European Journal of Integrative Medicine最新文献_第10页

Inhibitory effects of wogonin on hepatocellular carcinoma through modulation of lactate metabolism and suppression of regulatory T-cell differentiation 枸橼酸钠通过调节乳酸代谢和抑制调节性t细胞分化对肝癌的抑制作用

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-08-28 DOI: 10.1016/j.eujim.2025.102545

Fansheng Meng , Yiheng Zhang , Xujing Gu , Tianle Ma , Zhipeng Chen , Huihua Fang , Li Wu , Huaning Xu , Yan Huang

Introduction

Wogonin, an active flavonoid derived from the traditional Chinese medicinal herb Scutellaria baicalensis, has been reported to regulate cellular metabolism. Increasing evidence suggests that wogonin inhibits regulatory T-cell (Treg) differentiation and modulates immune responses both in vitro and in vivo. However, the underlying molecular mechanisms remain poorly understood. Our previous findings demonstrated that lactic acid, a metabolic byproduct of glycolysis in hepatocellular carcinoma (HCC) cells, promotes the differentiation of naïve CD4⁺ T cells into Tregs.

Methods

The effects of wogonin (1.25, 5, and 20 μg/mL) on naïve CD4⁺ T-cell differentiation were examined in the presence of lactic acid. The proportion of Tregs was analyzed using flow cytometry. Protein and mRNA expression levels of TGF-β, p-Smad2, p-Smad3, LDHA, p-mTOR, HIF-1α, ATP5B, and FOXP3 were measured by western blotting (WB) and RT-PCR, respectively. Levels of IL-10, α-KG, and 2-HG were quantified using ELISA. To further assess in vivo efficacy, a mouse hepatoma transplantation model was established by subcutaneous injection of H22 cells. Seven days after inoculation, mice were treated with wogonin (12.5 or 25 mg/kg). After three weeks, mice were euthanized. Tumors underwent histological analysis by HE staining, while CD4⁺and CD8⁺ T-cell populations were assessed via immunohistochemistry and flow cytometry. LDHA enzyme activity, intracellular and extracellular lactate and glucose concentrations were measured by ELISA. FOXP3 and IL-10 mRNA levels were evaluated by RT-PCR.

Results

Supplemental lactic acid significantly increased Treg differentiation following cytokine stimulation (anti-CD3, anti-CD28, and TGF-β). Conversely, wogonin treatment significantly and dose-dependently reduced Treg differentiation and LDHA expression. Through inhibitor screening, c-Myc was identified as a critical molecular target of wogonin. Mechanistically, wogonin suppressed c-Myc activity, subsequently downregulating LDHA expression and enzyme activity, reducing abnormal accumulation of 2-hydroxyglutarate (2-HG), normalizing the 2-HG/α-KG ratio, and ultimately decreasing FOXP3 and IL-10 expression.

Conclusions

Wogonin suppresses Treg differentiation and exerts anti-HCC effects by inhibiting c-Myc-mediated LDHA expression and disrupting the 2-HG/ATP5B/mTOR/HIF-1α signaling pathway. Given its potential to reshape the immunosuppressive tumor microenvironment, further investigation into its combination with PD-1/PD-L1 inhibitors is warranted.

黄芩苷是一种从黄芩中提取的活性类黄酮，具有调节细胞代谢的作用。越来越多的证据表明，在体外和体内，沃戈宁抑制调节性t细胞（Treg）分化并调节免疫反应。然而，潜在的分子机制仍然知之甚少。我们之前的研究结果表明，乳酸是肝细胞癌（HCC）细胞糖酵解的代谢副产物，可促进naïve CD4+ T细胞向Tregs的分化。方法在乳酸存在的情况下，观察枸枸素（1.25、5、20 μg/mL）对naïve CD4+ t细胞分化的影响。流式细胞术分析Tregs比例。western blotting （WB）和RT-PCR分别检测TGF-β、p-Smad2、p-Smad3、LDHA、p-mTOR、HIF-1α、ATP5B、FOXP3蛋白和mRNA的表达水平。ELISA法测定血清IL-10、α-KG、2-HG水平。为了进一步评估体内疗效，我们通过皮下注射H22细胞建立小鼠肝癌移植模型。接种后第7天，分别给小鼠注射12.5或25 mg/kg的沃戈宁。三周后，老鼠被安乐死。通过HE染色对肿瘤进行组织学分析，同时通过免疫组织化学和流式细胞术评估CD4+和CD8+ t细胞群。ELISA法测定LDHA酶活性、细胞内外乳酸和葡萄糖浓度。RT-PCR检测FOXP3、IL-10 mRNA表达水平。结果补充乳酸显著增加细胞因子刺激（抗cd3、抗cd28和TGF-β）后Treg的分化。相反，wogonin治疗显著且剂量依赖性地降低Treg分化和LDHA表达。通过抑制剂筛选，c-Myc被确定为wogonin的关键分子靶点。机制上，wogoonin抑制c-Myc活性，进而下调LDHA表达和酶活性，减少2-羟基戊二酸（2-hydroxyglutarate, 2-HG）的异常积累，使2-HG/α-KG比值正常化，最终降低FOXP3和IL-10的表达。结论swogonin通过抑制c- myc介导的LDHA表达，破坏2-HG/ATP5B/mTOR/HIF-1α信号通路，抑制Treg分化，发挥抗hcc作用。鉴于其重塑免疫抑制肿瘤微环境的潜力，进一步研究其与PD-1/PD-L1抑制剂的联合是有必要的。

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引用次数: 0

Baihu Jia Renshen decoction for type 2 diabetes: A multi-method study combining a systematic literature review, Delphi survey, and network pharmacology 白虎加人肾汤治疗2型糖尿病：系统文献综述、德尔菲调查、网络药理学相结合的多方法研究

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-05-30 DOI: 10.1016/j.eujim.2025.102501

Fangyan Yang , Kangle Shi , Xiaoyu Liu , Shiyao Wang , Hongyu Meng , Juan Cheng , Jiayue Li , Weihong Xu , Yangxi Li , Ruixi Tian , Ling Tang , Cong Lei , Zhijun Wang , Hongmei Duan , Qinggang Meng

Introduction

Baihu Jia Renshen Decoction is composed of Gypsum Fibrosum, Anemarrhenae Rhizoma, Oryza Sativa L., Glycyrrhizae Radix et Rhizoma and Ginseng Radix et Rhizoma. It is recommended by five guidelines in China for the treatment of type 2 diabetes mellitus (T2DM). However, evaluations of its efficacy involve a diverse range of outcomes. This multi-method study aims to identify clinical outcomes that traditional Chinese medicine (TCM) practitioners consider both predictive of T2DM progression and responsive to the formula, and to explore the herbal formula’s mechanisms of action on these outcomes.

Methods

We searched eight databases and collated clinical outcomes reported in randomized controlled trials, as well as signs and symptoms of clinical response listed in TCM clinical guidelines. A panel of eight TCM clinicians participated in three rounds of Delphi surveys to select the most important outcomes. Finally, overlapping genes between responsive outcomes-related genes and the targets of formula were obtained. Based on the enrichment analysis results, the“herb-compound-target-pathway-outcome” relationship was constructed to show how the formula affect clinical outcomes.

Results

Seventy-six outcomes were shortlisted from the literature, from which consensus was reached in the Delphi survey on eight. These were xerostomia, polydipsia, preference for cold drinks, red tongue, dry tongue, tongue coating dryness, large pulse and fasting blood glucose (FBG). Fifteen overlapping gene targets were identified. Based on enrichment analysis, we hypothesized that diosgenin, nicotinic acid, and anhydroicaritin from Anemarrhenae Rhizoma may act on SOD1, PPARGC1A, CHRM3, modulating AMPK signaling pathway and thereby influencing xerostomia and tongue dryness. The 29 components were found to act on PPARG, PPARGC1A, SHBG, etc, regulating insulin signaling pathway and the AMPK signaling pathway, ultimately affecting FBG.

Conclusion

Based on the network pharmacology studies, the potential mechanisms of action of Baihu Jia Renshen Decoction on the eight core clinical outcomes are as follows. Anemarrhenae Rhizoma may regulate dryness of the tongue and xerostomia. Anemarrhenae Rhizoma, Ginseng Radix et Rhizoma and Glycyrrhizae Radix et Rhizoma may modulate FBG levels. Further research is needed to explore the formula’s mechanisms of action for the remaining five outcomes and T2DM.

白虎加人肾汤由石膏纤维、知母、薏米、甘草、人参组成。在中国治疗2型糖尿病（T2DM）的五项指南中推荐使用。然而，对其疗效的评估涉及各种各样的结果。这项多方法研究旨在确定中医医生认为预测T2DM进展和对方剂反应的临床结果，并探讨中药方剂对这些结果的作用机制。方法检索8个数据库，整理随机对照试验报告的临床结局，以及中医临床指南中列出的临床反应体征和症状。一个由8名中医临床医生组成的小组参与了三轮德尔菲调查，以选择最重要的结果。最后，得到了反应结果相关基因与配方靶点之间的重叠基因。根据富集分析结果，构建“草药-化合物-靶点-途径-结果”关系，显示复方对临床疗效的影响。结果从文献中筛选出76个结果，其中8个结果通过德尔菲调查得到一致。这些症状包括口干、渴渴、喜欢喝冷饮、舌红、舌干、舌苔干燥、脉搏大和空腹血糖（FBG）。确定了15个重叠的基因靶点。基于富集分析，我们推测从鸭茅中提取的薯蓣皂苷元、烟酸和水杨桃素可能作用于SOD1、PPARGC1A、CHRM3，调节AMPK信号通路，从而影响口干和舌干。发现29种成分作用于PPARG、PPARGC1A、SHBG等，调控胰岛素信号通路和AMPK信号通路，最终影响FBG。结论基于网络药理学研究，白虎加人肾汤对8项核心临床疗效的潜在作用机制如下：知母可调节舌燥和口干。参、参、甘草均可调节FBG水平。需要进一步的研究来探索该配方对其余五种结果和T2DM的作用机制。

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引用次数: 0

Feasibility and acceptability of a yoga-based mind body intervention for women with a history of hypertensive disorder in pregnancy 以瑜伽为基础的身心干预对妊娠期高血压病史妇女的可行性和可接受性

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-14 DOI: 10.1016/j.eujim.2025.102499

Caroline A Smith , Kylie Barr , Angela Makris , Amanda Henry , Hannah Dahlen , Annemarie Hennessy , Alison Canty , Wendy Pickup

Introduction

Hypertensive disorders of pregnancy affect 5 to 10% of women and are a significant cause of perinatal morbidity and mortality. This group of women have been shown to have an elevated risk of cardiovascular disease (CVD) and premature mortality. There are currently no interventions specifically targeting this at-risk group of women to reduce relevant risk factors and improve outcomes. In other populations of individuals at high CVD risk, studies suggest yoga may be effective in reducing CVD risk. This study examined the feasibility of yoga in contributing to the management of blood pressure postpartum.

Methods

A feasibility study was conducted. The primary objective was to examine recruitment, adherence, satisfaction, and safety of the yoga intervention. Secondary objectives included change in blood pressure, serological measures, quality of life and anxiety. Women were eligible from five to seven months postpartum. An online yoga intervention was delivered over eight weeks.

Results

Ten women (16% of those eligible) were recruited. All women completed the intervention. Compliance with the clinical outcome assessments ranged between 70 and 90%. There was high fidelity with intervention engagement. There were no significant changes over time in any clinical outcome, although a trend to overall improved quality of life (p=0.06) was seen. There were no adverse reactions reported.

Conclusion

Although uptake was low, women engaged well with postpartum yoga. Further research on yoga is needed to test effectiveness for CVD risk reduction for women with hypertension in the postpartum setting, involving an appropriately powered randomised controlled trial. The study was registered with the Australian and New Zealand Clinical Trial Registry (Registration number ACTRN: 12622000450718).

妊娠期高血压疾病影响5%至10%的妇女，是围产期发病率和死亡率的重要原因。这组妇女患心血管疾病（CVD）和过早死亡的风险较高。目前还没有专门针对这一高危妇女群体的干预措施来减少相关风险因素和改善结果。在其他心血管疾病高风险人群中，研究表明瑜伽可能有效降低心血管疾病风险。本研究探讨了瑜伽对产后血压管理的可行性。方法进行可行性研究。主要目的是检查瑜伽干预的招募、依从性、满意度和安全性。次要目标包括血压、血清学指标、生活质量和焦虑的变化。妇女在产后5到7个月有资格。在线瑜伽干预持续了八周。结果共招募了10名女性（占符合条件的16%）。所有女性都完成了干预。临床结果评估的依从性在70%到90%之间。干预参与的保真度很高。虽然观察到总体生活质量改善的趋势（p=0.06），但随着时间的推移，任何临床结果都没有显著变化。无不良反应报告。结论虽然孕妇对产后瑜伽的接受程度较低，但她们对产后瑜伽的参与程度较高。需要进一步的研究来测试瑜伽对产后高血压妇女降低心血管疾病风险的有效性，包括适当的随机对照试验。该研究已在澳大利亚和新西兰临床试验注册中心注册（注册号ACTRN: 12622000450718）。

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引用次数: 0

Effects of Tai Chi and resistance exercise on fatigue in patients with ulcerative colitis: A randomized clinical trial 太极拳和抗阻运动对溃疡性结肠炎患者疲劳的影响：一项随机临床试验

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-29 DOI: 10.1016/j.eujim.2025.102519

Yu Zhou , Tengteng Ding , Ranran Qiao , Ping Zhang , Hui Li , Qiong Liu

Introduction

Fatigue is common and burdensome in patients with ulcerative colitis (UC), yet pharmacological treatments offer limited relief. Exercise is gaining attention as a non-pharmacological strategy, and resistance training is increasingly recommended. However, Tai Chi—a traditional Chinese exercise—has not yet been evaluated in this population. This study compared the effects of Tai Chi and resistance training on multiple outcomes in patients with UC.

Methods

This single-center, evaluator-blind, three-arm randomized clinical trial block-randomized 75 patients with UC to 12 weeks of Tai Chi or resistance training and a control group involving standard treatment and care with general exercise advice. Eligible participants had fatigue (Multidimensional Fatigue Inventory score ≥ 40) and were in remission or had mild-to-moderate disease activity (Modified Mayo score ≤ 10). The primary outcome was fatigue, secondary outcomes included handgrip strength (HGS), skeletal muscle mass index (SMI), sleep quality, anxiety, depression, and health-related quality of life, all strongly associated with fatigue.

Results

The three groups showed significant differences in total fatigue and in general, physical, and mental fatigue subdimensions. Compared with the control group, fatigue improved in both the Tai Chi group (mean difference:8.90 [95 % confidence interval [CI], -15.11 to -2.69]) and the resistance training group (mean difference:7.00 [95 % CI, -13.16 to -0.84]), with no significant differences between them. However, between the two interventions, Tai Chi showed numerically greater improvements in anxiety, depression, and emotional function, while resistance training led to greater improvements in HGS (mean difference: 7.50 [95 % CI, 2.37 to 12.63]) and SMI (mean difference: 0.54 [95 % CI, 0.01 to 1.08]). No adverse events occurred, except for one case of mild abdominal discomfort in the resistance training group, which resolved with rest.

Conclusions

Both Tai Chi and resistance training effectively reduced fatigue and improved related outcomes in UC patients. Tai Chi may be more beneficial for psychological symptoms, while resistance training showed greater improvements in physical strength. Given their complementary advantages and safety, both may serve as valuable non-pharmacological options in UC management. Future studies should explore their integration into long-term, multimodal treatment strategies.

Registration

ChiCTR2300071289.

Funding

None.

在溃疡性结肠炎（UC）患者中，疲劳是常见且令人难以忍受的，但药物治疗提供的缓解有限。运动作为一种非药物策略正受到越来越多的关注，阻力训练也越来越被推荐。然而，太极拳——一种中国传统运动——尚未在这一人群中得到评估。本研究比较了太极拳和阻力训练对UC患者多种预后的影响。这项单中心、评估盲、三组随机临床试验将75名UC患者随机分为12周的太极或阻力训练，对照组包括标准治疗和护理，并提供一般运动建议。符合条件的参与者有疲劳（多维疲劳量表评分≥40），缓解或有轻至中度疾病活动（改良梅奥评分≤10）。主要结局是疲劳，次要结局包括握力（HGS）、骨骼肌质量指数（SMI）、睡眠质量、焦虑、抑郁和健康相关生活质量，这些都与疲劳密切相关。结果三组在总疲劳、一般疲劳、身体疲劳和精神疲劳维度上均存在显著差异。与对照组相比，太极拳组（平均差异：8.90[95%可信区间[CI]， -15.11至-2.69]）和阻力训练组（平均差异：7.00[95%可信区间[CI]， -13.16至-0.84]）的疲劳有所改善，两者之间无显著差异。然而，在两种干预措施之间，太极拳在焦虑、抑郁和情绪功能方面表现出更大的改善，而阻力训练在HGS（平均差异：7.50 [95% CI， 2.37至12.63]）和SMI（平均差异：0.54 [95% CI， 0.01至1.08]）方面表现出更大的改善。除阻力训练组有1例腹部轻度不适外，其他不良事件均未发生。结论太极拳和阻力训练均能有效减轻UC患者的疲劳，改善相关预后。太极拳可能对心理症状更有益，而阻力训练对体力的改善更大。鉴于它们的互补优势和安全性，两者都可以作为UC管理中有价值的非药物选择。未来的研究应探索它们与长期、多模式治疗策略的结合。

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引用次数: 0

Is traditional Chinese medicine syndrome differentiation important in primary insomnia? An exploratory review with matching recombination indirect comparisons and network meta-analysis 中医辨证对原发性失眠重要吗？采用匹配重组、间接比较和网络元分析的探索性综述

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-17 DOI: 10.1016/j.eujim.2025.102515

Guo-Dong Li , Xin-Yu Hu , Yi Yuan , Xi-Jing Meng , Le-Yan Hu , Yu-Ting Huang , Hui-Juan Cao

Introduction

Syndrome differentiation is the primary method of Traditional Chinese Medicine (TCM) diagnosis and treatment of diseases and has become the key to the clinical development of acupuncture. However, there is a lack of supporting clinical evidence to determine the impact of syndrome differentiation on the efficacy of acupuncture treatment. Therefore, we aimed to evaluate the importance of point selection based on syndrome differentiation by re-analyzing the trials' results in treating primary insomnia with acupuncture.

Methods

We systematically searched 9 databases for eligible trials. Two authors extracted data independently from citations, interventions, and outcomes. Since the "treatment acupuncture" and "control acupuncture" data compared in this study were from different trials, we matched the data in a 1:1 ratio and minimized heterogeneity between the paired groups. Matching factors included age, sex ratio, and the baseline Pittsburgh Sleep Quality Index (PSQI) score. Meta-analyses were performed using Revman 5.4 software. STATA 15.0 was used for the network meta-analysis. Effect estimation presented continuous data with a standard mean difference (SMD) with a 95 % confidence interval (CI).

Results

We included a total of 172 trials. After matching, 19 recombinational pairs of studies were established. Meta-analysis of the 19 pairs showed that PSQI scores in the syndrome differentiation group were lower than the non-syndrome differentiation group (SMD: -0.87, 95 %CI -1.46 to -0.28, P = 0.004). Network meta-analysis of all included trials showed no statistical difference in acupoints selection between syndrome and non-syndrome differentiation (SMD: -0.40, 95 % CI -2.63 to 1.84). However, acupoint selection based on syndrome differentiation (43.9 %) ranks higher than acupoint selection based on non-syndrome differentiation (38.0 %) according to SUCRA curves.

Conclusions

Current evidence does not conclusively support the superiority of syndrome differentiation-based acupuncture over non-syndrome differentiation for primary insomnia. While statistically significant large effect size was observed in matched studies, the clinical relevance of this difference remains uncertain due to methodological limitations, heterogeneity, and inconsistent findings across analytical approaches. Future trials with direct comparisons and standardized outcome measures are needed to clarify the clinical utility of syndrome differentiation in acupuncture therapy.

辨证论治是中医诊断和治疗疾病的主要方法，已成为针灸临床发展的关键。然而，辨证论治对针灸治疗效果的影响，缺乏临床证据的支持。因此，我们旨在通过重新分析针灸治疗原发性失眠的试验结果，评估辨证取穴的重要性。方法系统检索9个数据库，筛选符合条件的试验。两位作者独立地从引文、干预措施和结果中提取数据。由于本研究比较的“治疗针灸”和“对照针灸”数据来自不同的试验，我们以1:1的比例匹配数据，尽量减少配对组之间的异质性。匹配因素包括年龄、性别比例和基线匹兹堡睡眠质量指数（PSQI）得分。采用Revman 5.4软件进行meta分析。采用STATA 15.0进行网络meta分析。效应估计提供了具有95%置信区间（CI）的标准平均差（SMD）的连续数据。结果共纳入172项试验。匹配后，共建立19对重组研究。对19对患者进行meta分析，辨证组PSQI评分低于非辨证组（SMD: -0.87, 95% CI -1.46 ~ -0.28, P = 0.004）。所有纳入试验的网络荟萃分析显示，辨证与非辨证在选穴上无统计学差异（SMD: -0.40, 95% CI -2.63 ~ 1.84）。但根据SUCRA曲线，辨证取穴（43.9%）高于非辨证取穴（38.0%）。结论目前证据尚不能完全支持辨证针刺治疗原发性失眠优于非辨证针刺治疗。虽然在匹配的研究中观察到统计上显著的大效应量，但由于方法学的局限性、异质性和分析方法的结果不一致，这种差异的临床相关性仍然不确定。未来的试验需要直接比较和标准化的结果测量来阐明针灸治疗中辨证的临床应用。

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引用次数: 0

Training needs for (UK) professional standards authority accredited register and regulated traditional, complementary and integrative medicine professions for supporting patients to make lifestyle and health behaviour changes: A rapid narrative review （联合王国）专业标准管理局认可、注册和管理的传统、补充和综合医学专业人员的培训需求，以支持患者改变生活方式和健康行为：快速叙述审查

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-12 DOI: 10.1016/j.eujim.2025.102517

Jonquil Pinto, Katie Read, Ella Tarabey, Felicity L. Bishop

Introduction

Improving healthy lifestyles is a public health priority. Traditional, Complementary and Integrative medicine (TCIM) providers, and certain professions on the UK Professional Standards Authority (PSA) Accredited Registers (AR) may be well-placed to contribute - some TCIM professions already support patients to make behaviour changes. We aimed to map the landscape of training for PSA AR and regulated TCIM practitioners working with individuals to support lifestyle changes, including current provision, gaps and training needs.

Methods

We conducted a rapid narrative review of training within PSA AR and regulated TCIM professions. We searched research databases for articles exploring perceptions, experiences and responses to training (for supporting behaviour change) and searched websites of UK professional bodies for educational guidelines for pre-qualification education. We conducted systematic data searching and extraction, quality appraisal and produced a narrative synthesis of research and guidelines which identified patterns across professions.

Results

We identified 24 education guidelines (4 were unlocated). A total of 548 research studies were identified from database searches, and we identified 5 further studies. A total of 20 full-text articles were retrieved, 7 were excluded, leaving 13 in the review. While 22 of 24 guidelines mentioned lifestyle or health behaviour, only 4 (chiropractic, nutritional therapy, osteopathy and acupuncture) provided any detailed recommendations about how to support patients to make health behaviour changes (e.g. providing written information or recording/monitoring progress). Eight of the 13 research studies focussed on chiropractic; most studies focussed on physical activity, two on smoking cessation, and several looked at training in broad techniques including motivational interviewing. Practitioners in research studies were generally positive about training in lifestyle and health behaviour change and there was some evidence that such training enhances practitioner self-efficacy or skills.

Conclusions

Most evidence of engagement with supporting lifestyle/behaviour change is within four professions: chiropractic, osteopathy, nutritional therapy and acupuncture. To build on existing knowledge and practice, future training for chiropractors, osteopaths, nutritional therapists and acupuncturists could target the capabilities (e.g. knowledge, skills, decision-making), opportunities (e.g. resources) and motivations (e.g. social/professional role) of practitioners. Future research should also evaluate the impact of practitioner training on patients’ lifestyle and health behaviours.

改善健康的生活方式是公共卫生的优先事项。传统、补充和综合医学（TCIM）提供者以及英国专业标准局（PSA）认可登记册（AR）上的某些专业可能会做出很好的贡献——一些TCIM专业已经支持患者做出行为改变。我们的目标是绘制PSA AR和受监管的TCIM从业人员与个人合作以支持生活方式改变的培训景观，包括目前的供应，差距和培训需求。方法我们对PSA AR和受监管的TCIM专业人员的培训进行了快速回顾。我们在研究数据库中搜索了探讨对培训（支持行为改变）的看法、经验和反应的文章，并在英国专业机构的网站上搜索了资格预审教育的教育指南。我们进行了系统的数据搜索和提取，质量评估，并产生了一个研究的叙述性综合和指导方针，以确定跨专业的模式。结果我们确定了24条教育指南（其中4条没有定位）。从数据库检索中共确定了548项研究，我们确定了5项进一步的研究。共检索到20篇全文文章，排除7篇，纳入综述13篇。虽然24项指南中有22项提到了生活方式或健康行为，但只有4项（脊椎指压疗法、营养疗法、整骨疗法和针灸）提供了关于如何支持患者改变健康行为的详细建议（例如提供书面信息或记录/监测进展）。13项研究中有8项关注脊椎指压疗法；大多数研究关注的是体育锻炼，两项研究关注的是戒烟，还有几项研究关注的是包括动机性访谈在内的广泛技术培训。研究中的从业人员对改变生活方式和健康行为的培训普遍持积极态度，有一些证据表明，这种培训提高了从业人员的自我效能或技能。结论：大多数支持生活方式/行为改变的证据来自四个专业：脊椎指压疗法、整骨疗法、营养疗法和针灸。在现有知识和实践的基础上，未来对脊医、整骨治疗师、营养治疗师和针灸师的培训可以针对从业者的能力（如知识、技能、决策）、机会（如资源）和动机（如社会/专业角色）。未来的研究还应评估从业人员培训对患者生活方式和健康行为的影响。

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引用次数: 0

Factors influencing the utilization of traditional Korean medicine and continuity of care among individuals with disabilities in Korea: A cross-sectional analysis using national health insurance data 影响韩国传统医学使用和韩国残疾人护理连续性的因素：使用国家健康保险数据的横断面分析

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-25 DOI: 10.1016/j.eujim.2025.102520

Ji-eun Yu , Hyunmin Kim , Chihyoung Son , Eunji Ahn , Dongsu Kim

Introduction

In South Korea, under a dual healthcare system, both Western and traditional Korean medicine (TKM) play a role in managing the health of individuals with disabilities. This study aimed to identify various factors influencing TKM utilization by individuals with disabilities and the continuity of TKM care.

Methods

Data from the “Sample Cohort Database” of the National Health Insurance Service were used, focusing on 55,876 individuals registered as persons with disabilities. Multinomial logistic regression analysis was conducted to identify the factors associated with TKM utilization and the level of continuity of outpatient care in TKM, as measured by TKM Continuity of Care Index (TKM-COCI), among individuals with disabilities.

Results

This study included 53,444 registered individuals with disabilities. The entire cohort was analyzed for factors influencing TKM utilization, while a subset of 16,330 individuals with prior TKM experience was examined for factors affecting continuity of TKM. Analysis of TKM utilization patterns by disability type revealed that, for all disability types, individuals with musculoskeletal disorders had the highest proportion of TKM utilization, with a higher frequency of utilization observed for mild conditions than for severe conditions. Variables affecting both TKM utilization and TKM-COCI for individuals with disabilities included sex, long-term care insurance for the elderly, household income, severity and the Charlson Comorbidity Index. TKM utilization was lower among men, individuals with long-term care insurance, medical aid recipients, those without comorbidities, and individuals with severe disabilities; however, the probability of having a high TKM-COCI was higher in these cases.

Conclusions

It was found that the trends in TKM utilization and TKM-COCI showed opposing patterns according to the severity of disability and CCI. This suggests that the primary purpose of TKM utilization among individuals with disabilities is to prevent or manage the exacerbation of symptoms. Further investigation is needed to clarify this relationship.

Funding

No funding was received for this study.

在韩国，在双重医疗体系下，西方和传统的韩国医学（TKM）在管理残疾人的健康方面发挥着作用。本研究旨在探讨影响残障人士TKM使用及TKM照护连续性的各种因素。方法采用国民健康保险服务“样本队列数据库”中的数据，以登记为残疾人的55,876人为研究对象。采用多项logistic回归分析确定与TKM利用相关的因素和TKM门诊护理的连续性水平，以TKM护理连续性指数（TKM- coci）衡量，在残疾人中。结果本研究共纳入53,444名登记残障人士。分析了整个队列中影响TKM利用的因素，同时对16,330名有TKM经验的个体进行了检查，以确定影响TKM连续性的因素。对残疾类型的TKM利用模式分析显示，在所有残疾类型中，肌肉骨骼疾病患者的TKM利用比例最高，轻度疾病患者的TKM利用频率高于重度疾病患者。影响残障人士TKM使用率和TKM- coci的变量包括性别、老年人长期护理保险、家庭收入、严重程度和Charlson合并症指数。男性、有长期护理保险的个体、医疗援助接受者、无合并症的个体和重度残疾个体的TKM利用率较低；然而，在这些病例中，具有高TKM-COCI的可能性更高。结论残障患者TKM利用率和TKM- coci随残障严重程度和CCI的变化趋势相反。这表明残疾人使用TKM的主要目的是预防或控制症状的恶化。需要进一步的调查来澄清这种关系。本研究未收到任何资金。

{"title":"Factors influencing the utilization of traditional Korean medicine and continuity of care among individuals with disabilities in Korea: A cross-sectional analysis using national health insurance data","authors":"Ji-eun Yu , Hyunmin Kim , Chihyoung Son , Eunji Ahn , Dongsu Kim","doi":"10.1016/j.eujim.2025.102520","DOIUrl":"10.1016/j.eujim.2025.102520","url":null,"abstract":"<div><h3>Introduction</h3><div>In South Korea, under a dual healthcare system, both Western and traditional Korean medicine (TKM) play a role in managing the health of individuals with disabilities. This study aimed to identify various factors influencing TKM utilization by individuals with disabilities and the continuity of TKM care.</div></div><div><h3>Methods</h3><div>Data from the “Sample Cohort Database” of the National Health Insurance Service were used, focusing on 55,876 individuals registered as persons with disabilities. Multinomial logistic regression analysis was conducted to identify the factors associated with TKM utilization and the level of continuity of outpatient care in TKM, as measured by TKM Continuity of Care Index (TKM-COCI), among individuals with disabilities.</div></div><div><h3>Results</h3><div>This study included 53,444 registered individuals with disabilities. The entire cohort was analyzed for factors influencing TKM utilization, while a subset of 16,330 individuals with prior TKM experience was examined for factors affecting continuity of TKM. Analysis of TKM utilization patterns by disability type revealed that, for all disability types, individuals with musculoskeletal disorders had the highest proportion of TKM utilization, with a higher frequency of utilization observed for mild conditions than for severe conditions. Variables affecting both TKM utilization and TKM-COCI for individuals with disabilities included sex, long-term care insurance for the elderly, household income, severity and the Charlson Comorbidity Index. TKM utilization was lower among men, individuals with long-term care insurance, medical aid recipients, those without comorbidities, and individuals with severe disabilities; however, the probability of having a high TKM-COCI was higher in these cases.</div></div><div><h3>Conclusions</h3><div>It was found that the trends in TKM utilization and TKM-COCI showed opposing patterns according to the severity of disability and CCI. This suggests that the primary purpose of TKM utilization among individuals with disabilities is to prevent or manage the exacerbation of symptoms. Further investigation is needed to clarify this relationship.</div></div><div><h3>Funding</h3><div>No funding was received for this study.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"78 ","pages":"Article 102520"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670878","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Renal protective effects of Tongxinluo capsule for hypertensive nephropathy: A systematic review and meta-analysis 通心络胶囊对高血压肾病的肾保护作用：系统综述和荟萃分析

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-27 DOI: 10.1016/j.eujim.2025.102521

Xuan Song , Xinkang Li , Luda Feng , Xinyi Shi , Rufan Xu , Ning Liang , Boyang Li , Boya Zhang , Jianguo Qin

Introduction

Hypertensive nephropathy (HN) remains the second leading cause of end-stage renal disease. Tongxinluo capsule is commonly used in the treatment of HN under the condition that there is no specific therapy. We aimed to assess the efficacy and safety of Tongxinluo capsule for HN.

Methods

We systematically searched Pubmed, Embase, the Cochrane Library, China National Knowledge Infrastructure, Chinese Scientific Journals Database of VIP INFORMATION, Wanfang Data, and SinoMed from their inception to December 2024. Randomized controlled trials (RCTs) comparing the efficacy of Tongxinluo capsule versus placebo or no specific therapy based on usual care among patients with hypertensive nephropathy were included. Study selection and data extraction were independently conducted by two reviewers. The primary outcome was 24-hour urine protein, and secondary outcomes include the level of urinary β2-microglobulin, creatinine clearance rate, serum creatinine, systolic blood pressure, and diastolic blood pressure. In terms of safety, the incidence of adverse events was the main indicator. A fixed-effects model or random-effects model was used when applicable. A 2-tailed p<0.05 was considered statistically significant.

Results

Eight RCTs (742 participants) were included in our study. The quantitative synthesis showed that Tongxinluo capsule could significantly reduce 24-hour proteinuria (MD, -0.11; 95 % CI, -0.20 to -0.02) and urinary β2-microglobulin (MD, -244.26; 95 % CI, -463.50 to -25.01), and slightly increase creatinine clearance rate (MD, 2.28; 95 % CI, 0.42 to 4.14). No significant differences were observed in decreasing serum creatinine (MD, -8.82; 95 % CI, -18.00 to 0.36), or antihypertensive effect (systolic blood pressure [MD, -2.18; 95 % CI, -5.98 to 1.63]; diastolic blood pressure [MD, -2.55; 95 % CI -6.03 to 0.92]). There are no obvious anomalies in terms of adverse events.

Conclusion

This is currently the first systematic review to provide up-to-date evidence regarding the Tongxinluo capsule treatment profile in HN. Based on the available RCTs, Tongxinluo capsule showed promising renal protective benefits in reducing proteinuria levels, and could be a therapeutic option for HN. High-quality studies are needed to further verify our findings.

Protocol registration

PROSPERO (CRD42023484654).

高血压肾病（HN）仍然是终末期肾脏疾病的第二大原因。通心络胶囊在没有特效药的情况下，常用于治疗HN。目的是评价通心络胶囊治疗HN的疗效和安全性。方法系统检索Pubmed、Embase、Cochrane图书馆、中国国家知识基础设施、中国科学期刊数据库VIP信息、万方数据、中国医学信息数据库自成立至2024年12月的数据库。随机对照试验（rct）比较通心络胶囊与安慰剂或基于常规护理的无特异性治疗对高血压肾病患者的疗效。研究选择和数据提取由两名审稿人独立进行。主要终点是24小时尿蛋白，次要终点包括尿β2-微球蛋白水平、肌酐清除率、血清肌酐、收缩压和舒张压。在安全性方面，不良事件发生率是主要指标。适用时采用固定效应模型或随机效应模型。双尾p<；0.05被认为具有统计学意义。结果共纳入8项随机对照试验（rct），共742名受试者。定量合成表明通心络胶囊可显著降低24小时蛋白尿(MD, -0.11；95% CI, -0.20 ~ -0.02)和尿β2微球蛋白(MD, -244.26；95% CI, -463.50 ~ -25.01)，肌酐清除率略有增加(MD, 2.28；95% CI, 0.42 - 4.14)。血清肌酐(MD, -8.82；95% CI, -18.00 - 0.36)，或降压效果(收缩压[MD， -2.18；95% CI, -5.98 ~ 1.63]；舒张压[MD， -2.55；95% CI -6.03 ~ 0.92])。在不良事件方面没有明显的异常。结论：本研究为通心络胶囊治疗HN提供了最新的系统评价。根据现有的随机对照试验，通心络胶囊在降低蛋白尿水平方面显示出良好的肾保护作用，可能是HN的治疗选择。需要高质量的研究来进一步验证我们的发现。协议注册prospero （CRD42023484654）。

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引用次数: 0

Cross-cultural adaptation of the pediatric version of the SafetyNet reporting system for use in French-speaking Canada 加拿大法语区儿童版安全报告系统的跨文化改编

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-08-25 DOI: 10.1016/j.eujim.2025.102542

Isabelle Pagé , Anne Dolbec , Geneviève Côté , Chantale Doucet , David Hayes , Pierre Langevin , Katherine A. Pohlman , Marie-Hélène Vallières , Stéphane Sobczak

Introduction

Though manual therapies are frequently utilized in pediatric care, they carry inherent risks of adverse events. The pediatric iteration of the SafetyNet reporting system encompasses three questionnaires specifically crafted for completion by a child's legal guardian, complemented by one intended for the provider to record treatment details. The objective of this study is to culturally adapt the pediatric SafetyNet reporting system for the French-speaking Canadian demographic.

Methods

A multidisciplinary committee was convened to undertake the translation and cross-cultural adaptation of the four questionnaires comprising the pediatric version of the SafetyNet reporting system. The adaptation process encompassed several stages, including: (1) Forward translation, (2) Synthesis of the translated versions, (3) Cross-cultural adaptation, (4) Review and proposal of the pre-final Canadian French version, and (5) Cognitive debriefing and proposal of the final version. Committee adaptations were subject to review by a developer of the SafetyNet system. Cognitive debriefing involved the participation of French-Canadian legal guardians and clinicians to assess questionnaires’ clarity.

Results

The committee comprised seven researchers and clinicians from diverse backgrounds, including chiropractic, anatomy, and physiotherapy as well as a research associate with a background in linguistics. Upon receiving approval of the cross-cultural adaptations from the developer of the SafetyNet reporting system, all committee members unanimously endorsed the pre-final version. After incorporating improvements based on the cognitive debriefing step, which involved feedback from 13 legal guardians and 10 clinicians, the final version was proposed.

Conclusion

Despite the need for adaptations to existing translation guidelines, the pediatric version of the SafetyNET reporting system was successfully translated and adapted to the Canadian French context.

虽然手工疗法经常用于儿科护理，但它们具有固有的不良事件风险。SafetyNet报告系统的儿童版本包括三份专门为儿童的法定监护人制作的问卷，以及一份供提供者记录治疗细节的问卷。本研究的目的是对加拿大法语人口统计的儿科安全网报告系统进行文化调整。方法召集一个多学科委员会，对儿童版安全网报告系统的四份问卷进行翻译和跨文化改编。适应过程包括几个阶段，包括：(1)向前翻译，(2)翻译版本的综合，(3)跨文化适应，(4)审查和建议预定稿加拿大法语版本，(5)认知述职和建议定稿版本。委员会的调整须经“安全网”系统的开发人员审查。认知汇报涉及法裔加拿大法律监护人和临床医生的参与，以评估问卷的清晰度。结果该委员会由来自不同背景的七名研究人员和临床医生组成，包括脊椎指压疗法、解剖学和物理疗法，以及一名具有语言学背景的研究助理。在收到SafetyNet报告系统开发者对跨文化改编的批准后，所有委员会成员一致认可了预定稿。在纳入基于认知汇报步骤的改进后，提出了最终版本，该步骤涉及13名法定监护人和10名临床医生的反馈。结论：尽管需要对现有的翻译指南进行调整，儿童版本的SafetyNET报告系统还是成功地翻译并适应了加拿大法语的语境。

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引用次数: 0

Knowledge, attitude, and practice towards traditional Chinese medicine treatment among patients with polycystic ovary syndrome: A cross-sectional study 多囊卵巢综合征患者中医治疗知识、态度与行为的横断面研究

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-06 DOI: 10.1016/j.eujim.2025.102498

Nan Li , Lijun Wang , Hui Zhang , Yudong Zhang , Yuan Pang , Xiaoyue Lang , Yue Yang , Xiaoying Zhao , Xuke Zhang , Wenxi Yin , Yuqi Leng , Jun Bai

Introduction

This study aimed to evaluate the knowledge, attitude, and practice of patients with polycystic ovary syndrome (PCOS) regarding Traditional Chinese Medicine (TCM) treatment for PCOS.

Methods

This cross-sectional study was conducted among patients with PCOS at the Gynecology Outpatient Department and Reproductive Medicine Center of our hospital between January and May 2024. A self-reported questionnaire was used to assess demographic information, knowledge, attitude, and practice scores toward TCM treatment of PCOS. A threshold of ≥70.0 % of the maximum possible score was set for adequate knowledge, positive attitude, and proactive practice

Results

A total of 519 patients completed the questionnaire, 90.4 % aged 18-35. The mean scores for knowledge, attitude, and practice were 7.13 ± 5.41 (range 0-25), 30.74 ± 4.04 (range 8-40), and 16.95 ± 3.63 (range 5-25), respectively. The results of Spearman correlation analysis showed that knowledge score was correlated to the attitude (r = 0.272, P < 0.001) and practice (r = 0.421, P < 0.001) scores. The attitude score was correlated to the practice score (r = 0.410, P < 0.001). The Structural Equation Modeling showed that knowledge directly influenced attitude (β = 0.336, P < 0.001). Attitude directly influenced practice (β = 0.432, P < 0.001).

Conclusions

The patients exhibited inadequate knowledge, positive attitude, and proactive practice regarding TCM for PCOS. We recommend improving awareness and acceptance of TCM among patients with PCOS through targeted education, enhanced doctor-patient communication, and promotion of effective treatment models to enhance their quality of life.

本研究旨在了解多囊卵巢综合征（PCOS）患者对中医治疗的认知、态度和实践情况。方法对2024年1 - 5月在我院妇科门诊和生殖医学中心就诊的多囊卵巢综合征患者进行横断面研究。采用自填问卷对中医治疗多囊卵巢综合征的人口学信息、知识、态度和实践进行评估。充分的知识、积极的态度和积极的实践设定了≥70.0%的最大可能得分阈值。结果共519例患者完成了问卷，90.4%的患者年龄在18-35岁之间。知识、态度和实践的平均得分分别为7.13±5.41分（0 ~ 25分）、30.74±4.04分（8 ~ 40分）和16.95±3.63分（5 ~ 25分）。Spearman相关分析结果显示，知识得分与态度存在显著相关(r = 0.272, P <；0.001)和实践(r = 0.421, P <；0.001)分数。态度得分与练习得分呈显著相关(r = 0.410, P <；0.001)。结构方程模型显示知识直接影响态度(β = 0.336, P <；0.001)。态度直接影响练习(β = 0.432, P <；0.001)。结论患者对中医治疗PCOS的认识不足，态度积极，积极主动。我们建议通过有针对性的教育，加强医患沟通，推广有效的治疗模式，提高PCOS患者对中医的认识和接受度，以提高他们的生活质量。

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引用次数: 0