European Journal of Integrative Medicine最新文献_第9页

Traditional herbal medicine as an adjuvant therapy for preventing the recurrence of hepatocellular carcinoma after radical resection: Development and validation of a machine learning prediction model 传统草药作为预防肝癌根治后复发的辅助治疗：机器学习预测模型的开发和验证

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-08-06 DOI: 10.1016/j.eujim.2025.102535

Xinyu Yue , Meihuan Fu , Song Yu , Huayue Shi , Simo Cheng , Xiaofeng Zhai

Introduction

Hepatocellular carcinoma (HCC) is the most prevalent pathological subtype of primary liver cancer. Although numerous studies have proposed models to predict recurrence following radical resection of HCC, none have accounted for the potential impact of traditional Chinese medicine (TCM). This study aims to evaluate whether adjuvant therapy with traditional herbal medicine (THM) can extend recurrence-free survival (RFS) in patients with HCC and to develop clinical prognostic models to aid in assessing the risk of recurrence after hepatectomy.

Methods

Clinical data from 403 patients who underwent radical resection at Shanghai Changhai Hospital from 2002 to 2023 were collected. Patients were categorized into THM and non-THM groups on the basis of whether they received THM therapy in the early postoperative period following HCC resection, and survival analysis was conducted to assess the differences in RFS and overall survival (OS) between the two groups. To build the models, the data were split into training and testing sets. Twenty-one variables were selected using Lasso regression, and predictive models were subsequently constructed employing Cox proportional hazards regression and the random survival forest (RSF) method. A nomogram was then developed based on the Cox regression model. The models were validated and compared based on their discriminatory power, calibration performance, and clinical utility. A nomogram was then developed based on the Cox regression model.

Results

RFS was significantly better in the THM group than in the non-THM group (p < 0.001), but there was no difference in OS between the two groups. The median RFS was 48.13 (95 % CI, 38.63, 57.64) months vs 18.07 months (95 % CI, 13.09, 23.04), and the 1-, 3-, and 5-year RFS rates in the THM and non-THM groups were 82.26 % vs 62.58 %, 62.10 % vs 35.55 % and 45.56 % vs 29.03 %, respectively. The variables identified through Lasso regression—including THM intervention, age, postoperative AFP levels, cirrhosis, tumor diameter, and gender—were incorporated into the development of both Cox and RSF models. Both models exhibited comparable performance with respect to discrimination, calibration, and clinical utility.

Conclusion

THM adjuvant therapy following HCC resection can effectively reduce the risk of early recurrence; however, it does not significantly extend overall survival. Cox regression and RSF prediction models were successfully established, and their combined application may aid clinicians in estimating individual recurrence risk and formulating personalized treatment strategies.

肝细胞癌（HCC）是原发性肝癌中最常见的病理亚型。尽管许多研究提出了预测肝癌根治后复发的模型，但没有一个研究考虑到中药（TCM）的潜在影响。本研究旨在评估传统草药（THM）辅助治疗是否可以延长HCC患者的无复发生存期（RFS），并建立临床预后模型以帮助评估肝切除术后复发的风险。方法收集2002 ~ 2023年在上海长海医院行根治性手术的403例患者的临床资料。根据HCC切除术后早期是否接受THM治疗，将患者分为THM组和非THM组，并进行生存分析，评估两组患者RFS和总生存期（OS）的差异。为了建立模型，数据被分成训练集和测试集。采用Lasso回归选择21个变量，采用Cox比例风险回归和随机生存森林（RSF）法构建预测模型。然后在Cox回归模型的基础上建立了一个nomogram。根据模型的鉴别能力、校准性能和临床效用对模型进行验证和比较。然后在Cox回归模型的基础上建立了一个nomogram。结果THM组的rfs明显优于非THM组（p < 0.001），但两组间OS无差异。中位RFS为48.13个月（95% CI, 38.63, 57.64） vs 18.07个月（95% CI, 13.09, 23.04）， THM组和非THM组的1、3、5年RFS率分别为82.26% vs 62.58%, 62.10% vs 35.55%和45.56% vs 29.03%。通过Lasso回归确定的变量——包括THM干预、年龄、术后AFP水平、肝硬化、肿瘤直径和性别——被纳入Cox和RSF模型的开发。两种模型在鉴别、校准和临床应用方面表现出相当的性能。结论肝癌切除术后thm辅助治疗可有效降低早期复发风险；然而，它并没有显著延长总生存期。Cox回归和RSF预测模型成功建立，两者的联合应用可以帮助临床医生估计个体复发风险，制定个性化治疗策略。

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引用次数: 0

Complementary and alternative medicine use among patients with diabetes mellitus in Iran: A systematic review and meta-analysis 伊朗糖尿病患者使用补充和替代药物：一项系统回顾和荟萃分析

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-08-05 DOI: 10.1016/j.eujim.2025.102533

Seyede Maryam Najibi, Seyede Hamide Rajaie, Mohadeseh Ostovar, Mohammad Hashem Hashempur

Introduction

This study aimed to systematically review the literature on the use of complementary and alternative medicine (CAM) among patients with diabetes in Iran.

Methods

Relevant studies were identified by searching international and Iranian databases up to August 2024. After study selection and data extraction, meta-analyses of proportions were performed using the DerSimonian and Laird random effects model. Subgroup analysis and sensitivity analysis were conducted to explore the sources of heterogeneity and evaluate the robustness of overall effects, respectively.

Results

The pooled prevalence of CAM use from nine studies was 62%. Heterogeneity was very high (I-squared (I²) = 99.03%) with a wide 95% prediction interval range of 14–95%. The most significant factor increasing the likelihood of CAM use was a positive attitude toward the safety of CAM. The most common sources of information on CAM were family and friends. Additionally, almost half of the participants disclosed the use of CAM to their healthcare provider.

Conclusion

The high prevalence of CAM use, alongside low rates of patient disclosure, underscores the critical importance of physician-patient communication. This reality makes it crucial for health professionals to engage in open discussions with patients about their CAM use, ensuring that such practices are safe and effective in conjunction with conventional diabetes management. Further research is recommended to explore the specific types of CAM utilized and their impacts on treatment success, and patient satisfaction.

本研究旨在系统回顾伊朗糖尿病患者使用补充和替代医学（CAM）的文献。方法检索截至2024年8月的国际和伊朗数据库，确定相关研究。在研究选择和数据提取后，采用DerSimonian和Laird随机效应模型对比例进行meta分析。进行亚组分析和敏感性分析，分别探讨异质性来源和评估总体效果的稳健性。结果9项研究中CAM使用的总患病率为62%。异质性非常高（i²(I2) = 99.03%）， 95%预测区间范围为14-95%。增加使用辅助治疗可能性的最显著因素是对辅助治疗安全性的积极态度。关于CAM最常见的信息来源是家人和朋友。此外，几乎一半的参与者向他们的医疗保健提供者透露了CAM的使用情况。结论CAM的高使用率和低患者披露率突出了医患沟通的重要性。这一现实使得卫生专业人员必须与患者就其辅助医学的使用进行公开讨论，确保这种做法与传统的糖尿病管理相结合是安全有效的。建议进一步研究所使用的CAM的具体类型及其对治疗成功和患者满意度的影响。

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引用次数: 0

Protocol for the development and validation of a patient centered assessment method questionnaire – patient version (PCAM-P) for use in chiropractic care generative 开发和验证以患者为中心的评估方法问卷-患者版本（PCAM-P）用于脊椎指压治疗生成的协议

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-26 DOI: 10.1016/j.eujim.2025.102530

Cassie M. Argenbright , Hayden J. Chighizola , Kent J. Stuber , Christopher A. Malaya

Introduction

The biopsychosocial (BPS) model offers a holistic framework for patient care, yet its implementation in chiropractic settings remains limited. The Patient-Centered Assessment Method (PCAM) evaluates patient complexity within the BPS model but lacks a corresponding tool for direct patient self-report. This study aims to develop and validate a patient-facing version of the PCAM (PCAM-P) tailored specifically for chiropractic care, enabling comparison between patient and provider perspectives on BPS needs.

Methods

A multi-phase design will guide the development, refinement, and validation of the PCAM-P. Initial adaptation will involve expert review to ensure conceptual alignment with the original PCAM. Pilot testing and validation phases will assess face validity, construct validity, and reliability, including analyses of internal consistency and patient-provider congruency. Participants will include chiropractic patients presenting with pain and their providers, with data collected via secure, online platforms. Demographic and clinical information will be incorporated into all analyses. Primary outcomes will include the PCAM-P’s reliability and validity in assessing biopsychosocial complexity in chiropractic care. Secondary outcomes will evaluate the congruency of patient-provider assessments and the tool’s feasibility and utility in supporting BPS-informed communication and care delivery.

Discussion

This is the first study to develop and evaluate a mirrored BPS assessment tool specifically for chiropractic patients. The PCAM-P is designed to improve patient-provider communication, enhance care alignment, and support the integration of biopsychosocial principles into routine chiropractic practice.

Conclusion

The PCAM-P aims to provide a validated, patient-centered tool for biopsychosocial assessment in chiropractic care. Study findings aim to inform clinical practice guidelines and promote interdisciplinary applications of the BPS model, advancing holistic and collaborative care.

生物心理社会（BPS）模型为患者护理提供了一个整体框架，但其在脊椎指压治疗环境中的实施仍然有限。以患者为中心的评估方法（PCAM）在BPS模型中评估患者复杂性，但缺乏相应的直接患者自我报告工具。本研究旨在开发和验证针对脊椎指压治疗的面向患者版本的PCAM (PCAM- p)，以便比较患者和提供者对BPS需求的看法。方法采用多阶段设计指导PCAM-P的研制、完善和验证。最初的调整将包括专家审查，以确保与原始PCAM的概念一致。试点测试和验证阶段将评估面部效度，结构效度和信度，包括内部一致性和患者-提供者一致性的分析。参与者将包括表现出疼痛的脊椎指压治疗患者及其提供者，数据将通过安全的在线平台收集。人口统计和临床信息将纳入所有分析。主要结果将包括PCAM-P在评估脊椎指压治疗生物心理社会复杂性方面的信度和效度。次要结果将评估患者-提供者评估的一致性，以及该工具在支持bps知情沟通和护理交付方面的可行性和实用性。这是第一个专门针对脊椎指压患者开发和评估镜像BPS评估工具的研究。PCAM-P旨在改善患者与提供者的沟通，增强护理一致性，并支持将生物心理社会原则整合到常规脊医实践中。结论PCAM-P旨在为捏脊治疗提供一种有效的、以患者为中心的生物心理社会评估工具。研究结果旨在为临床实践指南提供信息，促进BPS模式的跨学科应用，促进整体和协作护理。

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引用次数: 0

An ethnobotanical study of plants and traditional herbal therapies in the Kara-Koy Gorge, Kyrgyz Republic 吉尔吉斯共和国Kara-Koy峡谷植物和传统草药疗法的民族植物学研究

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-26 DOI: 10.1016/j.eujim.2025.102529

Nurbek Aldayarov , Askarbek Tulobaev , Kadyrbai Chekirov , Gulbubu Kurmanbekova , Nazgul Imanberdieva , Gulnara Sharshenalieva , Nurjamal Omurzakova , Bermet Kydyralieva

Introduction

The Kara-Koy Gorge, located in the southern region of the Kyrgyz Republic, is home to a diverse array of plant species, many of which are known for their medicinal properties. Despite their historical use, the pharmacological properties of these plants remain largely unexplored. These species represent a potential source for the development of novel therapeutic agents. This study aimed to document traditional plant-based remedies, focusing on their preparation methods, therapeutic applications, and associated ailments, as reported by local custodians of traditional wisdom.

Methods

Ethnomedicinal data were collected between March 2021 and October 2022 through semi-structured interviews with local informants. Two ethnobotanical indices were applied to analyze the data. Plant specimens were collected, taxonomically identified, and preserved as voucher specimens.

Results

A total of 160 plant species, representing 123 genera and 47 botanical families were cited in homemade single-species herbal remedies. These remedies were employed for the treatment of 117 ailments, grouped into 14 therapeutic categories. The highest informant consensus factor values were recorded for digestive (0.86) and integumentary (0.84) disorders. Dracocephalum imberbe Bunge, D. ferganicum Lazkov, Plantago major L., and Rosa canina L. exhibited the highest use values of 0.98. Aerial parts were the most frequently used plant parts (37 %), and decoction was the predominant method of preparation (40 %).

Conclusion

The findings highlight the presence of underexplored plant species with significant ethnomedicinal potential. Future research should prioritize phytochemical profiling and pharmacological validation to substantiate and preserve this traditional local knowledge.

卡拉-科伊峡谷位于吉尔吉斯共和国南部地区，是各种植物物种的家园，其中许多以其药用价值而闻名。尽管它们的历史用途，这些植物的药理学性质仍然很大程度上未被探索。这些物种代表了开发新型治疗剂的潜在来源。本研究旨在记录传统植物疗法，重点关注其制备方法、治疗应用和相关疾病，这些都是当地传统智慧守护者所报告的。方法在2021年3月至2022年10月期间，通过对当地信息提供者的半结构化访谈收集药物数据。采用两种民族植物学指标对数据进行分析。采集植物标本，进行分类鉴定，并作为代金券标本保存。结果国产单种中药共收录植物160种，隶属47科123属。这些疗法用于治疗117种疾病，分为14种治疗类别。在消化系统疾病（0.86）和肠道疾病（0.84）中，被调查者的共识因子值最高。利用价值最高的有龙头草（dracocphalum imberbe Bunge）、铁蹄草（D. ferganicum Lazkov）、车前草（Plantago major L.）和犬月季（Rosa canina L.），均为0.98。空中部位是最常用的植物部位（37%），汤剂是主要的制备方法（40%）。结论研究结果表明，该地区存在未被充分开发的具有重要民族医药潜力的植物物种。未来的研究应优先考虑植物化学分析和药理学验证，以证实和保护这一传统的地方知识。

{"title":"An ethnobotanical study of plants and traditional herbal therapies in the Kara-Koy Gorge, Kyrgyz Republic","authors":"Nurbek Aldayarov , Askarbek Tulobaev , Kadyrbai Chekirov , Gulbubu Kurmanbekova , Nazgul Imanberdieva , Gulnara Sharshenalieva , Nurjamal Omurzakova , Bermet Kydyralieva","doi":"10.1016/j.eujim.2025.102529","DOIUrl":"10.1016/j.eujim.2025.102529","url":null,"abstract":"<div><h3>Introduction</h3><div>The Kara-Koy Gorge, located in the southern region of the Kyrgyz Republic, is home to a diverse array of plant species, many of which are known for their medicinal properties. Despite their historical use, the pharmacological properties of these plants remain largely unexplored. These species represent a potential source for the development of novel therapeutic agents. This study aimed to document traditional plant-based remedies, focusing on their preparation methods, therapeutic applications, and associated ailments, as reported by local custodians of traditional wisdom.</div></div><div><h3>Methods</h3><div>Ethnomedicinal data were collected between March 2021 and October 2022 through semi-structured interviews with local informants. Two ethnobotanical indices were applied to analyze the data. Plant specimens were collected, taxonomically identified, and preserved as voucher specimens.</div></div><div><h3>Results</h3><div>A total of 160 plant species, representing 123 genera and 47 botanical families were cited in homemade single-species herbal remedies. These remedies were employed for the treatment of 117 ailments, grouped into 14 therapeutic categories. The highest informant consensus factor values were recorded for digestive (0.86) and integumentary (0.84) disorders. <em>Dracocephalum imberbe</em> Bunge, <em>D. ferganicum</em> Lazkov, <em>Plantago major</em> L., and <em>Rosa canina</em> L. exhibited the highest use values of 0.98. Aerial parts were the most frequently used plant parts (37 %), and decoction was the predominant method of preparation (40 %).</div></div><div><h3>Conclusion</h3><div>The findings highlight the presence of underexplored plant species with significant ethnomedicinal potential. Future research should prioritize phytochemical profiling and pharmacological validation to substantiate and preserve this traditional local knowledge.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102529"},"PeriodicalIF":1.7,"publicationDate":"2025-07-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144780287","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety investigation of LIMAN technology based curcumin formulation on knee osteoarthritis: a randomized double-blind placebo-controlled trial 基于LIMAN技术的姜黄素制剂治疗膝骨关节炎的疗效和安全性研究：一项随机双盲安慰剂对照试验

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-25 DOI: 10.1016/j.eujim.2025.102531

Girish HR , Harshith N , Nehru Sai Suresh Chalichem , Abhijith Phanindra , Mohammed S. Khan , Jayant Deshpande

Introduction

Knee osteoarthritis is the most common and extensively studied form of osteoarthritis, with varying prevalence reported across studies. Although the presentation of knee osteoarthritis can differ among individuals, it typically manifests as joint pain, stiffness, and restricted mobility, often accompanied by muscle weakness and balance issues. The present clinical study aimed to evaluate the safety and efficacy of Maxicuma®, a highly bioavailable form of curcumin, made from ethanolic extract of turmeric, at two different doses in reducing the symptoms and improving the functional status in individuals with knee osteoarthritis.

Methods

A total of 180 subjects with knee osteoarthritis as per NICE criteria were recruited into the study and severity of either Grade II or Grade III was assessed by radiographic analysis as per Kellgren-Lawrence (KL) scale. Participants received a daily single dose of either placebo, Maxicuma 100 or Maxicuam 250 per day for 90 days. Efficacy was assessed using WOMAC (Western Ontario and McMaster Universities Arthritis Index), VAS (Visual analog scale) and treadmill walk test to understand severity, intensity of pain and physical performance respectively, at day 30, day 45, day 60 and day 90.

Results

The test item was well tolerated with no major adverse events reported. A total of 180 and 174 subjects were considered for intention-to-treat and per-protocol analysis, respectively. Both doses of Maxicuma® demonstrated statistical significance (p < 0.05) compared to placebo starting from day 30 across all efficacy measures.

Conclusion

Findings from this clinical study indicate that Maxicuma® 100 mg and 250 mg are effective and well-tolerated supplement options for managing knee osteoarthritis. Both dosages showed potential in improving clinical symptoms and enhancing functional outcomes.

膝骨关节炎是最常见和研究最广泛的骨关节炎形式，不同研究报告的患病率不同。虽然膝关节骨性关节炎的表现因人而异，但其典型表现为关节疼痛、僵硬和活动受限，常伴有肌肉无力和平衡问题。本临床研究旨在评估Maxicuma®的安全性和有效性，Maxicuma®是一种高度生物利用的姜黄素形式，由姜黄的乙醇提取物制成，在两种不同剂量下减轻膝骨关节炎患者的症状和改善功能状态。方法共纳入180例符合NICE标准的膝关节骨性关节炎患者，根据Kellgren-Lawrence （KL）分级，通过x线分析评估II级或III级的严重程度。参与者每天接受单剂量安慰剂，每天服用Maxicuma 100或Maxicuma 250，持续90天。分别在第30天、第45天、第60天和第90天采用WOMAC （Western Ontario and McMaster university Arthritis Index）、VAS （Visual analogue scale）和跑步机步行测试来评估疗效，以了解疼痛的严重程度、强度和身体表现。结果试验项目耐受性良好，无重大不良事件报告。共有180名和174名受试者分别被考虑进行意向治疗和方案分析。两种剂量的Maxicuma®均具有统计学意义(p <；0.05)，与安慰剂相比，从第30天开始的所有疗效测量。结论：本临床研究结果表明，Maxicuma®100 mg和250 mg是治疗膝关节骨关节炎的有效且耐受性良好的补充选择。两种剂量均显示出改善临床症状和增强功能预后的潜力。

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引用次数: 0

Knowledge, attitude, and practice toward acupuncture among dry eye disease patients: A cross-sectional study 干眼症患者针灸的知识、态度和实践：一项横断面研究

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-23 DOI: 10.1016/j.eujim.2025.102527

Ruya Sheng , Zhuo Sun , Shanshan Sun , Qing Sun , Guofu Zhou , Guangxia Ni

Introduction

Acupuncture therapy plays an important role in the treatment of dry eye disease (DED); however, the perspectives of DED patients regarding acupuncture remain unclear. This study aimed to investigate the knowledge, attitudes, and practices (KAP) related to acupuncture therapy among DED patients in Changzhou, China, and to analyze the factors influencing these dimensions.

Methods

A cross-sectional study was conducted among DED patients at Changzhou Third People's Hospital from November to December 2024. A self-designed questionnaire was used to collect demographic information, DED characteristics, and KAP-related data. Multiple linear regression analysis was employed to identify influencing factors.

Results

A total of 245 valid questionnaires were collected. The KAP-based questionnaire demonstrated good reliability (Cronbach’s a = 0.893) and validity (Kaiser-Meyer-Olkin = 0.773). According to the Ocular Surface Disease Index (OSDI), the severity distribution of DED among respondents was as follows: mild in 7 patients (2.9 %), moderate in 19 (7.8 %), and severe in 219 (89.4 %). The total scores for knowledge, attitude, and practice were 8.70±3.62, 6.43±2.07, and 13.85±4.01, respectively. Practice scores were significantly associated with OSDI-symptom scores (β=0.337,p < 0.01), OSDI-impact on life scores (β=0.244, p < 0.01), knowledge scores (β=0.130, p = 0.023), and attitude scores (β=0.772, p < 0.01).

Conclusion

Healthcare professionals should strengthen health education for DED patients to improve their knowledge and acceptance of acupuncture therapy. It is also essential to consider the specific impact of DED on patients’ daily lives and to provide personalized treatment recommendations accordingly.

针刺疗法在干眼病（DED）的治疗中发挥着重要作用；然而，DED患者对针灸的看法尚不清楚。本研究旨在调查常州市DED患者针灸治疗相关知识、态度和行为（KAP），并分析影响这些维度的因素。方法对常州市第三人民医院2024年11 - 12月住院的DED患者进行横断面研究。采用自行设计的问卷收集人口统计信息、DED特征和kapa相关数据。采用多元线性回归分析确定影响因素。结果共回收有效问卷245份。问卷具有良好的信度（Cronbach’s a = 0.893）和效度（Kaiser-Meyer-Olkin = 0.773）。根据眼表疾病指数（OSDI），调查对象中DED的严重程度分布为：轻度7例（2.9%），中度19例（7.8%），重度219例（89.4%）。知识、态度、实践总分分别为8.70±3.62分、6.43±2.07分、13.85±4.01分。练习得分与osdi症状得分显著相关(β=0.337,p <；0.01)， osdi对生活评分的影响(β=0.244, p <；0.01)、知识得分（β=0.130, p = 0.023）、态度得分(β=0.772, p <；0.01)。结论医护人员应加强对DED患者的健康教育，提高患者对针灸疗法的认识和接受程度。考虑DED对患者日常生活的具体影响，并据此提供个性化的治疗建议也是必要的。

{"title":"Knowledge, attitude, and practice toward acupuncture among dry eye disease patients: A cross-sectional study","authors":"Ruya Sheng , Zhuo Sun , Shanshan Sun , Qing Sun , Guofu Zhou , Guangxia Ni","doi":"10.1016/j.eujim.2025.102527","DOIUrl":"10.1016/j.eujim.2025.102527","url":null,"abstract":"<div><h3>Introduction</h3><div>Acupuncture therapy plays an important role in the treatment of dry eye disease (DED); however, the perspectives of DED patients regarding acupuncture remain unclear. This study aimed to investigate the knowledge, attitudes, and practices (KAP) related to acupuncture therapy among DED patients in Changzhou, China, and to analyze the factors influencing these dimensions.</div></div><div><h3>Methods</h3><div>A cross-sectional study was conducted among DED patients at Changzhou Third People's Hospital from November to December 2024. A self-designed questionnaire was used to collect demographic information, DED characteristics, and KAP-related data. Multiple linear regression analysis was employed to identify influencing factors.</div></div><div><h3>Results</h3><div>A total of 245 valid questionnaires were collected. The KAP-based questionnaire demonstrated good reliability (Cronbach’s <em>a</em> = 0.893) and validity (Kaiser-Meyer-Olkin = 0.773). According to the Ocular Surface Disease Index (OSDI), the severity distribution of DED among respondents was as follows: mild in 7 patients (2.9 %), moderate in 19 (7.8 %), and severe in 219 (89.4 %). The total scores for knowledge, attitude, and practice were 8.70±3.62, 6.43±2.07, and 13.85±4.01, respectively. Practice scores were significantly associated with OSDI-symptom scores (<em>β</em>=0.337,<em>p</em> < 0.01), OSDI-impact on life scores (<em>β</em>=0.244, <em>p</em> < 0.01), knowledge scores (<em>β</em>=0.130, <em>p</em> = 0.023), and attitude scores (<em>β</em>=0.772, <em>p</em> < 0.01).</div></div><div><h3>Conclusion</h3><div>Healthcare professionals should strengthen health education for DED patients to improve their knowledge and acceptance of acupuncture therapy. It is also essential to consider the specific impact of DED on patients’ daily lives and to provide personalized treatment recommendations accordingly.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102527"},"PeriodicalIF":1.7,"publicationDate":"2025-07-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144763618","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Efficacy and safety of East Asian herbal medicine for treating depression in older adults: A systematic review and meta-analysis 东亚草药治疗老年人抑郁症的疗效和安全性：一项系统回顾和荟萃分析

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-22 DOI: 10.1016/j.eujim.2025.102528

Sang-Ho Kim , Ga-Young Jung

Introduction

Traditional East Asian herbal medicine (EAHM) has been used for centuries to treat depression. This review aimed to analyze the effectiveness and safety of EAHM in older adults with depression.

Methods

Eleven electronic databases were searched on May 30, 2024, for randomized controlled trials (RCTs) of EAHM for depression in older adults. The Cochrane risk of bias tool assessed the studies’ quality. We evaluated the efficacy and safety of EAHM for depression in older adults through a meta-analysis.

Results

Twenty RCTs (1681 participants) were included. Pooled results suggested that the efficacy of EAHM alone was similar to antidepressants alone in terms of the Hamilton depression scale (HAMD) scores (standardized mean difference [SMD], -0.60; 95% confidence interval [CI], -1.72 to 0.52; P = 0.29). The combination of EAHM with either antidepressants alone or antidepressants plus antihypertensive drugs yielded a statistically significant improvement in HAMD scores (SMD = -2.50, 95% CI: -3.37 to -1.63, P < 0.001) and total effective rate (TER) (RR = 1.20, 95% CI: 1.11–1.30; P < 0.001). The risk of adverse events was lower with EAHM alone compared to antidepressants alone, while combination therapy showed a similar risk. The overall risk of bias was high, and the evidence level ranged from very low to moderate.

Conclusion

This study indicates that EAHM, as monotherapy or adjunctive therapy to antidepressants, may benefit depression in older adults. However, the meta-analysis results may be overestimated due to the limited number of studies, their low methodological quality, and clinical heterogeneity. Therefore, the evidence remains inconclusive, and further studies are warranted.

几个世纪以来，传统的东亚草药（EAHM）一直被用来治疗抑郁症。本综述旨在分析EAHM治疗老年抑郁症的有效性和安全性。方法于2024年5月30日检索EAHM治疗老年人抑郁症的随机对照试验（rct）。Cochrane偏倚风险工具评估了研究的质量。我们通过荟萃分析评估了EAHM治疗老年人抑郁症的有效性和安全性。结果共纳入20项随机对照试验（rct），共1681名受试者。综合结果显示，在汉密尔顿抑郁量表（HAMD）评分方面，单独使用EAHM的疗效与单独使用抗抑郁药相似(标准化平均差[SMD]， -0.60；95%置信区间[CI]， -1.72 ~ 0.52；P = 0.29)。EAHM联合抗抑郁药或抗抑郁药联合抗高血压药均可显著改善HAMD评分(SMD = -2.50, 95% CI: -3.37 ~ -1.63, P <；0.001)和总有效率（TER） (RR = 1.20, 95% CI: 1.11-1.30；P & lt;0.001)。与单独使用抗抑郁药相比，单独使用EAHM的不良事件风险较低，而联合治疗显示出相似的风险。偏倚的总体风险很高，证据水平从极低到中等。结论EAHM作为抗抑郁药的单药或辅助治疗，对老年人抑郁症有一定的疗效。然而，由于研究数量有限、方法学质量低以及临床异质性，meta分析结果可能被高估。因此，证据仍然是不确定的，需要进一步的研究。

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引用次数: 0

Comparative efficacy of health Qigong and yoga on fatigue, sleep disturbance, depression and quality of life in patients with breast cancer: A systematic review and network meta-analysis 健康气功与瑜伽对乳腺癌患者疲劳、睡眠障碍、抑郁和生活质量的比较疗效：系统综述和网络荟萃分析

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-20 DOI: 10.1016/j.eujim.2025.102526

Zhengjia Li, Jun Zhao, Xincheng Duan, Keyu Han, Xiaomin Chang, Xi Chen, Wenxiao Zhao

Introduction

Both health Qigong, a practice rooted in traditional Chinese medicine, and yoga have demonstrated effectiveness in alleviating symptoms of fatigue, sleep disturbance, and depression while enhancing the quality of life in patients with breast cancer. However, it remains unclear which specific form of health Qigong or yoga is the most effective. This study aimed to compare the efficacy of various forms of health Qigong and yoga on fatigue, sleep disturbance, and depression and quality of life in patients with breast cancer.

Methods

Ten databases were searched to identify relevant studies from inception to May 21, 2025. A distribution Bayesian network meta-analysis with non-informative prior was conducted using R 4.4.0 software. Studies that met the eligibility criteria were assessed for risk of bias and certainty of evidence.

Results

The network meta-analysis included 34 eligible studies with 2344 participants with breast cancer across five exercise modalities. For improving cancer-related fatigue, Tai Chi demonstrated the highest surface under the cumulative ranking area (SUCRA) value at 0.76; for sleep quality improvement, Baduanjin scored the highest at 0.97; Liu- Zi Jue ranked highest at 0.90 for alleviating depression; and Tai Chi also led with a SUCRA value of 0.67 for enhancing quality of life.

Conclusions

This study suggested that Tai Chi is the most effective for improving cancer-related fatigue and quality of life, while Baduanjin is optimal for enhancing sleep quality. Liu Zi Jue is best suited for alleviating depression, highlighting Tai Chi as a comprehensive exercise option.

健康气功，一种根植于中国传统医学的练习，和瑜伽都被证明在缓解疲劳、睡眠障碍和抑郁症状方面有效，同时提高乳腺癌患者的生活质量。然而，目前还不清楚哪种健康形式的气功或瑜伽是最有效的。本研究旨在比较不同形式的健康气功和瑜伽对乳腺癌患者疲劳、睡眠障碍、抑郁和生活质量的影响。方法检索自成立至2025年5月21日的10个数据库进行相关研究。采用r4.4.0软件进行非信息先验的分布贝叶斯网络元分析。对符合入选标准的研究进行偏倚风险和证据确定性评估。网络荟萃分析包括34项符合条件的研究，涉及5种运动方式的2344名乳腺癌患者。在改善癌症相关疲劳方面，太极拳在累积排序面积（SUCRA）值下显示出最高的表面，为0.76；在改善睡眠质量方面，八段锦得分最高，为0.97；六子觉在缓解抑郁方面得分最高，为0.90；太极拳在提高生活质量方面也以0.67的SUCRA值领先。本研究表明，太极拳对改善癌症相关的疲劳和生活质量最有效，而八段筋对提高睡眠质量最有效。六子觉最适合缓解抑郁症，强调太极拳是一种全面的锻炼选择。

{"title":"Comparative efficacy of health Qigong and yoga on fatigue, sleep disturbance, depression and quality of life in patients with breast cancer: A systematic review and network meta-analysis","authors":"Zhengjia Li, Jun Zhao, Xincheng Duan, Keyu Han, Xiaomin Chang, Xi Chen, Wenxiao Zhao","doi":"10.1016/j.eujim.2025.102526","DOIUrl":"10.1016/j.eujim.2025.102526","url":null,"abstract":"<div><h3>Introduction</h3><div>Both health Qigong, a practice rooted in traditional Chinese medicine, and yoga have demonstrated effectiveness in alleviating symptoms of fatigue, sleep disturbance, and depression while enhancing the quality of life in patients with breast cancer. However, it remains unclear which specific form of health Qigong or yoga is the most effective. This study aimed to compare the efficacy of various forms of health Qigong and yoga on fatigue, sleep disturbance, and depression and quality of life in patients with breast cancer.</div></div><div><h3>Methods</h3><div>Ten databases were searched to identify relevant studies from inception to May 21, 2025. A distribution Bayesian network meta-analysis with non-informative prior was conducted using R 4.4.0 software. Studies that met the eligibility criteria were assessed for risk of bias and certainty of evidence.</div></div><div><h3>Results</h3><div>The network meta-analysis included 34 eligible studies with 2344 participants with breast cancer across five exercise modalities. For improving cancer-related fatigue, Tai Chi demonstrated the highest surface under the cumulative ranking area (SUCRA) value at 0.76; for sleep quality improvement, Baduanjin scored the highest at 0.97; Liu- Zi Jue ranked highest at 0.90 for alleviating depression; and Tai Chi also led with a SUCRA value of 0.67 for enhancing quality of life.</div></div><div><h3>Conclusions</h3><div>This study suggested that Tai Chi is the most effective for improving cancer-related fatigue and quality of life, while Baduanjin is optimal for enhancing sleep quality. Liu Zi Jue is best suited for alleviating depression, highlighting Tai Chi as a comprehensive exercise option.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"79 ","pages":"Article 102526"},"PeriodicalIF":1.7,"publicationDate":"2025-07-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144724178","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

The effect of melatonin mouthwash on prevention of chemotherapy-induced oral mucositis, a randomized double blinded placebo controlled clinical trial 褪黑素漱口水对预防化疗所致口腔黏膜炎的作用，一项随机双盲安慰剂对照临床试验

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-04 DOI: 10.1016/j.eujim.2025.102523

Aida Abdi , Zaynab Sadeghi Ghadi , Maryam Daei , Elliyeh Ghadrdan

Introduction

Chemotherapy can induce a range of unpleasant adverse effects, with oral mucositis being one of the most common. This condition significantly impacts patients' quality of life and can disrupt their adherence to treatment protocols. Oral mucositis serves as an important limiting factor in chemotherapy, often necessitating dose reductions or treatment delays, which in turn can compromise the overall effectiveness of the therapy. This study was conducted to investigate the effect of melatonin mouthwash on the prevention of chemotherapy-induced oral mucositis.

Methods

Following the preparation of melatonin and placebo mouthwashes, a randomized, double-blinded, placebo-controlled clinical trial was conducted on patients with solid tumor malignancies who had no oral lesions and were treated with chemotherapy regimens. The patients began using the mouthwash on the first day of their corresponding chemotherapy course, continuing for six weeks with a frequency of three times daily, 4mL per application. At the end of each week, the patients were evaluated for the severity and duration of mucositis, as well as the associated pain. Quality of life was assessed at the study's start and weekly thereafter.

Results

Seventy patients were randomized into melatonin (n = 35) and placebo (n = 35) groups. The melatonin group had a lower incidence of mucositis (11.43 % versus 34.28 %), with a relative risk of 0.74 (95 % confidence interval (CI): 0.56 to 0.96). The severity of mucositis showed statistically significant differences between the melatonin and placebo groups at the end of the fifth week (P = 0.003) and the sixth week (P = 0.002). Additionally, the intensity of pain caused by mucositis demonstrated statistically significant differences at the end of the third week (P = 0.021), the fifth week (P = 0.001), and the sixth week (P = 0.001). There was also a significant difference in the overall duration of mucositis between the melatonin and placebo groups (mean difference -8.83, 95 %CI: -14.54 to -3.12). The mouthwash was well tolerated in both groups.

Conclusion

The findings of this study suggest that melatonin mouthwash is effective in preventing chemotherapy-induced mucositis. A six-week regimen of melatonin mouthwash significantly reduces the severity and duration of mucositis, as well as the associated pain intensity.

化疗可引起一系列不良反应，口腔黏膜炎是最常见的不良反应之一。这种情况会严重影响患者的生活质量，并可能破坏他们对治疗方案的依从性。口腔黏膜炎是化疗的一个重要限制因素，通常需要减少剂量或延迟治疗，这反过来又会损害治疗的整体有效性。本研究旨在探讨褪黑素漱口水对化疗所致口腔黏膜炎的预防作用。方法在制备褪黑素和安慰剂漱口水后，随机、双盲、安慰剂对照的临床试验，对无口腔病变的恶性实体瘤患者进行化疗。患者在相应化疗疗程的第一天开始使用漱口水，持续六周，频率为每天三次，每次4毫升。在每周结束时，评估患者的严重程度和持续时间，以及相关的疼痛。在研究开始时和之后每周对生活质量进行评估。结果70例患者随机分为褪黑素组（n = 35）和安慰剂组（n = 35）。褪黑素组的黏膜炎发生率较低（11.43%对34.28%），相对危险度为0.74（95%可信区间（CI）： 0.56 ~ 0.96）。在第5周末（P = 0.003）和第6周末（P = 0.002），褪黑素组与安慰剂组的粘膜炎严重程度有统计学差异。此外，粘膜炎引起的疼痛强度在第3周末（P = 0.021）、第5周末（P = 0.001）和第6周末（P = 0.001）差异有统计学意义。褪黑素组和安慰剂组在粘膜炎的总持续时间上也有显著差异（平均差异为-8.83,95% CI: -14.54至-3.12）。两组对漱口水的耐受性都很好。结论褪黑素漱口水对化疗引起的黏膜炎有一定的预防作用。六周的褪黑素漱口水疗法显著降低了黏膜炎的严重程度和持续时间，以及相关的疼痛强度。

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引用次数: 0

Mushrooms, gut microbiota and cancer: A scoping review of preclinical studies and emerging human data 蘑菇，肠道微生物群和癌症：临床前研究和新出现的人类数据的范围审查

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-07-03 DOI: 10.1016/j.eujim.2025.102525

Kirsten Chick, Lisa Dowling, Karen Charlesworth

Introduction

Cancer is a leading cause of death worldwide. The use of mushrooms is popular within integrative oncology, and in exploring their anti-cancer mechanisms, attention has turned to the role of mushroom-driven changes to gut microbiota. The aim of this paper is to map and synthesise the evidence that examines the impact of mushrooms on cancer-related immunological processes due to their potential interaction with the gut microbiota.

Methods

PubMed, the Cochrane Library and the Allied and Complementary Medicine Database were searched using the primary search terms “Cancer”, “Microbiota” and “Mushrooms”. Relevant data were tabulated, and studies were critically appraised and qualitatively analysed.

Results

140 studies were screened and 23 identified (20 murine, one in vitro, one in silico, and one human cross-sectional). The most frequent mushroom and cancer studied were Ganoderma lucidum and colorectal cancer, respectively. Twenty-two studies reported statistically significant gut microbiota changes, eight of which found changes to diversity, two identified changes to the Firmicutes/Bacteroidetes (F/B) ratio, four found restored cancer-related pathways in gene pathway enrichment analysis, and six found increased short chain fatty acids (SCFAs) produced by gut microbiota. One study identified anti-cancer pathways via computer modelling of mushrooms and human gut microbiota. 85% of murine studies found evidence of tumour reduction, and 12 studies found changes to cytokines.

Conclusions

In mice, mushrooms resulted in favourable changes to tumour measurements, SCFA activity and gut microbiota gene pathway enrichment. Inconsistent changes were reported in other outcomes, and the complexity of the gut microbiome and immunity makes these findings difficult to interpret. Results from murine studies are difficult to extrapolate to humans, and human studies are lacking. Further human studies are therefore recommended, and in silico research may prove valuable as technologies progress. The findings of this review are insufficient to inform any kind of treatment protocol, and further research is recommended.

癌症是世界范围内的主要死亡原因。蘑菇的使用在综合肿瘤学中很受欢迎，在探索其抗癌机制时，人们的注意力转向了蘑菇驱动的肠道微生物群变化的作用。本文的目的是绘制和综合证据，检查蘑菇对癌症相关免疫过程的影响，因为它们与肠道微生物群的潜在相互作用。方法以“Cancer”、“Microbiota”和“mushroom”为主要检索词检索spubmed、Cochrane Library和Allied and Complementary Medicine Database。将相关数据制成表格，并对研究进行严格评价和定性分析。结果筛选了140项研究，确定了23项研究（20项小鼠研究，1项体外研究，1项计算机研究和1项人体横断面研究）。研究中最常见的蘑菇和癌症分别是灵芝和结直肠癌。22项研究报告了具有统计学意义的肠道菌群变化，其中8项研究发现了多样性的变化，2项研究发现了厚壁菌门/拟杆菌门（F/B）比率的变化，4项研究在基因途径富集分析中发现了恢复的癌症相关途径，6项研究发现肠道菌群产生的短链脂肪酸（SCFAs）增加。一项研究通过对蘑菇和人类肠道微生物群的计算机建模确定了抗癌途径。85%的小鼠研究发现了肿瘤减少的证据，12项研究发现了细胞因子的变化。结论在小鼠中，蘑菇对肿瘤测量、SCFA活性和肠道菌群基因途径富集产生了有利的变化。在其他结果中报告了不一致的变化，肠道微生物组和免疫的复杂性使得这些发现难以解释。小鼠研究的结果很难推断到人类，而且缺乏人体研究。因此，建议进行进一步的人体研究，随着技术的进步，计算机研究可能被证明是有价值的。本综述的发现不足以为任何治疗方案提供信息，建议进一步研究。

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引用次数: 0