS. The clinicians all agreed on the feasibility of COS (Phase 3). Finally, 10 outcomes and 6 EMs were included in the COS-PD-KM after the final modified Delphi consensus exercise (Phase 4). The effectiveness of HM used in primary clinics could be evaluated with this COS in patients with primary dysmenorrhea. Further studies that involve more relevant stakeholder groups, such as patient representatives and gynecological experts, are needed.
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Affiliation(s)
- Pyung-Wha Kim
- R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Sungha Kim
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Dong-Il Kim
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongguk University, Goyang 10326, Republic of Korea
| | - Jiyun Cha
- Digital Health Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - He-Sol Lee
- R&D Strategy Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Mi Mi Ko
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Soobin Jang
- Department of Preventive Medicine, College of Korean Medicine, Daegu Haany University, Gyeongsan 38610, Republic of Korea
| | - Changsop Yang
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
| | - Myeong Soo Lee
- KM Science Research Division, Korea Institute of Oriental Medicine, Daejeon 34054, Republic of Korea
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Lee HW, Choi TY, Lee MS, Lee JA, Jun JH, Choi J, Ang L, Lee CH, Lee JM, Park KS, Kim DC, Jang SR, Yoo JE, Kim DI, Cho SH, Yang SJ, Lee IS, Ahn IS, Lee DN, Choi CM, Song MH, Kim E. Prescription patterns of herbal medicine for menopausal disorders in major Korean medicine hospitals: a multicenter retrospective study. Integr Med Res 2021; 10:100706. [PMID: 33665094 PMCID: PMC7903342 DOI: 10.1016/j.imr.2020.100706] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 11/15/2020] [Accepted: 11/29/2020] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND This study aimed to obtain the symptom, prescription and therapeutic patterns for the treatment of patients with menopausal syndrome in major Korean medicine (KM) hospitals. METHODS We used a retrospective chart review of climacteric disorder and postmenopausal syndrome patients by examining medical records (ICD-10, menopausal and female climacteric states: N95.1, Menopausal and perimenopausal disorder, unspecified: N95.9) from eight university KM hospitals in South Korea. RESULTS The main symptoms of 1,682 patients with menopausal disorders visiting eight college-affiliated oriental medicine hospitals were hot flush, hyperhidrosis, fatigue, insomnia, and chest tightness. Guipi decoction, Si-wu guipi decoction, Qing-xin lianzi-yin, Jiawei xiao-yao-san and Guipi wen-dan decoction were the most commonly prescribed treatments for menopausal disorders. Patients were most often treated with a combination of herbal medicine and acupuncture. CONCLUSION Our study shows that the current prescribed herbal medicines were used for treating menopausal disorders in Korean medicine hospitals. However, the objectivity of the efficacy assessment should be studied further.
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Affiliation(s)
- Hye Won Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Tae-Young Choi
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Ju Ah Lee
- Hwa-pyeong Institute of Integrative Medicine, Incheon, Korea
| | - Ji Hee Jun
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Jiae Choi
- Integrative Health Promotion Team, Korea Health Promotion Institute, Seoul, Korea
| | - Lin Ang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Korea
| | - Chang-Hoon Lee
- Department of Korean Medicine Gynecology, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, Korea
| | - Jin-Moo Lee
- Department of Korean Medicine Gynecology, Kyung Hee University Korean Medicine Hospital at Gangdong, Seoul, Korea
| | | | - Dong Chul Kim
- Department of Gynecology, College of Korean Medicine, Daegu Hanny University, Gyeongsan, Korea
| | - Se-Ran Jang
- Department of Gynecology, College of Korean Medicine, Daegu Hanny University, Gyeongsan, Korea
| | - Jeong-Eun Yoo
- Department of Korean Medicine Obstetrics & Gynecology, College of Korean Medicine, Daejeon University, Daejeon, Korea
| | - Dong-il Kim
- Department of Obstetrics and Gynecology, Dongguk University Ilsan Korean Medicine Hospital, Goyang, Korea
| | - Seong-Hee Cho
- Department of Korean Obsterics & Gynecology, Dongshin University Hospital of Korean Medicine, Naju, Korea
| | - Seung-Jeong Yang
- Department of Korean Obsterics & Gynecology, Dongshin University Hospital of Korean Medicine, Naju, Korea
| | - In Seon Lee
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongeui University, Busan, Korea
| | - In-Suk Ahn
- Department of Obstetrics & Gynecology, College of Korean Medicine, Dongeui University, Busan, Korea
| | - Dong-Nyung Lee
- Department of Korean Obstetrics & Gynecology, Semyung University, Chungju, Korea
| | - Chang-Min Choi
- Department of Korean Obstetrics & Gynecology, Wonkwang University Hospital of Korean Medicine, Gwangju, Korea
| | - Mi-Hwa Song
- Department of Korean Obstetrics & Gynecology, Wonkwang University Hospital of Korean Medicine, Gwangju, Korea
| | - Eunseop Kim
- You & Green Korean Medical Clinic, Daejeon, Korea
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Park EJ, Baek SE, Kim M, Kim AR, Park HJ, Kwon O, Lee JH, Yoo JE. Effects of herbal medicine ( Danggwijagyaksan) for treating climacteric syndrome with a blood-deficiency-dominant pattern: A randomized, double-blind, placebo-controlled pilot trial. Integr Med Res 2021; 10:100715. [PMID: 33665100 PMCID: PMC7903340 DOI: 10.1016/j.imr.2021.100715] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2020] [Revised: 12/15/2020] [Accepted: 12/28/2020] [Indexed: 12/18/2022] Open
Abstract
Background Danggwijagyaksan (DJS) has been one of the most widely used herbal medicines for gynecological disorders in traditional East Asian medicine. Several clinical studies about DJS have shown improvement in menopausal symptoms. This pilot study aimed to evaluate the efficacy, safety and feasibility of DJS for treating climacteric syndrome with a blood-deficiency-dominant pattern. Methods This was a randomized, double-blind, placebo-controlled pilot trial. A group of 45-to 60-year-old women with climacteric syndrome were registered for the trial. The participants received treatment over a 4-week period and were then followed for 4 weeks. The primary outcome measure was the mean change in the Menopause Rating Scale (MRS). Secondary outcome measures included the World Health Organization Quality of Life-BREF (WHOQOL-BREF), the Blood-Deficiency Scoring System (BDSS), lean body mass, and serum hormone levels, including follicle-stimulating hormone (FSH) and estradiol (E2) levels. Results The MRS and BDSS scores decreased significantly in both groups, but the differences between two groups were not significant. The WHOQOL-BREF scores increased in the control group. No statistically meaningful differences in serum hormone levels or lean body mass were observed in both groups. There were no serious adverse events, and the laboratory tests were within the normal range. The recruitment rate, completion rate and medication adherence rate were over 90% in both groups, indicating high feasibility. Conclusions DJS showed clinical effectiveness in the treatment of climacteric syndrome with a blood-deficiency-dominant pattern. Additionally, DJS was shown to be safe and feasible for a large-scale study to confirm the efficacy of the treatment. Trial registration: Clinical Research Information Service (CRIS, https://cris.nih.go.kr): KCT0002387.
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Affiliation(s)
- Eun-Ji Park
- Department of Obstetrics and Gynecology, Cheonan Korean Medicine Hospital of Daejeon University, Cheonan, Republic of Korea
| | - Seon-Eun Baek
- Department of Obstetrics and Gynecology, Seoul Korean Medicine Hospital of Daejeon University, Seoul, Republic of Korea
| | - Mikyung Kim
- Department of Internal Medicine, College of Korean Medicine, Sangji University, Wonju, Republic of Korea
| | - Ae-Ran Kim
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Hyo-Ju Park
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Ojin Kwon
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jun-Hwan Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, Republic of Korea
| | - Jeong-Eun Yoo
- Department of Obstetrics and Gynecology, College of Korean Medicine, Daejeon University, Daejeon, Republic of Korea
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Shen C, Li C, Xu F, Wang Z, Shen X, Gao J, Ko R, Jing Y, Tang X, Yu R, Guo J, Xu F, Meng R, Cui Y. Web-based study on Chinese dermatologists' attitudes towards artificial intelligence. ANNALS OF TRANSLATIONAL MEDICINE 2020; 8:698. [PMID: 32617318 PMCID: PMC7327314 DOI: 10.21037/atm.2019.12.102] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
Background Artificial intelligence (AI) has become a powerful tool and is attracting more attention in the field of medicine. There are a number of AI studies focusing on skin diseases, and there are many AI products that have been applied in dermatology. However, the attitudes of dermatologists, specifically those from China, towards AI, is not clear as few, if any studies have focused on this issue. Methods A web-based questionnaire was designed by experts from the Chinese Skin Image Database (CSID) and published on the UMER Doctor platform (an online learning platform for dermatologists developed by the Shanghai Wheat Color Intelligent Technology Company, China). A total of 1,228 Chinese dermatologists were recruited and provided answers to the questionnaire online. The differences of dermatologists' attitudes towards AI among the different groups (stratified by age, gender, hospital level, education degree, professional title, and hospital ownership) were compared by using the Mann-Whitney U test and the Kruskal-Wallis H test. The correlations between stratified factors and dermatologists’ attitudes towards AI were calculated by using the Spearman’s rank correlation test. SPSS (version 22.0) was utilized for all analyses. A two-sided P value <0.05 was considered statistically significant in all analyses. Results A total of 1,228 Chinese dermatologists from 30 provinces, autonomous regions, municipalities, and other regions (including Hong Kong, Macau, and Taiwan) participated in this survey. The dermatologists who participated acquired AI-related information mainly through the Internet, meetings or forums, and 70.51% of participated dermatologists acquired AI-related information by two or more approaches. In total, 99.51% of participated dermatologists pay attention (general, passive-active, and active attention) to information pertaining to AI. Stratified analyses revealed statistically significant differences in their attention levels (unconcerned, general, passive-active, and active attention) to AI-related information by gender, hospital level, education degree, and professional title (P values ≤1.79E−02). In total, 95.36% of the participated dermatologists thought the role of AI to be in “assisting the daily diagnosis and treatment activities for dermatologists”. Stratified analyses about the thought of AI roles (unconcerned, useless, assist, and replace) showed that there was no statistically significant difference except for the hospital level (P value =4.09E−03). The correlations between stratified factors with attention levels and the opinions of AI roles showed extremely weak correlations. Furthermore, 64.17% of participated dermatologists thought secondary hospitals in China are in most need of the application AI, and 91.78% of participated dermatologists thought the priority implementation of AI should be in skin tumors. Conclusions The majority of Chinese dermatologists are interested in AI information and acquired information about AI through a variety of approaches. Nearly all dermatologists are attentive to information on AI and think the role of AI is in “assisting the daily diagnosis and treatment activities for dermatologists”. Future AI implementation should be primarily focused on skin tumors and utilized in in secondary hospitals.
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Affiliation(s)
- Changbing Shen
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China.,Hinda and Arthur Marcus Institute for Aging Research, Hebrew SeniorLife and Harvard Medical School, Boston, MA, USA
| | - Chengxu Li
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Feng Xu
- Department of Dermatology, Huashan Hospital, Fudan University, Shanghai, China
| | - Ziyi Wang
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
| | - Xue Shen
- Department of Dermatology, Chengdu Second People's Hospital, Chengdu, China
| | - Jing Gao
- Department of Dermatology, the Second Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Randy Ko
- The University of New Mexico School of Medicine, Albuquerque, NM, USA
| | - Yan Jing
- Department of Dermatology, the First Affiliated Hospital, Anhui Medical University, Hefei, China
| | - Xiaofeng Tang
- Shanghai Wheat Color Intelligent Technology Company, LTD, Shanghai, China
| | - Ruixing Yu
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China
| | - Junhu Guo
- Shanghai Wheat Color Intelligent Technology Company, LTD, Shanghai, China
| | - Feng Xu
- Shanghai Wheat Color Intelligent Technology Company, LTD, Shanghai, China
| | - Rusong Meng
- Department of Dermatology, Specialty Medical Center of the Air Force, Chinese People's Liberation Army, Beijing, China
| | - Yong Cui
- Department of Dermatology, China-Japan Friendship Hospital, Beijing, China.,Graduate School, Peking Union Medical College and Chinese Academy of Medical Sciences, Beijing, China
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Lee HW, Jun JH, Choi J, Choi TY, Lee JA, Ang L, Go HY, Lee MS. Herbal prescription for managing menopausal disorders: A practice survey in Korean medicine doctors. Complement Ther Clin Pract 2019; 38:101073. [PMID: 31765985 DOI: 10.1016/j.ctcp.2019.101073] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2019] [Accepted: 11/13/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND The aim of this study was to investigate the clinical practice of Korean medicine doctors (KMDs) for managing menopausal disorders. METHODS We conducted a web-based questionnaire for KMDs to respond to recommendations across the three main KM domains: major symptoms of menopausal disorders, herbal prescriptions, and pattern identification. RESULTS We received responses from 227 doctors who have treated menopausal disorders. The major pattern identifications recommended by the doctors for the pre-, peri-, and postmenopausal phases, respectively, were depression of liver energy (59.5%), kidney yin deficiency (49.8%), and kidney yin deficiency (50.7%). The most frequent herbal remedies prescribed for the pre-, peri-, and postmenopausal phases were Jiawei shaoyao-san (58.1%), Jiawei shaoyao-san (48.5%), and Jiawei guipi-decoction (37.9%), respectively. CONCLUSION The results of our clinical practice survey provide information on KMDs' clinical experiences of using herbal medicines and their use of pattern identification to manage menopausal disorders.
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Affiliation(s)
- Hye Won Lee
- Herbal Medicine Research Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ji Hee Jun
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Jiae Choi
- Integrative Health Promotion Team, Korea Health Promotion Institute, Seoul, South Korea
| | - Tae-Young Choi
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ju Ah Lee
- Hwa-pyeong Institute of Integrative Medicine, Incheon, South Korea
| | - Lin Ang
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea
| | - Ho-Yeon Go
- Internal Medicine College of Korean Medicine, Semyung University, Chungju, South Korea
| | - Myeong Soo Lee
- Clinical Medicine Division, Korea Institute of Oriental Medicine, Daejeon, South Korea.
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