Comparative effectiveness of East Asian traditional medicine for treatment of idiopathic short stature in children: Systematic review and network meta-analysis

Evidence-Based Complementary and Alternative Medicine

2022

Self Cite

Background. Korean medicine (KM) interventions are attractive for children with idiopathic short stature (ISS). We investigated the real-world clinical practice patterns of KM doctors in ISS treatment. Methods. The survey targeted KM doctors who have treated patients with ISS in KM clinical settings for >3 years. We included questions on the diagnosis and treatment patterns, effects, cost, and opinions of doctors on KM treatment for ISS. A frequency analysis was performed. Results. There were 58 respondents, and “heights of parents” (n = 57, 98.3%), “height, weight, and growth rate of child” (n = 55, 94.8%), and “amount of meals, digestive function” (n = 52, 89.7%) were frequently used as indicators for diagnosis and treatment. The most frequently used KM interventions were “herbal medicine” (n = 58, 100%), “acupuncture” (n = 49, 84.5%), “moxibustion” (n = 38, 65.5%), “dry cupping” (n = 26, 44.8%), and “physiotherapy” (n = 22, 37.9%). Herbal medicines were generally prescribed to tonify the spleen or kidney, and the most frequently used individual herbs were Acanthopanacis cortex, Astragali Radix, and Cervi parvum cornu. The most common acupuncture points were ST36, GB34, SP6, EX-LE5, and LI4. Conclusions. This study showed the use of KM for ISS in real-world clinical settings. In the future, well-designed clinical studies to verify the effect of KM treatment on ISS based on real-world clinical practice patterns should be actively performed.

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clinical Practice Pattern of Korean Medicine Doctors in Idiopathic Short Stature Treatment: A Survey Study

Jang

Evidence-Based Complementary and Alternative Medicine

2022

Self Cite

“…Due to various concerns, such as potential side effects and the fear of frequent injections among children and adolescents, complementary and alternative medical treatments are often sought to increase height growth [15]. Herbal medicine (HM) has been used to treat various diseases and is currently one of the most popular complementary and alternative medicines [16]. HM has been used for thousands of years in East Asia to treat growth disorders and SS.…”

Section: Introductionmentioning

confidence: 99%

“…Systematic reviews on the treatment of SS primarily focused on the effects of GH [10,[19][20][21], and currently, investigations on the effects of HM are also being conducted [16,22]. Several studies have been performed to determine the effects of combination therapy with HM and GH (CHG) for treating SS.…”

Section: Introductionmentioning

confidence: 99%

Effectiveness and Safety of Combination Therapy with Herbal Medicine and Growth Hormone Compared to Growth Hormone Monotherapy for Short Stature Children: A Systematic Review and Meta-Analysis

Shim

Ahn

Evidence-Based Complementary and Alternative Medicine

et al. 2022

Introduction. Herbal medicines (HM) and growth hormones (GH) are widely used to treat short stature (SS) in children. This systematic review aimed to evaluate the effectiveness and safety of combination therapy with HM and GH (CHG) compared to those of GH monotherapy (GHM) in children with SS. Methods. We searched 17 electronic databases from inception to 1 April 2021. Only randomized controlled trials (RCTs) were included. Two authors independently performed the selection and quality assessment of the included studies using Cochrane Handbook criteria. Relative risk (RR) was used to measure dichotomous outcomes with a 95% confidence interval (CI). Mean difference (MD) or standard MD (SMD) was used to measure continuous outcomes with a 95% CI. Results. Seven RCTs involving 455 participants with SS were included. Standard deviations in height (MD = 0.31, 95% CI: 0.24–0.38, p < 0.00001 ), and insulin-like growth factor binding protein-3 (MD = 1.39, 95% CI: 0.93–1.85, p < 0.00001 ) were significantly higher in the CHG group than in the GHM group. Growth velocity (MD = 1.82, 95% CI: 1.34–2.31, p < 0.00001 ) and insulin-like growth factor-1 (MD = 61.85, 95% CI: 55.80–67.90, p < 0.00001 ) were significantly higher in the CHG group. Adverse events were significantly lower in the CHG group (risk ratio: 0.10, 95% CI: 0.02–0.54, p = 0.007 ). However, the level of evidence was low. Conclusions. CHG demonstrated significantly better efficacy than GHM for treating SS, with a low incidence of adverse events. However, since the level of evidence is low, methodologically standardized RCTs are required to verify these results.

“…However, complementary and alternative medicine (CAM) treatment is often considered despite the following concerns: reluctance to start artificial hormone therapy at an early age, fear of potential side effects, discomfort of getting an injection every four weeks, and poorer outcomes than expected with regards to the improvement of final adult height [11]. Traditional Korean medicine (TKM) has been used for the treatment of various diseases and is currently one of the most popular CAM [12] treatments. ICPP, which accounts for the highest percentage of PP and is free from other identifiable diseases, can benefit from TKM [11].…”

Section: Introductionmentioning

confidence: 99%

Perceptions and Treatment of Precocious Puberty: A Questionnaire Survey among Caregivers in South Korea

Shim

Song

Evidence-Based Complementary and Alternative Medicine

2022

This study aims to provide the basis for developing complementary and alternative treatment approaches for precocious puberty (PP) by examining caregivers’ awareness, along with their preferences and expectations from various treatments. It included data collected between July 2019 and March 2020, from 175 caregivers of children who were undergoing or had undergone treatment for PP. The questionnaire comprised 53 questions on the awareness, acquisition of information, perceptions of treatments, and concerns about PP, as well as awareness of habit management (HM) and children’s actual habits. The collected data were analysed using the Chi-square test, t-tests, and one-way analysis of variance. The caregivers responded that PP could be recognized on the basis of breast development (79.8%) in girls and hair and body odor (73.1%) in boys. However, 86.9% of respondents were getting inaccurate information from the Internet. With respect to PP treatment approaches, 16% of respondents hoped to manage PP through conventional treatment (CT), 21.1% preferred traditional Korean medicine (TKM), and 62.3% preferred HM. Expectations of the effectiveness were highest in HM, followed by CT and TKM. Only the TKM group had statistically significant higher expectations than the nontreatment experience group (F = 4.566, p = 0.004 ). The caregivers were concerned about the side effects and high costs of CT. Around 43% of respondents had difficulties with the management of their children’s diet, 64.6% with exercise, and 57.1% with smart device usage. Clinicians should be aware of caregivers’ information acquisition patterns, preferences and expectations of various treatments, and their concerns. Considering these results, clinicians should try to establish more appropriate treatment plans for children with PP.