Integrative Medicine Research最新文献_第10页

Acupuncture or cupping plus standard care versus standard care in moderate to severe COVID-19 patients: An assessor-blinded, randomized, controlled trial 中重度COVID-19患者针灸或拔罐加标准治疗与标准治疗:一项评估盲、随机对照试验

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100898

Reihane Alipour , Saeidreza Jamalimoghadamsiahkali , Mehrdad Karimi , Asma Asadi , Haleh Ghaem , Mohammad Sadegh Adel-Mehraban , Amir Hooman Kazemi

Background

Non-pharmacological strategies that have been proposed by complementary medical systems, can be effective in management of COVID-19.

Methods

This study was designed as a three-arm, assessor-blinded, randomized controlled trial. A total of 139 hospitalized COVID-19 patients were randomly assigned into three groups: (1) acupuncture (ACUG), (2) cupping (CUPG), and (3) control (CTRG). All participants received conventional treatment. The primary study endpoint included changes in respiratory signs including oxygen saturation (SpO₂) and respiratory rate (RR). The secondary endpoints were COVID-19-related hospitalization duration and serious adverse events such as intensive care unit (ICU) admission, intubation or death, all up to day 30. Also, improvements in cough, dyspnea, chest tightness, oxygen demand, anorexia, headache, weakness, sore throat, and myalgia were evaluated.

Results

Forty-two patients in ACUG, 44 patients in CUPG, and 42 patients in CTRG completed the trial. After 3 days, SpO₂ and RR improved significantly in CUPG and ACUG compared with CTRG (effect size: 8.49 (6.4 to 10.57) and 8.51 (6.67 to 10.34), respectively: p<0.001). Compared with CTRG, patients in CUPG and ACUG recovered faster (mean difference: 6.58 (4.8 to 8.35) and 9.16 (7.16 to 11.15), respectively) and except for two patients in ACUG who were admitted to ICU, none of patients in ACUG or CUPG needed ICU or intubation (p<0.001 in comparison to CTRG). Amelioration of clinical COVID-19 related symptoms reached a high level of statistical significance in CUPG and ACUG in comparison with CTRG (p<0.01).

Conclusion

Cupping and acupuncture are promising safe and effective therapies in management of COVID-19. Trial registration: This study was registered at Iranian Registry of Clinical Trials: IRCT20201127049504N1 (https://en.irct.ir/trial/52621).

补充医疗系统提出的非药物策略可有效管理COVID-19。方法本研究设计为三组、评估盲、随机对照试验。139例新冠肺炎住院患者随机分为针刺组(ACUG)、拔火罐组(CUPG)和对照组(CTRG)。所有参与者均接受常规治疗。主要研究终点包括呼吸体征的变化，包括血氧饱和度(SpO2)和呼吸速率(RR)。次要终点是与covid -19相关的住院时间和严重不良事件，如重症监护病房(ICU)入院、插管或死亡，全部持续到第30天。此外，咳嗽、呼吸困难、胸闷、耗氧量、厌食症、头痛、虚弱、喉咙痛和肌痛的改善情况也进行了评估。结果ACUG组42例，CUPG组44例，CTRG组42例完成试验。3 d后，与CTRG相比，CUPG和ACUG的SpO2和RR显著改善(效应值分别为8.49(6.4 ~ 10.57)和8.51 (6.67 ~ 10.34):p<0.001)。与CTRG组相比，cuug组和ACUG组患者恢复更快(平均差值分别为6.58(4.8 ~ 8.35)和9.16(7.16 ~ 11.15))，除2例ACUG组患者入住ICU外，ACUG组和cuug组患者均无需ICU或插管(与CTRG组相比差值为0.001)。与CTRG组相比，CUPG组和ACUG组临床COVID-19相关症状的改善具有高度统计学意义(p<0.01)。结论拔火罐和针刺治疗新冠肺炎是一种安全有效的治疗方法。试验注册:本研究在伊朗临床试验注册中心注册:IRCT20201127049504N1 (https://en.irct.ir/trial/52621)。

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引用次数: 3

Increasing trends and impact of integrative medicine research: From 2012 to 2021 中西医结合研究的增长趋势和影响:从2012年到2021年

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100884

Eunhye Song , Lin Ang , Myeong Soo Lee

引用次数: 3

Regulatory status of complementary medicine in Qatar: An update 卡塔尔补充医学的监管状况:最新情况

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100896

Zainab AlMusleh , Tamer Aboushanab

引用次数: 0

Effect of herbal medicine (Jodeungsan) on migraine: A double-blind randomized clinical trial 中草药(九登山)对偏头痛的影响:一项双盲随机临床试验

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100885

Seyoung Kim , Jihye Seo , Cheol-hyun Kim , Hyun-Kyung Sung , Ho-Yeon Go , Woo Sang Jung , Seungwon Kwon , Minjung Kwak , Sangkwan Lee

Background

Migraine is a relatively common disease that has a significant effect on the daily activities of affected individuals. The purpose of this study was to explore the effects of herbal medicine (Jodeungsan, JDS) on migraine.

Methods

Sixty-four patients with migraine were recruited and randomized to either the JDS or placebo group at a 1:1 ratio. The subjects received JDS or placebo daily for four weeks. The primary outcome was a change in the number of headache attack days (HADs), and the secondary outcome measures were the headache impact test (HIT), migraine-specific quality of life (MSQoL), the deficiency and excess pattern identification questionnaire (DEPIQ), the cold and heat pattern identification questionnaire (CHPIQ), and the blood stasis pattern questionnaire (BSPQ).

Results

In all, 61 of the 64 patients took the investigational drugs for four weeks. The number of HADs did not significantly differ between the JDS and placebo groups at the end of the study. However, the HIT and MSQoL results showed significant improvement over the baseline in both groups.

Conclusions

JDS did not have a significant effect on chronic migraine. Larger studies are needed to confirm this result.

Trial registration

Clinical Research Information Service (https://cris.nih.go.kr/): KCT0003121.

背景:偏头痛是一种相对常见的疾病，对患者的日常活动有显著影响。本研究的目的是探讨中草药(Jodeungsan, JDS)对偏头痛的影响。方法招募64例偏头痛患者，按1:1的比例随机分为JDS组和安慰剂组。受试者每天服用JDS或安慰剂，持续四周。主要结局指标为头痛发作天数(HADs)的变化，次要结局指标为头痛影响试验(HIT)、偏头痛特异性生活质量(MSQoL)、虚虚证型识别问卷(DEPIQ)、寒热证型识别问卷(CHPIQ)和血瘀证型调查问卷(BSPQ)。结果64例患者中，61例患者连续用药4周。在研究结束时，JDS组和安慰剂组的HADs数量没有显著差异。然而，HIT和MSQoL结果显示两组均较基线有显著改善。结论sjds对慢性偏头痛无明显治疗作用。需要更大规模的研究来证实这一结果。临床研究信息服务(https://cris.nih.go.kr/): KCT0003121)。

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引用次数: 0

Observational studies of traditional Chinese medicine may provide evidence nearly consistent with the randomized controlled trials: A meta-epidemiological study 中医观察性研究可能提供与随机对照试验几乎一致的证据:一项荟萃流行病学研究

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100889

Haiqi Song , Nian Li , Wenjie Yang , Miaomiao Wu , Xiaoyang Liao , Yonggang Zhang

Background

In traditional Chinese medicine (TCM) field, the benefits of observational studies was more significant. Whether the evidence from observational studies agreed with RCTs in the field of TCM was still unclear.

Methods

A meta-epidemiological study was conducted. Meta-analyses and systematic reviews including cohort studies and case-control studies of TCM were included. Ratio of odds ratio (ROR) of randomized controlled trials and observational studies were calculated individually and intercomparisons were conducted by pool analysis.

Results

A total of 11 studies and 30 outcome pairs were included in the pool analysis. Using results from the observational studies as the reference group, the polled ROR comparing randomized controlled trials with observational studies was 1.23 (95% confidence interval 1.05 to 1.44, and 95% prediction interval 0.90 to 1.68). The ROR by subgroup analysis were 1.15 (95% confidence interval 0.96 to 1.38; 95% prediction interval 0.95 to 1.39) and 1.12 (95% confidence interval 0.86 to 1.46; 95% prediction interval 0.51 to 2.47) for cohort studies and case-control studies, respectively.

Conclusions

There is difference in pooled results between randomized controlled studies and observational studies on TCM. However, the prediction interval shows the difference is small, which suggests observational studies of TCM can be included in data analysis to provide evidence for TCM. Future studies are needed to verify the above conclusion.

在中医领域，观察性研究的益处更为显著。观察性研究的证据是否与中医领域的随机对照试验相一致尚不清楚。方法进行meta流行病学研究。meta分析和系统评价包括队列研究和病例对照研究。随机对照试验和观察性研究的优势比(ROR)分别计算，采用池分析进行相互比较。结果共纳入11项研究和30对结局对。以观察性研究结果为参照组，随机对照试验与观察性研究比较的投票ROR为1.23(95%可信区间1.05 ~ 1.44,95%预测区间0.90 ~ 1.68)。亚组分析的ROR为1.15(95%可信区间0.96 ~ 1.38;95%预测区间0.95 ~ 1.39)和1.12(95%置信区间0.86 ~ 1.46;队列研究和病例对照研究的95%预测区间分别为0.51 ~ 2.47)。结论随机对照研究与观察性研究的合并结果存在差异。然而，预测区间显示差异很小，这表明可以将中医的观察性研究纳入数据分析，为中医提供证据。以上结论需要进一步的研究来验证。

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引用次数: 0

Robustness of meta-analysis results in Cochrane systematic reviews: A case for acupuncture trials Cochrane系统评价中meta分析结果的稳健性:一个针灸试验的案例

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100890

Jiyoon Won

Background

Fragility index (FI) refers to the smallest value that change statistical significance of study results. Meta-analyses of Cochrane systematic reviews are considered as the best evidence for stake holders because they enable effect size estimation that cannot be derived by individual studies, particularly in the field of complementary and integrative medicine (CIM). Thus, this study aimed to evaluate robustness of meta-analysis in Cochrane systematic reviews of acupuncture, one of the most used CIM treatment, using FI of meta-analysis.

Methods

Meta-analyses of acupuncture Cochrane systematic reviews with binary benefit outcome measures were searched in PubMed, Embase, and CENTRAL and subject to analysis. Randomized clinical trials (RCTs) or quasi RCTs adopted penetrating needles as treatment and compared with controls such as sham acupuncture, usual care, and active control were included. FI of meta-analyses was calculated in web (https://clinicalepidemio.fr/fragility_ma/); and fragility quotient (FQ) was calculated by dividing FI by total sample size of meta-analysis.

Results

Of 248 retrieved studies, 12 Cochrane systematic reviews with 48 meta-analyses were analyzed. The median FI for statistically significant and non-significant meta-analyses was 7 [interquartile range: 3 - 12] and 6 [interquartile range: 3 - 10]. FQ was similar irrespective of statistical significance. Among controls, meta-analyses adopting sham acupuncture displayed the widest range of FI and FQ.

Conclusion

Robustness of meta-analyses in Cochrane systematic reviews for acupuncture was similar irrespective of statistical significance. Impact of control intervention cannot be determined in this study. As FI enables intuitive interpretation, applications for CIM field can be useful.

脆弱性指数(FI)是指研究结果改变统计显著性的最小值。Cochrane系统评价的荟萃分析被认为是利益相关者的最佳证据，因为它们使个体研究无法得出的效应大小估计成为可能，特别是在补充和综合医学(CIM)领域。因此，本研究旨在利用meta分析的FI来评估针灸(最常用的CIM治疗方法之一)在Cochrane系统评价中meta分析的稳健性。方法在PubMed、Embase和CENTRAL中检索具有二元获益结局指标的Cochrane系统评价并进行分析。随机临床试验(rct)或准rct采用穿透针作为治疗，并与假针灸、常规护理、主动对照等对照进行比较。meta分析的FI在web (https://clinicalepidemio.fr/fragility_ma/)中计算;脆弱性商(FQ)由FI除以meta分析的总样本量计算。结果在248项被检索的研究中，对12项Cochrane系统评价和48项meta分析进行了分析。统计显著和非显著荟萃分析的中位FI分别为7[四分位数范围:3 - 12]和6[四分位数范围:3 - 10]。FQ相似，无统计学意义。在对照组中，采用假针灸的meta分析显示FI和FQ的范围最广。结论针灸的Cochrane系统评价meta分析的稳健性相似，无统计学意义。本研究无法确定控制干预的影响。由于FI能够实现直观的解释，因此CIM领域的应用程序非常有用。

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引用次数: 0

The role of acupuncture and moxibustion in the treatment, prevention, and rehabilitation of patients with COVID-19: A scoping review 针灸在COVID-19患者的治疗、预防和康复中的作用:一项范围综述

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100886

Mengjuan Ren , Yunlan Liu , Xiaojia Ni , Zhuoran Kuang , Xufei Luo , Yikai Zhang , Huishan Li , Yaolong Chen

Background

This study aims to summarize the available evidence and guideline/consensus recommendations for acupuncture and moxibustion in the treatment, prevention and rehabilitation of patients with coronavirus disease 2019 (COVID-19).

Methods

A scoping review was performed. Eight electronic databases and other related websites were searched. All studies related to acupuncture and moxibustion for COVID-19 were considered. Descriptive analysis was applied to analyze the all included studies and guideline recommendations.

Results

We ultimately included 131 eligible studies. The main topics of the included studies were the treatment (82.4%) and prevention (38.9%) of COVID-19. The most included studies were literature reviews (65, 49.6%), protocols of systematic reviews (20, 15.3%), and guidelines and consensuses (18, 13.7%). The 18 (13.7%) COVID-19 guidelines and consensuses included 47 recommendations on acupuncture and moxibustion, which focused on the treatment (21/47, 44.7%), rehabilitation (17/47, 36.2%) and prevention (6, 12.8%) of COVID-19 patients. Zusanli (ST36), Feishu (BL13), Guanyuan (RN4) were recommended mostly for the treatment, rehabilitation and prevention respectively.

Conclusions

Acupuncture and moxibustion are effective in the treatment of COVID-19 patients to some extent. However, more high-quality of clinical trials still needed to determine the feasibility of acupuncture and moxibustion in COVID-19 patients to better guide clinical practice.

Study registration

Open Science Framework Registries (Registration DOI: 10.17605/OSF.IO/Z35WN; https://osf.io/z35wn).

本研究旨在总结针灸治疗、预防和康复冠状病毒病2019 (COVID-19)患者的现有证据和指南/共识建议。方法进行范围综述。检索了8个电子数据库和其他相关网站。纳入了所有与针灸治疗COVID-19相关的研究。采用描述性分析对所有纳入的研究和指南建议进行分析。结果我们最终纳入了131项符合条件的研究。纳入研究的主要主题是COVID-19的治疗(82.4%)和预防(38.9%)。纳入最多的研究是文献综述(65篇，49.6%)、系统评价方案(20篇，15.3%)和指南和共识(18篇，13.7%)。新冠肺炎指南和共识共18份(13.7%)，其中针灸建议47项，重点关注新冠肺炎患者的治疗(21/47,44.7%)、康复(17/47,36.2%)和预防(6,12.8%)。分别推荐足三里(ST36)、肺舒(BL13)、冠源(RN4)进行治疗、康复和预防。结论针灸治疗新冠肺炎患者有一定疗效。但仍需要更多高质量的临床试验来确定针灸治疗新冠肺炎患者的可行性，以更好地指导临床实践。研究注册开放科学框架注册(注册DOI: 10.17605/OSF.IO/Z35WN;https://osf.io/z35wn)。

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引用次数: 9

Effectiveness of herbal medicines to prevent and control symptoms of urinary tract infections and to reduce antibiotic use: A literature review 草药预防和控制尿路感染症状和减少抗生素使用的有效性:文献综述

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100892

Herman van Wietmarschen , Noortje van Steenbergen , Esther van der Werf , Erik Baars

Background

Antimicrobial resistance is a rapidly growing global issue affecting the effective treatment of infectious diseases. This provides a window of opportunity for the use and implementation of well researched effective complementary therapies such as herbal medicines. In this literature review, an overview is provided of the effectiveness of herbal medicine to control symptoms of urinary tract infections and reduce antibiotic use.

Methods

PubMed, CAM-Quest, CORE-Hom, ScienceDirect, CAMBase, Anthromedics.org and AnthroMedLibrary databases were searched for peer-reviewed meta-analyses, systematic reviews and randomized controlled trials from 2005 till 8 October 2020. Included were clinical studies on the use of herbal medicine for clinically diagnosed urinary tract infection with any control group except another herbal medicine. Study quality was assessed using the Joanna Briggs Institute critical appraisal tools.

Results

Of the 408 citations identified, 23 met the inclusion criteria: 5 meta-analyses, 3 systematic reviews and 15 randomized controlled trials. Of these studies 13 involved the use of cranberry products, 4 studies concerned traditional Chinese herbal medicines, and 6 studies dealt with other herbal medicines.

Conclusions

The latest published meta-analysis including 28 trials reports a clear benefit of Cranberry products for the prevention of recurrent UTIs in women. Five TCM formulas were found to be equally or more effective than antibiotics in the treatment of UTIs. Furthermore, Rosa canina seems to have the potential to prevent UTI in women undergoing a caesarean section. ‘Acidif Plus Tablets’ as well as ‘Canephron’ seem to be promising candidates for treating women with uncomplicated recurrent UTI.

抗生素耐药性是一个迅速增长的全球性问题，影响着传染病的有效治疗。这为使用和实施经过充分研究的有效补充疗法(如草药)提供了机会。在这篇文献综述中，概述了草药在控制尿路感染症状和减少抗生素使用方面的有效性。方法从2005年至2020年10月8日检索spubmed、CAM-Quest、core - hm、ScienceDirect、CAMBase、Anthromedics.org和AnthroMedLibrary数据库，检索同行评介的meta分析、系统评价和随机对照试验。包括在临床诊断为尿路感染的任何对照组中使用草药的临床研究，除了另一种草药。使用乔安娜布里格斯研究所的关键评估工具评估研究质量。结果在408篇文献中，23篇符合纳入标准:5篇荟萃分析、3篇系统评价和15篇随机对照试验。在这些研究中，13项研究涉及蔓越莓产品的使用，4项研究涉及传统中草药，6项研究涉及其他草药。最新发表的荟萃分析包括28项试验，报告了蔓越莓产品对预防女性复发性尿路感染的明显益处。五种中药方剂治疗尿路感染的效果与抗生素相同或更有效。此外，Rosa canina似乎具有预防剖腹产妇女尿路感染的潜力。“Acidif Plus片剂”和“Canephron”似乎是治疗女性无并发症复发性尿路感染的有希望的候选药物。

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引用次数: 3

Integrative medicine research for improving female reproductive health during COVID-19 新冠肺炎期间改善女性生殖健康的中西医结合研究

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100894

Jue Zhou , Weihuan Hu , Fan Qu

引用次数: 0

Prevalence and predictors of naturopathic practitioners’ self-reported practice behaviours: results of an international survey 自然疗法从业者自我报告的实践行为的患病率和预测因素:一项国际调查的结果

IF 3.4 4区医学 Q2 INTEGRATIVE & COMPLEMENTARY MEDICINE

Integrative Medicine Research

Pub Date : 2022-12-01 DOI: 10.1016/j.imr.2022.100897

Amie Steel , Iva Lloyd , Hope Foley , Matthew Leach

Background

The naturopathic workforce spans over 108 countries and is estimated to provide care to over 5.5 million patients globally per month. Despite such demand, naturopathic practitioners are not well integrated into mainstream health systems, in part due to poor knowledge about naturopathy among policy makers and other health professionals. This study aims to describe naturopathic practitioners’ practice behaviours and examine the characteristics that predict the use of naturopathic treatments and practices around the world.

Methods

An international cross-sectional online survey was distributed through World Naturopathic Federation membership organisations and social media accounts. Multivariate reverse stepwise logistic regression was undertaken to examine potential predictors of practice behaviours, adjusting for the influence of demographic and practice characteristics

Results

A response rate of 78.4% was achieved (n=478). Lifestyle modifications, dietary changes, nutritional products and herbal medicines were most consistently prescribed Always or Most of the time. At least one-half of participants discussed nine of the ten health topics during clinical practice Always or Most of the time. More than one-half (55.1%) of participants practiced in a location with statutory regulation/occupational certification. Compared to participants located in countries with voluntary certification/no regulation, those in countries with statutory registration/occupational licensing had higher odds of prescribing nutritional products (adjusted odds ratio (aOR)=2.5) or IV/injection therapies (aOR=18.4).

Conclusion

The findings of this study provide important insights into contemporary naturopathic practice behaviour, which may help to overcome misconceptions about such practice among other health professionals, policy makers and the community.

自然疗法从业人员遍布108个国家，估计每月为全球550多万患者提供护理。尽管有这样的需求，但自然疗法从业者并没有很好地融入主流卫生系统，部分原因是政策制定者和其他卫生专业人员对自然疗法的了解不足。本研究旨在描述自然疗法从业者的实践行为，并研究预测世界各地自然疗法治疗和实践使用的特征。方法通过世界自然疗法联合会会员组织和社交媒体账户进行国际横断面在线调查。采用多变量反向逐步logistic回归，对人口统计学和执业特征的影响进行校正，以检验执业行为的潜在预测因素。结果应答率为78.4% (n=478)。生活方式的改变、饮食习惯的改变、营养产品和草药的使用一直或大部分时间都是一致的。至少有一半的参与者在临床实践中总是或大部分时间讨论了10个健康主题中的9个。超过一半(55.1%)的参与者在有法定法规/职业认证的场所执业。与来自自愿认证/无监管国家的参与者相比，那些来自法定注册/职业许可国家的参与者开营养品处方的几率更高(调整优势比(aOR)=2.5)或静脉/注射疗法(aOR=18.4)。结论本研究的发现对当代自然疗法的实践行为提供了重要的见解，这可能有助于克服其他卫生专业人员、政策制定者和社区对自然疗法的误解。

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引用次数: 0