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Integrating yoga into comprehensive cancer care: Starting somewhere 将瑜伽融入癌症综合治疗:从某处开始
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-21 DOI: 10.1016/j.eujim.2024.102348
Kathryn M. Glaser , Christina R. Crabtree-Ide , Tessa F. Flores , Mary E. Reid

Introduction

The rapid increase in cancer survivors in the United States (US) highlights the importance of survivors’ long-term care needs and symptom management. Given evidence that yoga supports cancer related symptoms, our aim was to develop and implement a community yoga program available for cancer survivors, family members, and staff involved in cancer care at a public comprehensive cancer center in the US. Given the wide age range and potential side effects from cancer treatment, we adapted the yoga program to meet the needs of cancer survivors.

Methods

Beginning in May 2017, we offered sixty-minute gentle yoga sessions for all medically cleared cancer survivors and their family members, caregivers, and friends, as well as oncology staff. We aimed to evaluate acceptability, development, and implementation of an adaptive yoga program at our comprehensive cancer center using mixed methods. Classes were initially offered once a week, then increased to twice a week. A total of five service evaluations were sent approximately every six months between April 2018-October 2019 to evaluate participant satisfaction (n = 90 responses). Qualitative data were collected and analyzed using thematic analysis of participant satisfaction, allowing us to continuously monitor the yoga program and adjust to meet participants’ needs.

Results

Between May 2017 and February 2020, 176 people attended our program. Ages ranged from 21 to 72 years, with an average age of 45 years. Based on these evaluations, 96 % (n = 86) of participants rated both the program and teachers excellent, and 4 % (n = 4) rated the program and teachers good. Qualitative themes highlighted positive aspects of the program, including accessibility, inclusivity, and adaptive yoga based on medical needs, skill level, and abilities.

Conclusions

Adaptive yoga programs are well-accepted by cancer survivors and caregivers, and may contribute a solution to healthcare staff and physician burnout. It is essential to build a solid foundation of self-care and wellness programming for cancer survivors and to create and foster adaptive yoga classes. Next steps for our program include evaluating yoga within the clinical setting, including chemotherapy infusion centers, and further research on reduction in stress through yoga in cancer survivors.

导言:美国癌症幸存者人数的快速增长凸显了幸存者长期护理需求和症状管理的重要性。鉴于有证据表明瑜伽对癌症相关症状有帮助,我们的目标是开发并实施一项社区瑜伽计划,供美国一家公立综合癌症中心的癌症幸存者、家庭成员和癌症护理人员使用。考虑到癌症患者的年龄跨度较大,以及癌症治疗可能产生的副作用,我们对瑜伽课程进行了调整,以满足癌症幸存者的需求。方法从 2017 年 5 月开始,我们为所有通过医学检查的癌症幸存者及其家人、护理人员和朋友以及肿瘤科工作人员提供 60 分钟的温和瑜伽课程。我们旨在采用混合方法评估综合癌症中心适应性瑜伽课程的可接受性、发展和实施情况。课程最初每周一次,后来增加到每周两次。在 2018 年 4 月至 2019 年 10 月期间,大约每六个月共发出五份服务评价,以评估参与者的满意度(n = 90 份回复)。我们通过对参与者满意度的主题分析来收集和分析定性数据,从而对瑜伽项目进行持续监控,并根据参与者的需求进行调整。结果在 2017 年 5 月至 2020 年 2 月期间,共有 176 人参加了我们的项目。年龄从 21 岁到 72 岁不等,平均年龄为 45 岁。根据这些评价,96%(n = 86)的参与者将课程和教师都评为优秀,4%(n = 4)的参与者将课程和教师评为良好。定性主题强调了该计划的积极方面,包括可及性、包容性以及基于医疗需求、技能水平和能力的适应性瑜伽。结论适应性瑜伽计划深受癌症幸存者和护理人员的认可,并可能有助于解决医护人员和医生的职业倦怠问题。为癌症幸存者的自我保健和健康计划打下坚实的基础,并创建和促进适应性瑜伽课程是非常重要的。我们计划的下一步包括评估临床环境中的瑜伽,包括化疗输液中心,以及进一步研究通过瑜伽减轻癌症幸存者的压力。
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引用次数: 0
The add-on effect of oral East Asian herbal medicine to steroid therapy for alopecia areata: A systematic review and meta-analysis 口服东亚草药对类固醇疗法治疗斑秃的辅助效果:系统回顾与荟萃分析
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-17 DOI: 10.1016/j.eujim.2024.102345
Soojin Park , Jieun Lee , Seoyeon Jun , Kyuseok Kim

Introduction

Alopecia areata (AA) is an autoimmune disease that degrades patients' quality of life and adversely affects mental health. Since steroid therapy (ST) has limited efficacy and a risk of recurrence, East Asian herbal medicine (EAHM) combined with ST has been suggested as an alternative treatment. Many randomized controlled trials (RCTs) have been conducted on the efficacy of EAHM combined with ST in AA treatment; however, the efficacy of EAHM combined with ST and the treatment effects of ST alone have not yet been compared. This systematic review and meta-analysis aimed to evaluate the effectiveness and safety of the combination of ST and EAHM compared to ST alone in the treatment of AA.

Methods

We searched 10 databases: PubMed, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI), Wanfang, KoreaMed, Korean Medical Database (KMBASE), Korean Studies Information Service System (KISS), ScienceON, and Korea Science. Bias was independently assessed using Cochrane Risk of Bias tool (RoB 2.0), and meta-analysis was conducted using Review Manager (Revman) 5.4.1 with the application of random-effect models. The primary outcome was defined as the cure rate.

Results

Fifteen studies were selected, and 1,119 participants were included in the study. According to the results of the meta-analysis, a higher cure rate (RR 1.50, 95 % CI : 1.31, 1.71, P<0.00001, I2=0 %), a higher total efficacy rate (modified Total Efficacy Rate 1 (mTER1); (RR 1.10, 95 % CI: 1,06, 1.15, P < 0.00001, I2=0 %), modified Total Efficacy Rate 2 (mTER2); (RR 1.09, 95 % CI: 1.03, 1.16, P = 0.006, I2=0 %)), and a lower recurrence rate (RR 0.28, 95 % CI: 0.16, 0.48, P<0.00001, I2=0 % %) were confirmed in the ST with EAHM group than in the ST group. Low IFN-γ levels and high IL-10 levels were identified in the ST combined with EAHM group. No serious adverse effects were observed during treatment.

Conclusions

Compared to ST alone in AA treatment, the combination treatment of ST and EAHM may effectively and safely increase the cure and total efficacy rates and may lower the recurrence rate. However, to strengthen the basis of this review, higher quality RCTs must be performed.

Registration

CRD42023397023

斑秃(AA)是一种自身免疫性疾病,会降低患者的生活质量并对心理健康产生不利影响。由于类固醇疗法(ST)疗效有限,且有复发风险,因此有人建议将东亚草药疗法(EAHM)与类固醇疗法相结合,作为一种替代治疗方法。目前已有许多随机对照试验(RCT)研究了东亚中药与类固醇疗法联合治疗 AA 的疗效,但尚未对东亚中药与类固醇疗法联合治疗 AA 的疗效与单独使用类固醇疗法的疗效进行比较。本系统综述和荟萃分析旨在评估 ST 和 EAHM 联合治疗 AA 的有效性和安全性。我们检索了 10 个数据库:PubMed、EMBASE、Cochrane Library、中国国家知识基础设施(CNKI)、万方、KoreaMed、韩国医学数据库(KMBASE)、韩国研究信息服务系统(KISS)、ScienceON和韩国科学。使用 Cochrane Risk of Bias 工具(RoB 2.0)对偏倚进行了独立评估,并使用 Review Manager (Revman) 5.4.1 应用随机效应模型进行了荟萃分析。主要结果定义为治愈率。研究选取了 15 项研究,共纳入 1,119 名参与者。根据荟萃分析的结果,较高的治愈率(RR 1.50,95% CI : 1.31, 1.71,P<0.00001,I=0%)、较高的总有效率(修改后的总有效率 1 (mTER1);(RR 1.10,95% CI : 1,06, 1.15,P<0.00001,I=0%)、改良总有效率2(mTER2);(RR 1.09,95% CI:1.03,1.16,P=0.006,I=0%)),以及较低的复发率(RR 0.28,95% CI:0.16,0.48,P<0.00001,I=0%)均证实ST伴EAHM组低于ST组。ST联合EAHM组的IFN-γ水平较低,IL-10水平较高。治疗期间未观察到严重的不良反应。与单用 ST 治疗 AA 相比,ST 和 EAHM 联合治疗可有效、安全地提高治愈率和总有效率,并可降低复发率。然而,为了加强这项研究的基础,必须进行更高质量的研究性临床试验。CRD42023397023
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引用次数: 0
The effects of catgut embedding in patients with obesity of gastrointestinal internal heat: A randomised controlled trial 胃肠道内热肥胖症患者的猫肠嵌入术效果:随机对照试验
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2023.102327
Qingqing Zhu , Jian Cheng , Xiaolan Xu , Tangying Xu , Xingjiang Gu , Yun Xia , Lingzhen Mao , Nannan Hu , Yuexia Fang

Introduction

Globally, the incidence of obesity is increasing, causing increased rates of hypertension, diabetes, and cardiovascular diseases. Acupoint catgut embedding, a popular acupuncture method in China, has greater efficacy than acupuncture for weight control. The effectiveness of catgut embedding in patients with fatty liver associated with metabolic dysfunction was investigated.

Methods

In this randomised controlled trial, 60 patients with gastrointestinal internal heat-type obesity were randomised to the intervention (n = 30) and control (n = 30) groups. The intervention group participated in the catgut embeddings with diet and exercise for 2 months, with a catgut treatment frequency of once every 10 days for 30 min. The control group participated only in diet and exercise for the same period. Body weight; body mass index (BMI); waist-to-hip ratio (WHR); fasting plasma glucose, 2-hour blood glucose, glycated haemoglobin, and lipid levels were assessed before and after treatments.

Results

Fifty-seven patients completed the courses. After 2 months, the intervention group showed a statistically significant trend of decrease in WHR and total score of gastrointestinal internal heat-type clinical symptoms when compared with the control group (mean difference: −0.03, 95 % confidence level [CI]: −0.07 to 0.00 and mean difference: −6.04, 95 % CI: −8.59 to −3.50, respectively). In the intervention group, the mean reductions in body weight and BMI were 6.18 kg (95 % CI: 4.60 to 7.76) and 2.23 kg/m2 (95 % CI: 1.72 to 2.74), respectively. The total treatment efficiency for fatty liver in the intervention and control groups was 61.5 % and 30.8 %, respectively (risk ratio: 3.60; 95 % CI: 1.14 to 11.35).

Conclusion

Catgut embedding administered with diet and exercise is effective for patients with gastrointestinal internal heat-type obesity and some patients with obesity complicated by metabolic dysfunction-associated fatty liver disease. The effects observed in the intervention group were superior to those in the control group in terms of body weight, BMI, WHR, total score of gastrointestinal internal heat-type clinical symptoms, and treatment effectiveness for metabolic dysfunction-associated fatty liver disease. There were no serious adverse reactions during the treatment.

Registration number

ChiCTR2200057237.

Funding

This study was supported by the Hangzhou Medicine and Health Science and Technology Program and Hangzhou Lin'an District Hospital of Traditional Chinese Medicine.

导言:在全球范围内,肥胖症的发病率越来越高,导致高血压、糖尿病和心血管疾病的发病率增加。穴位埋线是中国流行的一种针灸方法,在控制体重方面比针灸更有效。方法在这项随机对照试验中,60 名胃肠道内热型肥胖患者被随机分为干预组(30 人)和对照组(30 人)。干预组在饮食和运动的基础上进行为期 2 个月的猫肠嵌入治疗,猫肠治疗频率为每 10 天一次,每次 30 分钟。对照组在同一时期只进行饮食和运动。对治疗前后的体重、体重指数(BMI)、腰臀比(WHR)、空腹血浆葡萄糖、2 小时血糖、糖化血红蛋白和血脂水平进行了评估。2 个月后,与对照组相比,干预组的 WHR 和胃肠道内热型临床症状总分均呈显著下降趋势(平均差:-0.03,95% 置信度(P<0.05)):-0.03,95% 置信度 [CI]:平均差:-0.03,95%置信水平[CI]:-0.07 至 0.00,平均差:-6.04,95%置信水平[CI]:-0.00分别为-6.04,95% 置信度[CI]:-8.59 至-3.50)。在干预组中,体重和体重指数的平均降幅分别为 6.18 千克(95% CI:4.60 至 7.76)和 2.23 千克/平方米(95% CI:1.72 至 2.74)。干预组和对照组治疗脂肪肝的总有效率分别为 61.5%和 30.8%(风险比:3.60;95% CI:1.14 至 11.35)。干预组在体重、体重指数、WHR、胃肠道内热型临床症状总分以及代谢功能障碍相关性脂肪肝的治疗效果方面均优于对照组。本研究得到了杭州市医药卫生科技项目和杭州市临安区中医院的支持。
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引用次数: 0
Combined Korean medicine therapies in children with allergic rhinitis: A prospective, multicenter, observational registry study at primary-care network clinics 过敏性鼻炎患儿的韩药联合疗法:初级保健网络诊所的前瞻性多中心观察登记试验
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2024.102336
Hongmin Chu , EunKyoung Lee , Seunghwan Moon PharmB , Hamsoa Clinics KM Doctors Group , Bo-Hyoung Jang

Introduction

Allergic rhinitis (AR) causes symptoms such as hyper-rhinorrhea, sneezing, nasal congestion, itching, and pain by triggering inflammation in the nasal mucosa and an immune response caused by antigen-specific Immunoglobulin E (IgE). This prospective multicenter observational study aimed to evaluate the symptoms change and safety of combined Korean medicine (KM) therapy in patients with AR.

Methods

This study was conducted in HAMSOA Korean Medicine Clinics, a network specializing in treating pediatric patients in Korea, and 15 centers participated. The patients were divided into three groups (mild, moderate, and severe) according to their baseline total nasal symptom score. The patients were treated with herbal medicine, acupuncture, cupping therapy, and moxibustion therapy.

Results

The study involved 72 subjects aged 6.47 ± 2.37 years. The average Numeric Rating Scale for allergic rhinitis symptoms at the baseline and final follow-up were 4.39 ± 2.14 to 3.47 ± 2.51, respectively, indicating a significant improvement over an average of 4 weeks. The Pediatric Allergic Disease Quality of Life Questionnaire scores at the final screening improved in all three groups. The mean difference was -10.44, with a 95 % confidence interval of -15.35 to -5.54 (p < 0.01.). Furthermore, no adverse events were reported in any patient in this study.

Conclusion

The results provide preliminary evidence suggesting that KM treatment may be a safe and effective option for reducing symptoms associated with allergic rhinitis in children. Additional prospective studies are required to confirm the results of the present study.

导言过敏性鼻炎(AR)通过引发鼻粘膜炎症和由抗原特异性免疫球蛋白E(IgE)引起的免疫反应,导致流鼻涕、打喷嚏、鼻塞、瘙痒和疼痛等症状。这项前瞻性多中心观察性研究旨在评估韩医(KM)联合疗法对 AR 患者的症状变化和安全性。方法这项研究在 HAMSOA 韩医诊所(韩国专门治疗儿科患者的网络)进行,共有 15 个中心参与。根据患者鼻部症状的基线总评分,将其分为三组(轻度、中度和重度)。患者接受了中药、针灸、拔罐和艾灸治疗。在基线和最终随访中,过敏性鼻炎症状的平均数值评定量表分别为(4.39±2.14)分和(3.47±2.51)分,这表明在平均 4 周的时间内,过敏性鼻炎症状有了显著改善。三组患者在最终筛查时的儿科过敏性疾病生活质量问卷得分均有所提高。平均差异为-10.44,95%置信区间为-15.35至-5.54(p<0.01)。结论:研究结果提供了初步证据,表明 KM 治疗可能是减少儿童过敏性鼻炎相关症状的一种安全有效的选择。要证实本研究的结果,还需要进行更多的前瞻性研究。
{"title":"Combined Korean medicine therapies in children with allergic rhinitis: A prospective, multicenter, observational registry study at primary-care network clinics","authors":"Hongmin Chu ,&nbsp;EunKyoung Lee ,&nbsp;Seunghwan Moon PharmB ,&nbsp;Hamsoa Clinics KM Doctors Group ,&nbsp;Bo-Hyoung Jang","doi":"10.1016/j.eujim.2024.102336","DOIUrl":"10.1016/j.eujim.2024.102336","url":null,"abstract":"<div><h3>Introduction</h3><p>Allergic rhinitis (AR) causes symptoms such as hyper-rhinorrhea, sneezing, nasal congestion, itching, and pain by triggering inflammation in the nasal mucosa and an immune response caused by antigen-specific Immunoglobulin E (IgE). This prospective multicenter observational study aimed to evaluate the symptoms change and safety of combined Korean medicine (KM) therapy in patients with AR.</p></div><div><h3>Methods</h3><p>This study was conducted in HAMSOA Korean Medicine Clinics, a network specializing in treating pediatric patients in Korea, and 15 centers participated. The patients were divided into three groups (mild, moderate, and severe) according to their baseline total nasal symptom score. The patients were treated with herbal medicine, acupuncture, cupping therapy, and moxibustion therapy.</p></div><div><h3>Results</h3><p>The study involved 72 subjects aged 6.47 ± 2.37 years. The average Numeric Rating Scale for allergic rhinitis symptoms at the baseline and final follow-up were 4.39 ± 2.14 to 3.47 ± 2.51, respectively, indicating a significant improvement over an average of 4 weeks. The Pediatric Allergic Disease Quality of Life Questionnaire scores at the final screening improved in all three groups. The mean difference was -10.44, with a 95 % confidence interval of -15.35 to -5.54 (<em>p</em> &lt; 0.01.). Furthermore, no adverse events were reported in any patient in this study.</p></div><div><h3>Conclusion</h3><p>The results provide preliminary evidence suggesting that KM treatment may be a safe and effective option for reducing symptoms associated with allergic rhinitis in children. Additional prospective studies are required to confirm the results of the present study.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"66 ","pages":"Article 102336"},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139510331","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
Selecting indicators of acupuncture service quality using analytic hierarchy process 利用层次分析法选择针灸服务质量指标
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2023.102324
Chao-Chan Wu , Chiung-Chen Ho , Kai-Chun Yang

Introduction

In traditional Chinese medicine (TCM) services, formulating management strategies and policies to improve service quality is essential for maintaining competitive advantages. The purpose of this study is to select key indicators of acupuncture service quality to assist in the development of relevant strategies in order to guide service management in TCM clinics.

Methods

This study uses analytic hierarchy process (AHP) to identify key indicators of acupuncture service quality. A hierarchical architecture comprising four main criteria and twelve sub-criteria was established based on a solid theoretical foundation. Next, the judgements of experts in pairwise comparisons were used to calculate the weight of each criterion and determine the critical criteria for acupuncture service quality. Furthermore, fuzzy AHP was utilized to validate the effectiveness of AHP.

Results

Of all the main criteria, “outcome quality” was the most important, followed by “interaction quality”. Among the twelve sub-criteria, “patient satisfaction” was deemed as the most important, with “expertise” and “waiting time” ranking second and third, respectively. “Interactional justice” and “process quality” were ranked fourth and fifth, respectively.

Conclusions

The key findings indicate outcome quality, interaction quality, and the five sub-criteria are key indicators of acupuncture service quality. Therefore, time-saving strategies for operating procedures and human resource policies should be developed to improve acupuncture services.

引言在传统中医(TCM)服务中,制定提高服务质量的管理策略和政策对于保持竞争优势至关重要。本研究旨在选择针灸服务质量的关键指标,以帮助制定相关策略,指导中医诊所的服务管理:本研究采用层次分析法(AHP)确定针灸服务质量的关键指标。在坚实的理论基础上,建立了由四个主要标准和十二个次级标准组成的层次结构。然后,利用专家在配对比较中的判断来计算各标准的权重,并确定针灸服务质量的关键标准。此外,还利用模糊 AHP 验证了 AHP 的有效性:在所有主要标准中,"结果质量 "最为重要,其次是 "互动质量"。在 12 个次级标准中,"患者满意度 "被认为是最重要的,"专业知识 "和 "等待时间 "分别排在第二和第三位。"互动公正 "和 "过程质量 "分别排在第四和第五位:主要研究结果表明,结果质量、互动质量和五个次级标准是针灸服务质量的关键指标。因此,应制定节省时间的操作程序策略和人力资源政策,以改善针灸服务。
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引用次数: 0
The effect of vitamin D supplementation in pregnancy on the incidence of preeclampsia: A systematic review and meta-analysis 孕期补充维生素 D 对子痫前期发病率的影响:系统回顾与荟萃分析
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2024.102343
Zainab Alimoradi , Farideh Kazemi , Azita Tiznobeik , Mark D. Griffiths , Seyyedeh Zahra Masoumi , Soodabeh Aghababaei

Introduction

The results of previous studies regarding the effect of vitamin D on the incidence of preeclampsia are inconsistent. Therefore, the primary objective of the present review was to determine the effect of vitamin D supplementation during pregnancy on the risk of preeclampsia.

Methods

Five major scientific databases were searched from inception to June 10, 2023. Studies with randomized controlled trial designs were identified. To assess the methodological quality of the selected studies, the Cochrane Tool Checklist (CTC) was used. The random effect model was chosen as a combination model. Statistical heterogeneity was evaluated using the standard χ2 test, and the intensity of heterogeneity was calculated using I2. Effect size indicators including risk ratio (RR), risk difference (RD), and number needed to treat (NNT) were calculated with estimated 95 % confidence intervals.

Results

Nineteen studies were included in the systematic review and meta-analysis. The pooled RR of preeclampsia in the intervention group compared to the control group was 0.61 (95 % CI, 0.47 to 0.78; I2=14.4 %; χ2=23.37; p = 0.27; tau2=0.05), and indicated a 39 % reduction in the risk of preeclampsia. The pooled RD of preeclampsia in the intervention group compared to the control group was -0.03 (95 % CI: -0.05 to -0.01; I2=45.5 %; χ2=36.68; p = 0.01; tau2=0.0008) and the difference in the risk of preeclampsia among women who received vitamin D supplements was 3 % less than the control group. The NNT was 29 (95 % CI: 20 to 52).

Conclusion

Vitamin D supplementation significantly reduces preeclampsia during pregnancy.

以往关于维生素 D 对子痫前期发病率影响的研究结果并不一致。因此,本综述的主要目的是确定孕期补充维生素 D 对子痫前期风险的影响。我们检索了从开始到 2023 年 6 月 10 日的五个主要科学数据库。检索了采用随机对照试验设计的研究。为了评估所选研究的方法学质量,使用了科克伦工具检查表(CTC)。选择随机效应模型作为组合模型。统计异质性采用标准 χ 检验进行评估,异质性强度采用 。计算效应大小指标,包括风险比(RR)、风险差异(RD)和治疗所需人数(NNT),并估计 95% 的置信区间。系统综述和荟萃分析共纳入了 19 项研究。与对照组相比,干预组先兆子痫的总RR为0.61 (95% CI, 0.47 to 0.78; =14.4%; χ=23.37; =0.27; tau=0.05),表明先兆子痫的风险降低了39%。与对照组相比,干预组先兆子痫的汇总RD为-0.03 (95% CI: -0.05 to -0.01; =45.5%; χ=36.68; =0.01; tau=0.0008),接受维生素D补充剂的妇女的先兆子痫风险差异比对照组低3%。NNT为29(95% CI:20至52)。补充维生素D可明显减少孕期子痫前期的发生。
{"title":"The effect of vitamin D supplementation in pregnancy on the incidence of preeclampsia: A systematic review and meta-analysis","authors":"Zainab Alimoradi ,&nbsp;Farideh Kazemi ,&nbsp;Azita Tiznobeik ,&nbsp;Mark D. Griffiths ,&nbsp;Seyyedeh Zahra Masoumi ,&nbsp;Soodabeh Aghababaei","doi":"10.1016/j.eujim.2024.102343","DOIUrl":"10.1016/j.eujim.2024.102343","url":null,"abstract":"<div><h3>Introduction</h3><p>The results of previous studies regarding the effect of vitamin D on the incidence of preeclampsia are inconsistent. Therefore, the primary objective of the present review was to determine the effect of vitamin D supplementation during pregnancy on the risk of preeclampsia.</p></div><div><h3>Methods</h3><p>Five major scientific databases were searched from inception to June 10, 2023. Studies with randomized controlled trial designs were identified. To assess the methodological quality of the selected studies, the Cochrane Tool Checklist (CTC) was used. The random effect model was chosen as a combination model. Statistical heterogeneity was evaluated using the standard χ<sup>2</sup> test, and the intensity of heterogeneity was calculated using <em>I</em><sup>2</sup>. Effect size indicators including risk ratio (RR), risk difference (RD), and number needed to treat (NNT) were calculated with estimated 95 % confidence intervals.</p></div><div><h3>Results</h3><p>Nineteen studies were included in the systematic review and meta-analysis. The pooled RR of preeclampsia in the intervention group compared to the control group was 0.61 (95 % CI, 0.47 to 0.78; <em>I<sup>2</sup></em>=14.4 %; χ<sup>2</sup>=23.37; <em>p</em> = 0.27; tau<sup>2</sup>=0.05), and indicated a 39 % reduction in the risk of preeclampsia. The pooled RD of preeclampsia in the intervention group compared to the control group was -0.03 (95 % CI: -0.05 to -0.01; <em>I<sup>2</sup></em>=45.5 %; χ<sup>2</sup>=36.68; <em>p</em> = 0.01; tau<sup>2</sup>=0.0008) and the difference in the risk of preeclampsia among women who received vitamin D supplements was 3 % less than the control group. The NNT was 29 (95 % CI: 20 to 52).</p></div><div><h3>Conclusion</h3><p>Vitamin D supplementation significantly reduces preeclampsia during pregnancy.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"66 ","pages":"Article 102343"},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139920601","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
Acacia leucophloea (Roxb.). Willd.: Multi-targeted therapeutic efficacy against type 2 diabetes mellitus Acacia leucophloea (Roxb.).Willd:对 2 型糖尿病的多靶点疗效
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2024.102344
Beena Levakumar Abhirami , Anithakumari Aswathy Krishna , Abdul Rahim Muhammed Jasim , Alaganandam Kumaran

Introduction

Acacia leucophloea (AL) has been used traditionally to treat diabetes, cancer, inflammation, ophthalmia, haemorrhoids and leukoderma, however the scientific evidence validating its antidiabetic activity is limited. Employing a multi-targeted therapeutic strategy could be advantageous for the management of type 2 diabetes mellitus which is strongly correlated with oxidative stress-induced pathways. The present study was intended to evaluate the antidiabetic and antioxidant potential of AL via in vitro assays, validating its traditional medicinal significance.

Methods

Anti-diabetic potential of the AL extract, its fractions and isolated compounds was assessed through the determination of α-glucosidase, DPP-IV inhibition, anti-glycation activity, and glucose uptake using 2-NBDG in differentiated L6 myoblast, along with cytotoxicity studies. Total phenolic and flavonoid content was measured and the antioxidant potential was evaluated using in vitro assays i.e., DPPH, ABTS and FRAP. In addition, quantitative determination of isolated compounds and their purity was analysed using HPLC-DAD.

Results

Fractions with the highest phenolic/flavonoid content (VI to XIII of AL) demonstrated substantial antioxidant and antidiabetic potential across selected therapeutic targets and these active fractions yielded six compounds upon fractionation using column chromatographic techniques. Structures of these compounds were examined using spectroscopic techniques and were identified as isoquercitrin, quercitrin, luteolin, epigallocatechin-3-O-(3-O-methyl)-gallate, apigenin-7-O-glucoside and ethyl gallate. Isolated compounds showed significant DPP-IV inhibitory activity in a concentration-dependent manner with the highest activity with minimum IC50 being possessed by isoquercitrin (IC50 4.28 ± 0.32 µM). At a concentration of 200 µM, apigenin-7-O-glucoside displayed a considerable glycation inhibitory effect (81.57 ± 2.66 %), surpassing the effect of other compounds. Moreover, at a concentration of 50 μM, the compounds apigenin-7-O-glucoside and isoquercitrin have increased the glucose uptake in L6 myotubes by 11.5 % and 11 % respectively, compared to a 6.1 % increase by the standard drug metformin. Notably, this study reveals for the first time the potential of both apigenin-7-O-glucoside and isoquercitrin to enhance glucose uptake in L6 myotubes.

Conclusion

AL and its isolated compounds exhibit promising effects in ameliorating post-prandial hyperglycemia. Their multifaceted therapeutic potential prompts further investigation to elucidate the underlying molecular mechanisms.

引言 白花相思豆(AL)在传统上被用于治疗糖尿病、癌症、炎症、眼炎、痔疮和白皮病,但证实其抗糖尿病活性的科学证据却很有限。2型糖尿病与氧化应激诱导的途径密切相关,采用多靶点治疗策略可能有利于2型糖尿病的治疗。本研究旨在通过体外检测评估 AL 的抗糖尿病和抗氧化潜力,验证其传统药用价值。方法通过测定 AL 提取物、其馏分和分离化合物的α-葡萄糖苷酶、DPP-IV 抑制作用、抗糖化活性、2-NBDG 在分化的 L6 肌母细胞中的葡萄糖吸收以及细胞毒性研究,评估 AL 提取物、其馏分和分离化合物的抗糖尿病潜力。对总酚和类黄酮含量进行了测定,并使用 DPPH、ABTS 和 FRAP 等体外检测方法对抗氧化潜力进行了评估。结果酚类/类黄酮含量最高的馏分(AL 的 VI 至 XIII 部分)在选定的治疗目标方面表现出了巨大的抗氧化和抗糖尿病潜力,这些活性馏分在使用柱层析技术进行分馏后产生了六种化合物。利用光谱技术对这些化合物的结构进行了检测,并确定其为异槲皮素、槲皮素、木犀草素、表儿茶素-3-O-(3″-O-甲基)-没食子酸酯、芹菜素-7-O-葡萄糖苷和没食子酸乙酯。分离出的化合物具有明显的 DPP-IV 抑制活性,其活性与浓度有关,其中异槲皮素的活性最高,IC50 最小(IC50 4.28 ± 0.32 µM)。在 200 µM 的浓度下,芹菜素-7-O-葡萄糖苷显示出相当大的糖化抑制效果(81.57 ± 2.66 %),超过了其他化合物的效果。此外,在浓度为 50 μM 时,芹菜素-7-O-葡萄糖苷和异槲皮素化合物能使 L6 肌细胞的葡萄糖摄取量分别增加 11.5 % 和 11 %,而标准药物二甲双胍只能增加 6.1 %。值得注意的是,这项研究首次揭示了芹菜素-7-O-葡萄糖苷和异槲皮素增强 L6 肌细胞葡萄糖摄取的潜力。其多方面的治疗潜力促使人们进一步研究其潜在的分子机制。
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引用次数: 0
Outcomes for clinical research on Chinese medicine dampness syndrome: A protocol of developing a core outcome set 中医湿证临床研究结果:核心结果集制定方案
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2023.102319
Xingying Qiu , Jun Tan , Wencong Cao , Zehuai Wen , Geng Li

Introduction

Chinese medicine (CM)/integrative medicine have been widely used to treat dampness syndrome, regarded as the main pathogenesis of many chronic diseases. Many clinical trials of CM/integrative medicine for dampness syndrome have been conducted. However, most of their conclusions should be viewed with caution because of their methodological quality defects. One of the defects is the inconsistency of outcomes, which results in obstacles to comparing and combining the results of related studies. This issue could be addressed by developing a core outcome set (COS).

Method

This study aims to develop a COS for clinical research of CM dampness syndrome (COS-CMDS). We will set up a study advisory group to organize and guide the development of the COS. The study consists of four stages: (1) a systematic review of CM dampness syndrome; (2) qualitative interviews with experts and patients to construct a preliminary outcome pool based on the systematic review; (3) a two-round Delphi survey; and (4) a consensus meeting to determine the final COS-CMDS. This study has been approved by the institute review board and has been registered at the Core Outcome Measures in Effectiveness Trials Initiative (COMET) database (https://www.comet-initiative.org/Studies/Details/1950).

Discussion

The development of COS-CMDS will provide a reference for outcome selection in clinical research on CM dampness syndrome, and contribute to the combination and comparison of results reported during systematic reviews and meta-analyses. It may help generate more high-quality evidence.

Conclusion

COS-CMDS will standardize the selection and reporting of outcomes in clinical research of CM dampness syndrome. It will be published in appropriate ways to promote further widespread use after completion.

中医/中西医结合已被广泛应用于治疗湿证,湿证被认为是许多慢性疾病的主要病机。中医与中西医结合治疗湿证的临床试验较多。然而,他们的大多数结论应该谨慎看待,因为他们的方法质量缺陷。其中一个缺陷是结果的不一致性,这给相关研究结果的比较和结合带来了障碍。这个问题可以通过开发核心结果集(COS)来解决。方法本研究旨在建立中医湿证(COS- cmds)临床研究的COS。我们将成立一个研究咨询小组,组织和指导COS的发展。本研究分为四个阶段:(1)CM湿证的系统综述;(2)对专家和患者进行定性访谈,在系统评价的基础上构建初步结果库;(3)两轮德尔菲调查;(4)召开协商一致会议,确定最终的COS-CMDS。本研究已获得研究所评审委员会批准,并已在COMET (Core Outcome Measures in Effectiveness Trials Initiative)数据库注册(https://www.comet-initiative.org/Studies/Details/1950).DiscussionThe),为CM湿证临床研究的结局选择提供参考,并有助于系统评价和meta分析中报告的结果的合并和比较。它可能有助于产生更多高质量的证据。结论cos - cmds将规范CM湿证临床研究结果的选择和报告。完成后将以适当方式出版,以促进进一步广泛使用。
{"title":"Outcomes for clinical research on Chinese medicine dampness syndrome: A protocol of developing a core outcome set","authors":"Xingying Qiu ,&nbsp;Jun Tan ,&nbsp;Wencong Cao ,&nbsp;Zehuai Wen ,&nbsp;Geng Li","doi":"10.1016/j.eujim.2023.102319","DOIUrl":"10.1016/j.eujim.2023.102319","url":null,"abstract":"<div><h3>Introduction</h3><p>Chinese medicine (CM)/integrative medicine have been widely used to treat dampness syndrome, regarded as the main pathogenesis of many chronic diseases. Many clinical trials of CM/integrative medicine for dampness syndrome have been conducted. However, most of their conclusions should be viewed with caution because of their methodological quality defects. One of the defects is the inconsistency of outcomes, which results in obstacles to comparing and combining the results of related studies. This issue could be addressed by developing a core outcome set (COS).</p></div><div><h3>Method</h3><p>This study aims to develop a COS for clinical research of CM dampness syndrome (COS-CMDS). We will set up a study advisory group to organize and guide the development of the COS. The study consists of four stages: (1) a systematic review of CM dampness syndrome; (2) qualitative interviews with experts and patients to construct a preliminary outcome pool based on the systematic review; (3) a two-round Delphi survey; and (4) a consensus meeting to determine the final COS-CMDS. This study has been approved by the institute review board and has been registered at the Core Outcome Measures in Effectiveness Trials Initiative (COMET) database (<span>https://www.comet-initiative.org/Studies/Details/1950</span><svg><path></path></svg>).</p></div><div><h3>Discussion</h3><p>The development of COS-CMDS will provide a reference for outcome selection in clinical research on CM dampness syndrome, and contribute to the combination and comparison of results reported during systematic reviews and meta-analyses. It may help generate more high-quality evidence.</p></div><div><h3>Conclusion</h3><p>COS-CMDS will standardize the selection and reporting of outcomes in clinical research of CM dampness syndrome. It will be published in appropriate ways to promote further widespread use after completion.</p></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"66 ","pages":"Article 102319"},"PeriodicalIF":2.5,"publicationDate":"2024-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S1876382023000951/pdfft?md5=ed3d337fa42c2ab933e2f26bca2034ef&pid=1-s2.0-S1876382023000951-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138508598","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
Phytochemical profile by LC-MS/MS analysis and evaluation of antioxidant, antidiabetic, anti-Alzheimer, and anticancer activity of Onobrychis argyrea leaf extracts 通过 LC-MS/MS 分析植物化学成分概况,并评估 Onobrychis argyrea 叶提取物的抗氧化、抗糖尿病、抗老年痴呆和抗癌活性
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2024.102337
Esma Yeniçeri , Ahmet Altay , Ekrem Koksal , Sevgi Altın , Parham Taslimi , Mustafa Abdullah Yılmaz , Oğuz Cakir , Abbas Tarhan , Ali Kandemir

Introduction

Studies on different species of Onobrychis, a member of the Fabaceae family, have revealed a number of biological activities with potential applications in alternative medicine. The phytochemical content of the plant Onobrychis argyrea subsp. argyrea and some of the important biological activities linked to its metabolism are quite limited. Therefore, this study was the first to determine the content of secondary metabolites in this species and to elucidate important biological activities related to metabolism.

Methods

LC-MS/MS was used for the quantitative analysis of bioactive compounds in the aerial part of O. argyrea extracts. The antioxidant properties of the extracts were assessed based on their ability to scavenge DPPH radicals and reduce iron ions. The anti-diabetic effect of the extracts was tested by the inhibition of α-amylase and α-glycosidase enzymes, and the anti-Alzheimer's ability was tested by the inhibition of the enzymes AChE and BChE. The cytotoxic effects of the extracts were tested on four different cancer lines, namely A-549, HT-29, MCF-7 and MDA-MB 453 using the XTT assay. The mechanism of the anti-cancer effect was determined by means of flow cytometry analysis on HT-29 cells.

Results

Twenty-nine phytochemicals were identified via the LC-MS/MS analysis in the plant extracts. The most abundant phytochemicals in the extracts were quinic acid, isoquercitrin, epicatechin, and routine, respectively. Antioxidant analysis showed that among all extracts, methanol extract (ME) was most effective in scavenging DPPH (IC50: 23.93 ± 0.96 µg/mL) and in reducing iron ions (53.24 ± 2.14 mgTEAC/g). Enzyme activity studies demonstrated that ME is a potent inhibitor of α-glycosidase (IC50: 15.06±0.64 µg/mL), AChE (IC50: 24.75±0.76 µg/mL), and BChE (IC50: 3.36±0.14 µg/mL). XTT assay results disclosed the strongest anti-proliferative activity of ME against the human colorectal adenocarcinoma HT-29 cell line with an IC50 value of 33.35±0.92 µg/mL. Flow cytometry analysis revealed that ME caused mitochondrial membrane damage in HT-29 cells (**p<0.01) and subsequently induced apoptosis (**p<0.01) by activating the caspase pathway (**p<0.001).

Conclusion

O. argyrea, rich in bioactive compounds, showed remarkable antioxidant, antidiabetic, Alzheimer's, and anticancer properties in vitro, demonstrating that this plant contains secondary metabolites that may be potential drug candidates for the treatment of metabolic diseases.

引言对豆科植物 Onobrychis 不同物种的研究揭示了其在替代医学中具有潜在应用价值的多种生物活性。关于箭毒草亚种(Onobrychis argyrea subsp. argyrea)的植物化学成分含量以及与其新陈代谢相关的一些重要生物活性的研究还很有限。因此,本研究首次测定了该物种中次生代谢物的含量,并阐明了与新陈代谢相关的重要生物活性。根据提取物清除 DPPH 自由基和还原铁离子的能力评估了提取物的抗氧化性。通过抑制α-淀粉酶和α-糖苷酶测试了提取物的抗糖尿病作用,通过抑制 AChE 和 BChE 测试了提取物的抗老年痴呆能力。利用 XTT 试验检测了提取物对四种不同癌株(即 A-549、HT-29、MCF-7 和 MDA-MB 453)的细胞毒性作用。结果通过 LC-MS/MS 分析鉴定了植物提取物中的 29 种植物化学物质。提取物中含量最高的植物化学物质分别是奎宁酸、异槲皮素、表儿茶素和常规。抗氧化分析表明,在所有提取物中,甲醇提取物(ME)对清除 DPPH(IC50:23.93 ± 0.96 µg/mL)和还原铁离子(53.24 ± 2.14 mgTEAC/g)最为有效。酶活性研究表明,ME 是 α-糖苷酶(IC50:15.06±0.64 µg/mL)、AChE(IC50:24.75±0.76 µg/mL)和 BChE(IC50:3.36±0.14 µg/mL)的强效抑制剂。XTT 检测结果显示,ME 对人类结直肠腺癌 HT-29 细胞株的抗增殖活性最强,IC50 值为 33.35±0.92 µg/mL。流式细胞仪分析表明,ME会导致HT-29细胞线粒体膜损伤(**p<0.01),随后通过激活caspase途径诱导细胞凋亡(**p<0.01)(**p<0.001)。
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引用次数: 0
Effect of transcutaneous electrical acupoint stimulation on sleep quality: A systematic review and meta-analysis 经皮穴位电刺激对睡眠质量的影响:系统回顾与荟萃分析
IF 2.5 4区 医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE Pub Date : 2024-02-01 DOI: 10.1016/j.eujim.2024.102338
Jia-rui Zhang , Yi Ruan , Xin Wang , Yan-li You , Zi-fei Yin , Wei Gu

Introduction

Poor sleep quality may have a negative effect on health. Clinical studies have assessed the ability of transcutaneous electrical acupoint stimulation (TEAS) to improve sleep quality. This review aims to explore the efficacy and safety of TEAS to improve sleep quality, as well as the most promising application scenarios for TEAS.

Methods

Eight databases were searched from their inception to 25 March 2023 to identify randomized controlled trials (RCTs) of the effects of TEAS on sleep quality compared to sham stimulation or pharmacotherapy. In the meta-analysis, Pittsburgh sleep quality index (PSQI) global score was the main outcome. The methodological quality of each included article was assessed using the Cochrane Risk of Bias tool. Publication bias was assessed by funnel plots.

Results

A total of 16 studies involving 1555 participants met the inclusion criteria. Twelve RCTs had low or moderate risk of bias and four RCTs had high risk of bias. Overall, the findings indicated that TEAS was effective in improving sleep quality (mean difference (MD) -2.22; 95% confidence interval (CI) [-3.29, -1.15]; p<0.0001) with high heterogeneity (I2=92%; p<0.00001). Among different causes of insomnia, TEAS was found to be effective in patients with postoperative insomnia (MD -0.95; 95% CI [-1.62, -0.27]; p=0.006; I2=66%). Subgroup analyses showed that TEAS was more effective in middle-aged patients (MD -1.60; 95% CI [-2.14, -1.06]; p<0.00001; I2=0%), and Neiguan (PC6) and Hegu (LI4) were effective acupoints during the perioperative period (MD -1.45; 95% CI [-1.95, -0.95]; p<0.00001; I2=6%). Four studies reported adverse effects, none of which were serious.

Conclusions

TEAS could effectively improve postoperative insomnia. For postoperative insomnia, the effect of TEAS was more significant in middle-aged patients, and simultaneous stimulation of PC6 and LI4 was effective. However, due to the small number of included studies and variation in patient types, additional high-quality, large-scale, multicenter RCTs of the effect of TEAS on sleep quality are needed.

Registration

CRD42023440453.

Funding

Military Special Program to Cultivate and Improve TCM Service Capability [2021ZY002]; Shanghai “Science and Technology Innovation Action Plan” Yangfan Project [23YF1459200].

导言:睡眠质量差可能会对健康产生负面影响。临床研究评估了经皮穴位电刺激(TEAS)改善睡眠质量的能力。本综述旨在探讨经皮穴位电刺激对改善睡眠质量的有效性和安全性,以及经皮穴位电刺激最有前景的应用场景。方法检索了从开始到2023年3月25日的8个数据库,以确定与假刺激或药物治疗相比,经皮穴位电刺激对睡眠质量影响的随机对照试验(RCT)。在荟萃分析中,匹兹堡睡眠质量指数(PSQI)总分是主要结果。采用科克伦偏倚风险工具评估了每篇纳入文章的方法学质量。结果 共有 16 项研究符合纳入标准,涉及 1555 名参与者。其中 12 项研究存在低度或中度偏倚风险,4 项研究存在高度偏倚风险。总体而言,研究结果表明,TEAS能有效改善睡眠质量(平均差(MD)-2.22;95%置信区间(CI)[-3.29,-1.15];p<0.0001),异质性较高(I2=92%;p<0.00001)。在不同的失眠原因中,TEAS对术后失眠患者有效(MD -0.95;95% CI [-1.62,-0.27];P=0.006;I2=66%)。亚组分析显示,TEAS对中年患者更有效(MD-1.60;95% CI [-2.14,-1.06];p<0.00001;I2=0%),内关(PC6)和合谷(LI4)是围手术期的有效穴位(MD-1.45;95% CI [-1.95,-0.95];p<0.00001;I2=6%)。四项研究报告了不良反应,均不严重。对于术后失眠,TEAS对中年患者的效果更为显著,同时刺激PC6和LI4有效。然而,由于纳入的研究数量较少,且患者类型存在差异,因此需要就TEAS对睡眠质量的影响进行更多高质量、大规模、多中心的RCT研究。
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引用次数: 0
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