European Journal of Integrative Medicine最新文献

Introduction

People with spinal cord injuries often experience constipation. Common surgical and conservative treatments for constipation may have long-term adverse events that outweigh their benefits in relieving symptoms temporarily. This proposed study aims to investigate the effects of acupressure on constipation, quality of life, psychosocial well-being, and bowel habits in a community-based spinal cord injury population.

Methods

This two-parallel-group, open-label controlled trial will randomly assign 78 eligible participants to the intervention or control groups. After receiving defecation education, the intervention group will perform 10-days of self-operated or caregiver-assisted acupressure manually, while the control group will conduct a manual light touch on the abdomen. The study will assess participants' constipation severity as the primary outcome, along with secondary outcomes including quality of life, psychosocial well-being, bowel habits, and participants’ perceptions of acupressure. Participants' perceptions of acupressure will be assessed through semi-structured focus group interviews after intervention. Other measurements will be taken at baseline, immediately post-intervention, and at a 1-month follow-up. The generalized estimating equations and content analysis will be employed to analyze the intervention effect and interview data, respectively.

Discussion

This study will be the first to evaluate the effect of applying acupressure in people with spinal cord injuries to improve their constipation. The intervention may offer an alternate, non-invasive therapy option for individuals with spinal cord injuries who live in the community.

Trial registration

This study is registered on ClinicalTrials.gov, ID: NCT05558657. Register date: September 28, 2022.

Introduction

Ephedrae Herba is a medicinal herb that has been frequently used for weight loss for several centuries. However, there are concerns regarding the safety and potential adverse events (AE) associated with Ephedrae Herba. This study aimed to develop a template suitable for reporting the AE of a Ephedrae Herba as a weight loss treatment in a clinical setting.

Methods

An initial consensus questionnaire was developed based on a literature review and discussion with the project management group. Delphi votes were performed, and three indices – content validity ratio, consensus, and convergence–were used to determine the core symptoms to be reported as AE. Finally, 12 Korean medicine doctors used the template for 1,043 patients from the Korean Medicine Registry of Herbal Medicine for weight loss, and evaluated its applicability.

Results

Following a two round Delphi survey, six items reached a consensus as the core symptoms of AE in Ephedrae Herba: headache, nausea, palpitations, dry mouth, constipation, and insomnia. The template has two main domains: (1) prescription of the herbal medicine, including Ephedrae Herba, and the dose and usage period; and (2) periods, severity, and causality of AE.

Conclusions

This is the first template specifically for reporting the AE of Ephedrae Herba. This template will help collect data in daily practice regarding the AE associated with Ephedrae Herba use for weight loss. This study could be valuable for practitioners who prescribe herbal medicines, including Ephedrae Herba, and stakeholders who manage the AE of herbal medicines to obtain long-term safety information associated with Ephedrae Herba.

Introduction

The WHO Traditional Medicine Strategy 2014–2023 emphasises the significance of traditional medicine systems for preventing and treating diseases, worldwide. As a result, many countries have developed national research programmes and research institutes dealing with traditional, complementary and integrative medicine (TCIM) (WHO Global Report on Traditional and Complementary Medicine, Geneva, 2019) or integrative medicine (IM). Despite considerable public interest in IM in the Netherlands, no Dutch programme or research institute has been established, yet. In 2018, a consortium for integrative care and health was founded, and developed a national research agenda with research priorities for the Netherlands.

Methods

The consensus-based strategy for developing the research agenda involved: (1) conducting a literature review, (2) organising an online consensus meeting with a select group of integrative medicine (IM) experts, (3) conducting a survey among IM stakeholders, and (4) organising a second consensus meeting with the same group of IM experts to discuss the survey results and further refine the research agenda. Snowball sampling was used to recruit IM stakeholders, starting from a list of those interested in or connected to IM.

Results

Ninety-two stakeholders completed the survey. The most promising research areas were oncology, pain management and palliative care. Respondents awarded the highest priority to research on the effectiveness, cost-effectiveness and safety of IM interventions. Directions for research included mind–body interventions, biological interventions and whole medical systems. Moreover, respondents strongly recommended developing reliable patient information tools. Facilitators for IM implementation were increasing attention on prevention, the rising incidence of chronic diseases and the shift from disease-focused to health-focused approaches. The identified barriers included a lack of knowledge about IM, the absence of health insurance reimbursement for complementary medicine, and governance structures of healthcare organisations.

Conclusions

The first Dutch IM research agenda was developed based on consensus among Dutch healthcare professionals, along with input from a smaller group of patients and researchers. This agenda provides clear research directions and distinguishes both positive developments and barriers for IM in the Netherlands.

Introduction

Globally 8.8 % of people aged 20–79 years have diabetes. Diabetes mellitus (DM) is a group of metabolic disorders characterized by hyperglycemia. Bergenia ligulata (Wall.) is a small, perennial, rhizomatous flowering herb used medicinally in India.

The present study aimed to evaluate the effect of B. ligulata rhizome as an adjuvant in decreasing blood glucose levels in type-II diabetes mellitus.

Methods

Forty patients were enrolled in a single-blind, randomized, placebo-controlled study; twenty patients were assigned to each of the test and control groups. Only those currently using 2 or less oral hypoglycaemic agents were included. Subjects took B. ligulata (4 gm) or placebo in capsule form, orally, for 8 weeks. Fasting blood sugar (FBS) and postprandial blood sugar (PPBS) were measured at baseline, fourth week, and end of the trial. Haemoglobin A1c (HbA1c) and quality of life (Asian Diabetes Quality of Life; ADQOL) scores were measured at baseline and the end of the trial. Data were statistically analyzed using analysis of variance (ANOVA), student's t-test, chi-square, and Fisher exact test to assess the effect of the intervention.

Results

After 8 weeks of treatment, the decrease in mean fasting blood sugar (FBS) level showed a significant difference between groups (Cohen's d= -0.457, 95 % confidence intervals (CIs) -0.174 to -1.082). PPBS level was significantly reduced in the test group compared to the control group (Cohen's d= -1.457, 95 % confidence interval (CIs) -0.749 to -2.150). There was a statistically significant reduction in HbA1c level in the test group compared to the control group (Cohen's d= -0.798, 95 % confidence interval (CIs) -0.148 to -1.438). B. ligulata was found to be more effective in improving ADQOL scores than placebo (Cohen's d = 0.762, 95 % confidence interval (CIs) 0.115 to 1.400). No B. ligulata related adverse events were observed.

Conclusion

B. ligulata appears to be an effective adjuvant treatment for type 2 diabetes mellitus. It reduced FBS, PPBS, and HbA1c and improved ADQOL scores significantly compared to the placebo. However, for more valid results, larger samples are needed.

Clinical trial registration no

CTRI /2019/05/019087.

Introduction

Healthy Life Centres (HLCs) in Turkey were established as primary health services to promote healthier lifestyle behaviours, aiming to reduce obesity and diseases linked to physical inactivity. This study aimed to investigate the weight management programme delivered by one HLC and to track the participants’ progress in terms of weight loss and adherence to the program.

Methods

This was a retrospective study. Participants consisted of adults aged ≥18 who attended the HLC for weight management from Sept 2017-June 2020. Data including attendance, age, gender, height and body weight were collected and analysed at 3, 6, 12-month time-points. Missing data were interpreted using last observed weight carried forward analysis (LOCF).

Results

Over a two-year period 2652 adults (88% female) consulted the nutrition counselling service, of whom 43% attended once. Mean age of those attending once was 40.2 (12.35) years and age increased significantly with adherence. Baseline body mass index (BMI) was 31.4 (6.32) kg/m². For those attending at the different time-points, weight loss was 4.4 % of initial body weight at 3-months (n = 841), 8.6 % of initial body weight at 6-month (n = 237), and 11.8 % initial body weight at 12-month follow-up (n = 56). LOCF analysis revealed a significant time effect for change in percentage body weight for the data collected at 6 and 12 months.

Conclusion

This programme was successful in reaching clinically meaningful weight loss at 3, 6, 12-month for the participants who committed to the weight management programme. However, there was a substantial decline in participant engagement, with only a 2 % attendance rate at 12 months. Furthermore, it is noteworthy that nearly half of the clients attended only one session during the study period. The findings of the current study can be used to inform policy makers about the strengths and weaknesses of HLCs.

Introduction

Cardiorespiratory fitness (CRF) declines with aging and is associated with age-related diseases. The decline in CRF among older adults has not been reported in China. Traditional Chinese medicine (TCM) believes that CRF is related to Qi and blood status, but there is no evidence to support this hypothesis. Therefore, the purpose of our study was 1) to observe the decline in CRF in Chinese older adults, and 2) to investigate the association between CRF and TCM Qi and blood status.

Methods

Eligible older adults underwent the 6-minute walk test (6MWT) and the Qi and Blood Status Questionnaire (QBSQ) assessment. Data encompassed general information, demographic and anthropometric details, underlying medical conditions, and results of the 6MWT and QBSQ. Data were analyzed for normal and abnormal 6MWD cohorts, and the correlation between 6MWD and QBSQ scores was explored.

Results

Among the 277 participants included, 77 individuals walked a distance of ≤450 m. The median (interquartile range [IQR]) for the normal-6MWD group was 472 (16) m and 420 (50) m for the abnormal-6MWD group. Comparative analysis between groups revealed disparities in age, sex, height, weight, BMI, education level, and the prevalence of chronic diseases such as hypertension, type-2 diabetes mellitus (T2DM), coronary heart disease (CHD), and hyperlipidemia (P < 0.05). Moreover, a significant negative linear correlation was observed between 6MWD and the QBSQ scores (P < 0.01). The receiver operating characteristic (ROC) analysis demonstrated the potential diagnostic value of QBSQ scores in identifying abnormal 6MWD. The combined model exhibited optimal validity, evidenced by an area under the curve (AUC) of 0.87 (95 % confidence interval: 0.768–0.879), a sensitivity of 0.87, a specificity of 0.71, and a cut-off total score value of 45.

Conclusion

The initial findings suggest a considerable percentage of Chinese older adults, including those with chronic diseases, exhibited abnormal 6MWD. We observed negative linear correlations between 6MWD and QBSQ scores, indicating that CRF is related to TCM Qi and blood status. However, future multi-center studies with lager sample sizes are still needed.

Introduction

This systematic review aimed to evaluate the effectiveness and safety of traditional Chinese medicine (TCM) interventions for airway remodelling in patients with asthma.

Methods

A systematic search was conducted of 8 international and Chinese databases and 2 clinical trial registries from the inception of the database to March 2022. The data were analysed for the outcomes of lung function, matrix metalloproteinases-9 (MMP-9), tissue inhibitor of metalloproteinases-1 (TIMP-1), and adverse events. The Cochrane “Risk of bias” tool and the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methods were used to assess the methodological quality and the certainty of the evidence. Descriptive analysis was employed to summarize the outcomes of TCM. The PROSPERO ID is CRD42022318617. This work was financially supported by the National Natural Science Foundation of China (No. 82,004,167).

Results

Twenty RCTs involving 1790 patients with asthma were included. The trials were at unclear or high risk of bias. The certainty of the evidence ranged from very low certainty to low certainty. The TCM used in each trial was different. Compared to those of conventional medicine, 9 trials showed greater effects of TCM alone or combined with conventional medicine on lung function, as indicated by the FEV₁, FVC, and FEV₁/FVC. Nine trials showed that TCM significantly reduced the expression of MMP-9 and TIMP-1. Five trials reported adverse events.

Conclusion

TCM alone or in combination with conventional medicine alleviated airway remodelling symptoms in patients with asthma. However, additional high-quality randomized trials are still needed to confirm the beneficial effectiveness of TCM.

Introduction

Breast pain is a frequently encountered problem in both pre- and postmenopausal women. The pain can be severe and persistent, and interferes with women's daily life. Acupuncture has been widely used for women with cyclic and noncyclic breast pain with possible favorable effects and few adverse events, however, the data have not been systematically reviewed. This systematic review aims to investigate the efficacy of acupuncture on alleviating breast pain.

Methods

Seven databases including Medline, Embase, Pubmed, CNKI, etc. were searched for English and Chinese literature from their inception to 22 January 2024. We included randomized clinical trials that assessed the effectiveness of acupuncture in reducing pain intensity for cyclic and noncyclic mastalgia unrelated to cancer. Two independent reviewers screened the retrieved studies and extracted the data. Risk of bias of included studies was assessed according to Cochrane Risk-of-Bias (RoB) tool version 2. Meta-analysis was conducted where applicable.

Results

Eleven studies were included. Eight studies with 588 women focused on cyclic breast pain (CBP), three studies with 210 women focused on noncyclic breast pain (NCBP). For CBP, the overall response rate of acupuncture was comparable to tamoxifen (3 studies, n=243; RR 1.24, 95% CI 0.75 to 2.06, p=0.39; very low certainty), however, the effect of acupuncture measured by visual analogue scale (VAS) score was inconsistent when compared with sham acupuncture in 3 studies (n=141; MD 11.08, 95% CI -3.95 to 26.10; p = 0.15; very low certainty). For NCBP, acupuncture provided significantly more reduction in VAS score than antibiotics for mastitis (2 studies, n=148; MD 12.69, 95% CI 8.38 to 17.00; p < 0.001; low certainty). A total of five cases of adverse events were reported.

Conclusion

Acupuncture may have similar effects to tamoxifen in treating women with CBP, and may be more effective than antibiotics in alleviating breast pain for women with mastitis. Acupuncture may be an effective complementary treatment for breast pain. However, the overall certainty of evidence was very low. The evidence was not conclusive and requires further investigation with robust methodological quality.

Registration number

CRD42020220134

Introduction

Recent studies have shown that the risks of mental disorders resulting from vitamin D deficiency, such as depression, anxiety and stress, can be affected by various high-risk alleles. Among the genes interacting with environmental factors are those associated with vitamin D binding protein (DBP) that affects the status of 25- OH vitamin D. Therefore, the present study aimed to determine the interaction between dietary patterns and DBP gene variants on mental health status in adults.

Methods

This cross-sectional study was conducted on a random sample of adult participants (n = 265 and 18–55 years old) in Tehran. Major dietary patterns were determined using principal component analysis (PCA) method on 24 food groups, using a valid and reliable 147-item food frequency questionnaire (FFQ). DBP genotypes were determined by polymerase chain reactions - restriction fragment length polymorphism (PCR-RFLP). Data about the mental health status were collected using the Depression, Anxiety, Stress Score (DASS-21).

Results

Results demonstrated strong interactions between higher adherence to healthy dietary patterns in individuals with the major allele (low-risk allele) carriers of rs7041 (GG genotype), in relation to reduced stress score (OR= -2.54, 95 % CI = -4.60 to -0.48, P interaction = 0.02). Also, individuals with higher adherence to healthy dietary patterns with GG genotype of rs7041 indicated reduced stress score, but it was not significant (OR = -1.84, 95 % CI = 0.18 to -3.86, P interaction = 0.07).

Conclusion

The present evidence indicates that interactions between healthy dietary patterns with DBP variants (rs7041 - GG genotype) may effectively reduce the odds of mental disorders , especially in stress, through consuming healthy food groups and inherited low-risk alleles.