Pub Date : 2025-10-14DOI: 10.1016/j.eujim.2025.102570
Thang Truong Le , Tien-Dung Nguyen , Minh-Thuong Nguyen-Van , Tran Ngo Bao Huynh , Thuan-Thien Dinh , Chau Dao Minh Huynh , Phuc Dao Thien Nguyen , Tan Nguyen Van Ho , Hieu Tran-Van , Viet Hoang
Introduction
Candida albicans (C. albicans) infections pose a significant health challenge, necessitating the exploration of novel antifungal agents. Essential oils derived from medicinal plants play a crucial role in aromatherapy as a complementary therapeutic approach. This study aimed to investigate the molecular mechanisms of Melaleuca bracteata F. Mueall (M. bracteata) essential oil against C. albicans, establishing its potential as a novel plant-derived antifungal therapeutic in response to increasing antimicrobial resistance.
Methods
This study employed a comprehensive approach, combining chemical analysis, in vitro experiments, and computational methods to investigate the antifungal properties of M. bracteata essential oil against C. albicans.
Results
Gas Chromatography-Mass Spectrometry (GCMS) analysis revealed eugenol methyl ether (EME) as the predominant component (86.87 %) of M. bracteata essential oil. The oil demonstrated potent antifungal activity against C. albicans, with a Minimum Inhibitory Concentration (MIC) of 400 µg/mL. It significantly inhibited biofilm formation, with 96.03 % inhibition at MIC, and caused notable morphological changes in C. albicans cells as observed through Scanning Electron Microscope (SEM). Gene expression analysis showed the downregulation of key biofilm-related genes (efg1, als3, act1) upon treatment with the oil. Molecular docking suggested potential interactions of EME with critical C. albicans proteins. Importantly, the oil exhibited limited cytotoxicity against various mammalian cell lines. Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) predictions indicated favorable pharmacokinetic properties for EME, while network pharmacology analysis suggested potential immunomodulatory effects.
Conclusions
These findings highlight the promising antifungal potential of M. bracteata essential oil, particularly EME, against C. albicans, warranting further investigation for its development as a novel therapeutic agent.
白色念珠菌(C. albicans)感染对健康构成重大挑战,需要探索新的抗真菌药物。从药用植物中提取的精油作为一种辅助治疗方法在芳香疗法中起着至关重要的作用。本研究旨在探讨白念珠菌(C. alaleuca bracteata F. Mueall, M. bracteata)精油抗白色念珠菌的分子机制,确定其作为一种新型植物源性抗真菌药物的潜力,以应对日益增加的抗生素耐药性。方法采用化学分析、体外实验和计算方法相结合的综合研究方法,研究苞叶分枝杆菌精油对白色念珠菌的抑菌作用。结果气相色谱-质谱(GCMS)分析显示,丁香酚甲醚(EME)为主要成分,占86.87%。该精油对白色念珠菌具有较强的抑菌活性,最低抑菌浓度(MIC)为400µg/mL。通过扫描电镜(SEM)观察,其显著抑制了生物膜的形成,MIC抑制率为96.03%,并引起白色念珠菌细胞形态的明显改变。基因表达分析显示,油处理后,关键生物膜相关基因(efg1, als3, act1)表达下调。分子对接提示EME可能与关键的白色念珠菌蛋白相互作用。重要的是,该油对多种哺乳动物细胞系显示出有限的细胞毒性。吸收、分布、代谢、排泄和毒性(ADMET)预测表明EME具有良好的药代动力学特性,而网络药理学分析表明EME具有潜在的免疫调节作用。结论这些研究结果表明,短苞草精油,特别是EME,对白色念珠菌具有良好的抗真菌潜力,值得进一步研究,以开发其作为一种新的治疗药物。
{"title":"Antifungal mechanisms of Melaleuca bracteata F. Mueall essential oil against Candida albicans: From chemical profiling to molecular targets","authors":"Thang Truong Le , Tien-Dung Nguyen , Minh-Thuong Nguyen-Van , Tran Ngo Bao Huynh , Thuan-Thien Dinh , Chau Dao Minh Huynh , Phuc Dao Thien Nguyen , Tan Nguyen Van Ho , Hieu Tran-Van , Viet Hoang","doi":"10.1016/j.eujim.2025.102570","DOIUrl":"10.1016/j.eujim.2025.102570","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Candida albicans (C. albicans)</em> infections pose a significant health challenge, necessitating the exploration of novel antifungal agents. Essential oils derived from medicinal plants play a crucial role in aromatherapy as a complementary therapeutic approach. This study aimed to investigate the molecular mechanisms of <em>Melaleuca bracteata</em> F. Mueall <em>(M. bracteata)</em> essential oil against <em>C. albicans</em>, establishing its potential as a novel plant-derived antifungal therapeutic in response to increasing antimicrobial resistance.</div></div><div><h3>Methods</h3><div>This study employed a comprehensive approach, combining chemical analysis, <em>in vitro</em> experiments, and computational methods to investigate the antifungal properties of <em>M. bracteata</em> essential oil against <em>C. albicans</em>.</div></div><div><h3>Results</h3><div>Gas Chromatography-Mass Spectrometry (GCMS) analysis revealed eugenol methyl ether (EME) as the predominant component (86.87 %) of <em>M. bracteata</em> essential oil. The oil demonstrated potent antifungal activity against <em>C. albicans</em>, with a Minimum Inhibitory Concentration (MIC) of 400 µg/mL. It significantly inhibited biofilm formation, with 96.03 % inhibition at MIC, and caused notable morphological changes in <em>C. albicans</em> cells as observed through Scanning Electron Microscope (SEM). Gene expression analysis showed the downregulation of key biofilm-related genes (<em>efg1, als3, act1</em>) upon treatment with the oil. Molecular docking suggested potential interactions of EME with critical <em>C. albicans</em> proteins. Importantly, the oil exhibited limited cytotoxicity against various mammalian cell lines. Absorption, Distribution, Metabolism, Excretion, and Toxicity (ADMET) predictions indicated favorable pharmacokinetic properties for EME, while network pharmacology analysis suggested potential immunomodulatory effects.</div></div><div><h3>Conclusions</h3><div>These findings highlight the promising antifungal potential of <em>M. bracteata</em> essential oil, particularly EME, against <em>C. albicans</em>, warranting further investigation for its development as a novel therapeutic agent.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102570"},"PeriodicalIF":1.7,"publicationDate":"2025-10-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145359469","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}
Pub Date : 2025-10-08DOI: 10.1016/j.eujim.2025.102569
Vibhuti Samarth Rao , Birinder S Cheema , Mike Armour , Caroline A Smith , Kashinath G Metri , Carolyn Ee
Introduction
Polycystic Ovary Syndrome (PCOS) is a prevalent endocrinopathy among women of reproductive age and is associated with excess weight. Yoga is a holistic mind-body practice that has shown some promise in targeting clinical outcomes in women with PCOS. This study aimed to understand the yoga therapists’ experiences and explore the characteristics of a yoga therapy (YT) program for weight management in women with Polycystic Ovary Syndrome (PCOS) to assist in a future trial.
Methods
Experienced yoga therapists with a degree in yoga, or equivalent, and >5 years of experience in delivering yoga to women with PCOS were invited to an online focus group. Discussions were audio-recorded, transcribed verbatim and analysed using descriptive content analysis.
Results
Eight yoga therapists participated. Four categories with several sub-categories were derived from the analysis: (i) yogic approach to PCOS management, (ii) benefits are beyond weight reduction, (iii) characteristics of yoga therapists, and (iv) characteristics of the YT program for managing weight in PCOS. Most participants believe that YT for PCOS should not be constructed as an exclusive form of exercise but as a mind-body intervention that focuses on lifestyle reforms, helps manage day-to-day stress, and promotes sleep and quality of life in women with PCOS. Overall, the participants indicated that a meticulously planned group-based, multicomponent, PCOS-specific, YT class can be a sustainable mode of healthy living for women with PCOS.
Conclusion
This is the first qualitative exploration from yoga therapists’ perspectives on weight management in women with PCOS. The results of this study provide a valuable preliminary basis for the design of future research in order to enhance lifestyle care for women with PCOS and excess weight.
{"title":"Yoga for weight management in women with polycystic ovary syndrome: A focus group study among yoga therapists","authors":"Vibhuti Samarth Rao , Birinder S Cheema , Mike Armour , Caroline A Smith , Kashinath G Metri , Carolyn Ee","doi":"10.1016/j.eujim.2025.102569","DOIUrl":"10.1016/j.eujim.2025.102569","url":null,"abstract":"<div><h3>Introduction</h3><div>Polycystic Ovary Syndrome (PCOS) is a prevalent endocrinopathy among women of reproductive age and is associated with excess weight. Yoga is a holistic mind-body practice that has shown some promise in targeting clinical outcomes in women with PCOS. This study aimed to understand the yoga therapists’ experiences and explore the characteristics of a yoga therapy (YT) program for weight management in women with Polycystic Ovary Syndrome (PCOS) to assist in a future trial.</div></div><div><h3>Methods</h3><div>Experienced yoga therapists with a degree in yoga, or equivalent, and >5 years of experience in delivering yoga to women with PCOS were invited to an online focus group. Discussions were audio-recorded, transcribed verbatim and analysed using descriptive content analysis.</div></div><div><h3>Results</h3><div>Eight yoga therapists participated. Four categories with several sub-categories were derived from the analysis: (i) yogic approach to PCOS management, (ii) benefits are beyond weight reduction, (iii) characteristics of yoga therapists, and (iv) characteristics of the YT program for managing weight in PCOS. Most participants believe that YT for PCOS should not be constructed as an exclusive form of exercise but as a mind-body intervention that focuses on lifestyle reforms, helps manage day-to-day stress, and promotes sleep and quality of life in women with PCOS. Overall, the participants indicated that a meticulously planned group-based, multicomponent, PCOS-specific, YT class can be a sustainable mode of healthy living for women with PCOS.</div></div><div><h3>Conclusion</h3><div>This is the first qualitative exploration from yoga therapists’ perspectives on weight management in women with PCOS. The results of this study provide a valuable preliminary basis for the design of future research in order to enhance lifestyle care for women with PCOS and excess weight.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102569"},"PeriodicalIF":1.7,"publicationDate":"2025-10-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270030","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}
Pub Date : 2025-10-02DOI: 10.1016/j.eujim.2025.102568
Soo-Hyun Sung , Kyeong-Han Kim , Hyein Jeong , Soobin Jang
Introduction
Many older adults and individuals with disabilities experience significant barriers to accessing clinic-based health services, often resulting in unmanaged chronic conditions and diminished quality of life. Home-based healthcare is emerging as a viable solution, and interest in traditional Korean medicine is increasing due to its accessibility and perceived safety. This study aimed to identify the needs and expectations of older adults and individuals with disabilities for home-based healthcare using traditional Korean medicine.
Methods
Our study employed a mixed methods design that combined survey data and qualitative research. The online survey was conducted among two groups: 1) older adults aged 65 years and older and 2) individuals with disabilities aged 20 years and older. Semi-structured focus group interviews were conducted for the respondents who received home visits from traditional Korean medicine doctors
Results
Survey findings revealed that older adults showed a higher demand and willingness to participate in home-based healthcare services than individuals with disabilities. Respondents identified chronic conditions such as hypertension, diabetes, stroke, and dementia as key targets for home-based care. High-priority needs included physical and mental health support, health monitoring, and integration with conventional medical services. The most valued benefit of home-based care was improved accessibility for those with difficulty visiting hospitals. Focus group interview participants, particularly older adults, described feeling psychologically supported and satisfied through extended health counseling provided during house calls. Individuals with disabilities emphasized the need for transportation support for follow-up hospital visits.
Conclusions
Our findings provide foundational evidence for the development of integrated, home-based healthcare policies targeting older adults and people with disabilities. Expanding home-based traditional Korean medicine care may address health inequities and enhance well-being among populations with limited mobility.
{"title":"Understanding the demands for home-based healthcare services using traditional Korean medicine in older adults and individuals with disabilities: A mixed methods study","authors":"Soo-Hyun Sung , Kyeong-Han Kim , Hyein Jeong , Soobin Jang","doi":"10.1016/j.eujim.2025.102568","DOIUrl":"10.1016/j.eujim.2025.102568","url":null,"abstract":"<div><h3>Introduction</h3><div>Many older adults and individuals with disabilities experience significant barriers to accessing clinic-based health services, often resulting in unmanaged chronic conditions and diminished quality of life. Home-based healthcare is emerging as a viable solution, and interest in traditional Korean medicine is increasing due to its accessibility and perceived safety. This study aimed to identify the needs and expectations of older adults and individuals with disabilities for home-based healthcare using traditional Korean medicine.</div></div><div><h3>Methods</h3><div>Our study employed a mixed methods design that combined survey data and qualitative research. The online survey was conducted among two groups: 1) older adults aged 65 years and older and 2) individuals with disabilities aged 20 years and older. Semi-structured focus group interviews were conducted for the respondents who received home visits from traditional Korean medicine doctors</div></div><div><h3>Results</h3><div>Survey findings revealed that older adults showed a higher demand and willingness to participate in home-based healthcare services than individuals with disabilities. Respondents identified chronic conditions such as hypertension, diabetes, stroke, and dementia as key targets for home-based care. High-priority needs included physical and mental health support, health monitoring, and integration with conventional medical services. The most valued benefit of home-based care was improved accessibility for those with difficulty visiting hospitals. Focus group interview participants, particularly older adults, described feeling psychologically supported and satisfied through extended health counseling provided during house calls. Individuals with disabilities emphasized the need for transportation support for follow-up hospital visits.</div></div><div><h3>Conclusions</h3><div>Our findings provide foundational evidence for the development of integrated, home-based healthcare policies targeting older adults and people with disabilities. Expanding home-based traditional Korean medicine care may address health inequities and enhance well-being among populations with limited mobility.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102568"},"PeriodicalIF":1.7,"publicationDate":"2025-10-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145325652","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}
Pub Date : 2025-10-01DOI: 10.1016/j.eujim.2025.102547
Gahena Ram , Rotina Kapini , Xian Zhou
Introduction
Australia has some of the highest rates of sun-related skin damage in the world. Native Australian flora is known to possess unique phytochemical profiles with potential protective effects against such damage. The Kakadu Plum (Terminalia ferdinandiana Exell), traditionally utilized by Indigenous Australians, is notable for its exceptionally high concentrations of vitamin C and diverse phenolic compounds. This scoping review aims to synthesise the available evidence regarding the efficacy of Kakadu Plum as a topical intervention for the primary prevention of photodamage.
Methods
The methodology was guided by the JBI Manual for Evidence Synthesis, and the reporting was guided by the PRISMA Extension for Scoping Reviews. A comprehensive search was conducted across multiple databases, including MEDLINE, PubMed, Embase, Scopus, Google Scholar, and the Agriculture Science Database, to gather direct and indirect data on Kakadu Plum's photoprotective potential and vitamin C concentrations over the past 20 years (2005–2025).
Results
A total of 31 preclinical studies were found. Only 1 study directly examined Kakadu Plum's photoprotective effect in an animal model, 22 studies provided evidence of indirect photoprotective mechanisms, including antioxidant and anti-inflammatory effects, and 8 studies exclusively reported on the vitamin C content.
Conclusion
The results demonstrated exceptionally high vitamin C concentrations, providing strong indirect evidence of Kakadu Plum's potential photoprotective effect. However, the absence of direct experimental or clinical evidence precludes definitive conclusions regarding its efficacy. Kakadu Plum, therefore, may be an underexplored natural resource, warranting further research into its photoprotective mechanisms and therapeutic potential.
Funding
Dr. Xian Zhou is supported by the Research Support Fellowship, Western Sydney University.
{"title":"Examining the potential of terminalisa ferdinandiana Exell (Kakadu Plum) in photoprotection through direct and indirect evidence: A scoping review","authors":"Gahena Ram , Rotina Kapini , Xian Zhou","doi":"10.1016/j.eujim.2025.102547","DOIUrl":"10.1016/j.eujim.2025.102547","url":null,"abstract":"<div><h3>Introduction</h3><div>Australia has some of the highest rates of sun-related skin damage in the world. Native Australian flora is known to possess unique phytochemical profiles with potential protective effects against such damage. The Kakadu Plum (<em>Terminalia ferdinandiana</em> Exell), traditionally utilized by Indigenous Australians, is notable for its exceptionally high concentrations of vitamin C and diverse phenolic compounds. This scoping review aims to synthesise the available evidence regarding the efficacy of Kakadu Plum as a topical intervention for the primary prevention of photodamage.</div></div><div><h3>Methods</h3><div>The methodology was guided by the JBI Manual for Evidence Synthesis, and the reporting was guided by the PRISMA Extension for Scoping Reviews. A comprehensive search was conducted across multiple databases, including MEDLINE, PubMed, Embase, Scopus, Google Scholar, and the Agriculture Science Database, to gather direct and indirect data on Kakadu Plum's photoprotective potential and vitamin C concentrations over the past 20 years (2005–2025).</div></div><div><h3>Results</h3><div>A total of 31 preclinical studies were found. Only 1 study directly examined Kakadu Plum's photoprotective effect in an animal model, 22 studies provided evidence of indirect photoprotective mechanisms, including antioxidant and anti-inflammatory effects, and 8 studies exclusively reported on the vitamin C content.</div></div><div><h3>Conclusion</h3><div>The results demonstrated exceptionally high vitamin C concentrations, providing strong indirect evidence of Kakadu Plum's potential photoprotective effect. However, the absence of direct experimental or clinical evidence precludes definitive conclusions regarding its efficacy. Kakadu Plum, therefore, may be an underexplored natural resource, warranting further research into its photoprotective mechanisms and therapeutic potential.</div></div><div><h3>Funding</h3><div>Dr. Xian Zhou is supported by the Research Support Fellowship, <span>Western Sydney University</span>.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102547"},"PeriodicalIF":1.7,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145265517","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}
Pub Date : 2025-09-24DOI: 10.1016/j.eujim.2025.102561
Bingrui Zhang , Kebin Wang , Yuxiao Li , Qinhua Fan , Qingxiao Li , Yingqiu Sun , Yawei Du , Wenquan Su , Shengxian Wu
Introduction
Astragalus membranaceus (AM) is a traditional Chinese medicine employed for supplementing qi and particularly used for ulcer treatment. This systematic review aimed to examine the effectiveness and safety of AM-based prescriptions (AMPs) for diabetic foot ulcer (DFU).
Methods
We searched eight databases to identify randomized controlled trials (RCTs) focusing on AMPs for DFU. The mean difference (MD) and relative risk (RR) with 95% confidence interval (CI) were calculated and used in the meta-analysis.
Results
We included 44 RCTs involving 3,238 participants. The AMPs included 24 oral AM formulas, 14 topical AM formulas, 4 topical AM alone, and 2 injections. Overall, study quality was low. Compared with Western medicine (WM), AMPs were associated with a higher healing rate (RR 1.64, 95% CI 1.4 to 1.9, 8 RCTs, n = 747), smaller ulcer size (MD –12.11 cm2, 95% CI –19.23 to –4.99, 4 RCTs, n = 304) and shorter healing time (MD –7.82 days, 95% CI –10.59 to –5.05, 4 RCTs, n = 353). AMPs plus WM were more efficacious than WM in healing rate (RR 1.22, 95% CI 1.07 to 1.4, 20 RCTs, n = 1497), amputation rate (RR 0.42, 95% CI 0.27 to 0.66, 3 RCTs, n = 265), mortality (RR 0.29, 95% CI 0.12 to 0.71, 3 RCTs, n = 265), ulcer size (MD –1.78 cm2, 95% CI –2.55 to –1.01, 10 RCTs, n = 761), healing time, ankle-brachial index (ABI), pain scores, clinical effective rate, and general symptoms. No severe adverse events were reported in the AMPs group.
Conclusion
AMPs may have potential effectiveness in ulcer healing, ABI increase, and pain alleviation. The exact efficacy of AMPs for DFU needs to be confirmed using high-quality double-blind RCTs.
Registration
Protocol of this review was registered via PROSPERO (CRD42024613403).
Funding
National Science and Technology Major Project of China [grant number 2017ZX09304019].
黄芪(astragalus aceus, AM)是一种传统的补气中药,特别用于治疗溃疡。本系统综述旨在研究AMPs治疗糖尿病足溃疡(DFU)的有效性和安全性。方法我们检索了8个数据库,以AMPs治疗DFU为重点的随机对照试验(rct)。计算具有95%置信区间(CI)的平均差值(MD)和相对危险度(RR)并用于meta分析。结果纳入44项随机对照试验,涉及3238名受试者。amp包括24个口服AM制剂、14个外用AM制剂、4个单独外用AM制剂和2个注射剂。总体而言,研究质量较低。与西药(WM)相比,AMPs具有更高的治愈率(RR 1.64, 95% CI 1.4 ~ 1.9, 8个rct, n = 747)、更小的溃疡面积(MD -12.11 cm2, 95% CI -19.23 ~ -4.99, 4个rct, n = 304)和更短的愈合时间(MD -7.82天,95% CI -10.59 ~ -5.05, 4个rct, n = 353)。AMPs加WM在治愈率(RR 1.22, 95% CI 1.07 ~ 1.4, 20个rct, n = 1497)、截肢率(RR 0.42, 95% CI 0.27 ~ 0.66, 3个rct, n = 265)、死亡率(RR 0.29, 95% CI 0.12 ~ 0.71, 3个rct, n = 265)、溃疡大小(MD -1.78 cm2, 95% CI -2.55 ~ -1.01, 10个rct, n = 761)、愈合时间、踝臂指数(ABI)、疼痛评分、临床有效率和一般症状等方面均优于WM。amp组无严重不良事件报告。结论抗菌肽对溃疡愈合、增加ABI、减轻疼痛具有潜在的作用。AMPs治疗DFU的确切疗效需要通过高质量的双盲随机对照试验来证实。本综述的注册方案通过PROSPERO注册(CRD42024613403)。国家科技重大专项[批准号:2017ZX09304019]。
{"title":"Effectiveness and safety of Astragalus membranaceus-based traditional Chinese medicine in treating diabetic foot ulcers: A systematic review and meta-analysis of randomized controlled trials","authors":"Bingrui Zhang , Kebin Wang , Yuxiao Li , Qinhua Fan , Qingxiao Li , Yingqiu Sun , Yawei Du , Wenquan Su , Shengxian Wu","doi":"10.1016/j.eujim.2025.102561","DOIUrl":"10.1016/j.eujim.2025.102561","url":null,"abstract":"<div><h3>Introduction</h3><div><em>Astragalus membranaceus</em> (AM) is a traditional Chinese medicine employed for supplementing qi and particularly used for ulcer treatment. This systematic review aimed to examine the effectiveness and safety of AM-based prescriptions (AMPs) for diabetic foot ulcer (DFU).</div></div><div><h3>Methods</h3><div>We searched eight databases to identify randomized controlled trials (RCTs) focusing on AMPs for DFU. The mean difference (MD) and relative risk (RR) with 95% confidence interval (CI) were calculated and used in the meta-analysis.</div></div><div><h3>Results</h3><div>We included 44 RCTs involving 3,238 participants. The AMPs included 24 oral AM formulas, 14 topical AM formulas, 4 topical AM alone, and 2 injections. Overall, study quality was low. Compared with Western medicine (WM), AMPs were associated with a higher healing rate (RR 1.64, 95% CI 1.4 to 1.9, 8 RCTs, n = 747), smaller ulcer size (MD –12.11 cm<sup>2</sup>, 95% CI –19.23 to –4.99, 4 RCTs, n = 304) and shorter healing time (MD –7.82 days, 95% CI –10.59 to –5.05, 4 RCTs, n = 353). AMPs plus WM were more efficacious than WM in healing rate (RR 1.22, 95% CI 1.07 to 1.4, 20 RCTs, n = 1497), amputation rate (RR 0.42, 95% CI 0.27 to 0.66, 3 RCTs, n = 265), mortality (RR 0.29, 95% CI 0.12 to 0.71, 3 RCTs, n = 265), ulcer size (MD –1.78 cm<sup>2</sup>, 95% CI –2.55 to –1.01, 10 RCTs, n = 761), healing time, ankle-brachial index (ABI), pain scores, clinical effective rate, and general symptoms. No severe adverse events were reported in the AMPs group.</div></div><div><h3>Conclusion</h3><div>AMPs may have potential effectiveness in ulcer healing, ABI increase, and pain alleviation. The exact efficacy of AMPs for DFU needs to be confirmed using high-quality double-blind RCTs.</div></div><div><h3>Registration</h3><div>Protocol of this review was registered via PROSPERO (CRD42024613403).</div></div><div><h3>Funding</h3><div><span>National Science and Technology Major Project of China</span> [grant number <span><span>2017ZX09304019</span></span>].</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102561"},"PeriodicalIF":1.7,"publicationDate":"2025-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145183678","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}
Pub Date : 2025-09-22DOI: 10.1016/j.eujim.2025.102560
Shih-Wei Yang , Chen-Wei Chang , Malcolm Koo
Introduction
Heart Rate Variability (HRV), a noninvasive marker of autonomic nervous system function, has become an increasingly utilized tool in complementary medicine (CM) research for objectively assessing physiological responses to interventions. While specific applications of HRV within individual CM modalities have been reviewed, comprehensive mapping of the broader research landscape remains limited. This bibliometric study aimed to provide a detailed overview of the evolution, key contributors, and thematic development of HRV research across diverse CM interventions between 2005 and 2024.
Methods
Original research articles published between January 1, 2005, and December 31, 2024, were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. A Boolean search strategy combined HRV-related terms with keywords representing a wide range of CM interventions, while deliberately excluding broad or ambiguous descriptors. The data were analyzed using the Bibliometrix package.
Results
A total of 1007 articles published across 375 journals and authored by 4969 individuals were identified, with publication output showing a steady increase and peaking in 2022. China (23.5%) and the United States (19.1%) emerged as the most prolific contributors, although United States publications exhibited a higher average citation rate. Leading institutions included Kyung Hee University (South Korea) and China Medical University (Taiwan). Evidence-Based Complementary and Alternative Medicine was the most frequent publishing journal. HRV and CM research has increasingly appeared in higher-ranked journals over time (p < 0.001). Keyword co-occurrence analysis positioned HRV as a central term, connecting clusters related to mind-body practices, psychophysiological constructs, music therapy, and electroacupuncture. Thematic evolution analysis revealed recent trends toward greater methodological rigor, increased emphasis on patient-centered outcomes, diversification of CM interventions, and incorporation of emerging digital health technologies.
Conclusion
This bibliometric analysis shows HRV research in CM as an evolving field positioned at the intersection of traditional practices, contemporary physiological science, and technological innovation. Recent trends indicate a shift toward increased methodological rigor, greater emphasis on patient-centered outcomes, and integration of digital technologies. As the field advances, novel technologies such as generative artificial intelligence offer promise for deepening physiological insights and enhancing the clinical relevance of CM applications within mainstream healthcare.
心率变异性(HRV)是一种自主神经系统功能的无创标志物,已成为补充医学(CM)研究中越来越多地使用的工具,用于客观评估对干预的生理反应。虽然已经审查了HRV在个体CM模式中的具体应用,但对更广泛的研究前景的全面绘制仍然有限。本文献计量学研究旨在提供2005年至2024年间不同CM干预措施中HRV研究的演变、关键贡献者和主题发展的详细概述。方法检索2005年1月1日至2024年12月31日发表的论文,检索Web of Science核心馆藏的科学引文索引扩展版。布尔搜索策略将hrv相关术语与代表广泛CM干预的关键字结合起来,同时故意排除宽泛或模糊的描述符。使用Bibliometrix软件包对数据进行分析。结果在375个期刊上共发现1007篇论文,作者4969人,发表量稳步增长,并在2022年达到峰值。中国(23.5%)和美国(19.1%)成为最多产的贡献者,尽管美国出版物的平均引用率更高。以证据为基础的补充和替代医学是出版频率最高的期刊。随着时间的推移,HRV和CM研究越来越多地出现在排名较高的期刊上(p < 0.001)。关键词共现分析将HRV定位为中心术语,将与身心实践、心理生理结构、音乐治疗和电针相关的集群联系起来。专题演变分析揭示了最近的趋势,即方法更加严谨,更加强调以患者为中心的结果,CM干预的多样化以及新兴数字卫生技术的结合。文献计量学分析表明,CM中的HRV研究是一个不断发展的领域,处于传统实践、当代生理科学和技术创新的交叉点。最近的趋势表明,越来越多的方法变得严谨,更加强调以患者为中心的结果,以及数字技术的整合。随着该领域的发展,生成式人工智能等新技术为深化生理学见解和增强主流医疗保健中CM应用的临床相关性提供了希望。
{"title":"Mapping the intersection of heart rate variability and complementary medicine: a two-decade bibliometric study (2005–2024)","authors":"Shih-Wei Yang , Chen-Wei Chang , Malcolm Koo","doi":"10.1016/j.eujim.2025.102560","DOIUrl":"10.1016/j.eujim.2025.102560","url":null,"abstract":"<div><h3>Introduction</h3><div>Heart Rate Variability (HRV), a noninvasive marker of autonomic nervous system function, has become an increasingly utilized tool in complementary medicine (CM) research for objectively assessing physiological responses to interventions. While specific applications of HRV within individual CM modalities have been reviewed, comprehensive mapping of the broader research landscape remains limited. This bibliometric study aimed to provide a detailed overview of the evolution, key contributors, and thematic development of HRV research across diverse CM interventions between 2005 and 2024.</div></div><div><h3>Methods</h3><div>Original research articles published between January 1, 2005, and December 31, 2024, were retrieved from the Science Citation Index Expanded of the Web of Science Core Collection. A Boolean search strategy combined HRV-related terms with keywords representing a wide range of CM interventions, while deliberately excluding broad or ambiguous descriptors. The data were analyzed using the Bibliometrix package.</div></div><div><h3>Results</h3><div>A total of 1007 articles published across 375 journals and authored by 4969 individuals were identified, with publication output showing a steady increase and peaking in 2022. China (23.5%) and the United States (19.1%) emerged as the most prolific contributors, although United States publications exhibited a higher average citation rate. Leading institutions included Kyung Hee University (South Korea) and China Medical University (Taiwan). <em>Evidence-Based Complementary and Alternative Medicine</em> was the most frequent publishing journal. HRV and CM research has increasingly appeared in higher-ranked journals over time (<em>p</em> < 0.001). Keyword co-occurrence analysis positioned HRV as a central term, connecting clusters related to mind-body practices, psychophysiological constructs, music therapy, and electroacupuncture. Thematic evolution analysis revealed recent trends toward greater methodological rigor, increased emphasis on patient-centered outcomes, diversification of CM interventions, and incorporation of emerging digital health technologies.</div></div><div><h3>Conclusion</h3><div>This bibliometric analysis shows HRV research in CM as an evolving field positioned at the intersection of traditional practices, contemporary physiological science, and technological innovation. Recent trends indicate a shift toward increased methodological rigor, greater emphasis on patient-centered outcomes, and integration of digital technologies. As the field advances, novel technologies such as generative artificial intelligence offer promise for deepening physiological insights and enhancing the clinical relevance of CM applications within mainstream healthcare.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102560"},"PeriodicalIF":1.7,"publicationDate":"2025-09-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154514","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}
Pub Date : 2025-09-20DOI: 10.1016/j.eujim.2025.102555
Gyu Chan Shim , Sook-Hyun Lee , Yoon Jae Lee , Su Won Lee , In-Hyuk Ha
Introduction
Low back pain (LBP) is a major cause of disability and economic burden. Herbal medicine (HM) decoctions, a core component of Traditional East Asian Medicine (TEAM), are gaining attention for their potential benefits. This systematic review evaluated HM decoctions for LBP.
Methods
The protocol was registered in PROSPERO (CRD42024599753). Eleven databases were searched for randomized controlled trials (RCTs) on HM decoctions for LBP published before July 2024. Primary outcomes were the clinical improvement rate (CIR) and visual analogue scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index and the Japanese Orthopedic Association scale. Quality assessments using the Cochrane Risk of Bias 2 tool and meta-analyses were conducted.
Results
Twenty-nine RCTs involving 2420 participants with LBP were included. HM decoction compared to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the CIR (risk ratio [RR] 1.16, 95 %CI: 1.05 to 1.29) and reduced VAS-pain (mean difference [MD] -0.87, 95 %CI: -1.59 to -0.14). When combined with TEAM, HM decoction improved the CIR (RR, 1.23, 95 %CI: 1.14 to 1.33) and VAS-pain (MD -1.24, 95 %CI: -1.80 to -0.67) compared to TEAM alone. The combination of HM decoction and TEAM improved the CIR (RR 1.25, 95 %CI: 1.01 to 1.55) and VAS-pain (MD -0.51, 95 %CI: -0.67 to -0.34) compared to NSAIDs alone, and a higher CIR (RR 1.30, 95 %CI: 1.12 to 1.52) than TEAM combined with NSAIDs. Combining HM decoction with NSAIDs improved the CIR (RR 1.48, 95 %CI: 1.19 to 1.85) compared to NSAIDs alone; however, there was no difference in VAS-pain (MD -1.09, 95 %CI: -2.35 to 0.17). HM decoction combined with non-pharmacological therapies (NPTs) improved the CIR (RR 1.18, 95 %CI: 1.05 to 1.32) and VAS-pain (MD -1.28, 95 %CI: -1.42 to -1.14). Finally, adding HM decoction to a regimen of NSAIDs and NPTs also improved the CIR (RR 1.24, 95 %CI: 1.09 to 1.42, but the reduction in VAS-pain was not statistically significant (MD -1.53, 95 %CI: -3.35 to -0.29).. In the seven RCTs that reported adverse events, these were absent or mild and comparable across intervention and control groups.
Conclusion
HM decoction demonstrated beneficial clinical effects for participants with LBP. Limitations included high risk of bias in many RCTs. Well-designed RCTs are warranted to validate effectiveness.
{"title":"Effects of traditional east asian herbal medicine decoctions on low back pain: A systematic review and meta-analysis","authors":"Gyu Chan Shim , Sook-Hyun Lee , Yoon Jae Lee , Su Won Lee , In-Hyuk Ha","doi":"10.1016/j.eujim.2025.102555","DOIUrl":"10.1016/j.eujim.2025.102555","url":null,"abstract":"<div><h3>Introduction</h3><div>Low back pain (LBP) is a major cause of disability and economic burden. Herbal medicine (HM) decoctions, a core component of Traditional East Asian Medicine (TEAM), are gaining attention for their potential benefits. This systematic review evaluated HM decoctions for LBP.</div></div><div><h3>Methods</h3><div>The protocol was registered in PROSPERO (CRD42024599753). Eleven databases were searched for randomized controlled trials (RCTs) on HM decoctions for LBP published before July 2024. Primary outcomes were the clinical improvement rate (CIR) and visual analogue scale (VAS) for pain. Secondary outcomes included the Oswestry Disability Index and the Japanese Orthopedic Association scale. Quality assessments using the Cochrane Risk of Bias 2 tool and meta-analyses were conducted.</div></div><div><h3>Results</h3><div>Twenty-nine RCTs involving 2420 participants with LBP were included. HM decoction compared to Non-Steroidal Anti-Inflammatory Drugs (NSAIDs) improved the CIR (risk ratio [RR] 1.16, 95 %CI: 1.05 to 1.29) and reduced VAS-pain (mean difference [MD] -0.87, 95 %CI: -1.59 to -0.14). When combined with TEAM, HM decoction improved the CIR (RR, 1.23, 95 %CI: 1.14 to 1.33) and VAS-pain (MD -1.24, 95 %CI: -1.80 to -0.67) compared to TEAM alone. The combination of HM decoction and TEAM improved the CIR (RR 1.25, 95 %CI: 1.01 to 1.55) and VAS-pain (MD -0.51, 95 %CI: -0.67 to -0.34) compared to NSAIDs alone, and a higher CIR (RR 1.30, 95 %CI: 1.12 to 1.52) than TEAM combined with NSAIDs. Combining HM decoction with NSAIDs improved the CIR (RR 1.48, 95 %CI: 1.19 to 1.85) compared to NSAIDs alone; however, there was no difference in VAS-pain (MD -1.09, 95 %CI: -2.35 to 0.17). HM decoction combined with non-pharmacological therapies (NPTs) improved the CIR (RR 1.18, 95 %CI: 1.05 to 1.32) and VAS-pain (MD -1.28, 95 %CI: -1.42 to -1.14). Finally, adding HM decoction to a regimen of NSAIDs and NPTs also improved the CIR (RR 1.24, 95 %CI: 1.09 to 1.42, but the reduction in VAS-pain was not statistically significant (MD -1.53, 95 %CI: -3.35 to -0.29).. In the seven RCTs that reported adverse events, these were absent or mild and comparable across intervention and control groups.</div></div><div><h3>Conclusion</h3><div>HM decoction demonstrated beneficial clinical effects for participants with LBP. Limitations included high risk of bias in many RCTs. Well-designed RCTs are warranted to validate effectiveness.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102555"},"PeriodicalIF":1.7,"publicationDate":"2025-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145270028","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}
Antimicrobial resistance (AMR) is a serious threat to global public health by compromising the effectiveness of infection prevention and treatment strategies. This escalating issue necessitates the exploration of alternative treatments and natural remedies to reduce reliance on antibiotics. Piper longum L. has historically been used in the treatment of respiratory infections in Ayurvedic medicine. This systematic review aims to evaluate the safety and efficacy of Piper longum in managing Acute Respiratory Infections (ARIs).
Methods
Nine databases (PubMed, Embase, Cochrane CENTRAL, CINAHL, AMED, ProQuest, CNKI, and Google Scholar) were systematically searched for randomized controlled trials (RCTs) and non-randomized controlled clinical trials (NRCTs) evaluating Piper longum. The primary outcomes assessed were improvement in acute respiratory infections, ARI symptoms and side effects. A narrative approach was used to synthesize the data. The Cochrane Risk of Bias tool was used to assess study quality, and Rayyan was used to screen eligible studies. Data extraction was performed independently by two reviewers.
Results
Two studies met the inclusion criteria (one RCT and one NRCT). One study reported that Piper longum improved symptoms of acute respiratory infections (ARIs), including frequency of cough bouts, sleep disturbances, sputum production, crepitations, throat infections, wheezing, nasal discharge, and loss of appetite. Side effects associated with Piper longum ranged from minimal (such as chest burning) to none. However, the methodological quality of the included trials was generally poor.
Conclusion
Piper longum may be beneficial and safe for relieving symptoms of ARIs. Nevertheless, these findings should be interpreted with caution due to the poor methodological quality and heterogeneity of the included studies. To better understand the efficacy and safety of Piper longum, well-designed trials with rigorous methodologies and transparent reporting are necessary.
{"title":"Safety and efficacy of Piper longum L. for acute respiratory infections: A systematic review","authors":"Anugraha George , Prakash Bangalore Nagendrappa , Unnikrishnana Payyappallimana , Xiao-Yang Hu , Xiaowen Zhang , Sadia Wali , Merlin Willcox","doi":"10.1016/j.eujim.2025.102559","DOIUrl":"10.1016/j.eujim.2025.102559","url":null,"abstract":"<div><h3>Introduction</h3><div>Antimicrobial resistance (AMR) is a serious threat to global public health by compromising the effectiveness of infection prevention and treatment strategies. This escalating issue necessitates the exploration of alternative treatments and natural remedies to reduce reliance on antibiotics. <em>Piper longum</em> L. has historically been used in the treatment of respiratory infections in Ayurvedic medicine. This systematic review aims to evaluate the safety and efficacy of <em>Piper longum</em> in managing Acute Respiratory Infections (ARIs).</div></div><div><h3>Methods</h3><div>Nine databases (PubMed, Embase, Cochrane CENTRAL, CINAHL, AMED, ProQuest, CNKI, and Google Scholar) were systematically searched for randomized controlled trials (RCTs) and non-randomized controlled clinical trials (NRCTs) evaluating <em>Piper longum</em>. The primary outcomes assessed were improvement in acute respiratory infections, ARI symptoms and side effects. A narrative approach was used to synthesize the data. The Cochrane Risk of Bias tool was used to assess study quality, and Rayyan was used to screen eligible studies. Data extraction was performed independently by two reviewers.</div></div><div><h3>Results</h3><div>Two studies met the inclusion criteria (one RCT and one NRCT). One study reported that <em>Piper longum</em> improved symptoms of acute respiratory infections (ARIs), including frequency of cough bouts, sleep disturbances, sputum production, crepitations, throat infections, wheezing, nasal discharge, and loss of appetite. Side effects associated with <em>Piper longum</em> ranged from minimal (such as chest burning) to none. However, the methodological quality of the included trials was generally poor.</div></div><div><h3>Conclusion</h3><div><em>Piper longum</em> may be beneficial and safe for relieving symptoms of ARIs. Nevertheless, these findings should be interpreted with caution due to the poor methodological quality and heterogeneity of the included studies. To better understand the efficacy and safety of <em>Piper longum</em>, well-designed trials with rigorous methodologies and transparent reporting are necessary.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102559"},"PeriodicalIF":1.7,"publicationDate":"2025-09-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145154515","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}
Pub Date : 2025-09-18DOI: 10.1016/j.eujim.2025.102558
Joana Almeida , Kavi Sharma , Jonathan Gabe , Richard Simcock , John L. Anderson
Introduction
Breast cancer patients frequently use complementary and alternative medicine (CAM) alongside biomedical treatment for symptom relief and to address the disruption caused by diagnosis and treatment. These experiences, however, are often overlooked within the cancer clinical encounter. This study explored CAM use in women with breast cancer, focusing on three main research questions: Why do women with breast cancer use CAM? In what ways does CAM help them maintain or regain a sense of normality? What barriers or tensions do they face when considering or using CAM?
Methods
The study used a qualitative interpretative-constructivist research design to analyse the subjective meanings women with breast cancer ascribed to their CAM use during their breast cancer journey. Unstructured interviews were conducted with nine female breast cancer patients undertaking treatment at a major NHS cancer centre in Southeast England. The interviews were analysed using reflexive thematic analysis.
Results
The women engaged with a wide range of CAM therapies during their cancer journey. CAM was used not only to alleviate symptoms, but also to restore a sense of ‘ordinariness’ and biographical continuity. Central to this process were practices of self-care, self-help, and self-management, and the collaboration of CAM practitioners and open-minded medical doctors. Barriers included dominant biomedical approaches, limited information sharing and communication about CAM, financial and geographical constraints, and little clinical validation by medical staff.
Conclusion
These women experienced tensions and conflicts when trying to use CAM alongside cancer treatment. They sought overall well-being but often encountered barriers to accessing CAM and sharing their experiences within a biomedical context. The study highlights the role and value of CAM in restoring a sense of normality in the lives of breast cancer survivors, and recommends raising professional awareness of CAM use by women with breast cancer, normalising CAM dialogue in the clinical encounter, and considering relational care in training.
{"title":"‘Biographical continuity’: A qualitative study of the role of complementary and alternative medicine in restoring the self after breast cancer diagnosis","authors":"Joana Almeida , Kavi Sharma , Jonathan Gabe , Richard Simcock , John L. Anderson","doi":"10.1016/j.eujim.2025.102558","DOIUrl":"10.1016/j.eujim.2025.102558","url":null,"abstract":"<div><h3>Introduction</h3><div>Breast cancer patients frequently use complementary and alternative medicine (CAM) alongside biomedical treatment for symptom relief and to address the disruption caused by diagnosis and treatment. These experiences, however, are often overlooked within the cancer clinical encounter. This study explored CAM use in women with breast cancer, focusing on three main research questions: Why do women with breast cancer use CAM? In what ways does CAM help them maintain or regain a sense of normality? What barriers or tensions do they face when considering or using CAM?</div></div><div><h3>Methods</h3><div>The study used a qualitative interpretative-constructivist research design to analyse the subjective meanings women with breast cancer ascribed to their CAM use during their breast cancer journey. Unstructured interviews were conducted with nine female breast cancer patients undertaking treatment at a major NHS cancer centre in Southeast England. The interviews were analysed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>The women engaged with a wide range of CAM therapies during their cancer journey. CAM was used not only to alleviate symptoms, but also to restore a sense of ‘ordinariness’ and biographical continuity. Central to this process were practices of self-care, self-help, and self-management, and the collaboration of CAM practitioners and open-minded medical doctors. Barriers included dominant biomedical approaches, limited information sharing and communication about CAM, financial and geographical constraints, and little clinical validation by medical staff.</div></div><div><h3>Conclusion</h3><div>These women experienced tensions and conflicts when trying to use CAM alongside cancer treatment. They sought overall well-being but often encountered barriers to accessing CAM and sharing their experiences within a biomedical context. The study highlights the role and value of CAM in restoring a sense of normality in the lives of breast cancer survivors, and recommends raising professional awareness of CAM use by women with breast cancer, normalising CAM dialogue in the clinical encounter, and considering relational care in training.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"80 ","pages":"Article 102558"},"PeriodicalIF":1.7,"publicationDate":"2025-09-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145269965","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}
Pub Date : 2025-09-17DOI: 10.1016/j.eujim.2025.102556
Rong Li , Yu Zhang , YuHang Xie , XiaoQin Chen
Introduction
Acupuncture involves many different methods that can effectively treat Chronic Fatigue Syndrome (CFS). However, the comparative efficacy of different acupuncture-related methods remains unclear. This study aims to evaluate and rank the effectiveness of various acupuncture therapies for CFS through a network meta-analysis.
Methods
A comprehensive search of the three Chinese and four English databases for randomized controlled trials evaluating the use of acupuncture in treating CFS, published from database inception to July 2025, was performed, focusing on FS-14 scores and total effective rates as primary and secondary outcomes, respectively. Bayesian network meta-analysis was used to compare the effectiveness of 9 different intervention methods.
Results
Thirty-five randomized controlled trials comprising 2383 participants were included. Pairwise comparison revealed that moxibustion (mean difference [MD]: 12.43, 95 % confidence interval [CI]: 4.03 to 21.14) and acupuncture (MD: 11.15, 95 %CI: 3.3 to 19.39) were more effective than Western medicine in improving FS-14 scores. Regarding the total effective rate, the therapeutic effect of moxibustion is superior to that of acupuncture (risk ratio [RR]: 0.82, 95 %CI: 0.74 to 0.9) and Western medicine (RR: 1.5, 95 %CI: 1.33 to 1.71). The SUCRA ranking results revealed that regardless of FS-14 score or total effectiveness, moxibustion yielded the first curative effect.
Conclusion
Moxibustion may be advantageous in alleviating the fatigue symptoms of patients with CFS. However, the number of included studies was limited, and high-quality research is needed to confirm our conclusions.
{"title":"Comparing different acupuncture methods for the treatment of chronic fatigue syndrome: A systematic review and network meta-analysis","authors":"Rong Li , Yu Zhang , YuHang Xie , XiaoQin Chen","doi":"10.1016/j.eujim.2025.102556","DOIUrl":"10.1016/j.eujim.2025.102556","url":null,"abstract":"<div><h3>Introduction</h3><div>Acupuncture involves many different methods that can effectively treat Chronic Fatigue Syndrome (CFS). However, the comparative efficacy of different acupuncture-related methods remains unclear. This study aims to evaluate and rank the effectiveness of various acupuncture therapies for CFS through a network meta-analysis.</div></div><div><h3>Methods</h3><div>A comprehensive search of the three Chinese and four English databases for randomized controlled trials evaluating the use of acupuncture in treating CFS, published from database inception to July 2025, was performed, focusing on FS-14 scores and total effective rates as primary and secondary outcomes, respectively. Bayesian network meta-analysis was used to compare the effectiveness of 9 different intervention methods.</div></div><div><h3>Results</h3><div>Thirty-five randomized controlled trials comprising 2383 participants were included. Pairwise comparison revealed that moxibustion (mean difference [MD]: 12.43, 95 % confidence interval [CI]: 4.03 to 21.14) and acupuncture (MD: 11.15, 95 %CI: 3.3 to 19.39) were more effective than Western medicine in improving FS-14 scores. Regarding the total effective rate, the therapeutic effect of moxibustion is superior to that of acupuncture (risk ratio [RR]: 0.82, 95 %CI: 0.74 to 0.9) and Western medicine (RR: 1.5, 95 %CI: 1.33 to 1.71). The SUCRA ranking results revealed that regardless of FS-14 score or total effectiveness, moxibustion yielded the first curative effect.</div></div><div><h3>Conclusion</h3><div>Moxibustion may be advantageous in alleviating the fatigue symptoms of patients with CFS. However, the number of included studies was limited, and high-quality research is needed to confirm our conclusions.</div></div><div><h3>Protocol registration</h3><div>PROSPERO: CRD42024534790</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102556"},"PeriodicalIF":1.7,"publicationDate":"2025-09-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145117619","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}