Pub Date : 2023-10-20DOI: 10.1016/j.imr.2023.101000
Ye-Seul Lee, Yoon Jae Lee, In-Hyuk Ha
Real world data (RWD) is increasingly used to investigate health outcomes and treatment efficacy in the field of integrative medicine. Due to the fact that the majority of RWDs are not intended for research, their secondary use in research necessitates complex study designs to account for bias and confounding. To conduct a robust analysis of RWD in integrative medicine, a comprehensive study design process that reflects the characteristics of integrative therapies is necessary. In this paper, we present a guide for designing comparative effectiveness RWE research in integrative medicine. We discuss key factors to consider when selecting RWDs for research on integrative medicine. We provide practical steps for developing a research question, formulating the PICOT objectives (population, intervention, comparator, outcome, and time horizon), and selecting and defining covariates with a summary table. Specific study designs are depicted with corresponding diagrams. Finally, data analysis procedures are introduced. We hope this article clarifies the importance of RWE research design and related processes in order to improve the rigor of RWD studies in the field of integrative medicine research.
{"title":"Real-world data analysis on effectiveness of integrative therapies: A practical guide to study design and data analysis using healthcare databases","authors":"Ye-Seul Lee, Yoon Jae Lee, In-Hyuk Ha","doi":"10.1016/j.imr.2023.101000","DOIUrl":"https://doi.org/10.1016/j.imr.2023.101000","url":null,"abstract":"<div><p>Real world data (RWD) is increasingly used to investigate health outcomes and treatment efficacy in the field of integrative medicine. Due to the fact that the majority of RWDs are not intended for research, their secondary use in research necessitates complex study designs to account for bias and confounding. To conduct a robust analysis of RWD in integrative medicine, a comprehensive study design process that reflects the characteristics of integrative therapies is necessary. In this paper, we present a guide for designing comparative effectiveness RWE research in integrative medicine. We discuss key factors to consider when selecting RWDs for research on integrative medicine. We provide practical steps for developing a research question, formulating the PICOT objectives (population, intervention, comparator, outcome, and time horizon), and selecting and defining covariates with a summary table. Specific study designs are depicted with corresponding diagrams. Finally, data analysis procedures are introduced. We hope this article clarifies the importance of RWE research design and related processes in order to improve the rigor of RWD studies in the field of integrative medicine research.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422023000793/pdfft?md5=89c1006144dfc63a4bf6a0117602b214&pid=1-s2.0-S2213422023000793-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90029701","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 : 2023-10-19DOI: 10.1016/j.imr.2023.100998
Saruul Erdenebileg , Yang-Ju Son , Myungsuk Kim , Sarangerel Oidovsambuu , Kwang Hyun Cha , Jaeyoung Kwon , Da Seul Jung , Chu Won Nho
Background
The root of Saposhnikovia divaricata (Turcz.) Schischk is a well-known traditional medicinal plant, containing various bioactive compounds with anti-inflammatory, antioxidant, and analgesic properties. However, no scientific studies have validated its clinical use as an anti-inflammatory agent against inflammatory bowel disease (IBD). This study aimed to investigate whether the root extract of S. divaricata ameliorates IBD and induces gut microbial alteration, using a RAW 264.7 cell line and a DSS-induced colitis mouse model.
Methods
To investigate the anti-inflammatory effects and alleviation of IBD, using a methanol extract of Saposhnikovia divaricata (Turcz.) Schischk. root (MESD), RAW 264.7, murine macrophages and a dextran sodium sulfate (DSS)-induced colitis mouse model were employed. 16S rRNA gene sequencing was conducted to determine the alterations in the gut microbiota of mice with DSS-induced colitis.
Results
MESD significantly decreased nitric oxide (NO) and inflammatory cytokine levels in lipopolysaccharide (LPS)-induced RAW 264.7 cells in vitro. Oral administration of MESD reduced the expression of inflammatory cytokines in the colons of mice with DSS-induced colitis. Additionally, MESD inhibited the abundance of Clostridium sensu stricto 1 and enhanced the predicted functional pathways, including l-glutamate degradation VIII (to propanoic acid). Seven compounds with anti-inflammatory properties were isolated from the MESD. Among them, 3′-O-acetylhamaudol and 3′-O-angeloylhamaudol exhibited strong anti-inflammatory effects in vitro.
Conclusion
Overall, MESD may be a potential natural product for the treatment of IBD by lowering inflammatory cytokine levels and altering gut microbiota composition.
背景:土属植物Saposhnikovia divaricata石竹是一种著名的传统药用植物,含有多种生物活性化合物,具有抗炎、抗氧化、镇痛等作用。然而,没有科学研究证实其作为抗炎症性肠病(IBD)的抗炎剂的临床应用。本研究旨在通过RAW 264.7细胞系和dss诱导的结肠炎小鼠模型,研究鸢尾根提取物是否能改善IBD并诱导肠道微生物改变。方法采用甲醇提取物对IBD的抗炎和缓解作用进行研究。Schischk。采用小鼠巨噬细胞和右旋糖酐硫酸钠(DSS)诱导的小鼠结肠炎模型。通过16S rRNA基因测序来确定dss诱导结肠炎小鼠肠道菌群的变化。结果smesd显著降低脂多糖(LPS)诱导的RAW 264.7细胞的一氧化氮(NO)和炎性细胞因子水平。口服MESD可降低dss诱导结肠炎小鼠结肠中炎症细胞因子的表达。此外,MESD抑制了严格感梭菌1的丰度,并增强了预测的功能途径,包括l-谷氨酸降解VIII(到丙酸)。从MESD中分离到7个具有抗炎作用的化合物。其中,3′- o -乙酰哈马多尔和3′- o - angeloyl哈马多尔在体外表现出较强的抗炎作用。综上所述,MESD可能是通过降低炎症细胞因子水平和改变肠道菌群组成来治疗IBD的潜在天然产物。
{"title":"Saposhnikovia divaricata root and its major components ameliorate inflammation and altered gut microbial diversity and compositions in DSS-induced colitis","authors":"Saruul Erdenebileg , Yang-Ju Son , Myungsuk Kim , Sarangerel Oidovsambuu , Kwang Hyun Cha , Jaeyoung Kwon , Da Seul Jung , Chu Won Nho","doi":"10.1016/j.imr.2023.100998","DOIUrl":"https://doi.org/10.1016/j.imr.2023.100998","url":null,"abstract":"<div><h3>Background</h3><p>The root of <em>Saposhnikovia divaricata</em> (Turcz.) Schischk is a well-known traditional medicinal plant, containing various bioactive compounds with anti-inflammatory, antioxidant, and analgesic properties. However, no scientific studies have validated its clinical use as an anti-inflammatory agent against inflammatory bowel disease (IBD). This study aimed to investigate whether the root extract of <em>S. divaricata</em> ameliorates IBD and induces gut microbial alteration, using a RAW 264.7 cell line and a DSS-induced colitis mouse model.</p></div><div><h3>Methods</h3><p>To investigate the anti-inflammatory effects and alleviation of IBD, using a methanol extract of <em>Saposhnikovia divaricata</em> (Turcz.) Schischk. root (MESD), RAW 264.7, murine macrophages and a dextran sodium sulfate (DSS)-induced colitis mouse model were employed. 16S rRNA gene sequencing was conducted to determine the alterations in the gut microbiota of mice with DSS-induced colitis.</p></div><div><h3>Results</h3><p>MESD significantly decreased nitric oxide (NO) and inflammatory cytokine levels in lipopolysaccharide (LPS)-induced RAW 264.7 cells <em>in vitro</em>. Oral administration of MESD reduced the expression of inflammatory cytokines in the colons of mice with DSS-induced colitis. Additionally, MESD inhibited the abundance of <em>Clostridium sensu stricto</em> 1 and enhanced the predicted functional pathways, including <span>l</span>-glutamate degradation VIII (to propanoic acid). Seven compounds with anti-inflammatory properties were isolated from the MESD. Among them, 3′-O-acetylhamaudol and 3′-O-angeloylhamaudol exhibited strong anti-inflammatory effects <em>in vitro</em>.</p></div><div><h3>Conclusion</h3><p>Overall, MESD may be a potential natural product for the treatment of IBD by lowering inflammatory cytokine levels and altering gut microbiota composition.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S221342202300077X/pdfft?md5=defe800f4db3bce02c67d4b4f5ab6743&pid=1-s2.0-S221342202300077X-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"92100321","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 : 2023-10-17DOI: 10.1016/j.imr.2023.100997
Jia-Ming Chen , Wan-Li Chiang , Bin-Chuan Ji , Ruei-Jhe Jhang , Pei-Hsin Chen , Ya-Lun Li , Che-Ju Chang , Sung-Yen Huang , Tsung-Chieh Lee , Chia-Yun Chen , Ching-Hsiung Lin , Sheng-Hao Lin
Background
In intensive care units, mechanical ventilation is an important therapy to help patients with dyspnea. However, long-term ventilator dependence would consume huge medical resources and increase the risk of morbidity and mortality. The aim of the study was to examine the efficacy of the acupuncture combined with western medical care on ventilator parameters in ventilator-dependent patients.
Methods
In this clinical trial, 80 ventilator-dependent patients aged 20 to 80 years old were randomly assigned to acupuncture group and control group in the respiratory care center (RCC) of Changhua Christian Hospital. Besides regular medical care and therapy, participants in the acupuncture group received acupuncture therapy at the same 17 acu-points for 20 minutes once a day, a total of 12 sessions. The ventilator parameters were recorded to evaluate the respiratory efficiency for all participants. The primary outcome was rapid shallow breathing index (RSBI), and secondary outcomes were respiratory rate (RR), tidal volume (TV) and ventilation per minute (MV),
Results
Though there was no significant difference in the parameter between the acupuncture group and the control group, we found the trend of decreasing RSBI in the acupuncture group. In subgroup analyses, the mean of RSBI significantly decreased 16.02 (with the SD in 60.84) in acupuncture group, while it increased 17.84 (with the SD in 39.38) in control group (p=0.036) after 12 sessions.
Conclusion
Acupuncture treatment can improve breathing ability of patients with respirator dependence in respiratory care center.
{"title":"Acupuncture for ventilator-dependent patients at a hospital-based respiratory care center: A randomized controlled trial","authors":"Jia-Ming Chen , Wan-Li Chiang , Bin-Chuan Ji , Ruei-Jhe Jhang , Pei-Hsin Chen , Ya-Lun Li , Che-Ju Chang , Sung-Yen Huang , Tsung-Chieh Lee , Chia-Yun Chen , Ching-Hsiung Lin , Sheng-Hao Lin","doi":"10.1016/j.imr.2023.100997","DOIUrl":"https://doi.org/10.1016/j.imr.2023.100997","url":null,"abstract":"<div><h3>Background</h3><p>In intensive care units, mechanical ventilation is an important therapy to help patients with dyspnea. However, long-term ventilator dependence would consume huge medical resources and increase the risk of morbidity and mortality. The aim of the study was to examine the efficacy of the acupuncture combined with western medical care on ventilator parameters in ventilator-dependent patients.</p></div><div><h3>Methods</h3><p>In this clinical trial, 80 ventilator-dependent patients aged 20 to 80 years old were randomly assigned to acupuncture group and control group in the respiratory care center (RCC) of Changhua Christian Hospital. Besides regular medical care and therapy, participants in the acupuncture group received acupuncture therapy at the same 17 acu-points for 20 minutes once a day, a total of 12 sessions. The ventilator parameters were recorded to evaluate the respiratory efficiency for all participants. The primary outcome was rapid shallow breathing index (RSBI), and secondary outcomes were respiratory rate (RR), tidal volume (TV) and ventilation per minute (MV),</p></div><div><h3>Results</h3><p>Though there was no significant difference in the parameter between the acupuncture group and the control group, we found the trend of decreasing RSBI in the acupuncture group. In subgroup analyses, the mean of RSBI significantly decreased 16.02 (with the SD in 60.84) in acupuncture group, while it increased 17.84 (with the SD in 39.38) in control group (p=0.036) after 12 sessions.</p></div><div><h3>Conclusion</h3><p>Acupuncture treatment can improve breathing ability of patients with respirator dependence in respiratory care center.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-10-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.sciencedirect.com/science/article/pii/S2213422023000768/pdfft?md5=371d4c2d4d36c5ec6fdb7be0ff12d3f0&pid=1-s2.0-S2213422023000768-main.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134656112","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 : 2023-09-28DOI: 10.1016/j.imr.2023.100996
Jeremy Y Ng, Sahar Popal, Sathurthika Selvanayagam
Background
Patients are increasingly utilizing the internet to learn about dietary and herbal supplements (DHSs) for various diseases/conditions, including pain management. Online health information has been found to be inconsistent and of poor quality in prior studies, which may have detrimental effects on patient health. This study assessed the quality of online DHSs consumer health information for pain.
Methods
Six search items related to DHSs and pain were used to generate the first 20 websites on Google across four English-speaking countries. The identified 480 webpages produced 68 eligible websites, which were then evaluated using the DISCERN tool. The mean scores and standard deviations (SD) of the reviewers’ ratings on each of the 15 DISCERN instrument items as well as the overall total score were calculated.
Results
The mean summed score for the 68 eligible websites was 46.6 (SD = 10.1), and the mean overall rating was 3.3 (SD = 0.8). Websites lacked information regarding areas of uncertainty, the effects of no treatment being used, and how treatments affect the overall quality of life. These shortcomings were especially apparent across commercial websites, which frequently displayed bias, failed to report the risks of DHS products, and lacked support for shared decision-making regarding the use of DHSs.
Conclusion
Variability exists in the quality of online consumer health information regarding DHS use for pain. Healthcare providers should be aware of and provide guidance to patients regarding the identification of reliable online resources so that they can make informed decisions about DHS use for pain management.
{"title":"Dietary and herbal supplement consumer health information for pain: A cross-sectional survey and quality assessment of online content","authors":"Jeremy Y Ng, Sahar Popal, Sathurthika Selvanayagam","doi":"10.1016/j.imr.2023.100996","DOIUrl":"https://doi.org/10.1016/j.imr.2023.100996","url":null,"abstract":"<div><h3>Background</h3><p>Patients are increasingly utilizing the internet to learn about dietary and herbal supplements (DHSs) for various diseases/conditions, including pain management. Online health information has been found to be inconsistent and of poor quality in prior studies, which may have detrimental effects on patient health. This study assessed the quality of online DHSs consumer health information for pain.</p></div><div><h3>Methods</h3><p>Six search items related to DHSs and pain were used to generate the first 20 websites on Google across four English-speaking countries. The identified 480 webpages produced 68 eligible websites, which were then evaluated using the DISCERN tool. The mean scores and standard deviations (SD) of the reviewers’ ratings on each of the 15 DISCERN instrument items as well as the overall total score were calculated.</p></div><div><h3>Results</h3><p>The mean summed score for the 68 eligible websites was 46.6 (SD = 10.1), and the mean overall rating was 3.3 (SD = 0.8). Websites lacked information regarding areas of uncertainty, the effects of no treatment being used, and how treatments affect the overall quality of life. These shortcomings were especially apparent across commercial websites, which frequently displayed bias, failed to report the risks of DHS products, and lacked support for shared decision-making regarding the use of DHSs.</p></div><div><h3>Conclusion</h3><p>Variability exists in the quality of online consumer health information regarding DHS use for pain. Healthcare providers should be aware of and provide guidance to patients regarding the identification of reliable online resources so that they can make informed decisions about DHS use for pain management.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49709228","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}
Pub Date : 2023-09-24DOI: 10.1016/j.imr.2023.100995
Jennifer Hunter , Joanna E. Harnett , Wai-Jo Jocelin Chan , Marie Pirotta
Background
Operational definitions outline how a conceptual definition will be measured for consistent, reproducible data collection and analysis. This article reports the decision criteria that will be used for an operational definition of integrative medicine (IM) in a secondary analysis of an Australian national survey of general practitioner activity.
Methods
A multidisciplinary team applied an iterative approach, informed by expert knowledge and literature reviews to establish decision criteria for categorizing the terms in the Australian clinical interface terminology of the International Classification of Primary Care, second edition (ICPC-2 PLUS) and the Coding Atlas for Pharmaceutical Substances, according to whether they reflected IM, conventional/mainstream medicine (MM), or both IM and MM (IM/MM).
Results
The final decision criteria categorized all terms for examinations, investigations, advice/counselling, and drugs with synthetic ingredients, and terms for referrals to secondary care services and healthcare practitioners that are not a traditional or complementary medicine practitioner as MM. Terms that could apply to both styles of clinical practice (e.g., preventive health, lifestyle medicine, psychosocial and some drugs with natural ingredients) were categorised as IM/MM. The remaining terms, that mostly reflected the World Health Organization's theoretical definitions of traditional and complementary medicine, were categorized as IM.
Conclusion
Differentiating between integrative and conventional/mainstream medicine in general practice is context specific and not always possible. The category IM/MM proposes integrative medicine as an extension, rather than an alternative. The rationale for the integrative medicine operational definition has relevance for researchers and health services in Australia, and internationally.
{"title":"What is integrative medicine? Establishing the decision criteria for an operational definition of integrative medicine for general practice health services research in Australia","authors":"Jennifer Hunter , Joanna E. Harnett , Wai-Jo Jocelin Chan , Marie Pirotta","doi":"10.1016/j.imr.2023.100995","DOIUrl":"https://doi.org/10.1016/j.imr.2023.100995","url":null,"abstract":"<div><h3>Background</h3><p>Operational definitions outline how a conceptual definition will be measured for consistent, reproducible data collection and analysis. This article reports the decision criteria that will be used for an operational definition of integrative medicine (IM) in a secondary analysis of an Australian national survey of general practitioner activity.</p></div><div><h3>Methods</h3><p>A multidisciplinary team applied an iterative approach, informed by expert knowledge and literature reviews to establish decision criteria for categorizing the terms in the Australian clinical interface terminology of the International Classification of Primary Care, second edition (ICPC-2 PLUS) and the Coding Atlas for Pharmaceutical Substances, according to whether they reflected IM, conventional/mainstream medicine (MM), or both IM and MM (IM/MM).</p></div><div><h3>Results</h3><p>The final decision criteria categorized all terms for examinations, investigations, advice/counselling, and drugs with synthetic ingredients, and terms for referrals to secondary care services and healthcare practitioners that are not a traditional or complementary medicine practitioner as MM. Terms that could apply to both styles of clinical practice (e.g., preventive health, lifestyle medicine, psychosocial and some drugs with natural ingredients) were categorised as IM/MM. The remaining terms, that mostly reflected the World Health Organization's theoretical definitions of traditional and complementary medicine, were categorized as IM.</p></div><div><h3>Conclusion</h3><p>Differentiating between integrative and conventional/mainstream medicine in general practice is context specific and not always possible. The category IM/MM proposes integrative medicine as an extension, rather than an alternative. The rationale for the integrative medicine operational definition has relevance for researchers and health services in Australia, and internationally.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49729391","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}
Using network analysis, we sought to determine the acupoints most commonly used to treat functional gastrointestinal disorders (FGIDs), particularly functional dyspepsia (FD) and irritable bowel syndrome (IBS).
Methods
To explore the acupoint patterns used for FGID, data on acupoint combinations for FD and IBS were gathered from systematic reviews. Network analysis was used to determine the degree, closeness centrality, betweenness centrality, and eigenvector centrality of each acupoint. The most common acupoint combinations for FD and IBS were examined based on the eigenvector centrality.
Results
Network analysis revealed that CV12, ST25, ST36, CV10, and LR3, which had the highest eigenvector centrality values, were the main acupoints for treating FGID. CV12 was the main acupoint for treating FD, while ST25 was the hub acupoint for treating IBS in the abdomen. ST36, LR3, and PC6 were the key peripheral acupoints for FD and IBS.
Conclusions
Using network analysis, we provided data that will aid the selection of both general and specific acupoints for FD and IBS, along with spatial information (i.e., the positions of acupoints on a body map). These findings could be applied in future acupuncture research on therapy for gastrointestinal system dysfunction. They may also help bridge the gap between the traditional meridian theory, which assumes that there is a link between diseases/symptoms and the specific body region being treated, and real-world clinical evidence.
{"title":"Acupuncture treatment for functional gastrointestinal disorders: Identification of major acupoints using network analysis","authors":"Heeyoung Moon , Yeonhee Ryu , In-Seon Lee , Younbyoung Chae","doi":"10.1016/j.imr.2023.100970","DOIUrl":"10.1016/j.imr.2023.100970","url":null,"abstract":"<div><h3>Background</h3><p>Using network analysis, we sought to determine the acupoints most commonly used to treat functional gastrointestinal disorders (FGIDs), particularly functional dyspepsia (FD) and irritable bowel syndrome (IBS).</p></div><div><h3>Methods</h3><p>To explore the acupoint patterns used for FGID, data on acupoint combinations for FD and IBS were gathered from systematic reviews. Network analysis was used to determine the degree, closeness centrality, betweenness centrality, and eigenvector centrality of each acupoint. The most common acupoint combinations for FD and IBS were examined based on the eigenvector centrality.</p></div><div><h3>Results</h3><p>Network analysis revealed that CV12, ST25, ST36, CV10, and LR3, which had the highest eigenvector centrality values, were the main acupoints for treating FGID. CV12 was the main acupoint for treating FD, while ST25 was the hub acupoint for treating IBS in the abdomen. ST36, LR3, and PC6 were the key peripheral acupoints for FD and IBS.</p></div><div><h3>Conclusions</h3><p>Using network analysis, we provided data that will aid the selection of both general and specific acupoints for FD and IBS, along with spatial information (i.e., the positions of acupoints on a body map). These findings could be applied in future acupuncture research on therapy for gastrointestinal system dysfunction. They may also help bridge the gap between the traditional meridian theory, which assumes that there is a link between diseases/symptoms and the specific body region being treated, and real-world clinical evidence.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/18/a1/main.PMC10407428.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10026930","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 : 2023-09-01DOI: 10.1016/j.imr.2023.100974
Xiying Li , Xiaojuan Li , Xian Wang , Xuan Yin , Shanshan Li , Junyi Wu , Xiumei Ren , Wei Zhang , Yiqun Mi , Shifen Xu
Background
We conducted this randomized controlled trial (RCT) to evaluate the effectiveness and safety of moxibustion at Sanyinjiao (SP6) acupoint for treatment of negative mood and sleep quality in healthcare workers during the 2019 coronavirus disease (COVID-19).
Methods
A total of 180 participants were divided in a 1:1 ratio into two groups, the treatment group (for moxibustion) and the control group (for no treatment). The treatment group had a 30-minute moxibustion therapy once a day for two weeks, followed by a two-week follow-up. The Hamilton Anxiety Scale (HAMA) was used to assess the degree of the participants' anxiety, and the Patient Health Questionnaire-9 (PHQ-9) was utilized to examine their depressed condition. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to measure the level of burnout among healthcare workers. To determine the severity of insomnia, the Sleep Dysfunction Rating Scale (SDRS) was utilized. At baseline, week 2, and week 4, all scales were evaluated.
Results
Compared to the control group, the treatment group improved more significantly in the HAMA at week 2 (MD = -19.01, 95% CI: -21.89 to -16.14; P<0.001) and at week 4 follow-up visits (MD = -8.96, 95% CI: -11.19 to -6.73; P<0.001). A subgroup study of HAMA scores revealed that position and education had significant impact on treatment effectiveness. During the 2-week intervention period, the treatment group showed more significant improvements in depressive symptoms measured by PHQ-9 (13.00±2.41 vs. 15.60±3.65; P<0.001), work burnout symptoms measured by MBI-GS (MD = -11.88, 95% CI, -15.73 to -8.03; P<0.001), and insomnia symptoms measured by SDRS (MD = -2.45, 95% CI, -4.24 to -0.66; P<0.01). There were no significant adverse effects reported.
Conclusion
Moxibustion at SP6 may be an effective treatment to improve anxiety, depression, sleep quality, and quality of life for healthcare workers during COVID-19.
Trial registration
This trial was registered at Chinese Clinical Trial Registry (ChiCTR): ChiCTR-2200059327.
{"title":"Moxibustion for medical personnel with negative emotion and insomnia during COVID-19 pandemic: A randomized, controlled trial","authors":"Xiying Li , Xiaojuan Li , Xian Wang , Xuan Yin , Shanshan Li , Junyi Wu , Xiumei Ren , Wei Zhang , Yiqun Mi , Shifen Xu","doi":"10.1016/j.imr.2023.100974","DOIUrl":"10.1016/j.imr.2023.100974","url":null,"abstract":"<div><h3>Background</h3><p>We conducted this randomized controlled trial (RCT) to evaluate the effectiveness and safety of moxibustion at Sanyinjiao (SP6) acupoint for treatment of negative mood and sleep quality in healthcare workers during the 2019 coronavirus disease (COVID-19).</p></div><div><h3>Methods</h3><p>A total of 180 participants were divided in a 1:1 ratio into two groups, the treatment group (for moxibustion) and the control group (for no treatment). The treatment group had a 30-minute moxibustion therapy once a day for two weeks, followed by a two-week follow-up. The Hamilton Anxiety Scale (HAMA) was used to assess the degree of the participants' anxiety, and the Patient Health Questionnaire-9 (PHQ-9) was utilized to examine their depressed condition. The Maslach Burnout Inventory-General Survey (MBI-GS) was used to measure the level of burnout among healthcare workers. To determine the severity of insomnia, the Sleep Dysfunction Rating Scale (SDRS) was utilized. At baseline, week 2, and week 4, all scales were evaluated.</p></div><div><h3>Results</h3><p>Compared to the control group, the treatment group improved more significantly in the HAMA at week 2 (MD = -19.01, 95% CI: -21.89 to -16.14; <em>P</em><0.001) and at week 4 follow-up visits (MD = -8.96, 95% CI: -11.19 to -6.73; <em>P</em><0.001). A subgroup study of HAMA scores revealed that position and education had significant impact on treatment effectiveness. During the 2-week intervention period, the treatment group showed more significant improvements in depressive symptoms measured by PHQ-9 (13.00±2.41 vs. 15.60±3.65; <em>P</em><0.001), work burnout symptoms measured by MBI-GS (MD = -11.88, 95% CI, -15.73 to -8.03; <em>P</em><0.001), and insomnia symptoms measured by SDRS (MD = -2.45, 95% CI, -4.24 to -0.66; <em>P</em><0.01). There were no significant adverse effects reported.</p></div><div><h3>Conclusion</h3><p>Moxibustion at SP6 may be an effective treatment to improve anxiety, depression, sleep quality, and quality of life for healthcare workers during COVID-19.</p></div><div><h3>Trial registration</h3><p>This trial was registered at Chinese Clinical Trial Registry (ChiCTR): ChiCTR-2200059327.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/44/9a/main.PMC10448013.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10464641","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 : 2023-09-01DOI: 10.1016/j.imr.2023.100968
Prachi Garodia , Mangala Hegde , Ajaikumar B. Kunnumakkara , Bharat B. Aggarwal
Background
Despite the extensive research in recent years, the current treatment modalities for neurological disorders are suboptimal. Curcumin, a polyphenol found in Curcuma genus, has been shown to mitigate the pathophysiology and clinical sequalae involved in neuroinflammation and neurodegenerative diseases.
Methods
We searched PubMed database for relevant publications on curcumin and its uses in treating neurological diseases. We also reviewed relevant clinical trials which appeared on searching PubMed database using ‘Curcumin and clinical trials’.
Results
This review details the pleiotropic immunomodulatory functions and neuroprotective properties of curcumin, its derivatives and formulations in various preclinical and clinical investigations. The effects of curcumin on neurodegenerative diseases such as Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), brain tumors, epilepsy, Huntington's disorder (HD), ischemia, Parkinson's disease (PD), multiple sclerosis (MS), and traumatic brain injury (TBI) with a major focus on associated signalling pathways have been thoroughly discussed.
Conclusion
This review demonstrates curcumin can suppress spinal neuroinflammation by modulating diverse astroglia mediated cascades, ensuring the treatment of neurological disorders.
{"title":"Curcumin, inflammation, and neurological disorders: How are they linked?","authors":"Prachi Garodia , Mangala Hegde , Ajaikumar B. Kunnumakkara , Bharat B. Aggarwal","doi":"10.1016/j.imr.2023.100968","DOIUrl":"10.1016/j.imr.2023.100968","url":null,"abstract":"<div><h3>Background</h3><p>Despite the extensive research in recent years, the current treatment modalities for neurological disorders are suboptimal. Curcumin, a polyphenol found in <em>Curcuma</em> genus, has been shown to mitigate the pathophysiology and clinical sequalae involved in neuroinflammation and neurodegenerative diseases.</p></div><div><h3>Methods</h3><p>We searched PubMed database for relevant publications on curcumin and its uses in treating neurological diseases. We also reviewed relevant clinical trials which appeared on searching PubMed database using ‘Curcumin and clinical trials’.</p></div><div><h3>Results</h3><p>This review details the pleiotropic immunomodulatory functions and neuroprotective properties of curcumin, its derivatives and formulations in various preclinical and clinical investigations. The effects of curcumin on neurodegenerative diseases such as Alzheimer's disease (AD), amyotrophic lateral sclerosis (ALS), brain tumors, epilepsy, Huntington's disorder (HD), ischemia, Parkinson's disease (PD), multiple sclerosis (MS), and traumatic brain injury (TBI) with a major focus on associated signalling pathways have been thoroughly discussed.</p></div><div><h3>Conclusion</h3><p>This review demonstrates curcumin can suppress spinal neuroinflammation by modulating diverse astroglia mediated cascades, ensuring the treatment of neurological disorders.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/83/fd/main.PMC10469086.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10152438","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 : 2023-09-01DOI: 10.1016/j.imr.2023.100969
Yue Teng , Yan Wei , Yingyao Chen , Juntao Yan , Shimeng Liu , Fuming Li , Shiyi Bao , Yanfeng Ren , Liu Liu , Yi Yang
Background
Traditional Chinese Medicine (TCM), integrating patient preferences into decision-making process, has been widely used in the multimodality therapy of lung cancer. This study aimed to estimate patient preferences for treatment and shared decision-making (SDM) modes concerning inpatient TCM treatment of lung cancer in Shanghai in order to provide a basis for clinical decision-making process on TCM therapy for lung cancer.
Methods
This study was conducted among patients (n = 347) from nine tertiary hospitals in Shanghai by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-patient version (SDM-Q-9) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of patients were performed using mixed logit models. Additionally, subgroup analysis was conducted.
Results
In total, 347 respondents completed the questionnaire. All attributes’ coefficients were statistically significant for patients’ preferences. Patients showed strong preferences for increasing disease control rate, relieving nausea and vomiting, reducing the risk of side effects, and were concerned about monthly out-of-pocket costs. Subgroup analysis indicated that patients with a lower SDM-Q-9 score and those who were satisfied with medical services emphasized more importance of higher disease control rate. Furthermore, most of the patients (90.20%) self-reported a high willingness to use SDM during the decision-making process.
Conclusion
In Shanghai, patients mainly preferred SDM and considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The study findings could underscore the importance of considering patients’ preferences and promote SDM.
{"title":"Patient preferences and shared decision making for the traditional Chinese medicine treatment of lung cancer: A discrete choice experiment study","authors":"Yue Teng , Yan Wei , Yingyao Chen , Juntao Yan , Shimeng Liu , Fuming Li , Shiyi Bao , Yanfeng Ren , Liu Liu , Yi Yang","doi":"10.1016/j.imr.2023.100969","DOIUrl":"10.1016/j.imr.2023.100969","url":null,"abstract":"<div><h3>Background</h3><p>Traditional Chinese Medicine (TCM), integrating patient preferences into decision-making process, has been widely used in the multimodality therapy of lung cancer. This study aimed to estimate patient preferences for treatment and shared decision-making (SDM) modes concerning inpatient TCM treatment of lung cancer in Shanghai in order to provide a basis for clinical decision-making process on TCM therapy for lung cancer.</p></div><div><h3>Methods</h3><p>This study was conducted among patients (<em>n</em> = 347) from nine tertiary hospitals in Shanghai by discrete-choice experiment (DCE) survey and Shared Decision-Making Questionnaire-patient version (SDM-Q-9) survey. The DCE was developed with the inclusion of the most relevant attributes at appropriate levels for the TCM treatment of lung cancer. The empirical data analyses of patients were performed using mixed logit models. Additionally, subgroup analysis was conducted.</p></div><div><h3>Results</h3><p>In total, 347 respondents completed the questionnaire. All attributes’ coefficients were statistically significant for patients’ preferences. Patients showed strong preferences for increasing disease control rate, relieving nausea and vomiting, reducing the risk of side effects, and were concerned about monthly out-of-pocket costs. Subgroup analysis indicated that patients with a lower SDM-Q-9 score and those who were satisfied with medical services emphasized more importance of higher disease control rate. Furthermore, most of the patients (90.20%) self-reported a high willingness to use SDM during the decision-making process.</p></div><div><h3>Conclusion</h3><p>In Shanghai, patients mainly preferred SDM and considered disease control rate as the most essential attribute in the TCM treatment of lung cancer. The study findings could underscore the importance of considering patients’ preferences and promote SDM.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/5f/f2/main.PMC10400851.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10308768","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 : 2023-09-01DOI: 10.1016/j.imr.2023.100972
Carlo Maria Giovanardi , Marien Gonzalez-Lorenzo , Alessandra Poini , Eleonora Marchi , Antonio Culcasi , Francesco Ursini , Cesare Faldini , Alberto Di Martino , Umberto Mazzanti , Emanuela Campesato , Annunzio Matrà , Sabina Cevoli , Maria Grazia Benedetti
Background
Conventional therapies (CTs), pharmacological (PH) and non–pharmacological (NPH), do not always achieve benefits in the treatment of chronic low back pain (CLBP). We assessed efficacy and safety of acupuncture for CLBP as alternative or addition to CT.
Methods
We included randomised controlled trials (RCTs) comparing acupuncture alone or in combination with CT to CT. We searched Medline, Cochrane Library, Embase up to May 2022. We assessed risk of bias with the original Cochrane tool and GRADE certainty of evidence. Results were pooled through meta-analysis.
Results
Ten RCTs (2122 participants) were included comparing acupuncture versus CT and 4 RCTs (374 participants) were comparing acupuncture plus CT to CT alone. In terms of comparing acupuncture with NPH or PH, no differences were found for pain and disability. Comparing acupuncture with PH and NPH combined, pain and disability were reduced (SMD=-0.50, 95% CI -0.62 to -0.37; SMD=-0.71, 95% CI -1.17 to -0.24). Comparing acupuncture plus NPH with NPH alone, pain and disability were reduced (SMD=-0.70, 95% CI -0.94 to -0.46; SMD=-0.95, 95% CI -1.36 to -0.54). Comparing acupuncture plus PH with PH alone, pain and disability were reduced (MD=-0.21, 95% CI -433.28 to -10.42; MD=-3.1, 95% CI -4.87 to -1.83). Comparing acupuncture plus combined treatment versus combined treatment alone, no differences were found in pain, while disability was reduced (MD=-3.40 95% CI -5.17 to -1.63). No studies assessed adverse event. Certainty of evidence ranged from moderate to very low.
Conclusions
We are uncertain whether acupuncture is more effective and safer than CT. In the comparisons without estimates’ imprecision, acupuncture showed promising results. Acupuncture could be an option based on patients’ preferences.
{"title":"Acupuncture as an alternative or in addition to conventional treatment for chronic non-specific low back pain: A systematic review and meta-analysis","authors":"Carlo Maria Giovanardi , Marien Gonzalez-Lorenzo , Alessandra Poini , Eleonora Marchi , Antonio Culcasi , Francesco Ursini , Cesare Faldini , Alberto Di Martino , Umberto Mazzanti , Emanuela Campesato , Annunzio Matrà , Sabina Cevoli , Maria Grazia Benedetti","doi":"10.1016/j.imr.2023.100972","DOIUrl":"10.1016/j.imr.2023.100972","url":null,"abstract":"<div><h3>Background</h3><p>Conventional therapies (CTs), pharmacological (PH) and non–pharmacological (NPH), do not always achieve benefits in the treatment of chronic low back pain (CLBP). We assessed efficacy and safety of acupuncture for CLBP as alternative or addition to CT.</p></div><div><h3>Methods</h3><p>We included randomised controlled trials (RCTs) comparing acupuncture alone or in combination with CT to CT. We searched Medline, Cochrane Library, Embase up to May 2022. We assessed risk of bias with the original Cochrane tool and GRADE certainty of evidence. Results were pooled through meta-analysis.</p></div><div><h3>Results</h3><p>Ten RCTs (2122 participants) were included comparing acupuncture versus CT and 4 RCTs (374 participants) were comparing acupuncture plus CT to CT alone. In terms of comparing acupuncture with NPH or PH, no differences were found for pain and disability. Comparing acupuncture with PH and NPH combined, pain and disability were reduced (SMD=-0.50, 95% CI -0.62 to -0.37; SMD=-0.71, 95% CI -1.17 to -0.24). Comparing acupuncture plus NPH with NPH alone, pain and disability were reduced (SMD=-0.70, 95% CI -0.94 to -0.46; SMD=-0.95, 95% CI -1.36 to -0.54). Comparing acupuncture plus PH with PH alone, pain and disability were reduced (MD=-0.21, 95% CI -433.28 to -10.42; MD=-3.1, 95% CI -4.87 to -1.83). Comparing acupuncture plus combined treatment versus combined treatment alone, no differences were found in pain, while disability was reduced (MD=-3.40 95% CI -5.17 to -1.63). No studies assessed adverse event. Certainty of evidence ranged from moderate to very low.</p></div><div><h3>Conclusions</h3><p>We are uncertain whether acupuncture is more effective and safer than CT. In the comparisons without estimates’ imprecision, acupuncture showed promising results. Acupuncture could be an option based on patients’ preferences.</p></div>","PeriodicalId":13644,"journal":{"name":"Integrative Medicine Research","volume":null,"pages":null},"PeriodicalIF":3.4,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://ftp.ncbi.nlm.nih.gov/pub/pmc/oa_pdf/13/d0/main.PMC10448023.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10482866","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}