Pub Date : 2024-03-26DOI: 10.1016/j.imr.2024.101040
Xiaotong Li , Raymond E. Baser , Karolina Bryl , Lindsay Amann , Susan Chimonas , Jun J. Mao
Background
Outcome expectancy is an important component of non-specific effect that may play an important role in pain research and clinical care. We sought to evaluate whether pretreatment expectancy predicts pain reduction in cancer survivors receiving electroacupuncture (EA) or battlefield acupuncture (BFA).
Methods
We analyzed data from a randomized clinical trial that compared EA and BFA versus wait list control (WLC) for chronic musculoskeletal pain in cancer survivors. Expectancy was measured by the Acupuncture Expectancy Scale (AES) at baseline. Pain severity was assessed using the Brief Pain Inventory (BPI) at baseline and week 12. For each treatment arm, multivariable regression models were used to evaluate the association between pretreatment expectancy and week 12 pain severity, controlling for baseline pain severity, age, sex, race, and education.
Results
Among 360 participants enrolled, the mean age was 62.1 years (SD 12.7), with 251 (69.7 %) women and 88 (24.4 %) non-white survivors. Pretreatment expectancy was similar for all groups at baseline (EA: 13.9 ± 3.6; BFA: 13.2 ± 3.7, WLC:12.8 ± 3.3, p = 0.14). Greater pretreatment expectancy was not significantly associated with greater pain reduction in any group, after adjusting for co-variates (EA: Coef. = -0.05, 95 % CI = -0.14 – 0.04, p = 0.28; BFA: Coef. = -0.07, 95 % CI = -0.16 – 0.02, p = 0.15; WLC: Coef. = -0.09, 95 % CI = -0.25 – 0.06, p = 0.23).
Conclusions
Pretreatment expectancy did not predict pain reduction for either EA or BFA in cancer survivors. Our study contributes to the interpretation of analgesic effects of EA or BFA, beyond the notion of a mere 'placebo effect'.
{"title":"How does pretreatment expectancy influence pain outcomes with electroacupuncture and battlefield acupuncture in cancer survivors?","authors":"Xiaotong Li , Raymond E. Baser , Karolina Bryl , Lindsay Amann , Susan Chimonas , Jun J. Mao","doi":"10.1016/j.imr.2024.101040","DOIUrl":"10.1016/j.imr.2024.101040","url":null,"abstract":"<div><h3>Background</h3><p>Outcome expectancy is an important component of non-specific effect that may play an important role in pain research and clinical care. We sought to evaluate whether pretreatment expectancy predicts pain reduction in cancer survivors receiving electroacupuncture (EA) or battlefield acupuncture (BFA).</p></div><div><h3>Methods</h3><p>We analyzed data from a randomized clinical trial that compared EA and BFA versus wait list control (WLC) for chronic musculoskeletal pain in cancer survivors. Expectancy was measured by the Acupuncture Expectancy Scale (AES) at baseline. Pain severity was assessed using the Brief Pain Inventory (BPI) at baseline and week 12. For each treatment arm, multivariable regression models were used to evaluate the association between pretreatment expectancy and week 12 pain severity, controlling for baseline pain severity, age, sex, race, and education.</p></div><div><h3>Results</h3><p>Among 360 participants enrolled, the mean age was 62.1 years (SD 12.7), with 251 (69.7 %) women and 88 (24.4 %) non-white survivors. Pretreatment expectancy was similar for all groups at baseline (EA: 13.9 ± 3.6; BFA: 13.2 ± 3.7, WLC:12.8 ± 3.3, <em>p</em> = 0.14). Greater pretreatment expectancy was not significantly associated with greater pain reduction in any group, after adjusting for co-variates (EA: Coef. = -0.05, 95 % CI = -0.14 – 0.04, <em>p</em> = 0.28; BFA: Coef. = -0.07, 95 % CI = -0.16 – 0.02, <em>p</em> = 0.15; WLC: Coef. = -0.09, 95 % CI = -0.25 – 0.06, <em>p</em> = 0.23).</p></div><div><h3>Conclusions</h3><p>Pretreatment expectancy did not predict pain reduction for either EA or BFA in cancer survivors. Our study contributes to the interpretation of analgesic effects of EA or BFA, beyond the notion of a mere 'placebo effect'.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000209/pdfft?md5=a2d025fb5c7b0f24740e5c8f75335613&pid=1-s2.0-S2213422024000209-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140400621","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-03-22DOI: 10.1016/j.imr.2024.101039
Xiao-ying Chen , Chun-li Lu , Qian-yun Wang , Xing-ru Pan , Yang-yang Zhang , Jia-le Wang , Jun-Ya Liao , Nai-chong Hu , Chen-yang Wang , Bing-jie Duan , Xue-han Liu , Xin-yan Jin , Jennifer Hunter , Jian-ping Liu
Background
Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection.
Methods
Ten English and Chinese language databases and grey literature were searched up to 12 April 2023 for randomized controlled trials (RCTs). Cochrane “Risk of bias” (RoB) tool was applied. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Effect estimates were presented as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI).
Results
Thirteen RCTs with 1632 participants were included. One RCT showed that Bufei Huoxue herbal capsules reduced fatigue (n=129, MD -14.90, 95%CI -24.53 to -5.27), one RCT reported that Ludangshen herbal liquid lowered fatigue (n=184, MD -1.90, 95%CI -2.38 to -1.42), and the other one RCT shown that fatigue disappearance rate was higher with Ludangshen herbal liquid (n=184, RR 4.19, 95%CI 2.06 to 8.53). Compared to traditional Chinese medicine rehabilitation (TCM-rahab) alone, one RCT showed that fatigue symptoms were lower following Qingjin Yiqi granules plus TCM-rehab (n=388, MD -0.48, 95%CI -0.50 to -0.46). Due to concerns with RoB and/or imprecision, the certainty in this evidence was low to very low. No serious adverse events was reported.
Conclusions
Limited evidence suggests that various TCIM interventions might reduce post COVID-19 fatigue. Larger, high quality RCTs of longer duration are required to confirm these preliminary findings.
Study Registration
The protocol of this review has been registered at PROSPERO: CRD42022384136.
{"title":"Traditional, complementary and integrative medicine for fatigue post COVID-19 infection: A systematic review of randomized controlled trials","authors":"Xiao-ying Chen , Chun-li Lu , Qian-yun Wang , Xing-ru Pan , Yang-yang Zhang , Jia-le Wang , Jun-Ya Liao , Nai-chong Hu , Chen-yang Wang , Bing-jie Duan , Xue-han Liu , Xin-yan Jin , Jennifer Hunter , Jian-ping Liu","doi":"10.1016/j.imr.2024.101039","DOIUrl":"https://doi.org/10.1016/j.imr.2024.101039","url":null,"abstract":"<div><h3>Background</h3><p>Chronic fatigue is a predominant symptom of post COVID-19 condition, or long COVID. We aimed to evaluate the efficacy and safety of Traditional, Complementary and Integrative Medicine (TCIM) for fatigue post COVID-19 infection.</p></div><div><h3>Methods</h3><p>Ten English and Chinese language databases and grey literature were searched up to 12 April 2023 for randomized controlled trials (RCTs). Cochrane “Risk of bias” (RoB) tool was applied. Evidence certainty was assessed using Grading of Recommendations Assessment, Development, and Evaluation (GRADE). Effect estimates were presented as risk ratio (RR) or mean difference (MD) with 95% confidence interval (CI).</p></div><div><h3>Results</h3><p>Thirteen RCTs with 1632 participants were included. One RCT showed that Bufei Huoxue herbal capsules reduced fatigue (n=129, MD -14.90, 95%CI -24.53 to -5.27), one RCT reported that Ludangshen herbal liquid lowered fatigue (n=184, MD -1.90, 95%CI -2.38 to -1.42), and the other one RCT shown that fatigue disappearance rate was higher with Ludangshen herbal liquid (n=184, RR 4.19, 95%CI 2.06 to 8.53). Compared to traditional Chinese medicine rehabilitation (TCM-rahab) alone, one RCT showed that fatigue symptoms were lower following Qingjin Yiqi granules plus TCM-rehab (n=388, MD -0.48, 95%CI -0.50 to -0.46). Due to concerns with RoB and/or imprecision, the certainty in this evidence was low to very low. No serious adverse events was reported.</p></div><div><h3>Conclusions</h3><p>Limited evidence suggests that various TCIM interventions might reduce post COVID-19 fatigue. Larger, high quality RCTs of longer duration are required to confirm these preliminary findings.</p></div><div><h3>Study Registration</h3><p>The protocol of this review has been registered at PROSPERO: CRD42022384136.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000192/pdfft?md5=bc76ea5e2313a749574bd58c0233f6ff&pid=1-s2.0-S2213422024000192-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140879247","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Tagetes erecta Linn, popularly known as Marigold, has various pharmacological effects. It is used as a dietary supplement, especially for the posterior segment of the eye. However, the effect of T. erecta Linn on ocular disorders is still unknown. The purpose of this study was to investigate the effect of oral administration of ethanol extract of T. erecta Linn flower (TE) for dry eye syndrome (DED) in a murine model.
Methods
Twenty-four mice were subjected to desiccation stress (DS) to induce DED and subcutaneous injection of scopolamine hydrobromide was administered 4 times a day for 21 days. TE and cyclosporine A (CsA) were administered for an additional 14 days under DS conditions. Mice were randomly divided into four groups: control, TE200, TE400, and CsA. Changes in tear production and corneal fluorescein staining were measured at baseline, after 7 days of DS, and after treatment for 7 and 14 days.
Results
DS significantly decreased tear production and increased corneal fluorescein score; the parameters were significantly reversed in the TE400 (oral administration of 400 mg TE/kg body weight) group. TE markedly improved DS-induced changes including corneal epithelial detachment and lacrimal gland inflammation. The anti-inflammatory effect of TE 400 supplementation was similar to that of CsA.
Conclusions
Our findings suggest that oral administration of TE may protect against DS-induced DED via stabilization of the tear film and suppression of inflammation. This study provides an experimental basis for further studies on the potential clinical use of TE in preventing DED.
Tagetes erecta Linn 俗称万寿菊,具有多种药理作用。它被用作天然食品着色剂、家禽饲料添加剂和营养补充剂,尤其是对眼球后段的作用。然而,直立金盏花对眼部疾病的影响尚不清楚。为了研究口服麟花乙醇提取物(TE)对小鼠干眼症(DED)模型的影响,我们对小鼠进行了干燥应激(DS)实验,并给小鼠皮下注射氢溴酸东莨菪碱,每天四次,连续 21 天。在干燥应激条件下,再注射 14 天 TE 和环孢素 A (CsA)。分别在基线、DS 7 天后以及治疗 7 天和 14 天后测量泪液分泌量和角膜荧光素染色的变化。DS明显降低了泪液分泌量,增加了角膜荧光素评分;TE400(口服400毫克TE/千克体重)组明显逆转了这些参数。TE 明显改善了 DS 引起的变化,包括角膜上皮脱落和泪腺炎症。补充 TE 400 的抗炎效果与 CsA 相似。我们的研究结果表明,口服 TE 可保护泪膜稳定和抑制炎症,防止 DS 引起的 DED。这项研究为进一步研究 TE 在预防 DED 方面的潜在临床应用提供了实验基础。
{"title":"Ameliorative effects of Tagetes erecta Linn. flower against desiccation stress-induced dry eye symptoms in the mice model","authors":"Hyesook Lee , Hyun Hwangbo , Jin-Won Hyun , Jung-Hyun Shim , Sun-Hee Leem , Gi-Young Kim , Yung Hyun Choi","doi":"10.1016/j.imr.2024.101038","DOIUrl":"10.1016/j.imr.2024.101038","url":null,"abstract":"<div><h3>Background</h3><p>Tagetes erecta Linn, popularly known as Marigold, has various pharmacological effects. It is used as a dietary supplement, especially for the posterior segment of the eye. However, the effect of T. erecta Linn on ocular disorders is still unknown. The purpose of this study was to investigate the effect of oral administration of ethanol extract of <em>T. erecta</em> Linn flower (TE) for dry eye syndrome (DED) in a murine model.</p></div><div><h3>Methods</h3><p>Twenty-four mice were subjected to desiccation stress (DS) to induce DED and subcutaneous injection of scopolamine hydrobromide was administered 4 times a day for 21 days. TE and cyclosporine A (CsA) were administered for an additional 14 days under DS conditions. Mice were randomly divided into four groups: control, TE200, TE400, and CsA. Changes in tear production and corneal fluorescein staining were measured at baseline, after 7 days of DS, and after treatment for 7 and 14 days.</p></div><div><h3>Results</h3><p>DS significantly decreased tear production and increased corneal fluorescein score; the parameters were significantly reversed in the TE400 (oral administration of 400 mg TE/kg body weight) group. TE markedly improved DS-induced changes including corneal epithelial detachment and lacrimal gland inflammation. The anti-inflammatory effect of TE 400 supplementation was similar to that of CsA.</p></div><div><h3>Conclusions</h3><p>Our findings suggest that oral administration of TE may protect against DS-induced DED <em>via</em> stabilization of the tear film and suppression of inflammation. This study provides an experimental basis for further studies on the potential clinical use of TE in preventing DED.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-03-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000180/pdfft?md5=0c1067b98ff7ae394de01323ba6a8e26&pid=1-s2.0-S2213422024000180-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140150903","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-17DOI: 10.1016/j.imr.2024.101026
Younbyoung Chae , Jun-Hwan Lee , Myeong Soo Lee
Acupuncture treatment can be defined as a medical procedure with an acupuncture needle at acupoints. Establishing suitable control settings is essential, based on the target elements of the acupuncture therapy. In order to properly design a clinical trial or an experiment, a control group must be established. Here, we overview the significance of the control group and its limitations in acupuncture research. Clinical trials have employed a variety of study designs and controls for acupuncture treatment in order to compare the effects of actual treatments with control groups that include no treatment or treatment as usual, sham acupuncture at true acupoints, real acupuncture at non-acupoints, and sham acupuncture at non-acupoints. In order to determine the point-specificity of acupuncture, real acupuncture at non-acupoints should be taken into consideration, whereas sham acupuncture at the same true acupoints should be used to determine the needling-specific effect of acupuncture. It is crucial to choose the optimum control for acupuncture treatments depending on the study's main goal and to interpret the results in accordance with the research design.
{"title":"Using the right design controls for acupuncture trials: Methodological rigor and validity in research","authors":"Younbyoung Chae , Jun-Hwan Lee , Myeong Soo Lee","doi":"10.1016/j.imr.2024.101026","DOIUrl":"https://doi.org/10.1016/j.imr.2024.101026","url":null,"abstract":"<div><p>Acupuncture treatment can be defined as a medical procedure with an acupuncture needle at acupoints. Establishing suitable control settings is essential, based on the target elements of the acupuncture therapy. In order to properly design a clinical trial or an experiment, a control group must be established. Here, we overview the significance of the control group and its limitations in acupuncture research. Clinical trials have employed a variety of study designs and controls for acupuncture treatment in order to compare the effects of actual treatments with control groups that include no treatment or treatment as usual, sham acupuncture at true acupoints, real acupuncture at non-acupoints, and sham acupuncture at non-acupoints. In order to determine the point-specificity of acupuncture, real acupuncture at non-acupoints should be taken into consideration, whereas sham acupuncture at the same true acupoints should be used to determine the needling-specific effect of acupuncture. It is crucial to choose the optimum control for acupuncture treatments depending on the study's main goal and to interpret the results in accordance with the research design.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000064/pdfft?md5=f9cce0036e86b6ddf4f91f1598c56b9f&pid=1-s2.0-S2213422024000064-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139942456","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-16DOI: 10.1016/j.imr.2024.101025
Jun-Yong Choi , Bom Choi , Ojin Kwon , Chang-Seob Seo , Ae-Ran Kim , Hyeun-kyoo Shin , Kibong Kim
Background
Gongjin-dan (GJD, also known as Gongchen-dan) and Ssanghwa-tang (SHT, also known as Shuanghe-tang or Souwa-to) are herbal medicines that are widely used in Korea for treating fatigue. However, few studies have evaluated the efficacy and safety of GJD and SHT in the treatment of chronic fatigue.
Methods
In this randomized, double-blind, placebo-controlled clinical trial, 90 individuals with persistent (≥6 months) chronic fatigue of unknown cause and a Fatigue Severity Scale (FSS) score of ≥4 were randomly assigned to GJD group, SHT group, and control group in a 1:1:1 ratio. Outcomes were the changes in the self-reported fatigue questionnaire scores, levels of fatigue-related biomarkers and safety assessment.
Results
Out of 103 patients recruited, 90 were included in the analysis. A significant improvement in the Social Functioning (SF) score of Short-Form 36 Health Survey (SF-36) at week 4 was observed in the GJD group; similarly, a significant improvement compared with that in the Control group was observed in the Role Emotional (RE) score of SF-36 at weeks 4 and 6 and the Physical Functioning (PF) score of SF-36 at week 6 in the SHT group. Laboratory tests revealed no abnormalities, and serious intervention-related adverse events were not reported.
Conclusions
It is suggested that SHT can effectively treat chronic mental and physical fatigue, whereas GJD can effectively treat chronic mental and social fatigue. Furthermore, this study presents evidence supporting the safety of the long-term use of GJD and SHT (up to 4 weeks).
Trial registration
This study was registered at Clinical Research Information Service (CRIS) of Korea with the registration number KCT0007515.
{"title":"Efficacy and safety of herbal medicine Gongjin-Dan and Ssanghwa-Tang in patients with chronic fatigue: A randomized, double-blind, placebo-controlled, clinical trial","authors":"Jun-Yong Choi , Bom Choi , Ojin Kwon , Chang-Seob Seo , Ae-Ran Kim , Hyeun-kyoo Shin , Kibong Kim","doi":"10.1016/j.imr.2024.101025","DOIUrl":"10.1016/j.imr.2024.101025","url":null,"abstract":"<div><h3>Background</h3><p>Gongjin-dan (GJD, also known as Gongchen-dan) and Ssanghwa-tang (SHT, also known as Shuanghe-tang or Souwa-to) are herbal medicines that are widely used in Korea for treating fatigue. However, few studies have evaluated the efficacy and safety of GJD and SHT in the treatment of chronic fatigue.</p></div><div><h3>Methods</h3><p>In this randomized, double-blind, placebo-controlled clinical trial, 90 individuals with persistent (≥6 months) chronic fatigue of unknown cause and a Fatigue Severity Scale (FSS) score of ≥4 were randomly assigned to GJD group, SHT group, and control group in a 1:1:1 ratio. Outcomes were the changes in the self-reported fatigue questionnaire scores, levels of fatigue-related biomarkers and safety assessment.</p></div><div><h3>Results</h3><p>Out of 103 patients recruited, 90 were included in the analysis. A significant improvement in the Social Functioning (SF) score of Short-Form 36 Health Survey (SF-36) at week 4 was observed in the GJD group; similarly, a significant improvement compared with that in the Control group was observed in the Role Emotional (RE) score of SF-36 at weeks 4 and 6 and the Physical Functioning (PF) score of SF-36 at week 6 in the SHT group. Laboratory tests revealed no abnormalities, and serious intervention-related adverse events were not reported.</p></div><div><h3>Conclusions</h3><p>It is suggested that SHT can effectively treat chronic mental and physical fatigue, whereas GJD can effectively treat chronic mental and social fatigue. Furthermore, this study presents evidence supporting the safety of the long-term use of GJD and SHT (up to 4 weeks).</p></div><div><h3>Trial registration</h3><p>This study was registered at Clinical Research Information Service (CRIS) of Korea with the registration number KCT0007515.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000052/pdfft?md5=0180e2aec9ae7d2e2114f8bded2ad2bb&pid=1-s2.0-S2213422024000052-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139927571","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-09DOI: 10.1016/j.imr.2024.101024
Jeremy Y. Ng , Holger Cramer , Myeong Soo Lee , David Moher
The convergence of traditional, complementary, and integrative medicine (TCIM) with artificial intelligence (AI) is a promising frontier in healthcare. TCIM is a patient-centric approach that combines conventional medicine with complementary therapies, emphasizing holistic well-being. AI can revolutionize healthcare through data-driven decision-making and personalized treatment plans. This article explores how AI technologies can complement and enhance TCIM, aligning with the shared objectives of researchers from both fields in improving patient outcomes, enhancing care quality, and promoting holistic wellness. This integration of TCIM and AI introduces exciting opportunities but also noteworthy challenges. AI may augment TCIM by assisting in early disease detection, providing personalized treatment plans, predicting health trends, and enhancing patient engagement. Challenges at the intersection of AI and TCIM include data privacy and security, regulatory complexities, maintaining the human touch in patient-provider relationships, and mitigating bias in AI algorithms. Patients' trust, informed consent, and legal accountability are all essential considerations. Future directions in AI-enhanced TCIM include advanced personalized medicine, understanding the efficacy of herbal remedies, and studying patient-provider interactions. Research on bias mitigation, patient acceptance, and trust in AI-driven TCIM healthcare is crucial. In this article, we outlined that the merging of TCIM and AI holds great promise in enhancing healthcare delivery, personalizing treatment plans, preventive care, and patient engagement. Addressing challenges and fostering collaboration between AI experts, TCIM practitioners, and policymakers, however, is vital to harnessing the full potential of this integration.
{"title":"Traditional, complementary, and integrative medicine and artificial intelligence: Novel opportunities in healthcare","authors":"Jeremy Y. Ng , Holger Cramer , Myeong Soo Lee , David Moher","doi":"10.1016/j.imr.2024.101024","DOIUrl":"https://doi.org/10.1016/j.imr.2024.101024","url":null,"abstract":"<div><p>The convergence of traditional, complementary, and integrative medicine (TCIM) with artificial intelligence (AI) is a promising frontier in healthcare. TCIM is a patient-centric approach that combines conventional medicine with complementary therapies, emphasizing holistic well-being. AI can revolutionize healthcare through data-driven decision-making and personalized treatment plans. This article explores how AI technologies can complement and enhance TCIM, aligning with the shared objectives of researchers from both fields in improving patient outcomes, enhancing care quality, and promoting holistic wellness. This integration of TCIM and AI introduces exciting opportunities but also noteworthy challenges. AI may augment TCIM by assisting in early disease detection, providing personalized treatment plans, predicting health trends, and enhancing patient engagement. Challenges at the intersection of AI and TCIM include data privacy and security, regulatory complexities, maintaining the human touch in patient-provider relationships, and mitigating bias in AI algorithms. Patients' trust, informed consent, and legal accountability are all essential considerations. Future directions in AI-enhanced TCIM include advanced personalized medicine, understanding the efficacy of herbal remedies, and studying patient-provider interactions. Research on bias mitigation, patient acceptance, and trust in AI-driven TCIM healthcare is crucial. In this article, we outlined that the merging of TCIM and AI holds great promise in enhancing healthcare delivery, personalizing treatment plans, preventive care, and patient engagement. Addressing challenges and fostering collaboration between AI experts, TCIM practitioners, and policymakers, however, is vital to harnessing the full potential of this integration.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000040/pdfft?md5=b8cbf1adb83572dbee54fa4b37730fde&pid=1-s2.0-S2213422024000040-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139743281","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-07DOI: 10.1016/j.imr.2024.101022
Libin Jia , Michelle Beidelschies , Joel M. Evans , Richard C. Niemtzow , Songxuan Zhou Niemtzow , Jeffery A. Dusek , Yufang Lin , Charles Wu , Yi-Chang Su , C. Jason Wang , Chien-Yu Lin , Peristiwan Ridha Widhi Astana , Danang Ardiyanto , Rusmiyati Hardjoutomo , Khwanchai Visithanon , Jagravudh Puagkong , Julalak Chokpaisarn , Martha Villar Lopez , Hiroshi Yotsuyanagi , Myeong Soo Lee , Cecilia C. Maramba-Lazarte
This article - Recommendations and Guidelines of Integrative Medicine (IM) for COVID-19 Care - was one of the outcomes from an Asia-Pacific Economic Cooperation (APEC) Project (Integrative Medicine (IM) and COVID -19 Care) during the time between May 2022 and March 2023. With the efforts from care providers, researchers, health policy makers and healthcare administrative leaders among APEC economies, the purpose of this file was to provide comprehensive IM systems for COVID-19 care as recommendations and suggestive guidelines including care methods, tools, procedures, symptom conditions and targets selections, and points need to be considered during care applications. All cited COVID-19 care practices have confirmed their efficacy and usefulness either used alone or combined with conventional medicine. This article provides current useful medical information on IM for COVID-19 care which could benefit APEC economies and world health communities on their healthcare system.
{"title":"Recommendations and guidelines of integrative medicine for COVID-19 care: The APEC project outcome","authors":"Libin Jia , Michelle Beidelschies , Joel M. Evans , Richard C. Niemtzow , Songxuan Zhou Niemtzow , Jeffery A. Dusek , Yufang Lin , Charles Wu , Yi-Chang Su , C. Jason Wang , Chien-Yu Lin , Peristiwan Ridha Widhi Astana , Danang Ardiyanto , Rusmiyati Hardjoutomo , Khwanchai Visithanon , Jagravudh Puagkong , Julalak Chokpaisarn , Martha Villar Lopez , Hiroshi Yotsuyanagi , Myeong Soo Lee , Cecilia C. Maramba-Lazarte","doi":"10.1016/j.imr.2024.101022","DOIUrl":"https://doi.org/10.1016/j.imr.2024.101022","url":null,"abstract":"<div><p>This article - Recommendations and Guidelines of Integrative Medicine (IM) for COVID-19 Care - was one of the outcomes from an Asia-Pacific Economic Cooperation (APEC) Project (Integrative Medicine (IM) and COVID -19 Care) during the time between May 2022 and March 2023. With the efforts from care providers, researchers, health policy makers and healthcare administrative leaders among APEC economies, the purpose of this file was to provide comprehensive IM systems for COVID-19 care as recommendations and suggestive guidelines including care methods, tools, procedures, symptom conditions and targets selections, and points need to be considered during care applications. All cited COVID-19 care practices have confirmed their efficacy and usefulness either used alone or combined with conventional medicine. This article provides current useful medical information on IM for COVID-19 care which could benefit APEC economies and world health communities on their healthcare system.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000027/pdfft?md5=810297852db3200d2ed65099f89cf9a7&pid=1-s2.0-S2213422024000027-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139975972","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-02-06DOI: 10.1016/j.imr.2024.101023
Shanze Wang , Chao Yang , Weimei Zeng , Hongfang Tian , Shihao Du , Jiping Zhao
Background
Hashimoto's thyroiditis (HT) has a high incidence rate and unresolved clinical symptoms. Although Hand Yangming Meridian Penetrating Acupuncture has been used to treat thyroid diseases in China, there is no randomized controlled trial (RCT) on HT.
Methods
This exploratory RCT aims to preliminarily evaluate the efficacy, safety, and feasibility of Hand Yangming Meridian Penetrating Acupuncture in the treatment of HT. Included subjects were randomly assigned to the acupuncture group and the waiting treatment group at a ratio of 1:1. Subjects in the acupuncture group received 16 weeks of acupuncture treatment, followed by a 16-week follow-up observation phase. Subjects in the waiting group received thyroxine supplementation for 16 weeks, followed by 16 weeks of compensation treatment. Serum thyroid peroxidase antibody (TPOab) and thyroglobulin antibody (TGab) levels were the main indicators, and Thyroid-Related Patient-Reported Outcome short form (ThyPRO-39), MOS Item Short Form Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS) scores were also recorded.
Results
In total, 58 subjects were included. After 16 weeks of treatment, there was no statistical difference in the changes in TPOab levels between the two groups, but the TGab level in the acupuncture group was significantly lower than in the waiting group (difference: −141.97 [95 % CI: −222.4 to −61.5], P = 0.011). Moreover, the total ThyPRO-39 and SF-36 scores were statistically different between the two groups (PThyPRO-39 < 0.001, PSF-36 = 0.005). There was no statistical difference in HADS between the two groups.
Conclusions
Hand Yangming Meridian Penetrating Acupuncture may be safe and feasible for HT hypothyroidism to improve symptoms and reduce TGab levels.
Trial registration number
This trial was registered at Acupuncture-Moxibustion Clinical Trial Registry: AMCTR-IOR-19000308 (ChiCTR1900026830, https://www.chictr.org.cn/searchprojEN.html).
{"title":"Acupuncture treatment for Hashimoto's thyroiditis: An exploratory randomized controlled trial","authors":"Shanze Wang , Chao Yang , Weimei Zeng , Hongfang Tian , Shihao Du , Jiping Zhao","doi":"10.1016/j.imr.2024.101023","DOIUrl":"10.1016/j.imr.2024.101023","url":null,"abstract":"<div><h3>Background</h3><p>Hashimoto's thyroiditis (HT) has a high incidence rate and unresolved clinical symptoms. Although Hand Yangming Meridian Penetrating Acupuncture has been used to treat thyroid diseases in China, there is no randomized controlled trial (RCT) on HT.</p></div><div><h3>Methods</h3><p>This exploratory RCT aims to preliminarily evaluate the efficacy, safety, and feasibility of Hand Yangming Meridian Penetrating Acupuncture in the treatment of HT. Included subjects were randomly assigned to the acupuncture group and the waiting treatment group at a ratio of 1:1. Subjects in the acupuncture group received 16 weeks of acupuncture treatment, followed by a 16-week follow-up observation phase. Subjects in the waiting group received thyroxine supplementation for 16 weeks, followed by 16 weeks of compensation treatment. Serum thyroid peroxidase antibody (TPOab) and thyroglobulin antibody (TGab) levels were the main indicators, and Thyroid-Related Patient-Reported Outcome short form (ThyPRO-39), MOS Item Short Form Health Survey (SF-36), and Hospital Anxiety and Depression Scale (HADS) scores were also recorded.</p></div><div><h3>Results</h3><p>In total, 58 subjects were included. After 16 weeks of treatment, there was no statistical difference in the changes in TPOab levels between the two groups, but the TGab level in the acupuncture group was significantly lower than in the waiting group (difference: −141.97 [95 % CI: −222.4 to −61.5]<em>, P</em> = 0.011). Moreover, the total ThyPRO-39 and SF-36 scores were statistically different between the two groups (<em>P</em><sub>ThyPRO-39</sub> < 0.001, <em>P</em><sub>SF-36</sub> = 0.005). There was no statistical difference in HADS between the two groups.</p></div><div><h3>Conclusions</h3><p>Hand Yangming Meridian Penetrating Acupuncture may be safe and feasible for HT hypothyroidism to improve symptoms and reduce TGab levels.</p></div><div><h3>Trial registration number</h3><p>This trial was registered at Acupuncture-Moxibustion Clinical Trial Registry: AMCTR-IOR-19000308 (ChiCTR1900026830, <span>https://www.chictr.org.cn/searchprojEN.html</span><svg><path></path></svg>).</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2024-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422024000039/pdfft?md5=46d85862d2dae13130ef55fe03b3b5ba&pid=1-s2.0-S2213422024000039-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139754365","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-20DOI: 10.1016/j.imr.2024.101021
Xue-Zhou Wang , Cun-Zhi Liu , Li-Qiong Wang , Zhi-Cheng Qu , Ying Cao , Shi-Yan Yan , Jing-Wen Yang , Jian-Feng Tu
Background
The integration of acupuncture with intramuscular injection of diclofenac sodium can expedite the onset of analgesia in treating acute renal colic caused by urolithiasis. However, it remains unclear whether acupuncture can accelerate pain relief constantly until complete remission. This study aimed to explore the extent to which acupuncture can expedite the onset time of response or complete pain relief in treating acute renal colic, and the predictive value of patient characteristics for treatment efficacy.
Methods
This secondary analysis utilized data from a prior randomized controlled trial. Eighty patients with acute renal colic were randomly assigned 1:1 to the acupuncture group or the sham acupuncture group. After intramuscular injection of diclofenac sodium, acupuncture or sham acupuncture was delivered to patients. The outcomes included time to response (at least a 50 % reduction in pain) and complete pain relief. Between-group comparison under the 2 events was estimated by Kaplan-Meier methodology. Subgroup analysis was performed utilizing the Cox proportional hazards model.
Results
The median response time and complete pain relief time in the acupuncture group were lower than those in the sham acupuncture group (5 vs 30 min, Log Rank P < 0.001; 20 min vs not observed, Log Rank P < 0.001, respectively). Hazard Ratios (HRs) for response across all subgroups favored the acupuncture group. All HRs for complete pain relief favored acupuncture, expect large stone and moderate pain at baseline. No interaction was found in either event.
Conclusion
Acupuncture can accelerate the response time and complete pain relief time for patients with acute renal colic, with the efficacy universally.
Trial registration
This study has been registered at Chinese Clinical Trial Registry: ChiCTR1900025202.
背景 在治疗由尿路结石引起的急性肾绞痛时,针灸与肌肉注射双氯芬酸钠的结合可加快镇痛的开始。然而,针灸是否能持续加速疼痛缓解直至完全缓解仍不清楚。本研究旨在探讨针灸在治疗急性肾绞痛时能在多大程度上加快起效时间或完全缓解疼痛,以及患者特征对疗效的预测价值。80 名急性肾绞痛患者按 1:1 随机分配到针灸组或假针灸组。肌肉注射双氯芬酸钠后,对患者进行针灸或假针灸。结果包括反应时间(疼痛至少减轻 50%)和疼痛完全缓解。采用 Kaplan-Meier 方法估算 2 个事件下的组间比较。结果针灸组的反应时间和疼痛完全缓解时间低于假针灸组(分别为 5 分钟 vs 30 分钟,Log Rank P < 0.001;20 分钟 vs 未观察到,Log Rank P < 0.001)。所有分组的反应危险比(HRs)均倾向于针灸组。所有完全缓解疼痛的危险比都倾向于针灸组,预计大结石和基线中度疼痛。结论针灸可加快急性肾绞痛患者的反应时间和完全缓解疼痛的时间,疗效普遍。
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Pub Date : 2023-12-24DOI: 10.1016/j.imr.2023.101020
Haeun Kim , Dong-Woo Lee , Jae-Kwan Hwang
Background
Cancer cachexia—characterized by anorexia, body weight loss, skeletal muscle atrophy, and fat loss—affects nearly 80% of cancer patients and accounts for 20% of cancer deaths. Curcuma xanthorrhiza, known as Java turmeric, and its active compound xanthorrhizol (XAN) exhibit anticancer, anti-inflammatory, and antioxidant properties. However, the ameliorative effects of C. xanthorrhiza extract (CXE) and XAN on cancer-associated adipose atrophy remain unexplored. This study aimed to evaluate the therapeutic effects of CXE and XAN on cancer cachexia-induced adipose tissue wasting in CT26 tumor-bearing mice.
Methods
CT26 cells were injected subcutaneously into the right flank of BALB/c mice to establish a cancer cachexia model. To evaluate the inhibitory effects of CXE and XAN on cancer cachexia, 50 and 100 mg/kg CXE and 15 mg/kg XAN were administered orally every day for 1 week.
Results
CXE and XAN administration significantly attenuated the loss of body weight and epidydimal fat mass by cancer cachexia. In epididymal adipose tissues, administration of CXE or XAN inhibited white adipose tissue browning by repressing expression of the thermogenic genes. Simultaneously, CXE or XAN attenuated fat catabolism through the downregulation of lipolytic genes. The administration of CXE or XAN induced the expression of genes associated with adipogenesis and lipogenesis-related genes. Moreover, CXE or XAN treatment was associated with maintaining metabolic homeostasis; regulating the expression of adipokines and AMP-activated protein kinase (AMPK).
Conclusions
CXE and XAN mitigate cancer-induced adipose tissue atrophy, primarily by modulating lipid metabolism and WAT browning, indicating their therapeutic potential for cachectic cancer patients.
背景癌症恶病质以厌食、体重下降、骨骼肌萎缩和脂肪减少为特征,影响着近 80% 的癌症患者,占癌症死亡人数的 20%。莪术(又名爪哇姜黄)及其活性化合物黄皮酚(XAN)具有抗癌、抗炎和抗氧化特性。然而,黄柏提取物(CXE)和黄柏酚(XAN)对癌症相关性脂肪萎缩的改善作用仍有待探索。本研究旨在评估 CXE 和 XAN 对 CT26 肿瘤小鼠因癌症恶病质引起的脂肪组织萎缩的治疗作用。为了评估 CXE 和 XAN 对癌症恶病质的抑制作用,小鼠每天口服 50 和 100 mg/kg CXE 和 15 mg/kg XAN,持续 1 周。在附睾脂肪组织中,服用 CXE 或 XAN 可抑制生热基因的表达,从而抑制白色脂肪组织的褐变。同时,CXE 或 XAN 通过下调脂肪分解基因,抑制脂肪分解。服用 CXE 或 XAN 会诱导脂肪生成相关基因和脂肪生成相关基因的表达。结论CXE和XAN主要通过调节脂质代谢和WAT棕色化来缓解癌症诱导的脂肪组织萎缩,这表明它们对恶性肿瘤患者具有治疗潜力。
{"title":"Curcuma xanthorrhiza extract and xanthorrhizol ameliorate cancer-induced adipose wasting in CT26-bearing mice by regulating lipid metabolism and adipose tissue browning","authors":"Haeun Kim , Dong-Woo Lee , Jae-Kwan Hwang","doi":"10.1016/j.imr.2023.101020","DOIUrl":"10.1016/j.imr.2023.101020","url":null,"abstract":"<div><h3>Background</h3><p>Cancer cachexia—characterized by anorexia, body weight loss, skeletal muscle atrophy, and fat loss—affects nearly 80% of cancer patients and accounts for 20% of cancer deaths. <em>Curcuma xanthorrhiza</em>, known as Java turmeric, and its active compound xanthorrhizol (XAN) exhibit anticancer, anti-inflammatory, and antioxidant properties. However, the ameliorative effects of <em>C. xanthorrhiza</em> extract (CXE) and XAN on cancer-associated adipose atrophy remain unexplored. This study aimed to evaluate the therapeutic effects of CXE and XAN on cancer cachexia-induced adipose tissue wasting in CT26 tumor-bearing mice.</p></div><div><h3>Methods</h3><p>CT26 cells were injected subcutaneously into the right flank of BALB/c mice to establish a cancer cachexia model. To evaluate the inhibitory effects of CXE and XAN on cancer cachexia, 50 and 100 mg/kg CXE and 15 mg/kg XAN were administered orally every day for 1 week.</p></div><div><h3>Results</h3><p>CXE and XAN administration significantly attenuated the loss of body weight and epidydimal fat mass by cancer cachexia. In epididymal adipose tissues, administration of CXE or XAN inhibited white adipose tissue browning by repressing expression of the thermogenic genes. Simultaneously, CXE or XAN attenuated fat catabolism through the downregulation of lipolytic genes. The administration of CXE or XAN induced the expression of genes associated with adipogenesis and lipogenesis-related genes. Moreover, CXE or XAN treatment was associated with maintaining metabolic homeostasis; regulating the expression of adipokines and AMP-activated protein kinase (AMPK).</p></div><div><h3>Conclusions</h3><p>CXE and XAN mitigate cancer-induced adipose tissue atrophy, primarily by modulating lipid metabolism and WAT browning, indicating their therapeutic potential for cachectic cancer patients.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-12-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422023000999/pdfft?md5=45e7aae2ce23721f60bbb95812194cda&pid=1-s2.0-S2213422023000999-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139036846","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}