Complementary Medicine Research最新文献

Am Beispiel des in verschiedenen lokalen Traditionen genutzten Blutwurz, Tormentill (Potentilla erecta) wird exemplarisch eine offensichtliche Kluft zwischen üblichen indikationsgetriebenen Zulassungsverfahren und der empirischen Realität sowie dem Potential vieler Heilpflanzen aufgezeigt. Für Tormentillae rhizoma ist ein breites Spektrum an Inhaltsstoffen und das mit dem Vielstoffgemisch einhergehende Wirkprofil einer u.a. vielfältig antiinflammatorisch wirkenden, systemischen Droge experimentell belegt. Die traditionelle Empirie der dämpfenden Effekte im Entzündungsgeschehen wird dadurch plausibilisiert. Die moderne Forschung liefert also Daten für einen sinnvollen Einsatz einer gut verträglichen Heilpflanze mit vielfältigen Anwendungsmöglichkeiten für Haut und Schleimhaut (innerlich und äusserlich). Auf dem Markt gibt es aber, abgesehen von vereinzelten topischen Spezialitäten und Arzneitees, kaum Zubereitungen als zugelassene Arzneispezialität. Denn die derzeitige Praxis der Arzneimittelzulassung bevorzugt die spezifischen und organbezogenen Wirkungen und übersieht dabei das systemische Potential, die Modulationsfähigkeit dieser natürlichen Stoffgemische, wie sie durch traditionelle und empirische Belege angezeigt wird. Systemische Wirkungen zeigen ihre Stärke gerade im Zusammenspiel mit anderen Therapien insbesondere beim additiven Einsatz mit Spezifika, indem sie bestimmte Wirkungen verstärken bzw. abschwächen oder die Verträglichkeit der Spezifika erhöhen bzw. deren Nebenwirkungen abmildern. Die Kombination von spezifisch wirkenden Arzneimitteln mit solchen Systemmitteln (wie z.B. Blutwurz, Tormentill) stellt damit eine weitere Therapieoption dar, die als sinnvolle Ergänzung, wenn nicht sogar als Grundlage bei Prävention, Therapie und Lebensgestaltung zu werten ist.

Introduction: Various aspects of yoga have been researched for their psychological benefits, yet the neurological mechanisms underlying physical yoga postures (asana) remain inadequately explored due to limitations in prior neuroimaging techniques. The pre-frontal cortex (PFC) has been established as an important region of interest (ROI) concerning psychological health. Therefore, this study aimed to characterize changes in the PFC before, during and after asana by applying the functional near-infrared spectroscopy (fNIRS) mobile neuroimaging technique.

Methods: Twenty-seven healthy adults completed two 6-minute, task-independent resting-states before and after a 23-minute asana routine. With the fNIRS device positioned on the frontal region of the skull, PFC activity was measured during each asana and resting state. The block design involved alternating between three active postures and one control posture. Each active posture was performed for 30 seconds and repeated 8 times, while the control posture was held during inter-trial intervals lasting 25-30 seconds. Across the session, this block design resulted in a total of 24 active blocks (8 repetitions of each active posture) and 25 baseline blocks (control posture intervals).

Results: All three active asanas significantly increased PFC activity versus baseline, particularly in the right PFC. Furthermore, analysis of short-term changes in resting-state functional connectivity (rsFC) revealed a significant decrease, primarily in the left medial prefrontal cortex (PFC), a key region of the default mode network (DMN), an area known to exhibit heightened activity in individuals suffering from depression and anxiety Conclusion: This study provides neurological insight into the effects of yoga asana and supports fNIRS for assessing movement-based practices in real-world settings.

Introduction: The role of acupuncture in treating gastro-esophageal reflux disease (GERD) has been previously investigated; however, it's unclear whether manual acupuncture is effective for treating GERD. This study aimed to evaluate the effectiveness and safety of manual acupuncture in treating GERD.

Methods: Potentially eligible studies were identified from PubMed, Embase, Cochrane Central Registry for Controlled Trials(CENTRAL), China National Knowledge Infrastructure (CNKI), and Chinese Biomedical Literature database (Sinomed). Sensitivity analysis was conducted through excluding low-quality studies. Subgroup analysis was performed according to different proton pump inhibitors (PPIs) and treatment duration. Certainty of evidence was rated using the Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework.

Results: Based on 504 records, 12 relevant studies was included in our meta-anaysis. Trial sequential analysis confirmed that manual acupuncture improved symptom scores (mean difference [MD]=-3.43, 95% CI=-5.14 to -1.73, I2=88%, P<0.001, very low evidence) and reduced recurrence rates (risk ratio [RR]=0.32, 95% confidence interval=0.16 to 0.64, I2=0%, P=0.001, very low evidence). Although meta-analysis showed no difference in adverse events between manual acupuncture and PPIs (RR=0.38, 95% CI=0.09 to 1.58, I2=0%, P=0.18, very low evidence), TSA revealed extremely insufficient statistical power. Furthermore, the global symptom improvement rate was lower with acupuncture compared to PPIs (RR=1.22, 95%CI=1.14 to 1.30, I2=18%, P<0.001, low evidence). Sensitivity analysis demonstrated the robustness of results. Subgroup analysis suggested the therapeutic effects of manual acupuncture alone irrespective of categories of PPIs and treatment duration.

Conclusion: Manual acupuncture has the potential to alleviate the severity of symptoms and decrease the recurrence rate in patients with GERD. However, considering the efficacy of PPI therapy in significantly improving overall symptoms, along with its established safety profile and extensive clinical utilization over the years, we do not recommend manual acupuncture alone as the primary treatment for patients with GERD.

Background: The Mediterranean lifestyle is widely recognized for its role in reducing the risk of chronic diseases, including cardiovascular diseases, type 2 diabetes, and cancer. The PREVESMED questionnaire was developed to evaluate adherence to this lifestyle, integrating dietary and non-dietary behaviors. Unlike existing tools, PREVESMED incorporates underexplored elements such as eating pace, herbal tea consumption, and physical activity, providing a multidimensional approach to lifestyle assessment.

Methods: The validation of PREVESMED was carried out as part of a planned interim analysis using data collected from participants in the PREVES-ENERGY survey, a cross-sectional study targeting 1,000 adults aged 18 years and above. To assess the reliability of the PREVESMED scale, internal consistency was evaluated using Cronbach's alpha, ensuring an acceptable level of reliability. To investigate the relationships between lifestyle factors, individual questionnaire items, and adherence to Mediterranean lifestyle according to the PREVESMED scale, a correlation analysis was performed. Additionally, to identify significant predictors of better adherence, a multivariable linear regression model was utilized, highlighting key factors influencing adherence. Finally, an exploratory factor analysis (EFA) was conducted to reveal the underlying structure of the PREVESMED scale, identifying key dimensions and their contributions to the total variance.

Results: The cohort analyzed for the preliminary validation of the PREVESMED questionnaire consisted of 268 participants, in line with the protocol's planned sample size. Internal consistency analysis demonstrated acceptable reliability (Cronbach's alpha = 0.628). In the correlation analysis, the strongest associations with the total PREVESMED score emerged for physical activity, extra virgin olive oil use, and fruit/vegetable consumption, whereas daily alcohol intake showed the weakest correlation. The multivariable linear regression highlighted higher education, lower BMI, nonsmoking status, higher WHO-5 scores, and older age as significant predictors of better adherence. Exploratory factor analysis identified five factors explaining 59.32% of the total variance.

Conclusion: Our findings suggest that the PREVESMED questionnaire is a promising, multidimensional tool for evaluating adherence to a Mediterranean lifestyle, demonstrating acceptable reliability and significant associations with key health indicators. Further refinement and extended validation - encompassing test-retest reliability, weighted scoring, and biomarker correlations - will strengthen its applicability across diverse populations.

Introduction: Aromatherapy has not accrued enough evidence to be integrated into standardized clinical medicine. If high-quality evidence supports the effects of aromatherapy, it will be handled as a parallel option to standardized medical treatment. The aromatherapeutic impact of peppermint (Mentha × piperita L.) essential oil has been researched to a certain extent, such as on pain, anxiety, fatigue, or depression. Considering the rising expenditure on dementia care, the potential effects of peppermint scents on cognition have become increasingly significant. Therefore, we performed a scoping review of the studies on the impact of peppermint scents on cognition and attention.

Methods: We focused on human research, and the effects of peppermint scents were required to be inhaled. According to the inclusion criteria, searching from PubMed, Scopus, and Gale Academic OneFile, we identified a total of 115 studies. Finally, eight references were selected for review. The risk of bias was analyzed according to the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) criteria.

Results: Each reviewed reference had its own strength in investigating the effects of peppermint scents. However, as most studies have noted, the impact of peppermint scent should be assessed from multiple perspectives, including psychological, physiological, neurological, and pharmacological factors. The risk of bias was not found to be severe (high risk of bias rate: 35.7 ± 3.4%); our critical review elucidated the heterogeneity of the reviewed studies.

Conclusion: In summary, drawing a definitive conclusion at this stage is premature. Therefore, more carefully designed studies are needed to confirm this hypothesis.

Introduction: A healthy lifestyle is considered to be an important factor for healthy aging. Kneipp therapy (KT) includes a combination of hydrotherapy, herbal medicine, mind-body medicine, physical activities, and healthy nutrition. In this study, we investigated the effectiveness of KT care on activities of daily living, health, and quality of life in residents of nursing homes.

Methods: We conducted a prospective, two-armed comparative observational study to compare matched nursing homes with KT (Kneipp group) versus nursing homes with common preventive interventions (control group) over a 12-month period. Outcome measures included activities of daily living (Barthel Index), cognition (Mini-Mental State Examination [MMSE]), and quality of life (QUALIDEM; Short-Form 12 [SF-12]).

Results: We included 7 nursing homes (n = 105 residents) for the Kneipp group and 6 nursing homes (n = 69) as control. Except for Barthel Index, there were no time point-dependent differences between the groups. The Barthel Index showed a smaller difference from baseline in the control group (mean difference 0.94, 95% CI [-1.94; 3.82]) compared to the Kneipp group (-4.08, 95% CI [-6.46; -1.69]; p = 0.009) after 6 months; mean difference between groups Kneipp versus control: 5.01, 95% CI [1.25; 8.77]; p = 0.009. Pooled over the time points, the SF-12 mental health sum scale exhibited a smaller difference from baseline in the Kneipp group (-1.3, 95% CI [-3.6; 0.9]) compared to the control group (-3.8, 95% CI [-6.3; -1.4]; p = 0.027). Furthermore, the MMSE sum score decreased less in the Kneipp group compared to control (-1.1, 95% CI [-2.2, -0.1]; p = 0.033) after 12 months. A post hoc comparison of residents from both groups who received at least 30 preventive interventions monthly exhibited better values for QUALIDEM items "social relations," "social isolation," and "feeling at home."

Conclusion: This comparative observational study showed only small differences in outcome measures between the groups. The frequency of treatments may positively influence social components of behavior and well-being in residents. High-quality pragmatic randomized trials are needed for further investigations.

Background: The quality of homeopathic research studies is controversially discussed. In order to improve, the overall assessment of homeopathic studies and subsequently facilitate evidence-based clinical decision-making, we aimed to combine methodological tools for scientific rigor with tools for external and model validity into one global tool.

Method: Against the background of previous literature and the results of a preparatory survey, a first draft of a potential overarching tool was presented to an expert panel. Then, Delphi feedback rounds were conducted to elicit responses on the feasibility. The resulting preliminary tool was pilot-tested by five research experts on five randomly selected studies. After further optimization, another five studies were assessed by the same experts and another three experts tested the second version. The ratings were tested for interrater-reliability using Gwet's AC2.

Results: The appraisal tool comprises four domains. These are (1) the assessment of risk-of-bias using the Cochrane Tool, (2) the studies' credibility including the CONSORT statement and its extension on homeopathy, (3) the study interventions' coherence with homeopathic textbooks and previous research, and (4) the studies' clinical relevance. Each domain is assessed using a point system, which is then added up to an overall score. The instrument was evaluated as useful and "easy to apply" by the raters. The interrater reliability was 0.81 (95% CI 0.75-0.88) for five raters, and 0.64 (95% CI 0.49-0.79) for additional three raters in round 2, signifying good to moderate interrater reliability.

Conclusion: We have developed an applicable and reliable assessment tool for homeopathic intervention studies. Using it in systematic reviews and meta-analyses will increase their scientific value.

Introduction: Many patients with breast cancer use complementary and alternative medicine (CAM) including mistletoe preparations (Viscum album extracts, VAE). CAM alone has been associated with poor outcomes. Few, if any, confirmed breast cancer remissions have been reported with CAM treatment alone.

Case presentations: Case 1: 60-year-old female with a histologically confirmed local recurrence of hormone receptor positive (HR+) Her2/neu negative (HER2-) breast cancer 3 years after the initial diagnosis and treatment. The patient declined conventional therapies and was treated with intratumoral VAE plus intratumoral influenza vaccine (IV) and concurrent VAE-induced hyperthermia. Lumpectomy 5 months later confirmed a near pathological complete remission (near pCR). Follow-up at 3 years confirms durable remission. Case 2: 57-year-old female with histologically confirmed HR+, HER2- right sided breast cancer with 2-[18F]FDG-PET/computed tomography (CT) positive metastatic disease who declined conventional treatment. The patient was treated with 17 monthly cycles of VAE-induced hyperthermia, eight of which included intratumoral VAE, four of these eight including intratumoral IV. Almost 2 years after treatment start, a follow-up 2-[18F]FDG-PET/CT showed marked morphological and metabolic reduction of breast tumor on the right side, stable local lymph node metastases in the right axilla, complete remission of pulmonary metastases, the single bone metastasis, and the majority of hilomediastinal lymph node metastases but a new metabolic highly active left adrenal lesion.

Conclusions: Clinical studies of intratumoral VAE-influenza vaccine with concurrent VAE-induced hyperthermia in ER positive HER2/neu negative breast cancer are warranted.