Pub Date : 2024-02-01DOI: 10.1016/j.ctim.2023.103011
Richard Hammerschlag , Meredith L. Sprengel , Ann L. Baldwin
A set of guidelines has been developed to help improve reporting of clinical trials of biofield therapies. The need for enhanced transparency when reporting trials of this family of integrative health practices, e.g., External Qigong, Healing Touch, Reiki and Therapeutic Touch, has been advocated in systematic reviews of these studies. The guidelines, called Biofield Therapies: Reporting Evidence Guidelines (BiFi REGs), supplement CONSORT 2010 by including details of the intervention protocols relevant to biofield therapy trials. BiFi REGs evolved through a draft document created by a core group, two rounds of a Delphi process with an international group of subject matter experts and two panels, meeting via Zoom, which included editors of complementary and integrative medicine journals. BiFi REGs comprises a 15-item Intervention checklist. Modifications of two other CONSORT topic areas are also proposed to enhance their relevance to trials of biofield therapies. Included for each item are an explanation, and exemplars of reporting from peer-reviewed published reports of biofield therapy trials. When used in conjunction with all other items from CONSORT 2010, we anticipate that BiFi REGs will expedite the peer review process for biofield therapy trials, facilitate attempts at trial replication and help to inform decision-making in the clinical practice of biofield therapies.
{"title":"Biofield therapies: Guidelines for reporting clinical trials","authors":"Richard Hammerschlag , Meredith L. Sprengel , Ann L. Baldwin","doi":"10.1016/j.ctim.2023.103011","DOIUrl":"10.1016/j.ctim.2023.103011","url":null,"abstract":"<div><p>A set of guidelines has been developed to help improve reporting of clinical trials of biofield therapies. The need for enhanced transparency when reporting trials of this family of integrative health practices, e.g., External Qigong, Healing Touch, Reiki and Therapeutic Touch, has been advocated in systematic reviews of these studies. The guidelines, called <strong>Bi</strong>o<strong>fi</strong>eld Therapies: <strong>Re</strong>porting <strong>E</strong>vidence <strong>G</strong>uidelines (BiFi REGs), supplement CONSORT 2010 by including details of the intervention protocols relevant to biofield therapy trials. BiFi REGs evolved through a draft document created by a core group, two rounds of a Delphi process with an international group of subject matter experts and two panels, meeting via Zoom, which included editors of complementary and integrative medicine journals. BiFi REGs comprises a 15-item Intervention checklist. Modifications of two other CONSORT topic areas are also proposed to enhance their relevance to trials of biofield therapies. Included for each item are an explanation, and exemplars of reporting from peer-reviewed published reports of biofield therapy trials. When used in conjunction with all other items from CONSORT 2010, we anticipate that BiFi REGs will expedite the peer review process for biofield therapy trials, facilitate attempts at trial replication and help to inform decision-making in the clinical practice of biofield therapies.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229923000985/pdfft?md5=39865fcc56937a0536c16bb3c3f11488&pid=1-s2.0-S0965229923000985-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139669152","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 : 2024-01-20DOI: 10.1016/j.ctim.2024.103026
Anne Kristine Amstrup, Lars Rejnmark
Objectives
Studies suggest that melatonin may promote cardiovascular protection. Previous trials have primarily been performed on co-morbid patients. Little information exist on the effect in postmenopausal women with general good health.
Design, participants and intervention
In a double-blinded placebo-controlled study, we randomized 41 postmenopausal women to either 10 mg melatonin per day or placebo for 3 months.
Outcome measures
Outcomes of the trial was changes in blood pressure, pulse wave velocity (PWV), and quality of sleep evaluated by Pittsburgh Sleep Quality Index (PSQI).
Results
Thirty-nine women completed the study. Mean age was 63 years (range 55–75 years). Over the 3 months of the trial, PWV did not differ between groups: Placebo 1.1% (IQR −2.1;9.9) vs. melatonin 0.0% (IQR-9.8;4.1), p = 0.43). The were no significant differences in blood pressure bewteen melatonin and placebo group. Both groups had a pour quality of sleep at baseline (placebo: PSQI 6.0 (IQR 3.3; 8.8) vs. melatonin PSQI 6.0 (IQR 3.0; 10.0), p = 0.94), which did not change in response to treatment.
Conclusion
In healthy postmenopausal women, supplementation with 10 mg melatonin was well-tolerated, but we did not observe any significant improvements in pulse wave velocity, blood pressure or quality of sleep compared with placebo.
{"title":"Effects of melatonin on blood pressure, arterial stiffness and quality of life in postmenopausal women: A randomized controlled trial","authors":"Anne Kristine Amstrup, Lars Rejnmark","doi":"10.1016/j.ctim.2024.103026","DOIUrl":"10.1016/j.ctim.2024.103026","url":null,"abstract":"<div><h3>Objectives</h3><p>Studies suggest that melatonin may promote cardiovascular protection. Previous trials have primarily been performed on co-morbid patients. Little information exist on the effect in postmenopausal women with general good health.</p></div><div><h3>Design, participants and intervention</h3><p>In a double-blinded placebo-controlled study, we randomized 41 postmenopausal women to either 10 mg melatonin per day or placebo for 3 months.</p></div><div><h3>Outcome measures</h3><p>Outcomes of the trial was changes in blood pressure, pulse wave velocity (PWV), and quality of sleep evaluated by Pittsburgh Sleep Quality Index (PSQI).</p></div><div><h3>Results</h3><p>Thirty-nine women completed the study. Mean age was 63 years (range 55–75 years). Over the 3 months of the trial, PWV did not differ between groups: Placebo 1.1% (IQR −2.1;9.9) vs. melatonin 0.0% (IQR-9.8;4.1), p = 0.43). The were no significant differences in blood pressure bewteen melatonin and placebo group. Both groups had a pour quality of sleep at baseline (placebo: PSQI 6.0 (IQR 3.3; 8.8) vs. melatonin PSQI 6.0 (IQR 3.0; 10.0), p = 0.94), which did not change in response to treatment.</p></div><div><h3>Conclusion</h3><p>In healthy postmenopausal women, supplementation with 10 mg melatonin was well-tolerated, but we did not observe any significant improvements in pulse wave velocity, blood pressure or quality of sleep compared with placebo.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000141/pdfft?md5=a579c3b81dc9dfa85261021c6b0b61c8&pid=1-s2.0-S0965229924000141-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139510139","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 : 2024-01-15DOI: 10.1016/j.ctim.2024.103025
Armin Ebrahimzadeh , Shokouh Mohseni , Mohammad Safargar , Abbas Mohtashamian , Sara Niknam , Mohammadreza Bakhoda , Sanaz Afshari , Amirhossein Jafari , Anahita Ebrahimzadeh , Sara Fooladshekan , Alireza Mohtashami , Gordon A. Ferns , Siavash Babajafari , Zahra Sohrabi
Objectives
Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate previous findings for the effect of curcumin supplementation on glycaemic indices, lipid profile, blood pressure, inflammatory markers, and anthropometric measurements of NAFLD patients.
Methods
Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, SCOPUS, WOS, Science Direct, Ovid and Cochrane. The systematic review and meta-analysis were conducted according to the 2020 PRISMA guidelines. The quality of the papers was assessed the using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Pooled effect sizes were calculated using a random-effects model and reported as the WMD and 95% CI. Also, subgroup analyses were done to find probable sources of heterogeneity among studies.
Results
Out of 21010 records initially identified, 21 eligible RCTs were selected for inclusion in a meta-analysis. Overall, 1191 participants of both genders, 600 in the intervention and 591 in the control group with NAFLD were included. There are several limitations in the studies that were included, for instance, the results are weakened substantially by potential bias or failure to account for potential adulteration (with pharmaceuticals) or contamination (with other herbs) of the curcumin supplements that were tested. However, previous studies have reported curcumin to be a safe complementary therapy for several conditions. Our study indicated that curcumin supplementation in doses of 50−3000 mg/day was associated with significant change in FBG [WMD: −2.83; 95% CI: −4.61, −1.06), = 51.3%], HOMA-IR [WMD: −0.52; 95% CI: −0.84, −0.20), = 82.8%], TG [WMD: −10.31; 95% CI: −20.00, −0.61), = 84.5%], TC [WMD: −11.81; 95% CI: −19.65, −3.96), = 94.6%], LDL [WMD: −8.01; 95% CI: −15.79, −0.24), = 96.1%], weight [WMD: −0.81; 95% CI: −1.28, −0.35), = 0.0%] and BMI [WMD: −0.35; 95% CI: −0.57, −0.13), = 0.0%] in adults with NAFLD. There was no significant change in HbA1C, plasma insulin, QUICKI, HDL, SBP, DBP, CRP, TNF-α and WC after curcumin therapy. Subgroup analysis suggested a significant changes in serum FBG, TG, SBP, WC in RCTs for intervention durations of ≥ 8 weeks, and SBP, TG, LD
{"title":"Curcumin effects on glycaemic indices, lipid profile, blood pressure, inflammatory markers and anthropometric measurements of non-alcoholic fatty liver disease patients: A systematic review and meta-analysis of randomized clinical trials","authors":"Armin Ebrahimzadeh , Shokouh Mohseni , Mohammad Safargar , Abbas Mohtashamian , Sara Niknam , Mohammadreza Bakhoda , Sanaz Afshari , Amirhossein Jafari , Anahita Ebrahimzadeh , Sara Fooladshekan , Alireza Mohtashami , Gordon A. Ferns , Siavash Babajafari , Zahra Sohrabi","doi":"10.1016/j.ctim.2024.103025","DOIUrl":"10.1016/j.ctim.2024.103025","url":null,"abstract":"<div><h3>Objectives</h3><p>Curcumin has antioxidant properties and has been proposed as a potential treatment for NAFLD. The aim of current systematic review and meta-analysis was to evaluate previous findings for the effect of curcumin supplementation on glycaemic indices, lipid profile, blood pressure, inflammatory markers, and anthropometric measurements of NAFLD patients.</p></div><div><h3>Methods</h3><p>Relevant studies published up to January 2024 were searched systematically using the following databases: PubMed, SCOPUS, WOS, Science Direct, Ovid and Cochrane. The systematic review and meta-analysis were conducted according to the 2020 PRISMA guidelines. The quality of the papers was assessed the using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist. Pooled effect sizes were calculated using a random-effects model and reported as the WMD and 95% CI. Also, subgroup analyses were done to find probable sources of heterogeneity among studies.</p></div><div><h3>Results</h3><p>Out of 21010 records initially identified, 21 eligible RCTs were selected for inclusion in a meta-analysis. Overall, 1191 participants of both genders, 600 in the intervention and 591 in the control group with NAFLD were included. There are several limitations in the studies that were included, for instance, the results are weakened substantially by potential bias or failure to account for potential adulteration (with pharmaceuticals) or contamination (with other herbs) of the curcumin supplements that were tested. However, previous studies have reported curcumin to be a safe complementary therapy for several conditions. Our study indicated that curcumin supplementation in doses of 50−3000 mg/day was associated with significant change in FBG [WMD: −2.83; 95% CI: −4.61, −1.06), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span> = 51.3%], HOMA-IR [WMD: −0.52; 95% CI: −0.84, −0.20), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span>= 82.8%], TG [WMD: −10.31; 95% CI: −20.00, −0.61), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span> = 84.5%], TC [WMD: −11.81; 95% CI: −19.65, −3.96), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span> = 94.6%], LDL [WMD: −8.01; 95% CI: −15.79, −0.24), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span> = 96.1%], weight [WMD: −0.81; 95% CI: −1.28, −0.35), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span>= 0.0%] and BMI [WMD: −0.35; 95% CI: −0.57, −0.13), <span><math><msup><mrow><mi>I</mi></mrow><mrow><mn>2</mn></mrow></msup></math></span>= 0.0%] in adults with NAFLD. There was no significant change in HbA1C, plasma insulin, QUICKI, HDL, SBP, DBP, CRP, TNF-α and WC after curcumin therapy. Subgroup analysis suggested a significant changes in serum FBG, TG, SBP, WC in RCTs for intervention durations of ≥ 8 weeks, and SBP, TG, LD","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S096522992400013X/pdfft?md5=a0f4b90bf51244efc173a70d65eb088f&pid=1-s2.0-S096522992400013X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139470751","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}
Post-stroke spasticity (PSS) is the most common complication of stroke. Acupuncture is widely used in clinical practice for the treatment of PSS, and is therefore considered a common complementary treatment. Several systematic reviews (SRs) and meta-analyses (MAs) have demonstrated the efficacy and safety of acupuncture in the treatment of PSS; however, the quality of evidence of these studies has not been adequately assessed.
Objective
To evaluate and summarize the SRs/MAs and inform future research and clinical practice on the efficacy and safety of acupuncture for PSS.
Data sources and extracion
The following databases were searched from their dates of inception to March 26, 2023: PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, SinoMed, and Chinese Science and Technology Periodical Database (VIP), and grey literature were manually searched. Two reviewers independently completed literature retrieval, screening, and data extraction.
Review appraisal
Systematic evaluation tools to Assess Systematic Reviews (AMSTAR) 2, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020 Checklist), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system were used to systematically evaluate the methodological, reporting, and evidence quality of the SRs/MAs.
Results
Overall, 226 papers were examined, and after careful consideration, 10 SRs/MAs were deemed eligible for inclusion. The AMSTAR 2 assessment revealed that one SR/MA had medium, one study had low, and the remaining eight studies had critically low methodological qualities. Additionally, four SRs/MAs completed more than 60 % of the PRISMA 2020 checklist. The GRADE system indicated that six outcomes were medium, 26 outcomes were low, and 24 outcomes were critically low.
Conclusion
Based on the evidence, acupuncture may be a promising complementary treatment to improve post-stroke spasticity and quality of life. Further high-quality RCTs are needed in future studies to support the broader application of acupuncture for the treatment of PSS.
{"title":"Acupuncture for post-stroke spasticity: An overview of systematic reviews","authors":"Lizhen Yi, Linxing Huang, Ruixue Chen, Sheng Zhan, Huiyuan Huang, Zenghui Yue","doi":"10.1016/j.ctim.2024.103024","DOIUrl":"10.1016/j.ctim.2024.103024","url":null,"abstract":"<div><h3>Background</h3><p>Post-stroke spasticity (PSS) is the most common complication of stroke. Acupuncture is widely used in clinical practice for the treatment of PSS, and is therefore considered a common complementary treatment. Several systematic reviews (SRs) and meta-analyses (MAs) have demonstrated the efficacy and safety of acupuncture in the treatment of PSS; however, the quality of evidence of these studies has not been adequately assessed.</p></div><div><h3>Objective</h3><p>To evaluate and summarize the SRs/MAs and inform future research and clinical practice on the efficacy and safety of acupuncture for PSS.</p></div><div><h3>Data sources and extracion</h3><p>The following databases were searched from their dates of inception to March 26, 2023: PubMed, Embase, The Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, SinoMed, and Chinese Science and Technology Periodical Database (VIP), and grey literature were manually searched. Two reviewers independently completed literature retrieval, screening, and data extraction.</p></div><div><h3>Review appraisal</h3><p>Systematic evaluation tools to Assess Systematic Reviews (AMSTAR) 2, Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA 2020 Checklist), and the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) system were used to systematically evaluate the methodological, reporting, and evidence quality of the SRs/MAs.</p></div><div><h3>Results</h3><p>Overall, 226 papers were examined, and after careful consideration, 10 SRs/MAs were deemed eligible for inclusion. The AMSTAR 2 assessment revealed that one SR/MA had medium, one study had low, and the remaining eight studies had critically low methodological qualities. Additionally, four SRs/MAs completed more than 60 % of the PRISMA 2020 checklist. The GRADE system indicated that six outcomes were medium, 26 outcomes were low, and 24 outcomes were critically low.</p></div><div><h3>Conclusion</h3><p>Based on the evidence, acupuncture may be a promising complementary treatment to improve post-stroke spasticity and quality of life. Further high-quality RCTs are needed in future studies to support the broader application of acupuncture for the treatment of PSS.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000128/pdfft?md5=6d54a5bfe7ce6cc8e5c4df6400e42f38&pid=1-s2.0-S0965229924000128-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139470703","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 : 2024-01-15DOI: 10.1016/j.ctim.2024.103023
David Villarreal-Zegarra , Teodoro Yllescas-Panta , Sofía Malaquias-Obregon , Andrea Dámaso-Román , Nikol Mayo-Puchoc
Background
Systematic reviews suggest that animal-assisted therapy (AAT) and pet-robot interventions (PRI) achieve a reduction in mental health variables such as depressive symptoms. However, these systematic reviews include both randomised and non-randomised studies, which prevents an adequate assessment of the effect of confounding variables.
Objective
This systematic review and meta-analysis aimed to evaluate the comparative effectiveness of AAT and PRI through randomized controlled trials (RCTs) in reducing depression in older adults.
Methods
Our study is a systematic review. We searched three databases of scientific articles: SCOPUS, Web of Science and PubMed. We included studies that their population was older adults, aged 65 years or older, with or without a clinical condition, clinical diagnosis based on mental examination/test or documentation from medical records, accredited by the facilities' staff. We included trials in which the comparator was a passive intervention or an active intervention. We used the Cochrane risk-of-bias tool for randomised trials (RoB 2) to assess the risk of bias for each study. Our study was registered in PROSPERO (CRD42023393740).
Results
Twenty-three studies were included in this systematic review. However, only 19 trials were included in the meta-analysis. At the overall risk of bias level, 78.9% of the studies were at high risk of bias (n = 15). We found that AAT (g= −0.72; 95%CI −1.13 to −0.31; p = 0.001) has a moderate and statistically significant effect as an intervention to reduce depressive symptoms in older adults. However, the PRIs do not show a significant effect on reducing depressive symptoms in older adults. In addition, a sub-analysis based on dog-assisted therapy (g= −0.65; 95%CI −1.21 to −0.08; p = 0.025), a specific type of AAT, showed a modest effect on reducing depressive symptoms.
Conclusions
Our study concluded that AAT and DAT had a moderate and statistically significant effect as interventions to reduce depressive symptoms in older adults. On the other hand, PRI did not show a significant effect in reducing depressive symptoms.
{"title":"Effectiveness of animal-assisted therapy and pet-robot interventions in reducing depressive symptoms among older adults: A systematic review and meta-analysis","authors":"David Villarreal-Zegarra , Teodoro Yllescas-Panta , Sofía Malaquias-Obregon , Andrea Dámaso-Román , Nikol Mayo-Puchoc","doi":"10.1016/j.ctim.2024.103023","DOIUrl":"10.1016/j.ctim.2024.103023","url":null,"abstract":"<div><h3>Background</h3><p>Systematic reviews suggest that animal-assisted therapy (AAT) and pet-robot interventions (PRI) achieve a reduction in mental health variables such as depressive symptoms. However, these systematic reviews include both randomised and non-randomised studies, which prevents an adequate assessment of the effect of confounding variables.</p></div><div><h3>Objective</h3><p>This systematic review and meta-analysis aimed to evaluate the comparative effectiveness of AAT and PRI through randomized controlled trials (RCTs) in reducing depression in older adults.</p></div><div><h3>Methods</h3><p>Our study is a systematic review. We searched three databases of scientific articles: SCOPUS, Web of Science and PubMed. We included studies that their population was older adults, aged 65 years or older, with or without a clinical condition, clinical diagnosis based on mental examination/test or documentation from medical records, accredited by the facilities' staff. We included trials in which the comparator was a passive intervention or an active intervention. We used the Cochrane risk-of-bias tool for randomised trials (RoB 2) to assess the risk of bias for each study. Our study was registered in PROSPERO (CRD42023393740).</p></div><div><h3>Results</h3><p>Twenty-three studies were included in this systematic review. However, only 19 trials were included in the meta-analysis. At the overall risk of bias level, 78.9% of the studies were at high risk of bias (n = 15). We found that AAT (g= −0.72; 95%CI −1.13 to −0.31; p = 0.001) has a moderate and statistically significant effect as an intervention to reduce depressive symptoms in older adults. However, the PRIs do not show a significant effect on reducing depressive symptoms in older adults. In addition, a sub-analysis based on dog-assisted therapy (g= −0.65; 95%CI −1.21 to −0.08; p = 0.025), a specific type of AAT, showed a modest effect on reducing depressive symptoms.</p></div><div><h3>Conclusions</h3><p>Our study concluded that AAT and DAT had a moderate and statistically significant effect as interventions to reduce depressive symptoms in older adults. On the other hand, PRI did not show a significant effect in reducing depressive symptoms.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000116/pdfft?md5=93742e8d24b14b8f1f92e4eda56620c3&pid=1-s2.0-S0965229924000116-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139471000","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}
Chinese herbal medicine (CHM) has been shown to be effective in autoimmune rheumatic diseases, but harmful herb-drug interactions might be inherent. We aim to review the evidence regarding herb-drug interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and CHM.
Methods
We searched PubMed, EMBASE and CINAHL from inception till 30 April 2023 using keywords that encompassed ‘herb-drug interactions’, ‘herbs’ and ‘immunosuppressants’. Articles were included if they contained reports about interactions between immunosuppressive drugs used in the treatment of rheumatic diseases with CHM. Level of evidence for each pair of interaction was graded using the algorithm developed by Colalto.
Results
A total of 65 articles and 44 unique pairs of interactions were identified. HDIs were reported for cyclophosphamide, cyclosporine, tacrolimus, methotrexate, mycophenolic acid, glucocorticoids, sulfasalazine, tofacitinib and biologic disease-modifying antirheumatic drugs. Among these, cyclosporine (n = 27, 41.5%) and tacrolimus (n = 19, 29.2%) had the highest number of documented interactions. Hypericum perforatum had the highest level of evidence of interaction with cyclosporine and tacrolimus. Consumption reduced the bioavailability and therapeutic effects of the drugs. Schisandra sphenanthera had the highest level of evidence of interaction with tacrolimus and increased the bioavailability of the drug. Majority of the articles were animal studies.
Conclusion
Overall level of evidence for the included studies were low, though interactions between cyclosporine, tacrolimus, Hypericum perforatum and Schisandra sphenanthera were the most and well-documented. Healthcare professionals should actively enquire about the concurrent use of CHM in patients, especially when drugs with a narrow therapeutic index are consumed.
{"title":"Evidence of the interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and Chinese herbal medicine: A scoping review","authors":"Ting Hui Woon , Melissa Jia Hui Tan , Yu Heng Kwan , Warren Fong","doi":"10.1016/j.ctim.2024.103017","DOIUrl":"10.1016/j.ctim.2024.103017","url":null,"abstract":"<div><h3>Objectives</h3><p>Chinese herbal medicine (CHM) has been shown to be effective in autoimmune rheumatic diseases, but harmful herb-drug interactions might be inherent. We aim to review the evidence regarding herb-drug interactions between immunosuppressive drugs used in autoimmune rheumatic diseases and CHM.</p></div><div><h3>Methods</h3><p>We searched PubMed, EMBASE and CINAHL from inception till 30 April 2023 using keywords that encompassed ‘herb-drug interactions’, ‘herbs’ and ‘immunosuppressants’. Articles were included if they contained reports about interactions between immunosuppressive drugs used in the treatment of rheumatic diseases with CHM. Level of evidence for each pair of interaction was graded using the algorithm developed by Colalto.</p></div><div><h3>Results</h3><p>A total of 65 articles and 44 unique pairs of interactions were identified. HDIs were reported for cyclophosphamide, cyclosporine, tacrolimus, methotrexate, mycophenolic acid, glucocorticoids, sulfasalazine, tofacitinib and biologic disease-modifying antirheumatic drugs. Among these, cyclosporine (n = 27, 41.5%) and tacrolimus (n = 19, 29.2%) had the highest number of documented interactions. <em>Hypericum perforatum</em> had the highest level of evidence of interaction with cyclosporine and tacrolimus. Consumption reduced the bioavailability and therapeutic effects of the drugs. <em>Schisandra sphenanthera</em> had the highest level of evidence of interaction with tacrolimus and increased the bioavailability of the drug. Majority of the articles were animal studies.</p></div><div><h3>Conclusion</h3><p>Overall level of evidence for the included studies were low, though interactions between cyclosporine, tacrolimus, <em>Hypericum perforatum</em> and <em>Schisandra sphenanthera</em> were the most and well-documented. Healthcare professionals should actively enquire about the concurrent use of CHM in patients, especially when drugs with a narrow therapeutic index are consumed.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000050/pdfft?md5=b3a2c19018ddcecc9cdd9577c02a29b8&pid=1-s2.0-S0965229924000050-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139457941","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 : 2024-01-09DOI: 10.1016/j.ctim.2024.103019
Hongshi Zhang , Xiaotu Zhang , Yidan Wang , Xuefeng Sun , Sixuan Li , Jindan Zhang , Jundong Jiao
Objectives
To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS).
Methods
The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata15.0 random effects model.
Results
Nineteen RCTs including 1315 participants were included in the analysis. The studies were found to be heterogeneous (I2 =86.2, P = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD =−0.66,95% CI [−1.08, −0.25], P = 0.002), improving sleep (SMD = −0.35,95% CI [−0.68,0. 01], P = 0.041) and relieving depression (SMD= −0.24,95% CI [−0.47, −0.02], P = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD =−0.20,95% CI [−0.48,0.09], P = 0.176).
Conclusions
TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.
目的：探讨五种传统中医运动对纤维肌痛综合征（FMS）患者的疗效和安全性：探讨五种传统中医运动对纤维肌痛综合征（FMS）患者的疗效和安全性：方法：在PubMed、Embase、Scopus、ProQuest、Web of Science、Cochrane、CNKI、WanFang和VIP数据库中全面检索了从开始到2023年2月发表的与TCE相关的随机对照试验（RCT）。采用标准化平均差（SMD）和95%置信区间（CI）确定干预的综合效果，并使用Cochrane偏倚风险评估工具和Review 5.2软件评估方法学质量。采用Stata15.0随机效应模型对数据进行提取和分析：结果：19 项 RCT（包括 1315 名参与者）被纳入分析。发现这些研究存在异质性（I2=86.2，P=0.000），因此采用随机效应模型对数据进行合并。结果显示，传统中医运动对FMS患者减轻疼痛（SMD=-0.66,95% CI [-1.08, -0.25]，P=0.002）、改善睡眠（SMD=-0.35,95% CI [-0.68, 0.01]，P=0.041）和缓解抑郁（SMD=-0.24,95% CI [-0.47, -0.02]，P=0.034）有潜在的有益作用。然而，在改善生活质量方面没有发现明显效果（SMD=-0.20,95% CI [-0.48,0.09]，n=16，P=0.176）：TCEs可以改善FMS患者的疼痛、睡眠质量和抑郁，并且是安全的。结论：TCEs 可以改善 FMS 患者的疼痛、睡眠质量和抑郁，并且是安全的。需要进一步开展大规模、高质量和多中心的 RCT 研究，以验证 TCEs 的疗效。
{"title":"Effects of traditional Chinese exercises in fibromyalgia syndrome: A meta-analysis of randomized controlled trials","authors":"Hongshi Zhang , Xiaotu Zhang , Yidan Wang , Xuefeng Sun , Sixuan Li , Jindan Zhang , Jundong Jiao","doi":"10.1016/j.ctim.2024.103019","DOIUrl":"10.1016/j.ctim.2024.103019","url":null,"abstract":"<div><h3>Objectives</h3><p>To explore the efficacy and safety of five traditional Chinese exercises (TCEs) in patients with fibromyalgia syndrome (FMS).</p></div><div><h3>Methods</h3><p>The PubMed, Embase, Scopus, ProQuest, Web of Science, Cochrane, CNKI, WanFang, and VIP databases were comprehensively searched for randomized controlled trials (RCTs) related to TCEs published from inception until February 2023. Standardized mean differences (SMD) and 95% confidence intervals (CI) were used to determine the combined effects of the intervention, and the Cochrane risk-of-bias assessment tool and Review 5.2 software were used to assess methodological quality. The data were extracted and analyzed by the Stata15.0 random effects model.</p></div><div><h3>Results</h3><p>Nineteen RCTs including 1315 participants were included in the analysis. The studies were found to be heterogeneous (<em>I</em><sup>2</sup> =86.2, <em>P</em> = 0.000), and thus a random effects model was used to combine the data. The results showed that traditional Chinese exercises had potentially beneficial effects on reducing pain (SMD =−0.66,95% CI [−1.08, −0.25], <em>P</em> = 0.002), improving sleep (SMD = −0.35,95% CI [−0.68,0. 01], <em>P</em> = 0.041) and relieving depression (SMD= −0.24,95% CI [−0.47, −0.02], <em>P</em> = 0.034) in FMS patients. However, no significant effects were found on improved quality of life (SMD =−0.20,95% CI [−0.48,0.09], <em>P</em> = 0.176).</p></div><div><h3>Conclusions</h3><p>TCEs can improve pain, sleep quality and depression in patients with FMS and are safe. However, they do not improve the quality of life significantly. Further large-scale, high-quality, and multi-center RCTs are required to verify the efficacy of TCEs.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000074/pdfft?md5=fe67e4b0716245b8affccef40a79af9e&pid=1-s2.0-S0965229924000074-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139424466","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 : 2024-01-08DOI: 10.1016/j.ctim.2024.103021
Larissa Vieira de Queiroz , José Favoreto Neto , Fernando Luiz Affonso Fonseca , Carlos Cleomir Pinheiro , Auro del Giglio
Introduction
Zerumbone is a natural compound found in bitter ginger plants (Zingiber zerumbet) that shows antiproliferative, antioxidant, anti-inflammatory, and analgesic properties. We aimed to investigate the role of zerumbone in improving the quality of life and symptom control in cancer patients with no treatment options.
Methods
We conducted a pilot, non-randomized, single-center, open prospective, and systematic study on the use of 400 mg of zerumbone twice a day.
Results
The study included 35 patients (mean age, 68 years; 64% men), of which 16 completed the eight-week study. The intention-to-treat population showed no significant changes in weight or sleep quality over the eight-week study. Assessments performed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) showed significant improvements in the quality of life in the global (p = 0.072), activity (p = 0.0393), social (p = 0.0001), and emotional (p = 0.0023) dimensions. The Hospital Anxiety and Depression Scale (HADS) questionnaire scores showed significant improvement in anxiety (p = 0.032) and depression (p = 0.021), while the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire scores also indicated a significant improvement (p = 0.001). Bitter ginger showed low toxicity.
Conclusions
Bitter ginger showed promising results in improving the quality of life and reducing symptoms of anxiety and depression in the study population. A randomized placebo-controlled study is necessary to confirm these results.
This trial was registered under the number FMABC: CAAE – 93459418.00000082, at ISRCTN (BIOMED CENTRAL) NUMBER 4388 (03/07/23) and at Plataforma Brasil (https://plataformabrasil.saude.gov.br/login.jsf)
{"title":"Bitter ginger (Zingiber zerumbet) for patients with solid tumors with no treatment options: A pilot clinical study","authors":"Larissa Vieira de Queiroz , José Favoreto Neto , Fernando Luiz Affonso Fonseca , Carlos Cleomir Pinheiro , Auro del Giglio","doi":"10.1016/j.ctim.2024.103021","DOIUrl":"10.1016/j.ctim.2024.103021","url":null,"abstract":"<div><h3>Introduction</h3><p>Zerumbone is a natural compound found in bitter ginger plants (<em>Zingiber zerumbet</em>) that shows antiproliferative, antioxidant, anti-inflammatory, and analgesic properties. We aimed to investigate the role of zerumbone in improving the quality of life and symptom control in cancer patients with no treatment options.</p></div><div><h3>Methods</h3><p>We conducted a pilot, non-randomized, single-center, open prospective, and systematic study on the use of 400 mg of zerumbone twice a day.</p></div><div><h3>Results</h3><p>The study included 35 patients (mean age, 68 years; 64% men), of which 16 completed the eight-week study. The intention-to-treat population showed no significant changes in weight or sleep quality over the eight-week study. Assessments performed using the European Organisation for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 (EORTC QLQ-C30) showed significant improvements in the quality of life in the global (p = 0.072), activity (p = 0.0393), social (p = 0.0001), and emotional (p = 0.0023) dimensions. The Hospital Anxiety and Depression Scale (HADS) questionnaire scores showed significant improvement in anxiety (p = 0.032) and depression (p = 0.021), while the Functional Assessment of Chronic Illness Therapy-Fatigue (FACIT-F) questionnaire scores also indicated a significant improvement (p = 0.001). Bitter ginger showed low toxicity.</p></div><div><h3>Conclusions</h3><p>Bitter ginger showed promising results in improving the quality of life and reducing symptoms of anxiety and depression in the study population. A randomized placebo-controlled study is necessary to confirm these results.</p><p>This trial was registered under the number FMABC: CAAE – 93459418.00000082, at ISRCTN (BIOMED CENTRAL) NUMBER 4388 (03/07/23) and at Plataforma Brasil (<span>https://plataformabrasil.saude.gov.br/login.jsf</span><svg><path></path></svg>)</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000098/pdfft?md5=38eecffbe31558f628faae653ba3b92d&pid=1-s2.0-S0965229924000098-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139416570","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 : 2024-01-06DOI: 10.1016/j.ctim.2024.103016
Chan-Young Kwon , Boram Lee
Objective
This systematic review analysed the effectiveness of mind-body modalities (MBMs) in Hwa-byung (HB).
Methods
Ten electronic databases were searched. Intervention studies using MBMs for individuals with HB, published up to July 2023, were included. The methodological quality of the included studies was assessed using the Cochrane RoB and ROBINS-I tools. Meta-analysis of continuous variables was presented as mean differences (MDs) and their 95% confidence intervals (CIs).
Results
Nine studies including five randomized controlled clinical trials, were included. The MBM types were meditation, relaxation, biofield therapy, art therapy, and forest-based MBM, and comprehensive HB programs. Most studies used an MBM group, with 5–6 sessions delivered during an average of 4–5 weeks. As a result of the meta-analysis, art therapy showed a statistically significantly better effect on improving the Hwa-Byung Scale (HB-S) score compared to the waitlist control (MD = −7.74; 95% CI = −9.81 to −5.66). In the before-and-after comparison, MBMs were frequently reported to have significant benefits for improving the HB-S total score (7/7, 100%), depressive mood (4/5, 80%), and state anxiety (6/8, 75%). Some methodological flaws were identified in the included studies, including the reliability of diagnosis, non-implementation of assessor blinding, and inappropriate control groups.
Conclusions
This review identified potentially promising MBMs that were not previously recommended in the current HB clinical practice guidelines. In the future, high-quality clinical studies that include the use of standardized HB diagnostic criteria, homogeneous interventions, appropriate control groups, standard assessment tools such as the HB-S, and assessor blinding are needed.
{"title":"Effectiveness of mind-body medicine for Hwa-Byung (a Korean cultural diagnosis of suppressed anger): A systematic review of interventional studies","authors":"Chan-Young Kwon , Boram Lee","doi":"10.1016/j.ctim.2024.103016","DOIUrl":"10.1016/j.ctim.2024.103016","url":null,"abstract":"<div><h3>Objective</h3><p>This systematic review analysed the effectiveness of mind-body modalities (MBMs) in Hwa-byung (HB).</p></div><div><h3>Methods</h3><p>Ten electronic databases were searched. Intervention studies using MBMs for individuals with HB, published up to July 2023, were included. The methodological quality of the included studies was assessed using the Cochrane RoB and ROBINS-I tools. Meta-analysis of continuous variables was presented as mean differences (MDs) and their 95% confidence intervals (CIs).</p></div><div><h3>Results</h3><p>Nine studies including five randomized controlled clinical trials, were included. The MBM types were meditation, relaxation, biofield therapy, art therapy, and forest-based MBM, and comprehensive HB programs. Most studies used an MBM group, with 5–6 sessions delivered during an average of 4–5 weeks. As a result of the meta-analysis, art therapy showed a statistically significantly better effect on improving the Hwa-Byung Scale (HB-S) score compared to the waitlist control (MD = −7.74; 95% CI = −9.81 to −5.66). In the before-and-after comparison, MBMs were frequently reported to have significant benefits for improving the HB-S total score (7/7, 100%), depressive mood (4/5, 80%), and state anxiety (6/8, 75%). Some methodological flaws were identified in the included studies, including the reliability of diagnosis, non-implementation of assessor blinding, and inappropriate control groups.</p></div><div><h3>Conclusions</h3><p>This review identified potentially promising MBMs that were not previously recommended in the current HB clinical practice guidelines. In the future, high-quality clinical studies that include the use of standardized HB diagnostic criteria, homogeneous interventions, appropriate control groups, standard assessment tools such as the HB-S, and assessor blinding are needed.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000049/pdfft?md5=eb2fbefbd0ae43d222aae1fb5bbaace1&pid=1-s2.0-S0965229924000049-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139377313","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}
Policosanol is a mixture of long chain alcohols refined from sugar cane. Significant reductions in liver enzymes have been observed in some studies. However, the impact of policosanol on liver enzymes remained controversial. The current meta-analysis aims to evaluate the effect of policosanol supplementation on the levels of alanine transaminase (ALT) and aspartate transaminase (AST).
Methods
The literature was systematically searched for studies published up to November 2023 in PubMed/Medline, Google Scholar, EMBASE, and Scopus. Randomized controlled trial (RCT) studies were included to evaluate the intervention effect of policosanol compared to placebo on ALT and AST. DerSimonian and Laird models were used to calculate effect sizes.
Results
Twenty-three trials including 2535 participants were included in the study. The combination of effect sizes, regarding the random-effects model, demonstrated significant changes in ALT serum levels after intervention (WMD: -1.48 U/L; 95% CI: -2.33 to -0.64; P = 0.001), and AST (WMD: -1.10 U/L; 95% CI: -1.70 to -0.51; P<0.001). Subgroup analysis of AST and ALT showed that this reduction effect was most often observed at the dose of 20 mg/d. The dose-response analysis represented a non-significant non-linear connection between the dosage and duration of policosanol intervention in ALT and AST serum reduction.
Conclusion
Policosanol supplementation exerts a beneficial effect on liver enzymes as well as ALT and AST concentrations in adults. However, further long-term and well-designed RCTs with better quality are needed to further assess and confirm these results.
{"title":"What is the influence of policosanol supplementation on liver enzymes? A systematic review and dose-response meta-analysis of randomized controlled trials","authors":"Afsaneh Gholamrezayi , Mohammad Reza Amini , Niloufar Rasaei , Camellia Akhgarjand , Zahra Kalantar , Gholamreza Askari , Azita Hekmatdoost","doi":"10.1016/j.ctim.2024.103018","DOIUrl":"10.1016/j.ctim.2024.103018","url":null,"abstract":"<div><h3>Objective</h3><p>Policosanol is a mixture of long chain alcohols refined from sugar cane. Significant reductions in liver enzymes have been observed in some studies. However, the impact of policosanol on liver enzymes remained controversial. The current meta-analysis aims to evaluate the effect of policosanol supplementation on the levels of alanine transaminase (ALT) and aspartate transaminase (AST).</p></div><div><h3>Methods</h3><p>The literature was systematically searched for studies published up to November 2023 in PubMed/Medline, Google Scholar, EMBASE, and Scopus. Randomized controlled trial (RCT) studies were included to evaluate the intervention effect of policosanol compared to placebo on ALT and AST. DerSimonian and Laird models were used to calculate effect sizes.</p></div><div><h3>Results</h3><p>Twenty-three trials including 2535 participants were included in the study. The combination of effect sizes, regarding the random-effects model, demonstrated significant changes in ALT serum levels after intervention (WMD: -1.48<!--> <!-->U/L; 95% CI: -2.33 to -0.64; P = 0.001), and AST (WMD: -1.10<!--> <!-->U/L; 95% CI: -1.70 to -0.51; P<0.001). Subgroup analysis of AST and ALT showed that this reduction effect was most often observed at the dose of 20<!--> <!-->mg/d. The dose-response analysis represented a non-significant non-linear connection between the dosage and duration of policosanol intervention in ALT and AST serum reduction.</p></div><div><h3>Conclusion</h3><p>Policosanol supplementation exerts a beneficial effect on liver enzymes as well as ALT and AST concentrations in adults. However, further long-term and well-designed RCTs with better quality are needed to further assess and confirm these results.</p></div>","PeriodicalId":10545,"journal":{"name":"Complementary therapies in medicine","volume":null,"pages":null},"PeriodicalIF":3.6,"publicationDate":"2024-01-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S0965229924000062/pdfft?md5=bd614c064dcb5afc376662ff03a668d8&pid=1-s2.0-S0965229924000062-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139376142","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}
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