Pub Date : 2025-10-13DOI: 10.1016/j.ctim.2025.103264
Ying-Ying Zhang , Yi-Jie Liu , Yuan Wang , Shi-Bing Liang , Tao Yin , Yun-Song Zheng , Jian-Ping Liu , Nicola Robinson , Hai-Fa Qiao
Background
This pilot study aims to evaluate the efficacy of auricular electro-acupuncture (AEA) for smoking cravings induced by quitting in young smokers and to investigate the underlying neural mechanism using functional magnetic resonance imaging (fMRI).
Methods
We recruited 16 young participants with nicotine dependence (ND) and 15 matched healthy non-smoking controls (HCs). ND participants were treated with AEA for 4 weeks, and underwent brain fMRI scanning following 24-hour abstinence, 20 min of smoking satisfaction, after 1 week, and 4 weeks of AEA treatment. HCs underwent a single fMRI scanning. Fractional Amplitude of Low-Frequency Fluctuations (fALFF) was assessed.
Results
Compared with HCs, fALFF values in ND participants following 24-hour abstinence decreased in the bilateral anterior cerebellar lobes (ACL), anterior cingulate cortex (ACC) and central tegmental area (CTA) /insula (P < 0.05). However, after 20 min of smoking satisfaction, fALFF values for ACC and bilateral ACL significantly increased (P < 0.05). Compared to 24-hour abstinence, the fALFF value of ACC and cerebellum in ND group significantly increased after 4 weeks of AEA treatment (P < 0.05). Compared to baseline, both smoking cravings (t = 3.87, P < 0.01) and nicotine dependence levels (t = 3.83, P < 0.01) showed significant reductions after 4 weeks of AEA treatment.
Conclusion
The results of this pilot study indicate that AEA may be effective in suppressing smoking cravings and alleviating nicotine dependence. ACC, cerebellum, CTA, and insula may be involved in modulating smoking cravings. AEA may inhibit cravings through regulating the functional activity of ACC and cerebellum.
背景：本初步研究旨在评价耳穴电针（AEA）治疗年轻吸烟者戒烟诱导的吸烟渴望的疗效，并利用功能磁共振成像（fMRI）探讨其潜在的神经机制。方法：我们招募了16名尼古丁依赖（ND）的年轻参与者和15名匹配的健康非吸烟对照（hc）。ND参与者服用AEA治疗4周，并在24小时戒烟，1周后20分钟吸烟满意，4周后进行脑功能磁共振成像扫描。HCS进行单次fMRI扫描。评估低频波动分数幅值（fALFF）。结果：与正常人相比，戒断24小时后ND参与者双侧小脑前叶（ACL）、前扣带皮层（ACC）和中央被盖区(CTA) /脑岛的fALFF值均下降（P < 0.05）。而吸烟满意20min后，ACC和双侧ACL的fALFF值显著升高（P < 0.05）。与24小时戒断相比，服用AEA 4周后ND组ACC和小脑的fALFF值显著升高（P < 0.05）。与基线相比，经4周AEA治疗后，吸烟渴望（t = 3.87, P < 0.01）和尼古丁依赖水平（t = 3.83, P < 0.01）均显著降低。结论：本初步研究结果提示AEA可有效抑制吸烟欲望，减轻尼古丁依赖。前扣带、小脑、CTA和脑岛可能参与调节吸烟欲望。AEA可能通过调节ACC和小脑的功能活动来抑制渴望。
{"title":"Auricular electro-acupuncture for smoking cravings in young smokers with nicotine dependence: A pilot fMRI study","authors":"Ying-Ying Zhang , Yi-Jie Liu , Yuan Wang , Shi-Bing Liang , Tao Yin , Yun-Song Zheng , Jian-Ping Liu , Nicola Robinson , Hai-Fa Qiao","doi":"10.1016/j.ctim.2025.103264","DOIUrl":"10.1016/j.ctim.2025.103264","url":null,"abstract":"<div><h3>Background</h3><div>This pilot study aims to evaluate the efficacy of auricular electro-acupuncture (AEA) for smoking cravings induced by quitting in young smokers and to investigate the underlying neural mechanism using functional magnetic resonance imaging (fMRI).</div></div><div><h3>Methods</h3><div>We recruited 16 young participants with nicotine dependence (ND) and 15 matched healthy non-smoking controls (HCs). ND participants were treated with AEA for 4 weeks, and underwent brain fMRI scanning following 24-hour abstinence, 20 min of smoking satisfaction, after 1 week, and 4 weeks of AEA treatment. HCs underwent a single fMRI scanning. Fractional Amplitude of Low-Frequency Fluctuations (fALFF) was assessed.</div></div><div><h3>Results</h3><div>Compared with HCs, fALFF values in ND participants following 24-hour abstinence decreased in the bilateral anterior cerebellar lobes (ACL), anterior cingulate cortex (ACC) and central tegmental area (CTA) /insula (<em>P < 0.05</em>). However, after 20 min of smoking satisfaction, fALFF values for ACC and bilateral ACL significantly increased (<em>P < 0.05</em>). Compared to 24-hour abstinence, the fALFF value of ACC and cerebellum in ND group significantly increased after 4 weeks of AEA treatment <em>(P < 0.05</em>). Compared to baseline, both smoking cravings (<em>t = 3.87, P < 0.01</em>) and nicotine dependence levels (<em>t = 3.83, P < 0.01</em>) showed significant reductions after 4 weeks of AEA treatment.</div></div><div><h3>Conclusion</h3><div>The results of this pilot study indicate that AEA may be effective in suppressing smoking cravings and alleviating nicotine dependence. ACC, cerebellum, CTA, and insula may be involved in modulating smoking cravings. AEA may inhibit cravings through regulating the functional activity of ACC and cerebellum.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"95 ","pages":"Article 103264"},"PeriodicalIF":3.5,"publicationDate":"2025-10-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145299046","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}
Herbal interventions such as Curcuma longa (CL) and Boswellia serrata (BS) have demonstrated efficacy and safety in managing knee osteoarthritis (KOA); however, the effects of their combined formulation, including both direct and indirect outcomes, remain insufficiently explored. We performed systematic review and network meta-analysis for clinical effects of CL, BS, and their mixed formulation in alleviating KOA symptoms.
Methods
The CENTRAL, PubMed, EMBASE, and EBSCO Open Dissertations, databases and also from Snowballing and citation searching were searched through March 2025. The randomized controlled trials (RCTs) that studied effectiveness of CL or BS in KOA participants using Visual Analog Scale (VAS) and KOA severity by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and adverse events as the main outcomes, were eligibly included. The Cochrane Risk of Bias a random-effects model, standardized mean differences (SMDs) along with 95 % confidence intervals (CIs) were employed.
Results
In total, 20 RCTs comprising 1633 participants were included. The modified formulations of CL showed a significant reduction in VAS compared to placebo (SMD: −2.82; 95 %CI: −5.30 to −0.33), while the modified formulations of BS demonstrated significant improvement in WOMAC pain, stiffness, and knee function compared to other intervention groups. No significant differences in adverse events were observed among all comparisons.
Conclusions
BS extract, particularly in modified formulations, improves joint function in patients with mild to moderate KOA, while only the modified formulation of CL demonstrates notable pain-reducing efficacy. The potential benefits of combined CL and BS preparations warrant further investigation.
{"title":"Evaluating the efficacy and safety of Curcuma longa, Boswellia serrata, and their mixed formulation in treating knee osteoarthritis: A systematic review and network meta-analysis","authors":"Chanya Inprasit , Siriwadee Bunyamahote , Kansak Boonpattharatthiti , Phiyanuch Thimkorn , Suwipa Intakhiao , Teerapon Dhippayom","doi":"10.1016/j.ctim.2025.103256","DOIUrl":"10.1016/j.ctim.2025.103256","url":null,"abstract":"<div><h3>Background</h3><div>Herbal interventions such as <em>Curcuma longa</em> (CL) and <em>Boswellia serrata</em> (BS) have demonstrated efficacy and safety in managing knee osteoarthritis (KOA); however, the effects of their combined formulation, including both direct and indirect outcomes, remain insufficiently explored. We performed systematic review and network meta-analysis for clinical effects of CL, BS, and their mixed formulation in alleviating KOA symptoms.</div></div><div><h3>Methods</h3><div>The CENTRAL, PubMed, EMBASE, and EBSCO Open Dissertations, databases and also from Snowballing and citation searching were searched through March 2025. The randomized controlled trials (RCTs) that studied effectiveness of CL or BS in KOA participants using Visual Analog Scale (VAS) and KOA severity by the Western Ontario and McMaster Universities Arthritis Index (WOMAC), and adverse events as the main outcomes, were eligibly included. The Cochrane Risk of Bias a random-effects model, standardized mean differences (SMDs) along with 95 % confidence intervals (CIs) were employed.</div></div><div><h3>Results</h3><div>In total, 20 RCTs comprising 1633 participants were included. The modified formulations of CL showed a significant reduction in VAS compared to placebo (SMD: −2.82; 95 %CI: −5.30 to −0.33), while the modified formulations of BS demonstrated significant improvement in WOMAC pain, stiffness, and knee function compared to other intervention groups. No significant differences in adverse events were observed among all comparisons.</div></div><div><h3>Conclusions</h3><div>BS extract, particularly in modified formulations, improves joint function in patients with mild to moderate KOA, while only the modified formulation of CL demonstrates notable pain-reducing efficacy. The potential benefits of combined CL and BS preparations warrant further investigation.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"96 ","pages":"Article 103256"},"PeriodicalIF":3.5,"publicationDate":"2025-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145285670","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}
Pub Date : 2025-10-07DOI: 10.1016/j.ctim.2025.103254
Mengqi Li , Guorui Ding , Ruobing Lan , Yu Li , Shuying Guan , Xiaolei Lu , Yuxing Zhang , Duo Zhao
Background
Constipation affects 75 % of children with cerebral palsy (CP). While massage is a safe non-invasive intervention, its clinical adoption remains limited due to insufficient evidence of its efficacy.
Objective
To evaluate the efficacy and safety of massage for CP-related constipation through meta-analysis.
Methods
Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven databases for randomised controlled trials (RCTs) on pediatric CP-related constipation treated with massage. Eligible RCTs underwent Cochrane risk-of-bias assessment. Meta-analysis using Stata evaluated the overall efficacy, defecation parameters, and heterogeneity sources.
Results
A total of 11 RCTs involving 728 patients were included. The results of the meta-analysis showed that, compared with traditional therapy alone, massage was more effective in treating constipation in children with CP. This difference was statistically significant (p < 0.05), as evaluated by the overall effective rate (RR, Relative Risk = 1.23; 95 % CI, 95 % Confidence Interval = 1.14, 1.33), defecation frequency (MD, Mean Difference = 1.57; 95 % CI = 0.40, 2.75), defecation time (MD = -3.23; 95 % CI = -3.82, -2.64), and stool form score (SMD, Standardized Mean Difference = 0.66; 95 % CI = 0.39, 0.94), confirming the superior efficacy of massage over conventional therapy. However, both interventions showed comparable effects on defecation difficulty (p > 0.05). The baseline patient characteristics, duration and techniques of the massage, and efficacy of the control group intervention may be the sources of heterogeneity.
Conclusion
Massage therapy improves constipation symptoms in children with CP. These results require validation through larger, high-quality RCTs given the sample size limitations of the current study.
背景：便秘影响75%的脑瘫（CP）患儿。虽然按摩是一种安全的非侵入性干预，但由于其有效性证据不足，其临床应用仍然有限。目的：通过meta分析，评价推拿治疗cp相关性便秘的疗效和安全性。方法：根据系统评价和荟萃分析的首选报告项目（PRISMA）指南，我们检索了7个数据库，检索了按摩治疗小儿cp相关便秘的随机对照试验（RCTs）。符合条件的随机对照试验进行Cochrane风险偏倚评估。meta分析使用Stata评估总体疗效、排便参数和异质性来源。结果：共纳入11项rct， 728例患者。meta分析结果显示，与单纯传统疗法相比，推拿治疗CP患儿便秘更有效，总有效率（RR, Relative Risk = 1.23, 95% CI， 95%可信区间= 1.14,1.33）、排便频率（MD, Mean difference = 1.57, 95% CI = 0.40, 2.75）、排便时间（MD = -3.23, p < 0.05），差异有统计学意义（p < 0.05）。95% CI = -3.82, -2.64)，粪便形态评分（SMD，标准化平均差= 0.66;95% CI = 0.39, 0.94），证实按摩优于常规治疗。然而，两种干预措施对排便困难的影响相当（p < 0.05）。患者的基线特征、按摩的持续时间和手法以及对照组干预的效果可能是异质性的来源。结论：按摩治疗可改善CP患儿的便秘症状。鉴于当前研究的样本量限制，这些结果需要通过更大、高质量的随机对照试验来验证。
{"title":"Effectiveness of massage therapy for constipation in children with cerebral palsy: A systematic review and meta-analysis","authors":"Mengqi Li , Guorui Ding , Ruobing Lan , Yu Li , Shuying Guan , Xiaolei Lu , Yuxing Zhang , Duo Zhao","doi":"10.1016/j.ctim.2025.103254","DOIUrl":"10.1016/j.ctim.2025.103254","url":null,"abstract":"<div><h3>Background</h3><div>Constipation affects 75 % of children with cerebral palsy (CP). While massage is a safe non-invasive intervention, its clinical adoption remains limited due to insufficient evidence of its efficacy.</div></div><div><h3>Objective</h3><div>To evaluate the efficacy and safety of massage for CP-related constipation through meta-analysis.</div></div><div><h3>Methods</h3><div>Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we searched seven databases for randomised controlled trials (RCTs) on pediatric CP-related constipation treated with massage. Eligible RCTs underwent Cochrane risk-of-bias assessment. Meta-analysis using Stata evaluated the overall efficacy, defecation parameters, and heterogeneity sources.</div></div><div><h3>Results</h3><div>A total of 11 RCTs involving 728 patients were included. The results of the meta-analysis showed that, compared with traditional therapy alone, massage was more effective in treating constipation in children with CP. This difference was statistically significant (<em>p < 0.05</em>), as evaluated by the overall effective rate (RR, Relative Risk = 1.23; 95 % CI, 95 % Confidence Interval = 1.14, 1.33), defecation frequency (MD, Mean Difference = 1.57; 95 % CI = 0.40, 2.75), defecation time (MD = -3.23; 95 % CI = -3.82, -2.64), and stool form score (SMD, Standardized Mean Difference = 0.66; 95 % CI = 0.39, 0.94), confirming the superior efficacy of massage over conventional therapy. However, both interventions showed comparable effects on defecation difficulty (<em>p > 0.05</em>). The baseline patient characteristics, duration and techniques of the massage, and efficacy of the control group intervention may be the sources of heterogeneity.</div></div><div><h3>Conclusion</h3><div>Massage therapy improves constipation symptoms in children with CP. These results require validation through larger, high-quality RCTs given the sample size limitations of the current study.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"94 ","pages":"Article 103254"},"PeriodicalIF":3.5,"publicationDate":"2025-10-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145250174","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}
Pub Date : 2025-10-01Epub Date: 2025-08-05DOI: 10.1016/j.ctim.2025.103223
Hui Ping Ng, Chun Yue Tan, Chien Joo Lim, Tong Leng Tan, Su-Yin Yang, Gillian Szu Chew Long, Siang Ing Tan, Yu Chun Chua, Yew Wai Yan, Derrick Bing Quan Soh, Tong Hwee Goh, Pu Jue Ng, Yee Teck Ng, Swee Boey Kuan, Bo Siang Teo, Keng He Kong, Gloria Ho, Hui Qi Koh, Michelle Jessica Pereira, Bryan Yijia Tan
Background: Acupuncture has increasingly gained popularity as alternative approach to conventional care for knee osteoarthritis (KOA) management. We conducted a pragmatic randomized controlled study to evaluate the clinical and health utility outcomes of acupuncture and heat therapy in conjunction with standard care for KOA.
Methods: Community-ambulating KOA patients of 45 years or older were randomly assigned to the intervention or control (SC) group. The HARMOKnee group received 12 acupuncture and heat treatments in addition to standard care for six weeks. We evaluated the Knee Injury and Osteoarthritis and Outcome Score-12 (KOOS-12) at baseline, 6-, 12- and 24-week. Secondary outcomes including Pain, Enjoyment of Life and General Activity (PEG) scores, Patient Health Questionnaire-4 (PHQ-4), and TCM syndrome differentiation were evaluated. Comparative analysis was performed using mixed-effect models.
Results: Among 101 participants (HARMOKnee=50; SC=51), the mean age was 63.99 ± 7.03 years, and KOA duration was 5.07 ± 6.35 years. There was a significant intervention-time interaction, favouring HARMOKnee group, for the KOOS-12 total score [Coef= 6.43, 95 %CI: 0.72, 12.14; p = 0.027], KOOS-12 quality of life (QOL) domain-score [Coef= 8.50, 95 %CI: 1.28, 15.73; p = 0.021], and PEG overall score [Coef= -1.32, 95 %CI: -2.14, -0.49; p = 0.002] at 6-week. No between-group differences were identified at other time-points. The HARMOKnee group demonstrated considerable pain reduction and improved knee flexion and extension after 12 treatments (0.001 < p < 0.014). This treatment approach markedly enhanced knee flexion in patients with Kidney yang deficiency with phlegm and blood stasis syndrome.
Conclusions: HARMOKnee provides short-term pain-management benefits to KOA patients compared to standard care alone, particularly in patients with Kidney yang deficiency with phlegm and blood stasis syndrome.
{"title":"Heat and acupuncture restore mobility in knee osteoarthritis (HARMOKnee): A pragmatic integrated care, randomized controlled study.","authors":"Hui Ping Ng, Chun Yue Tan, Chien Joo Lim, Tong Leng Tan, Su-Yin Yang, Gillian Szu Chew Long, Siang Ing Tan, Yu Chun Chua, Yew Wai Yan, Derrick Bing Quan Soh, Tong Hwee Goh, Pu Jue Ng, Yee Teck Ng, Swee Boey Kuan, Bo Siang Teo, Keng He Kong, Gloria Ho, Hui Qi Koh, Michelle Jessica Pereira, Bryan Yijia Tan","doi":"10.1016/j.ctim.2025.103223","DOIUrl":"10.1016/j.ctim.2025.103223","url":null,"abstract":"<p><strong>Background: </strong>Acupuncture has increasingly gained popularity as alternative approach to conventional care for knee osteoarthritis (KOA) management. We conducted a pragmatic randomized controlled study to evaluate the clinical and health utility outcomes of acupuncture and heat therapy in conjunction with standard care for KOA.</p><p><strong>Methods: </strong>Community-ambulating KOA patients of 45 years or older were randomly assigned to the intervention or control (SC) group. The HARMOKnee group received 12 acupuncture and heat treatments in addition to standard care for six weeks. We evaluated the Knee Injury and Osteoarthritis and Outcome Score-12 (KOOS-12) at baseline, 6-, 12- and 24-week. Secondary outcomes including Pain, Enjoyment of Life and General Activity (PEG) scores, Patient Health Questionnaire-4 (PHQ-4), and TCM syndrome differentiation were evaluated. Comparative analysis was performed using mixed-effect models.</p><p><strong>Results: </strong>Among 101 participants (HARMOKnee=50; SC=51), the mean age was 63.99 ± 7.03 years, and KOA duration was 5.07 ± 6.35 years. There was a significant intervention-time interaction, favouring HARMOKnee group, for the KOOS-12 total score [Coef= 6.43, 95 %CI: 0.72, 12.14; p = 0.027], KOOS-12 quality of life (QOL) domain-score [Coef= 8.50, 95 %CI: 1.28, 15.73; p = 0.021], and PEG overall score [Coef= -1.32, 95 %CI: -2.14, -0.49; p = 0.002] at 6-week. No between-group differences were identified at other time-points. The HARMOKnee group demonstrated considerable pain reduction and improved knee flexion and extension after 12 treatments (0.001 < p < 0.014). This treatment approach markedly enhanced knee flexion in patients with Kidney yang deficiency with phlegm and blood stasis syndrome.</p><p><strong>Conclusions: </strong>HARMOKnee provides short-term pain-management benefits to KOA patients compared to standard care alone, particularly in patients with Kidney yang deficiency with phlegm and blood stasis syndrome.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103223"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144793649","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}
Pub Date : 2025-10-01DOI: 10.1016/j.ctim.2025.103253
Lili Mo , Diying Liao , Jianwei She , Bangbang Yan , Maowei Chen
Objective
The objective of this study was to systematically analyze the effects of different dance or dance integrated with other modalities on depressed patients in China to identify the most effective dance-based intervention.
Methods
Eight databases were searched for screening randomized controlled trials. Quality assessment was performed with the Rob-2 and network meta-analysis was conducted with Stata 17.0.
Results
Nineteen studies were included. Dance movement therapy(DMT) combined with Chinese dance elements(CDE) was ranked as the most effective intervention for depression (SUCRA=99.7 %). DMT combined with drugs was the most effective intervention for anxiety (SUCRA=87.7 %) and self-efficacy (SUCRA=78.8 %). Drawing therapy combined with dance intervention and drugs was the most effective intervention for improving quality of life (SUCRA=98.2 %). DMT combined with psychological intervention and drugs was the most effective intervention for positive coping (SUCRA=90.9 %). Egger’s test confirmed the robustness of this research.
Conclusions
DMT combined with CDE demonstrated the highest efficacy in improving depression, highlighting the importance of incorporating regional culture into dance therapy. DMT combined with drugs showed the most substantial improvements in anxiety and self-efficacy, reinforcing the recommendation that patients should keep pharmacological treatment. Drawing therapy combined with dance intervention and drugs had the most significant impact on quality of life, suggesting that patients should be encouraged to do more activities. DMT combined with psychological intervention and drugs was the most effective for positive coping. This indicates that psychological counseling is also important. To address multifaceted challenges, targeted intervention should be developed to meet diverse and complex needs comprehensively for patients.
{"title":"Effects of dance intervention on health-related outcomes in patients with depression in Mainland China: A network meta-analysis","authors":"Lili Mo , Diying Liao , Jianwei She , Bangbang Yan , Maowei Chen","doi":"10.1016/j.ctim.2025.103253","DOIUrl":"10.1016/j.ctim.2025.103253","url":null,"abstract":"<div><h3>Objective</h3><div>The objective of this study was to systematically analyze the effects of different dance or dance integrated with other modalities on depressed patients in China to identify the most effective dance-based intervention.</div></div><div><h3>Methods</h3><div>Eight databases were searched for screening randomized controlled trials. Quality assessment was performed with the Rob-2 and network meta-analysis was conducted with Stata 17.0.</div></div><div><h3>Results</h3><div>Nineteen studies were included. Dance movement therapy(DMT) combined with Chinese dance elements(CDE) was ranked as the most effective intervention for depression (SUCRA=99.7 %). DMT combined with drugs was the most effective intervention for anxiety (SUCRA=87.7 %) and self-efficacy (SUCRA=78.8 %). Drawing therapy combined with dance intervention and drugs was the most effective intervention for improving quality of life (SUCRA=98.2 %). DMT combined with psychological intervention and drugs was the most effective intervention for positive coping (SUCRA=90.9 %). Egger’s test confirmed the robustness of this research.</div></div><div><h3>Conclusions</h3><div>DMT combined with CDE demonstrated the highest efficacy in improving depression, highlighting the importance of incorporating regional culture into dance therapy. DMT combined with drugs showed the most substantial improvements in anxiety and self-efficacy, reinforcing the recommendation that patients should keep pharmacological treatment. Drawing therapy combined with dance intervention and drugs had the most significant impact on quality of life, suggesting that patients should be encouraged to do more activities. DMT combined with psychological intervention and drugs was the most effective for positive coping. This indicates that psychological counseling is also important. To address multifaceted challenges, targeted intervention should be developed to meet diverse and complex needs comprehensively for patients.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"94 ","pages":"Article 103253"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217444","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}
Pub Date : 2025-10-01Epub Date: 2025-08-05DOI: 10.1016/j.ctim.2025.103226
Benlu Liao, Maolin Tian
Background: While physical activity (PA) provides established benefits for youth (children and adolescents) development, the differential effects of mentally passive versus mentally active screen time (ST) on academic achievement and social behavior among physically active youth remain unclear. This study examined associations between different types of ST and developmental outcomes in youth who met the PA guideline.
Methods: Data from the 2016-2017 National Survey of Children's Health were analyzed, including 9967 participants aged 6-17 years who met the PA guideline (≥ 60 min daily) ST was categorized as mentally passive (TV-based) ST and mentally active (computer-based) ST. Academic achievement was assessed through curiosity, psychological resilience, and memory difficulties. Social behaviors consisted of bullying victimization, friendship difficulties, and argumentative behavior. All data were collected through caregiver-completed questionnaires. Multi-variable logistic regression analyses were conducted, controlling for demographic factors including age, sex, ethnicity, socioeconomic status, premature birth and parental education.
Results: Mentally passive (TV-based) ST demonstrated predominantly negative associations across all social-cognitive domains. Heavy users (≥4 h daily) showed significantly lower curiosity (OR=0.38, 95 % CI: 0.17-0.89), reduced psychological resilience, nearly four times higher odds of memory difficulties (OR=3.80, 95 % CI: 1.65-8.78), and increased bullying victimization (OR=2.93, 95 % CI: 1.52-5.67). However, mentally active (computer-based) ST showed more complex patterns: light users (<1 h daily) demonstrated higher curiosity and resilience compared to non-users, while heavy users (≥4 h daily) experienced negative outcomes including reduced resilience (OR=0.54, 95 % CI: 0.34-0.87) and increased social difficulties. Both types of ST at high usage levels were associated with increased argumentative behavior (passive ST: OR=2.74, 95 % CI: 1.53-4.91; active ST: OR=2.99, 95 % CI: 1.89-4.74).
Conclusions: Among physically active youth, mentally passive and mentally active ST demonstrate distinct associations with academic and social outcomes. Mentally Passive ST shows predominantly negative associations across all domains, while mentally active ST exhibits potential benefits at low usage but negative effects at high usage levels. These findings suggest that ST recommendations should consider both duration and type of sedentary activities, as PA alone may not fully protect against the adverse effects of excessive ST, particularly mentally passive screen exposure.
{"title":"Differential associations of passive and active screen time with academic performance and social function among physically active youth: a cross-sectional analysis.","authors":"Benlu Liao, Maolin Tian","doi":"10.1016/j.ctim.2025.103226","DOIUrl":"10.1016/j.ctim.2025.103226","url":null,"abstract":"<p><strong>Background: </strong>While physical activity (PA) provides established benefits for youth (children and adolescents) development, the differential effects of mentally passive versus mentally active screen time (ST) on academic achievement and social behavior among physically active youth remain unclear. This study examined associations between different types of ST and developmental outcomes in youth who met the PA guideline.</p><p><strong>Methods: </strong>Data from the 2016-2017 National Survey of Children's Health were analyzed, including 9967 participants aged 6-17 years who met the PA guideline (≥ 60 min daily) ST was categorized as mentally passive (TV-based) ST and mentally active (computer-based) ST. Academic achievement was assessed through curiosity, psychological resilience, and memory difficulties. Social behaviors consisted of bullying victimization, friendship difficulties, and argumentative behavior. All data were collected through caregiver-completed questionnaires. Multi-variable logistic regression analyses were conducted, controlling for demographic factors including age, sex, ethnicity, socioeconomic status, premature birth and parental education.</p><p><strong>Results: </strong>Mentally passive (TV-based) ST demonstrated predominantly negative associations across all social-cognitive domains. Heavy users (≥4 h daily) showed significantly lower curiosity (OR=0.38, 95 % CI: 0.17-0.89), reduced psychological resilience, nearly four times higher odds of memory difficulties (OR=3.80, 95 % CI: 1.65-8.78), and increased bullying victimization (OR=2.93, 95 % CI: 1.52-5.67). However, mentally active (computer-based) ST showed more complex patterns: light users (<1 h daily) demonstrated higher curiosity and resilience compared to non-users, while heavy users (≥4 h daily) experienced negative outcomes including reduced resilience (OR=0.54, 95 % CI: 0.34-0.87) and increased social difficulties. Both types of ST at high usage levels were associated with increased argumentative behavior (passive ST: OR=2.74, 95 % CI: 1.53-4.91; active ST: OR=2.99, 95 % CI: 1.89-4.74).</p><p><strong>Conclusions: </strong>Among physically active youth, mentally passive and mentally active ST demonstrate distinct associations with academic and social outcomes. Mentally Passive ST shows predominantly negative associations across all domains, while mentally active ST exhibits potential benefits at low usage but negative effects at high usage levels. These findings suggest that ST recommendations should consider both duration and type of sedentary activities, as PA alone may not fully protect against the adverse effects of excessive ST, particularly mentally passive screen exposure.</p>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":" ","pages":"103226"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144798379","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}
Pub Date : 2025-10-01DOI: 10.1016/j.ctim.2025.103252
Xiaolin Wei , Dan Liu , Ruzhen Yuan , Wei Zheng , Kunpeng Li , Caiqin Wu
Background
Post-operative breast cancer patients undergoing chemotherapy frequently experience concurrent upper limb dysfunction and chemotherapy-related cognitive impairment, creating a synergistic burden that complicates rehabilitation. Existing interventions often target these issues in isolation. Baduanjin, a traditional Chinese mind-body exercise, integrates physical movement with cognitive engagement, making it a promising candidate for addressing both domains simultaneously. However, robust evidence from randomized controlled trials (RCTs) was lacking. This RCT aimed to evaluate the effects of Baduanjin on both cognitive performance and upper limb function in this population.
Methods
A two-arm, randomized controlled trial was conducted. Seventy women diagnosed with breast cancer and scheduled for chemotherapy were randomly assigned to either a 12-week supervised Baduanjin exercise group or a control group receiving usual care. Subjective cognitive function was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). The neuropsychological test battery included the Auditory Verbal Learning Test (AVLT), the Trail Making Test (TMT), and the Digit Symbol Substitution Test (DSST). Upper limb function was assessed using the Constant-Murley Score (CMS). All assessments were performed at baseline (T0), Week 4 (T1), Week 8 (T2), and Week 12 (T3).
Results
Compared to the control group, the Baduanjin group demonstrated significant improvements in total FACT-Cog scores (F=17.710, p < 0.001), perceived cognitive impairments (F=20.085, p < 0.001), and perceived cognitive abilities (F=5.116, p = 0.027). A statistically significant group effect was observed for AVLT6 (F=13.862, p < 0.001). In addition, significant differences were observed between the two groups in shoulder function (p = 0.004, 95 % CI: 1.09, 5.59) and ROM (p = 0.002, 95 % CI: 0.87, 3.98).
Conclusion
A 12-week Baduanjin exercise intervention significantly improved subjective cognitive complaints and shoulder function in breast cancer patients undergoing post-operative chemotherapy. The findings support Baduanjin as a safe, feasible, and beneficial adjunct therapy that can concurrently address two prevalent and distressing sequelae of breast cancer treatment.
背景：接受化疗的乳腺癌术后患者经常同时出现上肢功能障碍和化疗相关的认知障碍，造成了使康复复杂化的协同负担。现有的干预措施往往孤立地针对这些问题。八段锦是一种传统的中国身心运动，它将身体运动与认知参与结合起来，使其成为同时解决这两个领域的有希望的候选人。然而，缺乏随机对照试验（rct）的有力证据。本随机对照试验旨在评估八段锦对该人群认知能力和上肢功能的影响。方法：采用两组随机对照试验。70名确诊为乳腺癌并计划接受化疗的妇女被随机分配到一个为期12周的有监督的八段锦运动组和一个接受常规护理的对照组。主观认知功能评估采用癌症治疗-认知功能功能评估（FACT-Cog）。神经心理测试组包括听觉语言学习测试（AVLT）、痕迹制造测试（TMT）和数字符号替代测试（DSST）。采用Constant-Murley评分（CMS）评估上肢功能。所有评估均在基线（T0）、第4周（T1）、第8周（T2）和第12周（T3）进行。结果：与对照组相比，八段锦组在FACT-Cog总分（F=17.710, p < 0.001）、认知障碍感知（F=20.085, p < 0.001）和认知能力感知（F=5.116, p=0.027）方面均有显著改善。AVLT6的组效应有统计学意义（F=13.862, p < 0.001）。此外，两组肩关节功能（p=0.004, 95% CI: 1.09, 5.59）和关节活动度（p=0.002, 95% CI: 0.87, 3.98）也有显著差异。结论：为期12周的八段锦运动干预可显著改善乳腺癌术后化疗患者的主观认知主诉和肩部功能。研究结果支持八段锦作为一种安全、可行、有益的辅助疗法，可以同时解决乳腺癌治疗中两种普遍存在的令人痛苦的后遗症。
{"title":"Effects of Baduanjin on cognitive performance and upper limb function in patients receiving chemotherapy after breast cancer surgery: A randomized controlled trial","authors":"Xiaolin Wei , Dan Liu , Ruzhen Yuan , Wei Zheng , Kunpeng Li , Caiqin Wu","doi":"10.1016/j.ctim.2025.103252","DOIUrl":"10.1016/j.ctim.2025.103252","url":null,"abstract":"<div><h3>Background</h3><div>Post-operative breast cancer patients undergoing chemotherapy frequently experience concurrent upper limb dysfunction and chemotherapy-related cognitive impairment, creating a synergistic burden that complicates rehabilitation. Existing interventions often target these issues in isolation. Baduanjin, a traditional Chinese mind-body exercise, integrates physical movement with cognitive engagement, making it a promising candidate for addressing both domains simultaneously. However, robust evidence from randomized controlled trials (RCTs) was lacking. This RCT aimed to evaluate the effects of Baduanjin on both cognitive performance and upper limb function in this population.</div></div><div><h3>Methods</h3><div>A two-arm, randomized controlled trial was conducted. Seventy women diagnosed with breast cancer and scheduled for chemotherapy were randomly assigned to either a 12-week supervised Baduanjin exercise group or a control group receiving usual care. Subjective cognitive function was assessed using the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog). The neuropsychological test battery included the Auditory Verbal Learning Test (AVLT), the Trail Making Test (TMT), and the Digit Symbol Substitution Test (DSST). Upper limb function was assessed using the Constant-Murley Score (CMS). All assessments were performed at baseline (T0), Week 4 (T1), Week 8 (T2), and Week 12 (T3).</div></div><div><h3>Results</h3><div>Compared to the control group, the Baduanjin group demonstrated significant improvements in total FACT-Cog scores (<em>F</em>=17.710, <em>p</em> < 0.001), perceived cognitive impairments (<em>F</em>=20.085, <em>p</em> < 0.001), and perceived cognitive abilities (<em>F</em>=5.116, <em>p</em> = 0.027). A statistically significant group effect was observed for AVLT6 (<em>F</em>=13.862, <em>p</em> < 0.001). In addition, significant differences were observed between the two groups in shoulder function (<em>p</em> = 0.004, 95 % CI: 1.09, 5.59) and ROM (<em>p</em> = 0.002, 95 % CI: 0.87, 3.98).</div></div><div><h3>Conclusion</h3><div>A 12-week Baduanjin exercise intervention significantly improved subjective cognitive complaints and shoulder function in breast cancer patients undergoing post-operative chemotherapy. The findings support Baduanjin as a safe, feasible, and beneficial adjunct therapy that can concurrently address two prevalent and distressing sequelae of breast cancer treatment.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"94 ","pages":"Article 103252"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145224987","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}
Plook-Fire-Thatu (PFT) is an ancient Thai herbal formulation traditionally believed to increase breast milk volume. However, clinical studies on the PFT’s effectiveness for breast milk production are lacking.
Objective
This study aimed to evaluate the effectiveness and safety of PFT in increasing breast milk volume.
Materials and methods
A randomised controlled trial was conducted involving 60 postpartum women. The treatment group received standard care alongside 500 mg of PFT orally, three times daily for three days, while the control group received standard care alone. Serum prolactin levels, haematological parameters and blood chemistry were assessed on days 1 and 3. Breast milk volume was measured using an electronic pump on days 1, 2 and 3. Adverse drug reactions in mothers and infants were monitored on days 1, 2, 3, 7 and 30. Breast milk samples were analysed for macronutrient content using Fourier-transform infrared spectroscopy.
Results
Baseline characteristics were comparable between groups. The treatment group exhibited significantly greater breast milk volume on days 2 (p = 0.028) and 3 (p = 0.002) compared with the control group. Serum prolactin levels increased significantly in the treatment group (p = 0.002). No significant differences were observed in haematological or blood chemistry between groups. Glycogen and carbohydrate levels in breast milk were significantly higher in the treatment group. Two participants reported mild epigastric discomfort on the first day, with no further adverse events reported.
Conclusion
By the third day, PFT significantly increased breast milk volume and serum prolactin levels. Increases in glycogen and carbohydrate content in breast milk were also observed. The formulation was well tolerated, with no significant adverse effects in mothers or infants.
{"title":"Efficacy and safety of the Plook-Fire-Thatu recipe on breast milk volume and breast milk macronutrient composition in postpartum women: A randomised controlled trial","authors":"Pannida Sintupattanapun , Niwatchai Namvichaisirikul , Pattama Tongdee , Nareelux Suwannobol , Kanyarat Thueng-in , Aree Chueadet , Sukanya Tastub","doi":"10.1016/j.ctim.2025.103255","DOIUrl":"10.1016/j.ctim.2025.103255","url":null,"abstract":"<div><h3>Background</h3><div><em>Plook-Fire-Thatu</em> (PFT) is an ancient Thai herbal formulation traditionally believed to increase breast milk volume. However, clinical studies on the PFT’s effectiveness for breast milk production are lacking.</div></div><div><h3>Objective</h3><div>This study aimed to evaluate the effectiveness and safety of PFT in increasing breast milk volume.</div></div><div><h3>Materials and methods</h3><div>A randomised controlled trial was conducted involving 60 postpartum women. The treatment group received standard care alongside 500 mg of PFT orally, three times daily for three days, while the control group received standard care alone. Serum prolactin levels, haematological parameters and blood chemistry were assessed on days 1 and 3. Breast milk volume was measured using an electronic pump on days 1, 2 and 3. Adverse drug reactions in mothers and infants were monitored on days 1, 2, 3, 7 and 30. Breast milk samples were analysed for macronutrient content using Fourier-transform infrared spectroscopy.</div></div><div><h3>Results</h3><div>Baseline characteristics were comparable between groups. The treatment group exhibited significantly greater breast milk volume on days 2 (<em>p</em> = 0.028) and 3 (<em>p</em> = 0.002) compared with the control group. Serum prolactin levels increased significantly in the treatment group (<em>p</em> = 0.002). No significant differences were observed in haematological or blood chemistry between groups. Glycogen and carbohydrate levels in breast milk were significantly higher in the treatment group. Two participants reported mild epigastric discomfort on the first day, with no further adverse events reported.</div></div><div><h3>Conclusion</h3><div>By the third day, PFT significantly increased breast milk volume and serum prolactin levels. Increases in glycogen and carbohydrate content in breast milk were also observed. The formulation was well tolerated, with no significant adverse effects in mothers or infants.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"94 ","pages":"Article 103255"},"PeriodicalIF":3.5,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145217443","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}
Pub Date : 2025-09-22DOI: 10.1016/j.ctim.2025.103250
Lei Chen , Kaiyin Wang , Wenrui Huang , XueLian Du
<div><h3>Background</h3><div>This study aimed to compare the efficacy and safety of different acupuncture-related interventions for perimenopausal depression and anxiety using a frequentist network meta-analysis, in order to identify the most effective treatment strategies.</div></div><div><h3>Method</h3><div>We systematically searched Chinese and international databases for randomized controlled trials evaluating the efficacy and safety of acupuncture for perimenopausal depression and anxiety. Studies were screened and selected based on predefined PICOS criteria. Two reviewers independently performed study selection, data extraction, risk-of-bias assessment, and evaluation of evidence certainty using the CINeMA tool. A frequentist network meta-analysis was conducted using Stata 17.0. Mean differences were used for continuous outcomes and risk ratios for binary outcomes. Heterogeneity and consistency were assessed, and Surface under the cumulative ranking curve (SUCRA) values were calculated to rank the comparative effectiveness of different acupuncture interventions.</div></div><div><h3>Result</h3><div>A total of 54 randomized controlled trials were included, involving 4406 participants. The included studies were predominantly of moderate quality, with few at low or high risk of bias. According to the CINeMA assessment, the certainty of evidence for most pairwise comparisons was rated as low to moderate. Acupuncture-related interventions showed superior efficacy to Western medicine in improving clinical response rates, depressive and anxiety symptoms, menopausal complaints, and hormone levels. For clinical response, the most effective interventions were manual acupuncture (MA) + Chinese herbal medicine (CHM) (RR = 1.52, 95 % CI: 1.12–2.08) and electroacupuncture (EA) + CHM (RR = 1.49, 95 % CI: 1.05–2.12). Regarding depressive symptoms measured by the Hamilton Depression Scale (HAMD), EA + Western medicine (WM) (MD = –5.04, 95 % CI: –6.97 to –3.12) and MA + CHM (MD = –5.69, 95 % CI: –10.47 to –0.92) achieved the greatest reductions. For anxiety symptoms assessed by the Hamilton Anxiety Scale (HAMA), EA alone significantly reduced scores (MD = –8.40, 95 % CI: –14.31 to –2.49). On the Kupperman Index, MA + WM (MD = –5.37) and MA + CHM (MD = –5.00) were most effective. EA + WM also produced the largest improvement in Self-Rating Depression Scale (SDS) scores (MD = –9.10). Hormonally, MA + WM significantly increased estradiol (E2) levels (MD = 26.25), while both EA + WM and MA + CHM lowered follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. SUCRA analysis indicated that EA + WM and MA + CHM consistently ranked among the top treatments across most outcomes.</div></div><div><h3>Conclusion</h3><div>EA + WM and MA + CHM may be among the most effective acupuncture-based interventions for perimenopausal depression and anxiety. However, given the moderate quality of evidence, further high-quality trials are needed to confirm these findi
{"title":"Comparative efficacy of acupuncture-related interventions for perimenopausal depression and anxiety: A systematic review and frequentist meta-analysis","authors":"Lei Chen , Kaiyin Wang , Wenrui Huang , XueLian Du","doi":"10.1016/j.ctim.2025.103250","DOIUrl":"10.1016/j.ctim.2025.103250","url":null,"abstract":"<div><h3>Background</h3><div>This study aimed to compare the efficacy and safety of different acupuncture-related interventions for perimenopausal depression and anxiety using a frequentist network meta-analysis, in order to identify the most effective treatment strategies.</div></div><div><h3>Method</h3><div>We systematically searched Chinese and international databases for randomized controlled trials evaluating the efficacy and safety of acupuncture for perimenopausal depression and anxiety. Studies were screened and selected based on predefined PICOS criteria. Two reviewers independently performed study selection, data extraction, risk-of-bias assessment, and evaluation of evidence certainty using the CINeMA tool. A frequentist network meta-analysis was conducted using Stata 17.0. Mean differences were used for continuous outcomes and risk ratios for binary outcomes. Heterogeneity and consistency were assessed, and Surface under the cumulative ranking curve (SUCRA) values were calculated to rank the comparative effectiveness of different acupuncture interventions.</div></div><div><h3>Result</h3><div>A total of 54 randomized controlled trials were included, involving 4406 participants. The included studies were predominantly of moderate quality, with few at low or high risk of bias. According to the CINeMA assessment, the certainty of evidence for most pairwise comparisons was rated as low to moderate. Acupuncture-related interventions showed superior efficacy to Western medicine in improving clinical response rates, depressive and anxiety symptoms, menopausal complaints, and hormone levels. For clinical response, the most effective interventions were manual acupuncture (MA) + Chinese herbal medicine (CHM) (RR = 1.52, 95 % CI: 1.12–2.08) and electroacupuncture (EA) + CHM (RR = 1.49, 95 % CI: 1.05–2.12). Regarding depressive symptoms measured by the Hamilton Depression Scale (HAMD), EA + Western medicine (WM) (MD = –5.04, 95 % CI: –6.97 to –3.12) and MA + CHM (MD = –5.69, 95 % CI: –10.47 to –0.92) achieved the greatest reductions. For anxiety symptoms assessed by the Hamilton Anxiety Scale (HAMA), EA alone significantly reduced scores (MD = –8.40, 95 % CI: –14.31 to –2.49). On the Kupperman Index, MA + WM (MD = –5.37) and MA + CHM (MD = –5.00) were most effective. EA + WM also produced the largest improvement in Self-Rating Depression Scale (SDS) scores (MD = –9.10). Hormonally, MA + WM significantly increased estradiol (E2) levels (MD = 26.25), while both EA + WM and MA + CHM lowered follicle-stimulating hormone (FSH) and luteinizing hormone (LH) levels. SUCRA analysis indicated that EA + WM and MA + CHM consistently ranked among the top treatments across most outcomes.</div></div><div><h3>Conclusion</h3><div>EA + WM and MA + CHM may be among the most effective acupuncture-based interventions for perimenopausal depression and anxiety. However, given the moderate quality of evidence, further high-quality trials are needed to confirm these findi","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"94 ","pages":"Article 103250"},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136795","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}
Pub Date : 2025-09-22DOI: 10.1016/j.ctim.2025.103251
Bugse Yuceer , Fatma Ilknur Cinar
Background and purpose
Type II Diabetes Mellitus (DM) is a multifaceted, chronic metabolic condition requiring persistent adherence to treatment for effective management. Previous research has largely emphasized medical and behavioral determinants of adherence, while psychological and spiritual factors remain underexplored. Addressing this gap, the present study examines multidimensional factors associated with treatment adherence among individuals with Type II DM, within the framework of the Multidimensional Adherence Model (MAM), with a particular focus on the roles of mindfulness and spiritual well-being.
Materials and methods
A cross-sectional design was employed, involving 125 patients with Type II DM. Data were collected based on five dimensions within the MAM framework. The study utilized validated instruments, including the Patient Information Form, Mindful Attention Awareness Scale, Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale, Treatment Adherence in Type II DM Scale. The data were analysed using descriptive and correlational statistics and structural equation modelling. In this hypothesized model, the independent variable was mindfulness, the mediator was spiritual well-being, and the dependent variable was treatment adherence.
Results
Treatment adherence was significantly related to patient-related, socio-economic, healthcare system, and condition-related factors. Higher levels of mindfulness and spiritual well-being were positively associated with improved adherence behaviors. Notably, spiritual well-being demonstrated statistically significant indirect association in the link between mindfulness and treatment adherence.
Conclusion
This study highlights the need for a patient-centered approach to Type II DM care, integrating psychological and spiritual dimensions alongside medical management. Mindfulness and spiritual well-being emerged as key correlates of adherence, emphasizing the importance of holistic care in diabetes treatment.
{"title":"Multidimensional factors associated with treatment adherence in Type II diabetes: The roles of spiritual well-being and mindfulness","authors":"Bugse Yuceer , Fatma Ilknur Cinar","doi":"10.1016/j.ctim.2025.103251","DOIUrl":"10.1016/j.ctim.2025.103251","url":null,"abstract":"<div><h3>Background and purpose</h3><div>Type II Diabetes Mellitus (DM) is a multifaceted, chronic metabolic condition requiring persistent adherence to treatment for effective management. Previous research has largely emphasized medical and behavioral determinants of adherence, while psychological and spiritual factors remain underexplored. Addressing this gap, the present study examines multidimensional factors associated with treatment adherence among individuals with Type II DM, within the framework of the Multidimensional Adherence Model (MAM), with a particular focus on the roles of mindfulness and spiritual well-being.</div></div><div><h3>Materials and methods</h3><div>A cross-sectional design was employed, involving 125 patients with Type II DM. Data were collected based on five dimensions within the MAM framework. The study utilized validated instruments, including the Patient Information Form, Mindful Attention Awareness Scale, Functional Assessment of Chronic Illness Therapy–Spiritual Well-Being Scale, Treatment Adherence in Type II DM Scale. The data were analysed using descriptive and correlational statistics and structural equation modelling. In this hypothesized model, the independent variable was mindfulness, the mediator was spiritual well-being, and the dependent variable was treatment adherence.</div></div><div><h3>Results</h3><div>Treatment adherence was significantly related to patient-related, socio-economic, healthcare system, and condition-related factors. Higher levels of mindfulness and spiritual well-being were positively associated with improved adherence behaviors. Notably, spiritual well-being demonstrated statistically significant indirect association in the link between mindfulness and treatment adherence.</div></div><div><h3>Conclusion</h3><div>This study highlights the need for a patient-centered approach to Type II DM care, integrating psychological and spiritual dimensions alongside medical management. Mindfulness and spiritual well-being emerged as key correlates of adherence, emphasizing the importance of holistic care in diabetes treatment.</div></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":"94 ","pages":"Article 103251"},"PeriodicalIF":3.5,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145136724","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}
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