대한한방소아과학회지에 게재된 체계적 문헌고찰의 보고 질 및 방법론적 질 평가

심수보,이주아,이혜림 대한한방소아과학회 2020 대한한방소아과학회지 Vol.34 No.1

Objectives: The purpose of this study is to assess the reporting quality and methodological quality of systematic reviews from the Journal of Pediatrics of Korean Medicine. Methods: Systematic reviews were selected from the Journal of Pediatrics of Korean Medicine (JPKM) by utilizing Oriental Medicine Advanced Searching Integrated System (OASIS) and JPKM homepage. Two independent researchers assessed the reporting quality through Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guideline checklist, and assessed the methodological quality of systematic review through Assessment of Multiple Systematic Reviews (AMSTAR) 2 tool checklist. Results: Four systematic reviews were finally selected for the assessment. When assessed by PRISMA, three literatures were little insufficient, and one literature was sufficient. When assessed by AMSTAR 2, three literatures were moderate quality, and one literature was critically low quality. Also, all of the reviews had no information about ‘Protocol and registration’, ‘publication bias’, and ‘conflicts of interest’. Conclusions: Systematic review is important for Journal of Pediatrics of Korean Medicine and Korean Medicine Society. Efforts are needed to improve the reporting and methodological quality of the systematic reviews through PRISMA and AMSTAR 2. 목적: 본 연구의 목적은 대한한방소아과학회지에 발표된 체계적 문헌고찰들의 보고의 질과 방법론적 질을 평가하는 데 있다. 방법: 대한한방소아과학회지에 발표된 체계적 문헌고찰을 검색하기 위해 OASIS (Oriental Medicine Advanced Searching Integrated System) 전통의학정보포털과 대한한방소아과학회 홈페이지 학회지 검색 시스템을 사용했다. 2명의 독립된 연구자가 PRISMA 체크리스트를 활용하여 체계적 문헌고찰의 보고의 질을 평가했고, AMSTAR 2 도구를 활용하여 체계적 문헌고찰의 방법론적 질을 평가했다. 결과: 4건의 체계적 문헌고찰이 최종적으로 평가를 위해 선정되었고, PRISMA를 통해 평가해보았을 때, 3건의 논문은 약간 부족한 수준의 보고 질 (Little insufficient report)을 나타냈고, 1건의 논문은 충분한 수준의 보고 질 (Sufficient report)을 나타냈다. AMSTAR 2를 통해 평가해보았을 때, 3건의 논문은 중등도의 질 (Moderate quality)로 평가되었고, 1건의 논문은 매우 낮은 질 (Critically low quality)로 평가되었다. 모든 논문에서 프로토콜과 등록, 출판 비뚤림, 이해상충에 대한 항목을 누락했다. 결론: 체계적 문헌고찰은 대한한방소아과학회지 및 한의학계에 중요한 연구로, PRISMA와 AMSTAR 2를 통해 체계적 문헌고찰의 보고의 질과 방법론적 질을 재고하는 노력이 필요할 것으로 사료된다.

소아 야뇨의 한의학적 치료에 대한 국내외 임상연구 동향 - 2000년 이후 발표된 연구를 중심으로 -

이유빈,정아람 대한한방소아과학회 2020 대한한방소아과학회지 Vol.34 No.1

목적: 이 연구의 목적은 최근 발표된 야뇨의 한의학적 치료에 대한 임상연구들을 분석하여 연구 동향 및 한의학적 치료의 효과와 안정성을 살펴보기 위함이다. 방법: 국내외 데이터베이스인 OASIS, KISS, NDSL, RISS, Cochrane, CINAHL, Embase, Pubmed에서 검색하였고, 2000년 이후로 2019년 10월까지 출판된 임상연구만을 포함하였다. 선택된 연구들에 대한 출판 연도, 연구 유형, 야뇨의 유형, 인구통계학적 정보, 유병 기간, 치료 방법 및 내용, 추적 기간, 평가 지표 및 결과 그리고 부작용을 정리하여 분석하였다. 결과: 총 38편의 연구가 선정되었다. 선정된 연구 38편에서 야뇨증에 쓰인 한의학적 치료 방법으로는 침 치료가 가장 많았으며, 한약 치료, 전기 자극 치료, 뜸 치료, 혈위 지압 치료, 첩부 요법 순이었다. 침 치료에는 삼음교 (SP6)와 관원 (CV4)이 가장 많이 사용되었고, 한약 치료에선 축천환이 가장 많이 사용되었으며 약재는 익지인과 산약이 가장 높은 사용 빈도를 보였다. 치료 결과 대부분의 연구에서 한의학적 치료시 총유효율이 높은 것으로 나타났으며, 다른 평가 지표에서도 전반적으로 긍정적인 결과가 보고되었다. 한의학적 치료군에서 발생한 부작용은 모두 침 치료나 천자가 시행된 상황에서 발생한 것으로 조사되었다. 결론: 본 연구는 소아 야뇨증의 전반적인 한의학적 치료에 대한 국내외의 임상연구들을 분석함으로써 연구 동향을 파악하고, 한의학적 치료의 유효성과 안정성을 평가하였다. 하지만 소아 야뇨증에 대한 한의학적 치료의 유효성과 안정성이 입증되기 위해선 향후 더 많은 연구가 진행되어야 할 것으로 보인다. Objectives : The purpose of this study is to identify the research trends and to evaluate the effectiveness and safety of Korean medicine treatment by analyzing the recently published clinical studies of Korean medicine treatment on nocturnal enuresis in children. Methods: The literatures were searched from OASIS, KISS, NDSL, RISS, Cochrane, CINAHL, Embase, Pubmed, and only clinical studies published from 2000 to October 2019 were included. The publication year, study type, type of enuresis, demographic information of participants, duration of illness, intervention type and details, follow-up period, outcome measurements and adverse events of selected literatures were analyzed. Results: A total of 38 studies were selected. In the selected studies, acupuncture was the most frequently used treatment for nocturnal enuresis, followed by herbal medicine, electrical stimulation treatment, moxibustion, acupressure and plaster therapy. The most commonly used acupoints for acupuncture were SP6 and CV4, and the most used herbal medicine was Chukcheonwhan, while Alpiniae Fructus (益智仁) and Dioscoreae Rhizoma (山藥) were the most used herbal materials. Most of the studies showed that the total effective rate of Korean medicine treatment was high. All the adverse events occurred in the Korean medicine treatment group were caused by acupuncture or puncture. Conclusions : This study analyzed clinical studies of Korean medicine treatment on nocturnal enuresis in children, identified the research trends and evaluated the effectiveness and safety of the Korean medicine treatment.

영아 지루성(脂漏性) 피부염(皮膚炎)에 대한 증례(證例) 1례(例)

김장현,김기봉,Kim, Jang-Hyun,Kim, Ki-Bong 대한한방소아과학회 2006 대한한방소아과학회지 Vol.20 No.2

심한 두부(頭部) 발진(發疹), 소양(搔痒) 및 화농(化膿)을 호소하여 동국대학교(東國大學校) 분당한방병원(盆塘韓方病院) 한방소아과(韓方小兒科)에 내원(來院)한 영아 지루성(脂漏性) 피부염(皮膚炎) 환자(患者) 1예(例)에 대하여 초진(初診) 진료(診療) 후 Aroma Lotion과 Aroma oil을 혼합한 외용제(外用劑)를 사용한 도포치료(塗布治療)와 carbon 광선치료(光線治療)를 병행하여 37일간 치료(治療)한 결과 두부(頭部) 발진(發疹), 소양(搔痒) 및 화농(化膿)이 완전 소실되어 유효한 결과를 얻었기에 이에 치료경과(治療經過)를 보고하는 바이다.

한방병원 응급실에 내원한 소아 환자에 관한 임상적 고찰

김지은,백정한,Kim, Ji Eun,Baek, Jung Han 대한한방소아과학회 2014 대한한방소아과학회지 Vol.28 No.4

Objectives By analyzing data of the pediatric patients who had visited the emergency room of the oriental medical hospital, we can understand their characteristics and diseases. The purpose of this study was to introduce the excellence of the Oriental medicine, to develop various treatments, and to revitalize pediatric emergency care at the oriental medical hospital. Methods The study was composed of 334 pediatric patients who had visited the emergency room of the ${\bigcirc}{\bigcirc}$ university oriental hospital from January 2011 to December 2013. Results 1. It has showed that between 7 to 12 years old patients (27.8%) were the most common age populations. 2. The number of pediatric patients was increased during February. According to the weekly distribution data, the number of pediatric patients who had visited on Sunday was the highest (28.7%). Also, the number of pediatric patients who had visited the ER between 21 to 24 hours (29.0%) was the highest. 3. The two major reasons for inpatient hospitalization were digestive and nerve-related symptoms. Nerve-related symptoms were the most common in infants while digestive symptoms were the most common in other child development stages. 4. The duration of time interval from the onset of symptoms to the ER visit was most commonly within 6 hours (50.3%). An acupuncture and herbal medication treatment (70.1%) were the most common medical treatments. The majority of the pediatric patients (95.5%) were discharged after their medical treatments. Conclusions A serious acute illness was not the most common reason for the ER visit among the pediatric patients. The most common disease states that have preferred to be treated with the oriental medicine were dyspepsia, crying, facial palsy, and ankle sprain. We have to introduce the excellence of the oriental medicine. We also need to try developing other treatments such as magnetic acupuncture, aromatherapy, and revitalizing pediatric emergency care at the oriental medical hospital.

한방병원에 내원한 소아청소년기 말초성 안면마비 환자 284례를 통한 임상적 고찰

강기연,이혜림,한재경,김윤희,Kang, Ki Yeon,Lee, Hye Lim,Han, Jae Kyung,Kim, Yun Hee 대한한방소아과학회 2014 대한한방소아과학회지 Vol.28 No.4

Objectives The purpose of this study is to investigate the clinical characteristics in children and adolescents with peripheral facial palsy that was treated with Korean medicine. Methods The study was conducted based on 284 cases that consisted of 261 children (less than 19 years old) who visited the hospital of Korean medicine from August 2010 to August 2014. Then, this study was analyzed by reviewing the patients' charts. Results The incidence of facial palsy in pediatric patients was more common in boys than in girls and the mean age was 11.2 years. The prevalence of facial palsy was more common in winter and most were diagnosed with Bell's palsy. Recurrence was identified in 12.6% of the patients. The average age of the first attack was 9.5 years. It took about 3.2 years for recurrence to occur from the first onset. It took about 5 days to visit the hospital of Korean medicine from the onset. 81% of the patients came within 1 week from the onset. 50.7% of the cases did not receive any treatment before and 49.3% were previously treated at other hospitals. More than half of the patients (65.1%) received Korean medicine first. 54.6% of the patients were hospitalized and 45.4% received outpatient treatments in the hospital of Korean medicine. Outpatient treatments were administered about 11.5 times while hospitalized patients were treated for an average of 16.6 days. In general, hospitalized patients were treated more often than the outpatient group. An overall average duration of treatment was 70.6 days from the onset of facial palsy until the last day of treatment, and 53.0 days from the first day of treatment until the last day of treatment. 41.5% of the cases were treated only with Korean medicine and 49.0% were treated with a combination of Korean and Western medicine. The types of Korean medicine treatment used for facial palsy in descending order of frequency were acupuncture, Infra red, herbal medicine, SSP therapy, electro-acupuncture, carbone, hot pack, cupping, and moxibustion. The treatments that were most frequently used from Western medicines were steroid as monotherapy (61.7%) and a combination of steroids and antiviral therapy (37.6%). Conclusions This result showed that the risk of facial palsy recurrence among children is relatively high and that facial palsy requires a long-term treatment. It's helpful to explain about prognosis, treatment duration, and recurrence potential in children. Facial palsy in children is treated in various ways but more studies about the therapeutic effects of Korean medicine, Western medicine, and combination of Korean-Western medicine in children are needed.

천기병(川崎病)의 치험례(治驗例)

최장복,Choe Jang-Bok 대한한방소아과학회 1987 대한한방소아과학회지 Vol.2 No.1

성조숙증으로 진단된 여자 환아에서 호르몬 수치가 개선된 치험 1례

임영권,허광욱,박송이,서경석,천상렬,이석진,이훈,김호철,Lim, Youngkwern,Hur, Kwang-Wook,Park, Song Yi,Suh, Kyeung Suk,Chun, Sang Yeol,Lee, Suk Jin,Lee, Hoon,Kim, Hocheol 대한한방소아과학회 2014 대한한방소아과학회지 Vol.28 No.4

Objectives The purpose of this study is to find out how taking oriental herbal medicine may affect the sex hormone levels in a patient who was diagnosed with prematurity. Methods We prescribed 120 cc of oriental herbal medicine twice daily for a month to a patient suspected of the precocious puberty due to 11 pg/ml of the estradiol level. Upon finishing the course of oriental herbal medicine, the patient was retested for the follicular stimulating hormone, luteinizng hormone and estradiol levels. Results After administration, all levels of luteininzing hormone, follicular stimulating hormone and estradiol were decreased. There was no diagnosable evidence for the idiopathic central precocious puberty in the gonadotropin releasing hormone stimulation. Conclusions Oriental herbal medicine is a good alternative treatment of choice for the precocious puberty. However, more in-depth studies are to be followed.

백선피(白鮮皮) 추출물이 DNCB로 유발된 NC/Nga 생쥐의 아토피 피부염에 미치는 영향

이윤실,한재경,김윤희,Lee, Youn Shil,Han, Jae Kyung,Kim, Yun Hee 대한한방소아과학회 2014 대한한방소아과학회지 Vol.28 No.4

Objectives Dictamni Radicis Cortex extracts (DRC) has been known to suppress allergic reaction, however the cellular target of DRC and its mode of action remain unclear. The purpose of this study is to investigate the effects of Dictamni Radicis Cortex extracts on DNCB induced atopic dermatitis-like skin lesions of NC/Nga mouse. Methods This study was designed to investigate the effects of DRC extract in the DNP-IgE-induced activation of MC/9 murine mast cell lines in vitro and in the DNCB-induced activation of NC/Nga mouse in vivo. For this investigation, We examined IL-4, IL-5, IL-6, IL-13, TNF-${\alpha}$ and GM-CSF mRNA expression by Real-time PCR, IL-13, MIP-$1{\alpha}$ production by ELISA analysis and manifestations of NFAT1, NFAT2, AP-1 and NF-${\kappa}B$ p65 transcription factors by western blotting in vitro. Then, we examined WBC, eosinophil and neutrophil in NC/Nga mouse, IL-5, IL-13 in serum, IFN-${\gamma}$, IL-4 in the spleenocyte culture supernatant, the absolute cell numbers of $CD4^+$, $CD8^+$, $^+Gr-1^+CD11b$, $B220^+CD23^+$ in the ALN, PBMCs and dorsal skin, IL-5, IL-13 in the dorsal skin by Real-time PCR and the distribution of mast cells by H&E and toluidine blue. Results In vitro the mRNA expression of IL-4, IL-5, IL-6, IL-13, TNF-${\alpha}$, GM-CSF and IL-13, MIP-$1{\alpha}$ production by ELISA analysis were completely abolished by DRC and the western blot analysis decreased the expression of mast cell-specific transcription factors including NFAT-1, NF-${\kappa}B$ p65. In vivo DRC oral adminstration also decreased the counts of WBC, eosinophils and inflammatory cytokines such as IL-13 and IgE in the serum. DRC oral adminstration elevated IL-4 level in the spleenocyte culture supernatant. DRC oral adminstration decreased total ALN cells, total skin cells, cell numbers of $CD4^+$, $B220^+CD23^+$ in the ALN, $^+Gr-1^+CD11b$ in the PBMCs and $CD4^+$, $CD8^+$ in the dorsal skin. The mRNA expression of IL-5, IL-13, thickness of epidermis, inflammation immune cells and mast cells were abolished by DRC in the dorsal skin. Conclusions Histological examination showed that infiltration levels of immune cells in the skin of AD-induced NC/Nga mouse were much improved by DRC oral adminstration. These results, therefore, suggest that DRC can regulate molecular mediators and immune cells that are functionally associated with atopic dermatitis induced in NC/Nga mouse, and may play an important role in recovering AD symptoms.

소아의 성장과 한방치료에 대한 부모들의 인식조사

윤혜준,이진용,김덕곤,Yoon, Hye-Joon,Lee, Jin-Yong,Kim, Deog-Gon 대한한방소아과학회 2011 대한한방소아과학회지 Vol.25 No.1

Objectives: The purpose of this study is to evaluate the parents' awareness on the oriental medical treatment and their expectation on children's growth. Methods: The survey was conducted on 78 Health Kids Fair visitors, and 87 children's height and weight were measured in this study. Results: 1. Compare to other treatment, 62.82% of the parents responded that herbal medicine is relatively effective in treating weakness, followed by 'Allergic disease'(46.15%) 'Growth disturbance'(26.92%) 'Obesity'(26.92%) 'Respiratory disease'(26.92%) 'Digestive disease'(19.23%) 'Precocious puberty'(8.97%) 'Neurologic & psychologic disease'(6.41%) 'Urogenital disease'(3.85%). 2. Parents recognize that 'Oriental medicine have an effect on children's height mostly'(25.64%) 'Oriental medicine have an effect on children's height partially'(64.10%) 'Oriental medicine have no effect on children's height'(10.26%) 25.64% of the parents responded that herbal medicine would be helpful in increasing height, 64.10% of the parents said they would be helpful to the certain extent, and 10.26% said they would not play any roles. 3. Expected average weight, height, and BMI score for the boys were 71.8kg, 179.6cm and 22.10. For the girls, however, they were 53.4kg, 168.7, and 18.74. 4. Survey on parents' awareness on benefits of different treatments for challenged growth, Herbal medicine'(48.72%) 'Acupuncture'(7.69%), 'Moxibustion'(3.85%), 'Electronic acupuncture and Aqua acupuncture'(1.28%), 'Massage on acupuncture point'(19.23%), 'Consultation of eating habits'(61.54%), 'Consultation of exercise'(47.44%) were measured. Conclusions: Considering the collected results, we realized that the parents' expected height on their children was, in fact, higher than the standard height. In addition, for treatments for their children's growth improvement, parents expected that 'Herbal madicine' 'Massage on acupuncture point' 'Consultation of eating habits' 'Consultation of exercise would be beneficial.

성동구내 어린이집 원아 부모의 소아 한방치료에 대한 인식 및 이용에 관한 조사 연구

박유진,이슬지,윤지연,명성민,Park, You-Jin,Lee, Seul-Ji,Yoon, Ji-Yeon,Myoung, Sung-Min 대한한방소아과학회 2011 대한한방소아과학회지 Vol.25 No.1

Objectives: The purpose of this study is to examine the parental recognition and utilizing patterns of oriental medical care in children who live in Seong-Dong district. Methods 802 day-care center children's parents participated in the survey on recognition and utilizing patterns of oriental medical care, and 702 of the surveys were analyzed. Results: 1. 38.33% has received previous oriental medical treatments and most were received at the children's age under 12-24 months. Majority of the treatments took place in the clinical settings. By recommendation, some also received their treatment at the medical centers. One of the reasons why they receive oriental medical treatments was that they prefer to balance their treatment with the orental medical treatments along with the western's. 2. 53.85% of those who received oriental medical treatments were satisfied with their treatments. The effective treatment results were the major reason for the satisfaction. 3. 49.56% of those who had oriental medical treatments chose specific oriental medical facilities for the children's ailment. Most specific oriental medical facilities were local oriental medical clinics. Reputation fame were the main reason in choosing the clinics. 4. In 2009, 55.26% had received care in the specific oriental medical clinics for the diseases, such as respiratory symptoms, systemic symptoms, gastrointestinal symptoms, skin problems, neurological and psychiatric disease for infants, and respiratory symptoms, gastrointestinal symptoms, systemic symptoms, skin problems, neurological and psychiatric symptoms, urinary symptoms and musculoskeletal symptoms for toddlers. 5. The average duration of herbal treatment were 7-14 days, preferably 4-6 days, and preferred number of medical visits were once a week on Saturdays and preferred day for night cares were on Friday nights. Average treatment fee per treatment was less than 10,000 won which coincided with the preferred treatment fee per visit. 6. The very first medical institutions chosen by parents once their children are ill are the following; Western medical institutions, western medical clinics, pharmacies, oriental medical clinics, health centers, and lastly, oriental medical institutions. The major concerns in receiving oriental medical cares include pesticides in herbs and hazardous substances in heavy metals. Preferred form of oriental medicine was decoction, the negative feedback of oriental medicine was mostly due to the bitter taste of the oriental herbal decoctions. Preferred frequency of intake was twice a day with less than 10cc~20cc per single intake. Conclusions: Taken all together, we conclude that the growing recognition of Oriental Pediatric medicine is needed among parents.