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Effectiveness of infantile tuina for improving motor dysfunction in children with spastic cerebral palsy: A systematic review and meta-analysis of randomized controlled trials 婴儿推拿对改善痉挛性脑瘫儿童运动功能障碍的效果:随机对照试验的系统回顾和荟萃分析
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-26 DOI: 10.1016/j.eujim.2024.102382

Introduction

Infantile cerebral palsy (ICP) is a disease that causes cognitive and motor dysfunction in children, severely affecting their growth and mental health. Infantile tuina is a prominent treatment modality in traditional Chinese medicine (TCM). However, the effectiveness of infantile tuina remains uncertain. This systematic review aimed to assess the efficacy of infantile tuina in enhancing motor dysfunction in ICP through randomized controlled trials (RCTs).

Methods

We completed the meta-analysis according to the PRISMA 2020 checklist. Randomized controlled trials (RCTs) were searched for in seven databases including Medline, Ovid EMBASE, Cochrane Library, Web of Science, China national knowledge infrastructure, Chinese biomedical literature, and Wan Fang from the establishment of the database until November 7, 2023. The effectiveness of infantile tuina to treat motor dysfunction in children with spastic cerebral palsy was evaluated using outcome indexes such as effective rate, Gross motor function measure (GMFM), Modified Ashworth Scale (MAS), and ankle passive dorsiflexion angle.

Results

A total of 12 RCTs were included in this systematic review, which included 950 patients. Meta-analysis of the results indicated that infantile tuina combined with conventional rehabilitation treatment for ICP produced better results than conventional rehabilitation treatment alone. The experimental group intervention had a significant effect on the improvement of ICP treatment efficiency [Relative Risk (RR) = 1.21; 95% Confidence Interval (CI) = 1.10, 1.33], GMFM [MD = 4.76, 95% CI = 3.23, 3.29], MAS [Mean difference (MD) = -0.83, 95% CI = -1.02, -0.64], and ankle dorsiflexion angle [MD = -4.82, 95% CI = -7.45, -2.18]. The results were statistically significant (P < 0.05).

Conclusions

As a complementary therapy to conventional rehabilitation therapy, infantile tuina produced significant improvements in ICP treatment effectiveness in this systematic review. The main limitation in the evidence was a lack of high-quality studies and many studies had small sample sizes.

Registration

PROSPERO ID: CRD42023446889.

导言小儿脑瘫(ICP)是一种导致儿童认知和运动功能障碍的疾病,严重影响儿童的生长发育和心理健康。小儿推拿是传统中医的一种重要治疗方法。然而,小儿推拿的有效性仍不确定。本系统综述旨在通过随机对照试验(RCTs)评估婴幼儿推拿在改善 ICP 运动功能障碍方面的疗效。我们在 Medline、Ovid EMBASE、Cochrane Library、Web of Science、中国国家知识基础设施、中国生物医学文献和万方等 7 个数据库中检索了自数据库建立以来至 2023 年 11 月 7 日的随机对照试验(RCT)。采用有效率、大运动功能测量(GMFM)、改良阿什沃斯量表(MAS)和踝关节被动外展角度等结果指标评价小儿推拿治疗痉挛性脑瘫患儿运动功能障碍的有效性。元分析结果表明,小儿推拿与传统康复治疗相结合治疗ICP的效果优于单纯的传统康复治疗。实验组干预对ICP治疗有效率[相对风险(RR)=1.21;95%置信区间(CI)=1.10,1.33]、GMFM[MD=4.76,95%CI=3.23,3.29]、MAS[平均差(MD)=-0.83,95%CI=-1.02,-0.64]和踝关节背屈角度[MD=-4.82,95%CI=-7.45,-2.18]的改善有显著效果。结论作为传统康复治疗的一种辅助疗法,小儿推拿在本系统综述中显著改善了ICP的治疗效果。证据的主要局限性在于缺乏高质量的研究,而且许多研究的样本量较小:CRD42023446889。
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引用次数: 0
Investigating the role of miR-26b-5p and PTGS2 in schizophrenia treatment using Wendan decoction: Network pharmacology and experimental validation 利用文旦煎剂研究 miR-26b-5p 和 PTGS2 在精神分裂症治疗中的作用:网络药理学和实验验证
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-22 DOI: 10.1016/j.eujim.2024.102380
Yilin Liu , Xinling Zhao , Qing Long , Zeyi Guo , Xiang Cao , Xiaoqin Wu , Fangjun Tu , Yunqiao Zhang , Xu You , Xiuying Shi , Zhaowei Teng , Yong Zeng

Introduction

This study aimed to identify the target of action of Wendan decoction, a classical Chinese herbal formula used for the treatment of psychiatric disorders, specifically schizophrenia, using network pharmacology.

Methods

Traditional Chinese Medicine (TCM) bioinformatics and network pharmacology were employed to predict the genes regulated by miR-26b-5p and identify the active ingredients and related targets of the Wendan decoction from public databases. Key components and targets were screened by constructing a "TCM-component-target" network, followed by pathway enrichment analysis of the related targets. The expression levels of miR-26b-5p and prostaglandin-endoperoxide synthase 2 (PTGS2) in the peripheral blood of patients with schizophrenia patients and healthy individuals were determined using RT-qPCR. Molecular docking was performed to explore the interaction between the active ingredients of the Wendan decoction and key differentially expressed molecules, investigating the role of miR-26b-5p in the treatment of schizophrenia with the Wendan decoction.

Results

A total of 135 active constituents were extracted from the Wendan decoction, and 144 molecules, including PTGS2 and other derivatives, were screened for drug-target and disease-target inter-mapping. Compared to peripheral blood samples from healthy controls and patients with depression, peripheral blood samples from patients with schizophrenia patients showed low miR-26b-5p expression and elevated PTGS2 expression, with no significant difference observed in the expression between healthy controls and patients with depression. Molecular docking revealed that several active compounds were found in five of the six constituents of the Wendan decoction bound with PTGS2. Pathway enrichment analysis suggested that the Wendan decoction may have a potential therapeutic role in treating schizophrenia by regulating the circadian rhythm, N-methyl-d-aspartate glutamate receptor activity, inflammatory mediator regulation of transient receptor potential channels, and other pathways implicated in schizophrenia.

Conclusion

Wendan decoction may treat schizophrenia via the miR-26b-5p targeting factor PTGS2 and inflammation-related pathways. miR-26b-5p, combined with PTSG2, holds the potential as a differential diagnostic marker for schizophrenia.

方法运用中医生物信息学和网络药理学预测受 miR-26b-5p 调控的基因,并从公共数据库中识别文旦汤的有效成分和相关靶点。通过构建 "中药-成分-靶点 "网络筛选关键成分和靶点,并对相关靶点进行通路富集分析。采用 RT-qPCR 方法测定了 miR-26b-5p 和前列腺素内过氧化物合成酶 2(PTGS2)在精神分裂症患者和健康人外周血中的表达水平。结果 从文旦煎剂中提取了135种有效成分,并对包括PTGS2及其他衍生物在内的144个分子进行了药物-靶点和疾病-靶点的相互映射筛选。与健康对照组和抑郁症患者的外周血样本相比,精神分裂症患者的外周血样本中 miR-26b-5p 表达较低,而 PTGS2 表达较高,健康对照组和抑郁症患者的表达无明显差异。分子对接显示,文旦煎剂的六种成分中有五种发现了与 PTGS2 结合的几种活性化合物。通路富集分析表明,文旦煎剂可通过调节昼夜节律、N-甲基-d-天冬氨酸谷氨酸受体活性、炎症介质对瞬时受体电位通道的调控以及与精神分裂症有关的其他通路,在治疗精神分裂症方面发挥潜在的治疗作用。结论 文旦煎剂可通过 miR-26b-5p 靶向因子 PTGS2 和炎症相关途径治疗精神分裂症。 miR-26b-5p 与 PTSG2 结合,有望成为精神分裂症的鉴别诊断标志物。
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引用次数: 0
Comparing the use of colored Trace Images in Kids' Books with passive distractions to decrease pain and fear during cannulation in children: A randomized clinical trial 比较使用儿童读物中的彩色追踪图像和被动分散注意力法来减轻儿童插管时的疼痛和恐惧:随机临床试验
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-21 DOI: 10.1016/j.eujim.2024.102379
Sherzad Khudeida Suleman , Nizar BakirYahya , Stefan Nilsson , Karin Enskär

Introduction

Cannulation can be frightening and a source of pain and fear for pediatric patients. The study evaluated the effectiveness of Trace Image and Coloring for Kids-Book (TICK-B) as active distraction with two passive distractions in reducing children's pain and fear during cannulation.

Methods

This study employed a prospective, controlled, randomized experiment conducted from January 2023 to April 2023 at Heevi Pediatric hospital in the Kurdistan region of Iraq. A total of 176 participants were randomly assigned in to one of four study groups, with 44 participants assigned to each group. The interventions were administered 2–3 min before continued until the cannulation procedure finished. Data were collected through interviews conducted before and after the procedure. Children reported pain using Wong-Baker FACES® scale, and fear evaluated with the Child Fear Scale as an outcome after the cannulation procedure. Children's outcomes during and after procedure were measured 2–3 min after completed procedure.

Results

All distraction methods significantly reduced children's pain and fear compared to the control group. TICK-B showed large effects in reducing average pain (mean difference = -4.65, 95 % CI: -5.67 to -3.65) and fear (mean difference = -2.18, 95 % CI: -2.67 to -1.69) during cannulation. Post-procedure, TICK-B maintained large pain relief (mean difference = -4.10, 95 % CI: -4.98 to -3.22) and fear reduction (mean difference = -1.89, 95 % CI: -2.39 to -1.39) effects. Music listening and cartoon watching both showed improvements compared to the control group, with minimal differences between them in terms of pain and fear during the procedure. Also, the differences were the same after the procedure. No adverse events were reported.

Conclusion

All distraction techniques effectively and safely decreased children's pain and fear during cannulation. The TICK-B technique most effectively reduced children's pain and fear during cannulation procedures compared to music-listening and cartoon-watching techniques.

Trial registration

NCT04977323.

引言 插管可能会让儿童患者感到恐惧、疼痛和恐惧。本研究评估了《儿童追踪图像和着色书》(TICK-B)作为主动分散注意力的方法与两种被动分散注意力的方法在减少儿童插管时的疼痛和恐惧方面的效果。共有 176 名参与者被随机分配到四个研究组中的一组,每组 44 人。干预措施在插管前 2-3 分钟进行,直至插管过程结束。数据通过手术前后的访谈收集。插管过程结束后,儿童使用 Wong-Baker FACES® 量表报告疼痛情况,并使用儿童恐惧量表评估恐惧程度。与对照组相比,所有分散注意力的方法都能显著减轻儿童的疼痛和恐惧感。TICK-B 在减少插管过程中的平均疼痛(平均差异 = -4.65,95 % CI:-5.67 至 -3.65)和恐惧(平均差异 = -2.18,95 % CI:-2.67 至 -1.69)方面显示出巨大的效果。手术后,TICK-B 仍能保持较大的缓解疼痛(平均差异 = -4.10,95 % CI:-4.98 至 -3.22)和减少恐惧(平均差异 = -1.89,95 % CI:-2.39 至 -1.39)效果。与对照组相比,听音乐和看动画片的效果都有所改善,但在手术过程中的疼痛和恐惧方面,两者之间的差异很小。此外,手术后的差异也相同。结论 所有分散注意力的技术都能有效、安全地减轻儿童在插管过程中的疼痛和恐惧。与听音乐和看动画片的技术相比,TICK-B 技术能最有效地减轻儿童在插管过程中的疼痛和恐惧感。
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引用次数: 0
Protocol for the reporting assessment of clinical trials with non-pharmacological therapies in Chinese medicine 中医非药物疗法临床试验报告评估规程
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-20 DOI: 10.1016/j.eujim.2024.102381
Hanzhi Tan , Nana Wang , Han Li , Chung Wah Cheng , Yalin Jiao , Dongni Shi , Juan Wang , Jiashuai Deng , Ji Li , Fei Han , Ping Wang , Zhaoxiang Bian , Xuan Zhang

Introduction

Non-pharmacological treatment in Chinese Medicine (NPTCM) plays a crucial and distinct role in clinical practice, and increasingly within randomized controlled trials (RCTs). With the successive publication of Consolidated Standards Of Reporting Trials (CONSORT) extensions for acupuncture, moxibustion, cupping, and Tuina/massage, this study aims to assess the reporting characteristics and quality of published RCTs based on these specific reporting checklists.

Methods

Databases including All EBM Reviews, AMED, Embase, Ovid MEDLINE(R), CNKI, VIP Chinese Medical Journal Database, and Wanfang Data will be searched, with the publication date limited to January 1, 2022 to December 31, 2022. The interventions of interest are RCTs involving acupuncture, moxibustion, cupping or Tuina/massage, with language restricted to Chinese or English. Two reviewers will conduct the screening process with double-checking by the third reviewer. The purpose of data extraction is to summarize the study designs and implementation characteristics of these four types of interventions, and a pre-designed data extraction form will be utilized. For quality assessment, a standard operating procedure (SOP) will be developed, using an assessment form based on the checklist items of the four CONSORT extensions. Each article will be reviewed by two reviewers in a paired back-to-back manner, and Cohen's kappa statistic will be calculated to assess inter-rater agreement. Descriptive statistics will be used to present the quality of reporting. Subgroup comparisons will be conducted regarding different types of interventions, locations and publication languages.

Discussion

This study aims to identify and assess the current reporting characteristics and quality of the above four types of NPTCM interventional trials. Based on the results, it is hoped to provide suggestions for future application or promotion of the CONSORT extensions for NPTCM.

导言:中医非药物治疗(NPTCM)在临床实践中发挥着重要而独特的作用,在随机对照试验(RCT)中的作用也越来越大。随着针灸、艾灸、拔罐和推拿/按摩的《试验报告统一标准》(Consort)扩展版的陆续出版,本研究旨在根据这些特定的报告核对表评估已发表的 RCT 的报告特点和质量。感兴趣的干预措施是涉及针灸、艾灸、拔罐或推拿/按摩的 RCT,语言限于中文或英文。由两名审稿人进行筛选,第三名审稿人进行复核。数据提取的目的是总结这四类干预措施的研究设计和实施特点,并使用预先设计的数据提取表。在质量评估方面,将根据 CONSORT 四项扩展的核对表项目制定标准操作程序 (SOP)。每篇文章将由两名审稿人以背靠背的方式进行配对审阅,并计算科恩卡帕统计量以评估审稿人之间的一致性。将使用描述性统计来说明报告的质量。本研究旨在确定和评估上述四类 NPTCM 介入性试验的报告特点和质量。本研究旨在识别和评估上述四类 NPTCM 干预试验目前的报告特点和质量,并希望根据评估结果,为 NPTCM 未来应用或推广 CONSORT 扩展提供建议。
{"title":"Protocol for the reporting assessment of clinical trials with non-pharmacological therapies in Chinese medicine","authors":"Hanzhi Tan ,&nbsp;Nana Wang ,&nbsp;Han Li ,&nbsp;Chung Wah Cheng ,&nbsp;Yalin Jiao ,&nbsp;Dongni Shi ,&nbsp;Juan Wang ,&nbsp;Jiashuai Deng ,&nbsp;Ji Li ,&nbsp;Fei Han ,&nbsp;Ping Wang ,&nbsp;Zhaoxiang Bian ,&nbsp;Xuan Zhang","doi":"10.1016/j.eujim.2024.102381","DOIUrl":"https://doi.org/10.1016/j.eujim.2024.102381","url":null,"abstract":"<div><h3>Introduction</h3><p>Non-pharmacological treatment in Chinese Medicine (NPTCM) plays a crucial and distinct role in clinical practice, and increasingly within randomized controlled trials (RCTs). With the successive publication of Consolidated Standards Of Reporting Trials (CONSORT) extensions for acupuncture, moxibustion, cupping, and Tuina/massage, this study aims to assess the reporting characteristics and quality of published RCTs based on these specific reporting checklists.</p></div><div><h3>Methods</h3><p>Databases including All EBM Reviews, AMED, Embase, Ovid MEDLINE(R), CNKI, VIP Chinese Medical Journal Database, and Wanfang Data will be searched, with the publication date limited to January 1, 2022 to December 31, 2022. The interventions of interest are RCTs involving acupuncture, moxibustion, cupping or Tuina/massage, with language restricted to Chinese or English. Two reviewers will conduct the screening process with double-checking by the third reviewer. The purpose of data extraction is to summarize the study designs and implementation characteristics of these four types of interventions, and a pre-designed data extraction form will be utilized. For quality assessment, a standard operating procedure (SOP) will be developed, using an assessment form based on the checklist items of the four CONSORT extensions. Each article will be reviewed by two reviewers in a paired back-to-back manner, and Cohen's kappa statistic will be calculated to assess inter-rater agreement. Descriptive statistics will be used to present the quality of reporting. Subgroup comparisons will be conducted regarding different types of interventions, locations and publication languages.</p></div><div><h3>Discussion</h3><p>This study aims to identify and assess the current reporting characteristics and quality of the above four types of NPTCM interventional trials. Based on the results, it is hoped to provide suggestions for future application or promotion of the CONSORT extensions for NPTCM.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876382024000519/pdfft?md5=8866f83e65c4f29c875c6be8434107ea&pid=1-s2.0-S1876382024000519-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141539417","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of acupuncture in the treatment of osteoporosis-related fractures: A systematic review and Bayesian network meta-analysis 针灸治疗骨质疏松症相关骨折的疗效:系统综述和贝叶斯网络荟萃分析
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-19 DOI: 10.1016/j.eujim.2024.102378
Ruya Sheng , Mingxia Wu , Yali Qiu , Qing Sun

Introduction

In recent years, there has been an increasing interest in the utilization of different acupuncture regimens as alternative therapies for fractures linked to osteoporosis. Nevertheless, the efficacy of these diverse treatment choices continues to be a subject of contention. To tackle this matter, a comprehensive Bayesian network meta-analysis has been undertaken to thoroughly assess the potential advantages of various acupuncture techniques in the management of osteoporosis-related fractures.

Methods

Until April 12, 2023, an extensive search was carried out to identify randomized controlled trials investigating the application of acupuncture in the treatment of fractures related to osteoporosis. The search encompassed multiple databases, such as PubMed, EMBASE, Web of Science, Cochrane Library, China Knowledge Network (CNKI), WanFang, VIP Database, and SinoMed. The network meta-analysis specifically aimed to evaluate the efficacy of different acupuncture techniques in conjunction with conservative biomedical treatment or invasive biomedical surgical treatment for managing fractures related to osteoporosis.

Results

A total of 35 articles were included, involving 2,727 patients. These articles examined and investigated five different types of acupuncture treatment options. The evaluated acupuncture treatments included ordinary acupuncture, electroacupuncture, floating acupuncture, needle-knife, and warm acupuncture. Results showed that when electroacupuncture was combined with daily care, it resulted in a significant decrease in both the Visual Analogue Scale (VAS) score and the Oswestry Disability Index (ODI) score. Specifically, the VAS score decreased by -2.29 (95 % CI: -3.84 ∼ -0.75), while the ODI score decreased by -22.03 (95 % CI: -33.88 ∼ -10.54) compared to those who received only daily care. Additionally, there was a significant decrease in the VAS score when comparing the combination of ordinary acupuncture with percutaneous vertebroplasty (PVP) surgery to PVP surgery alone. The VAS score decreased by -1.39 (95 % CI: -2.73 ∼ -0.04) in the group that underwent both acupuncture and surgery. Similarly, in the comparison between warm acupuncture combined with percutaneous kyphoplasty (PKP) surgery and PKP surgery alone, there was a significant reduction in the VAS score. The VAS score decreased by -3.62 (95 % CI: -5.49 ∼ -1.74) in the group that received both acupuncture and surgery.

Conclusions

The implementation of a well-balanced acupuncture treatment regimen can effectively alleviate pain and disability experienced by patients with fractures related to osteoporosis, irrespective of whether surgical intervention is conducted.

导言近年来,人们越来越关注利用不同的针灸疗法作为替代疗法来治疗与骨质疏松症有关的骨折。然而,这些不同治疗方案的疗效仍存在争议。为了解决这个问题,我们进行了一项全面的贝叶斯网络荟萃分析,以彻底评估各种针灸技术在治疗骨质疏松症相关骨折方面的潜在优势。方法在2023年4月12日之前,我们进行了一次广泛的检索,以确定研究针灸治疗骨质疏松症相关骨折的随机对照试验。检索涵盖多个数据库,如 PubMed、EMBASE、Web of Science、Cochrane Library、中国知网(CNKI)、万方数据库、VIP 数据库和 SinoMed。该网络荟萃分析的具体目标是评估不同针灸技术与保守生物医学治疗或侵入性生物医学手术治疗相结合治疗骨质疏松症相关骨折的疗效。这些文章研究了五种不同类型的针灸治疗方案。评估的针灸疗法包括普通针灸、电针、浮针、针刀和温针。结果显示,当电针与日常护理相结合时,视觉模拟量表(VAS)评分和奥斯韦特里残疾指数(ODI)评分均显著下降。具体而言,与仅接受日常护理的患者相比,VAS 评分下降了 -2.29 (95 % CI: -3.84 ∼ -0.75),而 ODI 评分下降了 -22.03 (95 % CI: -33.88 ∼ -10.54)。此外,将普通针灸与经皮椎体成形术(PVP)手术相结合与单纯经皮椎体成形术手术相比,VAS 评分也有显著下降。同时接受针灸和手术治疗组的 VAS 评分下降了-1.39(95 % CI:-2.73 ∼ -0.04)。同样,在温针灸联合经皮椎体后凸成形术(PKP)手术与单纯经皮椎体后凸成形术手术的比较中,VAS评分也有显著下降。结论无论是否进行手术干预,实施均衡的针灸治疗方案都能有效缓解骨质疏松症相关骨折患者的疼痛和残疾。
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引用次数: 0
Acupoint prescriptions, treatment protocol and outcome evidence for acupuncture in diabetic peripheral neuropathy: A scoping review of clinical studies 针灸治疗糖尿病周围神经病变的穴位处方、治疗方案和结果证据:临床研究范围综述
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-18 DOI: 10.1016/j.eujim.2024.102376

Introduction

Acupuncture is a complementary therapy for diabetic peripheral neuropathy (DPN). This scoping review systematically collect clinical studies using acupuncture for the treatment of DPN to analyze and summarize acupuncture point prescriptions, treatment protocols, and outcome indicators regarding clinical trials of acupuncture for DPN. The results will help guide the selection of future clinical protocols.

Methods

Eight databases were searched from their inception to March 1, 2023, including PubMed, Excerpt Medica Database (EMBASE), Web of Science, Cochrane Library, Google Scholar, China National Knowledge Infrastructure (CNKI), China Biology Medicine disk (CBM disk), Wan Fang, and Chinese Scientific Journal Database (VIP). Demographic characteristics of study participants, patients, treatment details, acupuncture prescriptions, and outcome indicators were screened and extracted.

Results

A total of 219 clinical studies were included, and the number of published studies showed a year-on-year increase. Two hundred eleven studies (96.34%) were conducted in China. One hundred fifty one (68.95%) were conducted in Traditional Chinese Medicine (TCM) hospitals. Two hundred and six (94.06%) studies were randomized controlled trials (RCTs) that treated patients with different clinical symptoms of DPN in 17,945 patients. The primary intervention was manual acupuncture treatment, most commonly with stainless steel needles (φ0.35 mm × 40 mm) left in place for more than 30 minutes. Acupuncture points SP6 and ST36 combined were applied most frequently, and the five points with frequencies over 100 were ST36, SP6, LI11, LI4, and GB34. The outcome indicators of acupuncture for DPN were mainly nerve conduction velocity, effectiveness rating scale, and efficiency. Adverse events were reported in only a few studies and mainly included nausea, pain, and diarrhea.

Conclusions

This review provides evidence on treatment protocols, point prescriptions, and outcome metrics for acupuncture for DPN. However, the low quality of the study designs included in the clinical literature resulted in a degree of selection bias in the findings, which still needs to be validated by high-quality clinical trials. Future studies should be designed as more rigorous multicenter, large-sample randomized controlled trials to improve the accuracy and consistency of the effectiveness evaluation of acupuncture for DPN and enrich the standardized clinical treatment protocols for DPN.

引言 针灸是治疗糖尿病周围神经病变(DPN)的一种辅助疗法。本范围综述系统地收集了针灸治疗 DPN 的临床研究,对针灸治疗 DPN 的穴位处方、治疗方案和临床试验结果指标进行了分析和总结。方法检索了从开始到 2023 年 3 月 1 日的 8 个数据库,包括 PubMed、Excerpt Medica Database (EMBASE)、Web of Science、Cochrane Library、Google Scholar、中国国家知识基础设施 (CNKI)、中国生物医学文献数据库 (CBM)、万方数据库和中国科学期刊论文数据库 (VIP)。结果 共纳入 219 项临床研究,发表的研究数量呈逐年上升趋势。有 211 项研究(96.34%)在中国进行。其中 151 项(68.95%)在中医医院进行。216项(94.06%)研究为随机对照试验(RCT),对17945名DPN患者的不同临床症状进行了治疗。主要干预措施是人工针灸治疗,最常见的是使用不锈钢针(φ0.35 mm × 40 mm)留针 30 分钟以上。针刺频率最高的穴位是 SP6 和 ST36,频率超过 100 的五个穴位是 ST36、SP6、LI11、LI4 和 GB34。针灸治疗 DPN 的疗效指标主要是神经传导速度、疗效评分表和有效率。本综述提供了针灸治疗 DPN 的治疗方案、穴位处方和疗效指标方面的证据。然而,临床文献中的研究设计质量较低,导致研究结果存在一定程度的选择偏倚,这仍需要高质量的临床试验来验证。未来的研究应设计为更严格的多中心、大样本随机对照试验,以提高针灸治疗DPN疗效评价的准确性和一致性,丰富DPN的标准化临床治疗方案。
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引用次数: 0
Phytochemical profiling and therapeutic potential of Baliospermum montanum: A promising inhibitor of COX-2/15-LOX enzymes and NO production in LPS-stimulated RAW 264.7 macrophages 万年青的植物化学成分分析和治疗潜力:LPS 刺激的 RAW 264.7 巨噬细胞中 COX-2/15-LOX 酶和 NO 生成的有效抑制剂
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-08 DOI: 10.1016/j.eujim.2024.102377
Anithakumari Aswathy Krishna , Beena Levakumar Abhirami , Abdul Rahim Muhammed Jasim , Sulochana Priya , Alaganandam Kumaran

Introduction

Baliospermum montanum (BM) is traditionally used to treat various ailments such as inflammation, rheumatoid arthritis, pain, etc. The root part of BM is well documented for its anti-inflammatory activity. However, the present study evaluates the multitargeted anti-inflammatory activity of the less explored BM leaf part. This is the first study investigating the COX-2, 15-LOX dual inhibiting potential and NO production inhibition of BM leaf extracts, fractions and compounds.

Methods

The BM leaf's water, ethanol, and hydroethanolic extracts were evaluated for anti-inflammatory activity by assessing the inhibition of COX-2, 15-LOX, and NO production. Additionally, the antioxidant potential of the extracts was determined through DPPH, ABTS, and FRAP assays. The most active ethanol extract was fractionated into 12 fractions and tested for anti-inflammatory, antioxidant, phenol and flavonoid content. Compounds were isolated from the most active fractions and identified using NMR techniques. The isolated compounds were checked for their anti-inflammatory activity. In addition, HPLC analysis of ethanol extract, fractions, and isolated compounds was carried out.

Results

The ethanol extract exhibited higher inhibition of COX-2, 15-LOX enzymes and NO production (IC50 35.75 ± 1.95 μg/mL) in LPS-treated RAW 264.7 cells. It also showed higher antioxidant activity. Following the fractionation of the ethanol extract using different solvents, only the ethyl acetate fractions demonstrated inhibition of COX-2, 15-LOX enzymes, and NO production. The ethyl acetate and acetone fractions are excellent sources of antioxidants, phenolic and flavonoid compounds. An effort to find the active principles from these ethyl acetate fractions resulted in the isolation and identification of four potent anti-inflammatory agents, namely, (-)-epiafzelechin, afzelechin-(4α→8)-afzelechin, afzelechin-(4α→8)-epiafzelechin and β-sitosterol-d-glycoside. The first three compounds were reported for the first time from this plant and afzelechin-(4α→8)-afzelechin was found to be a potent inhibitor of the COX-2/15 LOX enzyme as well as NO production (IC50 = 5.9 ± 1.09 µM).

Conclusion

Based on these findings, we conclude that ethanol extract, fractions, and isolated compounds exert anti-inflammatory activity through multiple therapeutic mechanisms. The present study scientifically supports the traditional use of plant BM for treating inflammation and other related disorders.

导言孟加拉草(Baliospermum montanum,BM)传统上用于治疗各种疾病,如炎症、类风湿性关节炎、疼痛等。文冠果的根部具有抗炎活性,这一点已得到充分证明。然而,本研究评估了探索较少的 BM 叶部分的多靶点抗炎活性。这是首次研究 BM 叶提取物、馏分和化合物的 COX-2、15-LOX 双重抑制潜力和 NO 生成抑制作用。此外,还通过 DPPH、ABTS 和 FRAP 试验测定了提取物的抗氧化潜力。最有活性的乙醇提取物被分成 12 个馏分,并进行了抗炎、抗氧化、酚和类黄酮含量测试。从最具活性的馏分中分离出化合物,并使用核磁共振技术进行鉴定。对分离出的化合物进行了抗炎活性检测。结果乙醇提取物对 LPS 处理的 RAW 264.7 细胞中 COX-2、15-LOX 酶和 NO 的产生有较高的抑制作用(IC50 35.75 ± 1.95 μg/mL)。它还显示出较高的抗氧化活性。使用不同溶剂对乙醇提取物进行分馏后,只有乙酸乙酯馏分显示出对 COX-2、15-LOX 酶和 NO 生成的抑制作用。乙酸乙酯和丙酮馏分是抗氧化剂、酚类和类黄酮化合物的极佳来源。为了从这些乙酸乙酯馏分中找到活性成分,我们分离并鉴定了四种强效抗炎剂,即 (-)-epiafzelechin 、afzelechin-(4α→8)-afzelechin 、afzelechin-(4α→8)-epiafzelechin 和 β-谷甾醇-d-糖苷。前三种化合物是首次从该植物中发现的,而阿夫儿茶素-(4α→8)-阿夫儿茶素是 COX-2/15 LOX 酶和 NO 生成的强效抑制剂(IC50 = 5.9 ± 1.09 µM)。本研究为传统上使用植物 BM 治疗炎症和其他相关疾病提供了科学依据。
{"title":"Phytochemical profiling and therapeutic potential of Baliospermum montanum: A promising inhibitor of COX-2/15-LOX enzymes and NO production in LPS-stimulated RAW 264.7 macrophages","authors":"Anithakumari Aswathy Krishna ,&nbsp;Beena Levakumar Abhirami ,&nbsp;Abdul Rahim Muhammed Jasim ,&nbsp;Sulochana Priya ,&nbsp;Alaganandam Kumaran","doi":"10.1016/j.eujim.2024.102377","DOIUrl":"10.1016/j.eujim.2024.102377","url":null,"abstract":"<div><h3>Introduction</h3><p><em>Baliospermum montanum</em> (BM) is traditionally used to treat various ailments such as inflammation, rheumatoid arthritis, pain, etc. The root part of BM is well documented for its anti-inflammatory activity. However, the present study evaluates the multitargeted anti-inflammatory activity of the less explored BM leaf part. This is the first study investigating the COX-2, 15-LOX dual inhibiting potential and NO production inhibition of BM leaf extracts, fractions and compounds.</p></div><div><h3>Methods</h3><p>The BM leaf's water, ethanol, and hydroethanolic extracts were evaluated for anti-inflammatory activity by assessing the inhibition of COX-2, 15-LOX, and NO production. Additionally, the antioxidant potential of the extracts was determined through DPPH, ABTS, and FRAP assays. The most active ethanol extract was fractionated into 12 fractions and tested for anti-inflammatory, antioxidant, phenol and flavonoid content. Compounds were isolated from the most active fractions and identified using NMR techniques. The isolated compounds were checked for their anti-inflammatory activity. In addition, HPLC analysis of ethanol extract, fractions, and isolated compounds was carried out.</p></div><div><h3>Results</h3><p>The ethanol extract exhibited higher inhibition of COX-2, 15-LOX enzymes and NO production (IC<sub>50</sub> 35.75 ± 1.95 μg/mL) in LPS-treated RAW 264.7 cells. It also showed higher antioxidant activity. Following the fractionation of the ethanol extract using different solvents, only the ethyl acetate fractions demonstrated inhibition of COX-2, 15-LOX enzymes, and NO production. The ethyl acetate and acetone fractions are excellent sources of antioxidants, phenolic and flavonoid compounds. An effort to find the active principles from these ethyl acetate fractions resulted in the isolation and identification of four potent anti-inflammatory agents, namely, (-)-epiafzelechin, afzelechin-(4α→8)-afzelechin, afzelechin-(4α→8)-epiafzelechin and β-sitosterol-<span>d</span>-glycoside. The first three compounds were reported for the first time from this plant and afzelechin-(4α→8)-afzelechin was found to be a potent inhibitor of the COX-2/15 LOX enzyme as well as NO production (IC<sub>50</sub> = 5.9 ± 1.09 µM).</p></div><div><h3>Conclusion</h3><p>Based on these findings, we conclude that ethanol extract, fractions, and isolated compounds exert anti-inflammatory activity through multiple therapeutic mechanisms. The present study scientifically supports the traditional use of plant BM for treating inflammation and other related disorders.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141405494","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
Efficacy and safety of Chinese herbal formula CDD-2103 for remission maintenance of ulcerative colitis: Study protocol for a randomized, double-blinded, placebo-controlled trial 中药配方 CDD-2103 维持溃疡性结肠炎缓解的有效性和安全性:随机、双盲、安慰剂对照试验的研究方案
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-04 DOI: 10.1016/j.eujim.2024.102375
Xuan Zhang , Hor Yue Tan , Wing Lam To , Ziwan Ning , Ka Wing Cheng , Jialing Zhang , Emily Au , Keyi Zhou , Hoi Ki Wong , Heung Lam Mok , Jiaruo Xu , Matthew Koh , Zhaoxiang Bian

Introduction

Ulcerative colitis (UC) is a chronic lifelong disorder and a prominent subtype of inflammatory bowel disease (IBD) globally. Studies have indicated that Chinese herbal medicines (CHM) may offer advantages in alleviating the clinical symptoms experienced by UC patients. CDD (Centre for Chinese Herbal Medicine Drug Development)-2103 is a CHM formula for maintenance of UC remission. We aim to evaluate its efficacy and safety in remission patients with a traditional Chinese medicine (TCM) pattern of spleen deficiency with dampness obstruction (SDDO).

Methods

This study is a multi-center, randomized, double-blind, placebo-controlled clinical trial. A total of 82 eligible patients will be randomized to receive either CDD-2103 or placebo for 24 weeks, followed by post-treatment monitoring at week 36 and 48. The primary outcome is the recurrence rate according to the modified Mayo Score at week 24. The secondary outcomes consist of Partial Mayo Score, Inflammatory bowel disease questionnaire (IBDQ), Simple clinical colitis activity index (SCAAI), TCM syndrome scale and safety assessment.

Conclusion

This study will provide evidence on the effectiveness and safety of CDD-2103 in reducing chance of clinical relapse for UC patients, and will further shed light on the UC remission maintenance with TCM.

Trial registration

Chinese Clinical Trial Registry, ChiCTR2100043200. Registered on 8 February 2021. https://www.chictr.org.cn/showproj.html?proj=121,692.

导言溃疡性结肠炎(UC)是一种慢性终身性疾病,也是全球炎症性肠病(IBD)的一个重要亚型。研究表明,中药在缓解 UC 患者的临床症状方面可能具有优势。CDD(中药药物研发中心)-2103 是一种用于维持 UC 缓解的中药配方。我们的目的是评估其对中医脾虚湿阻(SDDO)型缓解期患者的疗效和安全性。方法本研究是一项多中心、随机、双盲、安慰剂对照临床试验。共有82名符合条件的患者将随机接受CDD-2103或安慰剂治疗24周,并在第36周和第48周接受治疗后监测。主要结果是第24周时根据改良梅奥评分得出的复发率。结论该研究将为CDD-2103在降低UC患者临床复发几率方面的有效性和安全性提供证据,并将进一步揭示中医药在维持UC缓解方面的作用。https://www.chictr.org.cn/showproj.html?proj=121,692。
{"title":"Efficacy and safety of Chinese herbal formula CDD-2103 for remission maintenance of ulcerative colitis: Study protocol for a randomized, double-blinded, placebo-controlled trial","authors":"Xuan Zhang ,&nbsp;Hor Yue Tan ,&nbsp;Wing Lam To ,&nbsp;Ziwan Ning ,&nbsp;Ka Wing Cheng ,&nbsp;Jialing Zhang ,&nbsp;Emily Au ,&nbsp;Keyi Zhou ,&nbsp;Hoi Ki Wong ,&nbsp;Heung Lam Mok ,&nbsp;Jiaruo Xu ,&nbsp;Matthew Koh ,&nbsp;Zhaoxiang Bian","doi":"10.1016/j.eujim.2024.102375","DOIUrl":"10.1016/j.eujim.2024.102375","url":null,"abstract":"<div><h3>Introduction</h3><p>Ulcerative colitis (UC) is a chronic lifelong disorder and a prominent subtype of inflammatory bowel disease (IBD) globally. Studies have indicated that Chinese herbal medicines (CHM) may offer advantages in alleviating the clinical symptoms experienced by UC patients. CDD (Centre for Chinese Herbal Medicine Drug Development)-2103 is a CHM formula for maintenance of UC remission. We aim to evaluate its efficacy and safety in remission patients with a traditional Chinese medicine (TCM) pattern of spleen deficiency with dampness obstruction (SDDO).</p></div><div><h3>Methods</h3><p>This study is a multi-center, randomized, double-blind, placebo-controlled clinical trial. A total of 82 eligible patients will be randomized to receive either CDD-2103 or placebo for 24 weeks, followed by post-treatment monitoring at week 36 and 48. The primary outcome is the recurrence rate according to the modified Mayo Score at week 24. The secondary outcomes consist of Partial Mayo Score, Inflammatory bowel disease questionnaire (IBDQ), Simple clinical colitis activity index (SCAAI), TCM syndrome scale and safety assessment.</p></div><div><h3>Conclusion</h3><p>This study will provide evidence on the effectiveness and safety of CDD-2103 in reducing chance of clinical relapse for UC patients, and will further shed light on the UC remission maintenance with TCM.</p></div><div><h3>Trial registration</h3><p>Chinese Clinical Trial Registry, ChiCTR2100043200. Registered on 8 February 2021. <span>https://www.chictr.org.cn/showproj.html?proj=121,692</span><svg><path></path></svg>.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":null,"pages":null},"PeriodicalIF":1.9,"publicationDate":"2024-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876382024000453/pdfft?md5=c0d787410cd1dd60ff45e10d5339e8af&pid=1-s2.0-S1876382024000453-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141410500","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Ethnobotanical exploration of botanical remedies used by traditional healers and herbalists for voice disorders 对传统医士和草药医生用于治疗嗓音疾病的植物疗法进行人种植物学探索
IF 1.9 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-06-04 DOI: 10.1016/j.eujim.2024.102374
Hala Jarrar , Mahmoud Alatrash , Faten Amer

Background

Traditional herbal medicine is an integral part of global healthcare, with a growing reliance on natural remedies. This study investigates herbal medicine practitioners' perspectives on plants used to treat voice disorders in Palestine.

Methods

A quantitative cross-sectional study was conducted in the West Bank of Palestine, involving 100 herbal medicine practitioners who completed a semi-structured questionnaire between March and June 2023. Information on herbs was collected, including their Arabic names, parts used, and preparation methods. Plant samples were preserved and identified at the pharmacognosy lab at An-Najah National University. Quantitative analysis employed fidelity level, use-value, and choice value to assess cultural and ecological aspects.

Results

The herbalists recommended 20 herbs. The top five herbs identified were Anthemis cotula, Pimpinella anisum, Zingiber officinale, Clinopodium serpyllifolium, and Mentha spicata, with fidelity levels ranging from 76 % to 96 %. Leaves and fruits were the most commonly utilized plant parts, with the Lamiaceae and Apiaceae families being the most frequent.

Conclusion

Folkloric herbal medicine contributes to community healthcare and drug development. This study documents 20 indigenous Palestinian phyto-remedies that enhance vocal health, highlighting rich traditional knowledge. Collaboration between traditional healers and healthcare professionals can offer informed recommendations, while educational programs bridge traditional and contemporary healthcare. This pioneering research provides valuable insights globally, being the first to explore herbalists' indigenous knowledge of voice disorder remedies. While focusing on the West Bank, its implications extend worldwide, guiding future research into herbal remedies for voice disorders.

背景传统草药是全球医疗保健不可或缺的一部分,人们对自然疗法的依赖与日俱增。本研究调查了巴勒斯坦草药从业者对用于治疗嗓音疾病的植物的看法。方法在巴勒斯坦约旦河西岸进行了一项定量横断面研究,100 名草药从业者在 2023 年 3 月至 6 月期间填写了一份半结构式问卷。收集的草药信息包括阿拉伯语名称、使用部位和制备方法。植物样本在安纳贾国立大学的药物学实验室进行了保存和鉴定。定量分析采用忠实度、使用价值和选择价值来评估文化和生态方面。鉴定出的前五种草药是 Anthemis cotula、Pimpinella anisum、Zingiber officinale、Clinopodium serpyllifolium 和 Mentha spicata,忠实度从 76 % 到 96 % 不等。叶和果是最常利用的植物部分,其中最常见的是唇形科和伞形科植物。本研究记录了 20 种能改善声带健康的巴勒斯坦本土植物疗法,突出了丰富的传统知识。传统治疗师和医疗保健专业人员之间的合作可以提供有依据的建议,而教育计划则是传统和现代医疗保健的桥梁。这项开创性的研究在全球范围内提供了宝贵的见解,是首次探索草药医生对嗓音疾病疗法的本土知识。虽然研究的重点是约旦河西岸,但其影响却遍及全球,为今后研究治疗嗓音失调的草药提供了指导。
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引用次数: 0
Development and implementation of an evidence-based biofield therapy standardized documentation tool 开发和实施循证生物场疗法标准化文档工具
IF 2.5 4区 医学 Q2 Medicine Pub Date : 2024-06-01 DOI: 10.1016/j.eujim.2024.102369
Paul Guillory , Tanecia Blue , John Casken , Courtnee Nunokawa

Introduction

Biofield therapy (BT) is a complementary health practice involving the use of subtle energy to promote healing; however, monitoring the quality of care after implementing a BT program can be particularly challenging. The aim of this project was to strategically design, implement, and evaluate an evidence-based BT documentation tool to capture relevant data elements to display in a quality metric dashboard, while also being satisfactory to the practitioners who use it.

Methods

Utilizing the Consolidated Framework for Implementation Research (CFIR) method, key stakeholders at a government healthcare facility were gathered to design and use a structured documentation tool. After the tool's deployment, the stakeholders were routinely assessed over a three-month period to evaluate its effectiveness and identify areas for improvement. At the end of the period a practitioner satisfaction questionnaire was deployed and a quality metric dashboard was launched.

Results

Seven of the eleven BT-trained practitioners (64 %) used the template during the evaluation period and 255 sessions were documented. Forty-five percent of the staff responded to the Likert scored satisfaction questionnaire with 100 % indicating the template improved documentation, fit into the workflow, and facilitated interdisciplinary communication. The dashboard presented nine data elements, such as session indication and patient symptom scores, which can be filtered by date and location.

Discussion

The satisfaction scores validated findings from the literature relative to structured documentation, quality review, and program evaluation. These outcomes support the expansion of BT into different clinical settings, foster future BT research endeavors, and allow for BT to be included in broader medical data analytic efforts.

Conclusion

A structured documentation tool designed with findings from the evidence and input from key stakeholders can be an effective and satisfactory means of capturing quality metrics for evaluating the implementation of BT.

导言:生物场疗法(BT)是一种利用微妙能量促进痊愈的辅助保健方法;然而,在实施生物场疗法项目后对护理质量进行监控却极具挑战性。本项目旨在战略性地设计、实施和评估一种循证 BT 记录工具,以捕捉相关数据元素,并将其显示在质量指标仪表板上,同时让使用该工具的从业人员感到满意。方法利用实施研究综合框架(CFIR)方法,召集一家政府医疗机构的主要利益相关者设计和使用一种结构化记录工具。工具部署后,在三个月内对利益相关者进行例行评估,以评价其有效性并确定需要改进的地方。结果11 名接受过 BT 培训的从业人员中有 7 人(64%)在评估期间使用了该模板,并记录了 255 个疗程。45% 的员工对李克特满意度调查问卷做出了答复,100% 的人表示该模板改进了记录工作,符合工作流程,并促进了跨学科交流。满意度得分验证了文献中有关结构化文档、质量审查和项目评估的结论。这些结果支持将 BT 扩展到不同的临床环境中,促进未来的 BT 研究工作,并允许将 BT 纳入更广泛的医疗数据分析工作中。结论根据证据结论和主要利益相关者的意见设计的结构化文档工具,可以成为一种有效且令人满意的获取质量指标的手段,用于评估 BT 的实施情况。
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引用次数: 0
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European Journal of Integrative Medicine
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