[논문]지루성 피부염의 한약 치료 효과에 대한 체계적 문헌고찰

김정윤; 장영우; 김혜경; 임승환

doi:10.6114/jkood.2018.31.3.067

지루성 피부염의 한약 치료 효과에 대한 체계적 문헌고찰
Efficacy of Herbal Medicines for the Treatment of Seborrheic Dermatitis : Systematic Review 원문보기

韓方眼耳鼻咽喉皮膚科學會誌 = The journal of Korean Medicine Ophthalmology & Otolaryngology & Dermatology, v.31 no.3, 2018년, pp.67 - 83

김정윤 (대전자생한방병원 한방안이비인후피부과) , 장영우 (대전자생한방병원 한방안이비인후피부과) , 김혜경 (대전자생한방병원 한방안이비인후피부과) , 임승환 (대전자생한방병원 한방안이비인후피부과)

초록
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목적 : 체계적 문헌고찰을 통하여 지루피부염에 한약복용의 효과와 연구의 질을 평가하기 위함. 방법 : OASIS, NDSL, EMBASE, Pubmed, Cochrane Library, CINAHL, CNKI, WANFANG, CiNii, J-STAGE를 이용하여 검색하였다. 검색은 2018년 6월 21일에 시행되었으며 P는 지루성 피부염, I는 한약 복용으로 진행하였다. 두 명의 연구자가 독립적으로 연구를 평가하고 선정하였으며, 의견이 다를 경우 제 3자가 개입하여 다수결로 결정하였다. 결과 : 중복 검색을 제외하고 총 952개의 연구가 검색되었으며 제목과 초록을 검토한 결과 897개의 연구가 제외되었다. 나머지 55개 연구의 전문을 검토한 결과 4개의 RCT연구가 최종 선정되었다. 선정된 연구는 발행연도, 대상, 중재법, 평가방법, 효과, 부작용, RoB를 통해 평가하였다. 한약 복용을 한 치료군에서 대조군에 비해 유의하게 호전을 보였으며 중대한 부작용은 없었다. 결론 : 지루성 피부염에 있어 한약 복용은 효과적이며 안전성이 있는 하나의 치료법이다. 향후 다양하고 체계적인 RCT의 시행이 요구된다.

주제어

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문제 정의

Moreover, recent researches on seborrheic dermatitis, reporting the effect of taking the herbal medicine takes majority. As a result, the purpose of this study was to investigate the effects of taking herbal medicine to external lesion which is seborrheic dermatitis, and to evaluate the quality of research. A total of 4 RCTs articles were collected from Korean and abroad patients with seborrheic dermatitis.
The purpose of this study was to evaluate the effect of herbal medicine intake on seborrheic dermatitis and the quality of the study. The conclusions of this study are as follows.

제안 방법

All four studies evaluated using different methods based on the number of lesions, the shape of the lesion, and subjective symptoms, etc. Currently, the seborrheic dermatitis is diagnosed by its distinguishing symptom of erythema and scale, and if necessary, serum zinc level, HIV test are examined for differential diagnosis¹⁾.
Data extraction was done by summarizing the year of publication, subject, treatment intervention procedure, evaluation method, treatment effect and side effect report.
refer to 《Clinical disease diagnosis based on cure improvement criteria(临床疾病诊断依据治愈好转标准)》, ‘cured’ for skin lesions disappear, returned to normal, ‘improve’ for most of the lesions disappeared and occasionally new skin appeared, and ‘invalid’ for no significant changes in lesions before and after treatment. Evaluated for 2 weeks, 4 weeks, and 6 weeks.
This study investigated the use of herbal medicine as an alternative treatment for seborrheic dermatitis by extensively reviewing related literatures. The purpose of this study is to evaluate the safety and efficacy of taking herbal medicine as seborrheic dermatitis treatment and to provide database for the further study including establishing clinical practise guidelines. Furthermore, this study is written in English in order to identify the global trends and provide reliable baseline data that so can be widely used in the field of alternative medicine worldwide in the future.
05). This study also evaluated the recurrence rate at 2 weeks and 4 weeks after treatment. The recurrence rate was investigated into 30 patients in the treatment group and 25 patients in the control group, compared with 42 patients in the treatment group and 40 patients in the control group at the start of the study.

대상 데이터

Search results were OASIS 15, NDSL 79, EMBASE 256, Pubmed 553, Cochrane Library 6, CINAHL 7, CNKI 70, WANFANG 116, CiNii 13, and J-STAGE 5. A total of 952 studies were found, excluding duplicates.
The study selection was undertaken by two review authors (KJY, JYW). The first selection was made after screening the title and abstract of articles found in the search, and after screening the full text, the second selection was done.

성능/효과

2. Herbal medicine taken to treat seborrheic dermatitis are Cheongyeolliseubryanghyeol-tang (Qingrelishiliangxie-tang), Sopung-san gagam (Xiaofeng-san jiajian), Sahwang-san gagam (Xiehuang-san jiajian), Meinuoping-keli, Bihaesamsseup-tang gagam(Bibishenshi-tang jiajian), all four studies have been focused on damp-heat inside body due to stress and dietary imbalance as the cause of seborrheic dermatitis.
3. All of the selected studies used different assessment scales which in need for standardized measures of diagnose and evaluation of seborrheic dermatitis.
5. There were no adverse effects in one study of 100 subjects, in a study of 82 subjects, 17 adverse effects were reported and in a study of 200 subjects, 8 adverse effects was reported. One study in which had no reports of side effects.
6. In risk of bias assessment using RoB, there was lack of checking selection bias, performance bias, and detection bias. The quality of the RCTs should be improved by referring and confirming the items described in the further RCTs.
All four studies reported similarity between the control and treatment group baseline values as the bias risk was assessed as ‘low risk’.
As a result, it was concluded that the use of herbal medicine intake for seborrheic dermatitis could be a good alternative for the treatment of seborrheic dermatitis. In addition, it seems to be possible to increase the effectiveness treating seborrheic dermatitis through applying suitable for each individual by the differentiation of symptoms of Korean medicine.
As a result, the total efficacy rate was higher in the treatment group than in the control group, and the difference between the two groups was statistically significant(P <0.05).
In the 6 weeks treatment, 89.5% of the treatment group, 66.4% of the control group showed the effect, and the total efficacy was 89.5% at the treatment group, 66.4% at the control group, that the difference was statistically significant(P <0.05).

후속연구

However, in the final selection, there was no mention of selection bias, performance bias, and detection bias. For the further clinical trials, high quality study is required through clarifying the random sequence generation, allocation concealment, and blinding of participants and personnel.
The purpose of this study is to evaluate the safety and efficacy of taking herbal medicine as seborrheic dermatitis treatment and to provide database for the further study including establishing clinical practise guidelines. Furthermore, this study is written in English in order to identify the global trends and provide reliable baseline data that so can be widely used in the field of alternative medicine worldwide in the future.

참고문헌 (23)

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Kim MG, Hwang MJ. Three Cases of Seborrheic Dermatitis Treated by Hwangryunhaedok-tang gagambang. J Korean Med Ophthalmol Otolaryngol Dermatol. 2014;27(1):140-8.

원문보기 상세보기
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상세보기
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