Complementary therapies in medicine最新文献

Background: Conventional treatments for cardiometabolic diseases face limitations related to cost, efficacy, and side effects. Hibiscus sabdariffa (HS) is a common food product and a potential alternative. However, previous studies have shown inconsistent results and lacked assessments of result certainty, intervention safety, and subgroup analysis credibility. This study evaluated the efficacy and safety of HS on blood pressure (BP), lipid profiles, glycemic control, anthropometric parameters, inflammatory markers, oxidative stress indicators, and liver enzymes.

Methods: To conduct this umbrella review, a systematic search of eligible meta-analyses was performed up to May 2024. The random-effects model was used to synthesize results from individual trials. Quality, certainty, and credibility of evidence were evaluated using the Cochrane Risk of Bias tool, AMSTAR-II, GRADE, and ICEMAN frameworks.

Results: Data from 26 randomized controlled trials involving 1,797 participants revealed that HS dose-dependently reduced systolic and diastolic BP compared to placebo and other teas. Although no significant differences were found between HS and antihypertensive drugs, HS showed moderate credibility for therapeutic BP reduction (>10mmHg), especially in individuals over 50 years, in trials lasting over four weeks, and in those with a low risk of bias. HS also reduced total cholesterol, LDL-C, fasting blood glucose, and increased HDL-C. A minor, clinically insignificant increase in aspartate aminotransferase was observed without elevating adverse event risks.

Conclusions: HS showed BP-lowering effects comparable to antihypertensive drugs and beneficial impacts on lipid and glycemic profiles. Although HS is generally considered safe, long-term and therapeutic dosing safety requires careful monitoring.

Background: Many individuals with depression explore complementary and alternative medicine, including spiritual healing. This pilot randomized controlled trial (RCT) aimed to assess the feasibility of a study that integrated spiritual healing with standard care versus standard care alone for adults with moderate depression.

Method: In this pilot RCT with two parallel groups, 28 adult patients with depression were randomized to receive either spiritual healing alongside usual care (n=14) or usual care alone (n=14). The healing session was highly individualized. The healer positioned her hands over various areas of the client's body (head, chest, knee, hip, and feet) intending to adjust the energy flow within the client. Outcomes were measured by changes in the Beck Depression Inventory for Primary Care (BDI) scores pre-and post-intervention. Participants' experiences with spiritual healing were explored through semi-structured interviews, and data were analyzed using direct content analysis.

Results: The BDI scores captured significant changes in depression severity, with the intervention group showing the greatest mean difference from baseline (BDI 23.0) to week 16 (BDI 14.9), compared to the control group which worsened from baseline (BDI 24.2) to week 16 (BDI 26.7). In addition, participants expressed satisfaction with the study components and procedures, and all completed the questionnaires at designated times. Recruiting from clinical practice proved suboptimal due to conflicts with primary care physicians' schedules leading to fewer participants in the study than planned. Measures to minimize loss to follow-up were effective.

Conclusion: Spiritual healing may be a beneficial option for individuals who suffer from moderate depression. The participants in this study were satisfied with the spiritual healing treatment, and adherence rates were high. Future RCTs should consider recruiting participants through different avenues to enhance research feasibility to alleviate the burden on family care physicians' offices.

Objectives: The current study aimed at investigating the efficacies of probiotics in alleviating the symptoms of irritability/emotional lability in individuals with a neurodevelopmental condition.

Methods: Randomized placebo-controlled trials were identified through searching major electronic databases from inception to December, 2023. The outcome of interests included improvements in the symptoms of irritability/emotional lability. Outcomes were quantitatively expressed as effect size (ES) based on standardized mean difference (SMD) with 95% confidence interval (CI).

Results: Seven studies with 1479 participants were included in this meta-analysis. The primary results revealed a significant improvement in the symptoms of irritability/emotional lability in individuals with neurodevelopmental conditions receiving probiotics compared with the placebos (SMD= -0.17, p=0.03). Subgroup analyses demonstrated an association between a significant improvement in the symptoms of irritability/emotional lability and the use probiotics relative to placebos only in studies using multiple-strain probiotics (SMD=-0.19, p=0.04, three studies with 452 participant) but not in those adopting single-strain regimens.

Conclusions: Our study supported the use of probiotics for alleviating the symptoms of irritability/emotional lability in individuals with neurodevelopmental conditions, mainly in those receiving multiple-strain probiotics as supplements. Nevertheless, the limited number of studies targeting irritability as their primary outcomes, and most did not investigate other confounding factors such as dietary habits or consumption of other nutritional supplements may impair the robustness of evidence. Our results, which were derived from a limited number of available trials, warrant further large-scale clinical investigations for verification.

Objectives: To systematically evaluate the efficacy and safety of Baduanjin exercise in patients with knee osteoarthritis through meta-analysis. While Baduanjin exercise, a traditional Chinese exercise therapy, is part of complementary and alternative medicine, its therapeutic value for knee osteoarthritis remains uncertain due to limited supporting evidence. This study seeks to address this gap.

Methods: The study protocol has been registered in PROSPERO(CRD42024501559). A systematic review and meta-analysis were conducted by searching six databases up to January 2024 (PubMed, Cochrane Library, EBSCO, Web of Science and CNKI, and Wanfang Medical), including RCTs that assessed Baduanjin exercise for KOA treatment. Two reviewers independently selected studies, extracted data, and assessed risk of bias using the Cochrane Risk of Bias tool (RoB2). Meta-analyses were performed using RevMan version 5.4.1 software. The outcome indicators included the WOMAC knee pain score, stiffness score, and physical function score, as well as the total score and adverse events. For summary results, weighted mean difference (MD) and 95 % confidence intervals (CI) were used.

Results: Twelve RCTs involving 846 participants were included. Baduanjin exercise significantly improved WOMAC pain score (MD=-2.59, 95 % CI: -4.20 to -0.97, P = 0.002), stiffness score (MD=-2.42, 95 % CI: -3.75 to - 1.08, P = 0.004), physical function score (MD=-4.42, 95 % CI: -5.67 to -3.17, P < 0.00001), and total score (MD=-11.27, 95 % CI: -14.26 to -8.28, P < 0.00001) compared to controls. Subgroup analyses revealed significant improvements regardless of intervention duration, frequency, or location. No adverse events were reported. However, high heterogeneity and methodological biases were observed.

Conclusion: Baduanjin exercise appears to be an effective and safe complementary therapy for improving pain and function in patients with KOA. High-quality RCTs are needed to confirm these findings and explore optimal intervention parameters. Future research should address the identified methodological limitations.

Objectives: To evaluate the acceptability of self-administered acupressure for Knee osteoarthritis (KOA) among middle-aged and older adults.

Methods: This is a mixed-method acceptability evaluation was embedded in a randomized controlled trial on self-administered acupressure for KOA. Participants received two 2-h training sessions on self-administered acupressure and were instructed to practice twice daily for 12 weeks. Quantitative data were collected using an acceptability questionnaire (n = 153) and acupressure logbooks (n = 157). Qualitative data were obtained through semi-structured interviews, including post-training (n = 13) and post-intervention focus groups (n = 13), and individual interviews with participants who dropped out (n = 5). Data were analysed using descriptive statistics and framework analysis based on the Theoretical Framework of Acceptability.

Results: The intervention had 91.7 % completion rate. Participants rated willingness to attend future sessions at 9.5/10 (SD=0.85). 57.8 % found technique education "very helpful" and 81.5 % followed the prescribed routine. Participants reported high overall acceptability of the self-administered acupressure training program, citing its practicality and potential benefits on knee pain, thigh strength, inflammation, and swelling. The minimal time and financial investment required were also appreciated. However, challenges related to personal efforts, time management, pressure from research monitoring, possible adverse events, and uncertainties with acupressure techniques were noted, leading to adherence issues. Participants expressed a need for continuous professional guidance.

Conclusion: Self-administered acupressure is highly acceptable to middle-aged and older adults with KOA due to its potential benefits and merits of minimal time and cost. Future research should focus on optimizing intervention implementation by providing professional support and efficient monitoring to address identified challenges.

Background: No single treatment is considered to be universally effective for tinnitus. Scalp acupuncture has been explored as a potential treatment.

Objective: This systematic review and meta-analysis aim to evaluate the clinical efficacy of scalp acupuncture in treating tinnitus.

Methods: A comprehensive search of relevant databases was conducted to identify randomized controlled trials comparing scalp acupuncture with a control treatment for tinnitus.The clinical efficacy rate and reduction in tinnitus severity were assessed using relative risk (RR) and standardized mean difference (SMD), respectively. Sensitivity analyses was performed to investigate sources of heterogeneity.

Results: A total of 20 research studies,with 1430 participants,were included.The systematic review and meta-analysis revealed that the scalp acupuncture groups had a significantly higher clinical effective rate compared to the control groups (RR=1.25, 95 % CI 1.16-1.35, p < 0.00001),with low heterogeneity(p = 0.27,I²=20 %).The scalp acupuncture groups and scalp acupuncture plus auxiliary acupoints groups had greater reduction in tinnitus severity compared to the control groups(SMD=-0.76,95 %CI:-1.02,-0.51,p < 0.00001;SMD:-0.93,95 %CI:-1.52,-0.33,p = 0.002, respectively),with a moderate heterogeneity(p = 0.005,I²=62 %) and a significant heterogeneity (p < 0.00001,I²=86 %) observed due to differences in study design, sample characteristics, and intervention protocols.Sensitivity analysis confirmed the stability of the results.The summary table generated through GRADEpro indicated that the certainty of evidence ranged from moderate to low.

Conclusions: Scalp acupuncture has demonstrated promising efficacy in the treatment of tinnitus compared to traditional acupuncture or pharmacotherapy. However, the current evidence is limited due to potential biases and heterogeneity across studies.Future studies should standardize protocols, ensure higher methodological rigor, and explore long-term effects to validate the findings further. The review was registered with PROSPERO (CRD42024537806):Jiadi Chen, Ruizhi Jing.Analysis of clinical effect of scalp acupuncture on tinnitus. Available from: https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024537806.

Objective: To evaluate the efficacy of non-pharmacological interventions in improving chemotherapy induced delayed nausea and vomiting symptoms using a network meta-analysis.

Methods: Four Chinese databases (CNKI, Wanfang Data Knowledge Service Platform, VIP, Sinomed) and five English databases (PubMed, Cochrane Library, Embase, Web of Science, CINAHL) were searched from the establishment of the database to April 2024. A Bayesian network meta-analysis was performed on the response rate to the improvement of chemotherapy induced delayed nausea and vomiting, as well as improvement in KPS score, under different non-pharmacological interventions by using R 4.4.0 software and the GeMTC package.

Results: A total of 58 RCTs 4081 patients were selected, involving 14 non-pharmacological interventions. The results of Meta-analysis showed that acupoint patch was identified as the most probable superior intervention in the improvement of chemotherapy induced delayed nausea and vomiting, and acupuncture was identified as the most probable superior intervention on the improvement of KPS scores.

Conclusion: Non-pharmacological interventions can serve as an effective complementary approach to managing delayed chemotherapy-induced nausea and vomiting. In particular, acupoint application may be the optimal complementary therapy to mitigate the incidence of delayed nausea and vomiting, though more high-quality, large-scale evidence is required to conclusively demonstrate the efficacy of acupuncture in enhancing the quality of life for cancer patients.

Background: Inflammatory markers play a pivotal role in schizophrenia, as they provide insight into the neuroinflammatory processes occurring in the context of the disorder. Elevated levels of these markers, particularly C-reactive protein (CRP), can indicate an underlying immune system dysregulation, potentially influencing symptom severity and progression. Recognizing these markers has led to investigate the use of probiotics as an adjuvant to improve the treatment of schizophrenia. The main objective of this study is to rigorously evaluate the efficacy of probiotics in reducing plasma levels of CRP in patients with schizophrenia.

Methods: A systematic search and meta-analysis were conducted to review randomized clinical trials following the PRISMA methodology. The following search strategy ((SCHIZO* OR PSYCHOTIC OR PSYCHOSES) AND (PROBIOTIC* OR BIFIDOBACTER* OR LACTOBACILL*)) was used for searching publications between June-December 2024 on the PubMed, Web of Science, and APA PsycINFO databases. Individual study quality was assessed with the Cochrane risk of bias (RoB2) and the certainty of total evidence was assessed with the GRADE system.

Results: The primary outcome assessed was the impact of probiotic supplementation on plasma CRP levels. Out of 78 studies initially identified, 4 were finally included in the meta-analysis. Three out four studies found a significant reduction in high-sensitivity C-reactive protein levels in the supplemented compared with the placebo group. The pooled analysis revealed a significant reduction in CRP levels with probiotic supplementation, with a standardized mean difference (SMD) of -0.46, (95% CI -0.719; -0.201; p = 0.001).

Conclusions: The synthesis and meta-analysis of available literature provide evidence for the potential role of probiotics in the reduction of serum CRP in schizophrenia compared with placebo. However, more clinical trials with better control of experimental design are needed before a clear recommendation as adjuvant therapy can be made.