Complementary therapies in medicine最新文献

Assessing the safety of herbal medicine use among type 2 diabetes mellitus patients: A systematic review and meta-analysis 评估2型糖尿病患者使用草药的安全性：一项系统综述和荟萃分析。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-01-13 DOI: 10.1016/j.ctim.2026.103319

Emna Boulares , Nicola Luigi Bragazzi , Tan Sabrina Chen Yin , Soo Jeung Choi , Jung Hwan Park , Dongwoon Han

Background

Herbal medicines (HM) use among type 2 diabetes mellitus (T2DM) patients has grown tremendously despite the existence of conventional treatments. However, evidence on their safety, potential side effects, and interactions remains scarce. This systematic review and meta-analysis aim to determine the global prevalence of HM use among T2DM patients and assess the safety and potential interactions.

Methods

A systematic search of four electronic databases was conducted until March 2024. Data were extracted and then assessed through an adapted quality appraisal tool. A meta-analysis estimated the pooled prevalence of HM use among T2DM patients and examined predictors of use. Identified herbs were classified based on safety and potential interactions with pharmacological treatments. The study followed PRISMA guidelines.

Results

Twenty-two cross-sectional studies from 19 countries were included. The global prevalence of HM use among T2DM patients was 53%, with significant regional variations. The highest prevalence of HM use among T2DM patients is in the African region, accounting for 39.8% of global HM use. Among 49 identified herbs, Opuntia ficus-indica L., Trigonella foenum graecum L., Allium sativum L., and Cinnamomum verum J. were the most commonly used. The safety classification reported 7 contraindicated herbs and 19 requiring caution, and 23 considered safe for use. Additionally, 12 herbs reported potential pharmacological interactions.

Conclusions

Although the use of HM is widespread globally, multiple herbs pose safety concerns. Therefore, to preserve patients’ safety, it is essential to avoid using contraindicated herbs and to seek healthcare practitioner supervision.

背景：尽管存在传统治疗方法，但2型糖尿病（T2DM）患者中草药（HM）的使用仍大幅增长。然而，关于它们的安全性、潜在副作用和相互作用的证据仍然很少。本系统综述和荟萃分析旨在确定T2DM患者使用HM的全球患病率，并评估其安全性和潜在的相互作用。方法：系统检索5个电子数据库，检索截止至2024年3月。提取数据，然后通过适应的质量评估工具进行评估。一项荟萃分析估计了T2DM患者中HM使用的总流行率，并检查了使用的预测因素。确定的草药根据安全性和与药物治疗的潜在相互作用进行分类。该研究遵循PRISMA指南。结果：纳入了来自19个国家的22项横断面研究。T2DM患者中HM使用的全球患病率为53%，具有显著的地区差异。2型糖尿病患者中HM使用率最高的地区是非洲地区，占全球HM使用率的39.8%。经鉴定的49种草本植物中，最常用的是榕树油桐（Opuntia ficus-indica L.）、梧桐（Trigonella Foenum Graecum L.）、葱（Allium sativum L.）和肉桂（Cinnamomum verum J.）。安全分类报告了7种禁忌症草药，19种需要注意，23种被认为是安全的。此外，12种草药报告了潜在的药理相互作用。结论：虽然HM在全球广泛使用，但多种草药存在安全问题。因此，为了保护患者的安全，必须避免使用禁忌症草药，并寻求保健医生的监督。

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引用次数: 0

Influence of acupuncture and moxibustion on postoperative gastrointestinal dysfunction among patients with gastrointestinal cancer: A network meta-analysis 针灸对胃肠道肿瘤患者术后胃肠功能障碍的影响：一项网络荟萃分析

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-16 DOI: 10.1016/j.ctim.2026.103331

Yudi Wu , Xiuxiu Li , Xinwei Tan , Jing Tan , Xiaorong Chang

Objective

This study aims to evaluate and compare the relative efficacy and safety of acupuncture and moxibustion interventions for the recovery of gastrointestinal function and the incidence of adverse reactions after gastrointestinal cancer (GIC) surgery.

Methods

Eight databases were retrieved up to July 2025. The observation indicators included: time to first flatus, defecation, food intake, and bowel sound; incidence of postoperative adverse reactions (nausea and vomiting, abdominal distension and diarrhea, and ileus); and clinical efficacy rate. Risk of bias was assessed using the Cochrane RoB 2.0 tool. Statistical analysis was conducted via Bayesian network meta-analysis implemented in R. Intervention efficacy was quantitatively ranked using the surface under the cumulative ranking curve (SUCRA), with relevant diagrams generated in Stata (version 18.0).

Results

In total, 43 randomized controlled trials (RCTs) were included in this study, involving 4019 patients, to evaluate the efficacy of 10 interventions of acupuncture and moxibustion. The network meta-analysis revealed that electroacupuncture was the most effective in shortening the time to first flatus after surgery (MD = −3.8, 95 % CI [-7.06, −0.61]) and the time to first defecation (MD = −4.97, 95 % CI [-9.61, −0.41]) (SUCRA = 75.1 %, SUCRA = 77.2 %). Parallel needling method (MD = −4.83, 95 % CI [-8.16, −1.45]) performed best in lessening the time to first postoperative bowel sound (SUCRA = 92.1 %). All interventions failed to significantly shorten the time to first food intake after surgery. In terms of clinical efficacy rate, moxibustion (MD = 1.54, 95 % CI [1.08, 2.3]) showed the best performance in ameliorating the overall clinical efficacy rate after surgery (SUCRA = 89.5 %). Thumbtack needle exerted the best effect in decreasing postoperative nausea and vomiting (RR = 6.7, 95 % CI [0.18, 269.63]) and abdominal distension and diarrhea (RR = 5.78, 95 % CI [1.07, 34.89]) (SUCRA = 76.1 %, SUCRA = 89.6 %).

Conclusion

Acupuncture and moxibustion therapy, as an adjunctive therapy, has exhibited favorable efficacy and safety in treating POGD related to GICs. RCTs of high quality are warranted to further ascertain these findings in the future.

PROSPERO Registration number

CRD42025111427

目的：本研究旨在评价和比较针灸干预对胃肠癌（GIC）术后胃肠功能恢复的相对疗效和安全性以及不良反应的发生率。方法：检索截至2025年7月的8个数据库。观察指标包括：首胀时间、排便时间、进食量、肠声；术后不良反应（恶心呕吐、腹胀腹泻、肠梗阻）的发生率；临床有效率。使用Cochrane RoB 2.0工具评估偏倚风险。统计分析采用r中实施的贝叶斯网络元分析，采用累积排序曲线下曲面（SUCRA）对干预效果进行定量排序，相关图表在Stata（18.0版本）中生成。结果：本研究共纳入43项随机对照试验（RCTs），共纳入4019例患者，对10项针灸干预措施的疗效进行评价。网络荟萃分析显示，电针在缩短术后首次放屁时间（MD = -3.8, 95% CI[-7.06, -0.61]）和首次排便时间（MD = -4.97, 95% CI [-9.61, -0.41]）（SUCRA = 75.1%, SUCRA = 77.2%）方面最有效。平行针刺法（MD = -4.83, 95% CI[-8.16, -1.45]）在缩短术后首次肠鸣时间方面表现最佳（supra = 92.1%）。所有干预措施均未能显著缩短手术后首次进食的时间。在临床有效率方面，艾灸（MD = 1.54, 95% CI[1.08, 2.3]）在改善术后总临床有效率方面表现最佳（SUCRA = 89.5%）。图钉针在减少术后恶心呕吐（RR = 6.7, 95% CI[0.18, 269.63]）和腹胀腹泻（RR = 5.78, 95% CI[1.07, 34.89]）方面效果最好（supra = 76.1%, sura = 89.6%）。结论：针灸作为辅助疗法治疗GICs相关POGD具有良好的疗效和安全性。高质量的随机对照试验有必要在未来进一步确定这些发现。普洛斯彼罗注册号：CRD42025111427。

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引用次数: 0

Effectiveness comparisons of acupoint stimulation therapies for irritable bowel syndrome: A Bayesian network meta‑analysis 穴位刺激治疗肠易激综合征的疗效比较：贝叶斯网络meta分析。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-16 DOI: 10.1016/j.ctim.2026.103332

Jun Zhou , Lamichhane Narendra , Yi Guo , Jing Huang , Jiaqi Wang , Jinghong Liang , Xuetong Zhang , Meidan Zhao , Zhifang Xu

Background

Irritable bowel syndrome (IBS) is a chronic functional disorder that significantly impacts patient health, causing physical discomfort and diminished quality of life. We aimed to compare various acupoint stimulation modalities for treating IBS using network meta-analysis (NMA).

Methods

We conducted a systematic search of five electronic databases (PubMed, Cochrane Central Register of Controlled Trials, Embase, Web of Science, and ClinicalTrials.gov) for randomized controlled trials (RCTs) on acupoint stimulation interventions for IBS published from inception to November 8, 2024, without language restrictions. Two authors independently performed data extraction and assessed the risk of bias. Outcomes included symptom severity and quality of life. Bayesian NMA was conducted using STATA 14.0 and Open BUGS 3.2.3.

Results

We identified 12 RCTs that included three different acupoint stimulation interventions (1839 participants)—namely, acupuncture, moxibustion, and placebo. Our NMA results showed that the three acupoint stimulation intervention therapies were effective in reducing symptom severity and improving the quality of life for patients with IBS. The most effective acupoint stimulation intervention was moxibustion, which significantly reduced symptom severity (mean difference [MD] = 101.50; 95 % credible interval [CrI]: 80.36, 122.30) and improved quality of life (MD = −19.75; 95 % CrI: −28.86, −10.75) compared to conventional medication in patients with IBS. Moreover, the adverse events of all interventions were acceptable.

Conclusions

The NMA suggests that moxibustion was the most effective modality in alleviating symptom severity and improving quality of life in patients with IBS, followed by acupuncture.

背景：肠易激综合征（IBS）是一种慢性功能障碍，严重影响患者健康，导致身体不适和生活质量下降。我们的目的是利用网络荟萃分析（NMA）比较不同的穴位刺激方式治疗肠易激综合征。方法：我们对5个电子数据库（PubMed、Cochrane Central Register of Controlled Trials、Embase、Web of Science和ClinicalTrials.gov）进行了系统检索，检索从成立到2024年11月8日发表的关于穴位刺激干预治疗IBS的随机对照试验（rct），没有语言限制。两位作者独立进行数据提取并评估偏倚风险。结果包括症状严重程度和生活质量。采用STATA 14.0和Open BUGS 3.2.3进行贝叶斯NMA分析。结果：我们确定了12项随机对照试验，包括三种不同的穴位刺激干预（1,839名参与者），即针灸、艾灸和安慰剂。我们的NMA结果显示，三种穴位刺激干预疗法在减轻IBS患者症状严重程度和改善生活质量方面是有效的。最有效的穴位刺激干预是艾灸，与常规药物相比，艾灸显著降低了IBS患者的症状严重程度（平均差值[MD] = 101.50； 95%可信区间[CrI]: 80.36, 122.30），改善了患者的生活质量（MD = -19.75； 95%可信区间[CrI]: -28.86, -10.75）。此外，所有干预措施的不良事件都是可以接受的。结论：NMA表明，艾灸是缓解IBS患者症状严重程度和改善生活质量最有效的方式，其次是针灸。

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引用次数: 0

Physical activity recommendations for pregnant women with gestational diabetes mellitus: A best evidence synthesis 妊娠期糖尿病孕妇的体育锻炼建议：最佳证据综合。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-19 DOI: 10.1016/j.ctim.2026.103327

Yue Peng , Wei Zhu , Yan Pu , Yuyang Wang , Yan Wang , Biru Luo

Background

A gap persists between recommendations and actual implementation of physical activity management for gestational diabetes mellitus (GDM), largely due to the limitations in the existing evidence. The objective of this study was to systematically identify and synthesize the available evidence regarding physical activity management for pregnant women with GDM.

Methods

A best-evidence synthesis was performed. Structured literature searches were conducted using the 6S model across selected evidence-based healthcare databases. Evidence extraction and synthesis followed the Joanna Briggs Institute’s (JBI) development process. The JBI Levels of Evidence (2014 edition) was applied to classify evidence levels, and the JBI Grades of Recommendation (2014 edition) was used to assign recommendation levels to each included piece of evidence.

Results

A total of 31,527 articles were identified, of which 7,936 were duplicates. After screening 23,591 titles and abstracts, 288 full-text articles were retrieved for eligibility assessment. Ninety-seven studies underwent quality assessment. Ultimately, 26 guidelines, 6 experts’ consensus, 19 systematic reviews, and 16 original studies were included for evidence extraction. Forty-seven distinct pieces of evidence were summarized across eight key aspects: assessment,exercise prescription, exercise timing, blood glucose management during exercise, sedentary and daily activities, health education, exercise promotion strategies, training, and effect evaluation.

Conclusion

Updating the limited evidence on the strategies to reduce sedentary behavior and the benefits and risks of different exercise methods would improve a better physical activity management in pregnant women with GDM.

Contribution of the paper

This study summarized the evidence on physical activity management in pregnant women with GDM.

背景：由于现有证据的局限性，妊娠期糖尿病（GDM）体力活动管理的建议与实际执行之间存在差距。本研究的目的是系统地识别和综合目前可获得的关于GDM孕妇身体活动管理的证据。方法：进行最佳证据综合。在选定的循证医疗数据库中使用6S模型进行结构化文献检索。证据提取和合成遵循了乔安娜布里格斯研究所（JBI）的发展过程。使用《JBI证据等级（2014版）》对证据等级进行分类，使用《JBI推荐等级（2014版）》对每条纳入的证据分配推荐等级。结果：共检出31 527篇，其中重复7 936篇。在筛选了23591篇标题和摘要后，检索了288篇全文文章进行合格性评估。97项研究进行了质量评估。最终纳入了26项指南、6项专家共识、19项系统综述和16项原始研究作为证据提取。研究人员从八个方面总结了47个不同的证据：评估、运动处方、运动时间、运动期间的血糖管理、久坐和日常活动、健康教育、运动促进策略、训练和效果评估。结论：更新关于减少久坐行为的策略以及不同运动方法的利弊的有限证据，将为GDM孕妇提供更好的身体活动管理。论文贡献：本研究总结了妊娠期糖尿病孕妇身体活动管理的相关证据。

{"title":"Physical activity recommendations for pregnant women with gestational diabetes mellitus: A best evidence synthesis","authors":"Yue Peng , Wei Zhu , Yan Pu , Yuyang Wang , Yan Wang , Biru Luo","doi":"10.1016/j.ctim.2026.103327","DOIUrl":"10.1016/j.ctim.2026.103327","url":null,"abstract":"<div><h3>Background</h3><div>A gap persists between recommendations and actual implementation of physical activity management for gestational diabetes mellitus (GDM), largely due to the limitations in the existing evidence. The objective of this study was to systematically identify and synthesize the available evidence regarding physical activity management for pregnant women with GDM.</div></div><div><h3>Methods</h3><div>A best-evidence synthesis was performed. Structured literature searches were conducted using the 6S model across selected evidence-based healthcare databases. Evidence extraction and synthesis followed the Joanna Briggs Institute’s (JBI) development process. The JBI Levels of Evidence (2014 edition) was applied to classify evidence levels, and the JBI Grades of Recommendation (2014 edition) was used to assign recommendation levels to each included piece of evidence.</div></div><div><h3>Results</h3><div>A total of 31,527 articles were identified, of which 7,936 were duplicates. After screening 23,591 titles and abstracts, 288 full-text articles were retrieved for eligibility assessment. Ninety-seven studies underwent quality assessment. Ultimately, 26 guidelines, 6 experts’ consensus, 19 systematic reviews, and 16 original studies were included for evidence extraction. Forty-seven distinct pieces of evidence were summarized across eight key aspects: assessment,exercise prescription, exercise timing, blood glucose management during exercise, sedentary and daily activities, health education, exercise promotion strategies, training, and effect evaluation.</div></div><div><h3>Conclusion</h3><div>Updating the limited evidence on the strategies to reduce sedentary behavior and the benefits and risks of different exercise methods would improve a better physical activity management in pregnant women with GDM.</div></div><div><h3>Contribution of the paper</h3><div>This study summarized the evidence on physical activity management in pregnant women with GDM.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"97 ","pages":"Article 103327"},"PeriodicalIF":3.5,"publicationDate":"2026-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146776268","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Impact of a 12-week calisthenic exercise regimen on glycaemic regulation and cardiovascular endurance in individuals with type 2 diabetes Mellitus. A randomized controlled trail 12周健美操运动方案对2型糖尿病患者血糖调节和心血管耐力的影响随机对照试验。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-17 DOI: 10.1016/j.ctim.2026.103333

Huma Khan , Kamran Ali , Tabish Fahim , Sunil Kohli , Zeinab A. Ali , Elfatih Yagoub Ali , Mastour Saeed Alshahrani , Basant Hamdy Elrefaey , Nasrin Mansuri , Irshad Ahmad

Background and aims

Diabetes Mellitus Type 2 (T2DM) is a metabolic disorder that is becoming increasingly common and can lead to a variety of problems. The purpose of this study was to explore the effects of calisthenic training exercises for twelve weeks on glucose levels, cardiovascular endurance, and body composition in people with type 2 diabetes.

Experimental procedure

Forty subjects, aged between 30 and 75 years, diagnosed with type 2 diabetes, clinically stable participated. Participants were randomized (1:1) using computer-generated sealed envelopes with assessor blinding; one pre-intervention group switch altered final allocation. Participants were randomly allocated into two groups: intervention group (n = 21), calisthenic exercises for twelve weeks under the supervision of physiotherapist, and control group (n = 19), followed routine medical treatment. The glycated haemoglobin (HbA1c) and the fasting/random glucose levels were the primary outcomes, whereas the body mass index, blood pressure, and the 6-minute walk distance (6MWD) were the secondary. Statistical analysis paired and independent t-tests were utilized, and confidence intervals of 95% were utilized.

Results and conclusion

Total of 40 participants who met the inclusion criteria, ages between 30–75 years, 20 subjects in each interventional and control group were assigned. Result of the study indicate that the intervention group exhibited noteworthy enhancements in HbA1c (9.60 ± 1.25–6.54 ± 0.92, p < 0.001), body mass index (BMI) (26.51 ± 3.45–24.45 ± 2.98, p = 0.007), systolic blood pressure (136.38 ± 15.32–116.29 ± 12.47 mmHg, p < 0.001), and six-minutes’ walk distance (400.00 ± 48.60 m to 517.14 ± 56.12 m, p < 0.001). The results of this study indicate that structured calisthenic exercise is an efficient, low-cost, and easily accessible method for enhancing glycemic control and cardiovascular fitness in patients who have type 2 diabetes.

背景和目的：2型糖尿病（T2DM）是一种越来越常见的代谢性疾病，可导致多种问题。这项研究的目的是探讨12周的健美操训练对2型糖尿病患者血糖水平、心血管耐力和身体成分的影响。实验程序：40名受试者，年龄在30 -75岁之间，诊断为2型糖尿病，临床稳定。参与者被随机分配（1:1），使用电脑生成的密封信封，评估员盲法；一个干预前组的开关改变了最终的分配。参与者被随机分为两组：干预组（n = 21），在物理治疗师的指导下进行12周的健美操练习；对照组（n = 19），进行常规药物治疗。糖化血红蛋白（HbA1c）和空腹/随机血糖水平是主要结局，而体重指数、血压和6分钟步行距离（6MWD）是次要结局。采用配对t检验和独立t检验，置信区间为95%。结果与结论：符合纳入标准的40例受试者，年龄在30-75岁之间，干预组和对照组各20例。研究结果显示，干预组HbA1c（9.60±1.25 ~ 6.54±0.92,p < 0.001）、体重指数（BMI）（26.51±3.45 ~ 24.45±2.98,p = 0.007）、收缩压（136.38±15.32 ~ 116.29±12.47mmHg, p < 0.001）、6分钟步行距离（400.00±48.60 ~ 517.14±56.12m, p < 0.001）均有显著改善。本研究结果表明，在2型糖尿病患者中，有组织的健美操运动是一种有效、低成本、容易获得的提高血糖控制和心血管健康的方法。

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引用次数: 0

Inter-rater reliability and usability of CATHIS core for homeopathic intervention studies CATHIS核心在顺势疗法干预研究中的信度和可用性。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-27 DOI: 10.1016/j.ctim.2026.103338

Martin Loef , Petra Weiermayer , Katharina Gaertner , Daniel Wrzałko , Abhijit Dutta , Subhranil Saha , J.A.D.S. Lakshani , Stephan Baumgartner , Robbert van Haselen

Background

The Critical Appraisal Tool for Homeopathic Intervention Studies (CATHIS) core is a streamlined appraisal tool for homeopathic intervention studies focusing on credibility, coherence, and clinical relevance. The aim of the research project was to evaluate its inter-rater reliability, feasibility, and face validity.

Methods

In a preregistered cross-sectional study, four raters independently applied CATHIS core to 28 trials (21 randomised controlled trials, 7 non-randomised studies on interventions) drawn from reviews on insomnia and hypertension; two external reviewers provided consensus ratings. Inter-rater reliability (IRR) was estimated using percent agreement, Fleiss’ κ, and Gwet’s AC2 (95% CIs). Feasibility was quantified as rating time and consensus time. Associations among the three domains were explored with correlation analyses and sensitivity checks.

Results

IRR varied markedly by domain. Credibility showed good agreement (Fleiss’ κ=0.66, 95% CI 0.57–0.74; AC2 =0.76, 0.71–0.82). Coherence yielded only poor-to-fair agreement (κ=0.28, 0.16–0.40; AC2 =0.41, 0.30–0.51). Clinical relevance was similarly limited (κ=0.32, 0.23–0.41; AC2 =0.36, 0.28–0.44). Individual ratings required on average 65.8 min, while consensus discussions averaged 17.7 min. Correlation analyses indicated heterogeneous and partly overlapping domain signals with limited interpretability. Face-validity responses reflected moderate-to-high acceptance but difficulties in consistent application.

Conclusion

CATHIS core yielded reproducible credibility ratings but only fair and operationally fragile agreement for coherence and clinical relevance, alongside non-trivial rating burden. Taken together, the current reliability profile is insufficient for confident use in systematic reviews. Targeted refinement appears warranted before broader implementation.

背景：顺势疗法干预研究的关键评估工具（CATHIS）核心是顺势疗法干预研究的精简评估工具，侧重于可信度、一致性和临床相关性。本研究的目的是评估量表的信度、可行性及面效度。方法：在一项预注册的横断面研究中，4名评分员独立地将CATHIS核心应用于28项试验（21项随机对照试验，7项非随机干预研究），这些试验来自失眠和高血压的综述；两名外部审稿人提供了一致的评级。评估者间信度（IRR）使用一致性百分比、Fleiss' κ和Gwet's AC2 （95% ci）来估计。可行性量化为评级时间和共识时间。通过相关分析和敏感性检查来探讨三个领域之间的关联。结果：不同区域的IRR差异显著。信度一致（Fleiss’κ=0.66, 95% CI 0.57-0.74; AC2=0.76, 0.71-0.82）。一致性只产生差到公平的一致性（κ=0.28, 0.16-0.40; AC2=0.41, 0.30-0.51）。临床相关性同样有限（κ=0.32, 0.23-0.41; AC2=0.36, 0.28-0.44）。个人评分平均需要65.8分钟，而共识讨论平均需要17.7分钟。相关分析表明信号具有异质性和部分重叠，可解释性有限。面孔效度反应反映了中等至高度的接受度，但在一致性应用方面存在困难。结论：CATHIS核心产生了可重复的可信度评级，但在一致性和临床相关性方面只有公平和操作上脆弱的协议，以及非琐碎的评级负担。综上所述，目前的可靠性概况不足以用于系统评价。在更广泛的实施之前，有针对性的改进似乎是有必要的。

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引用次数: 0

Effects of ashwagandha (Withania somnifera) on mental health in adults: A systematic review and dose–response meta-analysis of randomized controlled trials Ashwagandha （Withania somnifera）对成人心理健康的影响：随机对照试验的系统评价和剂量反应荟萃分析。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-03 DOI: 10.1016/j.ctim.2026.103325

Saleh A. Alsanie , Fahad Saad Alhodieb , Moein Askarpour

Background

Ashwagandha (Withania somnifera), as an important herbal medicine, has been increasingly recognized for its role in mental health management, particularly in reducing stress and anxiety, and reflects the growing relevance of complementary and alternative medicine in addressing psychological well-being. The present study aims to investigate its effectiveness by pooling the evidence from existing randomized controlled trials (RCTs).

Methods

Major medical databases of PubMed, Scopus, and Web of Science Core Collection were searched. Eligible studies were included. Meta-analysis, meta-regression, non-linear dose-response analysis, and subgroup analyses were conducted. Standardized mean differences (SMDs) were calculated. P-values < 0.05 were considered as statistically significant. The study protocol was registered in the PROSPERO database (CRD420251073134).

Results

Twenty-two studies met the eligibility criteria and were included. Meta-analysis revealed that supplementation with ashwagandha significantly improves stress (SMD = −5.88; 95 % CI: −8.15 to −3.60), depression (SMD = −5.68; 95 % CI: −8.43 to −2.94), and anxiety (SMD = −6.87; 95 % CI: −8.77 to −4.97). There was significant linear (coefficient = 0.005, P = 0.031) and non-linear (P-nonlinearity = 0.005) association between dosages of administered ashwagandha and stress levels.

Conclusion

Current evidence suggests that ashwagandha supplementation holds promising potential in alleviating symptoms of stress, anxiety, and depression. However, to strengthen these findings and translate them into clinical recommendations, well-designed, high-quality trials are still needed to address existing heterogeneity and to establish the most effective dosages and intervention durations.

背景：Ashwagandha （Withania somnifera）作为一种重要的草药，在心理健康管理，特别是减轻压力和焦虑方面的作用日益得到认可，并反映了补充和替代医学在解决心理健康方面日益增长的相关性。本研究旨在通过汇集现有随机对照试验（RCTs）的证据来研究其有效性。方法：检索PubMed、Scopus、Web of Science核心合集等主要医学数据库。纳入了符合条件的研究。进行meta分析、meta回归分析、非线性剂量-反应分析和亚组分析。计算标准化平均差（SMDs）。p值< 0.05认为有统计学意义。研究方案已在PROSPERO数据库中注册（CRD420251073134）。结果：22项研究符合入选标准。荟萃分析显示，补充ashwagandha可显著改善压力（SMD = -5.88; 95% CI: -8.15至-3.60）、抑郁（SMD = -5.68; 95% CI: -8.43至-2.94）和焦虑（SMD = -6.87; 95% CI: -8.77至-4.97）。给药剂量与应激水平存在显著的线性（系数= 0.005,P = 0.031）和非线性（P-非线性= 0.005）关系。结论：目前的证据表明，补充ashwagandha在缓解压力、焦虑和抑郁症状方面具有很大的潜力。然而，为了加强这些发现并将其转化为临床建议，仍然需要精心设计的高质量试验来解决现有的异质性，并确定最有效的剂量和干预持续时间。

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引用次数: 0

The anxiolytic effects of exercise: A systematic review and meta-analysis of randomized controlled trials 运动的抗焦虑作用：随机对照试验的系统回顾和荟萃分析。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-19 DOI: 10.1016/j.ctim.2026.103328

Hao Su , Yin Liang , Runyu Zhou , Yuanyuan Lv , Lingxiao He , Laikang Yu

Objective

This study aimed to evaluate the anxiolytic effects of exercise in individuals with high anxiety or diagnosed anxiety disorders and to identify optimal exercise prescription parameters. A key methodological innovation of this work is the application of a three-level meta-analytic model, which accounts for effect-size dependency arising from multiple outcomes within studies, thereby improving the robustness and precision of the pooled estimates.

Methods

A comprehensive literature search was conducted across five databases: Embase, PubMed, Cochrane Library, Web of Science, and Scopus. Inclusion criteria: (1) randomized controlled trial (RCT) design; (2) outcomes assessed using validated scales; (3) participants diagnosed with an anxiety disorder or identified as high-anxiety through validated scales; and (4) inclusion of both an intervention group and a control group, with the sole distinction between them being the addition of exercise in the intervention group. Analyses were performed using a three-level restricted maximum likelihood random-effects model.

Results

Twenty-seven randomized controlled trials involving 1447 participants were included. Exercise demonstrated a significant anxiolytic effect (Cohen’s d = −0.42, p < 0.01). Subgroup analysis indicated that comorbid chronic conditions attenuated treatment efficacy (Cohen’s d = −0.29, p < 0.01). Optimal outcomes were observed with exercise programs lasting < 12 weeks, sessions lasting 45–60 min, frequencies of > 3 times per week, and total weekly exercise durations of ≥ 180 min. In contrast, individuals without chronic conditions showed more favorable results. The most beneficial exercise regimens for this group included programs lasting < 12 weeks, sessions lasting > 60 min, frequencies of 3 times per week, and total weekly durations of > 180 min.

Conclusion

Exercise appears to be an effective non-pharmacological intervention for alleviating anxiety symptoms. While chronic conditions may diminish the magnitude of these benefits, tailored exercise prescriptions remain promising. Nevertheless, given the heterogeneity of interventions and limited long-term follow-up across included studies, further high-quality research is needed to confirm the sustainability and generalizability of these findings.

Trial registration

The protocol was registered in PROSPERO with the registration number CRD420251014897.

目的：本研究旨在评估运动对高焦虑或诊断为焦虑障碍的个体的抗焦虑作用，并确定最佳运动处方参数。这项工作的一个关键方法创新是应用了三层元分析模型，该模型考虑了研究中多个结果产生的效应大小依赖性，从而提高了汇总估计的稳健性和准确性。方法：在Embase、PubMed、Cochrane Library、Web of Science和Scopus五个数据库中进行全面的文献检索。纳入标准：(1)随机对照试验（RCT）设计；(2)使用经过验证的量表评估结果；(3)经有效量表诊断为焦虑障碍或高度焦虑的参与者；(4)包括干预组和对照组，两者之间唯一的区别是干预组增加了运动。采用三水平限制最大似然随机效应模型进行分析。结果：纳入27项随机对照试验，1447名受试者。运动表现出显著的抗焦虑作用（Cohen’s d = -0.42, p < 0.01）。亚组分析显示，慢性合并症降低了治疗效果（Cohen’s d = -0.29, p < 0.01）。当运动计划持续时间< 12周，每次运动时间45-60分钟，每周运动频率为100 - 30次，每周总运动时间≥180分钟时，观察到最佳结果。相比之下，没有慢性疾病的个体表现出更有利的结果。对于这组人来说，最有益的运动方案包括持续时间< 12周，每次持续60分钟，频率为每周3次，每周总持续时间为180分钟。结论：运动似乎是缓解焦虑症状的有效的非药物干预。虽然慢性疾病可能会降低这些好处的程度，但量身定制的运动处方仍然很有希望。然而，考虑到干预措施的异质性和纳入研究的有限长期随访，需要进一步的高质量研究来证实这些发现的可持续性和普遍性。试验注册：该方案在PROSPERO注册，注册号为CRD420251014897。

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引用次数: 0

Acupuncture for glucose metabolism: An updated meta-analysis of randomized controlled trials 针刺对葡萄糖代谢的影响：随机对照试验的最新荟萃分析。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-28 DOI: 10.1016/j.ctim.2026.103335

Xinyue Jiang , Hui Dong , Lingling Yu , Xingyue Yang , Yueheng Tang

This meta-analysis evaluates the efficacy of acupuncture in improving glucose metabolism in patients with metabolic disorders. We comprehensively searched PubMed, Web of Science, Excerpta Medica Database (Embase), Chinese National Knowledge Infrastructure (CNKI), Wanfang, and other databases from January 2017 to October 2025 for randomized controlled trials (RCTs) comparing acupuncture to control interventions. Fourteen RCTs involving 1179 participants were included. Pooled random-effects analyses demonstrated that acupuncture was associated with greater improvements in several glycemic parameters compared with control groups: homeostasis model assessment of insulin resistance (HOMA-IR; MD −0.79, 95% CI −1.30 to −0.28, I²=91%), glycosylated hemoglobin A1c (HbA1c; MD −0.68%, 95% CI −1.02 to −0.34, I²=88%), fasting plasma glucose (FPG; MD −0.61 mmol/L, 95% CI −0.82 to −0.41, I²=95%), 2-hour Postprandial Plasma Glucose (P2hPG; MD −0.94 mmol/l, 95% CI −1.49 to −0.39, I²=92%) and fasting insulin (FINS; MD −3.27 mU/L, 95% CI −5.59 to −0.95). However, these pooled estimates were accompanied by substantial to considerable heterogeneity, and findings varied across stratified analyses based on control type. Subgroup analyses suggested that manual acupuncture might be more effective. The overall certainty of evidence was moderate, with heterogeneity and potential risks of selection and detection bias, identified as major limitations. Adverse events were infrequent and mild. In conclusion, this meta-analysis indicates a potential role for acupuncture in managing glucose metabolism, but the high heterogeneity and methodological limitations preclude definitive conclusions. Future large-scale, rigorously designed RCTs with homogeneous comparators and standardized protocols are needed to establish its efficacy and optimal role in clinical practice.

本荟萃分析评估针刺改善代谢紊乱患者葡萄糖代谢的疗效。从2017年1月至2025年10月，我们综合检索了PubMed、Web of Science、医学摘录数据库（Embase）、中国知网（CNKI）、万方等数据库，以比较针灸与对照干预措施的随机对照试验（rct）。纳入14项随机对照试验，涉及1179名受试者。综合随机效应分析表明，与对照组相比，针灸与几个血糖参数的改善有更大的关系：胰岛素抵抗的稳态模型评估（HOMA-IR, MD -0.79, 95% CI -1.30至-0.28,I²=91%），糖化血红蛋白A1c (HbA1c, MD -0.68%, 95% CI -1.02至-0.34,I²=88%)，空腹血糖（FPG, MD -0.61mmol/L, 95% CI -0.82至-0.41,I²=95%），餐后2小时血糖(P2hPG；MD -0.94mmol/l, 95% CI -1.49 ~ -0.39, I²=92%)和空腹胰岛素（FINS; MD -3.27 mU/ l, 95% CI -5.59 ~ -0.95）。然而，这些汇总估计伴随着大量到相当大的异质性，并且基于对照类型的分层分析结果有所不同。亚组分析表明，手工针刺可能更有效。证据的总体确定性为中等，存在异质性和潜在的选择和检测偏倚风险，这是主要的局限性。不良事件罕见且轻微。总之，这项荟萃分析表明针灸在控制葡萄糖代谢方面具有潜在的作用，但是高度的异质性和方法学的局限性使我们无法得出明确的结论。未来需要大规模、严格设计、具有同质比较物和标准化方案的随机对照试验来确定其疗效和在临床实践中的最佳作用。

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引用次数: 0

The role of acupuncture in managing hyperhidrosis and vasomotor sweating: Evidence, mechanisms, and gaps 针灸在多汗症和血管舒缩性出汗中的作用：证据、机制和差距。

IF 3.5 3区医学 Q1 INTEGRATIVE & COMPLEMENTARY MEDICINE

Complementary therapies in medicine

Pub Date : 2026-05-01 Epub Date: 2026-02-27 DOI: 10.1016/j.ctim.2026.103337

Guangming Lu , Wenting Tong , Kexuan Zhu , Qiong Liu , Hongyu Tan , Delong Xiao , Jinglin Pan , Hui Zhang

Background and purpose

Hyperhidrosis and thermoregulatory disorders, including menopausal and treatment-induced hot flushes, can significantly impair quality of life. While acupuncture has been proposed as a potential non-pharmacological treatment for these conditions, the quality and consistency of available evidence remain unclear. This review aims to critically assess the current literature on acupuncture for various kinds of hyperhidrosis, evaluating its clinical efficacy, mechanisms of action, and limitations.

Methods

A narrative review was conducted based on English-language, PubMed-indexed published clinical studies, randomised controlled trials (RCTs), and meta-analyses investigating acupuncture as a treatment for primary hyperhidrosis, emotional sweating, paraneoplastic sweating, and hot flushes in both menopausal and breast cancer populations. Particular attention was paid to study quality, intervention protocols, and outcome durability.

Results

Evidence for the use of acupuncture in primary, emotional, and paraneoplastic hyperhidrosis is limited to small, often uncontrolled studies with significant methodological shortcomings. In contrast, acupuncture for menopausal and breast cancer-related hot flushes is supported by multiple RCTs and meta-analyses involving over 1000 participants, demonstrating short-term improvements in frequency and severity of symptoms. However, effects on hot flushes generally diminish after three months post-treatment. Mechanistically, acupuncture is thought to act via modulation of the autonomic nervous system and neuropeptide regulation, though precise pathways remain to be fully elucidated.

Conclusion

Acupuncture may offer short-term benefits for hot flushes in menopausal and breast cancer populations, but current evidence for its effectiveness in other kinds of hyperhidrosis remains weak and inconclusive. High-quality, standardised clinical trials with long-term follow-up are needed to better define its role in the integrative management of thermoregulatory disorders.

背景和目的：多汗症和体温调节障碍，包括绝经期和治疗性潮热，可显著损害生活质量。虽然针灸已被提议作为一种潜在的非药物治疗这些疾病，但现有证据的质量和一致性仍不清楚。本综述旨在批判性地评估目前关于针灸治疗各种多汗症的文献，评估其临床疗效、作用机制和局限性。方法：基于英文、pubmed索引的已发表临床研究、随机对照试验（rct）和荟萃分析，对针灸治疗绝经期和乳腺癌人群的原发性多汗症、情绪性出汗、副肿瘤性出汗和潮热进行了综述。特别关注研究质量、干预方案和结果持久性。结果：针灸治疗原发性多汗症、情绪性多汗症和副肿瘤性多汗症的证据仅限于小型的、通常不受控制的研究，这些研究存在显著的方法学缺陷。相比之下，针灸治疗更年期和乳腺癌相关的潮热得到了多个随机对照试验和荟萃分析的支持，涉及1000多名参与者，显示出症状频率和严重程度的短期改善。然而，对潮热的影响通常在治疗后三个月减弱。从机制上讲，针灸被认为是通过调节自主神经系统和神经肽调节来起作用的，尽管精确的途径仍有待充分阐明。结论：针灸可能对更年期和乳腺癌人群的潮热有短期的疗效，但目前关于其对其他类型多汗症的有效性的证据仍然薄弱和不确定。需要高质量、标准化的临床试验和长期随访，以更好地确定其在体温调节障碍综合管理中的作用。

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引用次数: 0