Pub Date : 2025-01-27DOI: 10.1016/j.ctim.2025.103133
Trine Stub , Anne Helen Hansen , Audun Campell Irgens , Olav Knudsen-Baas , Agnete E. Kristoffersen
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 a process evaluation. .
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.
{"title":"Assessing the feasibility of a spiritual healing intervention for adults with moderate depression: A pilot randomized controlled trial","authors":"Trine Stub , Anne Helen Hansen , Audun Campell Irgens , Olav Knudsen-Baas , Agnete E. Kristoffersen","doi":"10.1016/j.ctim.2025.103133","DOIUrl":"10.1016/j.ctim.2025.103133","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Method</h3><div>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 a process evaluation. .</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103133"},"PeriodicalIF":3.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045854","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.ctim.2025.103136
Natalia Płóciennik-Korycka , Sara Maria Pani , Bogumiła Bruc , Paolo Contu , Magdalena Wrzesińska
Introduction
IBS is a prevalent gut-brain interaction disorder characterized by abdominal pain and altered bowel habits, significantly affecting quality of life (QoL). IBS contributes to substantial work absenteeism and economic burdens and often coexists with other somatic and psychiatric conditions, with psychological well-being being a critical determinant of QoL. IBS sufferers often turn to MT due to dissatisfaction with conventional treatments. However, no comprehensive review has assessed the evidence for MT in treating IBS.
Objective
The objective of this review is to identify and map the available evidence on the effects of various manual therapy (MT) techniques on the biopsychosocial functioning, well-being, and QoL of individuals with irritable bowel syndrome (IBS).
Methods
A comprehensive search was conducted in PubMed, Embase, and Scopus. Studies involving adults with IBS and investigating the effects of MT on biological, psychological, and social outcomes, well-being, or QoL were included. A scoping review was conducted following PRISMA-ScR guidelines. Study quality was assessed using The National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tools. The protocol for this review was registered with the Open Science Framework and is available at https://doi.org/10.17605/OSF.IO/QN4WU.
Results
Of 730 records identified, 30 studies met the inclusion criteria (9 trials, 21 reviews). The interventions reviewed included osteopathic manipulative treatment (OMT), acupuncture, acupressure, reflexology, traditional Chinese spinal orthopaedic manipulation, and Tuina. The most frequently assessed outcomes were biological and psychological variables, as well as QoL, with well-being being the least commonly examined.
Conclusions
Although the results suggest potential benefits of MT in IBS treatment, they should be interpreted with caution due to the lack of robust trials, inconsistent findings, and occasional adverse events. High-quality randomized controlled trials and standardized outcome measures are necessary to validate these therapies and improve IBS management.
{"title":"Exploring manual therapy in the management of irritable bowel syndrome in adults: A scoping review","authors":"Natalia Płóciennik-Korycka , Sara Maria Pani , Bogumiła Bruc , Paolo Contu , Magdalena Wrzesińska","doi":"10.1016/j.ctim.2025.103136","DOIUrl":"10.1016/j.ctim.2025.103136","url":null,"abstract":"<div><h3>Introduction</h3><div>IBS is a prevalent gut-brain interaction disorder characterized by abdominal pain and altered bowel habits, significantly affecting quality of life (QoL). IBS contributes to substantial work absenteeism and economic burdens and often coexists with other somatic and psychiatric conditions, with psychological well-being being a critical determinant of QoL. IBS sufferers often turn to MT due to dissatisfaction with conventional treatments. However, no comprehensive review has assessed the evidence for MT in treating IBS.</div></div><div><h3>Objective</h3><div>The objective of this review is to identify and map the available evidence on the effects of various manual therapy (MT) techniques on the biopsychosocial functioning, well-being, and QoL of individuals with irritable bowel syndrome (IBS).</div></div><div><h3>Methods</h3><div>A comprehensive search was conducted in PubMed, Embase, and Scopus. Studies involving adults with IBS and investigating the effects of MT on biological, psychological, and social outcomes, well-being, or QoL were included. A scoping review was conducted following PRISMA-ScR guidelines. Study quality was assessed using The National Heart, Lung and Blood Institute (NHLBI) Study Quality Assessment Tools. The protocol for this review was registered with the Open Science Framework and is available at <span><span>https://doi.org/10.17605/OSF.IO/QN4WU</span><svg><path></path></svg></span>.</div></div><div><h3>Results</h3><div>Of 730 records identified, 30 studies met the inclusion criteria (9 trials, 21 reviews). The interventions reviewed included osteopathic manipulative treatment (OMT), acupuncture, acupressure, reflexology, traditional Chinese spinal orthopaedic manipulation, and Tuina. The most frequently assessed outcomes were biological and psychological variables, as well as QoL, with well-being being the least commonly examined.</div></div><div><h3>Conclusions</h3><div>Although the results suggest potential benefits of MT in IBS treatment, they should be interpreted with caution due to the lack of robust trials, inconsistent findings, and occasional adverse events. High-quality randomized controlled trials and standardized outcome measures are necessary to validate these therapies and improve IBS management.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103136"},"PeriodicalIF":3.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143064326","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-27DOI: 10.1016/j.ctim.2025.103132
Ping-Wen Huang , Chen Chia-Min , Cheuk-Kwan Sun , Yu-Shian Cheng , Yen-Hsiang Tang , Cheng Liu , Kuo-Chuan Hung
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.
{"title":"Therapeutic effects of probiotics on symptoms of irritability/emotional lability associated with neurodevelopmental conditions: A systematic review and meta-analysis of placebo-controlled trials","authors":"Ping-Wen Huang , Chen Chia-Min , Cheuk-Kwan Sun , Yu-Shian Cheng , Yen-Hsiang Tang , Cheng Liu , Kuo-Chuan Hung","doi":"10.1016/j.ctim.2025.103132","DOIUrl":"10.1016/j.ctim.2025.103132","url":null,"abstract":"<div><h3>Objectives</h3><div>The current study aimed at investigating the efficacies of probiotics in alleviating the symptoms of irritability/emotional lability in individuals with a neurodevelopmental condition.</div></div><div><h3>Methods</h3><div>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).</div></div><div><h3>Results</h3><div>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, <em>p</em> = 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, <em>p</em> = 0.04, three studies with 452 participant) but not in those adopting single-strain regimens.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103132"},"PeriodicalIF":3.3,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143045858","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-25DOI: 10.1016/j.ctim.2025.103135
Mostafa Norouzzadeh , Minoo Hasan Rashedi , Mohammad Hesam Azizi , Farshad Teymoori , Zohreh Maghsoomi , Farzad Shidfar
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 1797 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 (> 10 mmHg), 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.
{"title":"Efficacy and safety of Hibiscus sabdariffa in cardiometabolic health: An overview of reviews and updated dose-response meta-analysis","authors":"Mostafa Norouzzadeh , Minoo Hasan Rashedi , Mohammad Hesam Azizi , Farshad Teymoori , Zohreh Maghsoomi , Farzad Shidfar","doi":"10.1016/j.ctim.2025.103135","DOIUrl":"10.1016/j.ctim.2025.103135","url":null,"abstract":"<div><h3>Background</h3><div>Conventional treatments for cardiometabolic diseases face limitations related to cost, efficacy, and side effects. <em>Hibiscus sabdariffa</em> (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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>Data from 26 randomized controlled trials involving 1797 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 (> 10 mmHg), 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.</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103135"},"PeriodicalIF":3.3,"publicationDate":"2025-01-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143051709","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-20DOI: 10.1016/j.ctim.2025.103134
Weiqiang Tan , Zhaoquan Pan , Jiawei He , Tiexiong Wu , Feng Wu , Yachen Xu , Lisha Liu , Ziyu Yang , Chunrui Li , Yuechen Hu , Muxi Liao
<div><h3>Objective</h3><div>To systematically evaluate the efficacy of traditional Chinese exercises (TCEs) for neuropsychiatric symptoms (NPSs) in patients with Parkinson’s disease.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across eight databases, including PubMed, Cochrane Library, Embase, Web of Science (WoS), SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP), and Wanfang Database, covering studies published from their inception up to April 23, 2024. The search focused on identifying randomized controlled trials (RCTs) assessing the effectiveness of TCEs for NPSs in PD patients.</div><div>The authors independently performed literature screening and data extraction. Meta-analysis was executed employing Review Manager V.5.3 software, and Stata 17.0 was used to detect publication bias and perform sensitivity analysis. GRADEpro GDT was used to grade the certainty of each outcome evidence.</div></div><div><h3>Results</h3><div>Eighteen studies involving 937 participants were included. The meta-analysis showed significant improvements in depression-related scales (standardized mean difference (SMD) = –1.30, 95 % confidence interval (CI): –2.10 to –0.49, <em>p</em> = 0.002), anxiety-related scales (SMD = –1.11, 95 %CI: –2.14 to –0.08, <em>p</em> = 0.03), sleep disorder-related scales (SMD = –0.71, 95 %CI: –0.99 to –0.43, <em>p</em> < 0.00001), and cognition-related scales (SMD = 0.91, 95 %CI: 0.44–1.38, <em>p</em> = 0.0001). Quality of life also improved (SMD = –1.35, 95 % CI: –2.38 to –0.31, <em>p</em> = 0.01; SMD = 0.99, 95 % CI: 0.54–1.43, <em>p</em> < 0.0001). Subgroup analyses grounded in the duration of the intervention suggested that interventions lasting up to 12 weeks showed more significant anti-depression and anti-anxiety effects while those lasting beyond 12 weeks demonstrated greater improvements in sleep quality and cognitive function. Additionally, subgroup analyses based on the type of intervention revealed that both using TCEs alone and the combination of TCEs with conventional medications showed greater effects on anti-depression and cognitive function, while the latter yield more significant anti-anxiety effects. However, no statistical significance was found for fatigue-related scales. The clinical trials included in this review also lacked a thorough description of the randomization process, and only a small proportion reported adequate allocation concealment procedures, raising concerns about potential selection bias. Moreover, owing to the inherent characteristics of TCEs, blinding both participants and practitioners is challenging, which may result in performance bias. Additionally, the absence of blinding could allow assessors’ subjective influences to affect the outcomes, leading to detection bias. The overall quality of the evidence, as assessed according to the GRADE criteria, was rated as very low or low for most
{"title":"Traditional Chinese exercises for the treatment of neuropsychiatric symptoms in Parkinson’s disease: A systematic review and meta-analysis","authors":"Weiqiang Tan , Zhaoquan Pan , Jiawei He , Tiexiong Wu , Feng Wu , Yachen Xu , Lisha Liu , Ziyu Yang , Chunrui Li , Yuechen Hu , Muxi Liao","doi":"10.1016/j.ctim.2025.103134","DOIUrl":"10.1016/j.ctim.2025.103134","url":null,"abstract":"<div><h3>Objective</h3><div>To systematically evaluate the efficacy of traditional Chinese exercises (TCEs) for neuropsychiatric symptoms (NPSs) in patients with Parkinson’s disease.</div></div><div><h3>Methods</h3><div>A comprehensive literature search was performed across eight databases, including PubMed, Cochrane Library, Embase, Web of Science (WoS), SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Periodical Database (VIP), and Wanfang Database, covering studies published from their inception up to April 23, 2024. The search focused on identifying randomized controlled trials (RCTs) assessing the effectiveness of TCEs for NPSs in PD patients.</div><div>The authors independently performed literature screening and data extraction. Meta-analysis was executed employing Review Manager V.5.3 software, and Stata 17.0 was used to detect publication bias and perform sensitivity analysis. GRADEpro GDT was used to grade the certainty of each outcome evidence.</div></div><div><h3>Results</h3><div>Eighteen studies involving 937 participants were included. The meta-analysis showed significant improvements in depression-related scales (standardized mean difference (SMD) = –1.30, 95 % confidence interval (CI): –2.10 to –0.49, <em>p</em> = 0.002), anxiety-related scales (SMD = –1.11, 95 %CI: –2.14 to –0.08, <em>p</em> = 0.03), sleep disorder-related scales (SMD = –0.71, 95 %CI: –0.99 to –0.43, <em>p</em> < 0.00001), and cognition-related scales (SMD = 0.91, 95 %CI: 0.44–1.38, <em>p</em> = 0.0001). Quality of life also improved (SMD = –1.35, 95 % CI: –2.38 to –0.31, <em>p</em> = 0.01; SMD = 0.99, 95 % CI: 0.54–1.43, <em>p</em> < 0.0001). Subgroup analyses grounded in the duration of the intervention suggested that interventions lasting up to 12 weeks showed more significant anti-depression and anti-anxiety effects while those lasting beyond 12 weeks demonstrated greater improvements in sleep quality and cognitive function. Additionally, subgroup analyses based on the type of intervention revealed that both using TCEs alone and the combination of TCEs with conventional medications showed greater effects on anti-depression and cognitive function, while the latter yield more significant anti-anxiety effects. However, no statistical significance was found for fatigue-related scales. The clinical trials included in this review also lacked a thorough description of the randomization process, and only a small proportion reported adequate allocation concealment procedures, raising concerns about potential selection bias. Moreover, owing to the inherent characteristics of TCEs, blinding both participants and practitioners is challenging, which may result in performance bias. Additionally, the absence of blinding could allow assessors’ subjective influences to affect the outcomes, leading to detection bias. The overall quality of the evidence, as assessed according to the GRADE criteria, was rated as very low or low for most ","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103134"},"PeriodicalIF":3.3,"publicationDate":"2025-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-17DOI: 10.1016/j.ctim.2025.103127
Ye Tian , Zi-Yuan Liu , Jia-Hao Wang , Jing-Hua Qian
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.
{"title":"The efficacy and safety of Baduanjin exercise as complementary therapy for pain reduction and functional improvement in knee osteoarthritis: A meta-analysis of randomized controlled trials","authors":"Ye Tian , Zi-Yuan Liu , Jia-Hao Wang , Jing-Hua Qian","doi":"10.1016/j.ctim.2025.103127","DOIUrl":"10.1016/j.ctim.2025.103127","url":null,"abstract":"<div><h3>Objectives</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"88 ","pages":"Article 103127"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143001190","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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.
{"title":"Acceptability of self-administered acupressure for knee osteoarthritis in middle-aged and older adults: A mixed-method secondary analysis","authors":"Shu-Cheng Chen , Nicole Nok Leung , Hui-Lin Cheng , Min-Ru Wu , Denise Shuk-Ting Cheung , Jia-Yin Ruan , Jing Qin , Ge Ren , Wing-Fai Yeung","doi":"10.1016/j.ctim.2025.103130","DOIUrl":"10.1016/j.ctim.2025.103130","url":null,"abstract":"<div><h3>Objectives</h3><div>To evaluate the acceptability of self-administered acupressure for Knee osteoarthritis (KOA) among middle-aged and older adults.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103130"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-17DOI: 10.1016/j.ctim.2025.103129
Jiadi Chen, Ruizhi Jing
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
背景:没有一种治疗耳鸣的方法被认为是普遍有效的。头皮针灸作为一种潜在的治疗方法已被探索。目的:本系统综述和荟萃分析旨在评价头皮针刺治疗耳鸣的临床疗效。方法:对相关数据库进行全面检索,以确定比较头皮针刺与对照治疗耳鸣的随机对照试验。分别采用相对危险度(RR)和标准化平均差(SMD)评价临床有效率和耳鸣严重程度的降低。进行敏感性分析以调查异质性的来源。结果:共纳入20项研究,1430名受试者。系统评价和荟萃分析显示,头皮针刺组的临床有效率显著高于对照组(RR=1.25, 95 % CI 1.16-1.35, p 2=20 %)。与对照组相比,头皮针刺组和头皮针刺加辅助穴位组耳鸣严重程度的降低更大(SMD=-0.76,95 %CI:-1.02,-0.51,p 2=62 %),由于研究设计、样本特征和干预方案的差异,观察到显著的异质性(p 2=86 %)。敏感性分析证实了结果的稳定性。通过GRADEpro生成的汇总表显示,证据的确定性从中等到低不等。结论:头皮针刺治疗耳鸣较传统针刺或药物治疗有较好的疗效。然而,由于潜在的偏倚和研究的异质性,目前的证据是有限的。未来的研究应使方案标准化,确保更高的方法严谨性,并探索长期影响以进一步验证研究结果。该综述已在普洛斯彼罗注册(CRD42024537806):陈佳迪,景瑞智。头皮针刺治疗耳鸣的临床疗效分析。可从:https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024537806。
{"title":"The clinical efficacy of scalp acupuncture for tinnitus: A systematic review and meta-analysis","authors":"Jiadi Chen, Ruizhi Jing","doi":"10.1016/j.ctim.2025.103129","DOIUrl":"10.1016/j.ctim.2025.103129","url":null,"abstract":"<div><h3>Background</h3><div>No single treatment is considered to be universally effective for tinnitus. Scalp acupuncture has been explored as a potential treatment.</div></div><div><h3>Objective</h3><div>This systematic review and meta-analysis aim to evaluate the clinical efficacy of scalp acupuncture in treating tinnitus.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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, <em>p</em> < 0.00001),with low heterogeneity(<em>p</em> = 0.27,I<sup>2</sup>=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,<em>p</em> < 0.00001;SMD:-0.93,95 %CI:-1.52,-0.33,<em>p</em> = 0.002, respectively),with a moderate heterogeneity(<em>p</em> = 0.005,I<sup>2</sup>=62 %) and a significant heterogeneity (<em>p</em> < 0.00001,I<sup>2</sup>=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.</div></div><div><h3>Conclusions</h3><div>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.</div><div>The review was registered with PROSPERO (CRD42024537806):Jiadi Chen, Ruizhi Jing.Analysis of clinical effect of scalp acupuncture on tinnitus. Available</div><div>from: <span><span>https://www.crd.york.ac.uk/prospero/display_record.php?ID=CRD42024537806</span><svg><path></path></svg></span>.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"88 ","pages":"Article 103129"},"PeriodicalIF":3.3,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143000914","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-10DOI: 10.1016/j.ctim.2024.103124
Yongni Wang , Fang Wang , Feifei Hu , Fang Long
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.
目的:通过网络荟萃分析评估非药物干预对改善化疗诱导的延迟性恶心和呕吐症状的疗效。方法:检索自建库至2024年4月的4个中文数据库(CNKI、万方数据知识服务平台、VIP、Sinomed)和5个英文数据库(PubMed、Cochrane Library、Embase、Web of Science、CINAHL)。采用r4.1.3软件和GeMTC软件包,对不同非药物干预下化疗所致延迟性恶心呕吐改善的有效率及KPS评分改善情况进行贝叶斯网络meta分析。结果:共纳入58项rct 4081例患者,涉及14项非药物干预措施。meta分析结果显示,穴位贴片被认为是改善化疗引起的延迟性恶心和呕吐最可能的优越干预措施,针刺被认为是改善KPS评分最可能的优越干预措施。结论:非药物干预可以作为治疗延迟化疗引起的恶心和呕吐的有效补充方法。特别是,穴位应用可能是减轻延迟性恶心和呕吐发生率的最佳补充疗法,尽管需要更多高质量、大规模的证据来结论性地证明针灸在提高癌症患者生活质量方面的有效性。
{"title":"Effect of non-pharmacological interventions on chemotherapy induced delayed nausea and vomiting for tumors: A systematic review and Bayesian network meta-analysis","authors":"Yongni Wang , Fang Wang , Feifei Hu , Fang Long","doi":"10.1016/j.ctim.2024.103124","DOIUrl":"10.1016/j.ctim.2024.103124","url":null,"abstract":"<div><h3>Objective</h3><div>To evaluate the efficacy of non-pharmacological interventions in improving chemotherapy induced delayed nausea and vomiting symptoms using a network meta-analysis.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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.</div></div><div><h3>Conclusion</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"88 ","pages":"Article 103124"},"PeriodicalIF":3.3,"publicationDate":"2025-01-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969916","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-09DOI: 10.1016/j.ctim.2025.103126
Verónica Romero-Ferreiro , Lorena García-Fernández , José Miguel Biscaia , Carmen Romero , Rocío González-Soltero , Mónica De la Fuente , Miguel A. Álvarez-Mon , Rolf Wynn , Roberto Rodriguez-Jimenez
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.
背景:炎症标志物在精神分裂症中起着关键作用,因为它们提供了对精神分裂症背景下发生的神经炎症过程的洞察。这些标志物,特别是c反应蛋白(CRP)水平升高,可能表明潜在的免疫系统失调,可能影响症状的严重程度和进展。认识到这些标记导致研究使用益生菌作为辅助剂来改善精神分裂症的治疗。本研究的主要目的是严格评估益生菌在降低精神分裂症患者血浆CRP水平方面的疗效。方法:对采用PRISMA方法的随机临床试验进行系统检索和荟萃分析。以下搜索策略((SCHIZO* OR psychiatric OR PSYCHOSES)和(PROBIOTIC* OR BIFIDOBACTER* OR LACTOBACILL*))用于检索PubMed、Web of Science和APA PsycINFO数据库中2024年6月至12月之间的出版物。采用Cochrane偏倚风险(RoB2)评估个体研究质量,采用GRADE系统评估总证据的确定性。结果:评估的主要结果是益生菌补充对血浆CRP水平的影响。在最初确定的78项研究中,有4项最终纳入了荟萃分析。四分之三的研究发现,与安慰剂组相比,补充剂组的高敏c反应蛋白水平显著降低。合并分析显示,补充益生菌后CRP水平显著降低,标准化平均差异(SMD)为-0.46,(95% CI -0.719;-0.201;P = 0.001)。结论:对现有文献的综合和荟萃分析为益生菌与安慰剂相比在降低精神分裂症患者血清CRP方面的潜在作用提供了证据。然而,需要更多的临床试验和更好的实验设计控制,才能明确推荐作为辅助治疗。
{"title":"Effect of probiotics on C-reactive protein levels in schizophrenia: Evidence from a systematic review and meta-analysis","authors":"Verónica Romero-Ferreiro , Lorena García-Fernández , José Miguel Biscaia , Carmen Romero , Rocío González-Soltero , Mónica De la Fuente , Miguel A. Álvarez-Mon , Rolf Wynn , Roberto Rodriguez-Jimenez","doi":"10.1016/j.ctim.2025.103126","DOIUrl":"10.1016/j.ctim.2025.103126","url":null,"abstract":"<div><h3>Background</h3><div>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.</div></div><div><h3>Methods</h3><div>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.</div></div><div><h3>Results</h3><div>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; <em>p</em> = 0.001).</div></div><div><h3>Conclusions</h3><div>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.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"89 ","pages":"Article 103126"},"PeriodicalIF":3.3,"publicationDate":"2025-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142969917","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}