Complementary Medicine Research最新文献

Introduction: Cancer patients are prone to experiencing negative emotions such as anxiety and depression after receiving chemotherapy. Research has shown that acupressure may be beneficial in relieving the anxiety and depression caused by chemotherapy, but high-quality evidence is lacking. This study was designed to systematically evaluate the efficacy of acupressure for relieving chemotherapy-induced anxiety and depression.

Methods: This review was conducted in accordance with the PRISMA framework. Four English databases (PubMed, Embase, Web of Science, and the Cochrane Library) and four Chinese databases (CNKI, Wanfang, VIP, and CBM) were searched from inception to December 31, 2022, to identify randomized clinical trials examining the use of acupressure for the treatment of chemotherapy-induced anxiety and depression. Cochrane Review Manager 5.4 and RStudio were used for the meta-analysis.

Results: This meta-analysis included 1,119 patients from 12 randomized controlled trials. We mainly compared acupressure with sham acupressure and routine nursing. The results showed that acupressure alleviated chemotherapy-induced anxiety (standardized mean difference [SMD] = -0.72, 95% confidence interval [CI] [-1.15, -0.28], p = 0.001) and depression (SMD = -0.75, 95% CI [-1.36, -0.14], p = 0.02) more effectively than sham acupressure and routine nursing.

Conclusion: This meta-analysis found that acupressure (body point) can relieve chemotherapy-induced anxiety and depression and improve the quality of life of patients. However, the current relevant literature has low quality and is highly heterogeneous, which reduces the credibility of the research results. Therefore, more rigorously designed randomized controlled trials are needed to verify these conclusions.

Introduction: The objective of this study was to evaluate the efficacy and safety of acupoint-embedded needling combined with auricular acupressure in treating simple obesity associated with spleen deficiency and dampness accumulation.

Methods: Ninety-six patients with simple obesity were randomized into two groups. The intervention group received acupoint-embedded needling and auricular acupressure, while the control group received conventional acupuncture. After 30 days, body weight, body mass index (BMI), waist circumference, blood lipid profiles, traditional Chinese medicine (TCM) syndrome scores, and metabolic markers were assessed. These included homeostasis model assessment of insulin resistance, serum leptin, high-sensitivity C-reactive protein, body fat percentage, and basal metabolic rate. Adverse events were monitored.

Results: Compared to the control group, the intervention group showed significantly greater reductions in body weight, BMI, waist circumference, total cholesterol, triglycerides, and low-density lipoprotein cholesterol, as well as increases in high-density lipoprotein cholesterol (all p < 0.05). TCM scores and metabolic indicators also showed significant improvement. The overall adverse event rate was lower in the intervention group (8.33% vs. 29.17%, p = 0.019), although individual event types showed no statistically significant difference.

Conclusion: Acupoint-embedded needling combined with auricular acupressure is an effective and well-tolerated approach for managing simple obesity associated with spleen deficiency and dampness, with benefits in weight loss, improved metabolism, and symptom relief.

Introduction: Previous studies have shown that integrative medicine (IM) is of considerable relevance from the patients' perspective. The acceptance of healthcare professionals is essential to meet patient needs and integrate IM into routine clinical practice. The aim of this study was to assess personal use and attitudes toward IM, as well as the implementation of integrative nursing (IN), among employees at a German university hospital.

Methods: A cross-sectional online study was conducted among employees at University Hospital Ulm in 2022. Univariate analysis of frequencies and cross-tabulations with chi-square tests were performed.

Results: A total of 244 employees participated in the survey, 80.7% of whom were female and 49.3% were nurses. The mean age was 38.3 ± 12.3 years. Most respondents were familiar with IM (87.3%; n = 179). Overall, 63.2% (n = 129) rated its benefit as high. A total of 26.1% (n = 54) indicated that IN had been implemented in their own work settings, while the majority (91.4%; n = 171) supported broader implementation. Interest in training and education on IN was expressed by 52.4% (n = 98). Subgroup analyses revealed statistically significant associations between age and familiarity with IM (p = 0.039), personal use of IM (p = 0.019), and the rating of its benefits (p = 0.009), as well as between work-related patient contact and interest in further IN training (p < 0.001). No significant associations were observed for sex and profession.

Conclusion: The findings indicate a high level of personal use and favorable attitudes toward IM, along with notable interest in IN among hospital employees, highlighting potential for further implementation of IM within clinical practice.

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: Cupping therapy, a traditional treatment method, has been shown to be effective in various studies. However, there have been reports of significant neurological complications following cupping therapy. This comprehensive review aimed to investigate the important and potentially severe neurological complications documented in the literature.

Summary: The review analyzed case reports and case studies published in three major databases (PubMed, Google Scholar, and Cochrane) up to June 2024. The search strategy involved a three-step process, where two traditional medicine experts independently searched for case reports and published case series, and then a 3-person committee consisting of two traditional medicine experts and a neurologist reviewed the selected articles. Out of 280 case reports and case series, 12 studies were included in the review, reporting 14 patients with neurological complications. The majority of cases (7/14) involved interventions combining cupping with other traditional medicine manual therapies. Complications reported included vascular and infectious complications, with subdural hemorrhage being the most common (4/14). Most patients (11/14) were free of underlying diseases, and all but 3 patients recovered from their complications with surgical and medical treatments.

Key messages: The study concludes that although rare, neurological complications of cupping therapy can be severe and potentially life-threatening. Therefore, it is essential for traditional medicine practitioners to be aware of these risks and take necessary precautions to prevent them. Adopting proper techniques and adhering to health guidelines can help mitigate the likelihood of complications. The creation of an international system to record and report the side effects of cupping therapy is also recommended.

Introduction: Hypertension is recognized as a modifiable risk factor for cardiovascular diseases, alongside dyslipidemia. Studies have revealed that between 15 and 31% of individuals have both hypertension and dyslipidemia. However, emerging evidence suggests that natural therapies and yoga can help manage mild increases in blood pressure. This study aimed to evaluate the impact of yogic and naturopathy treatments on lipid profiles in hypertensive patients, thereby contributing to the existing literature.

Materials and methods: A randomized controlled experiment was conducted, involving 262 hypertensive patients randomly assigned to either the study group (SG) or control group (CG). The SG, consisting of 131 individuals, received yoga and naturopathic treatments for 10 days, while the CG (n = 131) did not. The lipid profile was measured at the beginning and end of the 10 days, and they were followed up and reassessed after 9 months.

Results: The study involved a total of 262 individuals, with 111 in the SG and 125 in the CG. After the 10-day intervention period, the SG showed significant reductions in total cholesterol, triglycerides, high-density lipoprotein, low-density lipoprotein, very low-density lipoprotein, apolipoprotein-A (Apo-A), apolipoprotein-B (Apo-B), and lipoprotein-A (Lp-A) (p < 0.001) compared to the CG. Also, the change was observed after 9 months in Apo-A, Apo-B, and Lp-A significantly (p < 0.001).

Conclusion: These findings underscore the potential of naturopathic and yogic interventions in improving lipid profiles in hypertensive patients, thereby contributing to the current literature. In conjunction with conventional management, these specific interventions could be considered as a safer form of complementary therapy in the treatment of dyslipidemia among hypertensive patients. Thus, these findings hold promise for the integration of naturopathic and yogic therapies in the standard care of hypertensive patients.

Introduction: High-dose dry extract preparations of St John's wort (Hypericum perforatum) (hd-SJW) are equally effective as synthetic antidepressants (SAD) for mild to moderate depression as shown by various randomized controlled trials (RCTs). Other available preparations of SJW such as fresh plant tinctures are dosed lower and no clinical study about their effect has been published so far. The aim of this study was to evaluate the effect of a SJW fresh plant tincture (C-SJW-ft) on depressive symptoms and its tolerability in patients comparable to patients reported in hd-SJW RCTs applying the same outcome, the Hamilton Depression Scale 17 (HAM-D 17).

Methods: Prospective observational study of outpatients with mild to moderate depressive episodes (ICD-10/DSM-IV) treated with C-SJW-ft. Outcomes were HAM-D 17 change from inclusion to 6 weeks (42 days ± 7 days), percentage of responders (>50% decline), and frequency and type of adverse events. Descriptive analysis was performed. From a systematic literature review of RCTs of hd-SJW applying HAM-D 17 as efficacy outcome at 6 weeks, the characteristics of the included patient population and the outcomes were extracted for comparison (rRCTs ["reference RCTs"]).

Results: Fifty-two evaluable patients were included, 1 patient dropped out (switch to SADs). Of the 51 (per protocol [PP] "expanded") patients, 42 completed the second HAM-D 17 within 42 ± 7 days (PP "strict"). The included patient population was comparable to the 10 identified rRCTs with hd-SJW for age (51/50.6 years [mean, pp strict/pp expanded], 40.2-51.4 years [mean, rRCTs] and gender (76%/75% female [pp strict/pp expanded], 54-86% [rRCTs]). The baseline HAM-D 17 was slightly lower (PP strict: 16.4 [mean, range 9-28]; PP expanded 16.9 [9-28) compared to rRCTs (19.7-22.8). The decline of HAM-D 17 in patients treated with C-SJW-ft (baseline/end of observation period) was 49% (PP strict) and 52% (PP expanded) comparable to the decline of 45-59% in the rRCTs of hd-SJW; likewise, responders were 50% and 57% compared to 42-70%. Adverse events were lower (4%) compared to 20-39% in the rRCTs.

Conclusion: In an observational prospective patient cohort with mild to moderate depressive episodes corresponding to patients included in RCTs of hd-SJW, applying the same efficacy outcome and timeframe, C-SJW-ft showed comparable effects and good tolerability. Further clinical trials seem justified.

Background: Acupuncture is an effective adjunctive therapy for stroke and has been suggested for the treatment for acute cerebral infarction (ACI). However, there is a lack of high-quality data from randomized clinical trials. Thus, this study aims to reach a consensus to guide the clinical research and practice.

Methods: The initial project list was based on a systematic review of research evidence and a clinical problem survey conducted by a multidisciplinary team. After discussion with experts and a two-round Delphi consensus survey, the final list was optimized. Then, Likert scale of 9 points was used to measure the degree of expert consensus (1 = strongly disagree, 9 = strongly agree) and 80% of scores between 7 and 9 were defined as "agreement."

Results: A total of 30 professionals (response rate: 100%) confirmed their participation in the voting group. After two rounds of Delphi voting, a consensus was achieved including 34 items that can be broadly categorized into six aspects. According to expert consensus, acupuncture should be initiated within 6 h and the main acupoints are Shuigou (GV26), Neiguan (PC6), Hegu (LI4), and Taichong (LR3), while the auxiliary acupoints include Quchi (LI11), Waiguan (SJ5), Huantiao (GB30), Weizhong (BL40), etc. Furthermore, the adverse events of acupuncture are generally considered to be few, only subcutaneous hematoma is commonly reported.

Conclusion: This expert consensus provides recommendations for clinical research and practice in treating ACI with acupuncture. However, due to the limited clinical evidence, further exploration is needed through rigorous clinical trials.

Introduction: Liquorice (Glycyrrhiza glabra) is a traditional herbal remedy with various pharmacological activities mainly used for digestive and respiratory ailments. GutGard® is a flavonoid-rich, deglycyrrhizinated liquorice root extract and is standardized to glabridin (≥3.5% w/w), and others viz., glabrol, eicosanyl caffeate, docosyl caffeate, and total flavonoids (≥10% w/w) with glycyrrhizin (≤3.0% w/w)  as glycyrrhizin causes electrolyte imbalance, hypertension, and water retention. Hence, the objective of the current study was to assess the efficacy, safety, and tolerability of GutGard® in managing gastroesophageal reflux (GER)-related symptoms when compared to placebo.

Methods: It was a double-blind, parallel group, randomized, placebo-controlled trial with participants randomized in a 1:1 ratio to either the placebo group or GutGard® group. The duration of the interventions/treatment was for 28 days and the follow-up visits were done at day 7, day 14, day 28, and day 35. A telephonic follow-up was also done on day 21. The primary outcome measures studied was the change in the Gastroesophageal Reflux Disease-Health-Related Quality of Life and the Gastroesophageal Reflux Disease Symptom Assessment Scale.

Results: We screened a total of n = 296 participants and enrolled n = 200 participants and obtained written, informed consent from them. Participants in the GutGard® group reported a significantly better quality of life at the end of the intervention period (p = 0.014). They also reported earlier resolution of symptoms of GER as against the placebo group, especially the symptoms of heartburn (p = 0.017 on day 14 and p = 0.005 on day 28) and regurgitation (p = 0.025 on day 7, p = 0.029 on day 14, and p = 0.022 on day 28).

Conclusions: The GutGard® group showed better and earlier resolution (within 2 weeks) of symptoms of GER as against the placebo group, especially heartburn and regurgitation.

Introduction: Liquorice (Glycyrrhiza glabra) is a traditional herbal remedy with various pharmacological activities mainly used for digestive and respiratory ailments. GutGard® is a flavonoid-rich, deglycyrrhizinated liquorice root extract and is standardized to glabridin (≥3.5% w/w), and others viz., glabrol, eicosanyl caffeate, docosyl caffeate, and total flavonoids (≥10% w/w) with glycyrrhizin (≤3.0% w/w)  as glycyrrhizin causes electrolyte imbalance, hypertension, and water retention. Hence, the objective of the current study was to assess the efficacy, safety, and tolerability of GutGard® in managing gastroesophageal reflux (GER)-related symptoms when compared to placebo.

Methods: It was a double-blind, parallel group, randomized, placebo-controlled trial with participants randomized in a 1:1 ratio to either the placebo group or GutGard® group. The duration of the interventions/treatment was for 28 days and the fo