[논문]범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로

김민재; 박현섭; 권찬영

doi:10.7231/jon.2023.34.4.403

[국내논문] 범불안장애의 한약 치료에 관한 체계적 문헌고찰 및 메타분석: 최근 5년 임상연구를 중심으로
Systematic Review and Meta-Analysis on Herbal Medicine for Generalized Anxiety Disorder: Focusing on Clinical Studies over the Past 5 Years 원문보기

동의신경정신과학회지 = Journal of oriental neuropsychiatry, v.34 no.4, 2023년, pp.403 - 420

김민재 (동의대학교 한의과대학 한방신경정신과) , 박현섭 (동의대학교 한의과대학 침구과) , 권찬영 (동의대학교 한의과대학 한방신경정신과)

Abstract ▼ AI-Helper

Objectives: This study investigated the effectiveness of herbal medicine for generalized anxiety disorder (GAD) based on recent clinical studies. Methods: Studies were searched through four databases. Clinical research studies on herbal medicine treatment for GAD patients were included. The studies were analyzed according to study design, diagnostic criteria, population, and intervention. A risk of bias assessment was performed to assess the quality of the included randomized controlled trials (RCT). If the intervention applied to the treatment and control groups was the same and two or more studies were reporting the same items as outcome indicators, a meta-analysis was performed. Results: A total of 19 studies, including 12 RCTs were selected. The most common pattern identification was 'Phlegm fire disturbing upward' (痰熱上擾), and the most used herb for therapeutic purposes was 'Rhizome of Poria cocos' (茯苓). Meta-analysis results of three studies showed that there were no significant differences in effectiveness between the herbal medicine intervention and the Western medicine intervention. Meta-analysis results of five studies showed that the Hamilton Anxiety Rating Scale was significantly reduced in the case of herbal medicine intervention compared to Western medicine intervention. Conclusions: The results of our study demonstrated that herbal medicine treatment for GAD is effective in alleviating anxiety symptoms and chief symptoms of GAD. However, this study has several limitations; there was a lack of placebo-controlled RCT and an absence of objective diagnostic criteria in case reports. Therefore, further well-designed clinical studies, conducted based on the results of this study, are recommended.

주제어

표/그림 (15)

그림 Fig. 1. Flow diagram preferred reporting items for review. TCM: Traditional Chinese Medicine.
그림 Fig. 2. Results of risk of bias graph.
그림 Fig. 3. Results of risk of bias graph.
그림 Fig. 4. Meta-analysis on herbal medicine: total effective rate. HM: herbal medicine, WM: Western medicine.
그림 Fig. 5. Meta-analysis on herbal medicine: HAMA. HM: herbal medicine, WM: Western medicine, HAMA: Hamilton Anxiety Rating Scale.
그림 Fig. 6. Meta-analysis on herbal medicine: SAS. HM: herbal medicine, WM: Western medicine, SAS: Self-rating Anxiety Scale.
그림 Fig. 7. Meta-analysis on herbal medicine: HAMA. HM: herbal medicine, PB: Placebo, HAMA: Hamilton Anxiety Rating Scale.
표 Table 1. The Frequency of TCM Pattern Identification
표 Table 2. The Frequency of Herbs Used in Studies
표 Table 3. Randomized Controlled Trials on Generalized Anxiety Disorder
표 Table 3. Continued 1
표 Table 4. Case Reports on Generalized Anxiety Disorder
표 Table 5. Interventions on Generalized Anxiety Disorder
표 Table 5. Continued 1
표 Table 5. Continued 2

참고문헌 (37)

National Institute for Korean Medicine Development. Clinical Practice Guideline of Korean Medicine for Anxiety Disorders. 2021:68-70.
Stein DJ, Kazdin AE, Ruscio AM, Chiu WT, Sampson NA, Ziobrowski HN, et al. Perceived helpfulness of treatment for generalized anxiety disorder: a World Mental Health Surveys report. BMC Psychiatry. 2021;21(1):392.
HIRA, Bigdata Open portal. Available from: URL: https://opendata.hira.or.kr/op/opc/olap4thDsInfoTab1.do
Hoffman DL, Dukes EM, Wittchen HU. Human and economic burden of generalized anxiety disorder. Depress Anxiety. 2008;25(1):72-90.

상세보기
Bandelow B, Werner AM, Kopp I, Rudolf S, Wiltink J, Beutel ME. The German Guidelines for the treatment of anxiety disorders: first revision. Eur Arch Psychiatry Clin. Neurosci. 2022;272(4):571-82.

상세보기
Hansen AH, Kristoffersen AE. The use of CAM providers and psychiatric outpatient services in people with anxiety/depression: a cross-sectional survey. BMC Complement Altern Med. 2016;16(1):461.
National Evidence-based Healthcare Collaborating Agency. NECA's guidance for undertaking systematic reviews and meta-analyses for intervention. 2020:78-85.
Li LY. Clinical observation on TCM syndrome differentiation in the treatment of generalized anxiety disorder. Journal of Clinical Medical Literature. 2019;6(07):14,16.
Wang WX, Chen J, Rong LY, Yang ZQ, Xian SX. Clinical Observation of Wendan Tablets in Treatment of Generalized Anxiety Disorder with Phlegm-heat Disturbance Syndrome. Journal of Guangzhou University of Traditional Chinese Medicine. 2019;36(11):1679-83.
Wang QL. Analysis of the clinical efficacy of modified Xiaoyao Powder in the treatment of patients with generalized anxiety disorder due to liver stagnation and spleen deficiency. Everyone Health. 2019;17:32.
Xiong H, Guo RJ. Clinical effect observation of Ningxin Anshen Formula in the treatment of mild to moderate generalized anxiety disorder. China Journal of Traditional Chinese Medicine and Pharmacy. 2019;34(06):2803-6.
Liu WJ, Li QQ. Application of TCM syndrome differentiation nursing in elderly patients with generalized anxiety disorder. Clinical Journal of Chinese Medicine. 2019; 11(24):26-7.
Sun MY, Lou MF, Wang JH. Clinical Observation of Bupleurum Plus Dragon Bone Oyster Soup in the Treatment of Generalized Anxiety Disorder. Journal of Zhejiang Chinese Medical University. 2019;43(06):595-8.
Jiang XY, Xu HY, Zhou HF, Guo QW. Observation on the efficacy of Suanzaoren Decoction in the treatment of 30 cases of generalized anxiety disorder due to yin deficiency and fire exuberance. Journal of North Pharmacy. 2020;17(01):83-4.
Diao HQ. Tang QS, Shao J, Tian HL, Ding HY, Wei D, Li XL. Effect of modified Huanglian Ejiao Decoction on treatment of 42 cases of generalized anxiety disorder in community. Beijing Journal of Traditional Chinese Medicine. 2020;39(12):1225-8.
Huang HY. Clinical Effect of Jingxin Anshen Decoction on Generalized Anxiety Anxiety Disorder. Guide of China Medicine. 2020;18(14):182-3.
Zhao Q, Huang J, Lu N, Wang XY, Zhan SQ, Hu YD, et al. Efficacy and safety of Jiuwei Zhenxin granule on the treatment of generalized anxiety disorder. China Medicine. 2022;17(07):1070-3.
Bao S. Study on the clinical efficacy of Jingxin Anshen Decoction in the treatment of generalized anxiety disorder of Qi stagnation and fire type. Electronic Journal of Clinical Medical Literature. 2020;7(18):34.
Liu Y. Analysis of the effect of modified Guipi Decoction in the treatment of generalized anxiety disorder of heart and spleen deficiency type. Health for Everyone. 2020(05): 276.
Jiang ZY, Wang ZL. New explanation of Bupleurum Guizhi Ganjiang Decoction in the treatment of generalized anxiety disorder. Shandong Journal of Traditional Chinese Medicine. 2020;39(11):1248-51.
Ru C, Li X, Xu J, Wang YQ, Zhang TT, Liu M. A case report on treatment of generalized anxiety disorder by differentiation of symptoms and signs. Journal of Tianjin University of Traditional Chinese Medicine. 2020;39(03): 312-5.
Wang YJ, Wang X, Jia MY, Zhao JJ. 2 cases of Professor Zhao Jianjun's treatment of generalized anxiety disorder. Cardiovascular Disease Electronic Journal of Integrated Traditional Chinese and Western Medicine. 2020;8(01): 187.
Yang SS, Wang JY, Liu XC. LIU Xinchun's Understanding and Treatment of Pathogenesis of General Anxiety Disorder in Young and Middle-aged. Journal of Practical Traditional Chinese Internal Medicine. 2020;34(12):57-60.
Yue TT, Du SH, Li L, He ZY, Zhu YX, Yang H. Du Shaohui treats generalized anxiety disorder based on the theory of "Too little intercourse produces Jueyin" of Qiantang Medical School. Guiding Journal of Traditional Chinese Medicine and Pharmacy. 2021;27(12):170-2,187.
Liu HX, Zhao J. Brief Talk on Treating Generalized Anxiety Disorder with the Method of Supporting Yang by Classic Prescriptions. Clinical Journal of Traditional Chinese Medicine. 2021;33(10):1900-3.
Liu HX, Liang X, Shen W, Wei JJ, Liu Y, Chi XS, et al. Zhang Yunling's experience in treating generalized anxiety disorder with six methods. Shanghai Journal of Traditional Chinese Medicine. 2022;56(10):29-32,52.
Zheng X. Guiding Principles for Clinical Research of New Traditional Chinese Medicines. Beijing : China Medical Science and Technology Press. 2002.
Seoul national college of medicine. The Epidemiological Survey of Mental Disorders in Korea. Ministry of health and welfare. 2021:56-7.
Wittchen HU, Kessler RC, Beesdo K, Krause P, Hofler M, Hoyer J. Generalized anxiety and depression in primary care: prevalence, recognition, and management. J Clin. Psychiatry. 2002;63(8):24-34.
Bandelow B, Baldwin D, Abelli M, Bolea-Alamanac B, Bourin M, Chamberlain SR, et al. Biological markers for anxiety disorders, OCD and PTSD: A consensus statement. Part II: Neurochemistry, neurophysiology and neurocognition. World J Biol Psychiatry. 2017;18(3):162-214.

상세보기
Chinese Association of Integrative Medicine, China Association of Chinese Medicine, Chinese Medical Association. Guidelines for the diagnosis and treatment of generalized anxiety disorder with integrated traditional Chinese and Western medicine. Modern Chinese Clinical Medicine. 2023;30(06):21-7,35.
Park DM, Kim SH, Park YC, Kang WC, Lee SR, Jung IC. The comparative clinical study of efficacy of GamisoyoSan (Jiaweixiaoyaosan) on generalized anxiety disorder according to differently manufactured preparations: Multicenter, randomized, double blind, placebo controlled trial. Journal of Ethnopharmacology. 2014;158:11-7.
Yang XY, Yang NB, Huang FF, Ren S, Li ZJ. Effectiveness of acupuncture on anxiety disorder: a systematic review and meta-analysis of randomised controlled trials. Ann Gen Psychiatry. 2021;20(1):9.
Park DM, Lee SR, Kang WC, Jung IC. Preliminary Study to Develop the Instrument of Pattern Identication for Jing Ji and Zheng Chong. Journal of oriental neuropsychiatry. 2010;21(2):1-15.
Choi WC, Lee HS Seo BN, Kang WC, Jung IC. A Study to Assess the Reliability and Improvement of the Instrument of Pattern Identication for Jing Ji and Zheng Chong. Journal of Oriental Neuropsychiatry. 2014;25(4):371-82.
Zhu KY, Mao QQ, Ip SP, Choi RC, Dong TT, Lau DT, et al. A standardized chinese herbal decoction, kai-xin-san, restores decreased levels of neurotransmitters and neurotrophic factors in the brain of chronic stress-induced depressive rats. Evid Based Complement Alternat Med. 2012;2012:149256.

상세보기
Yang L, Shergis JL, Di YM, Zhang AL, Lu C, Guo X, et al. Managing Depression with Bupleurum chinense Herbal Formula: A Systematic Review and Meta-Analysis of Randomized Controlled Trials. J Altern Complement Med. 2020;26(1):8-24.

상세보기

표제어: PCR

동의어: Packet Collision Rate

용어 설명 출처 목록 (6)

용어 설명: PCR은 세균 특이성이 있는 primer를 이용하여 적은 수의 세균이 있을지라도 쉽게 검출할 수 있는 유용한 방법이며, 이를 이용하여 구강 내 치면세균막이나 타액에서 직접 세균을 검출할 수 있게 되었다[8].

내보내기 구분	파일저장 인쇄 메일전송
구성항목	기본정보 상세정보 관리번호, 논문명, 저널/프로시딩명, 저자 , 발행년, 권, 호, 시작페이지, 끝페이지, 발행기관 관리번호, 논문명, 대등논문명, 저자 , 저널/프로시딩명, 발행기관, 발행년, 발행언어, 권, 호, 시작페이지, 끝페이지, ISBN, ISSN, 주제분야, 키워드, 초록(한글), 초록(영문), 저자(소속기관)
저장형식	Text(ASCII format) Excel format RefWorks Direct Export RIS format (for Reference Manager, ProCite, EndNote), Scholar's Aids, Mendeley
메일정보	받는사람 (필수) @ 보내는사람 (선택) @ 제목 내용 KISTI 검색결과 이메일 서비스
안내	총 건의 자료가 검색되었습니다. 다운받으실 자료의 인덱스를 입력하세요. (1-10,000) 검색결과의 순서대로 최대 10,000건 까지 다운로드가 가능합니다. 데이타가 많을 경우 속도가 느려질 수 있습니다.(최대 2~3분 소요) 다운로드 파일은 UTF-8 형태로 저장됩니다. 파일의 내용이 제대로 보이지 않을실 때는 웹브라우저 상단의 보기 -> 인코딩 -> 자동선택 여부를 확인하십시오. ~ Text(ASCII format) Excel format

연합인증