Recently, rehabilitative exercise therapies have been described as an important method of overcoming the limitations of the conventional therapies for Parkinson’s disease. The present study aimed to evaluate efficacy and safety of exercise therapies for Parkinson’s disease. Randomized controlled trials that evaluated exercise therapies in patients with Parkinson’s disease until December 2016 were searched for in five electronic databases: PubMed, CENTRAL, EMBASE, OASIS, and CNKI. Eighteen studies (1,144 patients) were included. The overall methodological quality was not high. Patients who underwent exercise therapies exhibited statistically significant improvements in the total UPDRS, UPDRS II and III, Berg Balance Scale, preferred walking speed, and Timed Up and Go Test compared to patients who underwent nonexercise therapies. In comparison to patients who performed regular activity, patients who underwent exercise therapies exhibited statistically significant improvements in the total UPDRS, UPDRS II, and UPDRS III. Exercise therapies were found to be relatively safe. Exercise therapies might promote improvements in the motor symptoms of Parkinson’s disease. However, due to the small number of randomized controlled trials and methodological limitations, we are unable to draw concrete conclusions. Therefore, further studies with better designs will be needed.
Background Mild cognitive impairment (MCI) is considered an intermediate phase between normal aging and dementia. As the majority of cases of amnestic MCI (aMCI) progress to Alzheimer’s disease (AD), it is considered the prodromal stage of AD, and a treatment target for prevention of further cognitive decline. However, no medications have been shown to have symptomatic or preventive benefits in MCI. Kami-guibi-tang (KGT) is a traditional herbal formula used in Korean medicine to treat amnesia, which is reported to increase acetylcholine levels via activation of choline acetyltransferase. The objective of this study was to evaluate the efficacy and safety of KGT in patients with aMCI. Methods This study was designed as a single-center, randomized, double-blind, placebo-controlled pilot study. Participants diagnosed with aMCI were randomized to receive either KGT or placebo granules for 24 weeks. The efficacy measure was a change in the Seoul Neuropsychological Screening Battery (SNSB) score. The safety measures included the occurrence of adverse events and abnormalities in vital signs and blood chemistry, electrocardiogram (ECG), and brain magnetic resonance imaging (MRI) findings. Results A total of 16 patients in the KGT group and 14 patients in the placebo group were investigated in the study. The mean score of Clinical Dementia Rating-Sum of Boxes (CDR-SB) significantly improved from 1.53 (0.64) points to 1.13 (0.62) points in the KGT group (p = 0.010), whereas it worsened from 1.61 (0.88) points to 1.75 (0.94) points in the placebo group. There was a significant difference in the CDR-SB scores between the two groups after the intervention (p = 0.045). The total SNSB-D scores and the scores in the memory domain after the treatment were significantly higher than the baseline values in the KGT group, but not in the placebo group. The frequency of adverse events was not significantly different between the two groups, and there were no abnormalities in vital signs or blood test, ECG, and brain MRI findings after the intervention. Conclusions KGT may provide a safe and effective treatment option for patients with aMCI. Further studies with a larger sample size are needed to validate the findings. Trial registration Korean Clinical Trial Registry, ID: KCT0002407; Registered on March 30, 2017, http://cris.nih.go.kr/
Background While the world struggles under the coronavirus disease 2019 (COVID-19) pandemic, a variety of antiviral agents and symptomatic treatments are being administered to patients and urgent clinical trials are underway. Under these circumstances, it is important to explore various possibilities for the treatment of COVID-19 including herbal medicines. Among various herbal medicines, Soshihotang (SSHT, Xiao Chai Hu Tang in Chinese) has been prescribed to treat various viral diseases and is used in combination with other herbal medicines depending on the patient’s symptoms. Methods For conducting the present review, we searched electronic databases focusing on the antiviral effect of SSHT in experimental and clinical study until April 2020. The search keywords included SSHT, constituents of SSHT, and antiviral effect. We also searched for materials related to topic directly from websites and published books. Based on these search results, we summarized the results of the included materials in the form of a narrative review. Results In a number of recent clinical studies, treatment with SSHT improved the infection status of the respiratory and hepatobiliary systems, and experimental studies demonstrated the antiviral effect of SSHT and its components. Furthermore, SSHT are being used in China—where COVID-19 outbreak first took place—and offer a new option to treat COVID-19. Conclusion Based on the present evidences, it is believed that SSHT is likely to be a new therapeutic option for COVID-19. Conducting further studies might provide improved understanding regarding the use of SSHT in treating COVID-19.
Background: Post-stroke dysphagia (PSD) requires effective treatment as it may cause aspiration pneumonia, dehydration, or malnutritution, which can increase the length of hospital stay as well as mortality. In the field of stroke, electroacupuncture (EA) has been widely used, and a number of clinical research papers have been published regarding its effects. This systematic review aims to evaluate the effectiveness of EA for the treatment of PSD. Methods: Randomized controlled trials evaluating the use of EA in PSD will be included in this meta-analysis. The following electronic databases will be searched from inception to July 31, 2020, using terms relating to EA and PSD: PubMed, the Cochrane Library, the Excerpta Medica Database, China National Knowledge Infrastructure, the Korean Medical Database, KoreaMed, the National Digital Science Library, and the Oriental Medicine Advanced Searching Integrated System. Two reviewers will independently search these databases, select studies for inclusion, and evaluate the quality of the studies. Methodological quality will be assessed using the Cochrane Handbook for Systematic Reviews of Interventions (version 6.0). The primary outcome will be the total effective rate; secondary outcomes will include results of other assessments of dysphagia such as the water drinking test scale and videofluoroscopic swallowing study. We will also investigate the number and severity of adverse events. The Cochrane Review Manager (RevMan) software (version 5.3.5) will be employed to assess bias risk, data integration risk, and meta-analysis risk. Mean difference and standardized mean difference will be used to represent continuous data, while risk ratios will be used for pooled binary data. Results: This study will provide a comprehensive review and evaluation of the available evidence regarding the efficacy and safety of EA as a treatment for PSD. Conclusion: This study will clarify whether EA could be an effective and safe treatment for PSD.
ObjectivesParkinson's disease (PD) is a neurodegenerative disease in which patients are suffering various symptoms. Previous experimental studies suggested that herbal medicine Ukgansan (UGS) could be beneficial for PD. The aim of this pilot clinical trial was to evaluate the efficacy of UGS for improving clinical symptoms in patients with PD.MethodsSixty patients with idiopathic PD were randomly assigned to receive either UGS plus acupuncture or acupuncture alone for 6 weeks. During the trial, all anti-parkinsonian medications were maintained. Subjects were evaluated for various clinical assessments of PD, including the Movement Disorder Society-Sponsored Revision of the Unified PD Rating Scale (MDS-UPDRS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39), until 12 weeks.ResultsIn MDS-UPDRS between the groups, no significant time x group interaction was found. In the subgroup analysis of participants with anxiety, a significant time x group interaction was found in the PDQ-39 domain of mobility (P = 0.007), activities of daily living (P = 0.042), and the PDQ-39 summary index (P = 0.048). In addition, post-hoc analysis in participants with anxiety showed a significant decrease in the domains of mobility (P = 0.001) and activities of daily living (P = 0.013) at week 7. There were no adverse events associated with UGS.ConclusionThe additional administration of UGS has the potential to significantly improve the quality of life of PD patients with anxiety. In order to create more definitive evidence, clinical trials with more rigorous methodologies should be conducted in future.Clinical trial registrationhttp://cris.nih.go.kr, identifier: KCT0003444.
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