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 : 2025-09-01 Epub 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

Bailemian capsule for insomnia: a systematic review with meta-analysis 百乐眠胶囊治疗失眠症：荟萃分析的系统评价

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-08-07 DOI: 10.1016/j.eujim.2025.102537

Yifan Yang , Qinghao Cai , Jiayu Huang , Runru Mai , Yuanyuan Hu , Lijun Ouyang , Zhimin Yang , Biyun Xu

Introduction

: Bailemian capsule is a Chinese patent medicine widely used for insomnia. Recently, numerous new randomized controlled trials (RCTs) have been published. Our objective was to evaluate the efficacy and safety of Bailemian capsule.

Methods

: Seven databases (EMBASE, PubMed, the Cochrane library, Web of Science, Chinese National Knowledge Infrastructure, Wanfang database and China Biomedical Literature database) were searched for RCTs of Bailemian capsule as of 24 February 2024. Primary outcomes were assessed with the Pittsburgh Sleep Quality Index (PSQI). The risk of bias was assessed by the Cochrane Collaboration's tool, and meta- analysis was performed using Review Manager 5.3. The review was registered in PROSPERO (CRD42024507706).

Results

: A total of 15 RCTs involving 1547 participants were included. Compared with monotherapy, combining Bailemian capsules with sedating psychotropic drugs (MD = -3.74, 95 % CI [-4.99, -2.48], Z = 5.85, P < 0.00001, I²= 87 %) or non-sedating psychotropic drugs (MD = -2.84, 95 % CI [-4.61, -1.08], Z = 3.16, P = 0.002, I²= 95 %) significantly reduced PSQI scores in patients with insomnia. The combination with non-sedating psychotropic drugs also significantly improved PSQI scores in patients with anxiety insomnia (MD = -1.28, 95 % CI [-1.85, -0.72], Z = 3.16, P < 0.00001, I² = 0 %) and depressive/anxiety insomnia (MD = -4.34, 95 % CI [-4.91, -3.77], Z = 4.49, P < 0.00001, I² = 0 %). Compared with sedating psychotropic drugs, the combination with Bailemian capsules led to greater reductions in PSQI scores in patients with insomnia disorder (MD = -3.55, 95 % CI: [-5.09, -2.00]; Z = 4.49, P = 0.0002, I2=92.9 %). Furthermore, the combination significantly reduced the incidence of adverse events compared with sedating (RR = 0.29, 95 % CI 0.17–0.50, Z = 4.47, P < 0.00001, I² = 0 %) and non-sedating psychotropic drugs alone (RR = 0.42, 95 % CI 0.25–0.69, Z = 3.42, P = 0.0006, I² = 0 %).

Conclusion

: This meta-analysis provides evidence for the efficacy and safety of Bailemian capsule in treating insomnia. However, with high heterogeneity and high risk of bias of the included studies, the recommendation of this conclusion remains cautious and requires further validation by high-quality clinical studies.

介绍：百乐眠胶囊是一种广泛用于治疗失眠的中成药。最近，许多新的随机对照试验（rct）被发表。我们的目的是评价百乐眠胶囊的有效性和安全性。方法：检索截至2024年2月24日的7个数据库（EMBASE、PubMed、Cochrane图书馆、Web of Science、中国国家知识基础设施、万方数据库和中国生物医学文献数据库），检索白莲面胶囊的rct。主要结果用匹兹堡睡眠质量指数（PSQI）进行评估。偏倚风险由Cochrane协作工具评估，meta分析使用Review Manager 5.3进行。该综述已在PROSPERO注册（CRD42024507706）。结果：共纳入15项rct， 1547名受试者。与单药治疗相比，百乐眠胶囊与镇静精神药物合用(MD = -3.74, 95% CI [-4.99, -2.48], Z = 5.85, P <；0.00001, I2= 87%)或非镇静性精神药物（MD = -2.84, 95% CI [-4.61, -1.08], Z = 3.16, P = 0.002, I2= 95%）显著降低失眠患者的PSQI评分。联用非镇静性精神药物也能显著改善焦虑性失眠患者的PSQI评分(MD = -1.28, 95% CI [-1.85, -0.72], Z = 3.16, P <；0.00001, I2 = 0%)和抑郁/焦虑性失眠(MD = -4.34, 95% CI [-4.91, -3.77], Z = 4.49, P <；0.00001, i2 = 0%)。与镇静精神药物相比，百乐眠胶囊对失眠患者PSQI评分的降低更大(MD = -3.55, 95% CI: [-5.09, - 2.50]；Z = 4.49, p = 0.0002, i2 = 92.9%)。此外，与镇静相比，联合用药显著降低了不良事件的发生率(RR = 0.29, 95% CI 0.17-0.50, Z = 4.47, P <；0.00001, I2 = 0%)和单独使用非镇静性精神药物（RR = 0.42, 95% CI 0.25 ~ 0.69, Z = 3.42, P = 0.0006, I2 = 0%）。结论：本荟萃分析为百乐眠胶囊治疗失眠症的有效性和安全性提供了证据。然而，由于纳入的研究具有高异质性和高偏倚风险，该结论的推荐仍然是谨慎的，需要通过高质量的临床研究进一步验证。

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引用次数: 0

Diterpenoids from Croton tonkinensis Gagnep as antitumor agents: A systematic review 巴豆中二萜类抗肿瘤物质的系统综述

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-10 DOI: 10.1016/j.eujim.2025.102513

Vo Linh Tu , Tran Thi Thuy Quynh , Nghiem Dinh Van An , Nguyen Le Linh Chi

Introduction

Traditional Vietnamese medicine has a long history of using Kho sam (Croton tonkinensis Gagnep) in the treatment of various cancers. Kho sam is an ingredient in numerous remedies for salivary gland cancer, bronchial-lung cancer, colorectal cancer, and liver cancer. This systematic review aims to comprehensively evaluate the existing literature on diterpenoids isolated from C. tonkinensis and their antitumor activities.

Methods

The protocol for this systematic review was registered in PROSPERO (CRD42024579468). A search was performed on PubMed, Virtual Health Library (VHL), Global Health Library (GHL), and Google Scholar on September 13, 2024. Two independent members conducted the steps of screening the article, scoring the risk of bias for the article, extracting and writing the results. Due to heterogeneity among the included studies, the results were narrative and no meta-analyses were conducted.

Results

From an initial retrieval of 500 articles, 11 met the inclusion criteria. These studies investigated thirty-seven different compounds, among which ent-kaurane diterpenoids with the 16-en-15-one functional group and 8,9-seco-ent-kaurane diterpenoids exhibited particularly cytotoxic effects. These effects were mediated through several molecular pathways, including protein kinase B, hypoxia-inducible factor-dependent transcription, heat shock protein, extracellular signal-regulating kinase 1/2, and AMP-activated protein kinase pathways.

Conclusions

Current literature highlights kongensin D, derived from C. tonkinensis, as the most promising candidate, demonstrating high anticancer activity and selectivity, along with in vivo antitumor potential and a favorable safety profile.

越南传统医学使用Kho sam （Croton tonkinensis Gagnep）治疗各种癌症的历史悠久。Kho sam是许多治疗唾液腺癌、支气管肺癌、结肠直肠癌和肝癌的成分。本系统综述旨在综合评价现有文献中有关冬棘二萜类化合物及其抗肿瘤活性的研究进展。方法本系统评价的方案在PROSPERO注册（CRD42024579468）。我们于2024年9月13日在PubMed、Virtual Health Library （VHL）、Global Health Library （GHL）和谷歌Scholar上进行了检索。两名独立成员进行了文章筛选、文章偏倚风险评分、提取和撰写结果的步骤。由于纳入的研究存在异质性，研究结果为叙述性，未进行meta分析。结果在初步检索的500篇文献中，有11篇符合纳入标准。研究了37种不同的化合物，其中具有16-烯-15- 1官能团的对kaurane二萜和8,9-seco- kaurane二萜具有特别的细胞毒性作用。这些作用是通过多种分子途径介导的，包括蛋白激酶B、缺氧诱导因子依赖性转录、热休克蛋白、细胞外信号调节激酶1/2和amp激活的蛋白激酶途径。结论目前的研究表明，从东金草中提取的kongensin D是最有希望的候选药物，具有较高的抗肿瘤活性和选择性，以及良好的体内抗肿瘤潜力和良好的安全性。

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引用次数: 0

Exploring the use of complementary and alternative medicine during pregnancy: A cross-sectional study from Indonesia 探索怀孕期间补充和替代药物的使用：来自印度尼西亚的横断面研究

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-05-28 DOI: 10.1016/j.eujim.2025.102507

Mukhlis Rauf , Yulia Yusrini Djabir , Abdul Rahim , Barbara Tóth , Muh. Akbar Bahar

Introduction

Complementary and alternative medicine (CAM) refers to therapies used alongside or in place of conventional medical care. CAM use during pregnancy has gained increasing attention, yet little is known about its patterns and determinants in Indonesia. This study aimed to explore CAM use among pregnant women, identify influencing factors, and assess potential herb-drug interactions.

Methods

A cross-sectional survey was conducted from August to November 2023 at a secondary hospital in Makassar, Indonesia. Pregnant women aged ≥ 18 years attending outpatient clinic were recruited through convenience sampling. Data were collected using a validated, structured questionnaire that assessed demographic characteristics, CAM and medication use, and perceptions of CAM. Potential herb-drug interactions were identified using the Indonesian Traditional Medicine Formulary and the Natural Medicines Comprehensive Database.

Results

Of the 560 respondents, 52.3 % reported currently using CAM, with herbal medicines being the most commonly used modality. Factors significantly associated with CAM use included educational level (p=0.021), gestational age (p=0.016), prior CAM use (p<0.001), CAM use among family/friends (p<0.001), and concurrent prescribed medications (p=0.003). Twelve potential herb-drug interactions were identified: eight were classified as moderate and four as minor interactions.

Conclusion

The high prevalence of CAM use among pregnant women highlights the need for healthcare providers to offer guidance on safe use and potential herb-drug interactions.

补充和替代医学（CAM）是指与传统医疗保健一起或代替传统医疗保健使用的疗法。怀孕期间CAM的使用已引起越来越多的关注，但在印度尼西亚对其模式和决定因素知之甚少。本研究旨在探讨怀孕妇女的CAM使用情况，确定影响因素，并评估潜在的草药-药物相互作用。方法于2023年8月至11月在印度尼西亚望加锡市某二级医院进行横断面调查。采用方便抽样的方法，招募年龄≥18岁门诊就诊的孕妇。数据收集使用有效的，结构化的问卷，评估人口特征，辅助生殖和药物使用，以及对辅助生殖的看法。利用印度尼西亚传统药物处方集和天然药物综合数据库确定潜在的草药相互作用。结果在560名答复者中，52.3%的人报告目前正在使用替代药物，其中草药是最常用的方式。与CAM使用显著相关的因素包括教育水平（p=0.021）、胎龄（p=0.016）、以前使用过CAM （p= 0.001）、家人/朋友使用CAM （p= 0.001）和同时服用处方药（p=0.003）。确定了12种潜在的草药相互作用：8种为中度相互作用，4种为轻微相互作用。结论孕妇中草药替代疗法的高使用率突出了卫生保健提供者在安全使用和潜在的中草药相互作用方面提供指导的必要性。

{"title":"Exploring the use of complementary and alternative medicine during pregnancy: A cross-sectional study from Indonesia","authors":"Mukhlis Rauf , Yulia Yusrini Djabir , Abdul Rahim , Barbara Tóth , Muh. Akbar Bahar","doi":"10.1016/j.eujim.2025.102507","DOIUrl":"10.1016/j.eujim.2025.102507","url":null,"abstract":"<div><h3>Introduction</h3><div>Complementary and alternative medicine (CAM) refers to therapies used alongside or in place of conventional medical care. CAM use during pregnancy has gained increasing attention, yet little is known about its patterns and determinants in Indonesia. This study aimed to explore CAM use among pregnant women, identify influencing factors, and assess potential herb-drug interactions.</div></div><div><h3>Methods</h3><div>A cross-sectional survey was conducted from August to November 2023 at a secondary hospital in Makassar, Indonesia. Pregnant women aged ≥ 18 years attending outpatient clinic were recruited through convenience sampling. Data were collected using a validated, structured questionnaire that assessed demographic characteristics, CAM and medication use, and perceptions of CAM. Potential herb-drug interactions were identified using the Indonesian Traditional Medicine Formulary and the Natural Medicines Comprehensive Database.</div></div><div><h3>Results</h3><div>Of the 560 respondents, 52.3 % reported currently using CAM, with herbal medicines being the most commonly used modality. Factors significantly associated with CAM use included educational level (p=0.021), gestational age (p=0.016), prior CAM use (p<0.001), CAM use among family/friends (p<0.001), and concurrent prescribed medications (p=0.003). Twelve potential herb-drug interactions were identified: eight were classified as moderate and four as minor interactions.</div></div><div><h3>Conclusion</h3><div>The high prevalence of CAM use among pregnant women highlights the need for healthcare providers to offer guidance on safe use and potential herb-drug interactions.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"78 ","pages":"Article 102507"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144522385","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 evolution of propolis research: A bibliometric analysis 蜂胶研究的演变：文献计量学分析

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-14 DOI: 10.1016/j.eujim.2025.102518

Tuğba Nigar Bozkuş

Introduction

Propolis is garnering increasing scientific and commercial interest due to its potential health benefits. Despite a surge in publications, a comprehensive overview of the propolis research landscape using bibliometric methods has been absent. This study aims to fill this gap by providing the first dedicated bibliometric analysis of global propolis research trends over the past two decades.

Methods

Data on propolis-related publications from 2004 to 2023 were retrieved from the Web of Science database. The R Bibliometrix package was employed to analyze publication trends, citation patterns, leading authors, institutions, countries, keyword co-occurrence, research themes, and collaboration networks.

Results

The analysis confirmed a substantial and consistent growth in propolis research. While publication volume is geographically concentrated (led by Brazil, China, Turkey), citation impact analysis revealed different patterns, with some countries (USA, Japan, Portugal, Bulgaria) demonstrating higher average citations per article, suggesting potential leadership in research quality or visibility. Thematic evolution mapping showed a clear trajectory from foundational studies focused on chemical composition and broad in vitro antioxidant/antimicrobial activity towards more sophisticated investigations into specific mechanisms (apoptosis, oxidative stress pathways), distinct propolis types (Brazilian green, stingless bee), and advanced applications (nanoparticles, nanofibers). Analysis identified central ‘’motor themes’’ (like chemical composition) requiring further development despite high interest, alongside highly developed ‘’niche themes’’ (like oxidative stress). Collaboration networks highlighted strong regional clusters but also opportunities for enhancing global integration, particularly bridging high-volume research hubs with high-impact centers.

Conclusion

This bibliometric analysis reveals propolis research as a dynamic, rapidly maturing, and increasingly interdisciplinary field. The divergence between publication quantity and citation impact, the clear evolution of research themes towards mechanistic depth, and the identification of specific developmental needs within the thematic structure offer critical strategic insights. The findings underscore a significant gap between the extensive preclinical investigation of biological activities of propolis and its translation into validated clinical applications. The findings advocate focused efforts on standardization, targeted international collaborations to leverage complementary strengths, and prioritizing clinical trials to substantiate the therapeutic potential suggested by the vast body of existing literature. This analysis provides an evidence-based roadmap to guide future research investments and collaborations effectively.

蜂胶由于其潜在的健康益处而获得越来越多的科学和商业兴趣。尽管出版物激增，蜂胶研究景观使用文献计量学方法的全面概述一直缺席。本研究旨在填补这一空白，提供了第一个专门的文献计量分析全球蜂胶研究趋势在过去的二十年。方法从Web of Science数据库中检索2004 - 2023年蜂胶相关文献资料。使用R Bibliometrix软件包分析出版趋势、引文模式、主要作者、机构、国家、关键词共现、研究主题和合作网络。结果分析证实了蜂胶研究的实质性和持续性增长。虽然出版物数量在地理上集中（以巴西、中国、土耳其为首），但引用影响分析显示出不同的模式，一些国家（美国、日本、葡萄牙、保加利亚）的每篇文章的平均引用率更高，表明在研究质量或知名度方面可能处于领先地位。主题进化图谱显示了清晰的轨迹，从专注于化学成分和广泛的体外抗氧化/抗菌活性的基础研究，到更复杂的特定机制（细胞凋亡、氧化应激途径）、不同蜂胶类型（巴西绿蜂胶、无刺蜂）和高级应用（纳米颗粒、纳米纤维）的研究。分析确定了需要进一步开发的核心“运动主题”（如化学成分），尽管人们对此很感兴趣，以及高度发达的“利基主题”（如氧化应激）。合作网络突出了强大的区域集群，但也为加强全球一体化提供了机会，特别是将高容量研究中心与高影响力中心连接起来。结论文献计量学分析表明蜂胶研究是一个动态的、迅速成熟的、跨学科的研究领域。出版物数量和引用影响之间的差异，研究主题向机制深度的明确演变，以及主题结构中特定发展需求的确定提供了关键的战略见解。这些发现强调了蜂胶生物活性的广泛临床前研究与其转化为有效的临床应用之间的重大差距。研究结果主张集中精力进行标准化，有针对性的国际合作，以利用互补优势，并优先进行临床试验，以证实大量现有文献所建议的治疗潜力。该分析提供了一个基于证据的路线图，以有效地指导未来的研究投资和合作。

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引用次数: 0

Global trends and hotspots in acupuncture for hypertension: a bibliometric study from 1994 to 2024 针灸治疗高血压的全球趋势和热点：1994 - 2024年文献计量学研究

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-04 DOI: 10.1016/j.eujim.2025.102510

Yun-Hua Zheng , Wei Zheng , Jian-Yu Liu

Introduction

Growing interest in non-pharmacological hypertension management has led to increased research in acupuncture as a potential treatment. This bibliometric analysis examines the global research landscape of acupuncture for hypertension using CiteSpace and VOS Viewer software. By analyzing publication trends, key contributors, and collaborative networks, we summarize the current state of research, identify emerging hotspots, and outline future directions in this rapidly evolving field.

Methods

We conducted a comprehensive literature search in the Web of Science Core Collection (WOSCC), including the Science Citation Index Expanded (SCI-E) and Emerging Sources Citation Index (ESCI) databases, covering publications from 1994 to 2024. Bibliometric analysis and knowledge mapping were performed using CiteSpace (version 6.2.R4) and VOS Viewer (version 1.6.18) to analyze publication trends, research collaborations, and thematic evolution.

Results

The analysis revealed a consistent upward trend in annual publications from 1994 to 2024, with China emerging as the most productive country in this research domain. Key thematic clusters identified through keyword analysis included "acupuncture," "stimulation," "blood pressure regulation," and "electroacupuncture." Co-citation analysis demonstrated significant research intensity for "systemic hypertension" (cluster strength: 6.94, 2015–2019), "randomized controlled trials" (4.31, 2022–2024), and "neurons" (3.9, 2012–2013). The study by Frank A Flachskampf et al. (burst strength = 8.48) showed the strongest citation burst.

Conclusion

Our bibliometric analysis reveals a marked surge in research output and scientific engagement, underscoring acupuncture’s expanding role as a therapeutic intervention for hypertension. The field exhibits robust growth potential, driven by intensifying global collaboration among leading institutions and interdisciplinary research teams.

随着人们对非药物高血压治疗的兴趣日益浓厚，针灸作为一种潜在的治疗方法的研究也越来越多。本文使用CiteSpace和VOS Viewer软件对针灸治疗高血压的全球研究现状进行了文献计量分析。通过分析出版趋势、主要贡献者和合作网络，我们总结了研究现状，确定了新兴热点，并概述了这个快速发展领域的未来方向。方法对Web of Science Core Collection （WOSCC）进行全面的文献检索，包括Science Citation Index Expanded （SCI-E）和Emerging Sources Citation Index （ESCI）数据库，检索时间为1994 - 2024年。使用CiteSpace （version 6.2.R4）和VOS Viewer （version 1.6.18）进行文献计量分析和知识图谱分析，分析出版趋势、研究合作和专题演变。结果分析显示，从1994年到2024年，中国的年度出版物数量呈持续上升趋势，中国成为该研究领域产量最高的国家。通过关键词分析确定的关键主题集群包括“针灸”、“刺激”、“血压调节”和“电针”。共引分析显示，“全体性高血压”（聚类强度：6.94,2015-2019）、“随机对照试验”（聚类强度：4.31,2022-2024）和“神经元”（聚类强度：3.9,2012-2013）的研究强度显著。Frank A Flachskampf等人的研究（burst strength = 8.48）表现出最强的引文爆发。我们的文献计量分析显示，研究产出和科学参与显著增加，强调了针灸作为高血压治疗干预措施的作用日益扩大。在全球领先机构和跨学科研究团队加强合作的推动下，该领域显示出强劲的增长潜力。

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引用次数: 0

Meta-analysis and trial sequential analysis of Huaiqihuang granules in treatment of cough variant asthma in pediatrics 怀芪黄颗粒治疗小儿咳嗽变异性哮喘的meta分析和试验序贯分析

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-06-05 DOI: 10.1016/j.eujim.2025.102511

Qiaoling Li, Jing Peng, Linhui Liu

Introduction

Many individuals with cough variant asthma (CVA) utilize Huaiqihuang granules to alleviate symptoms. However, there is a lack of systematic reviews investigating its efficacy and safety for CVA.

Methods

A computer-based retrieval of various databases was conducted to search for randomized controlled trials (RCTs) on the treatment of CVA in children using Huaiqihuang granules combined with Western medicine. The search encompassed eight databases, including China National Knowledge Infrastructure (CNKI), Wangfang, VIP (VIP Information Co.Ltd.), PubMed, Web of Science, The Cochrane Library, Embase, and Sinomed database, and covered literature up to April 2025. Articles were screened and selected based on predefined inclusion and exclusion criteria. The quality of the included articles was assessed, followed by a meta-analysis using RevMan5.3. The quality of evidence was graded using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) system. Additionally, trial sequential analysis (TSA) was performed using TSA 0.9.5.10 beta software.

Results

A total of 17 RCTs were included in the analysis, encompassing a total sample size of 1,742 patients. Results showed that the combination of Huaiqihuang granules with conventional Western medicine significantly enhanced clinical efficacy and reduced recurrence rates compared to Western medicine alone. This combination also improved immune parameters, including CD4+/CD8+, and modulated inflammatory markers such as inflammatory factors interleukin-4 (IL-4) and interferon-gamma (IFN-γ), while restoring immunoglobulin levels (IgA, IgE, IgG). Additionally, it improved pulmonary function indices, including FEV1, FEV1/FVC and PEF. No significant differences were observed in the incidence of adverse reactions between the two groups. TSA demonstrated that the total effective rate curve surpassed both the traditional and TSA boundaries, corroborating the clinical efficacy. According to the GRADE assessment, outcomes related to treatment efficacy, recurrence rate, IFN-γ, CD4+, and incidence of adverse reactions were rated as moderate-quality evidence, whereas the remaining outcomes were assessed as low-quality evidence.

Conclusion

The integration of Huaiqihuang granules with conventional Western medicine in the management of CVA significantly enhances clinical efficacy, reduces recurrence rates, improves immune parameters, restores pulmonary function, ameliorates inflammatory markers, and normalizes immunoglobulin levels, in comparison to the use of Western medicine alone.

许多咳嗽变异性哮喘（CVA）患者使用槐芪黄颗粒缓解症状。然而，缺乏对其治疗CVA的有效性和安全性的系统评价。方法计算机检索各类数据库，检索槐七黄颗粒联合西药治疗儿童CVA的随机对照试验（rct）。检索包括中国知网、网方、维普、PubMed、Web of Science、The Cochrane Library、Embase、Sinomed等8个数据库，涵盖截至2025年4月的文献。根据预先确定的纳入和排除标准对文章进行筛选和选择。评估纳入文章的质量，然后使用RevMan5.3进行meta分析。采用建议评估、发展和评价等级（Grade）系统对证据质量进行分级。采用TSA 0.9.5.10 beta软件进行试验序列分析（TSA）。结果共纳入17项随机对照试验，总样本量为1742例。结果表明，与单用西药相比，怀七黄颗粒联合西药治疗可显著提高临床疗效，降低复发率。该组合还改善了免疫参数，包括CD4+/CD8+，并调节炎症标志物，如炎症因子白介素-4 （IL-4）和干扰素-γ (IFN-γ)，同时恢复免疫球蛋白水平（IgA, IgE, IgG）。FEV1、FEV1/FVC、PEF等肺功能指标均有改善。两组患者不良反应发生率无显著差异。TSA显示总有效率曲线超越传统和TSA边界，证实了临床疗效。根据GRADE评估，与治疗疗效、复发率、IFN-γ、CD4+和不良反应发生率相关的结果被评为中等质量证据，而其余结果被评估为低质量证据。结论与单用西药相比，槐芪黄颗粒联合西药治疗CVA临床疗效显著提高，复发率降低，免疫指标改善，肺功能恢复，炎症指标改善，免疫球蛋白水平正常化。

{"title":"Meta-analysis and trial sequential analysis of Huaiqihuang granules in treatment of cough variant asthma in pediatrics","authors":"Qiaoling Li, Jing Peng, Linhui Liu","doi":"10.1016/j.eujim.2025.102511","DOIUrl":"10.1016/j.eujim.2025.102511","url":null,"abstract":"<div><h3>Introduction</h3><div>Many individuals with cough variant asthma (CVA) utilize Huaiqihuang granules to alleviate symptoms. However, there is a lack of systematic reviews investigating its efficacy and safety for CVA.</div></div><div><h3>Methods</h3><div>A computer-based retrieval of various databases was conducted to search for randomized controlled trials (RCTs) on the treatment of CVA in children using Huaiqihuang granules combined with Western medicine. The search encompassed eight databases, including China National Knowledge Infrastructure (CNKI), Wangfang, VIP (VIP Information Co.Ltd.), PubMed, Web of Science, The Cochrane Library, Embase, and Sinomed database, and covered literature up to April 2025. Articles were screened and selected based on predefined inclusion and exclusion criteria. The quality of the included articles was assessed, followed by a meta-analysis using RevMan5.3. The quality of evidence was graded using the Grade of Recommendations Assessment, Development, and Evaluation (GRADE) system. Additionally, trial sequential analysis (TSA) was performed using TSA 0.9.5.10 beta software.</div></div><div><h3>Results</h3><div>A total of 17 RCTs were included in the analysis, encompassing a total sample size of 1,742 patients. Results showed that the combination of Huaiqihuang granules with conventional Western medicine significantly enhanced clinical efficacy and reduced recurrence rates compared to Western medicine alone. This combination also improved immune parameters, including CD4+/CD8+, and modulated inflammatory markers such as inflammatory factors interleukin-4 (IL-4) and interferon-gamma (IFN-γ), while restoring immunoglobulin levels (IgA, IgE, IgG). Additionally, it improved pulmonary function indices, including FEV1, FEV1/FVC and PEF. No significant differences were observed in the incidence of adverse reactions between the two groups. TSA demonstrated that the total effective rate curve surpassed both the traditional and TSA boundaries, corroborating the clinical efficacy. According to the GRADE assessment, outcomes related to treatment efficacy, recurrence rate, IFN-γ, CD4+, and incidence of adverse reactions were rated as moderate-quality evidence, whereas the remaining outcomes were assessed as low-quality evidence.</div></div><div><h3>Conclusion</h3><div>The integration of Huaiqihuang granules with conventional Western medicine in the management of CVA significantly enhances clinical efficacy, reduces recurrence rates, improves immune parameters, restores pulmonary function, ameliorates inflammatory markers, and normalizes immunoglobulin levels, in comparison to the use of Western medicine alone.</div></div>","PeriodicalId":11932,"journal":{"name":"European Journal of Integrative Medicine","volume":"78 ","pages":"Article 102511"},"PeriodicalIF":1.9,"publicationDate":"2025-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144523261","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

Evaluation of the efficacy of Yiqi Jiedu decoction on diabetic peripheral neuropathy and related brain function changes: A randomized controlled trial protocol 益气解毒汤对糖尿病周围神经病变及相关脑功能改变的疗效评价：随机对照试验方案

IF 1.7 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-08-26 DOI: 10.1016/j.eujim.2025.102543

Chaofan Sun , Guoxing Ling , Chunquan Sun , Xingzhong Feng

Introduction

Diabetic peripheral neuropathy (DPN) is a common complication of type 2 diabetes, characterized by high disability and mortality rates. Pain, the primary symptom of DPN, leads to increased central nervous system responsiveness and decreased pain thresholds, resulting in conditions like hyperalgesia, anxiety, and depression—collectively referred to as "central sensitization." Changes in brain structure and function are closely linked to this phenomenon but remain unclear. While functional magnetic resonance imaging (fMRI) technology can monitor brain function changes, there is limited research on the effects of interventions on these functions in patients with DPN. Yiqi Jiedu (YQJD) Decoction has been used in China to treat DPN for many years, with some studies indicating it may improve symptoms and quality of life, but there is a lack of high-quality clinical evidence, and its central mechanism of action remains unclear.

Methods

This ongoing randomized, double-blind, placebo-controlled trial aims to enroll about 88 patients aged 45–75 with DPN, diagnosed with qi deficiency and blood stasis syndrome. Participants will be randomly assigned in a 1:1 ratio to either receive YQJD Granules or the placebo, with follow-up assessments at weeks 4 and 8. The primary outcomes include the Toronto Clinical Scoring System (TCSS), Michigan Diabetic Neuropathy Score (MDNS), Traditional Chinese Medicine (TCM) syndrome score, nerve conduction velocity, and fMRI changes. Secondary outcomes will assess psychological characteristics in patients and changes in serum cytokines and glucose-lipid metabolism indicators.

Discussion

This study aims to evaluate the efficacy and safety of YQJD Decoction in the treatment of DPN using fMRI technology. It will analyze changes in brain regions before and after treatment, explore the cerebral effects of YQJD, and elucidate the relationship between central sensitization and brain effect patterns in the pathogenesis of DPN. The findings of this study will provide clinical evidence and mechanistic insights for the integration of TCM and Western medicine in the treatment of DPN. It is expected to reveal the central mechanisms involved in the intervention of neuropathic pain through Chinese herbal medicine.

Trial registration

Chinese clinical trial registry, ChiCTR2400084649. Registered on 22 May 2024, https://www.chictr.org.cn/.

糖尿病周围神经病变（DPN）是2型糖尿病的常见并发症，其特点是高致残率和死亡率。疼痛是DPN的主要症状，导致中枢神经系统反应性增加和疼痛阈值降低，导致痛觉过敏、焦虑和抑郁等症状，统称为“中枢敏感化”。大脑结构和功能的变化与这一现象密切相关，但目前尚不清楚。虽然功能磁共振成像（fMRI）技术可以监测脑功能的变化，但关于干预措施对DPN患者这些功能的影响的研究有限。益气解毒汤在中国治疗DPN已有多年历史，一些研究表明益气解毒汤可以改善DPN的症状和生活质量，但缺乏高质量的临床证据，其主要作用机制尚不清楚。这项正在进行的随机、双盲、安慰剂对照试验旨在招募约88名年龄在45-75岁之间、诊断为气虚血瘀证的DPN患者。参与者将以1:1的比例随机分配接受YQJD颗粒或安慰剂，并在第4周和第8周进行随访评估。主要结局包括多伦多临床评分系统（TCSS）、密歇根糖尿病神经病变评分（MDNS）、中医证候评分、神经传导速度和功能磁共振成像（fMRI）变化。次要结局将评估患者的心理特征和血清细胞因子和糖脂代谢指标的变化。本研究旨在应用功能磁共振成像技术评价益芩汤治疗DPN的疗效和安全性。研究将分析治疗前后脑区变化，探讨青芪汤的脑效应，阐明中枢致敏与DPN发病机制中脑效应模式的关系。本研究结果将为中西医结合治疗DPN提供临床依据和机制见解。以期揭示中药干预神经性疼痛的中枢机制。中国临床试验注册中心，ChiCTR2400084649。2024年5月22日注册，网址：https://www.chictr.org.cn/。

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引用次数: 0

Shikonin enhances hypnotic effect and synergistic properties of diazepam, possibly through GABAergic interaction pathway: In vivo and in silico studies 紫草素增强地西泮的催眠作用和协同特性，可能通过gaba能相互作用途径：体内和计算机研究

IF 1.9 4区医学 Q3 INTEGRATIVE & COMPLEMENTARY MEDICINE

European Journal of Integrative Medicine

Pub Date : 2025-09-01 Epub Date: 2025-05-31 DOI: 10.1016/j.eujim.2025.102508

Shipan Paul , Raihan Chowdhury , Md. Sakib Al Hasan , Md. Shimul Bhuia , Mohammed Alfaifi , Salehin Sheikh , Asraful Islam Rakib , Faysal Mollah , Shakil Ahmmed , Sharmita Ghosh Situ , Irfan Aamer Ansari , Siddique Akber Ansari , Debasree Sen Oisay , Muhammad Torequl Islam

Introduction

Shikonin is a natural naphthoquinone from Lithospermum erythrorhizon with diverse pharmacological activities, including neuroprotective, anti-inflammatory, and hypnotic effects.

Methods

The current study was focused on investigating the hypnotic effect and combination characteristics of shikonin with diazepam through in vivo and in silico studies. Swiss albino mice received shikonin (SKN-10 and SKN-20 mg/kg), diazepam (DZP-2 mg/kg) as a positive control, and a vehicle as a negative control (NC). Two combinations of SKN-10 and SKN-20 with DZP-2 were also administered before thiopental sodium-induced sleep to assess hypnosis and sedation. Different computational tools were utilized for molecular interaction and pharmacokinetics.

Results

In vivo study demonstrated that shikonin significantly (p < 0.05) increased sleep duration and reduced sleep latency in animals compared to the NC group. In addition to combination therapy, SKN-10 significantly enhanced the effect of diazepam compared to DZP-2 + SKN-20, resulting in the longest sleep duration and shortest latency, indicating the strongest hypnotic effects compared to the other groups. Moreover, molecular docking indicated that the shikonin showed strong binding affinity (BA) (−8.9 kcal/mol) compared to diazepam for the GABA_A receptor.

Conclusion

In summary, shikonin showed significant hypnotic and synergistic effects along with diazepam. Acute toxicity studies showed shikonin caused no behavioral changes, toxicity, or mortality in mice up to 20 mg/kg, suggesting a high safety margin, with the oral LD₅₀ likely exceeding 1g/kg. Future research should explore shikonin’s long-term effects, safety, and optimal dosage, particularly in clinical settings. In vitro studies on GABA_A interactions, combination therapy with diazepam, and cognitive, behavioral, and toxicity assessments are crucial for its safe use in CNS disorders.

紫草素是紫草属植物中的天然萘醌类化合物，具有神经保护、抗炎、催眠等药理作用。方法通过体内和体外实验研究紫草素与地西泮的催眠作用及联用特点。瑞士白化小鼠以紫草素（SKN-10和SKN-20 mg/kg）、地西泮（DZP-2 mg/kg）为阳性对照，以载药为阴性对照（NC）。在硫喷妥钠诱导睡眠前给予SKN-10和SKN-20与DZP-2的两种组合，以评估催眠和镇静作用。不同的计算工具用于分子相互作用和药代动力学。结果体内实验表明，紫草素显著(p <；0.05)与NC组相比，小鼠睡眠持续时间增加，睡眠潜伏期减少。除联合治疗外，与DZP-2 + SKN-20相比，SKN-10显著增强了地西泮的作用，睡眠时间最长，潜伏期最短，催眠效果较其他组最强。此外，分子对接表明，与地西安定相比，紫草素对GABAA受体具有很强的结合亲和力（BA）（−8.9 kcal/mol）。结论紫草素与地西泮具有明显的协同催眠作用。急性毒性研究表明，紫草素在20mg /kg的剂量下不会引起小鼠行为改变、毒性或死亡，这表明紫草素具有很高的安全范围，口服LD50可能超过1g/kg。未来的研究应该探索紫草素的长期效果、安全性和最佳剂量，特别是在临床环境中。GABAA相互作用的体外研究、与地西泮联合治疗以及认知、行为和毒性评估对其在中枢神经系统疾病中的安全使用至关重要。

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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 : 2025-09-01 Epub 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